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Abstract There are widespread concerns about bias and discriminatory output related to artificial intelligence (AI), which may propagate social biases and disparities. Digital ageism refers to ageism reflected design, development, and implementation of AI systems and technologies and its resultant data. Currently, the prevalence of digital ageism and the sources of AI bias are unknown. A scoping review informed by the Arksey and O’Malley methodology was undertaken to explore age-related bias in AI systems, identify how AI systems encode, produce, or reinforce age-related bias, what is known about digital ageism, and the social, ethical and legal implications of age-related bias. A comprehensive search strategy that included five electronic bases and grey literature sources including legal sources was conducted. A framework of machine learning biases spanning from data to user by Mehrabi et al. is used to present the findings (Mehrabi et al. 2021). The academic search resulted in 7595 articles that were screened according to the inclusion criteria, of which 307 were included for full-text screening, and 49 were included in this review. The grey literature search resulted in 2639 documents screened, of which 235 were included for full text screening, and 25 were found to be relevant to the research questions pertaining to age and AI. As a result, a total of 74 documents were included in this review. The results show that the most common AI applications that intersected with age were age recognition and facial recognition systems. The most frequent machine learning algorithms used were convolutional neural networks and support vector machines. Bias was most frequently introduced in the early ‘data to algorithm’ phase in machine learning and the ‘algorithm to user’ phase specifically with representation bias (n = 33) and evaluation bias (n = 29), respectively (Mehrabi et al. 2021). The review concludes with a discussion of the ethical implications for the field of AI and recommendations for future research.

Abstract Cachexia syndrome develops in patients with diseases such as cancer and sepsis and is characterized by progressive muscle wasting. While iNOS is one of the main effectors of cachexia, its mechanism of action and whether it could be targeted for therapy remains unexplored. Here, we show that iNOS knockout mice and mice treated with the clinically tested iNOS inhibitor GW274150 are protected against muscle wasting in models of both septic and cancer cachexia. We demonstrate that iNOS triggers muscle wasting by disrupting mitochondrial content, morphology, and energy production processes such as the TCA cycle and acylcarnitine transport. Notably, iNOS inhibits oxidative phosphorylation through impairment of complexes II and IV of the electron transport chain and reduces ATP production, leading to energetic stress, activation of AMPK, suppression of mTOR, and, ultimately, muscle atrophy. Importantly, all these effects were reversed by GW274150. Therefore, our data establish how iNOS induces muscle wasting under cachectic conditions and provide a proof of principle for the repurposing of iNOS inhibitors, such as GW274150 for the treatment of cachexia.

Abstract Boosting antitumor immunity has emerged as a powerful strategy in cancer treatment. While releasing T‐cell brakes has received most attention, tumor recognition by T cells is a pre‐requisite. Radiotherapy and certain cytotoxic drugs induce the release of damage‐associated molecular patterns, which promote tumor antigen cross‐presentation and T‐cell priming. Antibodies against the “do not eat me” signal CD47 cause macrophage phagocytosis of live tumor cells and drive the emergence of antitumor T cells. Here we show that CXCR4 activation, so far associated only with tumor progression and metastasis, also flags tumor cells to immune recognition. Both CXCL12, the natural CXCR4 ligand, and BoxA, a fragment of HMGB1, promote the release of DAMPs and the internalization of CD47, leading to protective antitumor immunity. We designate as Immunogenic Surrender the process by which CXCR4 turns in tumor cells to macrophages, thereby subjecting a rapidly growing tissue to immunological scrutiny. Importantly, while CXCL12 promotes tumor cell proliferation, BoxA reduces it, and might be exploited for the treatment of malignant mesothelioma and a variety of other tumors.

