Use of the PARO robot as a social mediator in a sample of children with neurodevelopmental disorders and typical development.

Background: Social robotics is a research field aimed at providing robots with skills related to social behavior and natural human interaction. Many studies have demonstrated the efficacy of these robots as socio-communicative mediators. Others have used them to create a new communication channel and promote social interaction in chil-dren with autism spectrum disorder (ASD). For children with ASD prolonged interpersonal interaction can sometimes generate extreme frustration. They may find it difficult to focus their attention and learn social skills. The robot may therefore become a reliable and more predictable technological intermediary for the child. Methods: Our study involved the use of the PARO seal robot as a social mediator in groups of children with neurodevelopmental disorders. We aimed to investigate whether the social robot could facilitate relationships with adults in children with neurodevelopmental disorders by comparing their interactions with those of typically developing children. Results: The results of our research partially confirm what has been reported in the existing literature, while introducing some innovations that could be addressed by future research. The results of the statistical analysis show a positive correlation in the 'interaction' dimension and the presence of the PARO seal in subjects diagnosed with autism without intellectual impairment. These data highlight the PARO robot's ability to facilitate communication and social. Conclusions: The results of the present study confirm that social robotics can be a valid tool to improve socio-communication skills in clinical samples of children with autism without intellectual impai-rment.

Motor synergies: Evidence for a novel motor signature in autism spectrum disorder.

In autism spectrum disorder (ASD), socio-communicative impairments and stereotypical behaviours are paralleled by sensorimotor deficits. Individuals with ASD show an altered selection of motor parameters, resulting in clumsy and fragmented actions. Here, we investigated inter-joint coordination and motor synergies as a potential substrate of motor control problems in ASD. Synergies enable co-controlling redundant motor degrees of freedom (DoF, e.g. joint angles, muscles) by mapping behavioural goals into a flexible and low-dimensional set of variables. This mechanism simplifies motor control and helps to find unambiguous solutions for motor tasks. In a reaching-grasping paradigm, children with ASD showed reduced coupling between DoF, which correlated with socio-communicative symptoms severity. Impaired synergies may help to frame well-established motor problems in ASD, including impaired motor sequencing and abnormal trial-to-trial motor variability. On the other hand, synergies also provide an effective and compact coding system of observed actions. Impaired synergies may thus jeopardize motor interaction by initiating bottom-up cascade effects, leading to pervasive impairments of social behaviour. Finally, we trained an automatic classification algorithm to distinguish between ASD and typically developing (TD) participants based on reaching-grasping kinematics. Classification accuracy reached up to 0.947. This result corroborates and expands previous accounts claiming that motor-based early recognition is feasible and effective in ASD.

Publisher Correction: Anticipatory postural adjustments during joint action coordination.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Anticipatory postural adjustments during joint action coordination.

There is a current claim that humans are able to effortlessly detect others' hidden mental state by simply observing their movements and transforming the visual input into motor knowledge to predict behaviour. Using a classical paradigm quantifying motor predictions, we tested the role of vision feedback during a reach and load-lifting task performed either alone or with the help of a partner. Wrist flexor and extensor muscle activities were recorded on the supporting hand. Early muscle changes preventing limb instabilities when participants performed the task by themselves revealed the contribution of the visual input in postural anticipation. When the partner performed the unloading, a condition mimicking a split-brain situation, motor prediction followed a pattern evolving along the task course and changing with the integration of successive somatosensory feedback. Our findings demonstrate that during social behaviour, in addition to self-motor representations, individuals cooperate by continuously integrating sensory signals from various sources.

Explorative analysis of gender-specific characteristics in patients with heart failure in an Italian hospital.

Sex-related differences have been shown to deeply affect health-related aspects of patients. However, the lack of gender-specific analysis makes it difficult to advance personalized medicine in terms of a gender-based approach. The aim of the present study was to describe gender-specific features of patients diagnosed with heart failure (HF), with a focus on the clinical presentation. Data were collected from a properly designed database and referred to an Italian hospital. Patients aged ≥18 years with a primary or secondary diagnosis of HF between 1 January 2012 and 31 December 2016 were included, and their demographic and clinical characteristics were analyzed according to gender. Of the 719 HF patients included, 317 (44.1%) were male and 402 (55.9%) were female. Women tended to be older compared to men (82.4±8.8 years and 77.1±10.6 years, respectively). As for clinical presentation, 62.1% of female and 38.3% of male patients had preserved ejection fraction, and 56.1% of men and 58.2% of women suffered from atrial fibrillation. The left atrium was partially compromised in 62.4% of male and 63% of female patients, while right atrium dysfunction tended to be more frequent in male patients compared to female patients (29.1% and 25.5%, respectively). In conclusion, gender-specific features of a cohort of HF patients from a clinical setting were accurately described.

