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Eight weeks of eccentric training at long-muscle length increases fascicle length independently of adaptations in passive mechanical properties
No full textEccentric exercise training is believed to induce an increase in muscle fascicle length. However, the mechanisms underlying this adaptation are not fully understood. This study aimed to determine if an increase in gastrocnemius medialis fascicle length following an 8-week eccentric training is linked to changes in muscle tissue and joint mechanical properties. Thirty-three physically active young adults were assigned to one of two training protocols targeting the plantar flexors: eccentric exercise at 1) long-muscle length or 2) short-muscle length. Fascicle length and muscle shear modulus of the gastrocnemius medialis were assessed using ultrasound imaging during passive ankle rotations, alongside measurements of passive ankle torque. A total of 27 participants successfully completed the training program and data processing stage (long-muscle length, n=15; short-muscle length, n=12). Maximal voluntary isometric torque increased significantly following the training programs (9.5%), with no differences between training groups. An increase in fascicle length (mean 8.5%) was observed in the long-muscle length group, from 39.5±0.7° to 36.8±0.8° in plantar flexion; but not in the short-muscle length group. Notably, this macrostructural adaptation was detected only at muscle lengths shorter than the slack length (i.e., absence of any muscle passive tension). The eccentric training did not alter the muscle shear modulus or slack length. Collectively, these findings suggest that fascicle length adaptations in response to eccentric training were unrelated to changes in passive muscle-tendon mechanical properties. Consequently, the increase in fascicle length may be attributed to an increase in sarcomere length and/or an addition of sarcomeres in series
Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
No full textMigrant populations - including labour migrants, undocumented migrants, asylum seekers, refugees, internationally displaced persons, and other populations on the move - are exposed to a variety of stressors that affect their mental health. We designed and tested the effectiveness of a stepped-care programme consisting of two scalable psychological interventions developed by the World Health Organization (WHO) and locally adapted for migrant populations. A parallel-group randomized controlled trial was conducted in Italy. We recruited migrant adults (≥18 years) with psychological distress (score of at least 16 on the Kessler Psychological Distress Scale, K10). The experimental arm received psychological first aid (PFA) and a stepped-care programme consisting of two WHO interventions adapted for this population group: first, Doing What Matters in Times of Stress (DWM) and, for participants who still reported significant levels of psychological distress after DWM, Problem Management Plus (PM+). Each intervention lasted 5-6 weeks and was delivered remotely by lay facilitators. The control arm received PFA and care as usual (CAU). The primary outcome was the change in symptoms of depression and anxiety from baseline to week 21 after randomization, measured by the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Between December 14, 2021 and April 18, 2023, 108 migrants were randomized to the stepped-care intervention and 109 to CAU. Analysis of the primary outcome revealed that participants receiving the stepped-care programme showed a greater reduction in anxiety and depression symptoms compared to those receiving CAU (coefficient: -3.460, standard error, SE: 1.050, p=0.001) at week 21. The same difference was observed at week 7 (coefficient: -3.742, SE=1.008, p<0.001) and week 14 (coefficient: -6.381, SE=1.039, p<0.001). The stepped-care programme was also associated with a greater improvement of depression and anxiety symptoms assessed separately at all timepoints, of post-traumatic stress disorder symptoms at weeks 14 and 21, and of self-assessed problems, function and well-being at all timepoints. No serious adverse events occurred. This study provides evidence supporting the stepped-care delivery of DWM and PM+ for migrant population groups with elevated distress. As these interventions are low-intensity, transdiagnostic and task-shifting, they are highly scalable. Existing evidence-based guidelines and implementation packages should be updated accordingly
Extracorporeal Acoustic Shock Waves to Treat Complications of Polymethylmethacrylate
