Wearable wireless tactile display for virtual interactions with soft bodies.

We describe here a wearable, wireless, compact, and lightweight tactile display, able to mechanically stimulate the fingertip of users, so as to simulate contact with soft bodies in virtual environments. The device was based on dielectric elastomer actuators, as high-performance electromechanically active polymers. The actuator was arranged at the user's fingertip, integrated within a plastic case, which also hosted a compact high-voltage circuitry. A custom-made wireless control unit was arranged on the forearm and connected to the display via low-voltage leads. We present the structure of the device and a characterization of it, in terms of electromechanical response and stress relaxation. Furthermore, we present results of a psychophysical test aimed at assessing the ability of the system to generate different levels of force that can be perceived by users.The authors gratefully acknowledge financial support from COST – European Cooperation in Science and Technology, within the framework of “ESNAM – European Scientific Network for Artificial Muscles” (COST Action MP1003). Gabriele Frediani also acknowledges support from the European Commission, within the framework of the project “CEEDS: The Collective Experience of Empathic Data Systems” (FP7-ICT-2009.8.4, Grant 258749) and “Fondazione Cassa di Risparmio di Pisa,” within the framework of the project “POLOPTEL” (Grant 167/09

On some differential-geometric aspects of the Torelli map

In this note we survey recent results on the extrinsic geometry of the Jacobian locus inside $\mathsf{A}_g$. We describe the second fundamental form of the Torelli map as a multiplication map, recall the relation between totally geodesic subvarieties and Hodge loci and survey various results related to totally geodesic subvarieties and the Jacobian locus.Comment: To appear on Boll. UMI, special volume in memory of Paolo de Bartolomei

Differences in biologics for treating ankylosing spondylitis: The contribution of network meta-analysis

OBJECTIVE: Ankylosing Spondylitis (AS) is a chronic form of arthritis of unknown origin affecting the spine. In this study, we aimed to identify clinical and safety profiles of adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, and secukinumab that are biologic agents (biologics) mainly used for the treatment of AS, and to understand differences between them. MATERIALS AND METHODS: An extensive literature research was performed in MEDLINE and EMBASE in order to identify all network meta- analysis (NMA) and/or mixed treatment comparison (MTC) papers. NMA and/or MTC, with a ranking of the effectiveness of biologics in AS, were included in the analysis, and the adhesion to ISPOR guidelines was investigated. RESULTS: 60 studies were identified; after applying exclusion criteria methods, 7 studies underwent further analysis. Infliximab was the drug that exhibited the highest probability for achieving clinical efficacy by ASAS20 at 12 and 24 weeks. Considering only subcutaneous biologics, Golimumab achieved the highest probability for achieving the ASAS20 response at 12 weeks. CONCLUSIONS: Results from NMA on the use of biologics in AS indicates infliximab emerged as the drug with the highest probability of obtaining ASAS20 response both at 12 and 24 weeks of treatment

Osteoarticular pain: therapeutic approach by paradigms

Osteoarticular pain is a common condition in the adult population. It is a nociceptive pain modulated by different factors, and it is one of the major symptoms that force patients to seek medical advice. Since osteoarticular pain has a complex pathophysiology and it is not a linear condition, we propose in this paper an original approach to osteoarticular pain by paradigms, where a paradigm refers to a framework of concepts, results, and procedures within which subsequent work is structured. The paradigm presented is a conceptual tool that could help clinicians to choose the correct therapy considering both pain characteristics and clinical features

A sensor fusion strategy based on a distributed optical sensing of airframe deformation applied to actuator load estimation

Real-time health monitoring of mechatronic onboard systems often involves model-based approaches comparing measured (physical) signals with numerical models or statistical data. This approach often requires the accurate measurement of specific physical quantities characterizing the state of the real system, the command inputs, and the various boundary conditions that can act as sources of disturbance. In this regard, the authors study sensor fusion techniques capable of integrating the information provided by a network of optical sensors based on Bragg gratings to reconstruct the signals acquired by one or more virtual sensors (separately or simultaneously). With an appropriate Fiber Bragg Gratings (FBGs) network, it is possible to measure directly (locally) several physical quantities (e.g. temperature, vibration, deformation, humidity, etc.), and, at the same time, use these data to estimate other effects that significantly influence the system behavior but which, for various reasons, are not directly measurable. In this case, such signals could be "virtually measured" by suitably designed and trained artificial neural networks (ANNs). The authors propose a specific sensing technology based on FBGs, combining suitable accuracy levels with minimal invasiveness, low complexity, and robustness to EM disturbances and harsh environmental conditions. The test case considered to illustrate the proposed methodology refers to a servomechanical application designed to monitor the health status in real-time of the flight control actuators using a model-based approach. Since the external aerodynamic loads acting on the system influence the operation of most of the actuators, their measurement would be helpful to accurately simulate the monitoring model's dynamic response. Therefore, the authors evaluate the proposed sensor fusion strategy effectiveness by using a distributed sensing of the airframe strain to infer the aerodynamic loads acting on the flight control actuator. Operationally speaking, a structural and an aerodynamic model are combined to generate a database used to train data-based surrogates correlating strain measurements to the corresponding actuator load

Expert opinion on the management of patients with osteoporosis with anabolic drugs in Italy

