A Novel Approach for Multiple Material Extrusion in Arthroscopic Knee Surgery

Articular cartilage defects and degenerative diseases are pathological conditions that cause pain and the progressive loss of joint functionalities. The most severe cases are treated through partial or complete joint replacement with prostheses, even if the interest in cartilage regeneration and re-growth methods is steadily increasing. These methods consist of the targeted deposition of biomaterials. Only a few tools have been developed so far for performing these procedures in a minimally invasive way. This work presents an innovative device for the direct deposition of multiple biomaterials in an arthroscopic scenario. The tool is easily handleable and allows the extrusion of three different materials simultaneously. It is also equipped with a flexible tip to reach remote areas of the damaged cartilage. Three channels are arranged coaxially and a spring-based dip-coating approach allows the fabrication and assembly of a bendable polymeric tip. Experimental tests were performed to characterize the tip, showing the ability to bend it up to 90 degrees (using a force of similar to 1.5 N) and to extrude three coaxial biomaterials at the same time with both tip straight and tip fully bent. Rheometric analysis and fluid-dynamic computational simulations were performed to analyze the fluids' behavior; the maximum shear stresses were observed in correspondence to the distal tip and the channel convergence chamber, but with values up to similar to 1.2 kPa, compatible with a safe extrusion of biomaterials, even laden with cells. The cells viability was assessed after the extrusion with Live/Dead assay, confirming the safety of the extrusion procedures. Finally, the tool was tested arthroscopically in a cadaveric knee, demonstrating its ability to deliver the biomaterial in different areas, even ones that are typically hard-to-reach with traditional tools

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Progettazione e sviluppo di un sistema ergonomico per l'attivazione magnetica del dispositivo medico "RELIEF"

Relief srl sta sviluppando uno sfintere endo-uretrale magnetico innovativo contro l’incontinenza urinaria. Lo sfintere, impiantato a livello del collo vescicale, può essere aperto e chiuso avvicinando un magnete esterno in zona perianale. Lo scopo della tesi è progettare e sviluppare un sistema ergonomico per quest’ultimo. In particolare, l’obiettivo è realizzare un prodotto funzionante, di facile utilizzo e portabilità, che garantisca la sicurezza dell’utilizzatore. L'aspetto della sicurezza è stato affrontato analizzando i problemi creati dal magnete. La soluzione proposta consiste in una scatola in materiale schermante la cui efficacia è stata valutata con modelli FEM successivamente validati sperimentalmente. Sono state stimate la quantità di materiale schermante e le dimensioni della scatola tali da definire la soluzione sicura e portabile. Lo studio dell'integrazione dei principi ergonomici nello sviluppo del prodotto ha permesso di individuare i principali metodi di integrazione e gli obiettivi da perseguire per ottimizzare il processo produttivo. Dall’analisi degli “user needs” sono state definite le caratteristiche delle soluzioni realizzative ed è stata svolta un’analisi preliminare, sono stati poi disegnati e prodotti i prototipi. È stato realizzato un setup per la valutazione delle performance dei dispositivi. Tale valutazione ha permesso di individuare la soluzione ottimale tra quelle proposte e che rappresenta un miglioramento rispetto alla condizione attuale

La disciplina delle misure di allerta e prevenzione delle crisi aziendali nelle società "a controllo pubblico".

Lo scritto analizza la disciplina delle misure di previsione delle crisi aziendali prevista dal "Testo unico delle società a partecipazione pubblica" - anche quale microsistema normativo anticipatorio della disciplina generale delle misure di allerta e prevenzione dei fenomeno di crisi d'impresa dettata dal d.lgs. n. 14/2019 (Codice della crisi d'impresa e dell'insolvenza) - ponendone in evidenza i più rilevanti problemi di inquadramento sistematico e i più complessi nodi interpretativi, nella prospettiva di individuare, con riguardo agli uni e agli altri, le possibili soluzioni