Sistema wireless per il monitoraggio di parametri fisiologici del tratto gastro-esofageo

Lo scopo di questo lavoro di tesi e' la progettazione e realizzazione, a livello prototipale, di un sistema wireless miniaturizzato ed impiantabile per la rilevazione di parametri fisiologici del tratto gastro-esofageo. Questo studio si inserisce nell’ambito della ricerca di nuovi sistemi minimamente invasivi, che si possano sostituire ai dispositivi tradizionali attualmente in uso per effettuare alcuni esami clinici, in questo caso particolare la manometria e la pH-metria esofagea. Le problematiche riscontrate nei metodi tradizionali di rilevazione, sono legate fondamentalmente alla scarsa praticita’ che caratterizza il sistema di acquisizione dati: questi apparecchi infatti utilizzano sistemi di cateteri per la rilevazione di pH e pressione esofagei, che risultano molto fastidiosi per i pazienti sottoposti all’esame. Alla luce di quanto detto, il sistema elettronico proposto vuole sfruttare: · un modulo di telemetria con circuito di acquisizione e trasmissione dati, miniaturizzato ed impiantabile; · un circuito di ricezione, interfacciabile con PC per la memorizzazione e visualizzazione dei dati rilevati. Il sistema finale prevede che per ogni indagine clinica si utilizzino cinque capsule da agganciare all’esofago: quattro identiche fra loro (con sensore di pressione, convertitore A/D, trasmettitore, piu’ l’elettronica necessaria), una sola dotata anche di sensore per pH; esse devono essere posizionate lungo il tratto esofageo a 5 cm l’una dall’altra. Resta da sottolineare che il prototipo progettato presenta notevoli caratteristiche di flessibilita’: il modulo di telemetria puo’ infatti essere accoppiato con diversi tipi di circuiti di acquisizione del segnale e quindi utilizzato per svariate applicazioni. I problemi affrontati durante questo studio, sono legati dunque ai seguenti aspetti: · date le specifiche stringenti sulle dimensioni del circuito di acquisizione e trasmissione, e' stato necessario cercare e scegliere componenti di dimensioni opportune; in fase di realizzazione, si sono seguite metodologie che permettessero la minimizzazione degli ingombri dovuti alle piste di collegamento; · un ruolo rilevante ha avuto la ricerca di regole di layout in modo da minimizzare le emissioni spurie rispetto alla portante e migliorare la robustezza alle interferenze presenti nell’ambiente esterno; · e' stato necessario progettare diversi tipi di antenna, di dimensioni contenute, che sono state testate per ottenere un corretto dimensionamento della potenza di trasmissione; · per poter effettuare i test in vivo, sono state eseguite diverse prove di packaging per rendere il modulo adatto all’impianto: infatti il circuito deve risultare perfettamente isolato dall’ambiente circostante e rivestito di materiale biocompatibile per non causare danni ai tessuti biologici, ma contemporaneamente i sensori devono essere esposti all’esterno per poter rilevare i dati necessari. Come detto sopra, in questo lavoro di tesi gli esperimenti condotti sono stati finalizzati al possibile utilizzo del modulo di telemetria progettato come rilevatore di pH e pressione intra-esofagei: per questo motivo e' stato ritenuto opportuno inserire una descrizione anatomica del giunto esofago-gastrico, arricchita da alcune informazioni di carattere divulgativo sulla patologia di interesse. Si passa quindi ad una panoramica sulle principali applicazioni della radiotelemetria nel campo biomedico, in cui e' stato dedicato particolare spazio ai dispositivi piu’ innovativi recentemente realizzati. A questo punto segue la descrizione del lavoro eseguito, articolato in due fasi principali: inizialmente e' stato ripreso il lavoro svolto durante il periodo di tesi dall’Ing. P.Valdastri, in cui e' stato progettato un sistema di telemetria multicanale impiantabile; vengono descritte le caratteristiche principali del sistema, quindi viene dedicato ampio spazio all’analisi dei vari prototipi realizzati del circuito di trasmissione e ricezione, coi quali e' stata eseguita una serie di prove di laboratorio per verificare le funzionalita’ del sistema, per ottimizzarne i parametri circuitali e verificare il corretto accoppiamento tra trasmettitore e ricevitore. In questa fase e' stato necessario uno studio dei datasheet dei componenti utilizzati e degli application notes di recente uscita. A conclusione di questa prima parte di lavoro, e' stato progettato e realizzato un circuito per la rilevazione del pH: viene quindi riportata la descrizione del modulo dotato di sensore e di packaging biocompatibile, col quale e' stato effettuato il primo test in vivo su maiale, seguita dall’analisi dei risultati ottenuti da questo primo esperimento. A questo punto si passa alla descrizione della seconda parte di lavoro, che si basa sulla progettazione e realizzazione di un nuovo prototipo impiantabile miniaturizzato, completamente scalato nelle dimensioni rispetto al precedente. Le specifiche progettuali testate nella fase precedente, sono state mantenute anche per il secondo prototipo, apportando ove necessario alcune modifiche. Vengono prima descritti i componenti utilizzati, poi i circuiti progettati per il nuovo modulo. Segue la parte sugli strumenti utilizzati per la fase di realizzazione del prototipo e sui test effettuati per verificarne le funzionalita’. Viene poi dedicato spazio all’analisi del tipo di packaging piu’ adatto all’impianto, riportando le caratteristiche dei materiali utilizzati e del sistema proposto. Per concludere il lavoro svolto, si descrive poi l’ultimo test in vivo effettuato con questo secondo modulo, accompagnato da un’analisi dei risultati ottenuti dall’esperimento e delle conclusioni che ne derivano

