Sensor-Based Task Ergonomics Feedback for a Passive Low-Back Exoskeleton

Low-back exoskeletons are a wide-spreading technology tackling low-back pain, the leading work-related musculoskeletal disorder in many work sectors. Currently, spring-based (i.e., passive) exoskeletons are the mostly adopted in the industry, being cheaper and generally less complex and more intuitive to use. We introduce a system of interconnected wireless sensing units to provide online ergonomics feedback to the wearer. We integrate the system into our passive low-back exoskeleton and evaluate its usability with healthy volunteers and potential end users. In this way, we provide the exoskeleton with a tool aimed both at monitoring the interaction of the system with the user, providing them with an ergonomics feedback during task execution. The sensor system can also be integrated with a custom-developed Unity3D application which can be used to interface with Augmented- or Virtual-Reality applications with higher potential for improved user feedback, ergonomics training, and offline ergonomics evaluation of the workplace. We believe that providing ergonomics feedback to exoskeleton users in the industrial sector could help further reduce the drastic impact of low-back pain and prevent its onset

A highly-collimated SiO jet in the HH212 protostellar outflow

We mapped the HH212 Class 0 outflow in SiO(2--1, 5--4) and continuum using the PdBI in its extended configurations. The unprecedented angular resolution (down to 0.34") allows accurate comparison with a new, deep H2 image obtained at the VLT. The SiO emission is confined to a highly-collimated bipolar jet (width 0.35") along the outflow axis. The jet can be traced down to within 500 AU of the protostar, in a region that is heavily obscured in H2 images. Where both species are detected, SiO shows the same overall kinematics and structure as H2, indicating that both molecules are tracing the same material. We find that the high-velocity SiO gas near the protostar is not tracing a wide-angle wind but is already confined to a flow inside a narrow cone of half-opening angle < 6 deg.Comment: Astronomy and Astrophysics Letter, in pres

Analysis of BRCA1 and RAD51C promoter methylation in italian families at high-risk of breast and ovarian cancer

Previous studies on breast and ovarian carcinoma (BC and OC) revealed constitutional BRCA1 and RAD51C promoter hypermethylation as epigenetic alterations leading to tumor predisposition. Nevertheless, the impact of epimutations at these genes is still debated. One hundred and eight women affected by BC, OC, or both and considered at very high risk of carrying BRCA1 germline mutations were studied. All samples were negative for pathogenic variants or variants of uncertain significance at BRCA testing. Quantitative BRCA1 and RAD51C promoter methylation analyses were performed by Epityper mass spectrometry on peripheral blood samples and results were compared with those in controls. All the 108 analyzed cases showed methylation levels at the BRCA1/RAD51C promoter comparable with controls. Mean methylation levels (\ub1 stdev) at the BRCA1 promoter were 4.3% (\ub1 1.4%) and 4.4% (\ub1 1.4%) in controls and patients, respectively (p &gt; 0.05; t-test); mean methylation levels (\ub1 stdev) at the RAD51C promoter were 4.3% (\ub1 0.9%) and 3.7% (\ub1 0.9%) in controls and patients, respectively (p &gt; 0.05; t-test). Based on these observations; the analysis of constitutional methylation at promoters of these genes does not seem to substantially improve the definition of cancer risks in patients. These data support the idea that epimutations represent a very rare event in high-risk BC/OC populations

Hypercoagulability of COVID-19 patients in Intensive Care Unit: A Report of Thromboelastography Findings and other Parameters of Hemostasis

BACKGROUND: The severe inflammatory state secondary to Covid-19 leads to a severe derangement of hemostasis that has been recently described as a state of disseminated intravascular coagulation (DIC) and consumption coagulopathy, defined as decreased platelet count, increased fibrin(ogen) degradation products such as D-dimer as well as low fibrinogen. AIMS: Whole blood from 24 patients admitted at the intensive care unit because of Covid-19 was collected and evaluated with thromboelastography by the TEG point-of-care device on a single occasion and six underwent repeated measurements on two consecutive days for a total of 30 observations. Plasma was evaluated for the other parameters of hemostasis. RESULTS: TEG parameters are consistent with a state of hypercoagulability as shown by decreased R and K values, and increased values of K angle and MA. Platelet count was normal or increased, prothrombin time and activated partial thromboplastin time were near(normal). Fibrinogen was increased and D-dimer was dramatically increased. C-reactive protein was increased. Factor VIII and von Willebrand factor (n=11) were increased. Antithrombin (n=11) was marginally decreased and protein C (n=11) was increased. CONCLUSION: The results of this cohort of patients with Covid-19 are not consistent with acute DIC, rather they support hypercoagulability together with a severe inflammatory state. These findings may explain the events of venous thromboembolism observed in some of these patients and support antithrombotic prophylaxis/treatment. Clinical trials are urgently needed to establish the type of drug, dosage and optimal duration of prophylaxis

Unmatched ventilation and perfusion measured by electrical impedance tomography predicts the outcome of ARDS

