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Dr. Mirko Di Rosa
IRCCS INRCA National Institute of Health and Science on Aging

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Journal article
Published: 01 July 2021 in Journal of Clinical Medicine
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Background. The purpose of this study was to evaluate the prognostic impact of chest X-ray (CXR) score, frailty, and clinical and laboratory data on in-hospital mortality of hospitalized older patients with COVID-19. Methods. This retrospective study included 122 patients 65 years or older with positive reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and with availability to CXRs on admission. The primary outcome of the study was in-hospital mortality. Statistical analysis was conducted using Cox regression. The predictive ability of the CXR score was compared with the Clinical Frailty Scale (CFS) and fever data using Area Under the Curve (AUC) and net reclassification improvement (NRI) statistics. Results. Of 122 patients, 67 died during hospital stay (54.9%). The CXR score (HR: 1.16, 95% CI, 1.04–1.28), CFS (HR: 1.27; 95% CI, 1.09–1.47), and presence of fever (HR: 1.75; 95% CI, 1.03–2.97) were significant predictors of in-hospital mortality. The addition of both the CFS and presence of fever to the CXR score significantly improved the prediction of in-hospital mortality (NRI, 0.460; 95% CI, 0.102 to 0.888; AUC difference: 0.117; 95% CI, 0.041 to 0.192, p = 0.003). Conclusions. CXR score, CFS, and presence of fever were the main predictors of in-hospital mortality in our cohort of hospitalized older patients with COVID-19. Adding frailty and presence of fever to the CXR score statistically improved predictive accuracy compared to single risk factors.

ACS Style

Sara Cecchini; Mirko Di Rosa; Luca Soraci; Alessia Fumagalli; Clementina Misuraca; Daniele Colombo; Iacopo Piomboni; Francesca Carnevali; Enrico Paci; Roberta Galeazzi; Piero Giordano; Massimiliano Fedecostante; Antonio Cherubini; Fabrizia Lattanzio. Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19. Journal of Clinical Medicine 2021, 10, 2965 .

AMA Style

Sara Cecchini, Mirko Di Rosa, Luca Soraci, Alessia Fumagalli, Clementina Misuraca, Daniele Colombo, Iacopo Piomboni, Francesca Carnevali, Enrico Paci, Roberta Galeazzi, Piero Giordano, Massimiliano Fedecostante, Antonio Cherubini, Fabrizia Lattanzio. Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19. Journal of Clinical Medicine. 2021; 10 (13):2965.

Chicago/Turabian Style

Sara Cecchini; Mirko Di Rosa; Luca Soraci; Alessia Fumagalli; Clementina Misuraca; Daniele Colombo; Iacopo Piomboni; Francesca Carnevali; Enrico Paci; Roberta Galeazzi; Piero Giordano; Massimiliano Fedecostante; Antonio Cherubini; Fabrizia Lattanzio. 2021. "Chest X-ray Score and Frailty as Predictors of In-Hospital Mortality in Older Adults with COVID-19." Journal of Clinical Medicine 10, no. 13: 2965.

Study protocol
Published: 14 June 2021 in Trials
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Background Stroke is a leading cause of disability, injury, and death in elderly people and represents a major public health problem with substantial medical and economic consequences. The incidence of stroke rapidly increases with age, doubling for each decade after age 55 years. Gait impairment is one of the most important problems after stroke, and improving walking function is often a key component of any rehabilitation program. To achieve this goal, a robotic gait trainer seems to be promising. In fact, some studies underline the efficacy of robotic gait training based on end-effector technology, for different diseases, in particular in stroke patients. In this randomized controlled trial, we verify the efficacy of the robotic treatment in terms of improving the gait and reducing the risk of falling and its long-term effects. Methods In this single-blind randomized controlled trial, we will include 152 elderly subacute stroke patients divided in two groups to receive a traditional rehabilitation program or a robotic rehabilitation using G-EO system, an end-effector device for the gait rehabilitation, in addition to the traditional therapy. Twenty treatment sessions will be conducted, divided into 3 training sessions per week, for 7 weeks. The control group will perform traditional therapy sessions lasting 50 min. The technological intervention group, using the G-EO system, will carry out 30 min of traditional therapy and 20 min of treatment with a robotic system. The primary outcome of the study is the evaluation of the falling risk. Secondary outcomes are the assessment of the gait improvements and the fear of falling. Further evaluations, such as length and asymmetry of the step, walking and functional status, and acceptance of the technology, will be carried. Discussion The final goal of the present study is to propose a new approach and an innovative therapeutic plan in the post-stroke rehabilitation, focused on the use of a robotic device, in order to obtain the beneficial effects of this treatment. Trial registration ClinicalTrials.gov NCT04087083. Registered on September 12, 2019

ACS Style

Elvira Maranesi; Roberta Bevilacqua; Mirko Di Rosa; Giuseppe Pelliccioni; Valentina Di Donna; Riccardo Luzi; Micaela Morettini; Agnese Sbrollini; Elisa Casoni; Nadia Rinaldi; Renato Baldoni; Fabrizia Lattanzio; Laura Burattini; Giovanni R. Riccardi. An innovative training based on robotics for older people with subacute stroke: study protocol for a randomized controlled trial. Trials 2021, 22, 1 -8.

AMA Style

Elvira Maranesi, Roberta Bevilacqua, Mirko Di Rosa, Giuseppe Pelliccioni, Valentina Di Donna, Riccardo Luzi, Micaela Morettini, Agnese Sbrollini, Elisa Casoni, Nadia Rinaldi, Renato Baldoni, Fabrizia Lattanzio, Laura Burattini, Giovanni R. Riccardi. An innovative training based on robotics for older people with subacute stroke: study protocol for a randomized controlled trial. Trials. 2021; 22 (1):1-8.

Chicago/Turabian Style

Elvira Maranesi; Roberta Bevilacqua; Mirko Di Rosa; Giuseppe Pelliccioni; Valentina Di Donna; Riccardo Luzi; Micaela Morettini; Agnese Sbrollini; Elisa Casoni; Nadia Rinaldi; Renato Baldoni; Fabrizia Lattanzio; Laura Burattini; Giovanni R. Riccardi. 2021. "An innovative training based on robotics for older people with subacute stroke: study protocol for a randomized controlled trial." Trials 22, no. 1: 1-8.

