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In the last two decades, a growing interest has been focused on gait and balance robot-assisted rehabilitation in children with neurological disabilities. Robotic devices allow the implementation of intensive, task-specific training fostering functional recovery and neuroplasticity phenomena. However, limited attention has been paid to the protocols used in this research framework. This systematic review aims to provide an overview of the existing literature on robotic systems for the rehabilitation of gait and balance in children with neurological disabilities and their rehabilitation applications. The literature search was carried out independently and synchronously by three authors on the following databases: MEDLINE, Cochrane Library, PeDro, Institute of Electrical and Electronics Engineers, ScienceDirect, and Google Scholar. The data collected included three subsections referring to clinical, technical, and regulatory aspects. Thirty-one articles out of 81 found on the primary literature search were included in the systematic review. Most studies involved children with cerebral palsy. Only one-third of the studies were randomized controlled trials. Overall, 17 devices (nine end-effector systems and eight exoskeletons) were investigated, among which only 4 (24%) were bore the CE mark. Studies differ on rehabilitation protocols duration, intensity, and outcome measures. Future research should improve both rehabilitation protocols' and devices' descriptions. [ABSTRACT FROM AUTHOR]

The article deals with the theme of Transhumanism from a scientific point of view by briefly presenting four aspects that help to define this cultural movement. First of all, the development of artificial intelligence and its interaction and coexistence with humans is taken into consideration. Secondly, it is about the synthetic meat produced in laboratory and its relationship with life. We then move on to the presentation of the topic of human enhancement, achieved in particular by pharmacological means, and its promises of a fullness of life otherwise unattainable. Finally, the article treats of the issue of cyborgs, cybernetic organisms produced by the hybridization of living beings and machines, and of their possibility of giving birth to a human existence that promises to be better, but also perhaps no longer simply human. [ABSTRACT FROM AUTHOR]

Artificial intelligence is changing the world: every human activity, from medicine to national security, is undergoing profound transformations. In the face of this deluge of artificial intelligence, the ethical issue is urgent. The more universal the AI becomes, the more it is necessary to develop a new universal language that knows how to manage innovation, that of algor-ethics. The algorithms work on numerical values. Ethics, on the other hand, speaks of moral value. We must establish a language that can translate moral value into something computable for the machine. The perception of ethical value is a purely human ability. The ability to work with numerical values is instead the ability of the machine. The algor-ethics arises if we are able to transform moral value into something computable. [ABSTRACT FROM AUTHOR]

Looking at the great transformations that this new stage of technology is producing, I ask if these 'new artefacts 'are simply instruments or perhaps also 'sites' of our life that demand new anthropological and theological reflection. To do this 1 shall first introduce some new artefacts that seem to be key elements of these transformations and secondly I shall try to bring out some of the questions or issues the achievements of these technologies presents to philosophical and theological investigation. The conclusions seek to highlight how, in order to engage with the challenges technology confronts us with, we must first understand it not only as an instrument but also as a theological 'site'. In order to live in today's world we are called upon to reformulate the truths of the faith in a way that allows them to illuminate and give meaning to these 'new artefacts 'and the challenges these present. We are called upon to think theologically about technology also to understand more deeply the mystery of God and the human vocation. In addition, technological developments on these unexplored frontiers requires more than ever today interdisciplinary debates and contributions, including those of theology, if we are tofind adequate ends for the innumerable means it has at its disposal. [ABSTRACT FROM AUTHOR]

This article aims at replying to the proposal advanced by Aristide Fumagalli, moving from what the Author identifies as the nature of conjugal love. The 'nature' of conjugal love both justifies and upholds the task of the Church in its teachings on matrimony. The inevitable question that has to be asked is how to go about this task in today's world; what are the challenges to be faced and which cultural situations can either favour or obstruct this mission. It is of vital importance to know how to promote a healthy view of sexuality, because this is instrumental in living and expressing an all-round vision of love in the married state. [ABSTRACT FROM AUTHOR]

The author discusses the Catholic vision of fundamentalism and intolerance taking into account three elements: the experience of Christian faith in history; Fundamentalism as a 'malfunction' in the dynamics of faith and complementarity between fundamentalism and intolerance. [ABSTRACT FROM AUTHOR]

