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Bio‐inspired and biodegradable quantum optics scenarios constitute a pathway toward environmentally friendly front‐end technologies. Such an inspiring perspective necessitates the replacement of classic gain materials with a biological counterpart like photoluminescent bacteria. It is easy to imagine that, in this case, a planar and cell‐viable substitute of classic bulk solid‐states resonators can be highly beneficial. In this paper a micro‐ and nano‐photonic structuration of both a standard and a functionalized version of a typical bacterial growth medium (Luria‐Bertani Agar – LBA) is successfully realized. Three structures belonging to the categories of photonic crystals are replicated, such as quasi‐crystals and meta‐surfaces, demonstrating how the proposed media can be used as templates for high‐end photonic applications. The optical quality of the replicated structures is confirmed by far‐field diffraction measurements. The structured growth media allow for a broad control of the surface wettability by accessing a so‐called Wenzel state, in which the original hydrophilicity of a material is increased due to the photonic structuration. Finally, the suitability of the nano‐structured LBA as a plasmonic platform is evidenced. The proposed micro‐and nano‐structured photonic growth media constitute the first, fundamental step toward quantum optical frameworks from biological media. [ABSTRACT FROM AUTHOR]

Introduction: The myoelectric control strategy, based on surface electromyographic signals, has long been used for controlling a prosthetic system with multiple degrees of freedom. Several methods classify gestures and force levels but the simultaneous real-time control of hand/wrist gestures and force levels did not yet reach a satisfactory level of effectiveness. Methods: In this work, the hierarchical classification approach, already validated on 31 healthy subjects, was adapted for the real-time control of a multi-DoFs prosthetic system on 15 trans-radial amputees. The effectiveness of the hierarchical classification approach was assessed by evaluating both offline and real-time performance using three algorithms: Logistic Regression (LR), Non-linear Logistic Regression (NLR), and Linear Discriminant Analysis (LDA). Results: The results of this study showed the offline performance of amputees was promising and comparable to healthy subjects, with mean F1 scores of over 90% for the “Hand/wrist gestures classifier” and 95% for the force classifiers, implemented with the three algorithms with features extraction (FE). Another significant finding of this study was the feasibility of using the hierarchical classification strategy for real-time applications, due to its ability to provide a response time of 100 ms while maintaining an average online accuracy of above 90%. Discussion: A possible solution for real-time control of both hand/wrist gestures and force levels is the combined use of the LR algorithm with FE for the "Hand/wrist gestures classifier", and the NLR with FE for the Spherical and Tip force classifiers. [ABSTRACT FROM AUTHOR]

Introduction: The myoelectric control strategy, based on surface electromyographic signals, has long been used for controlling a prosthetic system with multiple degrees of freedom. Several methods classify gestures and force levels but the simultaneous real-time control of hand/wrist gestures and force levels did not yet reach a satisfactory level of effectiveness. Methods: In this work, the hierarchical classification approach, already validated on 31 healthy subjects, was adapted for the real-time control of a multi- DoFs prosthetic system on 15 trans-radial amputees. The effectiveness of the hierarchical classification approach was assessed by evaluating both offine and real-time performance using three algorithms: Logistic Regression (LR), Non- linear Logistic Regression (NLR), and Linear Discriminant Analysis (LDA). Results: The results of this study showed the offine performance of amputees was promising and comparable to healthy subjects, with mean F1 scores of over 90% for the "Hand/wrist gestures classifier" and 95% for the force classifiers, implemented with the three algorithms with features extraction (FE). Another significant finding of this study was the feasibility of using the hierarchical classification strategy for real-time applications, due to its ability to provide a response time of 100 ms while maintaining an average online accuracy of above 90%. Discussion: A possible solution for real-time control of both hand/wrist gestures and force levels is the combined use of the LR algorithmwith FE for the "Hand/wrist gestures classifier", and the NLR with FE for the Spherical and Tip force classifiers. [ABSTRACT FROM AUTHOR]

