When a Robot Is Your Teammate.

Creating effective teamwork between humans and robots involves not only addressing their performance as a team but also sustaining the quality and sense of unity among teammates, also known as cohesion. This paper explores the research problem of: how can we endow robotic teammates with social capabilities to improve the cohesive alliance with humans? By defining the concept of a human-robot cohesive alliance in the light of the multidimensional construct of cohesion from the social sciences, we propose to address this problem through the idea of multifaceted human-robot cohesion. We present our preliminary effort from previous works to examine each of the five dimensions of cohesion: social, collective, emotional, structural, and task. We finish the paper with a discussion on how human-robot cohesion contributes to the key questions and ongoing challenges of creating robotic teammates. Overall, cohesion in human-robot teams might be a key factor to propel team performance and it should be considered in the design, development, and evaluation of robotic teammates.

Beyond bariatric surgery and weight loss medicaments. A systematic review of the current practice in obesity rehabilitative inpatient programs in adults and pediatrics.

Background: Obesity treatment strategies mainly include outpatient lifestyle modification, drugs and bariatric surgery. Voluntary rehabilitative inpatient programs are gaining relevance as potential alternative settings of care that focus on weight loss and prevention of weight regain through a multidisciplinary approach, but their prevalence is still limited due to the high costs. Aim: Considering the lack of evidence in this area, the objective of this study is to systematically review the currently available literature on non-pharmacological and non-surgical inpatient programs aimed at weight loss, to clarify the efficacy and the characteristics of these interventions. Methods: Proper English language articles from 2000 to 2022 were searched on relevant databases. Quality assessment was performed by two different authors using ROB2 and robvis tools. Adult and pediatric studies were reviewed separately and their characteristics were systematically displayed. Results: 36 articles were included (20 on adults, 16 on children, and adolescents) for a total of 5,510 individuals. The multidisciplinary approach was mainly comprehensive of a low-calorie diet, scheduled physical activity, and psychological support based on behavioral treatment. Educational and cooking sessions were present at a lower rate. Globally, inpatient weight loss programs showed a consistent efficacy in reducing body weight and inducing beneficial effects on quality of life, psychological well-being, eating behavior, physical performance, and fatigue. Follow-up data were scarce, but with a high percentage of patients regaining weight after a short period. Conclusion: Weight loss inpatient rehabilitation is a promising area that has evidence of all-rounded success in the amelioration of several aspects related to obesity. Nevertheless, it appears to be quite inconsistent in preserving these benefits after the intervention. This might slow the innovation process in this area and preclude further investments from national healthcare. Personalized and enriched programs could show greater impact when focusing on the behavioral and educational aspects, which are crucial points, in particular in pediatrics, for setting up a long-lasting lifestyle modification. More studies are therefore necessary to evaluate long-term efficacy based on the different work-up models.

Calreticulin and PDIA3, two markers of endoplasmic reticulum stress, are associated with metabolic alterations and insulin resistance in pediatric obesity: A pilot study.

Our aim was to evaluate the markers of endoplasmic reticulum (ER) stress among children and adolescents with obesity in relation to metabolic alterations. Calreticulin (CALR) and PDIA3 circulating levels were assessed on 52 pediatric subjects-26 patients with obesity and 26 normal weight controls (4-18 years)-enrolled in a pilot study. Clinical and metabolic evaluations were performed (BMI-SDS, insulin, and glucose at fasting and during an oral glucose tolerance test, lipid profile, blood pressure), and metabolic syndrome was detected. PDIA3 was higher (p < 0.02) and CALR slightly higher in children with obesity than in controls. PDIA3 was related positively to the Tanner stages. Both PDIA3 and CALR were positively associated with insulin resistance, cholesterol, and triglycerides and the number of criteria identifying metabolic syndrome and negatively with fasting and post-challenge insulin sensitivity. Our preliminary findings suggest the existence of a link between ER stress and metabolic changes behind obesity complications even at the pediatric age. CALR and PDIA3 could be early markers of insulin resistance and dyslipidemia-related ER stress useful to stratify patients at high risk of further complications.

Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes.

Our aim was to evaluate adherence to the Mediterranean diet (MedDiet) among children and adolescents with type 1 diabetes (T1D) in relation to metabolic control. Adherence to the MedDiet was assessed with the Mediterranean Diet Quality Index (KIDMED) questionnaire and physical activity by the International Physical Activity Questionnaire for Adolescent (IPAQ-A) on 65 subjects (32 males, 9-18 years) with T1D. Clinical and metabolic evaluation was performed (standardized body mass index (BMI-SDS), hemoglobin A1C (HbA1c), continuous glucose monitoring metrics when present, blood pressure, lipid profile). Parental characteristics (age, body mass index (BMI), socio-economic status) were reported. The adherence to the MedDiet was poor in 12.3%, average in 58.6%, and high in 29.1% of the subjects. Furthermore, 23.4% of patients were overweight/obese. The most impacting factors on BMI-SDS were skipping breakfast and their father's BMI. HbA1c and time in range % were positively associated with sweets and fish intake, respectively. Additionally, the father's socio-economic status (SES) and mother's age were associated with glucose control. Blood pressure was associated with travelling to school in vehicles, extra-virgin olive oil intake and milk/dairy consumption at breakfast. The promotion of the MedDiet, mainly having a healthy breakfast, is a good strategy to include in the management of T1D to improve glucose and metabolic control. This research is valuable for parents to obtain the best results for their children with T1D.

Social isolation, physical inactivity and inadequate diet among European middle-aged and older adults.

BACKGROUND: Social isolation is a growing public health concern for older adults, as it has been associated with poor health and premature mortality. On the other hand, physical inactivity and an inadequate diet are important health risk behaviours associated with physical and mental health problems. Considering that there is no research examining the possible relationship between social isolation and the above mentioned health risk behaviours of European middle-aged and older adults, this cross-sectional study aims to contribute to filling this gap. METHODS: We used data from the SHARE project (Survey of Health, Ageing and Retirement in Europe), wave 6 (2015), release 7.0.0 (N = 67,173 individuals from 17 European countries plus Israel). Statistical tests for a two-group comparison were carried out to assess the differences between highly socially isolated individuals and low/intermediate socially isolated ones. Logistic regressions by country were performed to examine whether social isolation is associated with physical inactivity and an inadequate diet in the population aged 50 + . RESULTS: Our results point out that, for the majority of the countries analysed, highly socially isolated individuals are more likely than low/intermediate isolated ones to be physically inactive and to consume less fruit or vegetables on a daily basis. In 9 European countries (Austria, Germany, Sweden, Denmark, Greece, Belgium, Poland, Luxembourg and Estonia) highly socially isolated individuals are more likely to be physically inactive. On the other hand, in 14 European countries (Austria, Germany, Sweden, Italy, France, Denmark, Greece, Switzerland, Belgium, Czech Republic, Luxembourg, Slovenia, Estonia and Croatia), high social isolation increases the likelihood of having an inadequate diet. CONCLUSION: Highly socially isolated European middle-aged and older adults are more prone to be physically inactive and to have an inadequate diet in terms of daily consumption of fruit and vegetables. The reduced social integration, social support and companionship of the highly socially isolated individuals may explain this association. Our results reinforce the importance of social and health policies targeting highly socially isolated European individuals aged 50 + .

