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1. Hardware implementation of quantum stabilizers in superconducting circuits

Author

Dodge, K., Liu, Y., Klots, A. R., Cole, B., Shearrow, A., Senatore, M., Zhu, S., Ioffe, L. B., McDermott, R., and Plourde, B. L. T.

Subjects
Quantum Physics, Condensed Matter - Superconductivity
Abstract

Stabilizer operations are at the heart of quantum error correction and are typically implemented in software-controlled entangling gates and measurements of groups of qubits. Alternatively, qubits can be designed so that the Hamiltonian corresponds directly to a stabilizer for protecting quantum information. We demonstrate such a hardware implementation of stabilizers in a superconducting circuit composed of chains of $\pi$-periodic Josephson elements. With local on-chip flux- and charge-biasing, we observe a softening of the energy band dispersion with respect to flux that is exponential in the number of frustrated plaquette elements, in close agreement with our numerical modeling., Comment: 6+30 pages, 4+18 figures, 0+6 tables, published version

Published
2023
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3. Effectiveness of robot-assisted arm therapy in stroke rehabilitation: An overview of systematic reviews

Author

Straudi S., Baluardo L., Arienti C., Bozzolan M., Lazzarini S. G., Agostini M., Aprile I., Paci M., Casanova E., Marino D., La Rosa G., Bressi F., Sterzi S., Giansanti D., Perrero L., Battistini A., Miccinilli S., Filoni S., Sicari M., Petrozzino S., Solaro C. M., Gargano S., Benanti P., Boldrini P., Bonaiuti D., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzoleni S., Mazzon S., Molteni F., Petrarca M., Picelli A., Posteraro F., Senatore M., Turchetti G., Morone G., Palomba A., Cinnera AM, Desilvestri M., Bravi M., Bruno D., Santacaterina F., Pecchioli C., Gandolfi M., Russo EF, Boetto V., Straudi, S., Baluardo, L., Arienti, C., Bozzolan, M., Lazzarini, S. G., Agostini, M., Aprile, I., Paci, M., Casanova, E., Marino, D., La Rosa, G., Bressi, F., Sterzi, S., Giansanti, D., Perrero, L., Battistini, A., Miccinilli, S., Filoni, S., Sicari, M., Petrozzino, S., Solaro, C. M., Gargano, S., Benanti, P., Boldrini, P., Bonaiuti, D., Castelli, E., Draicchio, F., Falabella, V., Galeri, S., Gimigliano, F., Grigioni, M., Mazzoleni, S., Mazzon, S., Molteni, F., Petrarca, M., Picelli, A., Posteraro, F., Senatore, M., Turchetti, G., Morone, G., Palomba, A., Cinnera, Am, Desilvestri, M., Bravi, M., Bruno, D., Santacaterina, F., Pecchioli, C., Gandolfi, M., Russo, Ef, and Boetto, V.

Subjects
Stroke, robot-assisted arm therapy, exoskeleton device, exoskeleton devices, end-effector device, arm rehabilitation, end-effector devices
Abstract

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.

Published
2022

4. Robot-assisted gait training in patients with Parkinson's disease: Implications for clinical practice. A systematic review

Author

Carmignano, S, Fundaro, C, Bonaiuti, D, Calabro, R, Cassio, A, Mazzoli, D, Bizzarini, E, Campanini, I, Cerulli, S, Chisari, C, Colombo, V, Dalise, S, Gazzotti, V, Mazzoleni, D, Mazzucchelli, M, Melegari, C, Merlo, A, Stampacchia, G, Boldrini, P, Mazzoleni, S, Posteraro, F, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Morone, G, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Andrenelli, E, Carmignano S. M., Fundaro C., Bonaiuti D., Calabro R. S., Cassio A., Mazzoli D., Bizzarini E., Campanini I., Cerulli S., Chisari C., Colombo V., Dalise S., Gazzotti V., Mazzoleni D., Mazzucchelli M., Melegari C., Merlo A., Stampacchia G., Boldrini P., Mazzoleni S., Posteraro F., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Morone G., Petrarca M., Picelli A., Senatore M., Turchetti G., Andrenelli E., Carmignano, S, Fundaro, C, Bonaiuti, D, Calabro, R, Cassio, A, Mazzoli, D, Bizzarini, E, Campanini, I, Cerulli, S, Chisari, C, Colombo, V, Dalise, S, Gazzotti, V, Mazzoleni, D, Mazzucchelli, M, Melegari, C, Merlo, A, Stampacchia, G, Boldrini, P, Mazzoleni, S, Posteraro, F, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Morone, G, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Andrenelli, E, Carmignano S. M., Fundaro C., Bonaiuti D., Calabro R. S., Cassio A., Mazzoli D., Bizzarini E., Campanini I., Cerulli S., Chisari C., Colombo V., Dalise S., Gazzotti V., Mazzoleni D., Mazzucchelli M., Melegari C., Merlo A., Stampacchia G., Boldrini P., Mazzoleni S., Posteraro F., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Morone G., Petrarca M., Picelli A., Senatore M., Turchetti G., and Andrenelli E.

Abstract

BACKGROUND: Gait impairments are common disabling symptoms of Parkinson's disease (PD). Among the approaches for gait rehabilitation, interest in robotic devices has grown in recent years. However, the effectiveness compared to other interventions, the optimum amount of training, the type of device, and which patients might benefit most remains unclear. OBJECTIVE: To conduct a systematic review about the effects on gait of robot-assisted gait training (RAGT) in PD patients and to provide advice for clinical practice. METHODS: A search was performed on PubMed, Scopus, PEDro, Cochrane library, Web of science, and guideline databases, following PRISMA guidelines. We included English articles if they used a robotic system with details about the intervention, the parameters, and the outcome measures. We evaluated the level and quality of evidence. RESULTS: We included twenty papers out of 230 results: two systematic reviews, 9 randomized controlled trials, 4 uncontrolled studies, and 5 descriptive reports. Nine studies used an exoskeleton device and the remainders end-effector robots, with large variability in terms of subjects' disease-related disability. CONCLUSIONS: RAGT showed benefits on gait and no adverse events were recorded. However, it does not seem superior to other interventions, except in patients with more severe symptoms and advanced disease.