Objectives HCQ and AZA are used to control disease activity and reduce risk of flare during pregnancy in patients with SLE. The aim of this study was to determine the outcomes of children born to mothers with SLE exposed to HCQ or AZA during pregnancy and breast-feeding. Methods Women attending UK specialist lupus clinics with children ≤17 years old, born after SLE diagnosis, were recruited to this retrospective study. Data were collected using questionnaires and from clinical record review. Factors associated with the outcomes of low birth weight and childhood infection were determined using multivariable mixed-effects logistic regression models. Results We analysed 284 live births of 199 mothers from 10 UK centres. The first pregnancies of 73.9% of mothers (147/199) were captured in the study; (60.4%) (150/248) and 31.1% (87/280) children were exposed to HCQ and AZA, respectively. There were no significant differences in the frequency of congenital malformations or intrauterine growth restriction between children exposed or not to HCQ or AZA. AZA use was increased in women with a history of hypertension or renal disease. Although AZA was associated with low birth weight in univariate models, there was no significant association in multivariable models. In adjusted models, exposure to AZA was associated with increased reports of childhood infection requiring hospital management [odds ratio 2.283 (1.003, 5.198), P  = 0.049]. Conclusions There were no significant negative outcomes in children exposed to HCQ in pregnancy. AZA use was associated with increased reporting of childhood infection, which warrants further study. [ABSTRACT FROM AUTHOR]

Dipole–Dipole interactions (DDI) constitute an effective mechanism by which two physical entities can interact with each other. DDI processes can occur in a resonance framework if the energies of the two dipoles are very close. In this case, an energy transfer can occur without the need to emit a photon, taking the name of Förster Resonance Energy Transfer (FRET). Given their large dependence on the distance and orientation between the two dipoles, as well as on the electromagnetic properties of the surrounding environment, DDIs are exceptional for sensing applications. There are two main ways to carry out FRET-based sensing: (i) enhancing or (ii) inhibiting it. Interaction with resonant environments such as plasmonic, optical cavities, and/or metamaterials promotes the former while acting on the distance between the FRET molecules favors the latter. In this review, we browse both the two ways, pointing the spotlight to the intrinsic interdisciplinarity these two sensing routes imply. We showcase FRET-based sensing mechanisms in a variety of contexts, from pH sensors to molecular structure measurements on a nano-metrical scale, with a particular accent on the central and still mostly overlooked role played between a nano-photonically structured environment and photoluminescent molecules. [ABSTRACT FROM AUTHOR]

Background: In the field of myoelectric control systems, pattern recognition (PR) algorithms have become always more interesting for predicting complex electromyography patterns involving movements with more than 2 Degrees of Freedom (DoFs). The majority of classification strategies, used for the prosthetic control, are based on single, hierarchical and parallel linear discriminant analysis (LDA) classifiers able to discriminate up to 19 wrist/hand gestures (in the 3-DoFs case), considering both combined and discrete motions. However, these strategies were introduced to simultaneously classify only 2 DoFs and their use is limited by the lack of online performance measures. This study introduces a novel classification strategy based on the Logistic Regression (LR) algorithm with regularization parameter to provide simultaneous classification of 3 DoFs motion classes.Methods: The parallel PR-based strategy was tested on 15 healthy subjects, by using only six surface EMG sensors. Twenty-seven discrete and complex elbow, hand and wrist motions were classified by keeping the number of electromyographic (EMG) electrodes to a bare minimum and the classification error rate under 10 %. To this purpose, the parallel classification strategy was implemented by using three classifiers one for each DoF: the "Elbow classifier", the "Wrist classifier", and the "Hand classifier" provided the simultaneous control of the elbow, hand, and wrist joints, respectively.Results: Both the offline and real-time performance metrics were evaluated and compared with the LDA parallel classification results. The real-time recognition results were statistically better with the LR classifier with respect to the LDA classifier, for all motion classes (elbow, hand and wrist).Conclusions: In this paper, a novel parallel PR-based strategy was proposed for classifying up to 3 DoFs: three joint classifiers were employed simultaneously for classifying 27 motion classes related to the elbow, wrist, and hand and promising results were obtained. [ABSTRACT FROM AUTHOR]

Surface electromyography (sEMG) signals represent a promising approach for decoding the motor intention of amputees to control a multifunctional prosthetic hand in a non-invasive way. Several approaches based on proportional amplitude methods or simple thresholds on sEMG signals have been proposed to control a single degree of freedom at time, without the possibility of increasing the number of controllable multiple DoFs in a natural manner. Myoelectric control based on PR techniques have been introduced to add multiple DoFs by keeping low the number of electrodes and allowing the discrimination of different muscular patterns for each class of motion. However, the use of PR algorithms to simultaneously decode both gestures and forces has never been studied deeply. This paper introduces a hierarchical classification approach with the aim to assess the desired hand/wrist gestures, as well as the desired force levels to exert during grasping tasks. A Finite State Machine was introduced to manage and coordinate three classifiers based on the Non-Linear Logistic Regression algorithm. The classification architecture was evaluated across 31 healthy subjects. The "hand/wrist gestures classifier," introduced for the discrimination of seven hand/wrist gestures, presented a mean classification accuracy of 98.78%, while the "Spherical and Tip force classifier," created for the identification of three force levels, reached an average accuracy of 98.80 and 96.09%, respectively. These results were confirmed by Linear Discriminant Analysis (LDA) with time domain features extraction, considered as ground truth for the final validation of the performed analysis. A Wilcoxon Signed-Rank test was carried out for the statistical analysis of comparison between NLR and LDA and statistical significance was considered at p < 0.05. The comparative analysis reports not statistically significant differences in terms of F1Score performance between NLR and LDA. Thus, this study reveals that the use of non-linear classification algorithm, as NLR, is as much suitable as the benchmark LDA classifier for implementing an EMG pattern recognition system, able both to decode hand/wrist gestures and to associate different performed force levels to grasping actions. [ABSTRACT FROM AUTHOR]