Using the Process Digital Twin as a tool for companies to evaluate the Return on Investment of manufacturing automation

The fourth industrial revolution is gaining momentum, but still lacks full realization. Several studies suggest that many companies around the world have begun the digital transformation undertaking, but most are still far from full adoption and yet fail to see the full economic potential, being stuck in what has been called "pilot purgatory”. Digitalization is largely recognized as an accelerator and enabler for full automation in manufacturing, but companies are still struggling to assess the return on investment and the impact on operational performance indicators. Therefore, companies, especially SMEs characterized by dynamic, high-value, high-mix, and low-volume contexts, are reluctant to invest further. By incorporating simulation, data analytics and behavioral models, digital twins may also be used to support automation solutions ramp-up, demonstrate their impact evaluation, usage scenarios, eliminating the need for physical prototypes, reducing development time, and improving quality. Few forward-thinking companies are pursuing the digital transformation path, while the majority are clipping the wings of a transformation that is essential for a sustainable manufacturing. This paper describes a theoretical approach to exploit the digital twin technology to gather insights towards a realistic economical assessment of full automation solutions, to back and encourage investments to realize the potential of the digital manufacturing transformation. The approach is being tested under the European Union’s Horizon 2020 research and innovation program under grant agreement No. 958363, which provides an opportunity to assess how the various components of the method are constructed, how complex they are, and what level of effort is required, using a practical example.publishedVersio

The role of basiliximab in the evolving renal transplantation immunosuppression protocol

Basiliximab is a chimeric mouse-human monoclonal antibody directed against the alpha chain of the interleukin-2 (IL-2) receptor on activated T lymphocytes. It was shown in phase III trials to reduce the number and severity of acute rejection episodes in the first year following renal transplantation in adults and children, with a reasonable cost-benefit ratio. The drug does not increase the incidence of opportunistic infections or malignancies above baseline in patients treated with conventional calcineurin inhibitor-based immunosuppression. In the field of renal transplantation, basiliximab does not increase kidney or patient survival, despite the reduction in the number of rejection episodes. Basiliximab may reduce the incidence of delayed graft function. In comparison with lymphocyte-depleting antibodies basiliximab appears to have equal efficacy in standard immunological risk patients. Recently, IL-2 receptor monoclonal antibodies have been used with the objective of reducing or eliminating the more toxic elements of the standard immunosuppression protocol. Several trials have incorporated basiliximab in protocols designed to avoid or withdraw rapidly corticosteroids, as well as protocols which substitute target-of-rapamycin (TOR) inhibitors for calcineurin inhibitors

Microplastics in Sewage Sludge: A Known but Underrated Pathway in Wastewater Treatment Plants