Eficiência nutricional do Nitrogênio e produção de biomassa em Calendula officinalis L. (Asteraceae) em condições de casa de vegetação / Nitrogen nutritional efficiency and biomass production in Calendula officinalis L. (Asteraceae) under greenhouse conditions

O objetivo deste trabalho foi avaliar o efeito da aplicação de diferentes doses de nitrogênio no solo e de épocas de coleta sobre a eficiência nutricional do nitrogênio e a produção de biomassa em Calendula officinalis L. (Asteraceae) em condições de casa de vegetação. O substrato utilizado foi a camada de 0 - 20 cm de Latossolo Vermelho Distroférrico. O delineamento experimental foi inteiramente casualizado, com quatro repetições. Os tratamentos foram constituídos de quatro doses de N (0, 21, 42 e 84mg dm-3) e cinco épocas de colheita (15, 30, 45, 60 e 90 dias após o transplante). O teor de N na inflorescência de calêndula reduziu com as épocas de coleta, redução essa que ocorreu possivelmente devido à menor eficiência da absorção desse elemento pela planta e menor translocação do N para as inflorescências. Pode se concluir que as épocas de avaliação influenciaram na resposta da planta à eficiência de absorção (EFA), sendo a máxima EFA de N aos 51 dias após o transplante das mudas. Observou-se aumento na translocação de N da parte aérea (folhas e caules) para as inflorescências, tendo como consequência a redução do N na parte aérea. Houve incremento na produção de biomassa de calêndula em função das épocas de coleta , e do aumento das doses de N aplicadas no solo. A eficiência nutricional do N foi influenciada pelas épocas de avaliação e pelo teor de N presente no solo.

The aim of this study was to evaluate the effect of both the application of different nitrogen levels on the soil and the harvest periods on nitrogen nutritional efficiency and biomass production in Calendula officinalis L. (Asteraceae) under greenhouse conditions. The employed substrate was 0-20cm layer of Oxisol. Experimental design was completely randomized, with four replicates. Treatments consisted of four N levels (0, 21, 42 and 84 mg dm-3) and five harvest periods (15, 30, 45, 60 and 90 days after transplanting). N levels in Calendula officinalis inflorescences reduced with the harvest periods, and such a reduction was probably due to the lower efficiency of absorption of this element by the plant and to the lower N translocation to inflorescences. We can conclude that the evaluation periods influenced the response of plants to uptake efficiency (UE), and the maximal UE for N was found at 51 days after transplanting of seedlings. There was an increase in N translocation from the shoot (leaves and stems) to inflorescences, which has as consequence N reduction in the shoot. Calendula officinalis biomass production increased with the harvest periods and with the increase in the N levels applied on the soil. N nutritional efficiency was influenced by both the evaluation periods and the N levels present on the soil.

Adherence to therapeutic and diagnostic recommendations in patients with femur fracture and at risk of re-fracture or death: results of an analysis of administrative databases.

The aim of the present study was to evaluate the application into clinical practice of therapeutic and diagnostic recommendations for the prevention of bone re-fracture in postmenopausal women after an hospitalization for hip fracture in clinical practice and to assess the relationship between the application of diagnostic recommendations and re-fracture or death risk. A retrospective cohort analysis was conducted. All female patients, at least 65 years old, and with an hospitalization with main or secondary diagnosis of hip fracture during the period 1 January 2006 - 31 December 2008, were included. Besides demographic characteristics and comorbidities, drug treatment prescriptions related to bone fracture or supplementary with calcium or vitamin D and prescriptions of recommended laboratory and instrumental diagnostic tests (e.g. spine radiography), were analysed. A total of 5,636 patients were included in the study. The prescription of a drug treatment aimed to reduce the risk of re-fracture was found in 16.3% of patients, among them 76.3% (699 patients) used bisphosphonates only, 17.1% (157 patients) strontium ranelate only and 4.9% (45 patients) used more than one treatment during the observation period. Among the patients who did not receive drug treatment, 17.5% made use of only supplemental calcium and vitamin D. The remaining part of patients (69.1%) received no treatment. The prescription of at least one laboratory test of first and second level was performed, respectively, on 53.7% and 43.1% of included patients, whereas the prescription of at least one instrumental test of first and second level was performed, respectively, on 5.9% and 0.8%. Although it is established that the prescription of the recommended tests and appropriate drug treatment are significantly associated with reduced risk of re-fracture and death, today the application of these recommendations is reduced.

