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Ceccarelli M, D'Onofrio M, Ambrogi V, Russo M. A numerical analysis of ventilation motion after chest surgery with a RESPIRholter device. Respir Med Case Rep 2024; 49:102005. [PMID: 38576859 PMCID: PMC10992684 DOI: 10.1016/j.rmcr.2024.102005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/09/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
This case report presents a numerical evaluation of respiration in terms of biomechanical parameters of chest motion. This experimental evaluation is performed with RESPIRholter, a wearable device specifically developed to monitor the movement in the ribcage through the motion of the sixth rib whose characteristic motion is considered as representative of the motion of the thorax. Here we present test results acquired with a RESPIRholter device in a 6-h acquisition. These results characterize respiration biomechanics for diagnostic purposes in a chest surgery patient, highlighting the diagnostic utility of RESPIRholter in the identification of post-operation respiratory problem.
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Affiliation(s)
- Marco Ceccarelli
- Department of Industrial Engineering, University of Rome Tor Vergata, Via del Politecnico 1, 00133, Rome, Italy
| | - Manuel D'Onofrio
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Vincenzo Ambrogi
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Matteo Russo
- Department of Industrial Engineering, University of Rome Tor Vergata, Via del Politecnico 1, 00133, Rome, Italy
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Besharat ZM, Trocchianesi S, Verrienti A, Ciampi R, Cantara S, Romei C, Sabato C, Noviello TMR, Po A, Citarella A, Caruso FP, Panariello I, Gianno F, Carpino G, Gaudio E, Chiacchiarini M, Masuelli L, Sponziello M, Pecce V, Ramone T, Maino F, Dotta F, Ceccarelli M, Pezzullo L, Durante C, Castagna MG, Elisei R, Ferretti E. Correction: Circulating miR‑26b‑5p and miR‑451a as diagnostic biomarkers in medullary thyroid carcinoma patients. J Endocrinol Invest 2024; 47:485. [PMID: 37563447 PMCID: PMC10859328 DOI: 10.1007/s40618-023-02172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Affiliation(s)
- Z M Besharat
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - S Trocchianesi
- Department of Molecular Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - A Verrienti
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - R Ciampi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy
| | - S Cantara
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100, Siena, Italy
| | - C Romei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy
| | - C Sabato
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - T M R Noviello
- Biogem Scarl, Istituto di Ricerche Genetiche "Gaetano Salvatore", 83031, Ariano Irpino, Italy
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138, Naples, Italy
| | - A Po
- Department of Molecular Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - A Citarella
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - F P Caruso
- Biogem Scarl, Istituto di Ricerche Genetiche "Gaetano Salvatore", 83031, Ariano Irpino, Italy
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138, Naples, Italy
| | - I Panariello
- Thyroid Surgical Unit, IRCCS Fondazione G. Pascale, 80131, Naples, Italy
| | - F Gianno
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161, Rome, Italy
| | - G Carpino
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - E Gaudio
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - M Chiacchiarini
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - L Masuelli
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - M Sponziello
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - V Pecce
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - T Ramone
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy
| | - F Maino
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100, Siena, Italy
| | - F Dotta
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100, Siena, Italy
- Tuscany Centre for Precision Medicine (CReMeP), 53100, Siena, Italy
| | - M Ceccarelli
- Biogem Scarl, Istituto di Ricerche Genetiche "Gaetano Salvatore", 83031, Ariano Irpino, Italy
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138, Naples, Italy
| | - L Pezzullo
- Thyroid Surgical Unit, IRCCS Fondazione G. Pascale, 80131, Naples, Italy
| | - C Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161, Rome, Italy.
| | - M G Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100, Siena, Italy
| | - R Elisei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy
| | - E Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
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Nardi L, Davis NM, Sansolini S, Baratto de Albuquerque T, Laarraj M, Caputo D, de Cesare G, Shariati Pour SR, Zangheri M, Calabria D, Guardigli M, Balsamo M, Carrubba E, Carubia F, Ceccarelli M, Ghiozzi M, Popova L, Tenaglia A, Crisconio M, Donati A, Nascetti A, Mirasoli M. APHRODITE: A Compact Lab-on-Chip Biosensor for the Real-Time Analysis of Salivary Biomarkers in Space Missions. Biosensors (Basel) 2024; 14:72. [PMID: 38391991 PMCID: PMC10887022 DOI: 10.3390/bios14020072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/15/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024]
Abstract
One of the main challenges to be faced in deep space missions is to protect the health and ensure the maximum efficiency of the crew by preparing methods of prevention and in situ diagnosis. Indeed, the hostile environment causes important health problems, ranging from muscle atrophy, osteopenia, and immunological and metabolic alterations due to microgravity, to an increased risk of cancer caused by exposure to radiation. It is, therefore, necessary to provide new methods for the real-time measurement of biomarkers suitable for deepening our knowledge of the effects of space flight on the balance of the immune system and for allowing the monitoring of the astronaut's health during long-term missions. APHRODITE will enable human space exploration because it fills this void that affects both missions in LEO and future missions to the Moon and Mars. Its scientific objectives are the design, production, testing, and in-orbit demonstration of a compact, reusable, and reconfigurable system for performing the real-time analysis of oral fluid samples in manned space missions. In the frame of this project, a crew member onboard the ISS will employ APHRODITE to measure the selected target analytes, cortisol, and dehydroepiandrosterone sulfate (DHEA-S), in oral fluid, in four (plus one additional desired session) separate experiment sessions. The paper addresses the design of the main subsystems of the analytical device and the preliminary results obtained during the first implementations of the device subsystems and testing measurements on Earth. In particular, the system design and the experiment data output of the lab-on-chip photosensors and of the front-end readout electronics are reported in detail along with preliminary chemical tests for the duplex competitive CL-immunoassay for the simultaneous detection of cortisol and DHEA-S. Different applications also on Earth are envisaged for the APHRODITE device, as it will be suitable for point-of-care testing applications (e.g., emergency medicine, bioterrorism, diagnostics in developing countries, etc.).
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Affiliation(s)
- Lorenzo Nardi
- School of Aerospace Engineering, Sapienza University of Rome, Via Salaria 851, I-00138 Rome, Italy; (N.M.D.); (S.S.); (T.B.d.A.); (M.L.); (A.N.)
| | - Nithin Maipan Davis
- School of Aerospace Engineering, Sapienza University of Rome, Via Salaria 851, I-00138 Rome, Italy; (N.M.D.); (S.S.); (T.B.d.A.); (M.L.); (A.N.)
| | - Serena Sansolini
- School of Aerospace Engineering, Sapienza University of Rome, Via Salaria 851, I-00138 Rome, Italy; (N.M.D.); (S.S.); (T.B.d.A.); (M.L.); (A.N.)
| | - Thiago Baratto de Albuquerque
- School of Aerospace Engineering, Sapienza University of Rome, Via Salaria 851, I-00138 Rome, Italy; (N.M.D.); (S.S.); (T.B.d.A.); (M.L.); (A.N.)
| | - Mohcine Laarraj
- School of Aerospace Engineering, Sapienza University of Rome, Via Salaria 851, I-00138 Rome, Italy; (N.M.D.); (S.S.); (T.B.d.A.); (M.L.); (A.N.)
| | - Domenico Caputo
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, Via Eudossiana 18, I-00184 Rome, Italy; (D.C.); (G.d.C.)
| | - Giampiero de Cesare
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, Via Eudossiana 18, I-00184 Rome, Italy; (D.C.); (G.d.C.)
| | - Seyedeh Rojin Shariati Pour
- Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum—University of Bologna, Tecnopolo di Rimini, Via Dario Campana 71, I-47922 Rimini, Italy; (S.R.S.P.); (M.Z.); (M.M.)
| | - Martina Zangheri
- Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum—University of Bologna, Tecnopolo di Rimini, Via Dario Campana 71, I-47922 Rimini, Italy; (S.R.S.P.); (M.Z.); (M.M.)
| | - Donato Calabria
- Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum—University of Bologna, Via Selmi 2, I-40126 Bologna, Italy; (D.C.); (M.G.)
- Interdepartmental Centre for Industrial Aerospace Research (CIRI AEROSPACE), Alma Mater Studiorum—University of Bologna, Via Baldassarre Canaccini 12, I-47121 Forlì, Italy
| | - Massimo Guardigli
- Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum—University of Bologna, Via Selmi 2, I-40126 Bologna, Italy; (D.C.); (M.G.)