Objective. Fragility fractures (FF) resulting from osteoporosis pose a significant public health challenge in Italy, with considerable socio-health and economic implications. Despite the availability of safe and effective drugs, osteoporosis remains underdiagnosed and undertreated, leaving over 2 million high-risk Italian women without treatment. This paper aims to identify and propose key improvements in the management of osteoporosis, focusing particularly on the critical issues related to the use of anabolic drugs in secondary prevention, according to the current Italian Medicines Agency (AIFA) Note 79. Methods. The Expert Panel, composed of nine recognized Italian experts in rheumatology, analyzed current practices, prescribing criteria, and the most recent literature. Three main reasons for revising the indications on pharmacological treatment of osteoporosis were identified: inadequate treatment of osteoporosis, new evidence regarding frontline placement of anabolics in high-risk conditions, and emerging sequential or combined strategies. Results. The proposed improvements include the adoption of the Derived Fracture Risk Assessment algorithm for accurate fracture risk assessment, revision of AIFA Note 79 to reflect current evidence, improved prescribing appropriateness, broader access to anabolic agents, and the provision of sequential therapies with antiresorptives for teriparatide. These changes aim to enhance patient outcomes, streamline healthcare processes, and address the high percentage of undertreated individuals. Conclusions. This expert opinion emphasizes the importance of the appropriate use of anabolic drugs to reduce FF and associated costs while ensuring the sustainability of the National Health Service. The proposed recommendations are in line with the latest scientific evidence, providing a comprehensive strategy to optimize the management of osteoporosis in Italy

Intramuscular neridronate for the treatment of complex regional pain syndrome type 1: a randomized, double-blind, placebo-controlled study

Background: Complex regional pain syndrome type-1 (CRPS-1) is a severely disabling painful disease challenging to treat. This multicenter, randomized, double-blind placebo-controlled trial examined the efficacy of intramuscular (i.m.) neridronate in CRPS-1 patients. Methods: A total of 78 patients diagnosed with CRPS-1 (aged 59.5 ± 10.3, 66.7% female) were randomly assigned to 25 mg (i.m.) neridronate (N = 41) given once daily for 16 consecutive days or placebo control (N = 37). Efficacy was assessed after 30 days using a visual analogue scale (VAS) pain score and the number of patients achieving ⩾50% reduction in VAS score. Change in clinical signs and symptoms, quality of life (QoL) using Short Form Health Survey (SF-36) and the McGill Pain Questionnaire were also assessed. Results: After 30 days, VAS score decreased significantly to a greater extent in neridronate-treated patients versus placebo (31.9 ± 23.3 mm versus 52.3 ± 27.8 mm, p = 0.0003). Furthermore, the proportion of patients achieving a VAS reduction of ⩾50% was greater in the neridronate group (65.9% versus 29.7%, p = 0.0017). Clinical signs and symptoms were improved significantly in the neridronate group versus placebo for edema (72.5% versus 79.9%, p = 0.03), pain during motion (70% versus 83.3%, p = 0.0009), allodynia (20% versus 63.3%, p = 0.0004), and hyperalgesia (20% versus 56.7%, p = 0.0023). Whereas no difference was observed for QoL measures using the SF-36 questionnaire, three of the four pain variables using the McGill Pain Questionnaire improved significantly in the neridronate group. No serious drug-related adverse events were reported during the study. Conclusion: In patients with acute CRPS-1, i.m. injections of 25 mg neridronate were associated with clinically relevant benefit compared with placebo controls. Trial registration: EU Clinical Trials Register: https://www.clinicaltrialsregister.eu/ctr-search/search?query=2014-001156-2

Long-term efficacy and safety of neridronate treatment in patients with complex regional pain syndrome type 1: a pre-specified, open-label, extension study

Background: No data on the permanent and curative effect of bisphosphonate treatment in patients with complex regional pain syndrome type-1 (CRPS-1) are currently available. The aim of this pre-specified, open-label, observational study was to evaluate the long-term efficacy and safety of neridronate treatment. Design: A pre-specified, open-label, extension study. Methods: Patients treated with intramuscular (IM) placebo in the double-blind phase of the study were assigned to 100 mg intravenous (IV) neridronate treatment administered 4 times over 10 days. These patients, together with those previously treated with 400 mg IM neridronate, were followed for 1 year. Efficacy was assessed using a visual analogue scale (VAS) pain score. Changes in clinical signs and symptoms, quality of life (QoL) using the Short Form Health Survey (SF-36), and the McGill Pain Questionnaire were also assessed. Results: Benefits on pain, clinical and functional measures were maintained and further improved over 12 months in most patients treated with neridronate administered either IM or IV. In IM-treated patients, the percentage of those defined as responders (VAS score reduction ≥ 50%) progressively increased up to day 360 to 32 of 35 patients (91.4%). Among the 27 patients referred to as responders at the end of the double-blind phase, 26 reported the same result at day 360 (96.3%). In IV-treated patients, a responder rate of 88% (22 out 25) was found at day 360 (p = 0.66 between groups). Consistent improvements were also observed for all clinical signs and functional questionnaire. No drug-related adverse events were reported during the study. Conclusion: In patients with acute CRPS-1, the benefit in pain, clinical, and functional measures observed a few weeks after neridronate treatment administered either IM or IV is maintained and further improved over 12 months. Parenteral neridronate induces permanent disease remission preventing chronic pain and motor dysfunction. Trial registration: EU Clinical Trials Register (EudraCT Number): 2014-001156-2