Published
2022

5. Antibody Response to COVID-19 Booster Vaccination in Healthcare Workers

Author

Pani, A, Romandini, A, Schianchi, A, Senatore, M, Gagliardi, O, Gazzaniga, G, Agliardi, S, Conti, T, Schenardi, P, Maggi, M, D'Onghia, S, Panetta, V, Renica, S, Molteni, S, Vismara, C, Campisi, D, Bertuzzi, M, Giroldi, S, Zoppini, L, Moreno, M, Merli, M, Bosio, M, Puoti, M, Scaglione, F, Pani A., Romandini A., Schianchi A., Senatore M., Gagliardi O. M., Gazzaniga G., Agliardi S., Conti T., Schenardi P. A., Maggi M., D'Onghia S., Panetta V., Renica S., Molteni S. N., Vismara C., Campisi D., Bertuzzi M., Giroldi S., Zoppini L., Moreno M., Merli M., Bosio M., Puoti M., Scaglione F., Pani, A, Romandini, A, Schianchi, A, Senatore, M, Gagliardi, O, Gazzaniga, G, Agliardi, S, Conti, T, Schenardi, P, Maggi, M, D'Onghia, S, Panetta, V, Renica, S, Molteni, S, Vismara, C, Campisi, D, Bertuzzi, M, Giroldi, S, Zoppini, L, Moreno, M, Merli, M, Bosio, M, Puoti, M, Scaglione, F, Pani A., Romandini A., Schianchi A., Senatore M., Gagliardi O. M., Gazzaniga G., Agliardi S., Conti T., Schenardi P. A., Maggi M., D'Onghia S., Panetta V., Renica S., Molteni S. N., Vismara C., Campisi D., Bertuzzi M., Giroldi S., Zoppini L., Moreno M., Merli M., Bosio M., Puoti M., and Scaglione F.

Abstract

Objective: To evaluate the mean increase of anti-S IgG antibody titer between the basal, pre-booster level to the titer assessed 14 days after the booster dose of BNT162b2. Patients and Methods: The RENAISSANCE study is an observational, longitudinal, prospective, population-based study, conducted on healthcare workers of Niguarda Hospital in Milan, Italy who received a BNT162b2 booster dose at least 180 days after their second dose or after positivity for SARS-CoV-2 and accepted to take part in the study. The RENAISSANCE study was conducted from January 1, 2021 through December 28, 2021. Findings: 1,738 subjects were enrolled among healthcare workers registered for the booster administration at our hospital. Overall, 0.4% of subjects were seronegative at the pre-booster evaluation, and 1 subject had a titer equal to 50 AU/ml: none of the evaluated subjects was seronegative after the booster dose. Thus, the efficacy of the booster in our population was universal. Mean increase of pre- to post-booster titer was more significant in subjects who never had SARS-CoV-2 (44 times CI 95% 42-46) compared to those who had it, before (33 times, CI 95% 13-70) or after the first vaccination cycle (12 times, CI 95% 11-14). Differently from sex, age and pre-booster titers affected the post-booster antibody response. Nevertheless, the post-booster titer was very similar in all subgroups, and independent of a prior exposure to SARS-CoV-2, pre-booster titer, sex or age. Conclusion: Our study shows a potent universal antibody response of the booster dose of BNT162b2, regardless of pre-booster vaccine seronegativity.

Published
2022

6. Gait robot-assisted rehabilitation in persons with spinal cord injury: A scoping review

Author

Stampacchia, G, Gazzotti, V, Olivieri, M, Andrenelli, E, Bonaiuti, D, Calabro, R, Carmignano, S, Cassio, A, Fundaro, C, Companini, I, Mazzoli, D, Cerulli, S, Chisari, C, Colombo, V, Dalise, S, Mazzoleni, D, Melegari, C, Merlo, A, Boldrini, P, Mazzoleni, S, Posteraro, F, Mazzucchelli, M, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Morone, G, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Bizzarrini, E, Stampacchia G., Gazzotti V., Olivieri M., Andrenelli E., Bonaiuti D., Calabro R. S., Carmignano S. M., Cassio A., Fundaro C., Companini I., Mazzoli D., Cerulli S., Chisari C., Colombo V., Dalise S., Mazzoleni D., Melegari C., Merlo A., Boldrini P., Mazzoleni S., Posteraro F., Mazzucchelli M., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Morone G., Petrarca M., Picelli A., Senatore M., Turchetti G., Bizzarrini E., Stampacchia, G, Gazzotti, V, Olivieri, M, Andrenelli, E, Bonaiuti, D, Calabro, R, Carmignano, S, Cassio, A, Fundaro, C, Companini, I, Mazzoli, D, Cerulli, S, Chisari, C, Colombo, V, Dalise, S, Mazzoleni, D, Melegari, C, Merlo, A, Boldrini, P, Mazzoleni, S, Posteraro, F, Mazzucchelli, M, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Morone, G, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Bizzarrini, E, Stampacchia G., Gazzotti V., Olivieri M., Andrenelli E., Bonaiuti D., Calabro R. S., Carmignano S. M., Cassio A., Fundaro C., Companini I., Mazzoli D., Cerulli S., Chisari C., Colombo V., Dalise S., Mazzoleni D., Melegari C., Merlo A., Boldrini P., Mazzoleni S., Posteraro F., Mazzucchelli M., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Morone G., Petrarca M., Picelli A., Senatore M., Turchetti G., and Bizzarrini E.

Abstract

BACKGROUND: Many robots are available for gait rehabilitation (BWSTRT and ORET) and their application in persons with SCI allowed an improvement of walking function.OBJECTIVE: The aim of the study is to compare the effects of different robotic exoskeletons gait training in persons with different SCI level and severity.METHODS: Sixty-two studies were included in this systematic review; the study quality was assessed according to GRADE and PEDro's scale.RESULTS: Quality assessment of included studies (n = 62) demonstrated a prevalence of evidence level 2; the quality of the studies was higher for BWSTRT (excellent and good) than for ORET (fair and good). Almost all persons recruited for BWSTRT had an incomplete SCI; both complete and incomplete SCI were recruited for ORET. The SCI lesion level in the persons recruited for BWSTRT are from cervical to sacral; mainly from thoracic to sacral for ORET; a high representation of AIS D lesion resulted both for BWSTRT (30%) and for ORET (45%). The walking performance, tested with 10MWT, 6MWT, TUG and WISCI, improved after exoskeleton training in persons with incomplete SCI lesions, when at least 20 sessions were applied. Persons with complete SCI lesions improved the dexterity in walking with exoskeleton, but did not recover independent walking function; symptoms such as spasticity, pain and cardiovascular endurance improved.CONCLUSION: Different exoskeletons are available for walking rehabilitation in persons with SCI. The choice about the kind of robotic gait training should be addressed on the basis of the lesion severity and the possible comorbidities.