Journal article
Published: 18 May 2021 in Prostate Cancer and Prostatic Diseases
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We aimed to evaluate oncological and functional outcomes of index lesion HIFU ablation with Focal-One®. We prospectively assessed treatment-naïve men with localized prostate cancer between 2017 and 2019. Inclusion criteria were stage cT ≤ 2, ≥5 years of life expectancy, grade group ≤3. Multiparametric magnetic resonance was performed before ablation. Patients with a prostate volume of ≥80 ml underwent debulking. Treatment failure was defined as a histologically confirmed tumor that required salvage treatment or androgen deprivation therapy. One hundred and eighty nine patients were enrolled. Data are presented as median and Interquartile Range (IQR). Median age was 70(11) years. Median baseline PSA was 5.8(3) ng/ml. Fourteen (7.4%) patients had prostate debulking before ablation. 104 (55%) patients underwent targeted ablation, 45 (23.8%) extended targeted ablation, 31 (16.4%) hemiablation, and 9 (4.8%) extended hemiablation. Median targeted ablated volume was 14(9) ml. Ninety-three complications occurred in 63/189 (33.3%) patients within 90 days. There were 77/93 (82.8%) minor (Clavien grade 1–2) and 16/93 (17.2%) major complications (Clavien grade 3a). Thirty-nine patients suffered from genito-urinary infections (Clavien grade 2). Fifteen patients required transurethral resection of the prostate/urethrotomy for recurrent urinary retention (Clavien grade 3a). One patient developed a recto-urethral fistula (Clavien grade 3a) and two long-lasting urinary incontinence. Median PSA nadir was 2.2(2.9) ng/ml. At a median follow-up of 29(15) months, 21/177 (11.9%) patients were treatment failures, 26 on monitoring, and 26 had a further ablation. Multivariable logistic regression found that failure patients had higher PSA (7.8 vs 5.7 ng/ml,p0.001) and double PSA nadir (4.8 vs 2.0 ng/ml, p < 0.001). Higher PSA nadir correlated with a 74% higher probability of failure (OR 1.74 95% CI 1.40–2.16). Cancer in the anterior stroma increased the odds of failure of three folds (OR 3.36 95% CI 1.18–9.53). Two mixed effect models (one for IPSS and one for IEEF-15) were estimated and they showed that time reaches the statistical significance coefficient only for the IEEF-15, meaning that subsequent evaluations of the indicators were significantly lower at each time point. Index lesion HIFU ablation demonstrated satisfactory early oncological outcome but anteriorly located tumors had inadequate ablation. Urinary function was well preserved. Sexual function slightly decreased during follow-up.

ACS Style

Marco Dellabella; Alessandro Branchi; Mirko Di Rosa; Michele Pucci; Luca Gasparri; Redi Claudini; Francesca Carnevali; Sara Cecchini; Daniele Castellani. Oncological and functional outcome after partial prostate HIFU ablation with Focal-One®: a prospective single-center study. Prostate Cancer and Prostatic Diseases 2021, 1 -9.

AMA Style

Marco Dellabella, Alessandro Branchi, Mirko Di Rosa, Michele Pucci, Luca Gasparri, Redi Claudini, Francesca Carnevali, Sara Cecchini, Daniele Castellani. Oncological and functional outcome after partial prostate HIFU ablation with Focal-One®: a prospective single-center study. Prostate Cancer and Prostatic Diseases. 2021; ():1-9.

Chicago/Turabian Style

Marco Dellabella; Alessandro Branchi; Mirko Di Rosa; Michele Pucci; Luca Gasparri; Redi Claudini; Francesca Carnevali; Sara Cecchini; Daniele Castellani. 2021. "Oncological and functional outcome after partial prostate HIFU ablation with Focal-One®: a prospective single-center study." Prostate Cancer and Prostatic Diseases , no. : 1-9.

Original article
Published: 28 April 2021 in Aging Clinical and Experimental Research
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Urologists may hesitate to offer transurethral resection of the prostate (TURP) because of increased morbidity in elderly patients. We aimed to compare data on postoperative outcomes of elderly men undergoing bipolar transurethral resection of the prostate (B-TURP) as compared to thulium laser vapoenucleation of the prostate (ThuVEP). We retrospectively reviewed data of all patients aged ≥ 75 years who underwent benign prostatic hyperplasia surgery. Differences between interventions were estimated using propensity scores (PS) to adjust for different patients characteristics. Between 2017 and 2020, 275 men were included in the analysis. Propensity score retrieved 65 patients in each group. Median age was 78 (4) years in B-TURP group and 78 (6) in ThuVEP group. Median prostate volume was 63 (35) ml and 54 (24) ml in B-TURP group and ThuVEP group, respectively. Only American Society of Anesthesiologists score was significantly higher in ThuVEP group (p = 0.006). Median operation time, catheterization time, and hospital stay were similar in both groups (55 min, 2 and 3 days). Overall, 84.6% of men had no complications, with no significant differences between the groups (p = 0.234). Only one patient in B-TURP group experienced a Clavien grade IIIb complication. By 1 year, there were a statistically significant differences in International Prostate Symptom Score (p = 0.000) in favor of B-TURP group and in maximal urine flow rate (p = 0.000) in favor of ThuVEP group. Both procedures showed excellent functional improvements one year after surgery with a low rate of major complications in men aged ≥ 75 years with small-to-medium sized prostates.

ACS Style

Daniele Castellani; Mirko Di Rosa; Gianna Pace; Emanuele Rubilotta; Marilena Gubbiotti; Giacomo Maria Pirola; Luca Gasparri; Alessandro Antonelli; Marco Dellabella. Comparison between thulium laser vapoenucleation and plasmakinetic resection of the prostate in men aged 75 years and older in a real-life setting: a propensity score analysis. Aging Clinical and Experimental Research 2021, 33, 1757 -1763.

AMA Style

Daniele Castellani, Mirko Di Rosa, Gianna Pace, Emanuele Rubilotta, Marilena Gubbiotti, Giacomo Maria Pirola, Luca Gasparri, Alessandro Antonelli, Marco Dellabella. Comparison between thulium laser vapoenucleation and plasmakinetic resection of the prostate in men aged 75 years and older in a real-life setting: a propensity score analysis. Aging Clinical and Experimental Research. 2021; 33 (6):1757-1763.

Chicago/Turabian Style

Daniele Castellani; Mirko Di Rosa; Gianna Pace; Emanuele Rubilotta; Marilena Gubbiotti; Giacomo Maria Pirola; Luca Gasparri; Alessandro Antonelli; Marco Dellabella. 2021. "Comparison between thulium laser vapoenucleation and plasmakinetic resection of the prostate in men aged 75 years and older in a real-life setting: a propensity score analysis." Aging Clinical and Experimental Research 33, no. 6: 1757-1763.

Research article
Published: 14 April 2021 in PLOS ONE
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Background Elder abuse is a growing public health question among policy makers and practitioners in many countries. Research findings usually indicate women as victims, whereas male elder abuse still remains under-detected and under-reported. We aimed to investigate the prevalence, severity and chronicity of abuse (psychological, physical, physical injury, sexual, and financial) against older men, and to scrutinize factors (e.g. demographics) associated with high chronicity of any abuse. Methods Randomly selected older men (n = 1908) aged 60–84 years from seven European cities (Ancona, Athens, Granada, Kaunas, Stuttgart, Porto, Stockholm) were interviewed in 2009 via a cross-sectional study concerning abuse exposure during the past 12 months. Results Findings suggested that prevalence of abuse towards older men varied between 0.3% (sexual) and 20.3% (psychological), with severe acts between 0.2% (sexual) and 8.2% (psychological). On the whole, higher chronicity values were for injury, followed by psychological, financial, physical, and sexual abuse. Being from Sweden, experiencing anxiety and having a spouse/cohabitant/woman as perpetrator were associated with a greater “risk” for high chronicity of any abuse. For men, severity and chronicity of abuse were in some cases relatively high. Conclusions Abuse towards older men, in the light of severe and repeated acts occurring, should be a source of concern for family, caring staff, social work practice and policy makers, in order to develop together adequate prevention and treatment strategies.

