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BackgroundType 2 diabetes mellitus (T2D) is a common age-related disease, and is a major health concern, particularly in developed countries where the population is aging, including Europe. The multi-scale immune system simulator for the onset of type 2 diabetes (MISSION-T2D) is a European Union-funded project that aims to develop and validate an integrated, multilevel, and patient-specific model, incorporating genetic, metabolic, and nutritional data for the simulation and prediction of metabolic and inflammatory processes in the onset and progression of T2D. The project will ultimately provide a tool for diagnosis and clinical decision making that can estimate the risk of developing T2D and predict its progression in response to possible therapies. Recent data showed that T2D and its complications, specifically in the heart, kidney, retina, and feet, should be considered a systemic disease that is sustained by a pervasive, metabolically-driven state of inflammation. Accordingly, there is an urgent need (1) to understand the complex mechanisms underpinning the onset of this disease, and (2) to identify early patient-specific diagnostic parameters and related inflammatory indicators. ObjectiveWe aim to accomplish this mission by setting up a multi-scale model to study the systemic interactions of the biological mechanisms involved in response to a variety of nutritional and metabolic stimuli and stressors. MethodsSpecifically, we will be studying the biological mechanisms of immunological/inflammatory processes, energy intake/expenditure ratio, and cell cycle rate. The overall architecture of the model will exploit an already established immune system simulator as well as several discrete and continuous mathematical methods for modeling of the processes critically involved in the onset and progression of T2D. We aim to validate the predictions of our models using actual biological and clinical data. ResultsThis study was initiated in March 2013 and is expected to be completed by February 2016. ConclusionsMISSION-T2D aims to pave the way for translating validated multilevel immune-metabolic models into the clinical setting of T2D. This approach will eventually generate predictive biomarkers for this disease from the integration of clinical data with metabolic, nutritional, immune/inflammatory, genetic, and gut microbiota profiles. Eventually, it should prove possible to translate these into cost-effective and mobile-based diagnostic tools.

Carlucci, F, Mazza, C, and Cappozzo, A. Does whole-body vibration training have acute residual effects on postural control ability of elderly women? J Strength Cond Res 24(12): 3363-3368, 2010--The purpose of this study was to investigate acute residual effects of a single vibration session on balance control in a group of elderly women. Several studies, in fact, have shown that whole-body vibration (WBV) training may improve balance in the elderly, but possible side effects of acute exposure to WBV, such as temporary reduction of balance control ability because of perturbations of the vestibular system, have not been investigated. Twenty-two healthy elderly women (71.8 [+ or -] 4.7 years of age) were trained with a 9.5-minute bout of static and dynamic knee-extensor exercises executed on a vibrating platform (Well-net Vibe Revolution). The vibration frequency was set at 35 Hz. A subgroup of 14 subjects performed the same exercise protocol also without the vibrations to discriminate between vibration and exercise effects. Balance control ability was assessed through computerized posturography: a force plate (Bertec Co, Columbus, OH, USA) was used to measure the center of pressure trajectories during 4 different experimental trials: before, immediately after, 15 minutes after, and 60 minutes after the training. A set of postural parameters, typically adopted to assess elderly subjects, was then computed and 2-way analysis of variance was used to determine differences between values found in the 4 postural tests (level of significance p = 0.05) in the 2 groups. The results showed no significant variations in the postural parameters recorded during the 4 sessions. A significant group effect was found for 2 postural parameters, with no interaction between the 2 factors. In conclusion, the proposed single bout of WBV does not induce dangerous acute effects on elderly women balance control ability and could be safely administered as part of a long-term intervention program. KEY WORDS whole-body vibrations, vibration platforms, posturography, balance control

The analysis of the mechanics of the musculo-skeletal system during the execution of a motor task requires the determination of the instantaneous position and orientation of the body segments involved in relation to an inertial system of reference. By using adequately assembled uniaxial accelerometric sensors, an easy-to-manage measurement system can be obtained that estimates the three-dimensional position and orientation (P&O) of a body segment through an appropriate analytical model. However, the extent to which experimental errors, in particular accelerometers (ACs) assembly inaccuracies, affect such estimation has never been systematically investigated. This paper systematically analyzes the sensitivity of analytical models of body segment P&O reconstruction through a six-AC system and a nine-AC system to different sources of experimental error. We simulated and statistically assessed the performance of these models in the case of body segment motions typical of movements under muscular control. The results obtained indicated that the inaccuracy in the orientation of the individual AC's active axes and the offset error in the AC responses were the major sources of P&O estimation errors. In particular, no accurate estimation of position was possible with the analytical models analyzed. Under the motion conditions simulated in this study, no substantial advantages were found in using a nine-AC system rather than a six-AC system. Considering that the magnitudes of the simulated experimental errors were quite low ([less than or equal to] 0.1 deg: AC's orientation; [less than or equal to] [10.sup.-4] m: uncertainty of the distance between two ACs; [less than or equal to] [10.sup.-2] [ms.sup.-2]: random error; 0.5*[10.sup.-2] [ms.sup.-2]: offset error), the results indicate that none of the two ACs systems analyzed is suitable for body segment P&O estimation in routine biomechanical applications. Index Terms--accelerometer, accuracy, human movement analysis, simulation, 3-D rigid body position and orientation.

