Overground walking training with the i-Walker, a robotic servo-assistive device, enhances balance in patients with subacute stroke: a randomized controlled trial

Background: Patients affected by mild stroke benefit more from physiological overground walking training than walking-like training performed in place using specific devices. The aim of the study was to evaluate the effects of overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) on walking, balance, gait stability and falls in a community setting in patients with mild subacute stroke. Methods: Forty-four patients were randomly assigned to two different groups that received the same therapy in two daily 40-min sessions 5 days a week for 4 weeks. Twenty sessions of standard therapy were performed by both groups. In the other 20 sessions the subjects enrolled in the i-Walker-Group (iWG) performed with the i-Walker and the Control-Group patients (CG) performed the same amount of conventional walking oriented therapy. Clinical and instrumented gait assessments were made pre- and post-treatment. The follow-up observation consisted of recording the number of fallers in the community setting after 6 months. Results: Treatment effectiveness was higher in the iWG group in terms of balance improvement (Tinetti: 68.4 +/- 27.6 % vs. 48.1 +/- 33.9 %, p = 0.033) and 10-m and 6-min timed walking tests (significant interaction between group and time: F(1,40) = 14.252, p = 0.001; and F(1,40) = 7.883, p = 0.008, respectively). When measured, latero-lateral upper body accelerations were reduced in iWG (F = 4.727, p = 0.036), suggesting increased gait stability, which was supported by a reduced number of falls at home. Conclusions: A robotic servo-assisted i-Walker improved walking performance and balance in patients affected by mild/moderate stroke, leading to increased gait stability and reduced falls in the community

Macro- And micro-nutrient composition and antioxidant activity of Chickpea and Pea Accessions

Epidemiological studies reported an inverse association between the consumption of legumes and the incidence of age-related diseases. This trend could be attributed to the presence of antioxidant compounds, especially phenolic and flavonoid compounds. In this paper, five pea (Pisum sativum L.) and twelve chickpea (Cicer arietinum L.) accessions, having different characteristics and geographical origin, were characterised in terms of antioxidant activity, as well as macro- and micro-nutrient composition. The antioxidant activity has been evaluated using both DPPH (2,2-diphenyl-1-picrylhydra-zyl) and ABTS (2,2'-azino-bis (3-ethylbenzthiazoline-6-sulfonic acid) radical scavenging capacity assays. Chickpea and pea accessions showed a different behaviour in the presence of these different radicals. Chickpea accessions were characterised by significantly higher DPPH• scavenging activity, while peas showed a significantly higher value of antioxidant activity evaluated using the ABTS assay. Pea accessions had the highest content of total phenolic compounds, Zn, and Cu. A positive correlation was found between some minerals, such as Zn, Cu and P, and the ABTS•+ scavenging activity. Black and brown chickpea accessions showed significantly higher contents of anthocyanins, Mn, Mg, and Ca, which were positively correlated with the antioxidant activity assessed with the DPPH assay. Despite the dataset investigated in our study included a limited number of accessions, it was possible to highlight the influence of the chemical composition on the antioxidant activity due to the high phenotypic diversity found between the accessions, emphasising the importance of selecting the antioxidant activity assay according to the matrix to be evaluated

Novel transglutaminase 1 mutations in patients affected by lamellar ichthyosis

Lamellar Ichthyosis (LI) is a form of congenital ichthyosis that is caused by mutations in the TGM1 gene that encodes for the transglutaminase 1 (TG1) enzyme. Functional inactivation of TG1 could be due to mutations, deletion or insertions. In this study, we have screened 16 patients affected by LI and found six new mutations: two transition/transversion (R37G, V112A), two nonsense mutations and two putative splice site both leading to a premature stop codon. The mutations are localized in exons 2 (N-terminal domain), 5, 11 (central catalytic domain), and none is located in the two beta-barrel C-terminal domains. In conclusion, this study expands the current knowledge on TGM1 mutation spectrum, increasing the characterization of mutations would provide more accurate prenatal genetic counselling for parents at-risk individuals

Free-amino acid metabolic profiling of visceral adipose tissue from obese subjects

Interest in adipose tissue pathophysiology and biochemistry have expanded considerably in the past two decades due to the ever increasing and alarming rates of global obesity and its critical outcome defined as metabolic syndrome (MS). This obesity-linked systemic dysfunction generates high risk factors of developing perilous diseases like type 2 diabetes, cardiovascular disease or cancer. Amino acids could play a crucial role in the pathophysiology of the MS onset. Focus of this study was to fully characterize amino acids metabolome modulations in visceral adipose tissues (VAT) from three adult cohorts: (i) obese patients (BMI 43-48) with metabolic syndrome (PO), (ii) obese subjects metabolically well (O), and (iii) non obese individuals (H). 128 metabolites identified as 20 protein amino acids, 85 related compounds and 13 dipeptides were measured by ultrahigh performance liquid chromatography-tandem mass spectroscopy (UPLC-MS/MS) and gas chromatography-/mass spectrometry GC/MS, in visceral fat samples from a total of 53 patients. Our analysis indicates a probable enhanced BCAA (leucine, isoleucine, valine) degradation in both VAT from O and PO subjects, while levels of their oxidation products are increased. Also PO and O VAT samples were characterized by: elevated levels of kynurenine, a catabolic product of tryptophan and precursor of diabetogenic substances, a significant increase of cysteine sulfinic acid levels, a decrease of 1-methylhistidine, and an up regulating trend of 3-methylhistidine levels. We hope this profiling can aid in novel clinical strategies development against the progression from obesity to metabolic syndrome