ACS Style

Maria Gabriella Melchiorre; Mirko Di Rosa; Gloria Macassa; Bahareh Eslami; Francisco Torres-Gonzales; Mindaugas Stankunas; Jutta Lindert; Elisabeth Ioannidi-Kapolou; Henrique Barros; Giovanni Lamura; Joaquim J. F. Soares. The prevalence, severity and chronicity of abuse towards older men: Insights from a multinational European survey. PLOS ONE 2021, 16, e0250039 .

AMA Style

Maria Gabriella Melchiorre, Mirko Di Rosa, Gloria Macassa, Bahareh Eslami, Francisco Torres-Gonzales, Mindaugas Stankunas, Jutta Lindert, Elisabeth Ioannidi-Kapolou, Henrique Barros, Giovanni Lamura, Joaquim J. F. Soares. The prevalence, severity and chronicity of abuse towards older men: Insights from a multinational European survey. PLOS ONE. 2021; 16 (4):e0250039.

Chicago/Turabian Style

Maria Gabriella Melchiorre; Mirko Di Rosa; Gloria Macassa; Bahareh Eslami; Francisco Torres-Gonzales; Mindaugas Stankunas; Jutta Lindert; Elisabeth Ioannidi-Kapolou; Henrique Barros; Giovanni Lamura; Joaquim J. F. Soares. 2021. "The prevalence, severity and chronicity of abuse towards older men: Insights from a multinational European survey." PLOS ONE 16, no. 4: e0250039.

Journal article
Published: 27 January 2021 in Nutrients
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A double-blind, placebo-controlled study was performed in a sample of geriatric patients treated with home enteral nutrition (HEN) to analyze the efficacy of a probiotic supplement Proxian®, which contains Lactiplantibacillus plantarum LP01 (LMG P-21021), Lentilactobacillus buchneri Lb26 (DSM 16341), Bifidobacterium animalis subsp. lactis BS01 (LMG P-21384), and is enriched with zinc (Zn) and selenium (Se), in reducing the incidence of infections and modulating inflammation. Thirty-two subjects were enrolled (mean age 79.7 ± 10.3 years), 16 in the intervention group, 16 controls. They received Proxian® or placebo for 60 days. Patients were assessed at baseline (t0) and 60 (t1) and 90 (t2) days after the beginning. Infections were detected by information regarding their clinical manifestations and the incidence of antibiotic therapy. Levels of C-reactive protein (CRP) were measured to study inflammation. Information on bowel function, nutritional status and testimonials regarding the feasibility of administration of the product were collected. Differences between the two groups in number of infections (25% intervention group vs. 44% controls), antibiotic therapies (12% vs. 37%) and modulation of CRP levels (median CRP moved from 0.95 mg/L (t0), to 0.6 (t1) and 0.7 (t2) in intervention group vs. 0.7 mg/L, 0.5 and 0.7 in controls) did not reach statistical significance. No significant changes in bowel function and nutritional status were found. Caregivers’ adherence was 100%. Results of this “IntegPRO” study showed that Proxian® is potentially safe, easy to administer and promising for further studies but it appears not to change the incidence of infections or modulate inflammation in elderly treated with HEN. The utility of Proxian® in reducing the incidence of infections and modulating inflammation in these subjects needs to be investigated by a larger multi-center clinical trial, and by using additional analyses on inflammatory markers and markers of infections.

ACS Style

Paolo Orlandoni; Nikolina Jukic Peladic; Angela Amoruso; Marco Pane; Mirko Di Rosa; Jennifer Vedruccio; Franco Santini. Safety and Efficacy of Probiotic Supplementation in Reducing the Incidence of Infections and Modulating Inflammation in the Elderly with Feeding Tubes: A Pilot, Double-Blind, Placebo-Controlled Study, “IntegPRO”. Nutrients 2021, 13, 391 .

AMA Style

Paolo Orlandoni, Nikolina Jukic Peladic, Angela Amoruso, Marco Pane, Mirko Di Rosa, Jennifer Vedruccio, Franco Santini. Safety and Efficacy of Probiotic Supplementation in Reducing the Incidence of Infections and Modulating Inflammation in the Elderly with Feeding Tubes: A Pilot, Double-Blind, Placebo-Controlled Study, “IntegPRO”. Nutrients. 2021; 13 (2):391.

Chicago/Turabian Style

Paolo Orlandoni; Nikolina Jukic Peladic; Angela Amoruso; Marco Pane; Mirko Di Rosa; Jennifer Vedruccio; Franco Santini. 2021. "Safety and Efficacy of Probiotic Supplementation in Reducing the Incidence of Infections and Modulating Inflammation in the Elderly with Feeding Tubes: A Pilot, Double-Blind, Placebo-Controlled Study, “IntegPRO”." Nutrients 13, no. 2: 391.

Original article
Published: 03 January 2021 in Aging Clinical and Experimental Research
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Chronic kidney disease (CKD) is a common condition in older people and represents a global health issue since it increases the risk of associated comorbidities and all-cause mortality. Furthermore, older people with reduced renal function might be at higher risk for developing functional limitation and disability. Moreover, the current creatinine-based measures of renal function are influenced by several factors in older population. The aims of the CKD-3D project are to perform an observational study to expand the knowledge about CKD-disability relationship and to investigate the use of novel biomarkers of kidney function. An observational, multicenter, prospective cohort study will be conducted in 75 + old patients consecutively admitted to acute care wards of geriatric medicine at participating hospitals. The study planned to enroll 440 patients undergoing clinical and laboratory evaluations at baseline and after 12 months. Face-to-face follow-up at 6 months and telephone follow-up at 3 and 9 months will be carried out. Comprehensive Geriatric Assessment (CGA) and the measurement of Cystatin C, Beta-Trace Protein and Beta2-Microglobulin levels will be included. This study will provide useful information to prevent CKD-related disability by collecting real-life data over 1-year period. The combined approach of CGA and the investigation of innovative existing biomarkers will make it possible to develop new recommendations and guidelines for a patient-centered approach. It is believed that such a study may lead to an improvement of knowledge on CKD in elderly patients and may also have implications in daily clinical practice and in decision-making process.

ACS Style

Andrea Corsonello; Francesco Mattace-Raso; Lisanne Tap; Marcello Maggio; Luna Zerbinati; Francesco Guarasci; Annalisa Cozza; Sonia D’Alia; Luca Soraci; Valentina Corigliano; Mirko Di Rosa; Paolo Fabbietti; Fabrizia Lattanzio. Design and methodology of the chronic kidney disease as a dysmetabolic determinant of disability among older people (CKD-3D) study: a multicenter cohort observational study. Aging Clinical and Experimental Research 2021, 1 -7.

AMA Style

Andrea Corsonello, Francesco Mattace-Raso, Lisanne Tap, Marcello Maggio, Luna Zerbinati, Francesco Guarasci, Annalisa Cozza, Sonia D’Alia, Luca Soraci, Valentina Corigliano, Mirko Di Rosa, Paolo Fabbietti, Fabrizia Lattanzio. Design and methodology of the chronic kidney disease as a dysmetabolic determinant of disability among older people (CKD-3D) study: a multicenter cohort observational study. Aging Clinical and Experimental Research. 2021; ():1-7.

