WSN and RFID Integration in the IoT scenario: an Advanced Safety System for Industrial Plants

The paper proposes and discusses the integration of WSN and RFID technologies in the IoT scenario. The proposed approach is based on the REST paradigm, thanks to which the two technologies can be seamless integrated by representing sensors, actuators and RFID related data as network resources globally addressable through state-of-the-art IoT protocols. The integration approach is detailed for the Smart Factory use case by proposing and developing an advanced IoT-based WSN and RFID integrated solution aiming at improving safety in industrial plants. The developed system can guarantee a safe access to factory dangerous areas in which safety equipments are required. In the paper, the system design is first presented, then, all the developed hardware and software solutions are described before presenting system performance results in a real test bed. System performance are reported in terms of response time and accuracy for authorization control and location tracking applications

The Role of a Multidisciplinary Approach in Gender Affirmation Surgery: What to Expect and Where Are We Currently?

Gender Affirmation Surgeries (GASs), erstwhile called Sex Reassignment Surgeries (SRSs), may be necessary for transgender individuals to change their bodily sexual characteristics and thereby affirm their gender identity. GASs encompass all medically necessary interventions to relieve gender dysphoria and should be available to patients who wish to, and who meet the surgical criteria of the World Professional Association for Transgender Health (WPATH) and Standards of Care (SOC). The comprehensive clinical assessment involves many health specialists, including general practitioners, psychologists, psychiatrists, speech therapists, endocrinologists, surgeons, anesthesiologists, nurses, and other healthcare professionals. To define the patients’ complex care needs and their objectives, high-volume specialized centers, accredited training programs, skilled surgeons and health professionals specializing in transgender care within a multidisciplinary team are essential. Currently, the most prominent challenges are related to ethical issues such as the treatment of underage individuals, fertility, parenting and the potential for regret after GAS. Finally, although GAS has been practiced for more than half a century, data on long-term follow-up represents a further topic for investigation

Efficacy and safety of two disposable circumcision suture devices for circumcision in adults: A prospective comparative multicenter study.

INTRODUCTION AND OBJECTIVE: Disposable circumcision suture devices have been developed to optimize outcomes of circumcision, one of the most common surgical procedures worldwide. The aim of this study is to evaluate the efficacy and safety of two different disposable circumcision suture devices (DCSDs) and compare their surgical outcomes. METHODS: A prospective comparative multicenter study was performed between November 2019 and October 2021. Patients with congenital or acquired phimosis were included. Patients underwent circumcision using a DCSD (CircCurerTM or the ZSR® device) according to the surgeon preference and device availability. Postoperative follow-up was scheduled at 1 week and 2 months for all patients. RESULTS: A total of 215 patients were enrolled, 120 underwent circumcision using CircCurerTM (Group A) and 95 patients using ZSR® (Group B). No differences were observed in baseline characteristics between the two groups (p>0.05). Mean (SD) operative time was 7.0 (2.5) minutes with no significant difference between the groups (p=0.678). Seven patients (5.8%) in Group A and 2 (2.1%) in Group B required accessory stitches (p=0.156). Four subjects (3.3%) in Group A and 1 (1.1%) in group B presented hematoma (p=0.266). Surgical site infection occurred in 1 (0.8%) in Group A and 2 (2.1%) in Group B (p=0.413). Metal clips fell out spontaneously in 39 patients (32.5%) of Group A and 47 (49.5%) of Group B (p<0.001). Median (IQR) Numeric Rating Scale (NRS) for postoperative pain was 2.5 (0-4) in Group A and 2.0 (0-4) in Group B (p=0.284). At 2 months, patients of both groups reported a median (IQR) satisfaction of 9 (8-9) points (p=0.469). CONCLUSIONS: DCSDs appear to allow effective and safe circumcision, with short operative times, uncommon and mild complications, and high patient satisfaction; although there are several devices with some relevant differences on the market.post-print229 K