Published
2022

7. Evidence-based improvement of gait in post-stroke patients following robot-assisted training: A systematic review

Author

Mazzucchelli, M, Mazzoleni, D, Campanini, I, Merlo, A, Mazzoli, D, Melegari, C, Colombo, V, Cerulli, S, Piscitelli, D, Perin, C, Andrenelli, E, Bizzarini, E, Calabro, R, Carmignano, S, Cassio, A, Chisari, C, Dalise, S, Fundaro, C, Gazzotti, V, Stampacchia, G, Boldrini, P, Mazzoleni, S, Posteraro, F, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Morone, G, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Bonaiuti, D, Mazzucchelli M., Mazzoleni D., Campanini I., Merlo A., Mazzoli D., Melegari C., Colombo V., Cerulli S., Piscitelli D., Perin C., Andrenelli E., Bizzarini E., Calabro R. S., Carmignano S. M., Cassio A., Chisari C., Dalise S., Fundaro C., Gazzotti V., Stampacchia G., Boldrini P., Mazzoleni S., Posteraro F., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Morone G., Petrarca M., Picelli A., Senatore M., Turchetti G., Bonaiuti D., Mazzucchelli, M, Mazzoleni, D, Campanini, I, Merlo, A, Mazzoli, D, Melegari, C, Colombo, V, Cerulli, S, Piscitelli, D, Perin, C, Andrenelli, E, Bizzarini, E, Calabro, R, Carmignano, S, Cassio, A, Chisari, C, Dalise, S, Fundaro, C, Gazzotti, V, Stampacchia, G, Boldrini, P, Mazzoleni, S, Posteraro, F, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Morone, G, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Bonaiuti, D, Mazzucchelli M., Mazzoleni D., Campanini I., Merlo A., Mazzoli D., Melegari C., Colombo V., Cerulli S., Piscitelli D., Perin C., Andrenelli E., Bizzarini E., Calabro R. S., Carmignano S. M., Cassio A., Chisari C., Dalise S., Fundaro C., Gazzotti V., Stampacchia G., Boldrini P., Mazzoleni S., Posteraro F., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Morone G., Petrarca M., Picelli A., Senatore M., Turchetti G., and Bonaiuti D.

Abstract

Background: The recovery of walking after stroke is a priority goal for recovering autonomy. In the last years robotic systems employed for Robotic Assisted Gait Training (RAGT) were developed. However, literature and clinical practice did not offer standardized RAGT protocol or pattern of evaluation scales. Objective: This systematic review aimed to summarize the available evidence on the use of RAGT in post-stroke, following the CICERONE Consensus indications. Methods: The literature search was conducted on PubMed, Cochrane Library and PEDro, including studies with the following criteria: 1) adult post-stroke survivors with gait disability in acute/subacute/chronic phase; 2) RAGT as intervention; 3) any comparators; 4) outcome regarding impairment, activity, and participation; 5) both primary studies and reviews. Results: Sixty-one articles were selected. Data about characteristics of patients, level of disability, robotic devices used, RAGT protocols, outcome measures, and level of evidence were extracted. Conclusion: It is possible to identify robotic devices that are more suitable for specific phase disease and level of disability, but we identified significant variability in dose and protocols. RAGT as an add-on treatment seemed to be prevalent. Further studies are needed to investigate the outcomes achieved as a function of RAGT doses delivered.

Published
2022

8. Effects of robotic upper limb treatment after stroke on cognitive patterns: A systematic review

Author

Bressi F., Cricenti L., Campagnola B., Bravi M., Miccinilli S., Santacaterina F., Sterzi S., Straudi S., Agostini M., Paci M., Casanova E., Marino D., La Rosa G., Giansanti D., Perrero L., Battistini A., Filoni S., Sicari M., Petrozzino S., Solaro C. M., Gargano S., Benanti P., Boldrini P., Bonaiuti D., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzoleni S., Mazzon S., Molteni F., Petrarca M., Picelli A., Posteraro F., Senatore M., Turchetti G., Morone G., Gallotti M., Germanotta M., Aprile I., Bressi, F., Cricenti, L., Campagnola, B., Bravi, M., Miccinilli, S., Santacaterina, F., Sterzi, S., Straudi, S., Agostini, M., Paci, M., Casanova, E., Marino, D., La Rosa, G., Giansanti, D., Perrero, L., Battistini, A., Filoni, S., Sicari, M., Petrozzino, S., Solaro, C. M., Gargano, S., Benanti, P., Boldrini, P., Bonaiuti, D., Castelli, E., Draicchio, F., Falabella, V., Galeri, S., Gimigliano, F., Grigioni, M., Mazzoleni, S., Mazzon, S., Molteni, F., Petrarca, M., Picelli, A., Posteraro, F., Senatore, M., Turchetti, G., Morone, G., Gallotti, M., Germanotta, M., and Aprile, I.

Subjects
Stroke, robotic, cognitive outcome, rehabilitation, robotic rehabilitation, systematic review, upper limb
Abstract

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.

Published
2022

9. Robot-Assisted Upper Limb Training for Patients with Multiple Sclerosis: An Evidence-Based Review of Clinical Applications and Effectiveness

Author

Straudi S., Tramontano M., Russo E. F., Perrero L., Agostini M., Gandolfi M., Aprile I., Paci M., Casanova E., Marino D., La Rosa G., Bressi F., Sterzi S., Giansanti D., Battistini A., Miccinilli S., Filoni S., Sicari M., Petrozzino S., Solaro C. M., Gargano S., Benanti P., Boldrini P., Bonaiuti D., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzoleni S., Mazzon S., Molteni F., Petrarca M., Picelli A., Posteraro F., Senatore M., Turchetti G., Morone G., Palomba A., Arienti C., Baluardo L., Cinnera A. M., Desilvestri M., Bravi M., Bruno D., Santacaterina F., Pecchioli P., Boetto V., Straudi, S., Tramontano, M., Russo, E. F., Perrero, L., Agostini, M., Gandolfi, M., Aprile, I., Paci, M., Casanova, E., Marino, D., La Rosa, G., Bressi, F., Sterzi, S., Giansanti, D., Battistini, A., Miccinilli, S., Filoni, S., Sicari, M., Petrozzino, S., Solaro, C. M., Gargano, S., Benanti, P., Boldrini, P., Bonaiuti, D., Castelli, E., Draicchio, F., Falabella, V., Galeri, S., Gimigliano, F., Grigioni, M., Mazzoleni, S., Mazzon, S., Molteni, F., Petrarca, M., Picelli, A., Posteraro, F., Senatore, M., Turchetti, G., Morone, G., Palomba, A., Arienti, C., Baluardo, L., Cinnera, A. M., Desilvestri, M., Bravi, M., Bruno, D., Santacaterina, F., Pecchioli, P., and Boetto, V.