Chicago/Turabian Style

Andrea Corsonello; Francesco Mattace-Raso; Lisanne Tap; Marcello Maggio; Luna Zerbinati; Francesco Guarasci; Annalisa Cozza; Sonia D’Alia; Luca Soraci; Valentina Corigliano; Mirko Di Rosa; Paolo Fabbietti; Fabrizia Lattanzio. 2021. "Design and methodology of the chronic kidney disease as a dysmetabolic determinant of disability among older people (CKD-3D) study: a multicenter cohort observational study." Aging Clinical and Experimental Research , no. : 1-7.

Journal article
Published: 19 November 2020 in JMIR mHealth and uHealth
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Information and communication technologies are tools that are able to support cognitive functions, monitor health and movements, provide reminders to maintain residual memory abilities, and promote social support, especially among patients with dementia. Among these technologies, embodied conversational agents (ECAs) are seen as screen-based entities designed to stimulate human face-to-face conversation skills, allowing for natural human-machine interaction. Unfortunately, the evidence that such agents deliver care benefits in supporting people affected by dementia and their caregivers has not yet been well studied. Therefore, research in this area is essential for the entire scientific community. This study aims to evaluate the usability and acceptability of the virtual agent Anne by people living with dementia. The study is also designed to assess the ability of target users to use the system independently and receive valuable information from it. We conducted a 4-week trial that involved 20 older adults living with dementia and 14 family caregivers in home environment settings in Italy. This study used a mixed methods approach, balancing quantitative and qualitative instruments to gather data from users. Telemetry data were also collected. Older users were particularly engaged in providing significant responses and participating in system improvements. Some of them clearly discussed how technical problems related to speech recognition had a negative impact on the intention to use, adaptiveness, usefulness, and trust. Moreover, the usability of the system achieved an encouraging score, and half of the sample recognized a role of the agent Anne. This study confirms that the quality of automatic speech recognition and synthesis is still a technical issue and has room for improvement, whereas the touch screen modality is almost stable and positively used by patients with dementia. This study demonstrated the ability of target users to use the system independently in their home environment; overall, the involved participants shared good engagement with the system, approaching the virtual agents as a companion able to support memory and enjoyment needs. Therefore, this research provides data that sustain the use of ECAs as future eHealth systems that are able to address the basic and higher-level needs of people living with dementia. This specific field of research is novel and poorly discussed in the scientific community. This could be because of its novelty, yet there is an urgent need to strengthen data, research, and innovation to accelerate the implementation of ECAs as a future method to offer nonpharmacological support to community-dwelling people with dementia.

ACS Style

Vera Stara; Benjamin Vera; Daniel Bolliger; Lorena Rossi; Elisa Felici; Mirko Di Rosa; Michiel de Jong; Susy Paolini. Usability and Acceptance of the Embodied Conversational Agent Anne by People with Dementia and their Caregivers: an exploratory study in home environment settings (Preprint). JMIR mHealth and uHealth 2020, 9, e25891 .

AMA Style

Vera Stara, Benjamin Vera, Daniel Bolliger, Lorena Rossi, Elisa Felici, Mirko Di Rosa, Michiel de Jong, Susy Paolini. Usability and Acceptance of the Embodied Conversational Agent Anne by People with Dementia and their Caregivers: an exploratory study in home environment settings (Preprint). JMIR mHealth and uHealth. 2020; 9 (6):e25891.

Chicago/Turabian Style

Vera Stara; Benjamin Vera; Daniel Bolliger; Lorena Rossi; Elisa Felici; Mirko Di Rosa; Michiel de Jong; Susy Paolini. 2020. "Usability and Acceptance of the Embodied Conversational Agent Anne by People with Dementia and their Caregivers: an exploratory study in home environment settings (Preprint)." JMIR mHealth and uHealth 9, no. 6: e25891.

Preprint content
Published: 19 November 2020
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BACKGROUND Information and Communication Technologies are seen as tools able to support cognitive functions, monitor health and movements, provide reminders to maintain residual memory abilities and promote social support, especially among patients with dementia. Among these technologies, Embodied Conversational Agents (ECAs) are seen as screen-based entities, designed to stimulate human face-to-face conversation skills and thus allow for natural human-machine interaction. Unfortunately, the efficacy of ECA in supporting people affected by dementia and their caregivers is not yet well studied. Therefore, research in this area is essential for the entire scientific community. OBJECTIVE This study aims to evaluate the usability and acceptance of the ECA Anne by seniors affected with dementia. The study is also designed to assess the ability of target users to utilize the system independently and receive valuable information from it. METHODS A 4-week trial was conducted involving 20 older adults with dementia and 14 family caregivers in home environment settings in Italy. This study used a mixed method approach, balancing quantitative and qualitative instruments to gather data from users. Telemetry data was also collected. RESULTS It emerges that older users were particularly engaged in providing significant responses and participated in system improvements. Some of them clearly discussed how technical problems related to speech recognition negatively impacted on the intention to use, adaptiveness, usefulness and trust. Moreover, the usability of the system achieved an encouraging score and the half of the sample recognized a role in the ECA. This study confirms that the quality of automatic speech recognition and synthesis is still a technical issue and has room for improvement, whereas touchscreen modality is almost stable and positively used by patients with dementia. CONCLUSIONS This specific field of research is novel and poorly discussed in the scientific community. This could be due to its newness, yet there is an urgent need to strengthen data, research and innovation to accelerate the implementation of ECA as a future way to offer non-pharmacological support to community-dwelling persons with dementia.

ACS Style

Vera Stara; Benjamin Vera; Daniel Bolliger; Lorena Rossi; Elisa Felici; Mirko Di Rosa; Michiel De Jong; Susy Paolini. Usability and Acceptance of the Embodied Conversational Agent Anne by People with Dementia and their Caregivers: an exploratory study in home environment settings (Preprint). 2020, 1 .

AMA Style

Vera Stara, Benjamin Vera, Daniel Bolliger, Lorena Rossi, Elisa Felici, Mirko Di Rosa, Michiel De Jong, Susy Paolini. Usability and Acceptance of the Embodied Conversational Agent Anne by People with Dementia and their Caregivers: an exploratory study in home environment settings (Preprint). . 2020; ():1.

Chicago/Turabian Style

Vera Stara; Benjamin Vera; Daniel Bolliger; Lorena Rossi; Elisa Felici; Mirko Di Rosa; Michiel De Jong; Susy Paolini. 2020. "Usability and Acceptance of the Embodied Conversational Agent Anne by People with Dementia and their Caregivers: an exploratory study in home environment settings (Preprint)." , no. : 1.