Abstract The scientific literature peer review workflow is under strain because of the constant growth of submission volume. One response to this is to make initial screening of submissions less time intensive. Reducing screening and review time would save millions of working hours and potentially boost academic productivity. Many platforms have already started to use automated screening tools, to prevent plagiarism and failure to respect format requirements. Some tools even attempt to flag the quality of a study or summarise its content, to reduce reviewers’ load. The recent advances in artificial intelligence (AI) create the potential for (semi) automated peer review systems, where potentially low-quality or controversial studies could be flagged, and reviewer-document matching could be performed in an automated manner. However, there are ethical concerns, which arise from such approaches, particularly associated with bias and the extent to which AI systems may replicate bias. Our main goal in this study is to discuss the potential, pitfalls, and uncertainties of the use of AI to approximate or assist human decisions in the quality assurance and peer-review process associated with research outputs. We design an AI tool and train it with 3300 papers from three conferences, together with their reviews evaluations. We then test the ability of the AI in predicting the review score of a new, unobserved manuscript, only using its textual content. We show that such techniques can reveal correlations between the decision process and other quality proxy measures, uncovering potential biases of the review process. Finally, we discuss the opportunities, but also the potential unintended consequences of these techniques in terms of algorithmic bias and ethical concerns.

Abstract Mutations in MECP2 cause several neurological disorders of which Rett syndrome (RTT) represents the best‐defined condition. Although mainly working as a transcriptional repressor, MeCP2 is a multifunctional protein revealing several activities, the involvement of which in RTT remains obscure. Besides being mainly localized in the nucleus, MeCP2 associates with the centrosome, an organelle from which primary cilia originate. Primary cilia function as “sensory antennae” protruding from most cells, and a link between primary cilia and mental illness has recently been reported. We herein demonstrate that MeCP2 deficiency affects ciliogenesis in cultured cells, including neurons and RTT fibroblasts, and in the mouse brain. Consequently, the cilium‐related Sonic Hedgehog pathway, which is essential for brain development and functioning, is impaired. Microtubule instability participates in these phenotypes that can be rescued by HDAC6 inhibition together with the recovery of RTT‐related neuronal defects. Our data indicate defects of primary cilium as a novel pathogenic mechanism that by contributing to the clinical features of RTT might impact on proper cerebellum/brain development and functioning, thus providing a novel therapeutic target.

Abstract During obesity, macrophages infiltrate the breast tissue leading to low‐grade chronic inflammation, a factor considered responsible for the higher risk of breast cancer associated with obesity. Here, we formally demonstrate that breast epithelial cells acquire malignant properties when exposed to medium conditioned by macrophages derived from human healthy donors. These effects were mediated by the breast cancer oncogene IKKε and its downstream target—the serine biosynthesis pathway as demonstrated by genetic or pharmacological tools. Furthermore, amlexanox, an FDA‐approved drug targeting IKKε and its homologue TBK1, delayed in vivo tumour formation in a combined genetic mouse model of breast cancer and high‐fat diet‐induced obesity/inflammation. Finally, in human breast cancer tissues, we validated the link between inflammation–IKKε and alteration of cellular metabolism. Altogether, we identified a pathway connecting obesity‐driven inflammation to breast cancer and a potential therapeutic strategy to reduce the risk of breast cancer associated with obesity.

Objectives: This study aimed to assess more clinical and pathological factors associated with prostate cancer (PCa) progression in high-risk PCa patients treated primarily with robot-assisted radical prostatectomy (RARP) and extended pelvic lymph node dissection (ePLND) in a tertiary referral center. Materials and methods: In a period ranging from January 2013 to October 2020, RARP and ePLND were performed on 180 high-risk patients at Azienda Ospedaliera Universitaria Integrata of Verona (Italy). PCa progression was defined as biochemical recurrence/persistence and/or local recurrence and/or distant metastases. Statistical methods evaluated study endpoints, including Cox's proportional hazards, Kaplan-Meyer survival curves, and binomial logistic regression models. Results: The median age of included patients was 66.5 [62–71] years. Disease progression occurred in 55 patients (30.6%), who were more likely to have advanced age, palpable tumors, and unfavorable pathologic features, including high tumor grade, stage, and pelvic lymph node invasion (PLNI). On multivariate analysis, PCa progression was predicted by advanced age (≥ 70 years) (HR = 2.183; 95% CI = 1.089–4377, p = 0.028), palpable tumors (HR = 3.113; 95% CI = 1.499–6.465), p = 0.002), and PLNI (HR = 2.945; 95% CI = 1.441–6.018, p = 0.003), which were associated with clinical standard factors defining high-risk PCa. Age had a negative prognostic impact on elderly patients, who were less likely to have palpable tumors but more likely to have high-grade tumors. Conclusions: High-risk PCa progression was independently predicted by advanced age, palpable tumors, and PLNI, which is associated with standard clinical prognostic factors. Consequently, with increasing age, the prognosis is worse in elderly patients, who represent an unfavorable age group that needs extensive counseling for appropriate and personalized management decisions. [ABSTRACT FROM AUTHOR]