Subjects
robotics, Fluid Flow and Transfer Processes, Exoskeleton, Multiple sclerosis, Rehabilitation, Robotic devices, Technology, QH301-705.5, Process Chemistry and Technology, Physics, QC1-999, General Engineering, Multiple sclerosis, robotics, rehabilitation, exoskeleton, Engineering (General). Civil engineering (General), Computer Science Applications, NO, Chemistry, General Materials Science, Multiple sclerosi, TA1-2040, Biology (General), Instrumentation, QD1-999
Abstract

Upper extremities limitation is a common functional impairment in patients with Multiple Sclerosis (PwMS). Novel technological devices are increasingly used in neurorehabilitation to support motor function improvement and the quantitative assessment of motor performance during training in patients with neurological diseases. In this review, we systematically report the evidence on clinical applications and robotic-assisted arm training (RAT) in functional recovery in PwMS. PubMed/MEDLINE, the Cochrane Library, and the Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to March 2021. The 10-item PEDro scale assessed the study quality for the RCT, and the AMSTAR-2 was used to assess the quality of the systematic review. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 10 studies (161 subjects) were included. The selected studies included one systematic review, four RCTs, one randomized crossover, and four case series. The RCTs were scored as high-quality studies, while the systematic review was determined to be of low quality. Shoulder range of motion, handgrip strength, and proximal arm impairment improved after RAT. Manual dexterity, arm function, and use in daily life also ameliorated arm function. The high clinical heterogeneity of treatment programs and the variety of robot devices affects the generalizability of the study results; therefore, we emphasize the need to standardize the intervention type in future studies that evaluate the role of robotic-assisted training in PwMS. Robot-assisted treatment seems safe and useful to increase manual dexterity and the quality of movement execution in PwMS with moderate to severe disability. Additional studies with an adequate sample size and methodological rigour are warranted to drive definite conclusions.

Published
2022

10. What does evidence tell us about the use of gait robotic devices in patients with multiple sclerosis? A comprehensive systematic review on functional outcomes and clinical recommendations

Author

Calabro, R, Cassio, A, Mazzoli, D, Andrenelli, E, Bizzarini, E, Campanini, I, Carmignano, S, Cerulli, S, Chisari, C, Colombo, V, Dalise, S, Fundaro, C, Gazzotti, V, Mazzoleni, D, Mazzucchelli, M, Melegari, C, Merlo, A, Stampacchia, G, Boldrini, P, Mazzoleni, S, Posteraro, F, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Morone, G, Bonaiuti, D, Calabro R. S., Cassio A., Mazzoli D., Andrenelli E., Bizzarini E., Campanini I., Carmignano S. M., Cerulli S., Chisari C., Colombo V., Dalise S., Fundaro C., Gazzotti V., Mazzoleni D., Mazzucchelli M., Melegari C., Merlo A., Stampacchia G., Boldrini P., Mazzoleni S., Posteraro F., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Petrarca M., Picelli A., Senatore M., Turchetti G., Morone G., Bonaiuti D., Calabro, R, Cassio, A, Mazzoli, D, Andrenelli, E, Bizzarini, E, Campanini, I, Carmignano, S, Cerulli, S, Chisari, C, Colombo, V, Dalise, S, Fundaro, C, Gazzotti, V, Mazzoleni, D, Mazzucchelli, M, Melegari, C, Merlo, A, Stampacchia, G, Boldrini, P, Mazzoleni, S, Posteraro, F, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Morone, G, Bonaiuti, D, Calabro R. S., Cassio A., Mazzoli D., Andrenelli E., Bizzarini E., Campanini I., Carmignano S. M., Cerulli S., Chisari C., Colombo V., Dalise S., Fundaro C., Gazzotti V., Mazzoleni D., Mazzucchelli M., Melegari C., Merlo A., Stampacchia G., Boldrini P., Mazzoleni S., Posteraro F., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Petrarca M., Picelli A., Senatore M., Turchetti G., Morone G., and Bonaiuti D.

Abstract

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 1st, 2010 and December 31st, 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 robot

Published
2021

11. robotic-assisted gait rehabilitation following stroke: A systematic review of current guidelines and practical clinical recommendations

Author

Calabro, R, Sorrentino, G, Cassio, A, Mazzoli, D, Andrenelli, E, Bizzarini, E, Campanini, I, Carmignano, S, Cerulli, S, Chisari, C, Colombo, V, Dalise, S, Fundaro, C, Gazzotti, V, Mazzoleni, D, Mazzucchelli, M, Melegari, C, Merlo, A, Stampacchia, G, Boldrini, P, Mazzoleni, S, Posteraro, F, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Morone, G, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Bonaiuti, D, Calabro R. S., Sorrentino G., Cassio A., Mazzoli D., Andrenelli E., Bizzarini E., Campanini I., Carmignano S. M., Cerulli S., Chisari C., Colombo V., Dalise S., Fundaro C., Gazzotti V., Mazzoleni D., Mazzucchelli M., Melegari C., Merlo A., Stampacchia G., Boldrini P., Mazzoleni S., Posteraro F., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Morone G., Petrarca M., Picelli A., Senatore M., Turchetti G., Bonaiuti D., Calabro, R, Sorrentino, G, Cassio, A, Mazzoli, D, Andrenelli, E, Bizzarini, E, Campanini, I, Carmignano, S, Cerulli, S, Chisari, C, Colombo, V, Dalise, S, Fundaro, C, Gazzotti, V, Mazzoleni, D, Mazzucchelli, M, Melegari, C, Merlo, A, Stampacchia, G, Boldrini, P, Mazzoleni, S, Posteraro, F, Benanti, P, Castelli, E, Draicchio, F, Falabella, V, Galeri, S, Gimigliano, F, Grigioni, M, Mazzon, S, Molteni, F, Morone, G, Petrarca, M, Picelli, A, Senatore, M, Turchetti, G, Bonaiuti, D, Calabro R. S., Sorrentino G., Cassio A., Mazzoli D., Andrenelli E., Bizzarini E., Campanini I., Carmignano S. M., Cerulli S., Chisari C., Colombo V., Dalise S., Fundaro C., Gazzotti V., Mazzoleni D., Mazzucchelli M., Melegari C., Merlo A., Stampacchia G., Boldrini P., Mazzoleni S., Posteraro F., Benanti P., Castelli E., Draicchio F., Falabella V., Galeri S., Gimigliano F., Grigioni M., Mazzon S., Molteni F., Morone G., Petrarca M., Picelli A., Senatore M., Turchetti G., and Bonaiuti D.

Abstract

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.

