Analysis of belimumab prescription and outcomes in a 10-year monocentric cohort: is there an advantage with early use?

OBJECTIVE: The objective is to evaluate perscriptions of belimumab (BEL), how these have changed over the years and their impact on clinical outcomes in patients with systemic lupus erythematosus (SLE). METHODS: This is a retrospective analysis of prospectively collected data. We retrieved demographic and clinical data and concomitant therapies at BEL starting (baseline). Disease activity was assessed at baseline and after 6 and 12 months and organ damage at baseline and at the last visit. RESULTS: From 422 patients followed in the Pisa SLE cohort, 102 patients received BEL and were included and 22 (21.6%) were immunosuppressant (IS)-naïve. Lupus Low Disease Activity State (LLDAS) with a glucocorticoid (GC) dosage ≤5 mg/day (LLDAS5) and remission were achieved by 47% and 38% of patients at 6 months, and by 75% and 66% at 12 months. Comparing IS-naïve patients with those who received BEL after at least one conventional IS, we did not find significant differences in baseline characteristics and in the achievement of LLDAS5 and remission. Despite at baseline we did not observe significant differences in mean GC daily dosage, IS-naïve patients were taking a significantly lower GC daily dose at 6 and 12 months. Interestingly, IS-naïve patients were more common in the most recent years. CONCLUSIONS: Our data confirm that BEL is effective in controlling disease activity, and in recent years BEL has been considered as an earlier treatment option before other IS. Early introduction of BEL can be at least as effective as a step-up approach and can help to reduce the GC dosage.

Updating design guidelines for cognitive ergonomics in human-centred collaborative robotics applications: An expert survey.

Within the framework of Industry 5.0, human factors are essential for enhancing the work conditions and well-being of operators interacting with even more advanced and smart manufacturing systems and machines and increasing production performances. Nevertheless, cognitive ergonomics is often underestimated when implementing advanced industrial human-robot interaction. Thus, this work aims to systematically update, develop, and validate guidelines to assist non-experts in the early stages of the design of anthropocentric and collaborative assembly applications by focusing on the main features that have positively influenced workers' cognitive responses. A methodology for structured development has been proposed. The draft guidelines have been created starting from the outcomes of a systematic and extended screening of the scientific literature. Preliminary validation has been carried out with the help of researchers working in the field. Inputs on comprehensibility and relevance have been gathered to enhance the guidelines. Lastly, a survey was used to examine in depth how international experts in different branches can interpret such guidelines. In total, 108 responders were asked to qualitatively and quantitatively evaluate the guideline's comprehensibility and provide general comments or suggestions for each guideline. Based on the survey's results, the guidelines have been validated and some have been reviewed and re-written in their final form. The present work highlights that integrating human factors into the design of collaborative applications can significantly bolster manufacturing operations' resilience through inclusivity and system adaptability by enhancing worker safety, ergonomics, and wellbeing.

Gender differences in SLE: report from a cohort of 417 Caucasian patients.

BACKGROUND: SLE is an autoimmune disease that predominantly affects women. As most epidemiological and interventional studies are on populations with a clear female prevalence, the influence of gender in disease course, drug response and damage accrual is yet to be fully explored and comprehended. OBJECTIVES: To describe gender differences in disease course, comorbidities, use of medications and long-term outcomes of a large cohort of patients with SLE. METHODS: Retrospective gender-based analysis of prospectively collected data from a monocentric cohort of Caucasian patients with SLE with at least 1 year of follow-up. RESULTS: 417 patients were included, 51 men and 366 women. Men displayed a significantly higher median age at disease onset and diagnosis and a higher prevalence of late-onset SLE, serositis at disease onset, antiphospholipid syndrome (APS) and use of mycophenolate within the first year of disease. Women had a higher prevalence of haematological abnormalities, a higher cumulative exposure to azathioprine and higher cumulative dose of glucocorticoids at 5 years. Male patients had a shorter time to first damage item and a higher prevalence of damage at 1 and 5 years, but this association was no longer significant when late-onset patients were excluded. No differences were found in prevalence of childhood onset, delay between onset and diagnosis, time to renal involvement and histology, cumulative autoantibody positivity, number of flares and hospitalisations, median SLE Damage Index score, type of damage, age and time to first cardiovascular event, chronic kidney disease and death. CONCLUSIONS: In our cohort, clinical manifestations and disease course were similar in male and female patients; however, male patients displayed higher prevalence of APS and early damage accrual probably due to the later disease onset. These data highlight the importance of an intensive follow-up, prevention and treatment of complications in this category of patients, especially in the first years of disease.

Development and evaluation of design guidelines for cognitive ergonomics in human-robot collaborative assembly systems.

Industry 4.0 is the concept used to summarize the ongoing fourth industrial revolution, which is profoundly changing the manufacturing systems and business models all over the world. Collaborative robotics is one of the most promising technologies of Industry 4.0. Human-robot interaction and human-robot collaboration will be crucial for enhancing the operator's work conditions and production performance. In this regard, this enabling technology opens new possibilities but also new challenges. There is no doubt that safety is of primary importance when humans and robots interact in industrial settings. Nevertheless, human factors and cognitive ergonomics (i.e. cognitive workload, usability, trust, acceptance, stress, frustration, perceived enjoyment) are crucial, even if they are often underestimated or ignored. Therefore, this work refers to cognitive ergonomics in the design of human-robot collaborative assembly systems. A set of design guidelines has been developed according to the analysis of the scientific literature. Their effectiveness has been evaluated through multiple experiments based on a laboratory case study where different participants interacted with a low-payload collaborative robotic system for the joint assembly of a manufacturing product. The main assumption to be tested is that it is possible to improve the operator's experience and efficiency by manipulating the system features and interaction patterns according to the proposed design guidelines. Results confirmed that participants improved their cognitive response to human-robot interaction as well as the assembly performance with the enhancement of workstation features and interaction conditions by implementing an increasing number of guidelines.