Abstract The role of the fragile X mental retardation protein (FMRP) is well established in brain, where its absence leads to the fragile X syndrome (FXS). FMRP is almost ubiquitously expressed, suggesting that, in addition to its effects in brain, it may have fundamental roles in other organs. There is evidence that FMRP expression can be linked to cancer. FMR1 mRNA, encoding FMRP, is overexpressed in hepatocellular carcinoma cells. A decreased risk of cancer has been reported in patients with FXS while a patient‐case with FXS showed an unusual decrease of tumour brain invasiveness. However, a role for FMRP in regulating cancer biology, if any, remains unknown. We show here that FMRP and FMR1 mRNA levels correlate with prognostic indicators of aggressive breast cancer, lung metastases probability and triple negative breast cancer (TNBC). We establish that FMRP overexpression in murine breast primary tumours enhances lung metastasis while its reduction has the opposite effect regulating cell spreading and invasion. FMRP binds mRNAs involved in epithelial mesenchymal transition (EMT) and invasion including E‐cadherin and Vimentin mRNAs, hallmarks of EMT and cancer progression.

Abstract The activity, localization and fate of many cellular proteins are regulated through ubiquitination, a process whereby one or more ubiquitin (Ub) monomers or chains are covalently attached to target proteins. While Ub‐conjugated and Ub‐associated proteomes have been described, we lack a high‐resolution picture of the dynamics of ubiquitination in response to signaling. In this study, we describe the epidermal growth factor (EGF)‐regulated Ubiproteome, as obtained by two complementary purification strategies coupled to quantitative proteomics. Our results unveil the complex impact of growth factor signaling on Ub‐based intracellular networks to levels that extend well beyond what might have been expected. In addition to endocytic proteins, the EGF‐regulated Ubiproteome includes a large number of signaling proteins, ubiquitinating and deubiquitinating enzymes, transporters and proteins involved in translation and transcription. The Ub‐based signaling network appears to intersect both housekeeping and regulatory circuitries of cellular physiology. Finally, as proof of principle of the biological relevance of the EGF‐Ubiproteome, we demonstrated that EphA2 is a novel, downstream ubiquitinated target of epidermal growth factor receptor (EGFR), critically involved in EGFR biological responses.

Introduction and objective: Although advanced age doesn't seem to impair oncological outcomes after robot-assisted radical prostatectomy (RARP), elderly patients have increased rates of prostate cancer (PCa) related deaths due to a higher incidence of high-risk disease. The potential unfavorable impact of advanced age on oncological outcomes following RARP remains an unsettled issue. We aimed to evaluate the oncological outcome of PCa patients > 69 years old in a single tertiary center. Materials and methods: 1143 patients with clinically localized PCa underwent RARP from January 2013 to October 2020. Analysis was performed on 901 patients with available follow-up. Patients ≥ 70 years old were considered elderly. Unfavorable pathology included ISUP grade group > 2, seminal vesicle, and pelvic lymph node invasion. Disease progression was defined as biochemical and/or local recurrence and/or distant metastases. Results: 243 cases (27%) were classified as elderly patients (median age 72 years). Median (IQR) follow-up was 40.4 (38.7–42.2) months. Disease progression occurred in 159 cases (17.6%). Elderly patients were more likely to belong to EAU high-risk class, have unfavorable pathology, and experience disease progression after surgery (HR = 5.300; 95% CI 1.844–15.237; p = 0.002) compared to the younger patients. Conclusions: Elderly patients eligible for RARP are more likely to belong to the EAU high-risk category and to have unfavorable pathology that are independent predictors of disease progression. Advanced age adversely impacts on oncological outcomes when evaluated inside these unfavorable categories. Accordingly, elderly patients belonging to the EAU high-risk should be counseled about the increased risk of disease progression after surgery. [ABSTRACT FROM AUTHOR]