Cardiovascular (CV) disease is the leading cause of death in chronic kidney disease (CKD) and end-stage renal disease (ESRD). A key driver in this pathology is increased aortic stiffness, which is a strong, independent predictor of CV mortality in this population. Aortic stiffening is a potentially modifiable biomarker of CV dysfunction and in risk stratification for patients with CKD and ESRD. Previous work has suggested that therapeutic modification of aortic stiffness may ameliorate CV mortality. Nevertheless, future clinical implementation relies on the ability to accurately and reliably quantify stiffness in renal disease. Pulse wave velocity (PWV) is an indirect measure of stiffness and is the accepted standard for non-invasive assessment of aortic stiffness. It has typically been measured using techniques such as applanation tonometry, which is easy to use but hindered by issues such as the inability to visualize the aorta. Advances in cardiac magnetic resonance imaging now allow direct measurement of stiffness, using aortic distensibility, in addition to PWV. These techniques allow measurement of aortic stiffness locally and are obtainable as part of a comprehensive, multiparametric CV assessment. The evidence cannot yet provide a definitive answer regarding which technique or parameter can be considered superior. This review discusses the advantages and limitations of non-invasive methods that have been used to assess aortic stiffness, the key studies that have assessed aortic stiffness in patients with renal disease and why these tools should be standardized for use in clinical trial work. [ABSTRACT FROM AUTHOR]

Clinical studies showed that renal expression and serum levels of nerve growth factor (NGF) are increased in renal diseases characterized by progressive fibrosis, a pathologic process in which TGF-β1 mediates most of the key events leading to tubular epithelial–mesenchymal transition (EMT). However, the pathogenic role of high NGF levels has not yet been elucidated. In this study, we found that in tubular renal cells, HK-2, NGF transcriptionally up-regulated TGF-β1 expression and secretion and enhanced cell motility by activating EMT markersviaits receptors, TrkA and p75NTR. Interestingly, we observed that TGF-β1–SMAD pathway activation and the up-regulation of EMT markers NGF-induced were both prevented when knockdown of TGF-β1 gene occurred and that the pretreatment with an antibody anti-NGF reversed the nuclear translocation of pSMAD3/SMAD4 complex. Collectively, our results demonstrated that NGF promotes renal fibrosisviaTGF-β1-signaling activation, suggesting that in kidney diseases high NGF serum levels could contribute to worsen renal fibrosis. [ABSTRACT FROM AUTHOR]

To propose a clinical prognostic index for death and heart failure in patients with ischemic cardiomyopathy implanted with an ICD. This prospective study included 192 consecutive patients (age 68 ± 10) recruited from 2004 to 2009 and implanted with an ICD for MADIT II criteria. All patients performed 24-h ambulatory blood pressure monitoring after discharge and common haematological samples. The prognostic index (PI) was built according to the formula: 120 − age + mean 24 h systolic blood pressure − (creatinine × 10). Other variables were assessed: EF, haemoglobin concentration, mean 24 h heart rate and diastolic blood pressure, sodium level, pacing mode and diabetes. Non-arrhythmic cardiac death and new hospitalizations for heart failure during 1-year follow-up were the combined end point. A total of 48 events (25 %) occurred during the follow-up: 7 cardiac deaths and 41 hospitalizations for acute heart failure. Cox proportional-hazards model showed that PI was the only predictor of events (HR = 0.96; CI 95 % 0.944-0.976, p < 0.0001). ROC curve showed that PI best cut-off was 144, with AUC 0.79, p < 0.0001; sensitivity 77 %, specificity 74 %, positive predictive value 50 %, negative predictive value 90 %. PI was predictive of events in a clinical setting where EF had no predictive value. PI works according to the rule 'the lower the worse'. The high negative predictive value (90 %) of PI allows to identify subjects at lower risk for death and heart failure. PI can be a practical tool to stratify risk in ischemic cardiomyopathy. [ABSTRACT FROM AUTHOR]