Published
2021

12. Sex differences in electrolyte imbalances caused by SARS-CoV-2: A cross-sectional study

Author

Pani, A, Inglese, E, Puoti, M, Cento, V, Alteri, C, Romandini, A, Di Ruscio, F, Senatore, M, Moreno, M, Tarsia, P, Colombo, F, Epis, O, Panetta, V, Vismara, C, Bellone, A, Scaglione, F, Pani A., Inglese E., Puoti M., Cento V., Alteri C., Romandini A., Di Ruscio F., Senatore M., Moreno M., Tarsia P., Colombo F., Epis O. M., Panetta V., Vismara C., Bellone A., Scaglione F., Pani, A, Inglese, E, Puoti, M, Cento, V, Alteri, C, Romandini, A, Di Ruscio, F, Senatore, M, Moreno, M, Tarsia, P, Colombo, F, Epis, O, Panetta, V, Vismara, C, Bellone, A, Scaglione, F, Pani A., Inglese E., Puoti M., Cento V., Alteri C., Romandini A., Di Ruscio F., Senatore M., Moreno M., Tarsia P., Colombo F., Epis O. M., Panetta V., Vismara C., Bellone A., and Scaglione F.

Abstract

Background: Since SARS-CoV-2 spread, evidence regarding sex differences in progression and prognosis of COVID-19 have emerged. Besides this, studies on patients' clinical characteristics have described electrolyte imbalances as one of the recurrent features of COVID-19. Methods: We performed a cross-sectional study on all patients admitted to the emergency department (ED) from 1 March to 31 May 2020 who had undergone a blood gas analysis and a nasopharyngeal swab test for SARS-CoV-2 by rtPCR. We defined positive patients as cases (n = 710) and negatives as controls (n = 619), for a total number of patients of 1.329. The study was approved by the local ethics committee Area 3 Milan. Data were automatically extracted from the hospital laboratory SQL-based repository in anonymised form. We considered as outcomes potassium (K+), sodium (Na+), chlorine (Cl−) and calcium (Ca++) as continuous and as categorical variables, in their relation with age, sex and SARS-CoV-2 infection status. Results: We observed a higher prevalence of hypokalaemia among patients positive for SARS-CoV-2 (13.7% vs 6% of negative subjects). Positive patients had a higher probability to be admitted to the ED with hypokalaemia (OR 2.75, 95% CI 1.8-4.1, P <.0001) and women were twice as likely to be affected than men (OR 2.43, 95% CI 1.67-3.54, P <.001). Odds ratios for positive patients to manifest with an alteration in serum Na+ was (OR 1.6, 95% CI 1.17-2.35, P <.001) and serum chlorine (OR 1.6, 95% CI 1.03-2.69, P <.001). Notably, OR for positive patients to be hypocalcaemic was 7.2 (95% CI 4.8-10.6, P <.0001) with a low probability for women to be hypocalcaemic (OR 0.63, 95% CI 0.4-0.8, P =.005). Conclusions: SARS-CoV-2 infection is associated with a higher prevalence of hypokalaemia, hypocalcaemia, hypochloraemia and sodium alterations. Hypokalaemia is more frequent among women and hypocalcaemia among men.

Published
2021

13. Results of the RENAISSANCE Study: REsponse to BNT162b2 COVID-19 vacciNe—short- And long-term Immune reSponSe evAluatioN in health Care workErs

Author

Pani, A, Cento, V, Vismara, C, Campisi, D, Di Ruscio, F, Romandini, A, Senatore, M, Schenardi, P, Gagliardi, O, Giroldi, S, Zoppini, L, Moreno, M, Corradin, M, Epis, O, Ughi, N, Cuppari, I, Crocchiolo, R, Merli, M, Bosio, M, Rossini, S, Puoti, M, Scaglione, F, Pani A., Cento V., Vismara C., Campisi D., Di Ruscio F., Romandini A., Senatore M., Schenardi P. A., Gagliardi O. M., Giroldi S., Zoppini L., Moreno M., Corradin M., Epis O. M., Ughi N., Cuppari I., Crocchiolo R., Merli M., Bosio M., Rossini S., Puoti M., Scaglione F., Pani, A, Cento, V, Vismara, C, Campisi, D, Di Ruscio, F, Romandini, A, Senatore, M, Schenardi, P, Gagliardi, O, Giroldi, S, Zoppini, L, Moreno, M, Corradin, M, Epis, O, Ughi, N, Cuppari, I, Crocchiolo, R, Merli, M, Bosio, M, Rossini, S, Puoti, M, Scaglione, F, Pani A., Cento V., Vismara C., Campisi D., Di Ruscio F., Romandini A., Senatore M., Schenardi P. A., Gagliardi O. M., Giroldi S., Zoppini L., Moreno M., Corradin M., Epis O. M., Ughi N., Cuppari I., Crocchiolo R., Merli M., Bosio M., Rossini S., Puoti M., and Scaglione F.

Abstract

Objective: To evaluate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike (S) IgG antibody production after vaccination with BNT162b2 and the protection from symptomatic breakthrough infections in health care workers. Methods: This prospective observational study (RENAISSANCE) had as a primary end point the evaluation of serologic response to BNT162b2 14 days after a second dose. SARS-CoV-2 anti-S IgG antibodies were evaluated with LIAISON SARS-CoV-2 TrimericS IgG assay (DiaSorin S.p.A.), which is able to detect the presence of both binding and neutralizing antibodies for trimeric spike glycoprotein. Participants were recruited from February 1, 2021, to February 22, 2021. Occurrence of vaccine breakthrough infections was assessed by reverse transcription–polymerase chain reaction on symptomatic and contact cases up to June 6, 2021. Results: Of 2569 staff evaluated, only 4 were nonresponders (0.16%; 95% CI, 0.04% to 0.41%). All 4 nonresponders were severely immunosuppressed and receiving treatment with mycophenolate mofetil or mycophenolic acid. At 14 days after the second dose, 67.5% (1733) of staff had anti-S IgG titers of 2000 BAU/mL or higher; 19.2% (494), between 1500 and 2000 BAU/mL; 9.8% (251), between 1000 and 1500 BAU/mL; and 3.4% (87), 1000 BAU/mL or lower. Women had a higher probability of having higher titers than men (64.5% [1044/1618] vs 58.3% [410/703]; P=.005). This was confirmed after adjustment for age group (odds ratio, 1.275; 95% CI, 1.062 to 1.531; P=.009). Four months after the end of the vaccination program, only 13 participants (0.26%) had experienced a breakthrough SARS-CoV-2 infection, including 1 nonresponder. This was the only participant requiring hospitalization for severe COVID-19. Conclusion: The vaccination campaign among health care workers at the ASST GOM Niguarda has resulted in a marked serologic response and reduction of incident COVID-19 cases. Yet, the lack of protection should not be overlooked in immu

Published
2021

17. Robot-assisted arm therapy in neurological health conditions: Rationale and methodology for the evidence synthesis in the CICERONE Italian Consensus Conference