We investigated the force produced by a conical piezoelectric (PZT, lead zirconate titanate) transducer actuated by high voltage pulses (HVP) in contact with a steel transfer plate. Using elastic wave propagation theory in a semi-infinite plate, we aimed to quantify the magnitude and estimate the shape of the force–time function via the body waves produced in the transfer plate using the displacement field recorded on an array of 20 absolutely calibrated PZT receivers. We first calibrated the receiver array using glass capillary fracture. We proceeded to use a conical PZT transducer to actively produce a source at the origin, allowing us to study the displacement field produced on the now calibrated PZT receiver array. We studied two types of HVP: An impulsive and step source. The calibrated receiver array was used to estimate the general shape of the force–time functions for each type of HVP. From our hypothesized force–time functions we were able to estimate the peak force produced by the PZT actuator: The impulsive source generated a force of f peak = 2.90 ± 0.42 N and the step source generated f peak = 1.79 ± 0.30 N, respectively, for a peak applied voltage of 273 V. This translates to an applied force of ∼ 0.011 N/V and 0.007 N/V for the impulse and step force–time functions, respectively, which is similar to estimates found in the literature for other conical transducers in contact with metallic transfer media. This measurement was verified directly by independent measurements of the peak force f peak using a dynamic force transducer. We found that our methodology correctly estimated the magnitude of the force but is limited to transducers with incident angles θ < 53 ∘ . Beyond this angle, overestimates of the force were observed due to the lack of body wave energy produced by the source. These results allow us to quantitatively determine the forces produced by active PZT techniques using only the measurement of the displacement field captured on a calibrated conical PZT array. Quantitative understanding of active PZT sources additionally constrains the transfer functions approach, which is commonly used in the non-destructive testing of materials and in other fields, such as rock physics and laboratory seismology. [ABSTRACT FROM AUTHOR]

Background: Delirium is frequent though undetected in older patients admitted to the Emergency Department (ED). Aims: To develop and validate a delirium risk assessment tool for older persons admitted to the ED Observation Unit (OU). Methods: We used data from two samples of 65 + year-old patients, one admitted to the ED of Brescia Hospital (n = 257) and one to the ED of Desio Hospital (n = 107), Italy. Data from Brescia were used as training sample, those collected in Desio as testing one. Delirium was assessed using the 4AT and patients' characteristic were retrieved from medical charts. Variables found to be associated with delirium in the training sample were tested for the creation of a delirium risk assessment tool. The resulting tool's performances were assessed in the testing subsample. Results: Of all possible scores tested, the combination with the highest discriminative ability in the training sample included: age ≥ 75 years, dementia diagnosis, chronic use of neuroleptics, and hearing impairment. The delirium score exhibited an AUC of 0.874 and 0.893 in the training and testing samples, respectively. For a 1-point increase in the score, the odds of delirium increased more than twice in both samples. Discussion: We propose a delirium risk assessing tool that includes variables that can be easily collected at ED admission and that can be calculated rapidly. Conclusion: A risk assessment tool could help improving delirium detection in older persons referring to ED. [ABSTRACT FROM AUTHOR]