Papel do ambiente familiar no desenvolvimento de sintomatologia psicopatológica em jovens adultos / Role of family environment in the development of psychopathological symptoms in young adults / Papel del entorno familiar en el desarrollo de síntomas psicopatológicos en jóvenes adultos

A perceção do ambiente familiar constitui um fator essencial para o desenvolvimento psicoafectivo e ajustamento emocional do indivíduo, bem como no desenvolvimento de sintomatologia psicopatológica. Desse modo, a dinâmica das relações pais-filhos parece assumir um papel dicotómico, protetor ou de risco no ajustamento emocional e desenvolvimento de sintomatologia psicopatológica. A presente investigação tem como principal objetivo analisar o efeito do ambiente familiar no desenvolvimento de sintomatologia psicopatológica dos jovens adultos. A amostra é constituída por 432 jovens adultos, com idades compreendidas entre os 18 e os 30 anos. Para a recolha de dados recorreu-se à Family Environment Scale, o Inventário de Sintomas Psicopatológicos e um questionário sociodemográfico. Os resultados apontam que a perceção de coesão no ambiente familiar prediz negativamente a sintomatologia depressiva e ansiosa, enquanto a perceção de alterações na expressividade e existência de conflitos no ambiente familiar predizem positivamente a sintomatologia ansiosa nos jovens adultos. Os resultados serão analisados à luz da perspetiva ecológica de Bronfenbrenner, no sentido de discutir a importância do ambiente familiar adaptativo no desenvolvimento afetivo e na sintomatologia psicopatológica nos jovens adultos.

The perception of family environment is an essential factor for the development of the individual psycho-affective and emotional adjustment, as well as development of psychopathological symptoms. Thus, the dynamics of parent-child relationships seems to assume a dichotomous, risk or protective role in emotional adjustment and development of psychopathology symptoms. This research aims to analyze the effect of family environment on the development of psychopathological symptoms in young adults. The sample was composed by 432 young adults, aged between 18 and 30 years. To collect data there was recourse to the Family Environment Scale, the Brief Symptom Inventory and the sociodemographic questionnaire. The results show that the perception of cohesion in the family environment predicts negatively the depressive and anxious symptoms, while the perception of changes in the expressiveness and existence of conflicts in the family environment predict positively anxious symptomatology in young adults. Results will be analyzed in the the ecological perspective of Bronfenbrenner, to discuss the importance of an adaptive family environment on the emotional development and the psychopathological symptoms in young adults.

La percepción del entorno familiar es un factor esencial para el desarrollo psico-afectivo y ajuste emocional del individuo, así como en el desarrollo de sintomatología psicopatológica. Asi mismo, la dinámica de la relación padre-hijo parece ejercer un papel dicotómico, protector o de riesgo a la adaptación emocional y el desarrollo de los síntomas psicopatológicos. Esta investigación tiene como objetivo analizar el efecto del entorno familiar en el desarrollo de síntomas psicopatológicos en jóvenes adultos. La muestra se compone por 432 jóvenes adultos entre 18 y 30 años. Para la recolección de datos se utilizó la Family Environment Scale, el Brief Symptom Inventory y un cuestionario sociodemográfico. Los resultados muestran que la percepción de cohesión en el entorno familiar predice negativamente los síntomas depresivos y de ansiedad, mientras que la percepción de los cambios en la expresión y la existencia de conflictos en el ámbito familiar predice positivamente los síntomas de ansiedad en los jóvenes adultos. Los resultados serán analizados a la luz de la perspectiva ecológica de Bronfenbrenner, discutiendo la importancia del ambiente familiar adaptativo en el desarrollo afectivo y síntomas psicopatológicos en jóvenes adultos.

Hyponatremia in a Teenager: A Rare Diagnosis.

INTRODUCTION: Hyponatremia is a common electrolyte alteration which has the potential for significant morbidity and mortality. Endocrine disorders, such as primary hypothyroidism and adrenal insufficiency are uncommon causes of hyponatremia. We present the case of a teenager with symptomatic hyponatremia caused by a rare disorder. CASE: A 17-year-old boy was admitted to the emergency department with abdominal pain, nausea and vomiting, asthenia, and weight loss. He was in poor general condition, hypotensive, and he had dry mucous membranes and skin as well as mucosa hyperpigmentation. The laboratory findings showed severe hyponatremia, hyperkalemia, and renal dysfunction. The patient started inotropic support and antibiotics. Plasma cortisol and corticotropin levels allowed the diagnosis of primary adrenal insufficiency. He began replacement therapy with hydrocortisone and fludrocortisone, with gradual symptom resolution. An abdominal computed tomography scan showed adrenal hypoplasia. Findings for antiadrenal and antithyroid antibodies were positive, allowing the diagnosis of autoimmune polyglandular syndrome type II. DISCUSSION: Adrenal insufficiency is a rare disease, especially in children, and its clinical manifestations are due to glucocorticoid and mineralocorticoid deficiency. In most of the cases, symptoms are nonspecific, requiring a high index of clinical suspicion. If the diagnosis and treatment are delayed, acute adrenal insufficiency carries a high morbidity and mortality.