Chiavacci saw the birth and development of Bioethics, a discipline that changed the panorama of Moral Philosophy and Theological Ethics. The new discipline influenced Chiavacci, and on the other hand his thought contributed to its development. In the intellectual itinerary of the theologian that leads from the Moral Theology of the physical life to Bioethics, is perceived many other requests present in Gaudium et Spes, in particular the constant attention for the hiatus between evangelical values and contemporary culture, a cordial and vigilant pastoral spirit that aims at interpreting the signs of the times. The work of Chiavacci can thus be synthesized with the very title of the Pastoral Constitution: not a message of the Church to the contemporary world, but a thought aiming at being the Church in the contemporary world. [ABSTRACT FROM AUTHOR]

Cyborg and human enhancement. Mainlines for an ethical-theological evaluation. During the 1960s two researchers – Manfred E. Clynes and Nathan S. Kline – joined the two terms cybernetic and organism thus coining the term cyborg. Their study intended to investigate which opportunities were available for human journeys into the extraterrestrial space resulting into a future colonization of other planets. Since then this term went through a complex evolution until it assumed the meaning of human improvement achieved through technology. This study analyses this path and proposes a possible ethical and theological analysis on the questions rising from the interaction between man and technology and resulting into human enhancement. In its specific ethical-theological part this text presents a few subjects currently used in the ethical analysis of both cyborg and human enhancement. Finally this contribution presents a proposal on how these processes may be dealt with. [ABSTRACT FROM AUTHOR]

The note offers a brief synthesis of the Seminar of ATISM [Association for the study of Moral Theology (Associazione teologica per lo studio della morale)] which was held at Brescia on July 2-5, 2013 on the theme, Moral theology and spiritual theology: intersections and parallels [Teologia morale e teologia spiritual: intersezioni e parallelismi]. In the course of the work were presented the following relations: Donna Orsuto, on the theme of the conference; Diego Facchetti, on the work of Tullo Goffi (1916-1996); Basilio Petrà (An Outlook of moral theology on spiritual theology); Ezio Bolis (The Outlook of spiritual theology on moral theology); Jesus Manuel Garcia (Promising prospects and guidelines for work through the relationship between spiritual theology and moral theology); Giuseppe Trentin (Moral theology and spiritual theology: problematic junctions and future horizons). In addition to the contents of the relations, significant contributions that emerged from group work are outlined. [ABSTRACT FROM AUTHOR]

Background: Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has been considered only in a few recent studies., Objective: To verify whether, in the current state of the literature, cognitive measures are used as inclusion or exclusion criteria and/or outcomes measures in robotic upper limb rehabilitation in stroke patients., Methods: The systematic review was conducted according to PRISMA guidelines. Studies eligible were identified through PubMed/MEDLINE and Web of Science from inception to March 2021., Results: Eighty-one studies were considered in this systematic review. Seventy-three studies have at least a cognitive inclusion or exclusion criteria, while only seven studies assessed cognitive outcomes., Conclusion: Despite the high presence of cognitive instruments used for inclusion/exclusion criteria their heterogeneity did not allow the identification of a guideline for the evaluation of patients in different stroke stages. Therefore, although the heterogeneity and the low percentage of studies that included cognitive outcomes, seemed that the latter were positively influenced by RT in post-stroke rehabilitation. Future larger RCTs are needed to outline which cognitive scales are most suitable and their cut-off, as well as what cognitive outcome measures to use in the various stages of post-stroke rehabilitation.

Background: Robot-based treatments are developing in neurorehabilitation settings. Recently, the Italian National Health Systems recognized robot-based rehabilitation as a refundable service. Thus, the Italian neurorehabilitation community promoted a national consensus on this topic., Objective: To conceptualize undisclosed perspectives for research and applications of robotics for neurorehabilitation, based on a qualitative synthesis of reference theoretical models., Methods: A scoping review was carried out based on a specific question from the consensus Jury. A foreground search strategy was developed on theoretical models (context) of robot-based rehabilitation (exposure), in neurological patients (population). PubMed and EMBASE® databases were searched and studies on theoretical models of motor control, neurobiology of recovery, human-robot interaction and economic sustainability were included, while experimental studies not aimed to investigate theoretical frameworks, or considering prosthetics, were excluded., Results: Overall, 3699 records were screened and finally 9 papers included according to inclusion and exclusion criteria. According to the population investigated, structured information on theoretical models and indications for future research was summarized in a synoptic table., Conclusion: The main indication from the Italian consensus on robotics in neurorehabilitation is the priority to design research studies aimed to investigate the role of robotic and electromechanical devices in promoting neuroplasticity.

