956 research outputs found

    CASE DELLA COMUNITÀ E OSPEDALI DI COMUNITÀ

    No full text
    In quest'era di cambiamenti, la progettazione delle strutture sanitarie sta subendo una profonda rivoluzione. L'evoluzione delle esigenze sociali, le avanzate tecnologie, i cambiamenti demografici ed epidemiologici in corso, ecc. hanno rivoluzionato il modo in cui dobbiamo concepire la rete socio-sanitaria. In aggiunta, la recente pandemia di Covid-19 ha messo in luce le difficoltà dell’intero Sistema Sanitario Nazionale portando a riconoscere le limitazioni del modello ospedale-centrico e quindi estendendo la necessità di cambiamento anche verso la sanità diffusa sul territorio. Da diversi decenni il CNETO si impegna a realizzare eventi e momenti formativi, viaggi studio e gruppi di lavoro proprio atti a condividere la pratica professionale, riflessioni ed esperienze progettuali e organizzative che possano essere linee di indirizzo e strategie utili per i professionisti e per gli enti istituzionali nazionali, regionali e locali. Nello specifico, con questa pubblicazione il CNETO ha voluto dare un contributo sotto forma di indicazioni progettuali e funzionali con il supporto di casi studio e best practices, alla luce degli obiettivi imposti nella Missione 6 “Salute” del PNRR e dei documenti di indirizzo per il metaprogetto delle nuove Case e Ospedali di Comunità e Centrali Operative Territoriali pubblicate da AGENAS con i Supplementi dei Quaderni di Monitor. L’intento è quello sia di aggiornare i tecnici su un tema così emergente e di grande attualità, sia di raccogliere esperienze e condividere competenze e saperi dei professionisti coinvolti. Infatti, il miglioramento della rete dell'assistenza sociosanitaria a livello territoriale e lo sviluppo di servizi integrati che possano fornire cure personalizzate e vicine alle esigenze della Comunità, passa non solo da professionisti aperti all'innovazione, ma anche consapevoli della storia e delle cause di alcune sfide ancora irrisolte. Il Gruppo di Lavoro multidisciplinare, composto da architetti, ingegneri e medici, ha esaminato le sfide e le opportunità di questi nuovi modelli di assistenza socio-sanitaria, ponendo particolare enfasi sulla qualità progettuale e sulla capacità di adattarsi alle mutevoli esigenze sia del singolo cittadino che della Comunità. A tutti gli effetti le Case e gli Ospedali di Comunità rientrano nell’ambito delle cosiddette Architetture per la Salute: si tratta di spazi protesici orientati alla promozione e alla prevenzione della Salute come aspetto del benessere olistico, e non più solamente volti al trattamento delle malattie. Oggi, infatti, grazie agli avanzamenti nella ricerca medica, nella diagnostica, nella genetica e nell’applicazione delle biotecnologie e dei nuovi sistemi informatici, le strutture sanitarie sono intrinsecamente connesse con una vasta gamma di servizi sanitari e non. In questa nuova visione sinergica tra le diverse scale di assistenza, gli ospedali entrano in gioco principalmente per procedure mediche avanzate, delegando le strutture territoriali diffuse ad intervenire con le attività di prevenzione e la promozione della salute e l'assistenza a lungo termine per pazienti cronici e fragili. A partire dalla recente pandemia, il contributo delle strutture territoriali diventa a maggior ragione cruciale nella gestione delle emergenze sanitarie, riducendo gli accessi e i ricoveri impropri ai pronto soccorso. Con l’occasione del PNRR, le Case e gli Ospedali di Comunità possono diventare anche occasione di rigenerazione urbana e sociale, inserendosi capillarmente nel territorio e offrendo alle comunità anche luoghi di vita, relazione e aggregazione. Le informazioni ad oggi fornite a livello nazionale e regionale ai tecnici sono specifiche sulla mission di queste strutture e il loro contenuto. Confidiamo che questo documento possa diventare uno strumento complementare che, con un approccio multidisciplinare, supporti i tecnici per la progettazione, programmazione e gestione flessibile e in grado di recepire in modo continuo e dinamico l’innovazione tecnologica e gli inevitabili adeguamenti futuri e futuribili. A ciò si aggiungono anche strategie per offrire spazi accoglienti, capaci di stimolare e orientare il forte impegno civile e sociale richiesto anche solo per preservare gli attuali livelli di benessere