When three-dimensional (3-D) human or animal movement is recorded using a photogrammetric system, bone-embedded frame positions and orientations are estimated from reconstructed surface marker trajectories using either nonoptimal or optimal algorithms. The effectiveness of these mathematical procedures in accommodating for both photogrammetric errors and skin movement artifacts depends on the number of markers associated with a given bone as well as on the size and shape characteristics of the relevant cluster. One objective of this paper deals with the identification of marker-cluster design criteria aimed at the minimization of error propagation from marker coordinates to bone-embedded frame position and orientation. Findings allow for the quantitative estimation of these errors for any given cluster configuration and suggest the following main design criteria. A cluster made up of four markers represents a good practical compromise. Planar clusters are acceptable, provided in quasi-isotropic distribution. The root mean square distance of the markers from their centroid should be greater than ten times the standard deviation of the marker position error. The second objective of this paper deals with the identification of the optimal cluster position and orientation on the limb aimed at the minimization of error propagation to anatomical landmark laboratory coordinates. Cluster position should be selected to minimize skin movement artifacts. The longest principal axis of the marker distribution should be oriented toward the relevant anatomical landmark position. Index Terms - Cluster design, error propagation, singular value decomposition, stereophotogrammetry, surface-marker cluster, 3-D bone movement.

Abstract Background The control of the head movements during walking allows for the stabilisation of the optic flow, for a more effective processing of the vestibular system signals, and for the consequent control of equilibrium. In young individuals, the oscillations of the upper body during level walking are characterised by an attenuation of the linear acceleration going from pelvis to head level. In elderly subjects the ability to implement this motor strategy is reduced. The aim of this paper is to go deeper into the mechanisms through which the head accelerations are controlled during level walking, in both young and elderly women specifically. Methods A stereophotogrammetric system was used to reconstruct the displacement of markers located at head, shoulder, and pelvis level while 16 young (age: 24 ± 4 years) and 20 older (age: 72 ± 4 years) female volunteers walked at comfortable and fast speed along a linear pathway. The harmonic coefficients of the displacements in the medio-lateral (ML), antero-posterior (AP), and vertical (V) directions were calculated via discrete Fourier transform, and relevant accelerations were computed by analytical double differentiation. The root mean square of the accelerations were used to define three coefficients for quantifying the attenuations of the accelerations from pelvis to head, from pelvis to shoulder, and from shoulder to head. Results The coefficients of attenuation were shown to be independent from the walking speed, and hence suitable for group and subject comparison. The acceleration in the AP direction was attenuated by the two groups both from pelvis to shoulder and from shoulder to head. The reduction of the shoulder to head acceleration, however, was less effective in older women, suggesting that the ability to exploit the cervical hinge to attenuate the AP acceleration is challenged in this population. Young women managed to exploit a pelvis to shoulder attenuation strategy also in the ML direction, whereas in the elderly group the head acceleration was even larger than the pelvis acceleration. Conclusion The control of the head acceleration is fundamental when implementing a locomotor strategy and its loss could be one of the causes for walking instability in elderly women.

The proper execution of the sprint start is crucial in determining the performance during a sprint race. In this respect, when moving from the crouch to the upright position, trunk kinematics is a key element. The purpose of this study was to validate the use of a trunk-mounted inertial measurement unit (IMU) in estimating the trunk inclination and angular velocity in the sagittal plane during the sprint start. In-laboratory sprint starts were performed by five sprinters. The local acceleration and angular velocity components provided by the IMU were processed using an adaptive Kalman filter. The accuracy of the IMU inclination estimate and its consistency with trunk inclination were assessed using reference stereophotogrammetric measurements. A Bland-Altman analysis, carried out using parameters (minimum, maximum, and mean values) extracted from the time histories of the estimated variables, and curve similarity analysis (correlation coefficient > 0.99, root mean square difference < 7 deg) indicated the agreement between reference and IMU estimates, opening a promising scenario for an accurate in-field use of IMUs for sprint start performance assessment. [ABSTRACT FROM AUTHOR]