Interest in the presence of microplastics (MPs) in wastewater has grown significantly in recent years. In fact, wastewater treatment plants (WWTPs) represent the last barrier before the discharge of MPs into an aquatic ecosystem. The research has highlighted how MPs are in part effectively removed from the waters and accumulated inside the sewage sludge (SeS) produced by the WWTP, being a cause for concern, especially in the case of agricultural reuse. This work aims to analyze the existing literature on the (i) methodical procedure for MPs analysis (thermal, spectroscopic, optical analyses), (ii) qualitative and quantitative presence of MPs in SeS, (iii) effect on sludge properties, and (iv) the possible accumulation in amended soils. Based on the results already obtained in the literature, this work aims to provide critical insights to stimulate interest in the topic and direct future research on aspects that should be deepened. In particular, it emerges that there is a clear need for standardization of the collection methods and the analytical techniques for identifying and quantifying MPs, since their physico-chemical characterization and the study on aging and on the response towards acid or basic pre-treatments are fundamental for the understanding of microplastics ecotoxicological potential

A Framework for Enabling Manufacturing Flexibility and Optimizing Industrial Demand Response Services

The energy industry is experiencing significant changes in terms of sustainability and competition, primarily driven by the introduction of renewable energy targets and emission limits. Demand response is a potential solution to reduce the critical peak; however, its implementation in industries can be challenging due to their production requirements. Technology enablers such as digital twin technology can enhance energy flexibility and optimize manufacturing and service processes. In this study, we aim to develop a framework that can help the manufacturing industry to optimise industrial demand response services and achieve a seamless interaction of different layers such as the physical, data infrastructure, digital twin, management, and aggregator. A systematic literature review and workshops were conducted to identify key technologies, decision areas and methods to enable both manufacturing and energy flexibility to reach demand response. Based on the results, an energy-flexible framework for manufacturing industries was developed.acceptedVersio

The extended unconscious group field and metabolization of pandemic experience: dreaming together to keep cohesion alive

Introduction: Working with dreams in groups allows understanding of unconscious phenomena that characterize it as unity and totality. The dreamer becomes the vehicle of emotions, fantasies,and anxieties that dominate the group at a given moment, allowing them to be understood and processed (Friedman et al., 2002). Recognizing a projected theme in the group generates a change of perspective for the group, which becomes a specific psychic space (Kaës, 2001), a shared psychic field. The analysis of the shared dreams helps the understanding of the emotional concerns related to the Covid 19 and its psychological repercussions. Methods: Six matrices of social dreaming of different groups for analytical purposes were conducted during the Covid pandemic period. The sessions were transcribed and the texts were analyzed by performing a thematic analysis (Braun & Clarke, 2006) with the support of Atlas.ti software. Results: From the analysis of the results, three main themes were identified: a) “Lately I have more nightmares when I am awake than when I am asleep": Nightmares during the Covid-19 pandemic; b) “Losing one’s senses and losing the sense”: Helplessness and environmental mastery across time and space; c) Do play like a child: Recalling the child-past in the uncertain present. Discussion and conclusions: Through dreams and dream narratives we witness the evolution of group thinking through a progressive growth of the links between individuals and the common and shared field. The members of the group are thus able to identify within dreams the meanings that are useful for the entire group to process the painful experience that unites them

Measurements of the Viscosity of Hydrogen and a (Hydrogen + Methane) Mixture with a Two-Capillary Viscometer

Measurements of the viscosity of pure hydrogen and a binary (hydrogen + methane) mixture with a nominal composition 90 mol % hydrogen are presented. The measurements were conducted with a two-capillary viscometer relative to helium along three isotherms of (298.15, 323.15, and 348.15) K and at pressures of up to 18 MPa. Expanded relative combined uncertainties in viscosity range from (0.65 to 2.7) % (k = 2) for the hydrogen data, and from (0.91 to 3.2) % (k = 2) for the (hydrogen + methane) data. The viscosity data are compared to experimental literature data and viscosity correlations implemented in the NIST REFPROP v10.0 database. Good agreement between this work’s data, literature data, and the viscosity correlation was achieved for pure hydrogen. The (hydrogen + methane) mixture was compared to the Extended Corresponding States (ECS) model implemented in REFPROP v10.0. Relative deviations between the experimental data and the ECS model exceed the experimental uncertainty and were found to exhibit a positive trend with increasing density and a weakly pronounced negative trend with increasing temperature. No experimental literature data are available at overlapping state regions. Nonetheless, deviations to the ECS model imply reasonable consistency of this work’s data and literature data. In addition to experimental viscosities, experimental zero-density viscosity ratios of the fluids under investigation and helium are reported. Fairly good agreement within the experimental uncertainty of this work with a highly accurate literature value and a value obtained from accurate ab initio calculated data was achieved for hydrogen.Measurements of the Viscosity of Hydrogen and a (Hydrogen + Methane) Mixture with a Two-Capillary ViscometerpublishedVersio

