Multiphysics analyses of the effect of package on the performances of PMUT transducers

The paper deals with the multiphysics modeling of piezoelectric micromachined ultrasound transducers (PMUT), that can be used in several practical applications. The model accounts for the multiple couplings between the mechanical fields and the electric and acoustic ones. The numerical solution has been sought by means of the finite element method, for the special case of axial symmetry. The model has been validated with reference to experimental data, that have been obtained by the Authors. The numerical procedure has been applied to carry out a parametric analysis of the effect of package, to extract a set of design guidelines

On the solar origin of the 200 y Suess wiggles: Evidence from thermoluminescence in sea sediments

In order to understand the origin of the Suess wiggles, present in the tree ring 14C record, we have studied the thermoluminescence (TL) of a shallow-water Ionian sea core, in an attempt to provide a record of an indicator responding to the solar output more promptly than 14C in tree rings. The spectral content of the TL and radiocarbon records is very similar; neverthless, in addition to the 207 y Suess wave (A43.6% ), the TL record shows the second harmonic (103.5 y; A42.4% ), in phase with the envelope of the 11 y solar cycles. This result, obtained by different spectral methods, in particular by Superposition of Epochs (SE) and by Singular Spectrum Analysis (SSA), strongly supports the solar origin of the 200 y Suess wiggles

The three-body recombination of a condensed Bose gas near a Feshbach resonance

In this paper, we study the three-body recombination rate of a homogeneous dilute Bose gas with a Feshbach resonance at zero temperature. The ground state and excitations of this system are obtained. The three-body recombination in the ground state is due to the break-up of an atom pair in the quantum depletion and the formation of a molecule by an atom from the broken pair and an atom from the condensate. The rate of this process is in good agreement with the experiment on $^{23}$Na in a wide range of magnetic fields.Comment: 10 pages, 2 figures, to be published in Phys. Rev.

Second-line treatment in renal cell carcinoma: clinical experience and decision making

Currently, conventional treatments for metastatic RCC (mRCC) include immune-based combination regimens and/or targeted therapies, the latter mainly acting on angiogenesis, a key element of the process of tumor growth and spread. Although these agents proved able to improve patients’ outcomes, drug resistance and disease progression are still experienced by a substantial number of VEGFR-TKIs-treated mRCC patients. Following the inhibition of the VEGF/VEGFRs axis, two strategies have emerged: either specifically targeting resistance pathways, at the same time continuing to inhibit angiogenesis, or using a completely different approach aimed at re-activating the immune system through the use of inhibitors of specific negative immune checkpoints. These two approaches, practically represented by the use of either cabozantinib or nivolumab, seem to remain a rational therapeutic approach also when first-line immune-based combinations are used. The objective of this study is to design a preferential therapeutic pathway for the second-line treatment of mRCC. The procedure applied in this project was a group discussion, based on the Nominal Group Technique (NGT) method in a meeting session, aimed at defining the therapeutic choice for the second-line treatment of mRCC. The NGT process defined the most relevant parameters that, according to the interviewed panelists, clinicians should consider for the selection of the second-line therapy in the context of advanced renal cell carcinoma of mRCC. The algorithm developed for the treatment selection as a result of this process should thus be considered by clinicians as reference for therapy selection. Plain language summary: The result of this paper was the definition of an algorithm intended to suggest a preferential therapeutic pathway considering both the outputs of the Nominal Group Technique (NGT) process and the actual clinical practice and the experience of selected panelists. During the NGT process and the discussion phase, panelists defined the most important parameters to be included in the algorithm that are important for the treatment definition. Cabozantinib and nivolumab are identified as the most reasonable therapeutic options for patients progressing after first-line treatment and are the medication options included in the algorithm for therapy selection

Air-coupled PMUT at 100 kHz with PZT active layer and residual stresses: Multiphysics model and experimental validation

In this paper a complete Multiphysics modelling via the Finite Element Method (FEM) of an air-coupled Piezoelectric Micromachined Ultrasonic Transducer (PMUT) is described, with its experimental validation related to the mechanical and acoustic responses

A randomized clinical control study on the efficacy of three-dimensional upper limb robotic exoskeleton training in chronic stroke

Background : Although robotics assisted rehabilitation has proven to be effective in stroke rehabilitation, a limited functional improvements in Activities of Daily Life has been also observed after the administration of robotic training. To this aim in this study we compare the efficacy in terms of both clinical and functional outcomes of a robotic training performed with a multi-joint functional exoskeleton in goal-oriented exercises compared to a conventional physical therapy program, equally matched in terms of intensity and time. As a secondary goal of the study, it was assessed the capability of kinesiologic measurements—extracted by the exoskeleton robotic system—of predicting the rehabilitation outcomes using a set of robotic biomarkers collected at the baseline. Methods : A parallel-group randomized clinical trial was conducted within a group of 26 chronic post-stroke patients. Patients were randomly assigned to two groups receiving robotic or manual therapy. The primary outcome was the change in score on the upper extremity section of the Fugl-Meyer Assessment (FMA) scale. As secondary outcome a specifically designed bimanual functional scale, Bimanual Activity Test (BAT), was used for upper limb functional evaluation. Two robotic performance indices were extracted with the purpose of monitoring the recovery process and investigating the interrelationship between pre-treatment robotic biomarkers and post-treatment clinical improvement in the robotic group. Results : A significant clinical and functional improvements in both groups (p < 0.01) was reported. More in detail a significantly higher improvement of the robotic group was observed in the proximal portion of the FMA (p < 0.05) and in the reduction of time needed for accomplishing the tasks of the BAT (p < 0.01). The multilinear-regression analysis pointed out a significant correlation between robotic biomarkers at the baseline and change in FMA score (R2 = 0.91, p < 0.05), suggesting their potential ability of predicting clinical outcomes. Conclusion : Exoskeleton-based robotic upper limb treatment might lead to better functional outcomes, if compared to manual physical therapy. The extracted robotic performance could represent predictive indices of the recovery of the upper limb. These results are promising for their potential exploitation in implementing personalized robotic therapy. Clinical Trial Registration clinicaltrials.gov, NCT03319992 Unique Protocol ID: RH-UL-LEXOS-10. Registered 20.10.2017, https://clinicaltrials.gov/ct2/show/NCT0331999