Background: A novel effervescent buffered solution of 70 mg alendronate (ALN-EX) was developed to improve upper gastrointestinal (GI) tolerability over alendronate tablets (ALN-T). Whether a better GI tolerability can improve persistence remains to be determined. Aim: This study evaluated persistence and reasons for discontinuation in patients treated with ALN-EX compared to a historical cohort on ALN-T. Methods: Post-menopausal women (PMW) from a standardized clinical database with BMD T-score < -2.5, or between -2 and -2.5 and at least one vertebral fracture, starting ALN-EX between July 2015 and June 2016 were included. A historical cohort comprised of randomly selected and age-matched PMW on ALN-T was used as a control. Persistence at 6 and 12 months and reasons for discontinuation (e.g. adverse events; AE) were compared between the two groups. Results: A total of 144 PMW on ALN-EX and 216 PMW on ALN-T were analysed. Persistence at 6 and 12 months was 91% and 81% in the ALN-EX group vs. 75% and 69% in the ALN-T group, this difference attaining statistical significance at both 6- (p < 0.001) and 12 months (p = 0.009). A significantly higher proportion of patients receiving ALN-T discontinued treatment due to GI AEs (4% ALN-EX vs. 11% ALN-T; p = 0.027), or patient's decision to discontinue (6% ALN-EX vs. 13% ALN-T; p = 0.016). The adjusted odds ratio of persisting on ALN-EX treatment at 12 months was 2.02 (95% CI: 1.21–3.41, p = 0.008). Conclusion: Our findings demonstrate that ALN-EX can provide greater persistence and improved tolerability compared to ALN-T, allowing it to be a viable alternative option in the management of osteoporosis. [ABSTRACT FROM AUTHOR]

One of the challenges of Deep Learning research is to develop algorithms for mobile robotic agents that operate in uncontrolled environments, in which dynamic changes and limited processing power are common restrictions. A common solution is to develop separate vision and decision modules, so that the former is based on deep neural network architectures and the latter is based on rules, and then interconnect them. The drawback of this solution is that the modules need to exchange high-level information about the objects in the scene, which are usually the positions of all objects in the scene, and this is computationally expensive. To address this problem, this paper presents a Decision Tree of Deep Neural Networks (DT-DNN) that aims to perform end to end—from image to decision—processing, and, thus, eliminating the need for quantitative and relational information about the image. This model is composed of smaller and more specialized modular DNNs, thus solving the trade-off between performance and inference time. Experiments were carried out using a real robot in the RoboCup Humanoid League domain in a soccer field, and also in simulation. We compared DT-DNN with several traditional DNN architectures. From the results, it is possible to conclude that the use of the DT-DNN made the system simpler and more robust, with fewer parameters to be adjusted, reducing the time spent with inference and also increasing the performance when compared to the traditional approach. [ABSTRACT FROM AUTHOR]