- Interdepartmental Centre for Industrial Aerospace Research (CIRI AEROSPACE), Alma Mater Studiorum—University of Bologna, Via Baldassarre Canaccini 12, I-47121 Forlì, Italy
| | - Michele Balsamo
- Kayser Italy S.r.l. Unipersonale, Via di Popogna 501, I-57128 Livorno, Italy; (M.B.); (E.C.); (F.C.); (M.C.); (M.G.); (L.P.); (A.T.); (A.D.)
| | - Elisa Carrubba
- Kayser Italy S.r.l. Unipersonale, Via di Popogna 501, I-57128 Livorno, Italy; (M.B.); (E.C.); (F.C.); (M.C.); (M.G.); (L.P.); (A.T.); (A.D.)
| | - Fabrizio Carubia
- Kayser Italy S.r.l. Unipersonale, Via di Popogna 501, I-57128 Livorno, Italy; (M.B.); (E.C.); (F.C.); (M.C.); (M.G.); (L.P.); (A.T.); (A.D.)
| | - Marco Ceccarelli
- Kayser Italy S.r.l. Unipersonale, Via di Popogna 501, I-57128 Livorno, Italy; (M.B.); (E.C.); (F.C.); (M.C.); (M.G.); (L.P.); (A.T.); (A.D.)
| | - Michele Ghiozzi
- Kayser Italy S.r.l. Unipersonale, Via di Popogna 501, I-57128 Livorno, Italy; (M.B.); (E.C.); (F.C.); (M.C.); (M.G.); (L.P.); (A.T.); (A.D.)
| | - Liyana Popova
- Kayser Italy S.r.l. Unipersonale, Via di Popogna 501, I-57128 Livorno, Italy; (M.B.); (E.C.); (F.C.); (M.C.); (M.G.); (L.P.); (A.T.); (A.D.)
| | - Andrea Tenaglia
- Kayser Italy S.r.l. Unipersonale, Via di Popogna 501, I-57128 Livorno, Italy; (M.B.); (E.C.); (F.C.); (M.C.); (M.G.); (L.P.); (A.T.); (A.D.)
| | - Marino Crisconio
- Agenzia Spaziale Italiana (ASI), Italian Space Agency, Via del Politecnico, I-00133 Rome, Italy;
| | - Alessandro Donati
- Kayser Italy S.r.l. Unipersonale, Via di Popogna 501, I-57128 Livorno, Italy; (M.B.); (E.C.); (F.C.); (M.C.); (M.G.); (L.P.); (A.T.); (A.D.)
| | - Augusto Nascetti
- School of Aerospace Engineering, Sapienza University of Rome, Via Salaria 851, I-00138 Rome, Italy; (N.M.D.); (S.S.); (T.B.d.A.); (M.L.); (A.N.)
| | - Mara Mirasoli
- Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum—University of Bologna, Tecnopolo di Rimini, Via Dario Campana 71, I-47922 Rimini, Italy; (S.R.S.P.); (M.Z.); (M.M.)
- Interdepartmental Centre for Industrial Aerospace Research (CIRI AEROSPACE), Alma Mater Studiorum—University of Bologna, Via Baldassarre Canaccini 12, I-47121 Forlì, Italy
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Besharat ZM, Trocchianesi S, Verrienti A, Ciampi R, Cantara S, Romei C, Sabato C, Noviello TMR, Po A, Citarella A, Caruso FP, Panariello I, Gianno F, Carpino G, Gaudio E, Chiacchiarini M, Masuelli L, Sponziello M, Pecce V, Ramone T, Maino F, Dotta F, Ceccarelli M, Pezzullo L, Durante C, Castagna MG, Elisei R, Ferretti E. Circulating miR-26b-5p and miR-451a as diagnostic biomarkers in medullary thyroid carcinoma patients. J Endocrinol Invest 2023; 46:2583-2599. [PMID: 37286863 PMCID: PMC10632281 DOI: 10.1007/s40618-023-02115-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/15/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE/METHODS The determination of tumour biomarkers is paramount to advancing personalized medicine, more so in rare tumours like medullary thyroid carcinoma (MTC), whose diagnosis is still challenging. The aim of this study was to identify non-invasive circulating biomarkers in MTC. To achieve this goal, paired MTC tissue and plasma extracellular vesicle samples were collected from multiple centres and microRNA (miRNA) expression levels were evaluated. RESULTS The samples from a discovery cohort of 23 MTC patients were analysed using miRNA arrays. Lasso logistic regression analysis resulted in the identification of a set of circulating miRNAs as diagnostic biomarkers. Among them, miR-26b-5p and miR-451a, were highly expressed and their expression decreased during follow-up in disease-free patients in the discovery cohort. Circulating miR-26b-5p and miR-451a were validated using droplet digital PCR in a second independent cohort of 12 MTC patients. CONCLUSION This study allowed the identification and validation of a signature of two circulating miRNAs, miR-26b-5p and miR-451a, in two independent cohorts reporting a significant diagnostic performance for MTC. The results of this study offer advancements in molecular diagnosis of MTC proposing a novel non-invasive tool to use in precision medicine.
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Affiliation(s)
- Z M Besharat
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - S Trocchianesi
- Department of Molecular Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - A Verrienti
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - R Ciampi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy
| | - S Cantara
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100, Siena, Italy
| | - C Romei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy
| | - C Sabato
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - T M R Noviello
- Biogem Scarl, Istituto di Ricerche Genetiche "Gaetano Salvatore", 83031, Ariano Irpino, Italy
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138, Naples, Italy
| | - A Po
- Department of Molecular Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - A Citarella
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - F P Caruso
- Biogem Scarl, Istituto di Ricerche Genetiche "Gaetano Salvatore", 83031, Ariano Irpino, Italy
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138, Naples, Italy
| | - I Panariello
- Thyroid Surgical Unit, IRCCS Fondazione G.Pascale, 80131, Naples, Italy
| | - F Gianno
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161, Rome, Italy
| | - G Carpino
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - E Gaudio
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - M Chiacchiarini
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - L Masuelli
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - M Sponziello
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - V Pecce
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - T Ramone
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy
| | - F Maino
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100, Siena, Italy
| | - F Dotta
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100, Siena, Italy
- Tuscany Centre for Precision Medicine (CReMeP), 53100, Siena, Italy
| | - M Ceccarelli
- Biogem Scarl, Istituto di Ricerche Genetiche "Gaetano Salvatore", 83031, Ariano Irpino, Italy
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138, Naples, Italy
| | - L Pezzullo
- Thyroid Surgical Unit, IRCCS Fondazione G.Pascale, 80131, Naples, Italy
| | - C Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161, Rome, Italy.
| | - M G Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100, Siena, Italy
| | - R Elisei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy
| | - E Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
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Cao X, Huang X, Zhao Y, Sun Z, Li H, Jiang Z, Ceccarelli M. A Method of Human-Like Compliant Assembly Based on Variable Admittance Control for Space Maintenance. Cyborg Bionic Syst 2023; 4:0046. [PMID: 37681017 PMCID: PMC10482162 DOI: 10.34133/cbsystems.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/06/2023] [Indexed: 09/09/2023] Open
Abstract
On-orbit assembly has become a crucial aspect of space operations, where the manipulator frequently and directly interacts with objects in a complex assembly process. The traditional manipulator control has limitations in adapting to diverse assembly tasks and is vulnerable to vibration, leading to assembly failure. To address this issue, we propose a human-like variable admittance control method based on the variable damping characteristics of the human arm. By collecting the velocity and contact force of human arm operations in assembly, we analyze the damping change of human arm and establish the active compliance model based on S-type damping variation rule in assembly. Furthermore, 3 passive contact models are proposed between the end of the human arm and the environment: one-sided bevel contact, both sides bevel contact, and pin-hole contact. On the basis of these active and passive models, a typical space assembly task for a robot is designed, and a human-like variable admittance controller is established and simulated. Finally, we build a ground verification platform and complete different assembly tasks, thereby successfully verifying the safety, robustness, and adaptability of the human-like variable admittance control method.
