Spatio-temporal gait analysis based on human-smart rollator interaction

The ability to walk is typically related to several biomechanical components that are involved in the gait cycle (or stride), including free mobility of joints, particularly in the legs; coordination of muscle activity in terms of timing and intensity; and normal sensory input, such as vision and vestibular system. As people age, they tend to slow their gait speed, and their balance is also affected. Also, the retirement from the working life and the consequent reduction of physical and social activity contribute to the increased incidence of falls in older adults. Moreover, older adults suffer different kinds of cognitive decline, such as dementia or attention problems, which also accentuate gait disorders and its consequences. In this paper we present a methodology for gait identification using the on-board sensors of a smart rollator: the i-Walker. This technique provides the number of steps performed in walking exercises, as well as the time and distance travelled for each stride. It also allows to extract spatio-temporal metrics used in medical gait analysis from the interpretation of the interaction between the individual and the i-Walker. In addition, two metrics to assess users’ driving skills, laterality and directivity, are proposed.Peer ReviewedPostprint (author's final draft

Dynamics of chemosensitivity and chromosomal instability in recurrent glioblastoma

Glioblastoma multiforme is characterised by invasive growth and frequent recurrence. Here, we have analysed chromosomal changes in comparison to tumour cell aggressiveness and chemosensitivity of three cell lines established from a primary tumour and consecutive recurrences (BTL1 to BTL3) of a long-term surviving glioblastoma patient together with paraffin-embedded materials of five further cases with recurrent disease. Following surgery, the BTL patient progressed under irradiation/ lomustine but responded to temozolomide after re-operation to temozolomide. The primary tumour -derived BTL1 cells showed chromosomal imbalances typical of highly aggressive glioblastomas. Interestingly, BTL2 cells established from the first recurrence developed under therapy showed signs of enhanced chromosomal instability. In contrast, BTL3 cells from the second recurrence resembled a less aggressive subclone of the primary tumour. Although BTL2 cells exhibited a highly aggressive phenotype, BTL3 cells were characterised by reduced proliferative and migratory potential. Despite persistent methylation of the O6-methylguanine-DNA methyltransferase promoter, BTL3 cells exhibited the highest temozolomide sensitivity. A comparable situation was found in two out of five glioblastoma patients, both characterised by enhanced survival time, who also relapsed after surgery/chemotherapy with less aggressive recurrences. Taken together, our data suggest that pretreated glioblastoma patients may relapse with highly chemosensitive tumours confirming the feasibility of temozolomide treatment even in case of repeated recurrence

Strengths and Weaknesses of Immunotherapy for Advanced Non-Small-Cell Lung Cancer: A Meta-Analysis of 12 Randomized Controlled Trials

Background: Lung cancer is one of the leading causes of cancer death worldwide. Non-small-cell lung cancer (NSCLC) accounts for approximately 85 % of all lung cancers. Immunotherapy has yielded no consistent benefit to date for those patients. Assessing the objective efficacy and safety of immunotherapy for advanced NSCLC patients will help to instruct the future development of immunotherapeutic drugs. Methodology and Principal Findings: We performed a meta-analysis of 12 randomized controlled trials including 3134 patients (1570 patients in the immunotherapy group and 1564 patients in the control group) with histologically confirmed stage IIIA, IIIB, or IV NSCLC. The analysis was executed with efficacy end points regarding overall survival (OS), progressionfre