Eficiência da absorção, translocação e uso de N e P pela Pfaffia glomerata (Spreng. ) Pedersen / Efficiency of N and P uptake, translocation and use by Pfaffia glomerata (Spreng. ) Pedersen

Tendo como objetivo avaliar a eficiência de absorção, translocação e uso de nitrogênio (N) e fósforo (P) pela Pfaffia glomerata, foi conduzido o presente trabalho em casa de vegetação no delineamento inteiramente casualizado com três repetições. Os tratamentos foram dispostos em esquema fatorial 5 x 5, sendo cinco doses de N (0, 125, 250, 375 e 500 mg vaso-1) e cinco doses de P (P2O5) (0, 125, 250, 375 e 500 mg vaso-1). Os resultados evidenciaram que a eficiência de absorção de N e P foi influenciada pelas doses de N e P utilizadas no experimento apresentando interação entre os fatores em estudo. A eficiência de translocação do N foi consideravelmente menor que a de P, provavelmente pela maior concentração de compostos nitrogenados nas raízes em detrimento da parte aérea. Observou-se maior eficiência de uso do P devido à menor concentração desse elemento na planta. A absorção de N e de P foi influenciada pela dose desses elementos no solo, sendo possível a estimativa das doses desses nutrientes que proporcionem maiores eficiências de absorção, translocação, uso e teor total.

Aimed at evaluating the efficiency of nitrogen (N) and phosphorus (P) uptake, translocation and use by Pfaffia glomerata, the present study was conducted in greenhouse, in completely randomized design with three replicates. Treatments were displayed in 5 x 5 factorial design, with five N levels (0, 125, 250, 375 and 500 mg pot-1) and five P (P2O5) levels (0, 125, 250, 375 and 500 mg pot-1). Results evidenced that N and P uptake efficiency was influenced by the N and P levels used in the experiment, showing interaction among the studied factors. N translocation efficiency was considerably lower than that of P, probably due to the lower concentration of nitrogenous compounds in the roots than in the shoot. P use efficiency was higher due to the lower concentration of this element in the plant. N and P uptake was influenced by the level of these elements in the soil, being possible to estimate the levels of these nutrients which provide higher uptake, translocation and use efficiency besides total content.

Use of antihypertensive and lipid-lowering drugs: the management of cardiovascular risk in clinical practice.

The objective of the study was to analyse the treatment of high blood pressure (BP) and hypercholesterolaemia, as well as the effect of individual or combined antihypertensive-hypocholesterolaemic therapy on BP control and on circulating cholesterol. A retrospective study was performed using clinical data recorded in the general practitioner's database. The sample included all patients, aged > or =18 years, with BP reading or low-density lipoprotein (LDL) cholesterol measurement recorded between January 2003 and December 2004. BP and LDL cholesterol targets were defined using cutoffs based on the guidelines of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) and the National Cholesterol Education Program (NCEP/ATPIII). The study included 4764 patients (mean age 67.6+/-11.8 years, 43.5% males). Target BP was achieved in a higher number of patients under combined antihypertensive-hypocholesterolaemic therapy than in those treated only with antihypertensives: 57.0 vs 50.0% in patients with history of cardio/cerebrovascular (CV) hospitalization, 27.0 vs 16.9% in patients with diabetes or chronic renal insufficiency (CRI) and 59.7 vs 49.1% in patients with no CV hospitalization nor diabetes and nor CRI. The LDL cholesterol target was achieved in 61.3% of the subjects: it was independent on the therapy (individual or combined), but related to the degree of cardiovascular risk. Analysing the data contained in the general medicine database made it possible to evaluate the treatment of high BP and hypercholesterolaemia in relation to cardiovascular risk in clinical practice and to establish the need to pay greater attention to achieving the objective set by guidelines.

Time course for the reappearance of vibrissal motor representation following botulinum toxin injection into the vibrissal pad of the adult rat.