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Affiliation(s)
- Xiaolei Cao
- School of Mechatronical Engineering, Advanced Innovation Center for Intelligent Robots and Systems, Key Laboratory of Biomimetic Robots and Systems of Chinese Ministry of Education,
Beijing Institute of Technology, Beijing 100081, China
| | - Xiao Huang
- School of Mechatronical Engineering, Advanced Innovation Center for Intelligent Robots and Systems, Key Laboratory of Biomimetic Robots and Systems of Chinese Ministry of Education,
Beijing Institute of Technology, Beijing 100081, China
| | - Yan Zhao
- School of Mechatronical Engineering, Advanced Innovation Center for Intelligent Robots and Systems, Key Laboratory of Biomimetic Robots and Systems of Chinese Ministry of Education,
Beijing Institute of Technology, Beijing 100081, China
| | - Zeyuan Sun
- China Northern Vehicle Research Institute, Beijing 100071, China
| | - Hui Li
- School of Mechatronical Engineering, Advanced Innovation Center for Intelligent Robots and Systems, Key Laboratory of Biomimetic Robots and Systems of Chinese Ministry of Education,
Beijing Institute of Technology, Beijing 100081, China
| | - Zhihong Jiang
- School of Mechatronical Engineering, Advanced Innovation Center for Intelligent Robots and Systems, Key Laboratory of Biomimetic Robots and Systems of Chinese Ministry of Education,
Beijing Institute of Technology, Beijing 100081, China
| | - Marco Ceccarelli
- Department of Industrial Engineering,
University of Rome Tor Vergata, Via del Politecnico 1, 00133 Roma, Italy
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Ambrogi V, Bolli E, Ceccarelli M, Kaciulis S, Mezzi A, Montanari R, Pakhomova E, Richetta M, Varone A. Surface modifications of biodegradable AZ31 alloy after immersion in physiological solution. SURF INTERFACE ANAL 2023. [DOI: 10.1002/sia.7195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- V. Ambrogi
- Dipartimento di Scienze Chirurgiche, Università di Roma “Tor Vergata” Via del Politecnico 1 00133 Roma Italy
| | - E. Bolli
- Dipartimento di Ingegneria Industriale, Università di Roma “Tor Vergata” Via del Politecnico 1 00133 Roma Italy
- ISMN ‐ CNR
| | - M. Ceccarelli
- Dipartimento di Ingegneria Industriale, Università di Roma “Tor Vergata” Via del Politecnico 1 00133 Roma Italy
| | | | | | - R. Montanari
- Dipartimento di Ingegneria Industriale, Università di Roma “Tor Vergata” Via del Politecnico 1 00133 Roma Italy
| | - E. Pakhomova
- Dipartimento di Ingegneria Meccanica, Chimica e dei Materiali, Università di Cagliari Via Marengo 2 09123 Cagliari Italy
| | - M. Richetta
- Dipartimento di Ingegneria Industriale, Università di Roma “Tor Vergata” Via del Politecnico 1 00133 Roma Italy
| | - A. Varone
- Dipartimento di Ingegneria Industriale, Università di Roma “Tor Vergata” Via del Politecnico 1 00133 Roma Italy
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Di Giacomo A, Noviello T, Caruso F, Scala G, Ferraro L, Covre A, Coral S, Anichini A, Maio M, Ceccarelli M. 12P Multi-omics correlation with clinical outcome in metastatic melanoma patients treated with ipilimumab plus guadecitabine: The NIBIT-M4 study. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Puglisi L, Ceccarelli M, Taje R, Ambrogi V. An experimental characterization of ventilation motions in healthy subjects. Clin Biomech (Bristol, Avon) 2022; 100:105769. [PMID: 36228417 DOI: 10.1016/j.clinbiomech.2022.105769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 09/17/2022] [Accepted: 09/23/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Existing devices detect main breathing data and none is aimed to monitor biomechanics of ventilation motions with small wearable device. METHODS The used device has been designed for noninvasive wearing to detect main motion parameters of a rib during ventilation in an experimental campaign with 218 subjects. Experimental activity is carried out by testing in vivo with human volunteers for an experimental characterization of ventilation motions as related to normal breathing, maximal breathing and coughing. FINDINGS Findings can be summarized from a numerical analysis of experimental results in terms of statistical values of ventilation motion parameters in rotation and acceleration as function of age and sex of the tested subjects. The discussed campaign reporting results on healthy patients was carried out with the aim to build a reference database of normal conditions against which the status of patients with both thoracic and ventilation problems can then be judged. Females showed significantly larger lateral-to-lateral movements during basal breathing and lateral-to-lateral Z-axis movements during maximal breathing and cough. Males demonstrated wider antero-posterior Y-axis and cranio-caudal X-axis movements during maximal breathing, while antero-posterior movements prevailed during cough. Older participants demonstrated larger lateral-to-lateral Z-axis and antero-posterior Y-axis movements during basal breathing. Young participants showed more significant increments along antero-posterior Y-axis from basal to maximal breathing and basal to cough, demonstrating a more efficient muscular activity. INTERPRETATION The ventilation motion during ventilation act is useful to detect the status of ventilation and can give indications for diagnostics and medical solutions even in thoracic surgery.
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Affiliation(s)
- Lucrezia Puglisi
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Marco Ceccarelli
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Riccardo Taje
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenzo Ambrogi
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy.
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9
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Puglisi L, Ceccarelli M, Ambrogi V. An Experimental Study of Feasibility of a Mini-Invasive Fixator for Rib Osteosynthesis. J Med Device 2022. [DOI: 10.1115/1.4055861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Alternatives to the current invasive rib implants are discussed as from the current solutions with their constraints and disadvantages mainly in surgery application and clinical consequences. A novel rib fixator is presented with an experimental validation and characterization for a potential implementation in facilitating osteosynthesis of multifractured ribs. Testing is designed with lab facilities replicating normal breathing and coughing. Results of lab test with a Ribolution rib fixator prototype are discussed from experiences with pig ribs with satisfactory results in behavior and numerical values.
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Affiliation(s)
- Lucrezia Puglisi
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Marco Ceccarelli
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenzo Ambrogi
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy
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10
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Gao W, Ceccarelli M. Design and Performance Analysis of LARMbot Torso V1. Micromachines (Basel) 2022; 13:1548. [PMID: 36144171 PMCID: PMC9502744 DOI: 10.3390/mi13091548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
In this paper, laboratory experiments of LARMbot torso V1 are reported in the third mode, thereby providing a testing characterization. Sensors were used to measure parameters including the contact force between the shoulder and cables, linear acceleration, angles of the torso body, and power consumption. The results showed that the LARMbot torso V1 can bend successfully to the desired angles, and that it is able to complete a full motion smoothly. The LARMbot torso V1 can mimic human-like motiaons. Based on our analysis of the test results, improvements are suggested, and new designs are considered.
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11
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Fort A, Laribi MA, Ceccarelli M. Design and performance of a larmbot PK arm prototype. INT J HUM ROBOT 2022. [DOI: 10.1142/s0219843622500098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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12
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Aguilar-Pérez LA, Torres-SanMiguel CR, Ceccarelli M, Urriolagoitia-Calderón GM. Traumatic Impact Assessment of CPR Load on a Human Ribcage. Int J Environ Res Public Health 2022; 19:ijerph19063414. [PMID: 35329101 PMCID: PMC8953478 DOI: 10.3390/ijerph19063414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
Chest compression is a parameter of injury criteria assessment for human beings. Additionally, it is used to find the external compression response as a result of vehicle crashes, falls, or sporting impacts. This behavioral feature is described by many deterministic models related to specific experimental tests, hindering distinct scenarios. The present study evaluates the energy absorbed as a function of rib compression. The proposed model was obtained from three different computed tomography (CT) studies. The anthropometric values are interpolated to obtain a parametric curve for a human rib’s average size. The computed results are compared against an STL-DICOM® file used to obtain a virtual reconstruction of one rib. A numerical model of the behavior of the thorax displacement expressed injury in the human rib model’s stiffness. The proposed model is used to determine the correlation of the input payload versus the numerical stiffness value. The outcome is confirmed by numerical analyses applied to a virtual human rib reconstruction.
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Affiliation(s)
- Luis Antonio Aguilar-Pérez
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Zacatenco, Mexico City 07738, Mexico; (L.A.A.-P.); (G.M.U.-C.)
| | - Christopher René Torres-SanMiguel
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Zacatenco, Mexico City 07738, Mexico; (L.A.A.-P.); (G.M.U.-C.)
- Correspondence:
| | - Marco Ceccarelli
- Laboratory of Robot Mechatronics, Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Guillermo Manuel Urriolagoitia-Calderón
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Zacatenco, Mexico City 07738, Mexico; (L.A.A.-P.); (G.M.U.-C.)
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13
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Guardiani C, Cecconi F, Chiodo L, Cottone G, Malgaretti P, Maragliano L, Barabash ML, Camisasca G, Ceccarelli M, Corry B, Roth R, Giacomello A, Roux B. Computational methods and theory for ion channel research. Adv Phys X 2022; 7:2080587. [PMID: 35874965 PMCID: PMC9302924 DOI: 10.1080/23746149.2022.2080587] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/15/2022] [Indexed: 06/15/2023] Open
Abstract
Ion channels are fundamental biological devices that act as gates in order to ensure selective ion transport across cellular membranes; their operation constitutes the molecular mechanism through which basic biological functions, such as nerve signal transmission and muscle contraction, are carried out. Here, we review recent results in the field of computational research on ion channels, covering theoretical advances, state-of-the-art simulation approaches, and frontline modeling techniques. We also report on few selected applications of continuum and atomistic methods to characterize the mechanisms of permeation, selectivity, and gating in biological and model channels.
