Reliability of digital mems sensors: Metrological characterization of accelerometersand microphones

The reliability of digital MEMS accelerometer and microphone sensors is investigated, on the basis of suitable calibration procedures developed at INRiM, in order to provide the metrological traceability and the proper sensitivity in the digital domain. Nowadays, digital sensing systems, based on MEMS technology, are largely used in a wide range of advanced industrial, environmental, energy and medical applications. The possibility to have many accurate, low-power consuming and low-cost sensors present undoubted advantages, in terms of costs reduction and energy saving, while maintaining high quality in the control processes, monitoring or measurements and being flexible in providing enhanced data collection, automation and operation. Nevertheless, at present, digital MEMS sensors are not always reliable to quantify with adequate accuracy the measured physical phenomena, due to the lack of metrological traceability and sensitivity parameters for digital sensors

Survival and outcome of total elbow arthroplasty for distal humeral fracture at long-term follow-up

Background: Total elbow arthroplasty is an accepted procedure for the treatment of acute comminuted distal humeral fractures in elderly. Few long-term outcomes are available. The purpose of this study was to examine long-term clinical and radiological outcomes of prosthesis performed ( January 2002-June 2015) for complex fractures of the distal humerus (AO/C) in patients older than 65 years with low functional demands. Ma-terials and Methods: Further inclusion criteria were: the availability of a clinical and radiological follow-up of minimum 5 years and pattern of closed fracture. Demographic data and characteristics of patients were collected. All patients were clinically and radiographically assessed after 2 and 5 years from surgery. Results: Twelve patients were included with complete available data. The mean follow-up was 7.6 years. Five patients reported a worsening of the elbow functionality through the follow-ups. Five subjects had complications. There were no cases of revision surgery. The quality of fixation showed a progressive worsening with increase of radiolucency both on humeral and ulnar side. The recorded MEPS showed no correlation with the grade of periprosthetic osteolysis. Polyethylene bushing wear was scored of grade 2 in one subject who had showed type 4 Morrey radiolucency. Discussion and Conclusions: Total elbow arthroplasty is an effective and reliable procedure for comminuted fractures of the distal humerus in elderly, although the incidence of complications can not be considered as negligible. For the majority of these patients, a well-performed implant will give them a well-functioning elbow for their remaining life

Efficacy and safety of viscosupplementation with hyaluronic acid for hip osteoarthritis: Results from a cross-sectional study with a minimum follow-up of 4 years

Background and aim of the work: Osteoarthritis is the most common cause of disability in elderly. Hip osteoarthritis is the second most frequent form affecting a large joint and the social and economic impact on society of its related disability is expected to increase. The purpose of this study was to verify the efficacy and safety of ultrasound-guided viscosupplementation with high weight hyaluronic acid in hip osteoarthritis. Methods: 183 patients with painful hip OA (Kellgren-Lawrence 1-2-3) were treated from January 2014 to December 2016 with viscosupplementation. Patients were evaluated before injection (T0) and after 1,2,3,4 (T1-T2-T3-T4) years through the VAS scale and Harris Hip Score (HHS). Patients who underwent to subsequent injections were followed and assessed. Subjects who underwent prosthesis were analyzed for a minimum of 6 months in order to detect any early postoperative complication. Results: The mean improvement of HHS and VAS between T0 and T1 was statistically significant. Patients who underwent subsequent injections showed a higher improvement even if statistical significance was not observed. Results showed that patients with grade 2 of osteoarthritis had the higher change in the scores. No adverse effects were registered. No early complications were reported in those patients who needed prosthesis. Discussion and Conclusions: Results observed confirm that ultrasound-guided viscosupplementation with high weight hyaluronic acid could be a possibility in the treatment of hip osteoarthritis, especially in patients with Kellgren-Lawrence grade 2 of disease. Subsequent injections are not characterized by similar positive effects. Outcomes of pros-thetic surgery are not influenced by viscosupplementation

Dair approach in 7 infected total hip arthroplasties: our experience and current concepts of the literature

INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most challenging complications following total hip arthroplasty. In early infection, within four to twelve weeks from surgery, debridement, antibiotics and implant retention (DAIR) can be the initial treatment. The aim of this study is to report our case series and review current concepts reported in the literature about this topic. MATERIALS AND METHODS: This was an observational cohort study that included 7 patients managed with DAIR for PJI following primary total hip replacement (THR) between 2014 and 2020. Inclusion criteria were a primary THR, direct anterior or lateral approach, DAIR procedure, and PJI. Exclusion criteria were a PJI following a revision total hip replacement or hemiarthroplasty, posterolateral approach, 1-stage revision, 2-stage revision, and Girdlestone procedure without prior DAIR. For each patient demographic characteristics, laboratory values, microorganisms involved, antibiotic therapy and outcome at one-year follow-up were registered. RESULTS: The mean duration between THR and DAIR was 19 days. In all cases only one DAIR procedure was performed. Most infections were caused by Staphylococcus aureus (4 cases) [one methicillin resistant (MRSA)]. The other infections were caused by Streptococcus agalactiae, Staphylococcus coagulase negative and Escherichia coli. At the final follow-up, the procedure was considered as successful in 6 out of 7 patients (85%). The one with unsuccessful outcome underwent to a two-stage revision. DISCUSSION: Our results were comparable with those of a recent systematic review of the literature. Factors that have been postulated to influence the outcome of DAIR in the management of PJIs include the timing and numbers of debridement, the exchange of components, the responsible microorganism and the duration of antibiotic treatment. In conclusion, the outcomes following DAIR are better as the indications are refined and risk factors identified. PJI prevention remains the key but the current literature still lacks well documented and effective PJI prevention protocols. (www.actabiomedica.it)