Get PDFBackground: Polymethylmethacrylate (PMMA) fillers are permanent fillers known for their possible side effects. In case of complications, the only possible treatment is surgical removal, followed by procedures to minimize resulting deformity. The aims of this study were (1) to analyse the morphology of the PMMA material in the nodules, (2) to demonstrate that treatment by acoustic wave therapy (AWT) can help the removal of the nodules, and (3) to present an easy procedure to solve deformities. Methods: The data of 9 patients who underwent AWT, surgical PMMA removal, and deformity correction by enriched nanograft and dermagraft injections between April 2021 and May 2024 were presented. The leftover aspirated material was analysed by histology and scanning electron microscopy. Results: AWT resulted in no complications in all patients. After removal and correction surgeries, minor complications were observed in 5 cases. All the patients were delighted with the aesthetic outcome. In all patients, an important improvement of the deformities, with correction of the volume of the face, was observed. A substantial resolution of the initial clinical symptoms was documented. The ultrastructural analysis highlighted that PMMA appears in the form of laminar or prismatic formations with a paracrystalline structure. Conclusions: AWT acted directly on PMMA to facilitate its removal and reduce fibrosis around the PMMA filler. The lack of volume correlated with PMMA removal was resolved with the enriched nanograft and dermagraft injections, which led to very satisfying aesthetic results. Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266
From VinKo to AlpiLinK: web-based long-term storage and accessibility of information
No full textIn this contribution, we will discuss challenges, solutions and open questions connected with the reusability and therefore persistence of web-based research from the perspective of the AlpiLinK project (https://alpilink.it/en/progetto). AlpiLinK (Alpine Languages in Contact, , a 'project of relevant national interest' [PRIN] financed by the Italian Research Ministry) aims at the collection of oral linguistic data from the Germanic and Romance non-standard and minority languages spoken in alpine Italy. It collects its data online and intends to provide easy access to the collected data and to basic information regarding the varieties and the project itself not just for an academic audience, but also for a general public, including but not limited to the local speech communities (e.g., public-outreach activities involving local high schools like VinKiamo). While most of the publication of the scientific results continue to be paper based or in e-journals with paper-like procedures and standards, long-term storage and accessibility of online data and information for the general public is still in its infancy. AlpiLinK aims to maximize the probability of survival of its data by ensuring the data is stored in a structured format, which is machine- and human-readable, in a CLARIN repository (https://doi.org/10.5281/zenodo.8360169) similar to the related datasets VinKo (http://hdl.handle.net/20.500.12124/74), and AThEME (http://hdl.handle.net/20.500.12124/53). However, the permanent accessibility of the additional information - web pages with sometimes detailed, multimodal and even interactive speech-variety profiles, comparisons of linguistic features across language borders and language change descriptions - remains a challenge. This became especially evident in the transition from our previous VinKo project to AlpiLinK. While all data is securely stored in the above-quoted repository and the alternative data representation via an interactive map (much appreciated by the general public) has been transferred to AlpiLinK's interactive map, the pages of the old deactivated VinKo website with its additional information are no longer accessible
3-Step Combined Technique for Correction of Involutional Lower Eyelid Ectropion: A Case Series
Get PDFBackground: Involutional lower eyelid ectropion is a common disorder of the elderly population. Several surgical approaches have been described in the literature to address the multifactorial nature of this condition, each targeting different factors contributing to its development. Nevertheless, no single procedure has proven to be superior to the others. This study aims to assess the safety and effectiveness of a new 3-step combined technique in treating involutional ectropion. Methods: The surgical technique consists of a combination of lateral lid-shortening with removal of a base-up triangle (modified Bick procedure), lower eyelid skin release, and transposition of a laterally based myocutaneous flap from the upper eyelid. A retrospective chart review was conducted for all patients treated with this procedure at our institution between 2012 and 2023 was performed. Self-reported patient satisfaction with functional and esthetic outcomes was evaluated three months after surgery. Results: A total of thirty-six patients (forty-five eyelids) were included in the study, with a mean follow-up period of 22 months (range 3-144). Minor surgical revision was performed in one case for early wound dehiscence following premature stitches removal. The overall success rate was 93.2%, with one case of undercorrection and two cases of recurrence recorded at three years postoperatively. No additional complications or recurrences were observed during the follow-up period. Conclusions: The 3-step combined procedure demonstrated high efficacy and safety, offering excellent functional and esthetic outcomes. This approach provides a reliable solution for treating involutional ectropion, making it a valuable addition to the surgical options for this condition
Controllers for Edge-Cloud Cyber-Physical Systems