Background In acute respiratory distress syndrome (ARDS), non-ventilated perfused regions coexist with non-perfused ventilated regions within lungs. The number of unmatched regions might reflect ARDS severity and affect the risk of ventilation-induced lung injury. Despite pathophysiological relevance, unmatched ventilation and perfusion are not routinely assessed at the bedside. The aims of this study were to quantify unmatched ventilation and perfusion at the bedside by electrical impedance tomography (EIT) investigating their association with mortality in patients with ARDS and to explore the effects of positive end-expiratory pressure (PEEP) on unmatched ventilation and perfusion in subgroups of patients with different ARDS severity based on PaO2/FiO2 and compliance. Methods Prospective observational study in 50 patients with mild (36%), moderate (46%), and severe (18%) ARDS under clinical ventilation settings. EIT was applied to measure the regional distribution of ventilation and perfusion using central venous bolus of saline 5% during end-inspiratory pause. We defined unmatched units as the percentage of only ventilated units plus the percentage of only perfused units. Results Percentage of unmatched units was significantly higher in non-survivors compared to survivors (32[27–47]% vs. 21[17–27]%, p < 0.001). Percentage of unmatched units was an independent predictor of mortality (OR 1.22, 95% CI 1.07–1.39, p = 0.004) with an area under the ROC curve of 0.88 (95% CI 0.79–0.97, p < 0.001). The percentage of ventilation to the ventral region of the lung was higher than the percentage of ventilation to the dorsal region (32 [27–38]% vs. 18 [13–21]%, p < 0.001), while the opposite was true for perfusion (28 [22–38]% vs. 36 [32–44]%, p < 0.001). Higher percentage of only perfused units was correlated with lower dorsal ventilation (r =  − 0.486, p < 0.001) and with lower PaO2/FiO2 ratio (r =  − 0.293, p = 0.039). Conclusions EIT allows bedside assessment of unmatched ventilation and perfusion in mechanically ventilated patients with ARDS. Measurement of unmatched units could identify patients at higher risk of death and could guide personalized treatment

Agrammatic but numerate

A central question in cognitive neuroscience concerns the extent to which language enables other higher cognitive functions. In the case of mathematics, the resources of the language faculty, both lexical and syntactic, have been claimed to be important for exact calculation, and some functional brain imaging studies have shown that calculation is associated with activation of a network of left-hemisphere language regions, such as the angular gyrus and the banks of the intraparietal sulcus. We investigate the integrity of mathematical calculations in three men with large left-hemisphere perisylvian lesions. Despite severe grammatical impairment and some difficulty in processing phonological and orthographic number words, all basic computational procedures were intact across patients. All three patients solved mathematical problems involving recursiveness and structure-dependent operations (for example, in generating solutions to bracket equations). To our knowledge, these results demonstrate for the first time the remarkable independence of mathematical calculations from language grammar in the mature cognitive system

Gastrointestinal colonization with multidrug-resistant Gram-negative bacteria during extracorporeal membrane oxygenation: effect on the risk of subsequent infections and impact on patient outcome

Background: In ICU patients, digestive tract colonization by multidrug-resistant (MDR) Gram-negative (G 12) bacteria is a significant risk factor for the development of infections. In patients undergoing extracorporeal membrane oxygenation (ECMO), colonization by MDR bacteria and risk of subsequent nosocomial infections (NIs) have not been studied yet. The aim of this study is to evaluate the incidence, etiology, risk factors, impact on outcome of gastrointestinal colonization by MDR G 12 bacteria, and risk of subsequent infections in patients undergoing ECMO. Methods: This is a retrospective analysis of prospectively collected data: 105 consecutive patients, treated with ECMO, were admitted to the ICU of an Italian tertiary referral center (San Gerardo Hospital, Monza, Italy) from January 2010 to November 2015. Rectal swabs for MDR G 12 bacteria were cultured at admission and twice a week. Only colonization and NIs by MDR G 12 bacteria were analyzed. Results: Ninety-one included patients [48.5 (37\u201356) years old, 63% male, simplified acute physiology score II 37 (32\u201347)] underwent peripheral ECMO (87% veno-venous) for medical indications (79% ARDS). Nineteen (21%) patients were colonized by MDR G 12 bacteria. Male gender (OR 4.03, p = 0.029) and duration of mechanical ventilation (MV) before ECMO &gt; 3&nbsp;days (OR 3.57, p = 0.014) were associated with increased risk of colonization. Colonized patients had increased odds of infections by the colonizing germs (84% vs. 29%, p &lt; 0.001, OR 12.9), longer ICU length of stay (LOS) (43 vs. 24&nbsp;days, p = 0.002), MV (50 vs. 22&nbsp;days, p &lt; 0.001) and ECMO (28 vs. 12&nbsp;days, p &lt; 0.001), but did not have higher risk of death (survival rate 58% vs. 67%, p = 0.480, OR 0.68). Infected patients had almost halved ICU survival (46% vs. 78%, p &lt; 0.001, OR 4.11). Conclusions: In patients undergoing ECMO for respiratory and/or circulatory failure, colonization by MDR G 12 bacteria is frequent and associated with more the tenfold odds for subsequent infection. Those infections are associated with an increased risk of death