Mixture distribution modelling of the sensitivities of a digital 3-axis MEMS accelerometers large batch

Huge quantities of low-cost analogue or digital MEMS sensors, in the order of millions per week, are produced by manufacturers. Their use is broad, from consumer electronic devices to Industry 4.0, Internet of Things and Smart Cities. In many cases, such sensors have to be calibrated by accredited laboratories to provide traceable measurements. However, at present, such a massive number of sensors cannot be calibrated and large-scale calibration systems and procedures are still missing. A first step to implementing these methods can be based on the distribution of the sensitivities of the large batches produced. Such distribution is also useful for sensor network end-users who need a single sensitivity, with the associated uncertainty, to be attributed to the whole network. Recently, a large batch of 100 digital 3-axis MEMS accelerometers was calibrated with a primary calibration system developed at INRiM and suitable for 3-axis accelerometers. Distributions of their sensitivities as a function of axis and frequency were analyzed and their non-normal behaviour was shown. However, in the preliminary phase of the study, the calibration uncertainties were not considered in these distributions. Therefore, in this paper, a mixture distribution modelling, based on Monte Carlo simulations and aimed at including the calibration uncertainties in the sensitivity distributions, is implemented and the resulting distributions are compared to the previous ones in histogram form. These distributions are also fitted with Johnson's unbounded and bimodal functions to get continuous distributions. This paper represents a further step towards the development of large-scale statistical calibration methods

Treatment responses to antiangiogenetic therapy and chemotherapy in nonsecreting paraganglioma (PGL4) of urinary bladder with SDHB mutation: a case report

Paraganglioma (PGL) is a rare neuroendocrine tumor. Currently, the malignancy is defined as the presence of metastatic spread at presentation or during follow-up. Several gene mutations are listed in the pathogenesis of PGL, among which succinate dehydrogenase (SDHX), particularly the SDHB isoform, is the main gene involved in malignancy. A 55-year-old male without evidence of catecholamine secretion had surgery for PGL of the urinary bladder. After 1 year, he showed a relapse of disease and demonstrated malignant PGL without evidence of catecholamine secretion with a germline heterozygous mutation of succinate dehydrogenase B (SDHB). After failure of a second surgery for relapse, he started medical treatment with sunitinib daily but discontinued due to serious side effects. Cyclophosphamide, vincristine, and dacarbazine (CVD) chemotherapeutic regimen stopped the disease progression for 7 months. Conclusion: Malignant PGL is a very rare tumor, and SDHB mutations must be always considered in molecular diagnosis because they represent a critical event in the progression of the oncological disease. Currently, there are few therapeutic protocols, and it is often difficult, as this case demonstrates, to decide on a treatment option according to a reasoned set of choices. Abbreviations: CVD = cyclophosphamide, vincristine and dacarbazine, HIF-1a = hypoxia inducible factor 1 alpha, PGL = paraganglioma, SDH = succinate dehydrogenase, VEGF = vasoendothelial growth factor

Long-term results after modified Burton-Pellegrini’s technique in 24 cases affected by advanced rhizarthrosis

Background and aim: Rhizarthrosis iscommon in elderly and represents 10% of all artrhitic manifestations. Trapeziectomy with ligament reconstruction and tendon interposition remains the gold standard for stages II to IV according to Eaton and Littler. This retrospective study aimed to evaluate the results of 24 patients affected by advanced rhizarthrosis who underwent to modified Burton-Pellegrini’s trapeziectomy with ligamentoplasty using the entire flexor carpi radialis tendon. Methods: Patients were assessed through DASH and PRWHE questionnaires; the examination focused also on pain symptoms (VAS score) and the results obtained in carrying out specific tests to evaluate the trapezius-metacarpal functionality (key-pinch, grip strength, Kapandji test, reduction of wrist flexion strength). Furthermore, postoperative complications were evaluated. Results: Clinical evaluation and individual satisfaction were positive in most cases (mean DASH 18,8 and mean PRWHE 21,7). VAS pain score reduced of 76.7%, grip strength and key pinch were similar to those of the non-operated hand and Kapandji test was excellent in 20 patients. One superficial wound infection was encountered which resolved by specific antibiotic therapy. Conclusions: The choice of the most appropriate treatment depends on clinical conditions and socio-occupational factors of the patient (age, sex and functional needs), the degree of osteoarthritis and the presence of deformities of the first metacarpophalangeal joint. Surgery aims to relief pain and to improve joint function and strength. According to the results observed this surgical technique has to be considered a valid option for the treatment of advanced rhizarthrosis as it provides pain relief, stability and mobility of the thumb. (www.actabiomedica.it)

Dynamic calibration system for seismometers: Traceability from 0.03 Hz up to 30 Hz

Mechanical calibration and traceability of seismometers in operating conditions are still a technical challenge, since very low-frequency ranges (below 0.1 Hz) are involved, and sensors under investigation are generally heavy and bulky. Recently, within the vibration metrology field, some pioneering works proposed to evaluate the seismometers’ sensitivity by applying laboratory mechanical calibration procedures, against primary or secondary standards, according to the ISO 16063 methods. By following this path, at INRIM, it has been developed a suitable system for short period horizontal and vertical ground velocity calibration of 3-axis seismometers. The calibration system allows to directly evaluate the sensitivities of the 2 axes perpendicular to the gravity field, with respect to the horizontal ground velocity (S-waves), and to derive the sensitivity of the vertical axis, parallel to the gravity field, with respect to the vertical ground velocity (P-waves), in the frequency range between 0.03 Hz and 30 Hz