Author

Gimigliano, F., Palomba, A., Arienti, C., Morone, G., Perrero, L., Agostini, M., Aprile, I., Paci, M., Casanova, E., Marino, D., la Rosa, G., Bressi, F., Sterzi, S., Giansanti, D., Battistini, A., Miccinilli, S., Filoni, S., Sicari, M., Petrozzino, S., Solaro, C. M., Gargano, S., Benanti, P., Boldrini, P., Bonaiuti, D., Castelli, E., Draicchio, F., Falabella, V., Galeri, S., Grigioni, M., Mazzoleni, S., Mazzon, S., Molteni, F., Petrarca, M., Picelli, A., Posteraro, F., Senatore, M., Turchetti, G., Straudi, S., Baluardo, L., Boetto, V., Bravi, M., Bruno, D., Desilvestri, M., Gandolfi, M., Martino Cinnera, A., Pecchioli, C., Russo, E. F., Santacaterina, F., Gimigliano, F., Palomba, A., Arienti, C., Morone, G., Perrero, L., Agostini, M., Aprile, I., Paci, M., Casanova, E., Marino, D., la Rosa, G., Bressi, F., Sterzi, S., Giansanti, D., Battistini, A., Miccinilli, S., Filoni, S., Sicari, M., Petrozzino, S., Solaro, C. M., Gargano, S., Benanti, P., Boldrini, P., Bonaiuti, D., Castelli, E., Draicchio, F., Falabella, V., Galeri, S., Grigioni, M., Mazzoleni, S., Mazzon, S., Molteni, F., Petrarca, M., Picelli, A., Posteraro, F., Senatore, M., Turchetti, G., Straudi, S., Baluardo, L., Boetto, V., Bravi, M., Bruno, D., Desilvestri, M., Gandolfi, M., Martino Cinnera, A., Pecchioli, C., Russo, E. F., and Santacaterina, F.

Subjects
Upper extremity, Consensus, Robot, medicine.medical_treatment, Population, Psychological intervention, Physical Therapy, Sports Therapy and Rehabilitation, Context (language use), Consensu, Robotic surgical procedure, Consensus development conference, Neurological rehabilitation, Rehabilitation, Robotic surgical procedures, Arm, Humans, Italy, Disabled Persons, Robotics, NO, Nursing, medicine, education, Upper limb, education.field_of_study, Rehabilitation, Robotics, Upper extremity, Neurological rehabilitation, Consensus conference, business.industry, Consensus conference, Neurological health conditions, Data extraction, Electromechanical devices, Disabled Person, Working group, business, Evidence synthesis, Human
Abstract

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.

Published
2021

18. What is the impact of robotic rehabilitation on balance and gait outcomes in people with multiple sclerosis? A systematic review of randomized control trials

Author

Bowman, T., Gervasoni, E., Amico, A. P., Antenucci, R., Benanti, P., Boldrini, P., Bonaiuti, D., Burini, A., Castelli, E., Francesco, Draicchio, Falabella, V., Galeri, S., Gimigliano, F., Grigioni, M., Mazzon, S., Mazzoleni, S., Mestanza Mattos, F. G., Molteni, F., Morone, G., Petrarca, M., Picelli, A., Posteraro, F., Senatore, M., Turchetti, G., Crea, S., Cattaneo, D., Carrozza, M. C., Baricich, A., Bissolotti, L., Capecci, M., Cavalli, L., Di Stefano, G., Jonsdottir, J., Lentino, C., Massai, P., Morelli, S., Nardone, A., Panzeri, D., Taglione, E., Bowman, T., Gervasoni, E., Amico, A. P., Antenucci, R., Benanti, P., Boldrini, P., Bonaiuti, D., Burini, A., Castelli, E., Francesco, Draicchio, Falabella, V., Galeri, S., Gimigliano, F., Grigioni, M., Mazzon, S., Mazzoleni, S., Mestanza Mattos, F. G., Molteni, F., Morone, G., Petrarca, M., Picelli, A., Posteraro, F., Senatore, M., Turchetti, G., Crea, S., Cattaneo, D., Carrozza, M. C., Baricich, A., Bissolotti, L., Capecci, M., Cavalli, L., Di Stefano, G., Jonsdottir, J., Lentino, C., Massai, P., Morelli, S., Nardone, A., Panzeri, D., and Taglione, E.

Subjects
medicine.medical_specialty, medicine.medical_treatment, Physical Therapy, Sports Therapy and Rehabilitation, Context (language use), Walk Test, Cochrane Library, law.invention, Multiple sclerosis, Disability Evaluation, Physical medicine and rehabilitation, Gait training, Randomized controlled trial, law, Multiple Sclerosi, Neurologic, Medicine, Humans, Gait Disorders, Gait, Gait Disorders, Neurologic, Randomized Controlled Trials as Topic, Rehabilitation, Robotics, Combined Modality Therapy, Multiple Sclerosis, Exoskeleton Device, business.industry, Evidence-based medicine, Robotic, Berg Balance Scale, business, human activities, Human
Abstract

Introduction In recent years, robot-assisted gait training (RAGT) has been proposed as therapy for balance and gait dysfunctions in people with multiple sclerosis (PwMS). Through this systematic review, we aimed to discuss the impact of RAGT on balance and gait outcomes. Furthermore, characteristics of the training in terms of robots used, participants characteristics, protocols and combined therapeutic approaches have been described. Evidence acquisition As part of the Italian Consensus on robotic rehabilitation "CICERONE" a systematic search was provided in PubMed, the Cochrane Library and PEDro to identify relevant studies published before December 2019. Only randomized control trials (RCT) involving RAGT for PwMS were included. PEDro scale was used to assess the risk of bias and the Oxford Center for Evidence-Based Medicine (OCEBM) was used to assess level of evidence of included studies. Evidence synthesis The search on databases resulted in 336 records and, finally, 12 studies were included. RAGT was provided with Exoskeleton in ten studies (6-40 session, 2-5 per week) and with end-effector in two studies (12 sessions, 2-3 per week) with large variability in terms of participants' disability. All the exoskeletons were combined with bodyweight support treadmill and movement assistance varied from 0% to 100% depending on participants' disability, two studies combined exoskeleton with virtual reality. The end-effector speed ranged between 1.3 and 1.8 km/h, with bodyweight support starting from 50% and progressively reduced. In seven out of twelve studies RAGT was provided in a multimodal rehabilitation program or in combination with standard physical therapy. There is level 2 evidence that RAGT has positive impact in PwMS, reaching the minimally clinically importance difference in Berg Balance Scale, six-minute walking test and gait speed. Conclusions In available RCT, RAGT is mostly provided with exoskeleton devices and improves balance and gait outcomes in a clinically meaningful way. Considering several advantages in terms of safety, motor assistance and intensity of training provided, RAGT should be promoted for PwMS with severe disability in a multimodal rehabilitation context as an opportunity to maximize recovery.

