3,627 research outputs found

    MortalitĂ  per sclerosi multipla nella regione Toscana

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    OBIETTIVI: Valutare il trend di mortalità per Sclerosi Multipla (SM) in Toscana nel ventennio 1987-2006. METODI: I dati sulla mortalità per SM sono stati ottenuti consultando gli archivi informatici delle schede di morte presso l’Agenzia Regionale di Sanità Toscana. I dati raccolti sono stati suddivisi per i quattro quinquenni compresi tra il 1987 e il 2006: (1987-1991), (1992-1996), (1997-2001), (2002-2006). Sono stati calcolati i tassi standardizzati di mortalità (metodo di standardizzazione diretta) per SM rispetto alla popolazione toscana del 2000 e i tassi di mortalità per SM specifici per sesso ed età. RISULTATI: I tassi standardizzati di mortalità con causa SM calcolati per ogni anno mostrano una diminuzione della mortalità, in entrambi i sessi, particolarmente marcata nel primo quinquennio (1987-1991). Per i maschi si osserva, nei quattro quinquenni analizzati, un trend decrescente dei tassi di mortalità che va da 0,61 per il quinquennio 1987-1991 a 0,42 per 100.000 per quello 2002-2006. Analogamente per le femmine si osserva una diminuzione da 1,29 a 0,60 per 100.000. Analizzando i tassi di mortalità per SM specifici per età abbiamo osservato un picco della mortalità nei maschi in corrispondenza della fascia di età 75-79 anni, mentre nelle donne nella fascia 65-69 anni. In entrambi i sessi il numero dei decessi aumenta fortemente dopo i 45 anni e diminuisce dopo i 79 anni. Considerando l’età di esordio, che andava dai 25 ai 35 anni, e la sopravvivenza delle persone, pari a 30-35 anni dalla diagnosi, la mortalità maggiore si riscontra nelle fasce di età da noi osservate. CONCLUSIONI: A causa della piccola dimensione del campione, tutti i valori vanno interpretati con cautela, ma i dati presenti in letteratura sono in accordo con i dati osservati nel nostro studio relativi al primo quinquennio. Infatti, il decremento di mortalità nel periodo 1987-1991 è in linea con i dati precedentemente pubblicati in uno studio sulla mortalità per SM in Italia dal 1974 al 1993 (Tassinari, 2001). Per gli anni successivi non esistono dati in letteratura relativi alla mortalità per SM in Italia. La mortalità più elevata nelle femmine riflette il maggior numero di casi di SM nella popolazione femminile ed è supportata anche dai dati presenti in letteratura sia in Italia che all’estero (Massey e Schoenberg, 1982). La mortalità per SM osservata nel nostro studio è presumibilmente una sottostima poiché talvolta l’SM non viene indicata come causa di morte

    Development of an Embedded Myokinetic Prosthetic Hand Controller

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    The quest for an intuitive and physiologically appropriate human machine interface for the control of dexterous prostheses is far from being completed. In the last decade, much effort has been dedicated to explore innovative control strategies based on the electrical signals generated by the muscles during contraction. In contrast, a novel approach, dubbed myokinetic interface, derives the control signals from the localization of multiple magnetic markers (MMs) directly implanted into the residual muscles of the amputee. Building on this idea, here we present an embedded system based on 32 magnetic field sensors and a real time computation platform. We demonstrate that the platform can simultaneously localize in real-time up to five MMs in an anatomically relevant workspace. The system proved highly linear (R2 = 0.99) and precise (1% repeatability), yet exhibiting short computation times (4 ms) and limited cross talk errors (10% the mean stroke of the magnets). Compared to a previous PC implementation, the system exhibited similar precision and accuracy, while being ~75% faster. These results proved for the first time the viability of using an embedded system for magnet localization. They also suggest that, by using an adequate number of sensors, it is possible to increase the number of simultaneously tracked MMs while introducing delays that are not perceivable by the human operator. This could allow to control more degrees of freedom than those controllable with current technologies

    Discrete vibro-tactile feedback prevents object slippage in hand prostheses more intuitively than other modalities

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    In the case of a hand amputation, the affected can use myoelectric prostheses to substitute the missing limb and regain motor functionality. Unfortunately, these prostheses do not restore sensory feedback, thus users are forced to rely on vision to avoid object slippage. This is cognitively taxing, as it requires continuous attention to the task. Thus, providing functionally effective sensory feedback is pivotal to reduce the occurrence of slip events and reduce the users’ cognitive burden. However, only a few studies investigated which kind of feedback is the most effective for this purpose, mostly using unrealistic experimental scenarios. Here we attempt a more realistic simulation of involuntary hand opening and subsequent recovery of a stable grasp of the slipping object using a robotic hand operated by the subjects through a standard myoelectric control interface. We compared three stimulation modalities (vision, continuous grip force feedback and discrete slip feedback) and found that the discrete feedback allowed subjects to have higher success rates (close to 100%) in terms of objects recovered from slippage, basically requiring no learning. These results suggest that this simple yet effective feedback can be used to reduce grasp failures in prosthetic users, increasing their confidence in the device

    The SSSA-MyHand: a dexterous lightweight myoelectric hand prosthesis

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    The replacement of a missing hand by a prosthesis is one of the most fascinating challenges in rehabilitation engineering. State of art prostheses are curtailed by the physical features of the hand, like poor functionality and excessive weight. Here we present a new multi-grasp hand aimed at overcoming such limitations. The SSSA-MyHand builds around a novel transmission mechanism that implements a semi-independent actuation of the abduction/adduction of the thumb and of the flexion/extension of the index, by means of a single actuator. Thus, with only three electric motors the hand is capable to perform most of the grasps and gestures useful in activities of daily living, akin commercial prostheses with up to six actuators, albeit it is as lightweight as conventional 1-Degrees of Freedom prostheses. The hand integrates position and force sensors and an embedded controller that implements automatic grasps and allows inter-operability with different human-machine interfaces. We present the requirements, the design rationale of the first prototype and the evaluation of its performance. The weight (478 g), force (31 N maximum force at the thumb fingertip) and speed of the hand (closing time: <370 ms), make this new design an interesting alternative to clinically available multi-grasp prostheses

    Abruzzo

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    In Abruzzo region 55,4% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 29 cases of cervicocarcinoma and 12 related deaths and thus results to be cost-effective (20.836 €/QALY). When the vaccination programme is extended to 16-year-old girls a further 28 cancer cases and 12 deaths could be prevented, with a very similar cost-effectiveness ratio. In Abruzzo region, the net cost for woman vaccinated is 199 € for the single cohort and 202 € for the multiple cohort

    Laser irradiated foam targets: absorption and radiative properties

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    An experimental campaign to characterize the laser radiation absorption of foam targets and the subsequent emission of radiation from the produced plasma was carried out in the ABC facility of the ENEA Research Center in Frascati (Rome). Different targets have been used: plastic in solid or foam state and aluminium targets. The activated different diagnostics allowed to evaluate the plasma temperature, the density distribution, the fast particle spectrum and the yield of the X-Ray radiation emitted by the plasma for the different targets. These results confirm the foam homogenization action on laser-plasma interaction, mainly attributable to the volume absorption of the laser radiation propagating in such structured materials. These results were compared with simulation absorption models of the laser propagating into a foam target
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