    Robotic Monitoring of Habitats: the Natural Intelligence Approach

    Get PDF
    In this paper, we first discuss the challenges related to habitat monitoring and review possible robotic solutions. Then, we propose a framework to perform terrestrial habitat monitoring exploiting the mobility of legged robotic systems. The idea is to provide the robot with the Natural Intelligence introduced as the combination of the environment in which it moves, the intelligence embedded in the design of its body, and the algorithms composing its mind. This approach aims to solve the challenges of deploying robots in real natural environments, such as irregular and rough terrains, long-lasting operations, and unexpected collisions, with the final objective of assisting humans in assessing the habitat conservation status. Finally, we present examples of robotic monitoring of habitats in four different environments: forests, grasslands, dunes, and screes

    Motor cortex hemodynamic response to goal-oriented and non-goal-oriented tasks in healthy subjects

    No full text
    Background: Motor disorders are one of the world’s major scourges, and neuromotor rehabilitation is paramount for prevention and monitoring plans. In this scenario, exercises and motor tasks to be performed by patients are crucial to follow and assess treatments’ progression and efficacy. Nowadays, in clinical environments, quantitative assessment of motor cortex activities during task execution is rare, due to the bulkiness of instrumentation and the need for immobility during measurements [e.g., functional magnetic resonance imaging (MRI)]. Functional near-infrared spectroscopy (fNIRS) can contribute to a better understanding of how neuromotor processes work by measuring motor cortex activity non-invasively in freely moving subjects. Aim: Exploit fNIRS to measure functional activation of the motor cortex area during arm-raising actions. Design: All subjects performed three different upper limbs motor tasks: arm raising (non-goal-oriented), arm raising and grasping (goal oriented), and assisted arm raising (passive task). Each task was repeated ten times. The block design for each task was divided into 5 seconds of baseline, 5 seconds of activity, and 15 seconds of recovery. Population: Sixteen healthy subjects (11 males and 5 females) with an average (+/− standard deviation) of 37.9 (+/− 13.0) years old. Methods: Cerebral hemodynamic responses have been recorded in two locations, motor cortex (activation area) and prefrontal cortex (control location) exploiting commercial time-domain fNIRS devices. Haemodynamic signals were analyzed, separating the brain cortex hemodynamic response from extracerebral hemodynamic variations. Results: The hemodynamic response was recorded in the cortical motor area for goal-oriented and not-goaloriented tasks, while no response was noticed in the control location (prefrontal cortex position). Conclusions: This study provides a basis for canonical upper limb motor cortex activations that can be potentially compared to pathological cerebral responses in patients. It also highlights the potential use of TD-fNIRS to study goal-oriented versus non-goaloriented motor tasks. Impact: the findings of this study may have implications for clinical rehabilitation by providing a better understanding of the neural mechanisms underlying goal-oriented versus non-goal-oriented motor tasks. This may lead to more effective rehabilitation strategies for individuals with motor disorders and a more effective diagnosis of motor dysfunction supported by objective and quantitative neurophysiological readings

    Making Bipedal Robot Experiments Reproducible and Comparable: The Eurobench Software Approach

    Get PDF
    This study describes the software methodology designed for systematic benchmarking of bipedal systems through the computation of performance indicators from data collected during an experimentation stage. Under the umbrella of the European project Eurobench, we collected approximately 30 protocols with related testbeds and scoring algorithms, aiming at characterizing the performances of humanoids, exoskeletons, and/or prosthesis under different conditions. The main challenge addressed in this study concerns the standardization of the scoring process to permit a systematic benchmark of the experiments. The complexity of this process is mainly due to the lack of consistency in how to store and organize experimental data, how to define the input and output of benchmarking algorithms, and how to implement these algorithms. We propose a simple but efficient methodology for preparing scoring algorithms, to ensure reproducibility and replicability of results. This methodology mainly constrains the interface of the software and enables the engineer to develop his/her metric in his/her favorite language. Continuous integration and deployment tools are then used to verify the replicability of the software and to generate an executable instance independent of the language through dockerization. This article presents this methodology and points at all the metrics and documentation repositories designed with this policy in Eurobench. Applying this approach to other protocols and metrics would ease the reproduction, replication, and comparison of experiments.This study is supported by the European Union’s Horizon 2020 research and innovation program under Grant Agreement no 779963, project Eurobench