Published
2021

26. The Neapolitan Yellow Tuff tephra in the stratigraphic architecture of the Gulf of Gaeta shelf, eastern Tyrrhenian margin

Author

Meo, A., Falco, M., Insinga, D. D., Aiello, G., DONATO V, DI ., Iorio, M., Senatore, M. R., PETROSINO, PAOLA, Meo, A., Falco, M., Insinga, D. D., Petrosino, Paola, Aiello, G., DONATO V, DI ., Iorio, M., and Senatore, M. R.

Subjects
Neapolitan Yellow Tuff, Tephrostratigraphy, Gulf of Gaeta
Abstract

The Neapolitan Yellow Tuff (NYT) caldera-forming eruption (ca. 15 ka; Deino et al., 2004) is a large event occurred at Phlegraean Fields during the late Pleistocene-Holocene. It produced a widespread isochron marker which links marine and terrestrial archives of the central Mediterranean area and northern Europe. In this research we describe the stratigraphic signature of the NYT deposits in the Late Pleistocene-Holocene shelf sequence of the Gulf of Gaeta (northern Campania region, southern Tyrrhenian sea) by using a number of gravity cores along with a grid of seismic lines that include Subbottom Chirp, Sparker 1kJ and Uniboom profiles. The Gulf of Gaeta represents the northern Campania continental margin that is part of a large extensional Plio-Pleistocene basin associated with normal and strike-slip faults linked to the evolution of the eastern Tyrrhenian Sea margin. Since mid-late Pleistocene, extensional tectonics took place across the continental margin and it was accompanied by intense volcanism, from several districts of which the Phlegraean Fields activity has greatly influenced the sedimentation in this sector. The continental shelf, gently sloping seaward, is as wide as 30 km in front of the Garigliano river and narrows southward reaching its minimum width of ca. 10 km seaward of Cuma; the shelf break is located between 120 m and 125 m depth. The upper Pleistocene-Holocene stratigraphic architecture of the continental shelf is characterized by an offlap prograding succession followed by a very thick transgressive onlapping unit and by the upper highstand unit mainly characterized in the southern sector by undulations probably linked to gas prone sediment. The slope is characterized by a uniform profile and, in the southern sector, it is incised by several submarine gullies. According to Chiocci and Casalbore (2011), the high thickness of sediment on the shelf and slope area was influenced by hyperpycnal flows, linked to the sudden and large supply of pyroclastic and volcaniclastic deposits in the Volturno river catchment basin. In the studied seismic sections, the NYT matches a highly continuous and parallel reflector which is interbedded within the transgressive systems tract deposits. The deposit was recovered in cores raised from the slope, where it is present few milliseconds below the sea floor, while on the shelf where it is located at higher depths, ranging from 10 to 30 ms (8 to about 25 m) below sea floor, has been mapped out through the seismic lines.. The tephrostratigraphic analysis allowed to characterize the NYT in terms of lithology and chemistry and to provide new insights into the depositional mechanisms in the marine environment.

Published
2016

27. Fungal community, Fusarium head blight complex and secondary metabolites associated with malting barley grains harvested in Umbria, central Italy

Author

Beccari, G., Senatore, M., Tini, F., Sulyok, M., Covarelli, Lorenzo, Beccari, G., Senatore, M., Tini, F., Sulyok, M., and Covarelli, Lorenzo

Abstract

In recent years, due to the negative impact of toxigenic mycobiota and of the accumulation of their secondary metabolites in malting barley grains, monitoring the evolution of fungal communities in a certain cultivation area as well as detecting the different mycotoxins present in the raw material prior to malting and brewing processes have become increasingly important. In this study, a survey was carried out on malting barley samples collected after their harvest in the Umbria region (central Italy). Samples were analyzed to determine the composition of the fungal community, to identify the isolated Fusarium species, to quantify fungal secondary metabolites in the grains and to characterize the in vitro mycotoxigenic profile of a subset of the isolated Fusarium strains. The fungal community of barley grains was mainly composed of microorganisms belonging to the genus Alternaria (77%), followed by those belonging to the genus Fusarium (27%). The Fusarium head blight (FHB) complex was represented by nine species with the predominance of Fusarium poae (37%), followed by Fusarium avenaceum (23%), Fusarium graminearum (22%) and Fusarium tricinctum (7%). Secondary metabolites biosynthesized by Alternaria and Fusarium species were present in the analyzed grains. Among those biosynthesized by Fusarium species, nivalenol and enniatins were the most prevalent ones. Type A trichothecenes (T-2 and HT-2 toxins) as well as beauvericin were also present with a high incidence. Conversely, the number of samples contaminated with deoxynivalenol was low. Conjugated forms, such as deoxynivalenol-3-glucoside and HT-2-glucoside, were detected for the first time in malting barley grains cultivated in the surveyed area. In addition, strains of F. avenaceum and F. tricinctum showed the ability to biosynthesize in vitro high concentrations of enniatins. The analysis of fungal secondary metabolites, both in the grains and in vitro, revealed also the presence of other compounds, for which fu

Published
2018

28. Causal agents of Fusarium head blight of durum wheat (Triticum durum Desf.) in central Italy and their in vitro biosynthesis of secondary metabolites

Author

Beccari, G., Colasante, V., Tini, F., Senatore, M., Prodi, A., Sulyok, M., Covarelli, Lorenzo, Beccari, G., Colasante, V., Tini, F., Senatore, M., Prodi, A., Sulyok, M., and Covarelli, Lorenzo

Abstract

Durum wheat samples harvested in central Italy (Umbria) were analyzed to: evaluate the occurrence of the fungal community in the grains, molecularly identify the Fusarium spp. which are part of the Fusarium head blight (FHB) complex and characterize the in vitro secondary metabolite profiles of a subset of Fusarium strains. The Fusarium genus was one of the main components of the durum wheat fungal community. The FHB complex was composed of eight species: Fusarium avenaceum (61%), F. graminearum (22%), F. poae (9%), F. culmorum (4%), F. proliferatum (2%), F. sporotrichioides (1%), F. sambucinum (0.5%) and F. langsethiae (0.5%). F. graminearum population was mainly composed of the 15-acetyldeoxynivalenol chemotype, while, F. culmorum population was composed of the 3-acetyldeoxynivalenol chemotype. In vitro characterization of secondary metabolite biosynthesis was conducted for a wide spectrum of substances, showing the mycotoxigenic potential of the species complex. F. avenaceum strains were characterized by high enniantin and moniliformin production. F. graminearum strains were in prevalence deoxynivalenol producers. F. poae strains were characterized by a high biosynthesis of beauvericin like the F. sporotrichioides strain which was also found to be a high T-2/HT-2 toxins producer. Production of aurofusarin, butenolide, gibepyrone D, fusarin C, apicidin was also reported for the analyzed strains.