Background: In patients with acute stroke, the hyperdense middle cerebral artery (MCA) and internal carotid artery (ICA) signs on CT scans are markers of early ischemia, but their prognostic implications remain unclear.The aims of this prospective study were to assess: (1) the occurrence rate of hyperdense MCA and/or ICA in patients admitted for acute ischemic stroke; (2) the risk factors for hyperdense MCA and/or ICA; (3) the correlation between hyperdense MCA and/or ICA and functional outcome at 3 months. Methods: Consecutive patients admitted with ischemic stroke between 1 January 2006 and 30 June 2010 were included in this prospective single-centre cohort study. Results: 1,010 patients (mean age 71.9 years; 56.7% males) were included in the study. Among these patients, 148 (14.7%; mean age 71.2 years; 52% males) had hyperdense MCA and/or ICA. Overall, 163 patients (16.1%) had a final infarct covering more than one third of the MCA territory. Seventy-eight of 148 patients (52.7%) with hyperdense MCA and/or ICA had an infarct involving more than one third of the MCA territory compared to 85 of the 862 patients without artery hyperdensity (9.9%). At 3 months, 18 patients were lost to follow-up, 325 patients (32.8%) were disabled and 165 died (16.5%). Age (OR 1.06 for 1 added year; 95% CI 1.04-1.08), National Institute of Health Stroke Scale score for 1 added point on admission (OR 1.2; 95% CI 1.2-1.3), stroke due to atherosclerosis (OR 2.3; 95% CI 1.0-5.4), hemorrhagic transformation of the ischemic lesion (OR 2.2; 95% CI 1.0-4.9), and hyperdense MCA and/or ICA (OR 2.0; 95% CI 1.0-4.0) were associated with adverse outcome. Conclusions: In this prospective cohort of patients with acute ischemic stroke, we observed an incidence of hyperdense MCA and/or ICA arteries of about 15%; hyperdense MCA and/or ICA were associated with a final infarct involving more than one third of the MCA territory and poor functional outcome at 3 months. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We followed up 550 primary kidney transplant recipients in an observational retrospective cohort to evaluate the impact of three consecutive cytomegalovirus (CMV) prevention strategies. In period 1 (1996–2000; n = 190), no anti-CMV prophylaxis was given; in period 2 (2000–2004; n = 173), 6-month valacyclovir was given and in period 3 (>2004; n = 187), 6-month valganciclovir was given. Cytomegalovirus disease significantly decreased from 33.2% in period 1 to 13.9% in period 2 and to 8.6% in period 3; onset was significantly prolonged with valganciclovir (228 days) compared with valacyclovir (93 days) and with no prophylaxis (33 days). After Cox regression adjustments, both valganciclovir and valacyclovir were similarly protective factors for CMV disease. Cytomegalovirus diseases encountered in both valacyclovir and valganciclovir groups were primary infections (79.2 and 93.8% respectively) as compared with a significant low number (39.7%) in the nonprophylaxis group. Two cases of valganciclovir resistance were recorded in the valganciclovir group and no resistance was seen with valacyclovir. A significantly reduced incidence of other herpes viruses was only observed with valganciclovir. Valganciclovir was better tolerated than valacyclovir and this long-term prophylaxis was applicable to 85% of patients. Longer follow-up of valganciclovir or valacyclovir prophylaxis is still required to appreciate its impact on graft and patient survivals, as well as other indirect effects, in the mycophenolate mofetil and calcineurin inhibitor immunosuppressive era. [ABSTRACT FROM AUTHOR]

A bio-photonic cavity quantum electrodynamic (C-QED) framework could be imagined as a system in which both the "cavity" and the "atom" participating in the light-matter interaction scenario are bio-inspired. Can a cavity be made of a bio-polymer? If so, how should such a cavity appear and what are the best polymers to fabricate it? Can a bioluminescent material stand the comparison with new-fashion semiconductors? In this review we answer these fundamental questions to pave the way toward an eco-friendly paradigm, in which the ever-increasing demand for more performing quantum photonics technologies meets the ever-increasing yet silent demand of our planet to reduce our environmental footprint. [ABSTRACT FROM AUTHOR]

