Istituto Nazionale per l'Assicurazione Contro gli Infortuni sul Lavoro

Like bacteria and plants, fungi produce a remarkable diversity of small molecules with potent activities for human health known as natural products or secondary metabolites. One such example is mycophenolic acid (MPA), a powerful immunosuppressant drug that is administered daily to millions of transplant recipients worldwide. Production of MPA is restricted to a very limited number of filamentous fungi, and little is known about its biosynthetic modalities. It is therefore a particular challenge to improve our knowledge of the biosynthesis of this valuable natural compound, as this would contribute to a better understanding of the specialized metabolism of fungi and could also lead to the identification of new fungal producers for the supply of immunosuppressants. Here, we were interested in deciphering the origin and evolution of the fungal MPA biosynthetic pathway. Large-scale analyses of fungal genomic resources led us to identify several new species that harbour a gene cluster for MPA biosynthesis. Phylogenomic analysis suggests that the MPA biosynthetic gene cluster originated early in a common ancestor of the fungal family Aspergillaceae but was repeatedly lost and it is now present in a narrow but diverse set of filamentous fungi. Moreover, comparison of the IMPDH protein sequences that are the target of the MPA drug as well as analysis of MPA production and susceptibility suggest that all MPA fungal producers are resistant to this toxic compound, but that this resistance is likely to be based on different molecular mechanisms. Our study provides new insight into the evolution of the biosynthesis of the important secondary metabolite MPA in fungi.

Objective: This study examines the psychometric properties of a workplace-adapted version of an existing Technostress scale to assess technostress in workers over 50 across different companies. Methods: Data were collected from 470 workers over 50 across finance, packaging, and steel sectors. We evaluated the internal consistency, criterion validity, and factor structure of the Technostress scale using Cronbach’s alpha, McDonald’s Omega, Confirmatory Factor Analysis, and correlations with stress, coping, well-being, and workability. Results: Scale and subscales demonstrated strong reliability (coefficients>0.75) and validity. CFA confirmed bifactor model with optimal fit indices (CFI=0.98, TLI=0.96, RMSEA=0.05). Technostress correlated positively with stress and negatively with well-being and workability. Significant differences in technostress were observed by sex and occupational role. Conclusions: The adapted scale is a reliable tool for evaluating technostress among older workers, supporting tailored interventions to enhance workplace well-being and productivity.

Walking aids for individuals with musculoskeletal frailty or motor disabilities must ensure adequate physical support and assistance to their users. To this end, sensor-enabled human state monitoring and estimation are crucial. This paper proposes an innovative approach to assessing users' stability while walking with WANDER, a novel gait assistive device, by exploiting the correlation between the eXtrapolated Center of Mass ( XCoM ) and the Base of Support ( BoS ) edges. First, the soundness of this metric in monitoring gait stability is proven. Experiments on 25 healthy individuals show that the median value of Pearson's correlation coefficient (p-value $<$ 0.05) remained high during the forward walk for all subjects. Next, a correlation-based variable admittance (CVA) controller is implemented, whose parameters are tuned to physically support users when a gait perturbation is detected (i.e. low values of Pearson's correlation coefficient). To validate this approach, 13 healthy subjects were asked to compare our controller with a force threshold-based (FVA) one. The CVA controller's performance in discriminating stable and perturbed gait conditions showed a high sensitivity value, comparable to FVA, and improved performance in terms of specificity. The number of false and missed detections of gait perturbation was considerably reduced, independently of walking speed, exhibiting a higher level of safety and smoothness compared to the FVA controller. Overall, the outcome of this study gives promising evidence of the proposed metric capability in identifying user stability and triggering WANDER's assistance.

Monitoring foot prostheses is essential, as their performance impacts users’ daily lives. Fiber Bragg Grating (FBG) sensors represent a gold standard in monitoring applications, but traditional optoelectronic units are too cumbersome for wearable applications. This research addresses this issue by using a lightweight and compact optoelectronic unit and developing a compensation algorithm to overcome the signal drift phenomena caused by the light source instability. The proposed method uses an FBG as a reference to provide the algorithm with information on the signals drift. The developed algorithm is based on the assumptions of linearity among drift in different detection channels and the absence of drift at the initial time instant. The compensation variable was experimentally identified and validated. Experimental validation through temperature tests showed the algorithm reduces the drift error by 60%. Finally, mechanical tests were conducted on a foot prosthesis equipped with two FBGs: one used as a reference and the other for strain sensing. An electrical strain gauge was used to validate the FBG-based sensing system. The results of the mechanical tests indicate the possiblity to monitor a foot prosthesis using FBGs. The FBG and strain gauge measurements comparison aligns with previous studies where high-performance optoelectronic units were used.