Published
2018

31. Flexural strength and elastic modulus evaluation of structures made by conventional PMMA and PMMA reinforced with graphene.

Author

DI CARLO, S., DE ANGELIS, F., BRAUNER, E., PRANNO, N., TASSI, G., SENATORE, M., and BOSSÙ, M.

Abstract

OBJECTIVE: The aim of this study was to compare both the elastic modulus (EM) and the flexural strength (FS) of two materials used in dental prosthesis, namely polymethylmethacrylate (PMMA) and polymethylmethacrylate reinforced with graphene (G-PMMA). MATERIALS AND METHODS: Twenty rectangular samples were manufactured by a milling machine and divided into two groups (n= 10/group): Group 1, PMMA; Group 2, G-PMMA. The specimens were subjected to a three-point bending test conducted in the elastic range to evaluate EM. A similar test was protracted until fracture to evaluate FS. Data on EM and FS were statistically analyzed with independent-samples t-test in order to compare the two groups. A scanning electron microscope (SEM) (5.00 kx and 1.00 kx magnification) was used to evaluate the morphology of sample's fracture. RESULTS: Compared to PMMA samples, each G-PMMA sample showed significantly higher values of FS (p <0.001) and EM (p <0.001). SEM images analysis showed an inhomogeneous fracture morphology in G-PMMA samples. CONCLUSIONS: The results show that G-PMMA is a promising material to be used for prosthetic purposes. This is demonstrated by a significant increase in both peak load and bending stiffness, resulting from the bending test performed on G-PMMA samples. Furthermore, the latter exhibit greater homogeneity in their mechanical behavior, supporting the potential value of this material in dental prosthesis. [ABSTRACT FROM AUTHOR]

Published
2020

36. Late Pleistocene-Holocene paleoclimate and related paleoenvironmental changes, as recorded by calcareous nannofossil and planktonic foraminifera assemblages in Salerno bay (Palinuro Cape, Tyrrenian Sea, Italy)

Author

AMORE F. O., MASSA B., MORABITO S., BEGLIOMINI B., BERTOLDO M., BUCCHERI G., CAFFAU M., CAPRETTO G., CARELLA D., CIAMPO G., DI DONATO V., FERRUZZA G., GRECO A., MADONIA G., MARIOTTI M., MUNNO R., NAIMO D., PESCATORE T. S., PETROSINO P., SENATORE M. R., SPROVIERI M., STANZIONE, DAMIANO, Amore, F. O., Massa, B., Morabito, S., Begliomini, B., Bertoldo, M., Buccheri, G., Caffau, M., Capretto, G., Carella, D., Ciampo, G., DI DONATO, V., Ferruzza, G., Greco, A., Madonia, G., Mariotti, M., Munno, R., Naimo, D., Pescatore, T. S., Petrosino, P., Senatore, M. R., Sprovieri, M., and Stanzione, Damiano

Published
2002

37. Depositional history and paleogeographic reconstruction on Sele coastal plain during Magna Grecia Settlement of Hera Argiva (Southern Italy)

Author

BARRA, DIANA, RUSSO, BIANCA, CALDERONI G., CIPRIANI M., DE LA GENIRE J., FIORILLO L., GRECO G., MARIOTTI LIPPI M., MORI SECCI M., PESCATORE T., SENATORE M. R., TOCCO SCIARELLI G., THOREZ J., Barra, Diana, Calderoni, G., Cipriani, M., DE LA GENIRE, J., Fiorillo, L., Greco, G., MARIOTTI LIPPI, M., MORI SECCI, M., Pescatore, T., Russo, Bianca, Senatore, M. R., TOCCO SCIARELLI, G., and Thorez, J.

Subjects
Radiocarbon dating, Holocene, Paleoecology, Sedimentology, Sele coastal plain, Southern Italy, Geoarchaeology
Abstract

The Sele river coastal plain, located in Campania (southern Italy), is a broad subsiding area associated with rifting of the Tyrrhenian Sea. During the early Holocene, the fast sea-level rise led to a transgressive coastal system with landward shift of beach and marsh-lagoon deposits. During the late Holocene, the decrease of sea-level rise rate resulted in the coastal system progradation and lagoon infilling. Settlement of the sanctuary of Hera Argiva by Greeks, in the Sele coastal plain, occurred in 6th century B.C. Reconstruction of environments at that time allows to locate the coastline 250 m landward with respect to the present. A coastal system comprising a beach and sand dune ridge was present, and extensive bogs and ponds were formed behind the dunes. The sanctuary founded on the levee of the Sele river at the edge of the marshes was surrounded by a natural garden with luxuriant vegetation. The presence of Myrtus plants perhaps introduced by man in the Hera Argiva garden is inferred.

Published
1999

48. Types of continental shelf in the Gulf of Taranto

Author

PENNETTA, MICLA, RUSSO, BIANCA, PESCATORE T. S., SENATORE M. R., Atti Conf. 'Geology of the Oceans', Pennetta, Micla, Pescatore, T. S., Russo, Bianca, and Senatore, M. R.

Published
1990

49. Is apoptosis cause of pre-eclampsia?

Author

Buemi, Michele, Allegra, Alessandro, D'Anna, Rosario, Aloisi, Carmela, Corica, Francesco, Jasonni, Vm, Senatore, M, and Frisina, Nicola

Subjects
Adult, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Cardiovascular, Humans, Apoptosis, Female, Maternal-Fetal Exchange, apoptosis, pre-eclampsia
Abstract

Pre-eclampsia is the main cause of fetal and maternal morbidity and death associated with hypertension during complicating pregnancy. During physiological pregnancy, the immunological system undergoes secondary modifications, with an "exchange" between mother and fetus. Cytokines play an important role in the complex condition of partial fetal "rejection". It has suggested that the condition depend on immunological factors. In line with this hypothesis, apoptosis appear to play a key role in the pathophysiology of placental ischemia and the mechanism underlying this condition may be influenced by substances such as Bcl-2 which inhibits apoptosis. Neither aspirin nor calcium appear to improve maternal hypertension and proteinuria, although late ongoing trials may alter this view. At present, the condition can be resolved only by the end of pregnancy. Further studies are required in order to improve our understanding of these immunological mechanisms underlying hypertension during pregnancy, as the key to effective therapy may be their ability to "manipulate" them in an appropriate way.

Published
2000

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