The evolution of technological and surgical techniques has made it possible to obtain an even more intuitive control of multiple joints using advanced prosthetic systems. Targeted Muscle Reinnervation (TMR) is considered to be an innovative and relevant surgical technique for improving the prosthetic control for people with different amputation levels of the limb. Indeed, TMR surgery makes it possible to obtain reinnervated areas that act as biological amplifiers of the motor control. On the technological side, a great deal of research has been conducted in order to evaluate various types of myoelectric prosthetic control strategies, whether direct control or pattern recognition-based control. In the literature, different control performance metrics, which have been evaluated on TMR subjects, have been introduced, but no accepted reference standard defines the better strategy for evaluating the prosthetic control. Indeed, the presence of several evaluation tests that are based on different metrics makes it difficult the definition of standard guidelines for comprehending the potentiality of the proposed control systems. Additionally, there is a lack of evidence about the comparison of different evaluation approaches or the presence of guidelines on the most suitable test to proceed for a TMR patients case study. Thus, this review aims at identifying these limitations by examining the several studies in the literature on TMR subjects, with different amputation levels, and proposing a standard method for evaluating the control performance metrics. [ABSTRACT FROM AUTHOR]

A case of retrobulbar monolateral optic neuritis due to disseminated Cryptococcosis in a 32-year-old man with a new diagnosis of AIDS is described in the era of combination antiretroviral therapy (cART). The patient presented a monolateral rapid visual loss on day 7 of a liposomal amphotericin B treatment. Neuroradiological imaging showed the presence of retrobulbar neuritis. After starting ART and intravenous metilprednisolone 1 g daily for 3 days, we assisted to a progressive improvement of visual acuity. At 3 months of follow-up, complete clinical resolution was obtained. In this case, in the presence of effective antiretroviral and antifungal treatment, a short course of metilprednisolone was a safe therapy. [ABSTRACT FROM PUBLISHER]

Introduction: Cytomegalovirus (CMV) infection represents a common cause of morbidity and mortality in kidney transplant recipients (KTR). The NF‐kB signaling pathway is highly involved in the pathogenesis of CMV infection. The ‐94ins/delATTG functional polymorphism in the promoter of NFKB1 has been associated with low intracellular levels of the protein and high incidence of inflammatory and autoimmune disease. In this study, we evaluated the association of this NFKB1 polymorphism with the risk of CMV infection. Methods: CMV infection was defined as virus isolation or detection of viral antigens or nucleic acid in any body fluid or tissue specimen. Using Cox regression and survival analysis, we analyzed the association between the polymorphism and CMV infection as well as recurrence in the first 12 months after transplantation. Results: We analyzed the ‐94ins/delATTG NFKB1 polymorphism of 189 KTRs. The 65% of CMV infections occurred in ins/ins group. Survival free from CMV infection was 54.7% for ins/ins group and 79.4% for deletion carriers one year after transplantation (P < 0.0001). At multivariate regression, deletion carriers showed a lower risk of CMV infection and recurrence with respect to ins/ins KTRs (HR = 0.224 P = 0.0002; HR = 0.307, P = 0.012, respectively). Conclusions: In conclusion, pretransplantation screening for NFKB1 ‐94ins/delATTG polymorphism may predict CMV infection and improve the management of patients at higher risk of infection in the post‐transplant period. [ABSTRACT FROM AUTHOR]

Nerve growth factor is a neurotrophin that promotes cell growth, differentiation, survival and death through two different receptors: TrkANTR and p75NTR. Nerve growth factor serum concentrations increase during many inflammatory and autoimmune diseases, glomerulonephritis, chronic kidney disease, end-stage renal disease and, particularly, in renal transplant. Considering that nerve growth factor exerts beneficial effects in the treatment of major central and peripheral neurodegenerative diseases, skin and corneal ulcers, we asked whether nerve growth factor could also exert a role in Cyclosporine A-induced graft nephrotoxicity. Our hypothesis was raised from basic evidence indicating that Cyclosporine A-inhibition of calcineurin-NFAT pathway increases nerve growth factor expression levels. Therefore, we investigated the involvement of nerve growth factor and its receptors in the damage exerted by Cyclosporine A in tubular renal cells, HK-2. Our results showed that in HK-2 cells combined treatment with Cyclosporine A + nerve growth factor induced a significant reduction in cell vitality concomitant with a down-regulation of Cyclin D1 and up-regulation of p21 levels respect to cells treated with Cyclosporine A alone. Moreover functional experiments showed that the co-treatment significantly up-regulated human p21promoter activity by involvement of the Sp1 transcription factor, whose nuclear content was negatively regulated by activated NFATc1. In addition we observed that the combined exposure to Cyclosporine A + nerve growth factor promoted an up-regulation of p75 NTR and its target genes, p53 and BAD leading to the activation of intrinsic apoptosis. Finally, the chemical inhibition of p75NTR down-regulated the intrinsic apoptotic signal. We describe two new mechanisms by which nerve growth factor promotes growth arrest and apoptosis in tubular renal cells exposed to Cyclosporine A. [ABSTRACT FROM AUTHOR]