Background Transfemoral osseointegrated prostheses, like other uncemented prostheses experience the risk of aseptic loosening and post-operative periprosthetic fractures, with an incidence between 3% and 30%. To date, however, osseointegrated off-the-shelf prostheses are manufactured in a limited number of sizes, and some patients do not meet the strict eligibility criteria of commercial devices. A customized osseointegrated stem was developed and a pre-clinical in vitro investigation of the stem was performed, to evaluate its biomechanical performance. Materials and methods Six human cadaveric femurs were implanted with commercial stems, while the six contralateral were implanted with customized stems. Three more femurs that did not meet the eligibility criteria for the commercial stems were implanted with the customized stems. Two different loading scenarios (compression-flexion, and torsion) were simulated to measure the primary implant stability and the load transfer. For both loading scenarios, the displacements of the implant with respect to the host bone, and the strains on the bone surface were measured using digital image correlation (DIC). To measure the pull-out force, a tensile force was applied to the prostheses. Results The translational inducible micromotions during the compression-flexion test of the OsteoCustom stem were more than 4 times smaller than the commercial one (p < 0.05). The rotational inducible micromotions of the OsteoCustom stem were more than 3 times smaller than the commercial one (p < 0.05). Similar results were found from the torsional test. The full-field strain distribution of the commercial stem showed a slightly higher strain concentration near the stem tip (maximum principal strain = 1928±127 µɛ) than the OsteoCustom (maximum principal strain = 1758±130 µɛ). Similar results were found for the femurs that did not meet the eligibility criteria for the commercial stems and could be implanted with the OsteoCustom. No statistically significant difference was found in the extraction force between the two groups. Discussion and conclusion These results support the hypothesis that the OsteoCustom stem can offer better primary stability and load distribution compared to commercial implants. The outcome highlighted the potential benefits of the OsteoCustom prosthesis, which is capable of including a wider range of femoral anatomies than the current standard.

Work-related musculoskeletal disorders (WRMSDs) are a leading cause of chronic conditions among working-age adults. Preventing these disorders is crucial to reducing their impact, and quantitative analysis through sensors can help identify their causes and guide ergonomic solutions. This systematic review aims to compile research from 2000 to 2023 published in English and sourced from Web of Science, Scopus, or PubMed that examines workers’ movements during tasks using wearable sensor systems that are applicable in workplace settings. The goal is to identify the job sectors that have been studied and highlight tasks lacking ergonomic risk research. A total of 111 papers were selected through a screening process across three databases, assessed using the McMaster risk of bias tool. The studies span various job sectors and report on the use of different technologies for data collection and study population sizes. The review identifies existing research on WRMSD risks utilizing wearable systems in different job sectors, drawing attention to under-researched areas that warrant further study. It serves as a foundation for future research aimed at understanding the causes of WRMSDs and developing solutions supported by wearable technologies to mitigate these risks.

Understanding the psychophysiological state during robot-aided rehabilitation is crucial for assessing the patient experience during treatments. This paper introduces a psychophysiological estimation approach using a Fuzzy Logic inference model to assess patients’ perception of robots during upper-limb robot-aided rehabilitation sessions. The patients were asked to perform nine cycles of 3D point-to-point trajectories toward different targets at varying heights with the assistance of an anthropomorphic robotic arm (i.e. KUKA LWR 4+). Physiological parameters, including galvanic skin response, heart rate, and respiration rate, were monitored across ten out of forty daily sessions. This data enabled the construction of an inference model to estimate patients’ perception states. Results expressed in terms of correlation coefficients between the patient state and the increasing number of sessions. Correlation coefficients showed statistically significant strong associations: a state of heightened engagement (formerly described as “Excited”) had ρ=-0.73$\rho = -0.73$ (p-value=0.01), and a more calm and resting state (namely “Relaxed” state) had ρ=0.70$\rho = 0.70$ (p-value=0.02) with the number of sessions completed. All patients had positive interaction with the robot, initially expressing curiosity and interest that gradually shifted to a more “Relaxed” state over time.