    Adding pieces to the puzzle of differentiated-to-anaplastic thyroid cancer evolution: the oncogene E2F7

    Get PDF
    Anaplastic Thyroid Cancer (ATC) is the most aggressive and de-differentiated subtype of thyroid cancer. Many studies hypothesized that ATC derives from Differentiated Thyroid Carcinoma (DTC) through a de-differentiation process triggered by specific molecular events still largely unknown. E2F7 is an atypical member of the E2F family. Known as cell cycle inhibitor and keeper of genomic stability, in specific contexts its function is oncogenic, guiding cancer progression. We performed a meta-analysis on 279 gene expression profiles, from 8 Gene Expression Omnibus patient samples datasets, to explore the causal relationship between DTC and ATC. We defined 3 specific gene signatures describing the evolution from normal thyroid tissue to DTC and ATC and validated them in a cohort of human surgically resected ATCs collected in our Institution. We identified E2F7 as a key player in the DTC-ATC transition and showed in vitro that its down-regulation reduced ATC cells’ aggressiveness features. RNA-seq and ChIP-seq profiling allowed the identification of the E2F7 specific gene program, which is mainly related to cell cycle progression and DNA repair ability. Overall, this study identified a signature describing DTC de-differentiation toward ATC subtype and unveiled an E2F7-dependent transcriptional program supporting this process

    Relevance of hazards in exoskeleton applications: a survey-based enquiry

    Get PDF
    Exoskeletons are becoming the reference technology for assistance and augmentation of human motor functions in a wide range of application domains. Unfortunately, the exponential growth of this sector has not been accompanied by a rigorous risk assessment (RA) process, which is necessary to identify the major aspects concerning the safety and impact of this new technology on humans. This situation may seriously hamper the market uptake of new products. This paper presents the results of a survey that was circulated to understand how hazards are considered by exoskeleton users, from research and industry perspectives. Our analysis aimed to identify the perceived occurrence and the impact of a sample of generic hazards, as well as to collect suggestions and general opinions from the respondents that can serve as a reference for more targeted RA. Our results identified a list of relevant hazards for exoskeletons. Among them, misalignments and unintended device motion were perceived as key aspects for exoskeletons' safety. This survey aims to represent a first attempt in recording overall feedback from the community and contribute to future RAs and the identification of better mitigation strategies in the field

    A Single-Molecule Bioelectronic Portable Array for Early Diagnosis of Pancreatic Cancer Precursors

    Get PDF
    A cohort of 47 patients is screened for pancreatic cancer precursors with a portable 96-well bioelectronic sensing-array for single-molecule assay in cysts fluid and blood plasma, deployable at point-of-care (POC). Pancreatic cancer precursors are mucinous cysts diagnosed with a sensitivity of at most 80% by state-of-the-art cytopathological molecular analyses (e.g., KRASmut DNA). Adding the simultaneous assay of proteins related to malignant transformation (e.g., MUC1 and CD55) is deemed essential to enhance diagnostic accuracy. The bioelectronic array proposed here, based on single-molecule-with-a-large-transistor (SiMoT) technology, can assay both nucleic acids and proteins at the single-molecule limit-of-identification (LOI) (1% of false-positives and false-negatives). It comprises an enzyme-linked immunosorbent assay (ELISA)-like 8 × 12-array organic-electronics disposable cartridge with an electrolyte-gated organic transistor sensor array, and a reusable reader, integrating a custom Si-IC chip, operating via software installed on a USB-connected smart device. The cartridge is complemented by a 3D-printed sensing gate cover plate. KRASmut, MUC1, and CD55 biomarkers either in plasma or cysts-fluid from 5 to 6 patients at a time, are multiplexed at single-molecule LOI in 1.5 h. The pancreatic cancer precursors are classified via a machine-learning analysis resulting in at least 96% diagnostic-sensitivity and 100% diagnostic-specificity. This preliminary study opens the way to POC liquid-biopsy-based early diagnosis of pancreatic-cancer precursors in plasma
    • …
    corecore