System level framework for assessing the accuracy of neonatal EEG acquisition

Significant research has been conducted in recent years to design low-cost alternatives to the current EEG monitoring systems used in healthcare facilities. Testing such systems on a vulnerable population such as newborns is complicated due to ethical and regulatory considerations that slow down the technical development. This paper presents and validates a method for quantifying the accuracy of neonatal EEG acquisition systems and electrode technologies via clinical data simulations that do not require neonatal participants. The proposed method uses an extensive neonatal EEG database to simulate analogue signals, which are subsequently passed through electrical models of the skin-electrode interface, which are developed using wet and dry EEG electrode designs. The signal losses in the system are quantified at each stage of the acquisition process for electrode and acquisition board losses. SNR, correlation and noise values were calculated. The results verify that low-cost EEG acquisition systems are capable of obtaining clinical grade EEG. Although dry electrodes result in a significant increase in the skin-electrode impedance, accurate EEG recordings are still achievable

Analysis of a low-cost EEG monitoring system and dry electrodes toward clinical use in the neonatal ICU

Electroencephalography (EEG) is an important clinical tool for monitoring neurological health. However, the required equipment, expertise, and patient preparation inhibits its use outside of tertiary care. Non-experts struggle to obtain high-quality EEG due to its low amplitude and artefact susceptibility. Wet electrodes are currently used, which require abrasive/conductive gels to reduce skin-electrode impedance. Advances in dry electrodes, which do not require gels, have simplified this process. However, the assessment of dry electrodes on neonates is limited due to health and safety barriers. This study presents a simulation framework for assessing the quality of EEG systems using a neonatal EEG database, without the use of human participants. The framework is used to evaluate a low-cost EEG acquisition system and compare performance of wet and dry (Micro Transdermal Interface Platforms (MicroTIPs), g.tec-g.SAHARA) electrodes using accurately acquired impedance models. A separate experiment assessing the electrodes on adult participants was conducted to verify the simulation framework’s efficacy. Dry electrodes have higher impedance than wet electrodes, causing a reduction in signal quality. However, MicroTIPs perform comparably to wet electrodes at the frontal region and g.tec-g.SAHARA performs well at the occipital region. Using the simulation framework, a 25dB signal-to-noise ratio (SNR) was obtained for the low-cost EEG system. The tests on adults closely matched the simulated results

Real-Life Experience with Sonidegib for Locally Advanced Basosquamous Carcinoma: A Case Series

Introduction: Basosquamous carcinoma is an uncommon subtype of basal cell carcinoma (BCC), characterized by aggressive local growth and metastatic potential, that mainly develops on the nose, perinasal area, and ears, representing 1.2–2.7% of all head-neck keratinocyte carcinomas. Although systemic therapy with hedgehog inhibitors (HHIs) represents the first-line medical treatment in advanced BCC, to date, no standard therapy for advanced basosquamous carcinoma has been established. Herein, we reported a case series of patients affected by locally advanced basosquamous carcinomas, who were treated with HHIs. Case Presentation: Data of 5 patients receiving HHIs for locally advanced basosquamous carcinomas were retrieved (2 women and 3 males, age range: 63–89 years, average age of 77 years). Skin lesions were located on the head-neck area; in particular, 4 tumors involved orbital and periorbital area and 1 tumor developed in the retro-auricular region. A clinical response was obtained in 3 out of 5 patients (2 partial responses and 1 complete response), while disease progression was observed in the remaining 2 patients. Hence, therapy was interrupted, switching to surgery or immunotherapy. Conclusion: Increasing evidence suggests considering HHIs for large skin tumors developing in functionally and cosmetically sensitive areas, in patients with multiple comorbidities, although their use for basosquamous carcinoma require more exploration, large cohort populations, and long follow-up assessment

Development and characterization of passivation methods for microneedle-based biosensors

Microneedles (MN) are short, sharp structures that have the ability to painlessly pierce the stratum corneum, the outermost layer of the skin, and interface with the dermal interstitial fluid that lies beneath. Because the interstitial fluid is rich in biomarkers, microneedle-based biosensors have the potential to be used in a wide range of diagnostic applications. To act as an electrochemical sensor, the tip or the body of the MN must be functionalized, while the substrate areas are generally passivated to block any unwanted background interference that may occur outside of the skin. This work presents four different passivation techniques, based on the application of SiO2, polymethyl methacrylate (PMMA), an adhesive film, and varnish to the substrate areas. Optical, SEM and electrochemical measurements were performed to quantitatively assess the performance of each film. The data shows that whilst manual application of varnish provided the highest level of electrical isolation, the spin-coating of a 5 μm thick layer of PMMA is likely to provide the best combination of performance and manufacturability. Clinical Relevance— Substrate passivation techniques will improve the performance of microneedle-based non-invasive continuous monitoring systems