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Affiliation(s)
- C. Guardiani
- Dipartimento di Ingegneria Meccanica e Aerospaziale, Sapienza Università di Roma, Rome, Italy
| | - F. Cecconi
- CNR - Istituto dei Sistemi Complessi, Rome, Italy and Istituto Nazionale di Fisica Nucleare, INFN, Roma1 section. 00185, Roma, Italy
| | - L. Chiodo
- Department of Engineering, Campus Bio-Medico University, Rome, Italy
| | - G. Cottone
- Department of Physics and Chemistry-Emilio Segrè, University of Palermo, Palermo, Italy
| | - P. Malgaretti
- Helmholtz Institute Erlangen-Nürnberg for Renewable Energy (IEK-11), Forschungszentrum Jülich, Erlangen, Germany
| | - L. Maragliano
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy, and Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Genova, Italy
| | - M. L. Barabash
- Department of Materials Science and Nanoengineering, Rice University, Houston, TX 77005, USA
| | - G. Camisasca
- Dipartimento di Ingegneria Meccanica e Aerospaziale, Sapienza Università di Roma, Rome, Italy
- Dipartimento di Fisica, Università Roma Tre, Rome, Italy
| | - M. Ceccarelli
- Department of Physics and CNR-IOM, University of Cagliari, Monserrato 09042-IT, Italy
| | - B. Corry
- Research School of Biology, The Australian National University, Canberra, ACT 2600, Australia
| | - R. Roth
- Institut Für Theoretische Physik, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - A. Giacomello
- Dipartimento di Ingegneria Meccanica e Aerospaziale, Sapienza Università di Roma, Rome, Italy
| | - B. Roux
- Department of Biochemistry & Molecular Biology, University of Chicago, Chicago IL, USA
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14
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Schöffski P, Bahleda R, Wagner A, Burgess M, Junker N, Chisamore M, Peterson P, Ceccarelli M, William T. 154P Results of an open-label, phase Ia/Ib study of olaratumab plus pembrolizumab in patients with unresectable, locally advanced or metastatic soft tissue sarcoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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15
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Gardner F, Wainberg Z, Fountzilas C, Bahary N, Womack M, Mercada T, Garrido-Laguna I, Peterson P, Ceccarelli M, Pelzer U. 1475P Results of a randomized, double-blind, placebo-controlled, phase II study of gemcitabine and nab-paclitaxel ± olaratumab in treatment-naïve patients with unresectable metastatic pancreatic cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Nishio M, Paz-Ares L, Reck M, Nakagawa K, Garon E, Ceccarelli M, Wijayawardana S, Visseren-Grul C, Novello S. 1209P RELAY, ramucirumab plus erlotinib (RAM+ERL) in untreated metastatic EGFR-mutant NSCLC (EGFR+NSCLC): Association between TP53 status and clinical outcome. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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Ceccarelli M, Riabtsev M, Fort A, Russo M, Laribi MA, Urizar M. Design and Experimental Characterization of L-CADEL v2, an Assistive Device for Elbow Motion. Sensors (Basel) 2021; 21:5149. [PMID: 34372386 PMCID: PMC8347154 DOI: 10.3390/s21155149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 12/04/2022]
Abstract
An experimental characterization is presented for an improved version of a wearable assistive device for elbow motion. The design is revised with respect to requirements for elbow motion assistance, looking at applications both in rehabilitation therapies and exercising of elderly people. A laboratory prototype is built with lightweight, portable, easy-to-use features that are verified with test results, whose discussion is also provided as a characterization of operating performance.
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Affiliation(s)
- Marco Ceccarelli
- LARM2: Laboratory of Robot Mechatronics, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Mykhailo Riabtsev
- Department of Mechanical Engineering, University of the Basque Country (UPV/EHU), E-48013 Bilbao, Spain; (M.R.); (M.U.)
| | - Axel Fort
- Département Génie Mécanique et Systèmes Complexes, Institut PPRIME, Université de Poitiers, 86073 Poitiers, France; (A.F.); (M.A.L.)
| | - Matteo Russo
- Faculty of Engineering, University of Nottingham, Nottingham NG8 1BB, UK;
| | - Med Amine Laribi
- Département Génie Mécanique et Systèmes Complexes, Institut PPRIME, Université de Poitiers, 86073 Poitiers, France; (A.F.); (M.A.L.)
| | - Monica Urizar
- Department of Mechanical Engineering, University of the Basque Country (UPV/EHU), E-48013 Bilbao, Spain; (M.R.); (M.U.)
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18
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Abstract
This article presents an experimental characterization of ExoFinger, a finger exoskeleton for finger motion assistance. The exoskeletal device is analyzed in experimental lab activities that have been conducted with different users to characterize the operation performance and to demonstrate the adaptability of the proposed device. The behavior of this device is characterized in detail using sensors to measure finger motion and power consumption. Sensor measures also demonstrate the given motion assistance performance in terms of an electrical finger response and finger temperature by resulting in an efficient solution with a large motion range of a finger in assistance of recovering finger motion.
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Affiliation(s)
- Marco Ceccarelli
- LARM2: Laboratory of Robot Mechatronics, Department of Industrial Engnineering, University of Rome Tor Vergata, Roma, Italy
| | - Cuauhtemoc Morales-Cruz
- Centro de Innovacion y desarrollo tecnologico en Computo, Instituto Politecnico Nacional, Mexico City, Mexico
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19
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Lanteri D, Carco D, Castorina P, Ceccarelli M, Cacopardo B. Containment effort reduction and regrowth patterns of the Covid-19 spreading. Infect Dis Model 2021; 6:632-642. [PMID: 33898882 PMCID: PMC8054142 DOI: 10.1016/j.idm.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 01/24/2021] [Accepted: 02/16/2021] [Indexed: 01/08/2023] Open
Abstract
In all countries the political decisions aim to achieve an almost stable configuration with a small number of new infected individuals per day due to Covid-19. When such a condition is reached, the containment effort is usually reduced in favor of a gradual reopening of the social life and of the various economical sectors. However, in this new phase, the infection spread restarts and, moreover, possible mutations of the virus give rise to a large specific growth rate of the infected people. Therefore, a quantitative analysis of the regrowth pattern is very useful. We discuss a macroscopic approach which, on the basis of the collected data in the first lockdown, after few days from the beginning of the new phase, outlines different scenarios of the Covid-19 diffusion for longer time. The purpose of this paper is a demonstration-of-concept: one takes simple growth models, considers the available data and shows how the future trend of the spread can be obtained. The method applies a time dependent carrying capacity, analogously to many macroscopic growth laws in biology, economics and population dynamics. The illustrative cases of France, Italy and United Kingdom are analyzed.
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Affiliation(s)
- D Lanteri
- INFN, Sezione di Catania, I-95123, Catania, Italy.,Dipartimento di Fisica e Astronomia, Università di Catania, Italy
| | - D Carco
- Istituto Oncologico del Mediterraneo, Viagrande, Italy
| | - P Castorina
- INFN, Sezione di Catania, I-95123, Catania, Italy.,Faculty of Mathematics and Physics, Charles University, V Holešovičkách 2, 18000, Prague 8, Czech Republic
| | - M Ceccarelli
- U.O.C. Malattie Infettive, P.O. Garibaldi, Catania, Italy
| | - B Cacopardo
- U.O.C. Malattie Infettive, P.O. Garibaldi, Catania, Italy.,Dipartimento di Medicina clinica e sperimentale, Università di Catania, Italy
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20
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Ceccarelli M, Pavone P, Venanzi Rullo E, Nunnari G. Comment on safety and efficacy of oral lopinavir/ritonavir in pediatric patients with coronavirus disease: a nationwide comparative analysis. Eur Rev Med Pharmacol Sci 2021; 25:2473-2474. [PMID: 33829431 DOI: 10.26355/eurrev_202103_25408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M Ceccarelli
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, Catania, Italy.
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21
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Ceccarelli M, Venanzi Rullo E, Marino MA, d'Aleo F, Pellicanò GF, D'Andrea F, Marino A, Cacopardo B, Celesia BM, La Rocca G, Di Rosa M, Condorelli F, Berretta M, Nunnari G. Non-AIDS defining cancers: a comprehensive update on diagnosis and management. Eur Rev Med Pharmacol Sci 2021; 24:3849-3875. [PMID: 32329861 DOI: 10.26355/eurrev_202004_20852] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The increasing incidence of chronic pathologies and especially non-AIDS defining cancers, such as lung cancer, hepatocellular carcinoma, breast cancer, colorectal cancer, prostate cancer, and Hodgkin's lymphoma after the introduction of combined antiretroviral therapy requires the infectious diseases specialist to know how and when to suspect and diagnose cancer in people living with HIV. The aim of this review is to provide updated studies and information about non-AIDS defining cancers and their management in PLWH sheading a light on possible futures scenarios.
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Affiliation(s)
- M Ceccarelli
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
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22
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Remo A, Sina S, Barbi S, Simeone I, Insolda J, Parcesepe P, Giordano G, Cerulo L, Ceccarelli M, Fiorica F, Bonetti A, Pancione M, Manfrin E. Wnt (canonical and non canonical) pathways in breast carcinoma with extensive vascular invasion and inflammatory breast carcinoma. Pathol Res Pract 2021; 219:153347. [PMID: 33550148 DOI: 10.1016/j.prp.2021.153347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Breast carcinoma with extensive peritumoral vascular invasion (ePVI-BC) is a cancer with massive vascular invasion (>10) detected in more than one slide. This neoplasm shows clinic-pathological affinity with inflammatory breast carcinoma (IBC). In this paper we evaluate their biological relationship through the study of surrogate markers (β-catenin and NFAT5) of Canonical (cWnt) and non-canonical (nWnt) Wnt pathways activation. METHODS By immunoistochemistry, we investigate β-catenin and NFAT5 in 39 IBC, 74 ePVI-BC and 84 control cases (CG-BC). RESULTS cWnt was activated in 100 % of ePVI-BC, in 64 % of IBC and 10 % of CG-BC. nWnt was activated in 20 % of ePVI-BC, 50 % of IBC and 1% of CG-BC. The prognosis of carcinomas with nWnt activated was poor similar to IBC. The statistical analysis evidences as both the pathways are synergistic in malignant progression and survival time. β-catenin show an important association with prognostic factors and NFAT5 shows a relevant prognostic role on OS (p = 1.5*10-6) and DFS (P = 1,2*10-4). nWnt is associated with a worse prognosis independently of cWnt. cWnt is associated with adverse prognosis (DFS p = 0.0469; OS p = 0.004891) but its prognostic role is indifferent in carcinoma with nWnt activated. CONCLUSIONS Canonical Wnt pathway is involved in malignant progression with dominant role for vascular invasion whereas non canonical Wnt pathway plays an important role on survival time including the capacity to identify carcinomas with IBC-like prognosis. Furthermore ePVI may represent a "prodromal form of IBC" as demonstrated by its clinicopathological and biological similarity with IBC.