[Provocative tests in the diagnosis of childhood onset growth hormone insufficiency]. / O Papel dos Testes de Estimulação Farmacológica no Diagnóstico da Deficiência de Hormona do Crescimento em Crianças e Adolescentes.

INTRODUCTION: The incidence of short stature associated with growth hormone deficiency has been estimated to be about 1:4000 to 1:10000. It is the main indication for treatment with recombinant growth hormone. OBJECTIVES: The aims of the study were to evaluate the results of growth hormone stimulation tests and identify the growth hormone deficiency predictors. MATERIAL AND METHODS: A cross-sectional, analytical and observational study was conducted. We studied all the children and adolescents submitted to growth hormone pharmacological stimulation tests between January 2008 and May 2012. Growth hormone deficiency diagnosis was confirmed by two negatives growth hormone stimulation tests (growth hormone peak < 7 ng/ml). The statistical analysis was performed using student t-test, chi-square, Pearson correlation and logistic regression. Statistical significance determined at the 5% level (p ≤ 0.05). RESULTS: Pharmacological stimulation tests were performed in 89 patients, with a median age of 10 [3-17] years. Clonidine (n = 85) and insulin tolerance test (n = 4) were the first growth hormone stimulation tests performed. Growth hormone deficiency was confirmed in 22 cases. In cases with two growth hormone stimulation tests, the growth hormone peak showed a moderate correlation (r = 0.593, p = 0.01). In logistic regression model height (z-score) and the growth hormone peak in first stimulation test were predictors of growth hormone deficiency diagnosis (each one unit increase in z-score decrease the growth hormone deficiency probability). DISCUSSION: Measurement of IGF-1 cannot be used in diagnosing growth hormone deficiency. CONCLUSION: Auxological criteria associated with a positive test seems to be a reliable diagnostic tool for growth hormone deficiency.

Introdução: A incidência da deficiência de hormona do crescimento é de 1:4000 a 1:10000, sendo a principal indicação para tratamento com hormona do crescimento recombinante.Objectivos: Avaliar os resultados dos testes de estimulação da hormona do crescimento e identificar factores preditivos para o diagnóstico da deficiência de hormona do crescimento.Material e Métodos: Estudo observacional, analítico e transversal. Foram analisados dados clínicos e auxológicos e os resultados dos exames de diagnóstico de crianças e adolescentes submetidos a testes de estimulação farmacológica da hormona do crescimento (01/01/2008 a 31/05/2012). O diagnóstico definitivo de deficiência de hormona do crescimento foi efectuado mediante dois testes com estímulos farmacológicos diferentes negativos (pico máximo da hormona do crescimento < 7 ng/mL) ou um teste negativo associado à presença de alterações anatómicas da região hipotálamo-hipofisária, observadas na ressonância magnética cerebral. Para análise estatística, foram realizados o testes de t student, do qui- quadrado, correlação de Pearson e a regressão logística. Foi considerado como nível de significância estatística (p) um valor igual ou menor que 0,05.Resultados: Realizaram-se testes de estimulação em 89 doentes, com mediana de idade igual a 10 [3-17] anos, 67% do sexo masculino e 77% pré-púberes. Os fármacos utilizados no primeiro teste de estimulação foram a clonidina (n = 85) e a insulina (n = 4). Foram diagnosticados 22 casos de deficiência de hormona do crescimento. Nos casos submetidos a dois testes, os valores máximos de hormona do crescimento apresentaram uma correlação moderada entre si (r = 0,593, p = 0,01). Verificou-se que as variáveis estatura (z-score) e pico máximo de hormona do crescimento obtido no primeiro teste têm valor preditivo no diagnóstico de deficiência de hormona do crescimento.Discussão: A determinação do IGF-1 não demonstrou ser preditor de deficiência de hormona do crescimento.Conclusão: Os testes de estimulação são uma ferramenta de diagnóstico da deficiência de hormona do crescimento e que devem ser enquadrados nos parâmetros clínicos e auxológicos.

