From AAL to ambient assisted rehabilitation: a research pilot protocol based on smart objects and biofeedback

AbstractThe progressive miniaturization of electronic devices and their exponential increase in processing, storage and transmission capabilities, represent key factors of the current digital transformation, also sustaining the great development of Ambient Assisted Living (AAL) and the Internet of Things. Although most of the investigations in the recent years focused on remote monitoring and diagnostics, rehabilitation too could be positively affected by the widespread integrated use of these devices. Smart Objects in particular may be among the enablers to new quantitative approaches. In this paper, we present a proof-of-concept and some preliminary results of an innovative pediatric rehabilitation protocol based on Smart Objects and biofeedback, which we administered to a sample of children with unilateral cerebral palsy. The novelty of the approach mainly consists in placing the sensing device into a common toy (a ball in our protocol) and using the information measured by the device to administer multimedia-enriched type of exercises, more engaging if compared to the usual rehabilitation activities used in clinical settings. We also introduce a couple of performance indexes, which could be helpful for a quantitative continuous evaluation of movements during the exercises. Even if the number of children involved and sessions performed are not suitable to assess any change in the subjects' abilities, nor to derive solid statistical inferences, the novel approach resulted very engaging and enjoyable by all the children participating in the study. Moreover, given the almost non-existent literature on the use of Smart Objects in pediatric rehabilitation, the few qualitative/quantitative results here reported may promote the scientific and clinical discussion regarding AAL solutions in a "Computer Assisted Rehabilitation" perspective, towards what can be defined "Pediatric Rehabilitation 2.0"

Co-inoculação no desenvolvimento vegetativo e nodulação de plântulas de soja submetidas à calagem, fertilização nitrogenada e aplicação de micronutrientes

A co-inoculação (COI) com Azospirillum brasilense e bactérias do gênero Bradyrhizobium podem melhorar ainda mais o desempenho da cultura da soja. Com o objetivo de avaliá-la em detrimento da inoculação tradicional (I) com Bradyrhizobium, foram instalados dois experimentos em outubro de 2014, em casa de vegetação na UNIFEB-Barretos, SP. O delineamento foi o inteiramente casualizado com oito tratamentos com ou sem nitrogênio mineral; I e/ou COI (com ou sem) e aplicação de cobalto e molibdênio (Co-Mo) nas sementes (com ou sem), com oito repetições e quinze sementes/vaso. Através da análise química do solo foram efetuados os cálculos para calagem e doses de adubo. As avaliações constituíram-se na % de plântulas normais, número e massa seca de nódulos/planta, massa seca da parte aérea e raiz/planta. Na calagem realizada com 30 dias de antecedência da semeadura, o calcário não teve tempo suficiente de reagir com o solo, que mostrou deficiência em cálcio, além de toxicidade de alumínio e manganês, reduzindo a % de plântulas normais nos vasos, cujo lote de sementes já se encontrava com baixa qualidade fisiológica determinada nos testes de germinação e emergência. Apesar disso, a prática de co-inoculação combinada ao uso de formulação comercial de adubo sem nitrogênio mineral e sem aplicação de micronutrientes nas sementes destacou-se em relação aos parâmetros avaliados. Nessas condições, diferentes épocas de aplicação dos micronutrientes devem ser avaliadas para melhoria do desenvolvimento vegetativo e nodulação de plântulas de soja co-inoculadas, além de que, a calagem deve ser efetuada com maior antecedência da semeadura

Applications of Robotics for Autism Spectrum Disorder: a Scoping Review

Robotic therapies are receiving growing interest in the autism field, especially for the improvement of social skills of children, enhancing traditional human interventions. In this work, we conduct a scoping review of the literature in robotics for autism, providing the largest review on this field from the last five years. Our work underlines the need to better characterize participants and to increase the sample size. It is also important to develop homogeneous training protocols to analyse and compare the results. Nevertheless, 7 out of the 10 Randomized control trials reported a significant impact of robotic therapy. Overall, robot autonomy, adaptability and personalization as well as more standardized outcome measures were pointed as the most critical issues to address in future research