Background: Symptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection incidence is higher in the elderly patients. Pre-existing geriatric conditions such as comorbidity and frailty seem related to worse hospital outcomes. Aims: To assess the role of nutritional status as an independent prognostic factor for in-hospital death in elderly patients. Methods: Consecutive elderly patients (age > 65 years) hospitalized for novel coronavirus disease (COVID-19) were enrolled. Demographics, laboratory and comorbidity data were collected. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI). Uni- and multivariate Cox regression analyses to evaluate predictors for in-hospital death were performed. Results: One hundred and nine hospitalized elderly patients (54 male) were consecutively enrolled. At univariate analysis, age (HR 1.045 [CI 1.008–1.082]), cognitive impairment (HR 1.949 [CI 1.045–3.364]), C-reactive protein (HR 1.004 [CI 1.011–1.078]), lactate dehydrogenases (HR 1.003 [CI 1.001–1.004]) and GNRI moderate–severe risk category (HR 8.571 [CI 1.096–67.031]) were risk factors for in-hospital death, while albumin (HR 0.809 [CI 0.822–0.964]), PaO2/FiO2 ratio (HR 0.996 [CI 0.993–0.999]) and body mass index (HR 0.875 [CI 0.782–0.979]) were protective factors. Kaplan–Meier survival curves showed a significative higher survival in patients without GNRI moderate or severe risk category (p = 0.0013). At multivariate analysis, PaO2/FiO2 ratio (HR 0.993 [CI 0.987–0.999], p = 0.046) and GNRI moderate–severe risk category (HR 9.285 [1.183–72.879], p = 0.034) were independently associated with in-hospital death. Conclusion: Nutritional status assessed by GNRI is a significative predictor of survival in elderly patients hospitalized for COVID-19. The association between GNRI and PaO2/FiO2 ratio is a good prognostic model these patients. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic fatty liver disease (NAFLD) is the liver manifestation of metabolic syndrome, a risk factor for mortality and cardiovascular morbidity, but we ignore the role of steatosis per se in survival, and there is very little information about this condition in the geriatric patient. Aims: With the present study, we investigated the independent prognostic value of NAFLD on overall mortality in the elderly. Methods: Within the Pianoro Project, involving people ≥ 65 years, anamnestic, clinical and laboratoristic data related to NAFLD, insulin resistance, diabetes/hyperglycemia, hypertension, obesity and dyslipidemia were collected in 804 subjects (403 male, 401 female). These subjects were followed up for mortality for a median time of 12.6 years. A multivariate analysis was performed to evaluate the prognostic value of the covariates. Results: At Kaplan–Meier estimator the presence of NAFLD seems to be associated to a lower mortality, and survival tends to increase with the increasing of steatosis grade. Cox's analysis found that survival is increased for subjects having hypercholesterolemia (RR = 0.565), NAFLD (RR = 0.777), hypertension (RR = 0.711) and in female (RR = 0.741), while it is decreased for the older subjects (RR = 3.046), in patients with hypertriglyceridemia (RR = 1.699) and for diabetics (RR = 1.797). The variables BMI and HDL-cholesterol have no role. Conclusion: The data obtained in our study show that NAFLD is not associated to overall mortality in the elderly population. [ABSTRACT FROM AUTHOR]

The assessment of bone mainly relies on standard radiographs, CT, MRI, and bone scintigraphy depending on the anatomic region complexity and clinical scenario. Ultrasound (US), due to different acoustic impedance between soft tissues and the bone cortex, only allows the evaluation of the bone surfaces. Nevertheless, US can be useful in the evaluation of several bone disorders affecting the limbs as a result of its tomographic capabilities and high definition. This pictorial review article summarises our clinical experience in adults and reviews the literature on US bone examination. We first present the US appearance of normal bone and the main congenital anatomic variations, after which we illustrate the US findings of a variety of bone disorders. Although US has limits in bone assessment, its analysis must be a part of every musculoskeletal US examination. [ABSTRACT FROM AUTHOR]

Ultrasound (US) assessment of the wrist is frequently used for the evaluation of carpal tunnel due to high frequency of local compression of the median nerve (MN), but the ulnar–palmar wrist region (UPWR) has received limited attention in the medical literature. The possibilities of US in the assessment of UPWR are therefore likely underestimated by sonologists. This review article is focused on the US assessment of the normal anatomy and anatomic variations of the UPWR. The anatomy of this region of the wrist is complex and less studied than the radial side. In an effort to simplify it and to present it didactically, we have divided this region in three parts on the basis of osseous landmarks. Our review indicates sonography is effective in identifying the UPWR and related disorders, and is thus a valuable tool for ensuring appropriate management of a variety of disorders. [ABSTRACT FROM AUTHOR]