Journal article
Published: 10 September 2020 in International Journal of Environmental Research and Public Health
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Although up to 8% of European youngsters carry out high-intensity care for a family member, adolescent young carers (AYCs), especially those caring for their grandparents (GrPs), remain an under-researched group. This study aimed at addressing the current knowledge gap by carrying out an online survey in Italy, the Netherlands, Slovenia, Sweden, Switzerland, and the United Kingdom. The analysis included a final sample of 817 AYCs aged 15–17 years old. AYCs of grandparents (GrPs) were compared to AYCs of other care recipients (OCRs), in order to identify any difference in positive and negative caregiving outcomes and exposure factors between the two groups. Linear or logistic regression models were built, and multivariate analyses were repeated, including a fixed effect on the country variable. AYCs of GrPs experienced more positive caregiving outcomes than AYCs of OCRs across all six countries. Being female or non-binary, and having a migration background, were associated with more negative outcomes, regardless of the relationship with the care recipient. Further research on intergenerational caregiving outcomes is recommended for shaping measures and policies, which preserve the intergenerational emotional bonds, whilst protecting AYCs from inappropriate responsibilities, undermining their mental health and well-being.

ACS Style

Sara Santini; Marco Socci; Barbara D’Amen; Mirko Di Rosa; Giulia Casu; Valentina Hlebec; Feylyn Lewis; Agnes Leu; Renske Hoefman; Rosita Brolin; Lennart Magnusson; Elizabeth Hanson. Positive and Negative Impacts of Caring among Adolescents Caring for Grandparents. Results from an Online Survey in Six European Countries and Implications for Future Research, Policy and Practice. International Journal of Environmental Research and Public Health 2020, 17, 6593 .

AMA Style

Sara Santini, Marco Socci, Barbara D’Amen, Mirko Di Rosa, Giulia Casu, Valentina Hlebec, Feylyn Lewis, Agnes Leu, Renske Hoefman, Rosita Brolin, Lennart Magnusson, Elizabeth Hanson. Positive and Negative Impacts of Caring among Adolescents Caring for Grandparents. Results from an Online Survey in Six European Countries and Implications for Future Research, Policy and Practice. International Journal of Environmental Research and Public Health. 2020; 17 (18):6593.

Chicago/Turabian Style

Sara Santini; Marco Socci; Barbara D’Amen; Mirko Di Rosa; Giulia Casu; Valentina Hlebec; Feylyn Lewis; Agnes Leu; Renske Hoefman; Rosita Brolin; Lennart Magnusson; Elizabeth Hanson. 2020. "Positive and Negative Impacts of Caring among Adolescents Caring for Grandparents. Results from an Online Survey in Six European Countries and Implications for Future Research, Policy and Practice." International Journal of Environmental Research and Public Health 17, no. 18: 6593.

Short communication
Published: 17 August 2020 in Aging Clinical and Experimental Research
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Executive abilities are frequently impaired in patients with chronic obstructive pulmonary disease (COPD). We aimed at investigating the association between trail making test (TMT) and survival. Our series consisted of 68 stable COPD outpatients followed-up every 6 months for 52.6 ± 27.6 months. Enrolled patients underwent a baseline comprehensive neuropsychological assessment, including mini-mental state exam, attentional matrices, digit span, Rey auditory verbal learning, Rey–Osterrieth complex figure, copy drawing, tokens test, verbal fluency, category fluency, frontal assessment battery, Raven’s progressive matrices, TMT-A, -B and -B-A. The association between neuropsychological deficits and overall mortality was investigated by Cox regression. During follow-up period, 41 patients (60.3%) died. After adjusting for potential confounders, TMT-B was significantly associated with mortality (HR = 2.42, 95% CI = 1.10–5.31), along with age (HR = 1.06, 95% CI = 1.0–1.13), overall comorbidity (HR = 1.29, 95% CI = 1.02–1.62) and use of noninvasive ventilation (HR = 2.16, 95% CI = 1.05–4.45). Defective TMT-B may be associated with long-term mortality in patients with stable COPD.

ACS Style

Alessia Fumagalli; Clementina Misuraca; Sonia Riva; Luca Soraci; Paolo Fabbietti; Mirko Di Rosa; Andrea Corsonello; Fabrizia Lattanzio; Daniele Colombo. Does trail making test predict long-term prognosis in older patients with COPD? Aging Clinical and Experimental Research 2020, 33, 1699 -1703.

AMA Style

Alessia Fumagalli, Clementina Misuraca, Sonia Riva, Luca Soraci, Paolo Fabbietti, Mirko Di Rosa, Andrea Corsonello, Fabrizia Lattanzio, Daniele Colombo. Does trail making test predict long-term prognosis in older patients with COPD? Aging Clinical and Experimental Research. 2020; 33 (6):1699-1703.

Chicago/Turabian Style

Alessia Fumagalli; Clementina Misuraca; Sonia Riva; Luca Soraci; Paolo Fabbietti; Mirko Di Rosa; Andrea Corsonello; Fabrizia Lattanzio; Daniele Colombo. 2020. "Does trail making test predict long-term prognosis in older patients with COPD?" Aging Clinical and Experimental Research 33, no. 6: 1699-1703.

Review
Published: 15 August 2020 in International Journal of Environmental Research and Public Health
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Background: Despite the evidence on the positive role of self-management, the adoption of health coaching strategies for older people is still limited. To address these gaps, recent efforts have been made in the ICT sector in order to develop systems for delivering coaching and overcoming barriers relating to scarcity of resources. The aim of this review is to examine the efficacy of personal health coaching systems for older adults using digital virtual agents. Methods: A systematic review of the literature was conducted in December 2019 analyzing manuscripts from four databases over the last 10 years. Nine papers were included. Results: Despite the low number of studies, there was evidence that technology-integrated interventions can deliver benefits for health over usual care. However, the review raises important questions about how to maintain benefits and permanence of behavior change produced by short-term interventions. Conclusion: These systems offer a potential tool to reduce costs, minimize therapist burden and training, and expand the range of clients who can benefit from them. It is desirable that in the future the number of studies will grow, considering other aspects such as the role of the virtual coaches’ characteristics, social-presence, empathy, usability, and health literacy.

ACS Style

Roberta Bevilacqua; Sara Casaccia; Gabriella Cortellessa; Arlene Astell; Fabrizia Lattanzio; Andrea Corsonello; Paola D’Ascoli; Susy Paolini; Mirko Di Rosa; Lorena Rossi; Elvira Maranesi. Coaching Through Technology: A Systematic Review into Efficacy and Effectiveness for the Ageing Population. International Journal of Environmental Research and Public Health 2020, 17, 5930 .

AMA Style

Roberta Bevilacqua, Sara Casaccia, Gabriella Cortellessa, Arlene Astell, Fabrizia Lattanzio, Andrea Corsonello, Paola D’Ascoli, Susy Paolini, Mirko Di Rosa, Lorena Rossi, Elvira Maranesi. Coaching Through Technology: A Systematic Review into Efficacy and Effectiveness for the Ageing Population. International Journal of Environmental Research and Public Health. 2020; 17 (16):5930.

Chicago/Turabian Style

Roberta Bevilacqua; Sara Casaccia; Gabriella Cortellessa; Arlene Astell; Fabrizia Lattanzio; Andrea Corsonello; Paola D’Ascoli; Susy Paolini; Mirko Di Rosa; Lorena Rossi; Elvira Maranesi. 2020. "Coaching Through Technology: A Systematic Review into Efficacy and Effectiveness for the Ageing Population." International Journal of Environmental Research and Public Health 17, no. 16: 5930.

