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Skeletal muscle atrophy is characterized by a decrease in muscle mass and strength caused by an imbalance in protein synthesis and degradation. This process naturally occurs upon reduced or absent physical activity, often related to illness, forced bed rest, or unhealthy lifestyles. Currently, no treatment is available for atrophy, and it can only be prevented by overloading exercise, causing severe problems for patients who cannot exercise due to chronic diseases, disabilities, or being bedridden. The two murine models commonly used to induce muscle atrophy are hindlimb suspension and ankle joint immobilization, both of which come with criticalities. The lack of treatments and the relevance of this atrophic process require a unilateral, safe, and robust model to induce muscle atrophy. In this work, we designed and developed a 3D-printed cast to be used for the study of disuse skeletal muscle atrophy. Applying two halves of the cast is non-invasive, producing little to no swelling or skin damage. The application of the cast induces, in 2-weeks immobilized leg, the activation of atrophy-related genes, causing a muscle weight loss up to 25% in the gastrocnemius muscle, and 31% in the soleus muscle of the immobilized leg compared to the control leg. The cross-sectional area of the fibers is decreased by 31% and 34% respectively, with a peculiar effect on fiber types. In the immobilized gastrocnemius, absolute muscle force is reduced by 38%, while normalized force is reduced by 16%. The contralateral leg did not show signs of overload or hypertrophy when compared to free roaming littermates, offering a good internal control over the immobilized limb. Upon removing the cast, the mice effectively recovered mass and force in 3 weeks. [ABSTRACT FROM AUTHOR]

When encountering a family struggling with the human dimensions of dying, the family therapist cannot help but ask himself fundamental questions with profound ethical implications: how and when it is best to mend the split between medical time and the psychic times of the family? How can we support the freedom of choice both of the individual and the system when these do not coincide? Every functional loss dictated by the disease requires more caregivers and equipment which must be added: how and to what extent can the family integrate them? How can the therapist manage the Use of Self when dealing with constant losses? Does it make sense to offer psychotherapy, and on what dimensions does it have to work? Through the reflections on the clinical processes conducted by the Mourning team of the Clinical Center of the Accademia di psicoterapia della famiglia in Rome, the goal of our work has become to identify and strengthen the elements that allow the therapeutic system to keep on working with the vital processes of the family. The unsettling process of dying force the therapeutic system -- which in our thinking includes enlarged family, friends and therapists -- into continuous adaptive change; only by tolerating impotence and be willing to learn from this painful experience can the destructuring loss also became an opportunity to reconstruct new ways of communicating, of being, of living. Rebuilding relationships, seeking and fortifying intact resources, working on the meanings of Time and the conscious choice of how to live it, are the core of our clinical work. The therapeutic relationship is the elective place of this process of mutual learning that allows the family to know and recognize each other even within the new boundaries imposed by the disease and lead the therapists towards new edges of themselves and of what can be considered therapeutic. [ABSTRACT FROM AUTHOR]

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