The present study investigates the time course and pattern of movement representation recovery in the motor cortex during the recovery after a peripheral paralysis. To this end a transitory flaccid paralysis of the vibrissae muscle was induced in adult rats that underwent two unilateral injections of 8 U of botulinum toxin (BTX) into a vibrissal pad, at a duration of 12 days from one another. The compound muscle action potential (MAP) of the vibrissae muscle began to reappear 4 weeks after the first BTX injection. Intracortical microstimulation (ICMS) was used to map rat motor cortices 4, 5, 6, 7 and 8 weeks after the first BTX injection. Findings demonstrated that: (i) contralateral vibrissae movement reappears in the medial part of its normal cortical territory when the MAP is almost 10% of the control value; in the remaining part, ICMS elicits eye, ipsilateral vibrissae, neck and forelimb movements; (ii) the contralateral vibrissae movement reappears in sites where ipsilateral vibrissae and/or neck movement are co-represented; (iii) as MAP recovers, the vibrissae representation expands until it recovers the 90.8% of its territory after 7 weeks, when the MAP was almost 43.4% of the control value; (iv) from 4 to 7 weeks, the ICMS-evoked contralateral vibrissae movement shows a significantly higher electrical threshold vs. the control group; (v) recovery of the baseline excitability uniformly involves the vibrissae representation 1 week later, after its cortical territory has recovered 93.1% of the control value and the MAP has returned to 78.8% of the baseline value.

Ion release in stable hip arthroplasties using metal-on-metal articulating surfaces: a comparison between short- and medium-term results.

The use of metallic heads articulating with metallic cups could solve the problem of polyethylene (PE) wear in total hip replacement (THR) with metal-on-PE bearings. A conspicuous release of metal ions from new models of metal-on-metal bearings has been found in the short-term, but it is yet unclear whether the medium-term corrosion rate is high or, on the contrary, it becomes negligible, because of the continuous surface finishing. Our purpose was to compare the serum ion values (nanograms per milliliter) in 15 patients with metal-on-metal stable prosthesis (Group A), in the short-term (subgroup A(1); mean follow-up: 24 mo) and medium-term (subgroup A(2); mean follow-up: 52 mo), in order to determine whether the ion release decreased with time of implant. Chromium (Cr), cobalt (Co), molybdenum (Mo) and aluminum (Al) were analyzed. Twenty-two presurgical patients were used for comparison (Group B). The reference range was obtained from a population of 27 healthy subjects (Group C). Co and Cr levels in the medium-term (subgroup A(2)) were not decreased in comparison with the short-term values (subgroup A(1)) and were significantly higher (p < 0.001) than presurgical and reference values. Otherwise, Mo and Al concentrations were not significantly increased in comparison with reference values. In conclusion, despite the apparent advantage of metal-on-metal coupling, especially in younger patient populations, there is a major concern about the extent and duration of the relevant "internal" exposure to Cr and Co ions. This exposure should be carefully monitored, in order to clarify the biologic effects of ion dissemination and, consequently, to identify risks concerning long-term toxicity of metals.

Phalangeal ultrasonography in forearm fracture discrimination.

Over the last decade, the use of ultrasounds has been developed into an effective tool for investigating bone tissue and predicting the risk of fracture in osteoporosis. Studies have focused on hip and vertebral fractures while no information is available on the use of phalangeal ultrasonography to identify patients with forearm fractures. Thus, the current authors decided to compare 50 postmenopausal women with low energy forearm fractures (Fractured Group) with a control age-matched group of 94 women (Control Group). Measurements were taken at the distal metaphysis of the proximal phalanxes of the hand of the non-fractured arm using the DBM Sonic Bone Profiler. The reproducibility of the method was assessed by amplitude-dependent speed of sound (AD-SoS) CV% = 0.64 and by Ultrasound Bone Profiler Index (UBPI) CV% = 2.38. In the Control Group, the AD-SoS and UBPI mean values and standard deviations were significantly higher compared to the group with fractures (P < 0.0005). The receiver operating characteristic (ROC) curves were calculated and the areas under the curve (AUC) were 0.78 +/- 0.04 for AD-SoS and 0.77 +/- 0.05 for UBPI, respectively. Logistic regression analysis adjusted to age revealed that both AD-SoS (78.2%, ORAD-SoS = 12.03, P < 0.0005) and UBPI (76.0%, ORAD-SoS = 7.39, P < 0.0005) parameters discriminated correctly between fractured and non-fractured control women whereas the association of both parameters could not allow better discrimination. The present results showed that ultrasound investigation at the phalanxes is reproducible and efficiently discriminates between subjects with forearm fractures and those in the control subjects.

Ion release in patients with metal-on-metal hip bearings in total joint replacement: a comparison with metal-on-polyethylene bearings.