Journal article
Published: 30 July 2020 in International Journal of Environmental Research and Public Health
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Austerity measures on services provision, introduced due to recent economic crises, have stimulated the search for innovative welfare solutions, including options that are not directly or entirely funded by public sources. In Italy, recent legislation has promoted the development of occupational welfare (OW) measures, aimed at strengthening the supply of services to support employees with informal (elder) care responsibilities. This paper aims to describe how the newly introduced OW schemes might innovate existing care arrangements, by identifying their impact on the different actors involved in home care provision (care recipients, family carers, home care service providers and migrant care workers), as well as at a macro level in terms of promoting social innovation. The international relevance of the Italian case comes from the fact that it is one of the more representative familistic care regimes, largely characterized by home care provided by informal carers and migrant care workers (MCW). The importance of Italian OW schemes is increasing, and in 2018 their presence in company-level bargaining agreements grew by more than 15%. A rapid review of the literature and expert interviews allowed us to describe the complex Italian OW schemes system, and to identify the positive implications of their application for the country’s long-term care (LTC) context, underlining what makes these measures a clear example of “social innovation” likely to have a future positive impact on home-based care in Italy.

ACS Style

Georgia Casanova; Mirko Di Rosa; Oliver Fisher; Giovanni Lamura. Between Migrant Care Work and New Occupational Welfare Tools: Changing Home Care Arrangements in Italy. International Journal of Environmental Research and Public Health 2020, 17, 5511 .

AMA Style

Georgia Casanova, Mirko Di Rosa, Oliver Fisher, Giovanni Lamura. Between Migrant Care Work and New Occupational Welfare Tools: Changing Home Care Arrangements in Italy. International Journal of Environmental Research and Public Health. 2020; 17 (15):5511.

Chicago/Turabian Style

Georgia Casanova; Mirko Di Rosa; Oliver Fisher; Giovanni Lamura. 2020. "Between Migrant Care Work and New Occupational Welfare Tools: Changing Home Care Arrangements in Italy." International Journal of Environmental Research and Public Health 17, no. 15: 5511.

Case report
Published: 28 July 2020 in Infection
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The aim of our study was to assess respiratory function at the time of clinical recovery and 6 weeks after discharge in patients surviving to COVID-19 pneumonia. Our case series consisted of 13 patients with COVID-19 pneumonia. At the time of clinical recovery, FEV1 (2.07 ± 0.72 L) and FVC (2.25 ± 0.86 L) were lower compared to lower limit of normality (LLN) values (2.56 ± 0.53 L, p = 0.004, and 3.31 ± 0.65 L, p < 0.001, respectively), while FEV1/FVC (0.94 ± 0.07) was higher compared to upper limit of normality (ULN) values (0.89 ± 0.01, p = 0.029). After 6 weeks pulmonary function improved but FVC was still lower than ULN (2.87 ± 0.81, p = 0.014). These findings suggest that COVID-19 pneumonia may result in clinically relevant alterations in pulmonary function tests, with a mainly restrictive pattern.

ACS Style

Alessia Fumagalli; Clementina Misuraca; Achille Bianchi; Noemi Borsa; Simone Limonta; Sveva Maggiolini; Daniela Rita Bonardi; Andrea Corsonello; Mirko Di Rosa; Luca Soraci; Fabrizia Lattanzio; Daniele Colombo. Pulmonary function in patients surviving to COVID-19 pneumonia. Infection 2020, 49, 153 -157.

AMA Style

Alessia Fumagalli, Clementina Misuraca, Achille Bianchi, Noemi Borsa, Simone Limonta, Sveva Maggiolini, Daniela Rita Bonardi, Andrea Corsonello, Mirko Di Rosa, Luca Soraci, Fabrizia Lattanzio, Daniele Colombo. Pulmonary function in patients surviving to COVID-19 pneumonia. Infection. 2020; 49 (1):153-157.

Chicago/Turabian Style

Alessia Fumagalli; Clementina Misuraca; Achille Bianchi; Noemi Borsa; Simone Limonta; Sveva Maggiolini; Daniela Rita Bonardi; Andrea Corsonello; Mirko Di Rosa; Luca Soraci; Fabrizia Lattanzio; Daniele Colombo. 2020. "Pulmonary function in patients surviving to COVID-19 pneumonia." Infection 49, no. 1: 153-157.

Journal article
Published: 12 July 2020 in Journal of Clinical Medicine
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The prognostic interaction between chronic kidney disease (CKD) and cognitive impairment is still to be elucidated. We investigated the potential interaction of overall cognitive impairment or defective constructional praxis and CKD in predicting 1-year mortality among 646 older patients discharged from hospital. The estimated glomerular filtration rate (eGFR) was calculated using the Berlin Initiative Study (BIS) equation. Cognitive impairment was assessed by the Mini Mental State Exam (MMSE) and defective constructional praxis was ascertained by the inherent MMSE item. The study outcome was 1-year mortality. Statistical analysis was carried out using Cox regression. After adjusting for potential confounders, the co-occurrence of eGFR <30 and overall cognitive impairment (Hazard Ratio (HR) = 3.12, 95% Confidence Interval (CI) = 1.26–7.77) and defective constructional praxis (HR = 2.50, 95% CI = 1.08–5.77) were associated with the outcome. No significant prognostic interaction of eGFR < 30 with either overall cognitive impairment (HR = 1.99, 95% CI = 0.38–10.3) or constructional apraxia (HR = 1.68, 95% CI = 0.33–8.50) was detectable, while only cognitive deficits were found significantly associated with the outcome in the interaction models (HR = 3.12, 95% CI = 1.45–6.71 for overall cognitive impairment and HR = 2.16, 95% CI = 1.05–4.45 for constructional apraxia). Overall cognitive impairment and defective constructional praxis may be associated with increased risk of 1-year mortality among older hospitalized patients with severe CKD. However, no significant prognostic interaction between CKD and cognitive impairment could be observed.

ACS Style

Mirko Di Rosa; Sonia D’Alia; Francesco Guarasci; Luca Soraci; Elisa Pierpaoli; Federica Lenci; Maddalena Ricci; Graziano Onder; Stefano Volpato; Carmelinda Ruggiero; Antonio Cherubini; Andrea Corsonello; Fabrizia Lattanzio. Cognitive Impairment, Chronic Kidney Disease, and 1-Year Mortality in Older Patients Discharged from Acute Care Hospital. Journal of Clinical Medicine 2020, 9, 2202 .

AMA Style

Mirko Di Rosa, Sonia D’Alia, Francesco Guarasci, Luca Soraci, Elisa Pierpaoli, Federica Lenci, Maddalena Ricci, Graziano Onder, Stefano Volpato, Carmelinda Ruggiero, Antonio Cherubini, Andrea Corsonello, Fabrizia Lattanzio. Cognitive Impairment, Chronic Kidney Disease, and 1-Year Mortality in Older Patients Discharged from Acute Care Hospital. Journal of Clinical Medicine. 2020; 9 (7):2202.