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Affiliation(s)
- A Remo
- Pathology Unit, ULSS9 "Scaligera" and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy.
| | - S Sina
- Pathology Unit, ULSS9 "Scaligera" and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy
| | - S Barbi
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy
| | - I Simeone
- Center for Genomic Science of IIT@SEMM - Istituto Italiano di Tecnologia, Milan, Italy; Department of Science and Technology, University of Sannio, Benevento, Italy
| | - J Insolda
- Pathology Unit, ULSS9 "Scaligera" and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy
| | - P Parcesepe
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy
| | - G Giordano
- U.O.C. Oncologia Medica, Ospedali Riuniti Azienda Ospedaliera Universitaria, 71122, Foggia, Italy
| | - L Cerulo
- Department of Science and Technology, University of Sannio, Benevento, Italy; Bioinformatics Laboratory, BIOGEM, Ariano Irpino, Avellino, Italy
| | - M Ceccarelli
- Department of Science and Technology, University of Sannio, Benevento, Italy; Bioinformatics Laboratory, BIOGEM, Ariano Irpino, Avellino, Italy
| | - F Fiorica
- Radiotherapy Unit, ULSS9 "Scaligera"and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy
| | - A Bonetti
- Oncology Unit, ULSS9 "Scaligera"and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy
| | - M Pancione
- Department of Science and Technology, University of Sannio, Benevento, Italy
| | - E Manfrin
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy.
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23
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Abstract
Abstract
This paper presents the design and an experimental characterization of CADEL, a cable-driven elbow assisting device. The device design is presented to be portable and user-oriented solution and its kinematic model is formulated for functionality analysis. A first prototype and its experimental setup are discussed with the peculiarities of the novel solutions. Two operation modes are investigated with and without load in experimental testing. The performance characterization and feasibility are discussed referring to both the numerical and experimental results.
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Affiliation(s)
- Med Amine Laribi
- CNRS, Department GMSC, Pprime Institute, University of Poitiers-ENSMA, UPR 3346, Futuroscope Chasseneuil 86962 Cedex, France
| | - Marco Ceccarelli
- Laboratory of Robots Mechatronics, Department of Industrial Engineering, University of Rome Tor Vergata, Roma 00133, Italy
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24
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Guarneri C, Ceccarelli M, Rinaldi L, Cacopardo B, Nunnari G, Guarneri F. Helicobacter pylori and skin disorders: a comprehensive review of the available literature. Eur Rev Med Pharmacol Sci 2020; 24:12267-12287. [PMID: 33336746 DOI: 10.26355/eurrev_202012_24019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Helicobacter pylori is a Gram-negative bacterium identified for the first time about 30 years ago and commonly considered as the main pathogenic factor of gastritis and peptic ulcer. Since then, it was found to be associated with several gastrointestinal and extra-gastrointestinal diseases. Helicobacter pylori is also associated with many skin disorders including, but not limited to, chronic urticaria, rosacea, lichen planus, atopic dermatitis, psoriasis, pemphigus vulgaris, vitiligo, primary cutaneous MALT-type lymphoma, sublamina densa-type linear IgA bullous dermatosis, primary cutaneous marginal zone B-cell lymphomas and cutaneous T-cell pseudolymphoma. Literature up to September 2020 shows that clear evidence exists only for some of the mentioned associations, while in the majority of cases, data appear contrasting. The aim of this review is to summarize the available studies on the topic and draw possible conclusions. Further clinical and laboratory studies are needed to assess the real plausibility and relevance of these associations, as well as the possible role of Helicobacter pylori with the underlying pathogenic mechanisms.
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Affiliation(s)
- C Guarneri
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy.
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25
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Abstract
This article proposes a novel device for wrist motion rehabilitation. The proposed mechatronic architecture is based on a simple user-friendly design, which includes a mobile platform for hand support, which is operated by a single actuator. A dedicated assist-as-needed control is designed to operate the device for the required movements. The proposed control strategy is also integrated into a gaming software for stimulating the exercising by means of various interactions with patients. Experimental tests are carried out with 14 healthy subjects at the Physiotherapy Clinical Hospital of the Federal University of Uberlandia. Also, three patients with stroke have been enrolled in a pilot clinical testing. Each of the patients has been involved in four sessions per month with 15 min of assisted treatment. Results of experimental tests are analyzed in terms of improvements and amplitude gains for the flexion and extension wrist movements. Experimental results are reported as evidence for the feasibility and soundness of the proposed device as a tool to assist professionals in procedures of wrist rehabilitation.
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Ceccarelli M, Facciolà A, Taibi R, Pellicanò GF, Nunnari G, Venanzi Rullo E. The treatment of Kaposi's sarcoma: present and future options, a review of the literature. Eur Rev Med Pharmacol Sci 2020; 23:7488-7497. [PMID: 31539137 DOI: 10.26355/eurrev_201909_18860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Kaposi's Sarcoma (KS) is an angiogenic tumor involving skin, mucosa and splanchnic organs. It is caused by Human Herpes Virus 8 (HHV8), when in the presence of other cofactors, such as an immune dysregulation. KS is particularly frequent in HIV-infected individuals. The major goals of treatment are to prevent disease progression, to reduce tumor and edema, to avoid organ compromise, and to relieve psychological stress. The importance and the high cancer risk offered by this co-infection, together with the spread of both these viruses, and the fact that angiogenesis is such an important characteristic of KS led to a lively interest in finding a definitive therapy. Most of the ongoing studies are focused on finding an application of old drugs in KS. Unfortunately, given the number of studies with different targets, it seems we are still far from completely understanding this disease and obtaining a "cure" which could be effective and safe for everyone. Further studies will hopefully offer new and definitive solutions.
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Affiliation(s)
- M Ceccarelli
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
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Vella F, Senia P, Ceccarelli M, Vitale E, Maltezou H, Taibi R, Lleshi A, Venanzi Rullo E, Pellicanò GF, Rapisarda V, Nunnari G, Ledda C. Transmission mode associated with coronavirus disease 2019: a review. Eur Rev Med Pharmacol Sci 2020; 24:7889-7904. [PMID: 32744718 DOI: 10.26355/eurrev_202007_22296] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In late December 2019 in Wuhan (China), Health Commission reported a cluster of pneumonia cases of unknown etiology, subsequently isolated and named Severe Acute Respiratory Syndrome (SARS) Coronavirus 2 (CoV-2). In this review, the main transmission routes and causes of mortality associated with COVID-19 were investigated. MATERIAL AND METHODS A review was carried out to recognize relevant research available until 10 April 2020. RESULTS The main transmission routes of COVID-19 have been the following: animal to human and human-to-human pathways, namely: respiratory transmission; oro-fecal transmission; air, surface-human transmission. Transmission from asymptomatic persons, healthcare transmission, and interfamily transmission have been well documented. CONCLUSIONS SARS-CoV-2 possesses powerful pathogenicity and transmissibility. It is presumed to spread primarily via respiratory droplets and close contact. The most probable transmission pathway is definitely the inter-human one. Asymptomatic patients seem to play a crucial role in spreading the infection. Because of COVID-19 infection pandemic potential, careful surveillance is essential to monitor its future host adaptation, viral evolution, infectivity, transmissibility, and pathogenicity in order to gain an effective vaccine and flock immunity and reduce mortality as soon and as much as it is possible.
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Affiliation(s)
- F Vella
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Ceccarelli M, Nunnari G, Celesia BM, Pellicanò GF, Venanzi Rullo E, Berretta M, Santi Cacopardo B. Editorial - Coronavirus disease 2019 and people living with HIV: clinical considerations. Eur Rev Med Pharmacol Sci 2020; 24:7534-7539. [PMID: 32706096 DOI: 10.26355/eurrev_202007_21928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M Ceccarelli
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, Catania, Italy.
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D'Andrea F, Ceccarelli M, Facciolà A, Nunnari G, Pellicanò GF, Venanzi Rullo E. Breast cancer in women living with HIV. Eur Rev Med Pharmacol Sci 2020; 23:1158-1164. [PMID: 30779085 DOI: 10.26355/eurrev_201902_17007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
With the introduction of HAART, the life expectancy of the patients infected with HIV almost approached that of the general population. The incidence of certain HIV-Associated cancers as Kaposi Sarcoma (KS) and Non-Hodgkin Lymphoma (NHL) decreased, while an increase in Non-AIDS-Defining cancers (NADCs) has been documented. HIV infection is a risk factor for numerous cancers in PLWH. Breast cancer is the most common cancer worldwide among all women. The association between HIV infection and breast cancer has not been thoroughly investigated: when compared to the general population, people living with HIV/AIDS (PLWHA) have a similar or slightly lower risk of breast cancer. Screening tests are essential weapons to fight cancer burden and more effective therapeutic and preventive strategies are needed, especially among PLWHA. Further and more comprehensive studies are needed to better characterize breast cancer among PLWH.