Early detection of local complications (venipuncture complications, nerve lesions, infections, arthritis, and tenosynovitis, tendon adhesions and re-tears, complications related to orthopaedic hardware) after hand surgery is required for prompt treatment. Ultrasound has proven to be a valuable imaging modality for detecting and assessing a variety of disorders of the wrist and hand. The purpose of this pictorial essay is to present a wide range of complications after wrist and hand surgery assessed by ultrasound. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic right hemicolectomy is a commonly performed procedure. Little is known on how to perform the enterotomy closure after stapled side-to-side intracorporeal anastomosis.Method: A multicentric case-controlled study has been designed to compare different ways to fashion enterotomy closure: double layer versus single layer, sewn versus stapled, and robotic versus laparoscopic approach. Furthermore, additional characteristics including sutures' materials, interrupted versus running suture and the presence of deep corner suture has been investigated.Results: We collected data for 1092 patients who underwent right hemicolectomy at ten centers. We analyzed 176 robotic against 916 laparoscopic anastomosis: no significant differences were found in terms of bleedings (p = 0.455) and anastomotic leak (p = 0.405). We collected data from 126 laparoscopic sewn single-layer versus 641 laparoscopic sewn double-layer anastomosis: a significant reduction was recorded in terms of leaks in double-layer group (p = 0.02). About double-layer characteristics, we found a significant reduction of bleedings (p = 0.008) and leaks (p = 0.017) with a running suture; similarly, a reduction of bleedings (p = 0.001) and leaks (p = 0.005) was observed with the usage of deep corner closure. The presence of a barbed suture thread seemed to significantly reduce both bleedings (p = 0.001) and leaks (p = 0.001). We found no significant differences in terms of bleedings (p = 0.245) and anastomotic leak (p = 0.660) comparing sewn versus stapled anastomosis.Conclusions: Fashioning a stapled ileocolic intracorporeal anastomosis, we can recommend the adoption of a double-layer enterotomy closure using a running barbed suture in the first layer. Totally, stapled closure and robotic assistance have to be considered a non-inferior alternative. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: Is handgrip strength assessment in the supine position valid and reliable as compared to the traditional sitting position? Findings: Grip strength values assessed in the sitting position highly correlated with the values of strength assessed in the sitting position without significant differences in the mean values of the two different assessment methods. Results were consistent across gender, cognitive status and body side. Message: In bedridden patients grip strength assessment using the supine position can be considered a valid alternative to the sitting position. Purpose: Muscle strength evaluation is important in older people's functional assessment. We investigated the validity of grip strength measurement in a supine position as compared to the traditional one. Methods: Cross-sectional study conducted in older people hospitalized in a medical unit. Patients underwent measurements of grip strength in both supine and sitting positions. Agreement between results was evaluated using Pearson correlation and Infraclass correlation coefficient. The two measurements techniques were graphically compared with Bland–Altman plot. Results: Forty four participants enrolled (21 females), mean age 80.6. Correlation coefficients demonstrated a strong positive relationship between the two different measurement positions (all values greater than 0.9). Results were consistent and similar across gender, body side and were not affected by cognitive impairment. Infraclass correlation analyses demonstrate a very good inter-rate reliability. Conclusions: Grip strength assessed in the supine position can be considered a valid alternative in bedridden individuals. [ABSTRACT FROM AUTHOR]

This paper presents a humanoid robot framework, composed of a simulator and a telemetry interface. The framework is based on the Cross Architecture, and it is developed aiming for the RoboCup Soccer Humanoid League domain. A simulator is an important tool for testing cognitive algorithms without handling issues of real robots; furthermore, a simulator is extremely useful for allowing reproducibility of any developed algorithm, even if there is no robot available. The proposed simulator allows an easy transfer of the algorithms developed in the simulator to real robots, as long as it uses the Cross Architecture as its software architecture. Then, in order to evaluate the cognitive algorithms in real robots, a telemetry interface is proposed. From this interface, it is possible to monitor any variable in the robot’s shared memory. The framework is open source and has low computational cost. Experiments were conducted in order to analyze both, simulator and telemetry interface. Experiments performed with the simulator aim to validate the high-level strategy development and the portability to a real robot, while experiments with telemetry interface aim to evaluate the robot behavior using, as input, the information received from the shared memory passed by all processes. The results show that the simulator can be used to test and develop new algorithms, while the telemetry can be used to monitor the robot, thus validating the framework for this domain. [ABSTRACT FROM AUTHOR]