Chicago/Turabian Style

Mirko Di Rosa; Sonia D’Alia; Francesco Guarasci; Luca Soraci; Elisa Pierpaoli; Federica Lenci; Maddalena Ricci; Graziano Onder; Stefano Volpato; Carmelinda Ruggiero; Antonio Cherubini; Andrea Corsonello; Fabrizia Lattanzio. 2020. "Cognitive Impairment, Chronic Kidney Disease, and 1-Year Mortality in Older Patients Discharged from Acute Care Hospital." Journal of Clinical Medicine 9, no. 7: 2202.

Review
Published: 04 July 2020 in Journal of Clinical Medicine
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Older people have paid a huge toll in terms of mortality during the coronavirus disease-19 (COVID-19) pandemic. Frailty may have contributed to the vulnerability of older people to more severe clinical presentation. We aimed at reviewing available evidence about frailty and COVID-19. We searched PUBMED, Web of Science, and EMBASE from 1 December 2019 to 29 May 2020. Study selection and data extraction were performed by three independent reviewers. Qualitative synthesis was conducted and quantitative data extracted when available. Forty papers were included: 13 editorials, 15 recommendations/guidelines, 3 reviews, 1 clinical trial, 6 observational studies, 2 case reports. Editorials and reviews underlined the potential clinical relevance of assessing frailty among older patients with COVID-19. However, frailty was only investigated in regards to its association with overall mortality, hospital contagion, intensive care unit admission rates, and disease phenotypes in the few observational studies retrieved. Specific interventions in relation to frailty or its impact on COVID-19 treatments have not been evaluated yet. Even with such limited evidence, clinical recommendations on the use of frailty tools have been proposed to support decision making about escalation plan. Ongoing initiatives are expected to improve knowledge of COVID-19 interaction with frailty and to promote patient-centered approaches.

ACS Style

Giuseppe Maltese; Andrea Corsonello; Mirko Di Rosa; Luca Soraci; Cristiana Vitale; Francesco Corica; Fabrizia Lattanzio. Frailty and COVID-19: A Systematic Scoping Review. Journal of Clinical Medicine 2020, 9, 2106 .

AMA Style

Giuseppe Maltese, Andrea Corsonello, Mirko Di Rosa, Luca Soraci, Cristiana Vitale, Francesco Corica, Fabrizia Lattanzio. Frailty and COVID-19: A Systematic Scoping Review. Journal of Clinical Medicine. 2020; 9 (7):2106.

Chicago/Turabian Style

Giuseppe Maltese; Andrea Corsonello; Mirko Di Rosa; Luca Soraci; Cristiana Vitale; Francesco Corica; Fabrizia Lattanzio. 2020. "Frailty and COVID-19: A Systematic Scoping Review." Journal of Clinical Medicine 9, no. 7: 2106.

Journal article
Published: 30 June 2020 in Journal of Clinical Medicine
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Background: Type 2 diabetes (T2D) is correlated to amnestic mild cognitive impairment (aMCI) and to non-amnestic mild cognitive impairment (naMCI). This study evaluated whether the T2D variable characterizes a peculiar cognitive profile in elderly patients. Moreover, it explores the association between glycated hemoglobin levels (HbA1c), T2D duration, insulin and oral hypoglycemic agent treatment, and cognition in elderly diabetic patients. Methods: Detailed neuropsychological battery was used to diagnose MCI subtypes. A total of 39 MCI subjects with T2D (T2D-MCI) and 37 MCI subjects without T2D (ND-MCI), matched for age, educational level, and Mini-Mental State Examination score, were included. Results: ND-MCI performed worse in memory and language domains than T2D-MCI. The amnestic subtype is more frequent among ND-MCI and non-amnestic subtype in T2D-MCI. In T2D-MCI, high HbA1c levels correlate with episodic memory (immediate recall) and T2D duration. Some indexes of episodic memory (immediate recall), attention, and visual-spatial ability correlate with insulin treatment. Conclusions: An association between T2D and non-amnestic MCI is suggested. In the T2D-MCI group, significant associations between insulin treatment and memory (immediate recall), complex figure copy, and attention were found.

ACS Style

Silvia Valenza; Lucia Paciaroni; Susy Paolini; Anna Rita Bonfigli; Mirko Di Rosa; Rosa Anna Rabini; Elena Tortato; Paolo Pelliccioni; Giuseppe Pelliccioni. Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects. Journal of Clinical Medicine 2020, 9, 2055 .

AMA Style

Silvia Valenza, Lucia Paciaroni, Susy Paolini, Anna Rita Bonfigli, Mirko Di Rosa, Rosa Anna Rabini, Elena Tortato, Paolo Pelliccioni, Giuseppe Pelliccioni. Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects. Journal of Clinical Medicine. 2020; 9 (7):2055.

Chicago/Turabian Style

Silvia Valenza; Lucia Paciaroni; Susy Paolini; Anna Rita Bonfigli; Mirko Di Rosa; Rosa Anna Rabini; Elena Tortato; Paolo Pelliccioni; Giuseppe Pelliccioni. 2020. "Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects." Journal of Clinical Medicine 9, no. 7: 2055.

Rehabilitation medicine
Published: 15 June 2020 in BMJ Open
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IntroductionDeficits in balance and walking ability are relevant risk factors for falls during ageing. Moreover, falls are a risk factor for future falls, strongly associated with adverse health outcomes, such as fear of falling or fractures, particularly, hip fracture. For this reason, the development of prevention tools and innovative rehabilitation strategies is one of the main objectives in geriatrics. Effective interventions to promote hip recovery after hip fracture are characterised by intensive and repetitive movements. One treatment approach is to increase the number of steps during the rehabilitation sessions and to improve the balance and the endurance of the patients in the use of technological devices.Methods and analysisThis randomised controlled trial aimed to evaluate an innovative rehabilitation treatment of elderly patients with hip fractures. A total of 195 patients with hip fractures will be recruited and randomly divided into three groups: traditional rehabilitation programme, traditional rehabilitation programme plus TYMO system and traditional rehabilitation programme plus Walker View. Assessments will be performed at baseline, at the end of treatment, at 6 months, and at 1 and 2 years after the end of the treatment. Only subjects hospitalised 4 weeks prior to the beginning of the study will be taken into consideration. Twenty treatment sessions will be conducted, divided into three training sessions per week, for 7 weeks. The technological intervention group will carry out 30 min sessions of traditional therapy and 20 min of treatment with a technological device. The control group will perform traditional therapy sessions, each lasting 50 min. The primary outcomes are risk of falling, gait performance and fear of falling.Ethics and disseminationThe study was approved by the Istituto di Ricerca e Cura a Carattere Scientifica, Istituto Nazionale Ricovero e Cura Anziani Ethics Committee, with identification code number 19 014. Trial results will be submitted for publication in journals and conferences.Trial registration numberNCT04095338.

ACS Style

Elvira Maranesi; Giovanni Renato Riccardi; Fabrizia Lattanzio; Mirko Di Rosa; Riccardo Luzi; Elisa Casoni; Nadia Rinaldi; Renato Baldoni; Valentina Di Donna; Roberta Bevilacqua. Randomised controlled trial assessing the effect of a technology-assisted gait and balance training on mobility in older people after hip fracture: study protocol. BMJ Open 2020, 10, e035508 .

