Associations between serum biomarkers of cartilage metabolism and serum hyaluronic acid, with risk factors, pain categories, and disease severity in knee osteoarthritis: a pilot study.

BACKGROUND: Specific serum biomarkers of cartilage metabolism such as cartilage oligomeric matrix protein (sCOMP) and procollagen type II C-terminal propeptide (sPIICP) as well as hyaluronan (sHA), a biomarker of synovitis, have been implicated in the pathophysiology of knee osteoarthritis (OA). However, the associations of these biomarkers with the severity of the disease and OA risk factors, including age and obesity remain inconclusive. This analysis examines the associations between these serum biomarkers and the radiographic severity of OA and knee pain, as wells as obesity, the age and gender of the participants, and other OA risk factors. METHODS: From 44 patients with early knee OA and 130 patients with late knee OA we analyzed the radiographic severity of the disease using the Kellgren and Lawrence (KL) grading system. Moreover, 38 overweight healthy individuals were used as a control group. Specific information was collected from all participants during their recruitment. The levels of the three serum biomarkers were quantified using commercially available ELISA kits. Serum biomarkers were analyzed for associations with the average KL scores and pain in both knees, as well as with specific OA risk factors. RESULTS: The levels of sCOMP were elevated in patients with severe late OA and knee pain and correlated weakly with OA severity. A weakly correlation of sHA levels and OA severity OA was observed. We demonstrated that only sPIICP levels were markedly decreased in patients with late knee OA suggesting the alterations of cartilage metabolism in this arthritic disease. Moreover, we found that sPIICP has the strongest correlation with obesity and the severity of OA, as well as with the knee pain at rest and during walking regardless of the severity of the disease. ROC analysis showed that the area under the ROC curve (AUC) was 0.980 (95% CI: 0.945-0.995; p < 0.0001), suggesting high diagnostic accuracy of sPIICP. Interestingly, gender and age had also an effect on the levels of sPIICP. CONCLUSION: This study revealed the potential of serum PIICP to be used as a biomarker to monitor the progression of knee OA, however, further studies are warranted to elucidate its clinical implication.

Adaptive assistive robotics: a framework for triadic collaboration between humans and robots.

Robots and other assistive technologies have a huge potential to help society in domains ranging from factory work to healthcare. However, safe and effective control of robotic agents in these environments is complex, especially when it involves close interactions and multiple actors. We propose an effective framework for optimizing the behaviour of robots and complementary assistive technologies in systems comprising a mix of human and technological agents with numerous high-level goals. The framework uses a combination of detailed biomechanical modelling and weighted multi-objective optimization to allow for the fine tuning of robot behaviours depending on the specification of the task at hand. We illustrate our framework via two case studies across assisted living and rehabilitation scenarios, and conduct simulations and experiments of triadic collaboration in practice. Our results indicate a marked benefit to the triadic approach, showing the potential to improve outcome measures for human agents in robot-assisted tasks.

Development of a Robotic Surgery Training System.

Robotic Surgery is getting widely spread and applied to more and more clinical cases due to its advantages compared to open surgery, for both the patients and surgeons. However, Robotic Surgery requires a different set of skills and learning compared to open and also laparoscopic surgery. Tele-operation for a robotic system with hand controllers, the delay in the hand commands to be translated into robotic movements, slowness of the robotic movements, remote 2D or 3D vision of the actual operation, and lack of haptic feedback are some of the challenges that Robotic Surgery poses. Surgeons need to go through an intensive training for Robotic Surgery, and the learning and skill development continues throughout their early professional years. Despite the importance of training for Robotic Surgery, there are not yet dedicated, low-cost, and widespread training platforms; rather, surgeons mostly train with the same Robotic Surgery system they use in surgery; hence institutions need to invest on a separate surgical setup for training purposes. This is expensive for the institutions, it provides very limited access to the surgeons for training, and very limited, if any, access to researchers for experimentation. To address these, we have developed in our laboratory a low-cost, and experimental Robotic Surgery Trainer. This setup replicates the challenges that a Robotic Surgery system poses and further provides widespread access through internet connected control of the actual physical system. The overall system is composed of equipment that a standard engineering laboratory can afford. In this paper, we introduce the Robotic Surgery Training System and explain its development, parts, and functionality.

Cyprus' diatom diversity and the association of environmental and anthropogenic influences for ecological assessment of rivers using DNA metabarcoding.

Human activities are the leading cause of environmental impairments. Appropriate biomonitoring of ecosystems is needed to assess these activities effectively. In freshwater ecosystems, periphytic and epilithic biofilms have diatom assemblages. These assemblages respond rapidly to environmental changes, making diatoms valuable bioindicators. For this reason, freshwater biomonitoring programs are currently using diatoms (e.g., Water Framework Directive). In the past ten years, DNA metabarcoding coupled with next-generation sequencing and bioinformatics represents a complementary approach for diatom biomonitoring. In this study, this approach is used for the first time in Cyprus by considering the association of environmental and anthropogenic pressures to diatom assemblages. Statistical analysis was then applied to identify the environmental (i.e., river types, geo-morphological) and anthropogenic (i.e., physicochemical, human land-use pressures) variables' role in the observed diatom diversity. Results indicate differences in diatom assemblages between intermittent and perennial rivers. Achnanthidium minutissimum was more abundant in intermittent rivers; whereas Amphora pediculus and Planothidium caputium in perennial ones. Additionally, we could demonstrate the correlation between nutrients (e.g., nitrogen, phosphorus), stations' local characteristics (e.g., elevation), and land use activities on the observed differences in diatom diversity. Finally, we conclude that multi-stressors and anthropogenic pressures together as multiple stressors have a significant statistical relationship to the observed diatom diversity and play a pivotal role in determining Cyprus' rivers' ecological status.