Soft pneumatic devices for blood circulation improvement

The research activity I am presenting in this thesis lies within the framework of a cooperation between the University of Cagliari (Applied Mechanics and Robotics lab, headed by professor Andrea Manuello Bertetto, and the research group of physicians referencing to professor Alberto Concu at the Laboratory of Sports Physiology, Department of Medical Sciences), and the Polytechnic of Turin (professor Carlo Ferraresi and his equipe at the Group of Automation and Robotics, Department of Mechanical and Aerospace Engineering) This research was also funded by the Italian Ministry of Research (MIUR – PRIN 2009). My activity has been mainly carried on at the Department of Mechanics, Robotics lab under the supervision of prof. Manuello; I have also spent one year at the Control Lab of the School of Electrical Engineering at Aalto University (Helsinki, Finland). The tests on the patients were taken at the Laboratory of Sports Physiology, Cagliari. I will be describing the design, development and testing of some soft pneumatic flexible devices meant to apply an intermittent massage and to restore blood circulation in lower limbs in order to improve cardiac output and wellness in general. The choice of the actuators, as well as the pneumatic circuits and air distribution system and PLC control patterns will be outlined. The trial run of the devices have been field--‐tested as soon a prototype was ready, so as to tune its features step--‐by--‐ step. I am also giving a characterization of a commercial thin force sensor after briefly reviewing some other type of thin pressure transducer. It has been used to gauge the contact pressure between the actuator and the subject’s skin in order to correlate the level of discomfort to the supply pressure, and to feed this value back to regulate the supply air flow. In order for the massage to be still effective without causing pain or distress or any cutoff to the blood flow, some control objective have been set, consisting in the regulation of the contact force so that it comes to the constant set point smoothly and its value holds constant until unloading occurs. The targets of such mechatronic devices range from paraplegic patients lacking of muscle tone because of their spinal cord damage, to elite endurance athletes needing a circulation booster when resting from practicing after serious injuries leading to bed rest. Encouraging results have been attained for both these two categories, based on the monitored hemodynamic variables

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Comportamento di laminati in materiale composito in campo non lineare

Dottorato di ricerca in progettazione meccanica. 8. ciclo.Consiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome; Biblioteca Nazionale Centrale - P.za Cavalleggeri, 1, Florence / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

Elastoplastic Behaviour of Composite Laminates

Ductile matrix composites undergo plastic deformation even at low stress levels. In this paper the elastoplastic behaviour of APC2 (AS4/PEEK) laminas is studied by means of a one-parameter plastic potential. The extension to laminates of constitutive relations that are based on this yield function is examined; a comparison is made between experimental data and numerical results obtained by integrating the elastoplastic relations for various stacking sequences monotonically loaded. Results are also shown regarding notched strength prediction of angle-ply laminates with a circular hole, based on an elastoplastic behaviour assumption

Ultrasonic evaluation of matrix damage in impacted composite laminates

Conventional ultrasonic inspection methods are largely used for detection of delaminations in composite materials while only recently new techniques have been proposed to identify matrix cracks in simple tension loaded coupon specimens. In this study delaminations and matrix cracking caused by low-energy impacts on quasi-isotropic carbon/PEEK laminated plates are examined by means of different pulse-echo techniques: conventional time-of-flight and amplitude C-scans at normal incidence an used to check for the presence of delaminations, while backscattering C-scans tin which the transducer is set at an angle to the laminate plane) allow the detection of matrix cracks through the laminate thickness. Selected results from full waveform ultrasonic analysis of impacted carbon/PEEK laminates are discussed and compared with X-ray data in order to demonstrate the efficiency of the proposed inspection technique

Static and low frequency evaluation of a thin-film contact force sensor

Service robots meant for human interaction need to simulate touch sensitivity, or contact force is to be known for control purposes. Measurements have thus to be quick, reliable and have a good frequency response in the required band. Moreover, minimal dimensions are required, as well as an evenly responsive contact surface. We chose a commercial contact force sensor which exhibits all of these features: minimal overall dimensions, uniform measuring area, customizable range and certified linearity, no drift and hysteresis or good frequency response features. We present here our static and dynamic calibration results along with peculiarities we came across. We wanted to assess if the sensors would exhibit linear behaviour, no drift nor hysteresis as stated by the manufacturer. The sensors should offer uniform sensitivity over the sensing area, so matching section weights can be used to load them for static calibration. Besides this simple method, we also used hydrostatic pressure in a sealed chamber, getting rid of errors uncertainties coming from loading over the edges or from point loading. This method also allows for dynamic testing, as impulse loading or different frequency pressure waves can be applied to the sensors. Calibration curves will be presented in different loading conditions, focusing our attention on loading velocity and frequency. Although sensor gain exhibits remarkable changes after repeated loading, its smooth and continuous output make us think it can still be put in a feedback chain