AMA Style

Elvira Maranesi, Giovanni Renato Riccardi, Fabrizia Lattanzio, Mirko Di Rosa, Riccardo Luzi, Elisa Casoni, Nadia Rinaldi, Renato Baldoni, Valentina Di Donna, Roberta Bevilacqua. Randomised controlled trial assessing the effect of a technology-assisted gait and balance training on mobility in older people after hip fracture: study protocol. BMJ Open. 2020; 10 (6):e035508.

Chicago/Turabian Style

Elvira Maranesi; Giovanni Renato Riccardi; Fabrizia Lattanzio; Mirko Di Rosa; Riccardo Luzi; Elisa Casoni; Nadia Rinaldi; Renato Baldoni; Valentina Di Donna; Roberta Bevilacqua. 2020. "Randomised controlled trial assessing the effect of a technology-assisted gait and balance training on mobility in older people after hip fracture: study protocol." BMJ Open 10, no. 6: e035508.

Study protocol
Published: 13 May 2020 in BMC Neurology
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Background Parkinson’s disease is one of the most frequent causes of disability among the older adults. It is a chronic-progressive neuro-degenerative disease, characterized by several motor disorders. Balance disorders are a symptom that involves the body axis and do not respond to dopaminergic therapy used in Parkinson’s disease. Therefore, physiotherapy becomes an important intervention for the management of motor disorders. Originally, these rehabilitative approaches were based on empirical experiences, but several scientific evidences suggests that neuronal plasticity is exercise-dependent. In this context, robotic rehabilitation plays an important role because it allows to perform task-oriented exercises and to increase the number of repetitions and their intensity. This protocol study aims to evaluate the effectiveness of robotic-based intervention of the older adults with Parkinson’s disease, designed to improve the gait and to reduce the risk of falling. Methods This study is a single-blinded randomized controlled trial. The primary outcomes are: risk of falling, gait performance and fear of falling measured through Performance-Oriented Mobility Assessment (POMA), instrumental gait analysis and Short Falls Efficacy Scale – International (FES-I), respectively. One hundred ninety-five patients with PD will be recruited and randomly divided into three groups, to receive a traditional rehabilitation program or a robotic rehabilitation using Tymo system or Walker View in addition to the traditional therapy. Assessments will be performed at baseline, at the end of treatment and 6 months, 1 year and 2 years from the end of the treatment. A 10-treatment session will be conducted, divided into 2 training sessions per week, for 5 weeks. The control group will perform traditional therapy sessions lasting 50 min. The technological intervention group will carry out 30 min of traditional therapy and 20 min of treatment with a robotic system. Discussion The final goals of the present study are to propose a new approach in the PD rehabilitation, focused on the use of robotic device, and to check the results not only at the end of the treatment but also in the long term. Trial registration NCT04087031, registration date September 12, 2019.

ACS Style

Roberta Bevilacqua; Elvira Maranesi; Mirko Di Rosa; Riccardo Luzi; Elisa Casoni; Nadia Rinaldi; Renato Baldoni; Fabrizia Lattanzio; Valentina Di Donna; Giuseppe Pelliccioni; Giovanni Renato Riccardi. Rehabilitation of older people with Parkinson’s disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies. BMC Neurology 2020, 20, 1 -8.

AMA Style

Roberta Bevilacqua, Elvira Maranesi, Mirko Di Rosa, Riccardo Luzi, Elisa Casoni, Nadia Rinaldi, Renato Baldoni, Fabrizia Lattanzio, Valentina Di Donna, Giuseppe Pelliccioni, Giovanni Renato Riccardi. Rehabilitation of older people with Parkinson’s disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies. BMC Neurology. 2020; 20 (1):1-8.

Chicago/Turabian Style

Roberta Bevilacqua; Elvira Maranesi; Mirko Di Rosa; Riccardo Luzi; Elisa Casoni; Nadia Rinaldi; Renato Baldoni; Fabrizia Lattanzio; Valentina Di Donna; Giuseppe Pelliccioni; Giovanni Renato Riccardi. 2020. "Rehabilitation of older people with Parkinson’s disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies." BMC Neurology 20, no. 1: 1-8.

Journal article
Published: 27 March 2020 in Journal of Clinical Medicine
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Bleeding is the most common complication of transurethral resection of the prostate and simple open prostatectomy, especially in men on antiplatelet/anticoagulant therapy. The present study aimed to evaluate the safety and effectiveness of thulium laser vapoenucleation of the prostate (ThuVEP) for benign prostatic hyperplasia in patients on chronic antithrombotic medications. Between January 2015 and December 2019, 88 men underwent the procedure under antithrombotic agents in our center. The mean age was 74.7 ± 6.1 years. Median prostate volume was 66.5 mL. Patients on oral anticoagulants were bridged to low-molecular-weight heparin (n = 35). Aspirin (n = 39), clopidogrel (n = 10), and ticlopidine (n = 4) were maintained. Of the patients, 69.3% had an American Society of Anesthesiologists score ≥ 3. Blood loss at 24 h was comparable in all groups. Median catheterization length and postoperative stays were 2 and 3 days respectively. Acute cardiovascular events occurred in 2 patients (2.3%). Of the patients, 4 required prolonged bladder irrigation, 2 required blood transfusions, 1 required a cystoscopy for bleeding control, and 1 required a suprapubic cystostomy for blood clot evacuation. No patients died within 30 days of being discharged. Late complications occurred in 3 (3.8%) patients (1 optical urethrotomy and 1 bladder neck incision for stenosis; 1 acute myocardial infarction). All follow-up visits (1, 6, and 12-month) showed a significant improvement in all urinary parameters compared to baseline. ThuVEP appears to be a feasible surgical option in high-risk patients on antithrombotic regimens, with acceptable postoperative morbidity, good functional outcome, and low incidence of medium-term reoperation rate.

ACS Style

Daniele Castellani; Mirko Di Rosa; Luca Gasparri; Michele Pucci; Marco Dellabella. Thulium Laser Vapoenucleation of the Prostate (ThuVEP) in Men at High Cardiovascular Risk and on Antithrombotic Therapy: A Single-Center Experience. Journal of Clinical Medicine 2020, 9, 917 .

AMA Style

Daniele Castellani, Mirko Di Rosa, Luca Gasparri, Michele Pucci, Marco Dellabella. Thulium Laser Vapoenucleation of the Prostate (ThuVEP) in Men at High Cardiovascular Risk and on Antithrombotic Therapy: A Single-Center Experience. Journal of Clinical Medicine. 2020; 9 (4):917.

Chicago/Turabian Style

Daniele Castellani; Mirko Di Rosa; Luca Gasparri; Michele Pucci; Marco Dellabella. 2020. "Thulium Laser Vapoenucleation of the Prostate (ThuVEP) in Men at High Cardiovascular Risk and on Antithrombotic Therapy: A Single-Center Experience." Journal of Clinical Medicine 9, no. 4: 917.