Get PDFDeep Neural Networks (DNNs) are now widely used in Cyber-Physical Systems (CPSs), both for sensor data or perception processing and also as neural network controllers. However, resource constraints often prevent a full local deployment of the DNNs, e.g., on edge devices. Implementing them on the cloud, on the other hand, is associated with large delays and large volumes of data transfers. This has resulted in the emergence of Split Computing (SC), where a part of the DNN is implemented on an edge device and the rest in the cloud. However, how to design control strategies with such a setup has not been sufficiently investigated in the past. In this paper, we study controller design strategies where state estimates from sensor data processed on an edge device are combined with estimates obtained from the cloud. While the former is associated with low delays, the state estimates have higher errors or uncertainties. The estimates from the cloud, obtained with larger DNNs, are, however, delayed. We show that the problem of sizing the DNNs on the edge and the cloud can be formulated as an optimization problem with the goal of maximizing system safety
Sustained chromosomal passenger complex activity preserves the pluripotency of human embryonic carcinoma cells
Get PDFHuman embryonic carcinoma (hEC) cells are derived from teratocarcinomas, exhibit robust proliferation, have a high differentiation potential, are the malignant counterparts of human embryonic stem cells (hESCs), and are considered hESC-like. The chromosomal passenger complex (CPC), made up of the microtuble binding protein Borealin, the kinase Aurora-B, the CPC-stabilizing inner centromere protein (INCENP), and the inhibitor of apoptosis family member Survivin, regulates cell division and is active exclusively during mitosis in somatic cells. The anaphase-promoting complex/cyclosome and its cofactor Cdh1 (APC/CCdh1) is a ubiquitylating complex that catalyzes the degradation of Aurora-B and Borealin in somatic cells but has low activity during interphase in hESCs. Here, we found that Borealin and Aurora-B exhibited sustained stability throughout the cell cycle of hEC cells due to low APC/CCdh1 activity. In contrast with somatic cells, CPC activity persisted across the cell cycle of hEC cells because of diminished APC/CCdh1 activity. Disrupting the CPC complex by depleting its constituents triggered spontaneous differentiation in hEC cells. As hEC cells differentiated, APC/CCdh1 activation curtailed CPC activity. Inactivating the CPC by pharmacologically inhibiting Aurora-B induced hEC cell differentiation by activating the epithelial-to-mesenchymal transition (EMT) program. Hence, APC/CCdh1-mediated termination of CPC activity triggered hEC cell differentiation. Collectively, these findings demonstrate a role for the CPC in governing hESC cell fate
Assessing the influence of smoking on inflammatory markers in bacillus Calmette Guérin response among bladder cancer patients: a novel machine-learning approach
No full textBACKGROUND: Approximately 70% of bladder cancer is diagnosed as non-muscle invasive (NMIBC) and inflammation is known to impact the oncological outcomes. Adjuvant intravesical BCG in intermediate/high risk can lower recurrence and progression. The efficacy of intravesical BCG can be impacted by smoking effects on systemic inflammation. METHODS: Our retrospective, multicenter study with data from 1.313 NMIBC patients aimed to assess the impact of smoking and the systemic inflammatory status on BCG response in T1G3 bladder cancer, using a machine-learning CART based algorithm. RESULTS: In a median of 50-month follow-up (IQR 41-75), 344 patients experienced progression to muscle invasive or metastatic disease and 65 died due to bladder cancer. A CART algorithm has been employed to stratify patients in three prognostic clusters using smoking status, LMR (lymphocytes to monocytes ratio), NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio) as variables. Cox regression models revealed a 1.5-fold (HR 1.66, 95%, CI 1.20-2.29, P=0.002) and three-fold (HR 2.99, 95% CI 2.08-4.30, P<0.001) risk of progression, in intermediate and high risk NMIBC respectively, compared to the low-risk group. The model's concordance index was 0.66. CONCLUSIONS: Our study provides an insight into the influence of smoking on inflammatory markers and BCG re-sponse in NMIBC patients. Our machine-learning approach provides clinicians a valuable tool for risk stratification, treatment, and decision-making. Future research in larger prospective cohorts is required for validating these findings
Cartolarizzazioni, legittimazione ad agire e titolarita` dei crediti nell’apolidia finanziaria
No full textLa Corte di cassazione ha affrontato due questioni di rilevante impatto sul contenzioso riguardante crediti cartolarizzati e ceduti in blocco: la prima attiene alla prova della titolarita` del credito in capo al cessionario, a fronte delle contestazioni del debitore ceduto; la seconda riguarda la validita` del mandato ex lege alla riscossione conferito, in qualita` di servicer, a soggetto non iscritto all’albo di cui all’art. 106 t.u.b. Le norme, la giurisprudenza e le prassi applicative in materia di cartolarizzazione dei crediti si collocano nel quadro di attuale predominio dell’economia finanziaria, sovranazionale e apolide, che ha finito per mercificare, spersonalizzare e reificare il tradizionale rapporto socio-economico tra creditore (bancario) e debitore fondato sulla fiducia
The Mute Language of Things. David Reimondo's Neostructuralism
No full textUn'interpretazione complessiva del lavoro artistico di David Reimondo