Background: Robot-assisted arm therapy (RAT) has been used mainly in stroke rehabilitation in the last 20 years with rising expectations and growing evidence summarized in systematic reviews (SRs)., Objective: The aim of this study is to provide an overview of SRs about the effectiveness, within the ICF domains, and safety of RAT in the rehabilitation of adult with stroke compared to other treatments., Methods: The search strategy was conducted using search strings adapted explicitly for each database. A screening base on title and abstract was realized to find all the potentially relevant studies. The methodological quality of the included SRs was assessed using AMSTAR-2. A pre-determined standardized form was used to realize the data extraction., Results: 18 SRs were included in this overview. Generally, positive effects from the RAT were found for motor function and muscle strength, whereas there is no agreement for muscle tone effects. No effect was found for pain, and only a SR reported the positive impact of RAT in daily living activity., Conclusion: RAT can be considered a valuable option to increase motor function and muscle strength after stroke. However, the poor quality of most of the included SRs could limit the certainty around the results.

Background: Robot-assisted Arm Therapy (RAT) has been increasingly applied in the last years for promoting functional recovery in patients with disabilities related to neurological health conditions. Evidence of a knowledge-to-action gap for applying robot-assisted technologies in the rehabilitation of patients with neurological health conditions and the difficulty to apply and tailor the knowledge to the local contexts solicited the need for a national consensus conference on these interventions., Aim: The aim of this paper was to explain the methodology used by the working group dedicated to synthesizing evidence on the effectiveness of RAT in neurological health conditions in the context of the CICERONE Italian Consensus Conference., Design: The methodological approach of the working group., Setting: All rehabilitation settings., Population: Patients with disability following a neurological health condition., Methods: Following the indications proposed by the Methodological Manual published by the Italian National Institute of Health, a Promoting Committee and a Technical Scientific Committee have been set up. Six working groups (WGs) have been composed to collect evidence on different questions, among which WG2.2 was focused on the effectiveness of RAT in neurological health conditions., Results: WG2.2 started its work defining the specific research questions. It was decided to adopt the ICF as the reference framework for the reporting of all outcomes. Literature search, data extraction and qualitative assessment, evidence analysis and synthesis have been performed., Conclusions: This paper summarized the methodological approaches used by the WG2.2 of the CICERONE Italian Consensus Conference to define the effectiveness of RAT in the management of patients with neurological health conditions., Clinical Rehabilitation Impact: WG2.2 synthesis might help clinicians, researchers, and all rehabilitation stakeholders to address the use of RAT in the Individualized Rehabilitation Plan, to guide the allocation of resources and define clinical protocols and indications for the management of patients with different neurological health conditions.

Introduction: There is growing evidence on the efficacy of gait robotic rehabilitation in patients with multiple sclerosis (MS), but most of the studies have focused on gait parameters. Moreover, clear indications on the clinical use of robotics still lack. As part of the CICERONE Italian Consensus on Robotic Rehabilitation, the aim of this systematic review was to investigate the existing evidence concerning the role of lower limb robotic rehabilitation in improving functional recovery in patients with MS., Evidence Acquisition: We searched for and systematically reviewed evidence-based studies on gait robotic rehabilitation in MS, between January 1 st , 2010 and December 31 st , 2020, in the following databases: Cochrane Library, PEDro, PubMed and Google Scholar. The study quality was assessed by the 16-item assessment of multiple systematic reviews 2 (AMSTAR 2) and the 10-item PEDro scale for the other research studies., Evidence Synthesis: After an accurate screening, only 17 papers were included in the review, and most of them (13 RCT) had a level II evidence. Most of the studies used the Lokomat as a grounded robotic device, two investigated the efficacy of end-effectors and two powered exoskeletons. Generally speaking, robotic treatment has beneficial effects on gait speed, endurance and balance with comparable outcomes to those of conventional treatments. However, in more severe patients (EDSS >6), robotics leads to better functional outcomes. Notably, after gait training with robotics (especially when coupled to virtual reality) MS patients also reach better non-motor outcomes, including spasticity, fatigue, pain, psychological well-being and quality of life. Unfortunately, no clinical indications emerge on the treatment protocols., Conclusions: The present comprehensive systematic review highlights the potential beneficial role on functional outcomes of the lower limb robotic devices in people with MS. Future studies are warranted to evaluate the role of robotics not only for walking and balance outcomes, but also for other gait-training-related benefits, to identify appropriate outcome measures related to a specific subgroup of MS subjects' disease severity.