Backgrounds . In recent years, numerous robotic devices, together with allied technologies, have been developed to support rehabilitation, both in research settings and industry. Although robotic-assisted rehabilitation and related technologies hold significant promise for supporting healthcare practitioners and enhancing patient care, their use in clinical practice remains limited. One of the motivations could be that final users’ needs have not been given due consideration so far. As a matter of fact, understanding user needs and perceptions is crucial for designing these technological devices and for creating new organizational models within hospitals aiming to establish and maintain robotics-assisted rehabilitation gyms. Methods . We developed and distributed an online survey to the Italian community of healthcare practitioners working in rehabilitation, to depict the current landscape of robotic-assisted rehabilitation and to understand their opinions and demands across various domains and diseases. The questionnaire is divided into two main parts. The first section pertains to the respondents' demographics and professional experience. The second part includes questions about eight different categories of rehabilitative devices. For each category, practitioners can indicate whether they use a device in their practice, their perceptions, and any perceived barriers. Additionally, they can fill out a System Usability Scale for a specific device in that category. Results . We collected answers from 423 Italian rehabilitation professionals, including various clinical roles, that revealed significant insights into the use of robotics in rehabilitation. Conclusions . Despite a general positivity towards technology, there is a substantial lack of awareness about rehabilitation devices among professionals. The survey highlights the need for enhanced training and education on robotics in rehabilitation programs. Gender distribution shows a high prevalence of female professionals. Additionally, the limited focus on home rehabilitation is noted. The study emphasizes the importance of verifying both the effectiveness and economic sustainability of robotic devices in clinical practice.

Precise and efficient performance in remote robotic teleoperation relies on intuitive interaction. This requires both accurate control actions and complete perception (vision, haptic, and other sensory feedback) of the remote environment. Especially in immersive remote teleoperation, the complete perception of remote environments in 3D allows operators to gain improved situational awareness. Color and Depth (RGB-D) cameras capture remote environments as dense 3D point clouds for real-time visualization. However, providing enough situational awareness needs fast, high-quality data transmission from acquisition to virtual reality rendering. Unfortunately, dense point-cloud data can suffer from network delays and limits, impacting the teleoperator’s situational awareness. Understanding how the human eye works can help mitigate these challenges. This paper introduces a solution by implementing foveation, mimicking the human eye’s focus by smartly sampling and rendering dense point clouds for an intuitive remote teleoperation interface. This provides high resolution in the user’s central field, which gradually reduces toward the edges. However, this systematic visualization approach in the peripheral vision may benefit or risk losing information and burdening the user’s cognitive load. This work investigates these advantages and drawbacks through an experimental study and describes the overall system, with its software, hardware, and communication framework. This will show significant enhancements in both latency and throughput, surpassing 60% and 40% improvements in both aspects when compared with state-of-the-art research works. A user study reveals that the framework has minimal impact on the user’s visual quality of experience while helping to reduce the error rate significantly. Further, a 50% reduction in task execution time highlights the benefits of the proposed framework in immersive remote telerobotics applications.

Among Additive Manufacturing (AM) technologies, Laser Powder Bed Fusion (LPBF) has made a great contribution to optimizing the production of customized implant materials. However, the design of the ideal surface topography, capable of exerting the best biological effect without drawbacks, is still a subject of study. The aim of the present study is to topographically and biologically characterize AM‐produced Ti6Al4V ELI (Extra Low Interstitial) samples by comparing different surface finishing. Vertically and horizontally samples are realized by LPBF with four surface finishing conditions (as‐built, corundum‐sandblasted, zirconia‐sandblasted, femtosecond laser textured). Bioactivity in vitro tests are performed with human osteoblasts evaluating morphology, metabolic activity, and differentiation capabilities in direct contact with surfaces. Scanning electron microscope and profilometry analysis are used to evaluate surface morphology and samples’ roughness with and without cells. All tested surfaces show good biocompatibility. The influence of material surface features is evident in the early evaluation, with the most promising results of morphological study for laser texturing. Deposition orientations seem to influence metabolic activities, with XZ orientation more effective than XY. Current data provide the first positive feedback on the biocompatibility of laser texturing finishing, still poorly described in the literature, and support the future clinical development of devices produced with a combination of LPBF and different finishing treatments.