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Affiliation(s)
- F D'Andrea
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
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Facciolà A, Pellicanò GF, Visalli G, Paolucci IA, Venanzi Rullo E, Ceccarelli M, D'Aleo F, Di Pietro A, Squeri R, Nunnari G, La Fauci V. The role of the hospital environment in the healthcare-associated infections: a general review of the literature. Eur Rev Med Pharmacol Sci 2020; 23:1266-1278. [PMID: 30779096 DOI: 10.26355/eurrev_201902_17020] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Healthcare-associated infections (HAIs) are one of the most relevant public health problems worldwide. The role of the hospital environment as a reservoir of pathogens causing HAIs is still debated. These pathogens are common in several hospital environments, where they are able to persist from hours to months and their circulation is favored by healthcare workers (HCWs). Hospital surfaces at close contact with patients such as bed bars and header, bedside table, taps, and handles in wards ("high-touched surfaces"), are considered easily contaminable and at risk to transfer pathogens to patients. However, some studies showed the possible role played by "non-classical" surfaces such as healthcare workers' (HCWs) mobile phones and personal computers as well as oxygen humidifiers and protective lead garments used in operating rooms. HCWs' hands play a fundamental role in patient-to-patient transmission by touching contaminated surfaces or patients during care activities. The aim of this review is to evaluate the role of the hospital environment in the transmission of nosocomial pathogens, focusing on single pathogens causing HAIs and the importance of hospital surfaces as reservoirs.
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Affiliation(s)
- A Facciolà
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
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Guarneri C, Venanzi Rullo E, Gallizzi R, Ceccarelli M, Cannavò SP, Nunnari G. Diversity of clinical appearance of cutaneous manifestations in the course of COVID-19. J Eur Acad Dermatol Venereol 2020; 34:e449-e450. [PMID: 32441830 PMCID: PMC7280631 DOI: 10.1111/jdv.16669] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- C Guarneri
- Faculty of Medicine and Surgery, COVID Hospital, University of Messina, Messina, Italy.,Faculty of Medicine and Surgery, Department of Dermatology, University of Messina, Messina, Italy
| | - E Venanzi Rullo
- Faculty of Medicine and Surgery, COVID Hospital, University of Messina, Messina, Italy
| | - R Gallizzi
- Faculty of Medicine and Surgery, Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - M Ceccarelli
- Unit of Infectious Diseases, Hospital "G. Garibaldi-Nesima", Catania, Italy
| | - S P Cannavò
- Faculty of Medicine and Surgery, Department of Dermatology, University of Messina, Messina, Italy
| | - G Nunnari
- Faculty of Medicine and Surgery, COVID Hospital, University of Messina, Messina, Italy
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Pavone P, Ceccarelli M, Taibi R, La Rocca G, Nunnari G. Outbreak of COVID-19 infection in children: fear and serenity. Eur Rev Med Pharmacol Sci 2020; 24:4572-4575. [PMID: 32373997 DOI: 10.26355/eurrev_202004_21043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The recent outbreak of SARS-CoV-2 greatly involves the resources of the global healthcare system, as it affects newborns, adults, and elders. This infection runs in three major stages: a mild cold-like illness, a moderate respiratory syndrome and a severe acute interstitial pneumonia. SARS-CoV-2 infection seems to have a more benign evolution in children. As a matter of fact, low susceptibility and minor aggressivity have been highlighted in most cases. There are currently no effective antiviral drugs treatment for the affected children. No sufficient results have been reached by the use of interferon (IFN), lopinavir/ritonavir, orbidol, and oseltamivir in the treatment of the coronaviruses infection. The aim of this short review is to highlight the differences existing between COVID-19 cases in adults and children.
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Affiliation(s)
- P Pavone
- Section of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Diurno F, Numis FG, Porta G, Cirillo F, Maddaluno S, Ragozzino A, De Negri P, Di Gennaro C, Pagano A, Allegorico E, Bressy L, Bosso G, Ferrara A, Serra C, Montisci A, D'Amico M, Schiano Lo Morello S, Di Costanzo G, Tucci AG, Marchetti P, Di Vincenzo U, Sorrentino I, Casciotta A, Fusco M, Buonerba C, Berretta M, Ceccarelli M, Nunnari G, Diessa Y, Cicala S, Facchini G. Eculizumab treatment in patients with COVID-19: preliminary results from real life ASL Napoli 2 Nord experience. Eur Rev Med Pharmacol Sci 2020; 24:4040-4047. [PMID: 32329881 DOI: 10.26355/eurrev_202004_20875] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)-related pneumonia, referred to as COVID-19 (Coronavirus Disease 19), is a public health emergency as it carries high morbidity, mortality, and has no approved specific pharmacological treatments. In this case series, we aimed to report preliminary data obtained with anti-complement C5 therapy with eculizumab in COVID-19 patients admitted to intensive care unit (ICU) of ASL Napoli 2 Nord. PATIENTS AND METHODS This is a case series of patients with a confirmed diagnosis of SARS-CoV2 infection and severe pneumonia or ARDS who were treated with up to 4 infusions of eculizumab as an off-label agent. Patients were also treated with anticoagulant therapy with Enoxaparin 4000 IU/day via subcutaneous injection, antiviral therapy with Lopinavir 800 mg/day + Ritonavir 200 mg/day, hydroxychloroquine 400 mg/day, ceftriaxone 2 g/day IV, vitamine C 6 g/day for 4 days, and were on Non-Invasive Ventilation (NIV). RESULTS We treated four COVID-19 patients admitted to the intensive care unit because of severe pneumonia or ARDS. All patients successfully recovered after treatment with eculizumab. Eculizumab induced a drop in inflammatory markers. Mean C Reactive Protein levels dropped from 14.6 mg/dl to 3.5 mg/dl and the mean duration of the disease was 12.8 days. CONCLUSIONS Eculizumab has the potential to be a key player in treatment of severe cases of COVID-19. Our results support eculizumab use as an off-label treatment of COVID-19, pending confirmation from the ongoing SOLID-C19 trial.
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Affiliation(s)
- F Diurno
- Department of Emergency and Critical Care, ASL Napoli 2 Nord, "S.M. delle Grazie Hospital", Pozzuoli (NA), Italy.
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Ceccarelli M, Berretta M, Venanzi Rullo E, Nunnari G, Cacopardo B. Differences and similarities between Severe Acute Respiratory Syndrome (SARS)-CoronaVirus (CoV) and SARS-CoV-2. Would a rose by another name smell as sweet? Eur Rev Med Pharmacol Sci 2020; 24:2781-2783. [PMID: 32196628 DOI: 10.26355/eurrev_202003_20551] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M Ceccarelli
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Ceccarelli M, Berretta M, Venanzi Rullo E, Nunnari G, Cacopardo B. Differences and similarities between Severe Acute Respiratory Syndrome (SARS)-CoronaVirus (CoV) and SARS-CoV-2. Would a rose by another name smell as sweet? Eur Rev Med Pharmacol Sci 2020. [PMID: 32196628 DOI: 10.26355/eurrev] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Affiliation(s)
- M Ceccarelli
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Chen X, Ding W, Yu Z, Meng L, Ceccarelli M, Huang Q. Combination of Hardware and Control to Reduce Humanoids Fall Damage. INT J HUM ROBOT 2020. [DOI: 10.1142/s0219843620500024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Most existing motion control methods for humanoids aim at avoiding falling. However, the humanoid is generally an unstable system that cannot completely avoid falling and it is difficult to cope with the sudden fall of a robot. This paper designs a planning method of fall protection for humanoids according to the human falling motion. This method changes the impact position between the robot and ground by adjusting the motion of the robot as it falls. To further reduce damage to the robot, an appropriate cushioning material is installed at the point of impact to buffer the robot. The effectiveness of the proposed method is verified for a BHR6P humanoid robot falling in simulations and experiments.
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Affiliation(s)
- Xuechao Chen
- Beijing Advanced Innovation Center for Intelligent Robotics and Systems, Beijing Institute of Technology, Beijing 100081, P. R. China
- School of Mechantronical Engineering, Beijing Institute of Technology, Beijing 100081, P. R. China
| | - Wenpeng Ding
- School of Mechantronical Engineering, Beijing Institute of Technology, Beijing 100081, P. R. China
| | - Zhangguo Yu
- Beijing Advanced Innovation Center for Intelligent Robotics and Systems, Beijing Institute of Technology, Beijing 100081, P. R. China
- School of Mechantronical Engineering, Beijing Institute of Technology, Beijing 100081, P. R. China
| | - Libo Meng
- Beijing Advanced Innovation Center for Intelligent Robotics and Systems, Beijing Institute of Technology, Beijing 100081, P. R. China
- School of Mechantronical Engineering, Beijing Institute of Technology, Beijing 100081, P. R. China
| | - Marco Ceccarelli
- School of Mechantronical Engineering, Beijing Institute of Technology, Beijing 100081, P. R. China
- Department of Industrial Engineering, University of Rome Tor Vergata, Via del Politecnico 1, 00133 Roma, Italy
| | - Qiang Huang
- Beijing Advanced Innovation Center for Intelligent Robotics and Systems, Beijing Institute of Technology, Beijing 100081, P. R. China
- School of Mechantronical Engineering, Beijing Institute of Technology, Beijing 100081, P. R. China
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Abstract
Abstract
In this work, the Cassino Biped Locomotor, a biped walking robot, is presented as the leg design by using reduced parallel mechanisms. The proposed biped locomotor consists of two identical tripod leg mechanisms with a three degree-of-freedom parallel manipulator architecture. Kinematics analysis is carried out in terms of the forward and inverse kinematics of one leg mechanism and inverse kinematics of the biped locomotor. The walking operation is discussed in detail with gait planning and trajectories of feet and waist. A CAD model is elaborated in solidworks® environment and the corresponding prototype is fabricated with low-cost user-oriented features by using commercial components and structural parts that are manufactured by using 3D printing. An experimental layout and corresponding test modes are illustrated for characterizing the walking operation performance. Experimental results are analyzed for an operation performance evaluation and architecture design characterization of the Cassino Biped Locomotor.