Typing TREX1 gene in patients with systemic lupus erythematosus

An impaired expression of interferon-α regulated genes has been reported in patients with either systemic lupus erythematosus (SLE) or Aicardi-Goutières syndrome (AGS), a rare monogenic encephalopathy with onset in infancy. One of mutations causing AGS is located in the TREX1 gene on chromosome 3. Heterozygous mutations in TREX1 were reported in SLE patients. TREX1 is a DNA exonuclease with specificity for ssDNA. An impairment of its activity may result in the accumulation of nucleid acid. A recent study described a significant association between a haplotype including several common single nucleotide polymorphisms (SNPs) of TREX1 and neurological manifestations in European SLE patients. Fifty-one SLE patients were screened for TREX1 gene, and the corresponding data were collected from clinical charts. A novel heterozygous variant (p.Asp130Asn) was identified in one patient and in none of 150 controls. A missense variation was located in one of the three active sites of the gene and was classified as probably damaging. Variations of SNP rs11797 were detected in 33 SLE patients and a variation of rs3135944 in one. A significantly higher rate of the minor allele (T nucleotide) of SNP rs11797 was found in SLE patients with neuropsychiatric manifestations [12/16 (75%) vs 28/86 (32.5%) O=0.002, odds ratio=6.42 95% confidence interval (1.7-26.2)]. Only 1 out of 8 patients (12.5%) with neuropsychiatric SLE carried the wild-type form in homozygosity. Although we analyzed a small number of patients, we found a novel variation of TREX1, which may be pathogenic. The polymorphism of rs11797 was more frequent in SLE patients with neurological manifestations

Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience

In patients with asthma, particularly severe asthma, poor adherence to inhaled drugs negatively affects the achievement of disease control. A better adherence rate is expected in the case of injected drugs, such as omalizumab, as they are administered only in a hospital setting. However, adherence to omalizumab has never been systematically investigated. The aim of this study was to review the omalizumab drop-out rate in randomized controlled trials (RCTs) and real-life studies. A comparative analysis was performed between published data and the Italian North East Omalizumab Network (NEONet) database

Применение препарата пелокс-400 (пефлоксацин) в лечении острого пиелонефрита

Дана оценка эффективности применения антибактериального препарата пелокс−400 (пефлоксацин) в лечении острого пиелонефрита и рекомендовано его применение в комплексной терапии.The authors assess the efficacy of antibacterial medication рelox−400 (pefloxacin) in treatment of acute pyelonephritis. It is recommended to use it in complex therapy

AVALIAÇÃO DE INOCULANTES BIOLÓGICOS ASSOCIADOS À ADUBAÇÃO NITROGENADA REDUZIDA NOS PARÂMETROS FISIOLÓGICOS E PRODUTIVIDADE DE MILHO SAFRINHA

É importante buscar alternativas para atenuar o uso de adubos nitrogenados em milho, visto que, estes são de alto custo. Objetivou-se estudar os efeitos da inoculação e co-inoculação em diferentes doses e modos de aplicação associadas à adubação nitrogenada reduzida em parâmetros fisiológicos e componentes de produção de milho safrinha. O experimento foi instalado na safrinha de 2017, em área experimental da APTA de Colina, SP. Estudaram-se oito tratamentos: controle, adubações nitrogenadas nas doses de 55 e 110 kg ha-1 de N, 55 kg ha-1 de N + inoculação com Azospirillum na dose de 0,1 L ha-1 na semente, 55 kg ha-1 de N + co-inoculação (Bradyrhizobium e Azospirillum) no tratamento de sementes nas doses de 0,05 e 0,1 L ha-1 para cada inoculante e 55 kg ha-1 de N + co-inoculação aplicada nos estádios V3-V4 nas doses de 0,2 e 0,3 L ha-1 para cada inoculante. O delineamento foi o de blocos ao acaso com 4 repetições, com 32 parcelas. Foram avaliados alguns parâmetros no florescimento e componentes de produção por ocasião da maturação. Nota-se alta significância estatística para a maioria dos parâmetros nos diferentes tratamentos testados. De modo geral, maiores incrementos quanto aos componentes de produção foram obtidos com a inoculação com Azospirillum no tratamento de sementes que foi equivalente à prática da co-inoculação com uso das maiores doses de inoculantes via aplicação por pulverização com o jato dirigido sobre o solo entre V3-V4, sendo ambas práticas associadas a adubação nitrogenada reduzida. Sugere-se estudos mais aprofundados no tema envolvendo diferentes locais e safras visando ratificação dos resultados

