Background— Peripheral blood expansion of an unusual CD4+ T-cell subset lacking surface CD28 has been suggested to predispose rheumatoid arthritis (RA) patients to develop more aggressive disease. However, the potential association between CD4+CD28 null T cells and early atherosclerotic changes in RA has never been investigated. Methods and Results— The number of circulating CD4+CD28 null cells was evaluated in 87 RA and 33 control subjects who also underwent evaluation of carotid artery intima-media thickness (IMT) and endothelial function via flow-mediated vasodilation (FMV). Patients had higher IMT and lower FMV compared with control subjects. The frequency of CD4+CD28 null cells was significantly higher in patients than in control subjects. Twenty patients with persistent expansion of circulating CD4+CD28 null cells had more marked increase of carotid artery IMT and stronger decrease of brachial artery FMV. Blockade of tumor necrosis factor-α led to a partial reappearance of the CD28 molecule on the CD4+ cell surface. Conclusions— Circulating CD4+CD28 null lymphocytes are increased in RA. Patients with persistent CD4+CD28 null cell expansion show preclinical atherosclerotic changes, including arterial endothelial dysfunction and carotid artery wall thickening, more significantly than patients without expansion. These findings suggest a contribution of this cell subset in atheroma development in RA. Moreover, the demonstration that tumor necrosis factor-α blockade is able to reverse, at least in part, the CD28 deficiency on the CD4+ cell surface may be of interest for possible innovative therapeutic strategies in cardiovascular diseases.
End-effector-based robots are widely adopted by physiotherapists and caregivers as support in the delivery of the rehabilitation training to the patient. The validation of these devices presents critical aspects, since the system performance must be assessed analyzing the movement performed by the subject limb, i.e., elements outside the device. This paper presents a multi-sensor approach for the validation of an innovative end-effector-based device, comparing different measurement strategies for evaluating the system effectiveness in imposing an expected training. The study was performed monitoring the movement induced by the device on the upper limb of a young male healthy subject during a set of fictitious rehabilitation sessions. The kinematic structure of the device is characterized by a compact differential mechanism with two degrees of freedom. A sequence of repetitions of a planar reaching pattern was analyzed as illustrative training task. A kinematic model of subject and system was developed, and the kinematics of a set of specific landmark points on the subject limb was evaluated. Data obtained from two measurement systems were compared: (1) an optoelectronic system with two cameras and eight skin passive markers, and (2) two triaxial accelerometers. Results were analyzed in MATLAB and R environment, revealing a high repeatability of the limb movement. Although both the measurement systems allow evaluating the acceleration of subject’s arm and forearm, accelerometers should be preferred for punctual analysis, like components optimizations, whereas optical markers provide a general overview of the system, particularly suitable for the functional design process.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.