Polyethylene (PE) wear has been shown to be a problem in long-term joint replacement using metal-on-PE bearing. The use of metallic heads articulating with metallic cups could solve this problem: success will be enhanced if wear and corrosion of the articulating surfaces are maintained at a low level. New models with metal-on-metal bearing have been proposed, to be used mainly for young subjects: such coupling seems to have a reduced release, but it is unclear yet if the medium-term corrosion rate is really negligible or, on the contrary, it is significantly higher than in the metal-on-PE bearing. Aim of our study was the comparison of ion release in the serum of two groups of patients who had the same type of stable cementless prosthesis, but different bearing: twenty-six patients with metal-on-metal (Group A) and fifteen patients with metal-on-PE bearing (Group B) were examined. The follow-up was 14-38 months for group A and 18-34 months for group B. The serum concentration of chromium (Cr), cobalt (Co) and molybdenum (Mo) was measured. Twenty-two patients before surgery were used for comparison (Group C). The reference values were obtained from a population of twenty-two healthy subjects (Group D). Our findings indicate that metal-on-metal bearings produce a significantly higher systemic release of cobalt and chromium (ng/ml) when compared with levels found in metal-on-PE, pre-surgery and reference groups. Such a high release should induce to improve the bearing materials or, at least, to study the biologic fate of metal ions and consequently their long-term effects. In such a way a risk-to-benefit ratio for the patient could be established.

The surgical treatment of Rockwood grade III acromioclavicular dislocations.

The conservative or surgical treatment of Rockwood grade III acromioclavicular dislocations continues to be a controversial subject. Thus, the authors report their experience with 52 cases; long-term follow-up was obtained for 40 of these, paying close attention to the preoperative clinical and radiographic evaluation and to the results obtained in order to ascertain whether or not surgical repair is required. The results of surgical treatment, however satisfactory (90% excellent or very good), are nearly the same as those obtained when non surgical treatment is used as reported in the international literature. The authors conclude that the use of surgical treatment must be limited to carefully selected cases, should prolonged conservative treatment fail. Of the three surgical techniques used, temporary stabilization of the acromioclavicular joint using AO wires associated with restoration of the coracoclavicular connections has proven to be more effective than Dall-Miles metal wiring and tangential resection, with a lower incidence of complication.

Experimental study on rotator cuff repair.

It was the purpose of the experimental study to use laboratory experience to verify the effectiveness of different methods used to repair the rotator cuff. The sheep was used as an animal model because its infraspinous tendon is the most similar to that in the human. Three static trials were conducted using Instron machines, comparing the repair systems used most by the same authors in their clinical work, the hold of the suturing wires with two different threading procedures in the bone tunnels and two types of knotting, and the breakage loading of the suturing wires in the two different miniplate systems. The authors conclude that tendinous anchoring must be entrusted to reinforced suturing systems (modified SCOI and Mason Allen), the threading of wires in pairs in a single bone tunnel makes surgery easier and shortens the amount of time required, with threading of wires similar to or better than threading with a single wire. There are no differences in breakage loading of the wire at the level of the holes in the two miniplates considered in this study.

Lipoxygenase gene expression in the tobacco-Phytophthora parasitica nicotianae interaction.

A recently isolated cDNA clone of tobacco (Nicotiana tabacum L.) lipoxygenase (LOX) was used to study LOX gene expression in tobacco cell-suspension cultures and intact plants in response to infection with Phytophthora parasitica nicotianae (Ppn). Southern blot analysis of tobacco DNA indicated that only a small number of LOX genes hybridize to this probe. These genes were not constitutively expressed to a detectable level in control cells and healthy plants. In contrast, a rapid and transient accumulation of transcripts occurred in cells and plants after treatment with elicitor and inoculation with zoospores of Ppn, respectively. In cell cultures LOX gene expression could also be induced by linolenic acid, a LOX substrate, and by methyl jasmonate, one of the products derived from the action of LOX on linolenic acid. In the infection assays, LOX gene expression and enzyme activity were observed earlier when the plants carried a resistance gene against the race of Ppn used for inoculation. The differential expression of LOX during the race-cultivar-specific interaction between tobacco and Ppn, as well as its regulation by elicitors and jasmonate, suggest a role of LOX in plant resistance and establishment of the defense status against this pathogen.

Cobalt powdersintering industry (stone cutting diamond wheels): a study of environmental-biological monitoring, workplace improvement and health surveillance.

This communication deals with an aspect of occupational hygiene in a factory producing granite cutting diamond wheels by sintering, in moulds, of fine cobalt powder. The factory has been studied between 1988 and 1991; the Department of Preventive and Occupational Medicine of the Local Sanitary Unit of Reggio Emilia has followed the evolution of the local exhaust ventilation equipment supplied by the employer in that period. At the same time, the following measurements and observations were carried out: (a) cobalt exposure by personal sampling, (b) airborne cobalt measurements by area sampling, (c) biological monitoring of cobalt in urine, (d) health surveillance.