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Affiliation(s)
- Mingfeng Wang
- School of Mechanical and Electrical Engineering, State Key Laboratory of High-Performance Complex Manufacturing, Central South University, Changsha, Hunan 410083, China
| | - Marco Ceccarelli
- LARM2: Laboratory of Robot Mechatronics, University of Rome Tor Vergata, Roma 00133, Italy
| | - Giuseppe Carbone
- Department of Mechanical, Energy and Management Engineering, University of Calabria, Rende 87036, Italy
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D'Aleo F, Ceccarelli M, Venanzi Rullo E, Facciolà A, Di Rosa M, Pinzone MR, Condorelli F, Visalli G, Picerno I, Berretta M, Pellicanò GF, Nunnari G. Hepatitis C-related hepatocellular carcinoma: diagnostic and therapeutic management in HIV-patients. Eur Rev Med Pharmacol Sci 2019; 21:5859-5867. [PMID: 29272025 DOI: 10.26355/eurrev_201712_14035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The efficacy of the current HIV therapy has led to increased survival and prolongation of the average life expectancy of people living with HIV (PLWH), as well as the emergence of comorbidities and non-AIDS related cancer. Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Current evidence suggests that HCC is an important cause of morbidity and mortality in HIV infected patients. In fact, HCC prevalence rate is indeed higher with respect to the general population average. In this paper, we review the diagnostic and therapeutic management of Hepatitis C-related hepatocellular carcinoma in HCV-HIV co-infected patients. Several therapeutic options are available depending on several factors as HCC stage, liver functions, comorbidities and they have been divided into three groups: potentially curative, proven effective but not curative, and unproven or ineffective therapy. In HIV-infected patients, surgical options are preferred compared to non-surgical therapies. Further studies, especially multicenter ones, are needed in order to define the most appropriate, evidence-based therapeutic approach to PLWH suffering from HCC. It also appears necessary to develop appropriate care guidelines for PLWH.
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Affiliation(s)
- F D'Aleo
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy.
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Facciolà A, Venanzi Rullo E, Ceccarelli M, D'Aleo F, Di Rosa M, Pinzone MR, Condorelli F, Visalli G, Picerno I, Fisichella R, Nunnari G, Pellicanò GF. Kaposi's sarcoma in HIV-infected patients in the era of new antiretrovirals. Eur Rev Med Pharmacol Sci 2019; 21:5868-5869. [PMID: 29272026 DOI: 10.26355/eurrev_201712_14036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Kaposi's Sarcoma (KS) is a multicentric angioproliferative cancer of endothelial cells (ECs) caused by Human Herpesvirus 8 (HHV8) characterized by clinical heterogeneity depending on the host immune conditions. Despite its incidence has dramatically decreased in developed countries after the introduction of Highly Active Antiretroviral Therapy (HAART), KS remains the most frequent tumor in HIV-infected patients worldwide. Clinical presentation varies from an indolent slowly progressive behavior, generally limited to the skin, to an aggressive and rapidly progressing disease. In more than 50% of cases, the skin lesions are often associated with a more or less important visceral involvement, particularly to the oral cavity and the gastrointestinal tract that are involved in 35% and 40% of cases respectively. A large number of treatments can be used both as local and as systemic therapy. Particularly, HAART represents the first treatment in patients with moderate lesions limited to skin, and it can be sufficient to reduce significantly the size of lesions and, often, the complete disappear in 35% of cases after 3-9 months of treatment. In case of a rapidly progressive disease with extensive cutaneous and/or visceral involvement systemic drugs are used such as the liposomal anthracyclines pegylated liposomal doxorubicin (PLD) and daunorubicin citrate liposome (DNX), the combined treatment adriamycin-bleomycin-vincristine (ABV) and bleomycin-vincristine (BV), Paclitaxel and Interferon-alfa. In patients with limited skin localization, the local treatment can play an important role. Local medical therapy is based on the use of alitretinoin, antineoplastic drugs vincristine, vinblastine and bleomycin and Sodium Tetradecyl Sulfate (STS). In addition to medical therapy, physical treatment, such as cryotherapy and radiotherapy, are also commonly used.
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Affiliation(s)
- A Facciolà
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Italy.
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Cannon L, Weissman S, Pinzone M, Van Belzen J, Venanzi-Rullo E, Ceccarelli M, Bertuccio M, Nunnari G, O’Doherty U. Longitudinal proviral sequencing provides a window into selection pressures exerted on infected cells and provides an upper bound estimate of proviral half-lives which are influenced by expression and splicing potential. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)31074-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Huang G, Ceccarelli M, Huang Q, Zhang W, Yu Z, Chen X, Mai J. Design and Feasibility Study of a Leg-exoskeleton Assistive Wheelchair Robot with Tests on Gluteus Medius Muscles. Sensors (Basel) 2019; 19:s19030548. [PMID: 30696120 PMCID: PMC6387381 DOI: 10.3390/s19030548] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/10/2019] [Accepted: 01/23/2019] [Indexed: 11/16/2022]
Abstract
The muscles of the lower limbs directly influence leg motion, therefore, lower limb muscle exercise is important for persons living with lower limb disabilities. This paper presents a medical assistive robot with leg exoskeletons for locomotion and leg muscle exercises. It also presents a novel pedal-cycling actuation method with a crank-rocker mechanism. The mechanism is driven by a single motor with a mechanical structure that ensures user safety. A control system is designed based on a master-slave control with sensor fusion method. Here, the intended motion of the user is detected by pedal-based force sensors and is then used in combination with joystick movements as control signals for leg-exoskeleton and wheelchair motions. Experimental data is presented and then analyzed to determine robotic motion characteristics as well as the assistance efficiency with attached electromyogram (EMG) sensors. A typical muscle EMG signal analysis shows that the exercise efficiency for EMG activated amplitudes of the gluteus medius muscles approximates a walking at speed of 3 m/s when cycling at different speeds (i.e., from 16 to 80 r/min) in a wheelchair. As such, the present wheelchair robot is a good candidate for enabling effective gluteus medius muscle exercises for persons living with gluteus medius muscle disabilities.
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Affiliation(s)
- Gao Huang
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, 100081, China.
- Intelligent Robot Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, 100081, China.
- Key Laboratory of Biomimetic Robots and Systems, Beijing Institute of Technology, Ministry of Education, Beijing, 100081, China.
- LARM: Laboratory of Robotics and Mechatronics, University of Cassino and South Latium, Cassino, 03043, Italy.
| | - Marco Ceccarelli
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, 100081, China.
- Key Laboratory of Biomimetic Robots and Systems, Beijing Institute of Technology, Ministry of Education, Beijing, 100081, China.
- LARM: Laboratory of Robotics and Mechatronics, University of Cassino and South Latium, Cassino, 03043, Italy.
| | - Qiang Huang
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, 100081, China.
- Intelligent Robot Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, 100081, China.
- Key Laboratory of Biomimetic Robots and Systems, Beijing Institute of Technology, Ministry of Education, Beijing, 100081, China.
| | - Weimin Zhang
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, 100081, China.
- Intelligent Robot Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, 100081, China.
- Key Laboratory of Biomimetic Robots and Systems, Beijing Institute of Technology, Ministry of Education, Beijing, 100081, China.
| | - Zhangguo Yu
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, 100081, China.
- Intelligent Robot Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, 100081, China.
- Key Laboratory of Biomimetic Robots and Systems, Beijing Institute of Technology, Ministry of Education, Beijing, 100081, China.
| | - Xuechao Chen
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, 100081, China.
- Intelligent Robot Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, 100081, China.
- Key Laboratory of Biomimetic Robots and Systems, Beijing Institute of Technology, Ministry of Education, Beijing, 100081, China.
| | - Jingeng Mai
- The Robotics Research Group, College of Engineering, Peking University, China.
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Abstract
A service robot for Cultural Heritage frames is proposed as a novel robotic platform with a modular design for both ground locomotion and flight capability. The peculiarities of the system are discussed by performance evaluation via simulation. A prototype has been built and tested both to prove the feasibility of the proposed design and to characterize its operation performance.