Thrombotic and bleeding complications in patients with chronic lymphocytic leukemia and severe COVID-19: a study of ERIC, the European Research Initiative on CLL

BACKGROUND: Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to COVID-19 related poor outcomes, including thrombosis and death, due to the advanced age, the presence of comorbidities, and the disease and treatment-related immune deficiency. The aim of this study was to assess the risk of thrombosis and bleeding in patients with CLL affected by severe COVID-19. METHODS: This is a retrospective multicenter study conducted by ERIC, the European Research Initiative on CLL, including patients from 79 centers across 22 countries. Data collection was conducted between April and May 2021. The COVID-19 diagnosis was confirmed by the real-time polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 on nasal or pharyngeal swabs. Severe cases of COVID-19 were defined by hospitalization and the need of oxygen or admission into ICU. Development and type of thrombotic events, presence and severity of bleeding complications were reported during treatment for COVID-19. Bleeding events were classified using ISTH definition. STROBE recommendations were used in order to enhance reporting. RESULTS: A total of 793 patients from 79 centers were included in the study with 593 being hospitalized (74.8%). Among these, 511 were defined as having severe COVID: 162 were admitted to the ICU while 349 received oxygen supplementation outside the ICU. Most patients (90.5%) were receiving thromboprophylaxis. During COVID-19 treatment, 11.1% developed a thromboembolic event, while 5.0% experienced bleeding. Thrombosis developed in 21.6% of patients who were not receiving thromboprophylaxis, in contrast to 10.6% of patients who were on thromboprophylaxis. Bleeding episodes were more frequent in patients receiving intermediate/therapeutic versus prophylactic doses of low-molecular-weight heparin (LWMH) (8.1% vs. 3.8%, respectively) and in elderly. In multivariate analysis, peak D-dimer level and C-reactive protein to albumin ratio were poor prognostic factors for thrombosis occurrence (OR?=?1.022, 95%CI 1.007?1.038 and OR?=?1.025, 95%CI 1.001?1.051, respectively), while thromboprophylaxis use was protective (OR?=?0.199, 95%CI 0.061?0.645). Age and LMWH intermediate/therapeutic dose administration were prognostic factors in multivariate model for bleeding (OR?=?1.062, 95%CI 1.017-1.109 and OR?=?2.438, 95%CI 1.023-5.813, respectively). CONCLUSIONS: Patients with CLL affected by severe COVID-19 are at a high risk of thrombosis if thromboprophylaxis is not used, but also at increased risk of bleeding under the LMWH intermediate/therapeutic dose administration

COVID-19 severity and mortality in patients with CLL: an update of the international ERIC and Campus CLL study

Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to Coronavirus disease 2019 (COVID-19) due to age, disease, and treatment-related immunosuppression. We aimed to assess risk factors of outcome and elucidate the impact of CLL-directed treatments on the course of COVID-19. We conducted a retrospective, international study, collectively including 941 patients with CLL and confirmed COVID-19. Data from the beginning of the pandemic until March 16, 2021, were collected from 91 centers. The risk factors of case fatality rate (CFR), disease severity, and overall survival (OS) were investigated. OS analysis was restricted to patients with severe COVID-19 (definition: hospitalization with need of oxygen or admission into an intensive care unit). CFR in patients with severe COVID-19 was 38.4%. OS was inferior for patients in all treatment categories compared to untreated (p < 0.001). Untreated patients had a lower risk of death (HR = 0.54, 95% CI:0.41–0.72). The risk of death was higher for older patients and those suffering from cardiac failure (HR = 1.03, 95% CI:1.02–1.04; HR = 1.79, 95% CI:1.04–3.07, respectively). Age, CLL-directed treatment, and cardiac failure were significant risk factors of OS. Untreated patients had a better chance of survival than those on treatment or recently treated