Levels of circulating endothelial cells are low in idiopathic pulmonary fibrosis and are further reduced by anti-fibrotic treatments

Background: It has been suggested that circulating fibrocytes and endothelial cells actively participate in the intense remodelling of the pulmonary vasculature in patients with idiopathic pulmonary fibrosis (IPF). Indeed, fibrotic areas exist that have fewer blood vessels, whereas adjacent non-fibrotic tissue is highly vascularized. The number of circulating endothelial cells (CEC) and endothelial progenitor cells (EPC) might reflect the balance between vascular injury and repair. Thus, fibrocytes as well as endothelial cells could potentially be used as biomarkers of disease progression and treatment outcome. Methods: Peripheral blood samples were collected from 67 patients with a multidisciplinary diagnosis of IPF and from 45 age-matched and sex-matched healthy volunteers. Buffy coat was isolated according to standard procedures and at least 20 million cells were stained with different monoclonal antibodies for the detection of CEC, EPC and circulating fibrocytes. For the detection of CEC and EPC, cells were stained with anti-CD45, anti-CD34, anti-CD133, anti-CD14, anti-CD309 and with the viability probe Far-Red LIVE/DEAD. For the detection of circulating fibrocytes, cells were first stained with LIVE/DEAD and the following monoclonal antibodies: anti-CD3, anti-CD19, anti-CD45, anti-CD34 and anti-CD14, then cells were fixed, permeabilized and stained with fluorochrome-conjugated anti-collagen I monoclonal antibodies. Results: Patients with IPF displayed almost undetectable levels of circulating fibrocytes, low levels of CEC, and normal levels of EPC. Patients treated with nintedanib displayed higher levels of CEC, but lower levels of endothelial cells expressing CD309 (the type II receptor for vascular endothelial growth factor). Treatment with both nintedanib and pirfenidone reduced the percentage of CEC and circulating fibrocytes. Conclusions: Levels of CEC were reduced in patients with IPF as compared to healthy individuals. The anti-fibrotic treatments nintedanib and pirfenidone further reduced CEC levels. These findings might help explain the mechanism of action of these drugs and should be explored as predictive biomarkers in IPF

Piezoelectric inkjet coating of injection moulded, reservoir-tipped microneedle arrays for transdermal delivery

Coated microneedles have significant potential for use in transdermal delivery applications. In this paper, we describe the fabrication of microneedle master templates using microstereolithography techniques and subsequently use a commercial injection moulding process to replicate these microneedles in biocompatible cyclic olefin polymer (COP) materials. Notably, the 475 μm-tall needle designs feature a shallow pit or reservoir at the tip, thereby providing both a target and holder for incoming droplets that are deposited using a piezoelectric inkjet printer. Using this design, no tilting or rotation of the needle array is required during the filling process. In the preliminary tests reported here, the reservoir is filled with a FITC-labelled dye that acts as a model drug, and ex vivo skin tests are used to verify skin penetration, the transfer of this model drug to the skin and to measure the reliability of the needles themselves. To our knowledge, this is the first time that such an inkjet-filled, reservoir-tipped microneedle has been demonstrated

Universal applicator for digitally-controlled pressing force and impact velocity insertion of microneedles into skin

Microneedle technologies have been developed for dermal drug and vaccine delivery, including hollow-, solid-, coated-, and dissolving microneedles. Microneedles have been made in many different geometries and of many different materials, all of which may influence their skin-penetrating ability. To ensure reproducible and effective drug and vaccine delivery via microneedles, the optimal insertion parameters should be known. Therefore, a digitally-controlled microneedle applicator was developed to insert microneedles into the skin via impact insertion (velocity) or via pressing force insertion. Six microneedle arrays with different geometries and/or materials were applied onto ex vivo human skin with varying velocities or pressing forces. Penetration efficiency and delivered antigen dose into the skin after application of microneedles were determined. In general, microneedles pierced the skin more efficiently when applied by impact application as compared to application via pressing force. However, the angle of application of the applicator on the skin can affect the velocity of the impact, influencing the penetration efficiency of microneedles. Regarding the antigen delivery into the skin, the delivered dose was increasing by increasing the velocity or pressure, and thus, increasing the penetration efficiency. These data demonstrate that an applicator is an important tool to determine optimal application conditions with ex vivo human skin