Background: Recently the Berlin Aging Study II (BASE-II) showed that polypharmacy is associated with clinically relevant sarcopenia among community-dwelling older persons. Here we report findings from the GLISTEN study about the association of polypharmacy with sarcopenia among older medical in-patients. Methods: The GLISTEN study investigated prevalence and clinical correlates of sarcopenia in older patients admitted to geriatric and internal medicine acute care wards of 12 Italian hospitals. Results: In this sample of older medical in-patients with high prevalence of sarcopenia (34.7%) and polypharmacy (70.2%) we did not observe a significant association of polypharmacy with sarcopenia. Conclusions: Present findings demonstrate that the association of polypharmacy with sarcopenia, observed in the BASE-II study, is not evident in the GLISTEN sample, being our patients significantly older, more multi-morbid, with high prevalence of sarcopenia and polypharmacy, suggesting that this association might vary according to the heterogeneous health, functional, and nutritional characteristics of older people. [ABSTRACT FROM AUTHOR]

Purpose: The present work aims at showing how dyspareunia linked to endometriosis can affect the life of fertile age women and how surgical treatment of endometriosis can relieve painful symptoms and consequently improve sex and social life.Methods: From a cohort of 320 women with a clinical and instrumental diagnosis of pelvic endometriosis, 67 patients were selected. These patients had deep dyspareunia that underwent laparoscopic surgical treatment. All the patients had filled out a pre- and post-surgery questionnaire.Results: Six months after laparoscopic treatment, a significant reduction of dyspareunia was recorded, per VAS scores. A statistically significant improvement in sex life was observed between the pre- and post-surgical condition: in particular, an increased number of coituses and of non-difficult coituses, a higher number of patients who declared that pain did not negatively affect sexual pleasure and of patients achieving orgasm.Conclusions: The quality of the sex life in patients with endometriosis and dyspareunia showed significant improvement 6 months after laparoscopic treatment. In view of the diagnostic delay characterizing this disease and confirmed by our results, it is essential to involve a multidisciplinary team to assess all the signs and symptoms of endometriosis that may appear in a women of fertile age. This clinical approach is able to ensure a treatment that is as personalized as possible and an appropriate follow-up also with the objective of preserving reproductive performance. [ABSTRACT FROM AUTHOR]

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Purpose: To assess the efficacy, usability and tolerability of a dynamic orthosis compared with a standard plaster splint after the reconstruction of elbow medial or lateral collateral ligaments (MCL, LCL). Methods: Twenty-six subjects undergoing MCL ( n = 23) or LCL ( n = 3) reconstruction were randomly assigned to immobilization with an orthosis ( n = 13; group A 'Innovator X') or with a plaster splint ( n = 13; group B 'Plaster splint'). Outcome measures were visual analogue scale pain score, mid-arm (MA) circumference, grip strength, Oxford elbow score (OES) and range of motion (ROM). Patients were assessed at baseline and at 2, 6, 12 and 24 weeks. Results: Significant pain reduction was reported by all patients at 6, 12 and 24 weeks ( p < 0.05). Mean MA circumference was significantly higher in group A at all time points (all p < 0.05). Mean grip strength was greater in group A on weeks 2 and 6 ( p < 0.05), whereas the difference found on weeks 12 and 24 was not significant. The OES and passive ROM values of the two groups were not significantly different at any time point. Conclusions: The dynamic orthosis and the plaster splint both provided effective and safe elbow immobilization after MCL or LCL reconstruction. The orthosis provided greater pain reduction, faster recovery of muscle trophism and grip strength, and was better tolerated. [ABSTRACT FROM AUTHOR]

Incidental clinical observations suggest that buffering substances may accumulate in the distal esophagus of patients with systemic sclerosis. The aim of our study was to assess if the buffering capacity of the intraesophageal milieu is increased in patients with systemic sclerosis and if this effect can be correlated to some pathophysiological aspects of the disease. We recorded intraesophageal pH before and during a 10-min intraesophageal infusion of acid (HCl 0.01 N, 1 ml/min), as well as esophageal motility and clearance function, in 16 patients with systemic sclerosis and 10 healthy subjects. Esophageal buffering capacity expressed as the area under the curve of intraesophageal pH during acid infusion was significantly higher in the patients than in the controls, and this variable was directly correlated with esophageal clearing time. In conclusion, esophageal buffering capacity is increased in patients with systemic sclerosis and is possibly the consequence of the accumulation of buffering substances in the distal esophagus. [ABSTRACT FROM AUTHOR]