Training in the Occupational Safety and Health (OSH) sector is crucial for minimizing workplace hazards and ensuring employee well-being. Virtual Reality (VR) emerges as a training tool that can enhance learning outcomes and simulate hazardous scenarios safely. However, several aspects must be taken into consideration when implementing VR-based training solutions. The paper investigates how to effectively design, develop, integrate, and validate a VR OSH training tool. To this aim, a comprehensive guideline of 9 key elements articulated in 29 items is proposed. Every element and item is retrieved from analyzing the existing literature on the topic using a systematic approach. The result is a comprehensive guide to consider all these aspects from the outset of design, in a cohesive, complete, and tailored manner. This formalization is intended to facilitate the advancement of research and implementation of these solutions, which to date have been largely confined to prototypes or lack real practical application.

Introduction: Diving in SCUBA modality modifies human physiology in many ways. These modifications have been studied since Paul Bert in a seminal work. This area of research is very sensible to technological development. At now, it is possible to record heart rate (HR) continuously while diving. The study of HR changes in SCUBA diving at different depths in a constant temperature of thermal water is the objective of the present paper. Methods: 18 healthy subjects were enrolled and HR was recorded while SCUBA diving in thermal water at a constant temperature of 33.6∘ C in the deepest Italian pool at Montegrotto (Padova, Italy). Three depths were investigated: −20, −30 and −40 meters. The HR has been recorded with a Galileo SOL diving computer. The dive was subdivided into three phases: descent (DSC), steady on depth (STD), post–dive (RSF), and average HR was evaluated in each phase. Moreover, considering the DSC and STD time duration, a statistical linear regression of HR and relative parameters, intercept and slope, were here assessed. Results: In STD phase, HR slope obtained by regression decreased with depth. A significant difference was found between the slope during STD at −20 vs. −40 m (p ≤ 0.05). Discussion: Present results emphasized different HR physiological adjustments among diving phases. Firstly, during the DSC, a rapid HR decrease is recognized as probably due to a vagal response; secondly, at STD, the inward blood redistribution requires another physiological adjustment. This latter is depth-dependent because of a reduction of cardiac variability. Present data highlight the important cardiac stress need to counteract the diving activity.

The integration of robotics and Electrical Stimulation (ES) in neurorehabilitation combines the precise execution of complex tasks enabled by robotics with motor learning, muscle conditioning, and cardiovascular fitness induced by ES. We propose a hybrid lower-limb exoskeleton for gait training to maximize these benefits. Two neuromuscular electrical stimulators and a 4-degrees-of-freedom motorized exoskeleton were combined with different modalities: ES-motor cooperative integration for the swinging knee, synchronized but independently operating ES and motors for the hip both in swing and in stance phases, and for the knee during stance, and ES-only for the non-actuated ankle. Two conditions - exoskeleton only and hybrid - were compared on twelve non-disabled subjects and eleven participants with neurological disorders. Electrical stimulation reduced the output motor torque at the knee by approximately 50%, while maintaining comparable movement performance (tracking errors <8° in both conditions and groups). Overall, the hybrid system was perceived as more usable by participants with neurological disorders compared to the exoskeleton alone, with an improvement of around 16%. These results are promising for developing lighter exoskeletons with potentially enhanced therapeutic benefits for motor learning.

Elite athletes in speed roller skates perceive skating to be a more demanding exercise for the groin when compared to other cyclic disciplines, increasing their risk of injury. The objective of this study was to monitor the kinematic and electromyographic parameters of roller speed skaters, linearly, on a treadmill, and to compare different skating speeds, one at 20 km/h and one at 32 km/h, at a 1° inclination. The acquisition was carried out by placing an inertial sensor at the level of the first sacral vertebra, and eight surface electromyographic probes on both lower limbs. The kinematic and electromyographic analysis on the treadmill showed that a higher speed requires more muscle activation, in terms of maximum and average values and co-activation, as it not only increases the intrinsic muscle demand in the district, but also the athlete’s ability to coordinate the skating technique. The present study allows us to indicate not only how individual muscle districts are activated during skating on a surface different from the road, but also how different speeds affect the overall district load distributions concerning effective force, which is essential for the physiotherapist and kinesiologist for preventive and conditional purposes, while also considering possible variations in the skating technique in linear advancement.