Free-amino acid metabolic profiling of visceral adipose tissue from obese subjects

Interest in adipose tissue pathophysiology and biochemistry have expanded considerably in the past two decades due to the ever increasing and alarming rates of global obesity and its critical outcome defined as metabolic syndrome (MS). This obesity-linked systemic dysfunction generates high risk factors of developing perilous diseases like type 2 diabetes, cardiovascular disease or cancer. Amino acids could play a crucial role in the pathophysiology of the MS onset. Focus of this study was to fully characterize amino acids metabolome modulations in visceral adipose tissues (VAT) from three adult cohorts: (i) obese patients (BMI 43-48) with metabolic syndrome (PO), (ii) obese subjects metabolically well (O), and (iii) non obese individuals (H). 128 metabolites identified as 20 protein amino acids, 85 related compounds and 13 dipeptides were measured by ultrahigh performance liquid chromatography-tandem mass spectroscopy (UPLC-MS/MS) and gas chromatography-/mass spectrometry GC/MS, in visceral fat samples from a total of 53 patients. Our analysis indicates a probable enhanced BCAA (leucine, isoleucine, valine) degradation in both VAT from O and PO subjects, while levels of their oxidation products are increased. Also PO and O VAT samples were characterized by: elevated levels of kynurenine, a catabolic product of tryptophan and precursor of diabetogenic substances, a significant increase of cysteine sulfinic acid levels, a decrease of 1-methylhistidine, and an up regulating trend of 3-methylhistidine levels. We hope this profiling can aid in novel clinical strategies development against the progression from obesity to metabolic syndrome

Untangling species-level composition of complex bacterial communities through a novel metagenomic approach

16S small-subunit (SSU) rRNA gene-based bacterial profiling is the gold standard for cost-effective taxonomic reconstruction of complex bacterial populations down to the genus level. However, it has been proven ineffective in clinical and research settings requiring higher taxonomic resolution. We therefore developed a bacterial profiling method based on the internal transcribed spacer (ITS) region employing optimized primers and a comprehensive ITS database for accurate cataloguing of bacterial communities at (sub)species resolution. Performance of the microbial ITS profiling pipeline was tested through analysis of host-associated, food, and environmental matrices, while its efficacy in clinical settings was assessed through analysis of mucosal biopsy specimens of colorectal cancer, leading to the identification of putative novel biomarkers. The data collected indicate that the proposed pipeline represents a major step forward in cost-effective identification and screening of microbial biomarkers at (sub)species level, with relevant impact in research, industrial, and clinical settings. IMPORTANCE We developed a novel method for accurate cataloguing of bacterial communities at (sub)species level involving amplification of the internal transcribed spacer (ITS) region through optimized primers, followed by next-generation sequencing and taxonomic classification of amplicons by means of a comprehensive database of bacterial ITS sequences. Host-associated, food, and environmental matrices were employed to test the performance of the microbial ITS profiling pipeline. Moreover, mucosal biopsy samples from colorectal cancer patients were analyzed to demonstrate the scientific relevance of this profiling approach in a clinical setting through identification of putative novel biomarkers. The results indicate that the ITS-based profiling pipeline proposed here represents a key metagenomic tool with major relevance for research, industrial, and clinical settings

I-Support: A robotic platform of an assistive bathing robot for the elderly population

In this paper we present a prototype integrated robotic system, the I-Support bathing robot, that aims at supporting new aspects of assisted daily-living activities on a real-life scenario. The paper focuses on describing and evaluating key novel technological features of the system, with the emphasis on cognitive human–robot interaction modules and their evaluation through a series of clinical validation studies. The I-Support project on its whole has envisioned the development of an innovative, modular, ICT-supported service robotic system that assists frail seniors to safely and independently complete an entire sequence of physically and cognitively demanding bathing tasks, such as properly washing their back and their lower limbs. A variety of innovative technologies have been researched and a set of advanced modules of sensing, cognition, actuation and control have been developed and seamlessly integrated to enable the system to adapt to the target population abilities. These technologies include: human activity monitoring and recognition, adaptation of a motorized chair for safe transfer of the elderly in and out the bathing cabin, a context awareness system that provides full environmental awareness, as well as a prototype soft robotic arm and a set of user-adaptive robot motion planning and control algorithms. This paper focuses in particular on the multimodal action recognition system, developed to monitor, analyze and predict user actions with a high level of accuracy and detail in real-time, which are then interpreted as robotic tasks. In the same framework, the analysis of human actions that have become available through the project’s multimodal audio–gestural dataset, has led to the successful modeling of Human–Robot Communication, achieving an effective and natural interaction between users and the assistive robotic platform. In order to evaluate the I-Support system, two multinational validation studies were conducted under realistic operating conditions in two clinical pilot sites. Some of the findings of these studies are presented and analyzed in the paper, showing good results in terms of: (i) high acceptability regarding the system usability by this particularly challenging target group, the elderly end-users, and (ii) overall task effectiveness of the system in different operating modes