Membranoproliferative glomerulonephritis and x-linked agammaglobulinemia: an uncommon association.

Introduction. X-linked agammaglobulinemia (XLA) is a primary immunodeficiency characterized by agammaglobulinemia requiring replacement treatment with immunoglobulin. The association of XLA and membranoproliferative glomerulonephritis (MPGN) is unexpected and, to our knowledge, only one case was previously published. Case Report. The authors report the case of a 10-year-old boy with family history and prenatal diagnosis of XLA, treated from birth with intravenous immunoglobulin replacement therapy. He presented with pneumonia, macroscopic hematuria, nephrotic proteinuria, hypoalbuminemia, and hypercholesterolemia with normal renal function and serum complement levels. Renal histology showed immune complex mediated MPGN. He was started on high dose prednisolone and ramipril and switched to weekly subcutaneous immunoglobulin. After a 4-month treatment, hematuria and proteinuria significantly improved and prednisolone was gradually tapered without relapse. Conclusion. The pathogenic process underlying MPGN development in this patient is unknown but residual humoral immunity might play an important role. Thus, this case highlights the risk of autoimmune disorders among patients with XLA.

Cystic lymphangioma of the mediastinum.

Cystic lymphangioma is a rare congenital benign tumor. It results from focal proliferation of well-differentiated lymphatic tissue originating from abnormal development of the lymphatic system. Most cystic lymphangiomas occur in the primitive lymph sacs of children or young adults. They generally appear in the neck (75%) and axillary region (20%). Only 1% are located in the mediastinum. Acquired lymphangiomas, which are principally seen in middle-aged adults, are caused by a process of chronic lymphatic obstruction secondary to surgery, chronic infection, or radiation. Here, we present the case of a 50-year-old male with cystic lymphangioma of the mediastinum, detected on a routine chest X-ray.

Linfangioma cístico do mediastino / Cystic lymphangioma of the mediastinum

O linfangioma cístico é um tumor congênito benigno e raro. Resulta da proliferação focal de tecido linfático bem diferenciado com origem num anormal desenvolvimento do sistema linfático. A maioria ocorre em crianças ou adultos jovens nos sacos linfáticos primordiais. Geralmente ocorrem no pescoço (75%) e na região axilar (20%). Apenas 1% desses são localizados no mediastino. Os linfangiomas adquiridos, principalmente encontrados em adultos de meia-idade, são conseqüentes a um processo de obstrução linfática crônica secundária a cirurgia, infecção crônica ou radiação. Os autores apresentam um caso clínico de linfangioma cístico do mediastino num indivíduo do sexo masculino de 50 anos, detectado por achado em radiografia de tórax de rotina.

Cystic lymphangioma is a rare congenital benign tumor. It results from focal proliferation of well-differentiated lymphatic tissue originating from abnormal development of the lymphatic system. Most cystic lymphangiomas occur in the primitive lymph sacs of children or young adults. They generally appear in the neck (75%) and axillary region (20%). Only 1% are located in the mediastinum. Acquired lymphangiomas, which are principally seen in middle-aged adults, are caused by a process of chronic lymphatic obstruction secondary to surgery, chronic infection, or radiation. Here, we present the case of a 50-year-old male with cystic lymphangioma of the mediastinum, detected on a routine chest X-ray.