Tumour cell-derived small extracellular vesicles modulate macrophage immunosuppressive phenotype associated with PD-L1 expression

Introduction: Tumour-associated macrophages (TAMs) play a key role in promoting tumour progression, by exerting an immunosuppressive phenotype associated with M2 polarization and with the expression of CD204 and programmed cell death ligand 1 (PD-L1). It is well known that tumour-derived extracellular vesicles (TEVs) play a pivotal role in the tumour microenvironment, influencing TAM behaviour. The study was aimed to examine the effect of TEVs derived from colon cancer and multiple myeloma cells on macrophage functions. Methods: Non-polarized macrophages (M0) differentiated from THP-1 cells were co-cultured, for 3 up to 48 hours, with TEVs derived from a colon cancer cell line, SW480, and multiple myeloma cell line, MM1.S. The expression of M2 and TAM markers (respectively CD163 and CD204) as well as of PD-L1 and Interleukin 6 (IL6) were evaluated at mRNA and protein level. The apoptotic rate of CD3+ T cells cocultured with TEV-treated M0 macrophages was analysed by FACS. Results: Our results indicate that TEVs can significantly upregulate the expression of surface markers of M2-like phenotype (CD163) and TAM (CD204) as well as of PD-L1, inducing macrophages to acquire an immunosuppressive phenotype. In parallel, we found that TEVs were also able to induce a significant increase of IL6 expression at both mRNA and protein levels and to activate the STAT3 signalling pathway. Since PD-1/PD-L1 axis is involved in the inhibition of T cells, we assessed the ability of macrophages treated with TEVs to affect T cell viability. We found that CD3+ T cells co-cultured with TEVs-treated M0 showed an increase of their apoptotic rate in comparison to CD3 + T cells grown in the presence of untreated macrophages. Summary/Conclusion: Cumulatively, these preliminary data suggest that TEVs contribute to the immunosuppressive status of TAMs, promoting tumour growth and progression. Funding: Grant from the Fondazione AIRC per la Ricerca sul Cancro to Riccardo Alessandro (grant n° 18783)

Removal of Per- and Polyfluoroalkyl Substances by Adsorption on Innovative Adsorbent Materials

Per- and polyfluoroalkyl substances (PFAS) constitute a group of organofluorine chemical synthetic compounds widely used in industries and manufacturing due to their hydrophobic properties. However, PFAS have been found to cause negative human health outcomes. Therefore, a strong interest in the possible removal of these compounds from wastewater (WW) has been shown. This work aims to present a systematic analysis of the scientific literature related to the innovative and alternative adsorbent materials that can be used for treating PFAS-contaminated WW. Moreover, the adsorption processes are considered, focusing the attention on virgin adsorbent materials and biochar as adsorbents. Virgin adsorbent materials comprise conventional adsorbent materials, functional clays, metal-organic frameworks, and functionalized organic polymers. Biochar includes materials obtained from agricultural or food residues and from sewage sludge. The review shows that conventional treatment units using virgin adsorbent materials are characterized by high adsorption capacity, but also high costs. In addition, the refunctionalization of adsorbent materials is difficult to obtain. On the contrary, biochar, which is a residual product of other production processes, appears to be a cost-effective solution

A first assessment of genetic variability in the Eurasian Stone-curlew Burhinus oedicnemus

The Eurasian Stone-curlew is a species of conservation concern in Europe. We investigate for the first time the extent of population structure among populations sampled from six geographical areas, representing four subspecies inhabiting the western part of the species’ distribution. Neither mitochondrial nor nuclear markers fully supported current subspecies boundaries. However, both markers support significant differentiation of the Canary Island populations from those sampled from the Mediterranean. Further work is needed to establish the taxonomic status of this potentially distinct Macaronesian taxon. More broadly, further genetic research is required to design and implement an effective conservation plan for this species