Abstract Background: In gait analysis, walking is assumed to be periodic for the sake of simplicity, despite the fact that, strictly speaking, it can only approximate periodicity and, as such, may be referred to as pseudo-periodic. This study aims at: 1) quantifying gait pseudo-periodicity using information concerning a single stride; 2) investigating the effects of walking pathway length on gait periodicity; 3) investigating separately the periodicity of the upper and lower body parts movement; 4) verifying the validity of foot-floor contact events as markers of the gait cycle period. Methods: Ten young healthy subjects (6 males, 23 ± 5 years) were asked to perform various gait trials, first along a 20-m pathway that allowed reaching a steady-state condition, and then along an 8-m pathway. A stereophotogrammetric system was used to reconstruct the 3D position of reflective markers distributed over the subjects' body. Foot contact was detected using an instrumented mat. Three marker clusters were used to represent the movement of the whole body, the upper body (without upper limbs), and the lower body, respectively. Linear and rotational kinetic, and gravitational and elastic potential "energy-like" quantities were used to calculate an index J(t) that described the instantaneous "mechanical state" of the analysed body portion. The variations of J(t) in time allowed for the determination of the walking pseudo-period and for the assessment of gait aperiodicity. Results: The suitability of the proposed approach was demonstrated, and it was shown that, for young, healthy adults, a threshold of physiological pseudo-periodicity of walking at natural speed could be set. Higher pseudo-periodicity values were found for the shorter pathway only for the upper body. Irrespective of pathway length, the upper body had a larger divergency from periodicity than the lower body. The error that can be made in estimating the gait cycle duration for the upper body from the heel contacts was shown to be significant. Conclusion: The proposed method can be easily implemented in gait laboratories to verify the consistency of a recorded stride with the hypothesis of periodicity.

Abstract Background The assessment of the accuracy of the pose estimation of human bones and consequent joint kinematics is of primary relevance in human movement analysis. This study evaluated the performance of selected pose estimators in reducing the effects of instrumental errors, soft tissue artifacts and anatomical landmark mislocations occurring at the thigh on the determination of the knee kinematics. Methods The pattern of a typical knee flexion-extension during a gait cycle was fed into a knee model which generated a six-components knee kinematics and relevant marker trajectories. The marker trajectories were corrupted with both instrumental noise and soft tissue artifacts. Two different cluster configurations (4 and 12-marker cluster) were investigated. Four selected pose estimators, a Geometrical method, a SVD-based method, and the Pointer Cluster Technique in the optimized and non optimized version, were analyzed. The estimated knee kinematics were compared to the nominal kinematics in order to evaluate the accuracy of the selected pose estimators. Results Results have shown that optimal pose estimators perform better than traditional geometric pose estimators when soft tissue artifacts are present. The use of redundant markers improved in some cases the estimation of the dynamics of the kinematics patterns, while it does not reduce the offsets from the nominal kinematics curves. Overall, the best performance was obtained by the SVD-based pose estimator, while the performance of the PCT pose estimator in its optimal version was not satisfactory. However, the knee kinematics errors reached 5 deg for rotations and 10 mm for translations). Conclusion Given the favorable experimental conditions of this study (soft tissue artifacts determined from a young, healthy and non overweight subject), the errors found in estimating the knee kinematics have to be considered unsatisfactory even if the best performing pose estimator is used. Therefore, it is the authors' opinion that the movement analysis research community should make additional efforts in the search of more subject specific error models to increase the accuracy of joint kinematics estimations.

Abstract Background The interpretation of data obtained in a movement analysis laboratory is a crucial issue in clinical contexts. Collection of such data in large databases might encourage the use of modern techniques of data mining to discover additional knowledge with automated methods. In order to maximise the size of the database, simple and low-cost experimental set-ups are preferable. The aim of this study was to extract knowledge inherent in the sit-to-stand task as performed by healthy adults, by searching relationships among measured and estimated biomechanical quantities. An automated method was applied to a large amount of data stored in a database. The sit-to-stand motor task was already shown to be adequate for determining the level of individual motor ability. Methods The technique of search for association rules was chosen to discover patterns as part of a Knowledge Discovery in Databases (KDD) process applied to a sit-to-stand motor task observed with a simple experimental set-up and analysed by means of a minimum measured input model. Selected parameters and variables of a database containing data from 110 healthy adults, of both genders and of a large range of age, performing the task were considered in the analysis. Results A set of rules and definitions were found characterising the patterns shared by the investigated subjects. Time events of the task turned out to be highly interdependent at least in their average values, showing a high level of repeatability of the timing of the performance of the task. Conclusions The distinctive patterns of the sit-to-stand task found in this study, associated to those that could be found in similar studies focusing on subjects with pathologies, could be used as a reference for the functional evaluation of specific subjects performing the sit-to-stand motor task.

Assessing movement skills is a fundamental issue in motor development. Current process-oriented assessments, such as developmental sequences, are based on subjective judgments; if paired with quantitative assessments, a better understanding of movement performance and developmental change could be obtained. Our purpose was to examine the use of inertial sensors to evaluate developmental differences in hopping over distance. Forty children executed the task wearing the inertial sensor and relevant time durations and 3D accelerations were obtained. Subjects were also categorized in different developmental levels according to the hopping developmental sequence. Results indicated that some time and kinematic parameters changed with some developmental levels, possibly as a function of anthropometry and previous motor experience. We concluded that, since inertial sensors were suitable in describing hopping performance and sensitive to developmental changes, this technology is promising as an in-field and user-independent motor development assessment tool. [ABSTRACT FROM AUTHOR]