Introduction: The rapid development of electromechanical and robotic devices has profoundly influenced neurorehabilitation. Growth in the scientific and technological aspects thereof is crucial for increasing the number of newly developed devices, and clinicians have welcomed such growth with enthusiasm. Nevertheless, improving the standard for the reporting clinical, technical, and normative aspects of such electromechanical and robotic devices remains an unmet need in neurorehabilitation. Accordingly, this study aimed to analyze the existing literature on electromechanical and robotic devices used in neurorehabilitation, considering the current clinical, technical, and regulatory classification systems., Evidence Acquisition: Within the CICERONE Consensus Conference framework, studies on electromechanical and robotic devices used for upper- and lower-limb rehabilitation in persons with neurological disabilities in adulthood and childhood were reviewed. We have conducted a literature search using the following databases: MEDLINE, Cochrane Library, PeDro, Institute of Electrical and Electronics Engineers, Science Direct, and Google Scholar. Clinical, technical, and regulatory classification systems were applied to collect information on the electromechanical and robotic devices. The study designs and populations were investigated., Evidence Synthesis: Overall, 316 studies were included in the analysis. More than half (52%) of the studies were randomised controlled trials (RCTs). The population investigated the most suffered from strokes, followed by spinal cord injuries, multiple sclerosis, cerebral palsy, and traumatic brain injuries. In total, 100 devices were described; of these, 19% were certified with the CE mark. Overall, the main type of device was an exoskeleton. However, end-effector devices were primarily used for the upper limbs, whereas exoskeletons were used for the lower limbs (for both children and adults)., Conclusions: The current literature on robotic neurorehabilitation lacks detailed information regarding the technical characteristics of the devices used. This affects the understanding of the possible mechanisms underlying recovery. Unfortunately, many electromechanical and robotic devices are not provided with CE marks, strongly hindering the research on the clinical outcomes of rehabilitation treatments based on these devices. A more significant effort is needed to improve the description of the robotic devices used in neurorehabilitation in terms of the technical and functional details, along with high-quality RCT studies.

Introduction: Stroke is the third leading cause of adult disability worldwide, and lower extremity motor impairment is one of the major determinants of long-term disability. Although robotic therapy is becoming more and more utilized in research protocols for lower limb stroke rehabilitation, the gap between research evidence and its use in clinical practice is still significant. The aim of this study was to determine the scope, quality, and consistency of guidelines for robotic lower limb rehabilitation after stroke, in order to provide clinical recommendations., Evidence Acquisition: We systematically reviewed stroke rehabilitation guideline recommendations between January 1, 2010 and October 31, 2020. We explored electronic databases (N.=4), guideline repositories and professional rehabilitation networks (N.=12). Two independent reviewers used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, and brief syntheses were used to evaluate and compare the different recommendations, considering only the most recent version., Evidence Synthesis: From the 1219 papers screened, ten eligible guidelines were identified from seven different regions/countries. Four of the included guidelines focused on stroke management, the other six on stroke rehabilitation. Robotic rehabilitation is generally recommended to improve lower limb motor function, including gait and strength. Unfortunately, there is still no consensus about the timing, frequency, training session duration and the exact characteristics of subjects who could benefit from robotics., Conclusions: Our systematic review shows that the introduction of robotic rehabilitation in standard treatment protocols seems to be the future of stroke rehabilitation. However, robot assisted gait training (RAGT) for stroke needs to be improved with new solutions and in clinical practice guidelines, especially in terms of applicability.