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Affiliation(s)
- Marco Ceccarelli
- Laboratory of Robotics and Mechatronics, University of Cassino and South Latium, Cassino, Italy
| | - Daniele Cafolla
- Laboratory of Robotics and Mechatronics, University of Cassino and South Latium, Cassino, Italy
| | - Matteo Russo
- Laboratory of Robotics and Mechatronics, University of Cassino and South Latium, Cassino, Italy
| | - Giuseppe Carbone
- Laboratory of Robotics and Mechatronics, University of Cassino and South Latium, Cassino, Italy
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Pascarella A, Ferrandino G, Credendino SC, Moccia C, D'Angelo F, Miranda B, D'Ambrosio C, Bielli P, Spadaro O, Ceccarelli M, Scaloni A, Sette C, De Felice M, De Vita G, Amendola E. DNAJC17 is localized in nuclear speckles and interacts with splicing machinery components. Sci Rep 2018; 8:7794. [PMID: 29773831 PMCID: PMC5958099 DOI: 10.1038/s41598-018-26093-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/04/2018] [Indexed: 01/23/2023] Open
Abstract
DNAJC17 is a heat shock protein (HSP40) family member, identified in mouse as susceptibility gene for congenital hypothyroidism. DNAJC17 knockout mouse embryos die prior to implantation. In humans, germline homozygous mutations in DNAJC17 have been found in syndromic retinal dystrophy patients, while heterozygous mutations represent candidate pathogenic events for myeloproliferative disorders. Despite widespread expression and involvement in human diseases, DNAJC17 function is still poorly understood. Herein, we have investigated its function through high-throughput transcriptomic and proteomic approaches. DNAJC17-depleted cells transcriptome highlighted genes involved in general functional categories, mainly related to gene expression. Conversely, DNAJC17 interactome can be classified in very specific functional networks, with the most enriched one including proteins involved in splicing. Furthermore, several splicing-related interactors, were independently validated by co-immunoprecipitation and in vivo co-localization. Accordingly, co-localization of DNAJC17 with SC35, a marker of nuclear speckles, further supported its interaction with spliceosomal components. Lastly, DNAJC17 up-regulation enhanced splicing efficiency of minigene reporter in live cells, while its knockdown induced perturbations of splicing efficiency at whole genome level, as demonstrated by specific analysis of RNAseq data. In conclusion, our study strongly suggests a role of DNAJC17 in splicing-related processes and provides support to its recognized essential function in early development.
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Affiliation(s)
- A Pascarella
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - G Ferrandino
- Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - S C Credendino
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - C Moccia
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - F D'Angelo
- Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - B Miranda
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - C D'Ambrosio
- Proteomics & Mass Spectrometry Laboratory, ISPAAM, National Research Council, Napoli, Italy
| | - P Bielli
- Laboratory of Neuroembryology, Fondazione Santa Lucia, 00143, Rome, Italy.,Department of Biomedicine and Prevention, Università di Roma Tor Vergata, 00133, Rome, Italy
| | - O Spadaro
- Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - M Ceccarelli
- Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - A Scaloni
- Proteomics & Mass Spectrometry Laboratory, ISPAAM, National Research Council, Napoli, Italy
| | - C Sette
- Laboratory of Neuroembryology, Fondazione Santa Lucia, 00143, Rome, Italy.,Institute of Human Anatomy and Cell Biology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - M De Felice
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy.,Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - G De Vita
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy.
| | - E Amendola
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy.
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45
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Cenci-Goga B, Karama M, Sechi P, Iulietto M, Grispoldi L, Selvaggini R, Ceccarelli M, Barbera S. Fate of selected pathogens in spiked «SALAME NOSTRANO» produced without added nitrates following the application of NONIT™ technology. Meat Sci 2018; 139:247-254. [DOI: 10.1016/j.meatsci.2018.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 02/02/2018] [Accepted: 02/02/2018] [Indexed: 11/26/2022]
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46
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47
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Huang G, Zhang W, Yu Z, Chen X, Meng F, Ceccarelli M, Huang Q. Design and simulation of leg exoskeleton cycling-actuated wheelchair. INT J ADV ROBOT SYST 2017. [DOI: 10.1177/1729881417741739] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Gao Huang
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Haidian, Beijing, China
- Intelligent Robotics Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Haidian, Beijing, China
- Laboratory of Robotics and Mechatronics DICeM, University of Cassino and South Latium, Cassino (Fr), Italy
- International Joint Research Laboratory of Service Robotics, IRI-BIT and LARM-UCLAM, Beijing, China
| | - Weimin Zhang
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Haidian, Beijing, China
- Intelligent Robotics Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Haidian, Beijing, China
| | - Zhangguo Yu
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Haidian, Beijing, China
- Intelligent Robotics Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Haidian, Beijing, China
| | - Xuechao Chen
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Haidian, Beijing, China
- Intelligent Robotics Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Haidian, Beijing, China
| | - Fei Meng
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Haidian, Beijing, China
- Intelligent Robotics Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Haidian, Beijing, China
| | - Marco Ceccarelli
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Haidian, Beijing, China
- Laboratory of Robotics and Mechatronics DICeM, University of Cassino and South Latium, Cassino (Fr), Italy
- International Joint Research Laboratory of Service Robotics, IRI-BIT and LARM-UCLAM, Beijing, China
| | - Qiang Huang
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Haidian, Beijing, China
- Intelligent Robotics Institute, School of Mechatronical Engineering, Beijing Institute of Technology, Haidian, Beijing, China
- International Joint Research Laboratory of Service Robotics, IRI-BIT and LARM-UCLAM, Beijing, China
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48
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Mistrangelo M, Gallo F, Giordano L, Solerio D, Bau M, Romaniello I, Pietribiasi F, Pacquola M, Castiglione F, Sarli F, Monagheddu C, Ceccarelli M, Ciccone G, Mistrangelo M, Viale M, Bertetto O. The follow-up and lifestyle (FUCSAM project). Oncology Network of Piemonte and Valle d'Aosta: update 2017. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx433.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Galassi C, Ceccarelli M, Monagheddu C, Pagano E, Rosato R, Ivaldi P, Bollito E, Zitella A, De Luca S, Camilli M, Munoz F, Bellissimo A, Bongiovanni F, Ponti di Sant'Angelo F, Mistrangelo M, Ciccone G, Bertetto O. Start (active surveillance or radical treatment for newly diagnosed patients with a localized, low risk, prostate cancer): an epidemiological study of the Oncology Network of Piemonte and Valle d’Aosta. Update 2017. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx423.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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50
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Santini V, Allione B, Zini G, Gioia D, Lunghi M, Poloni A, Cilloni D, Sanna A, Masiera E, Ceccarelli M, Abdel-Wahab O, Terenzi A, Angelucci E, Finelli C, Onida F, Pelizzari A, Ferrero D, Saglio G, Figueroa M, Levis A. A phase II, multicentre trial of decitabine in higher-risk chronic myelomonocytic leukemia. Leukemia 2017; 32:413-418. [PMID: 28607470 PMCID: PMC5808077 DOI: 10.1038/leu.2017.186] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/21/2017] [Accepted: 05/24/2017] [Indexed: 12/30/2022]
Abstract
Chronic myelomonocytic leukemia (CMML) is a complex clonal hematological disorder classified among myelodysplastic (MDS)/myeloproliferative neoplasms. Prognosis is poor and there is a lack of effective treatments. The hypomethylating agent decitabine has shown activity against MDS and elderly acute myeloid leukemia, but there is little data focusing specifically on its efficacy in CMML. In this prospective, phase 2 Italian study, CMML patients received intravenous decitabine 20 mg/m2 per day on Days 1–5 of a 28-day treatment cycle. Response was evaluated after four and six cycles; patients responding at the end of six cycles could continue treatment with decitabine. Forty-three patients were enrolled; >50% were high-risk according to four CMML-specific scoring systems. In the intent-to-treat population (n=42), the overall response rate after six cycles was 47.6%, with seven complete responses (16.6%), eight marrow responses (19%), one partial response (2.4%) and four hematological improvements (9.5%). After a median follow-up of 51.5 months (range: 44.4–57.2), median overall survival was 17 months, with responders having a significantly longer survival than non-responders (P=0.02). Grade 3/4 anemia, neutropenia and thrombocytopenia occurred in 28.6%, 50% and 38% of patients, respectively. Decitabine appears to be an effective and well-tolerated treatment for patients with high-risk CMML.
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Affiliation(s)
- V Santini
- Department of Hematology, AOU Careggi, University of Florence, Florence, Italy
| | - B Allione
- AOU Citta della Salute e della Scienza, Torino, Italy
| | - G Zini
- Department of Oncology and Hematology, Hematology Institute, Fondazion e Policlinico Gemelli, UCSC, Rome, Italy
| | | | - M Lunghi
- Division of Haematology, Department of Translational Medicine, UPO, Novara, Italy
| | - A Poloni
- Department of Hematology, AOU Ospedali Riuniti, Università Politecnica Marche, Ancona, Italy
| | - D Cilloni
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Turin, Italy
| | - A Sanna
- Università degli studi di Firenze, Dipartimento di medicina sperimentale e Clinica, Firenze, Italy
| | | | - M Ceccarelli
- AOU Città della salute e della scienza di Torino, Torino, Italy
| | - O Abdel-Wahab
- Human Oncology and Pathogenesis Program, and Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Terenzi
- BMT Centre of Perugia, Department of Hematology, Perugia, Italy
| | - E Angelucci
- Hematology and Transplant Unit, Ospedale Oncologico di Riferimento Regionale Armando Businco, Cagliari, Italy
| | - C Finelli
- Institute of Hematology, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - F Onida
- Oncohematology Unit, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico-Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A Pelizzari
- Spedali Civili Brescia Hematology Unit, Brescia, Italy
| | - D Ferrero
- Hematology Division, Università degli Studi di Torino, Torino, Italy
| | - G Saglio
- Department of Clinical and Biological Sciences, University of Turin, Torino, Italy
| | - M Figueroa
- Department of Human Genetics and, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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