Self-Diagnostic and Self-Compensation Methods for Resistive Displacement Sensors Tailored for In-Field Implementation.

This paper presents a suitably general model for resistive displacement sensors where the model parameters depend on the current sensor conditions, thereby capturing wearout and failure, and proposes a novel fault detection method that can be seamlessly applied during sensor operation, providing self-diagnostic capabilities. On the basis of the estimation of model parameters, an innovative self-compensation method is derived to increase the accuracy of sensors subject to progressive wearout. The proposed model and methods have been validated by both numerical simulations and experimental tests on two real resistive displacement sensors, placed in undamaged and faulty conditions, respectively. The fault detection method has shown an accuracy of 97.2%. The position estimation error is < ±0.2% of the full-scale span for the undamaged sensor, while the self-compensation method successfully reduces the position estimation error from ±15% to approximately ±2% of the full-scale span for the faulty sensor.

Optimization of an Impact-Based Frequency Up-Converted Piezoelectric Vibration Energy Harvester for Wearable Devices.

This work presents a novel development of the impact-based mechanism for piezoelectric vibration energy harvesters. More precisely, the effect of an impacting mass on a cantilever piezoelectric transducer is studied both in terms of the tip mass value attached to the cantilever and impact position to find an optimal condition for power extraction. At first, the study is carried out by means of parametric analyses at varying tip mass and impact position on a unimorph MEMS cantilever, and a suitable physical interpretation of the associated electromechanical response is given. The effect of multiple impacts is also considered. From the analysis, it emerges that the most effective configuration, in terms of power output, is an impact at the cantilever tip without a tip mass. By changing the value of the tip mass, a sub-optimal impact position along the beam axis can also be identified. Moreover, the effect of a tip mass is deleterious on the power performance, contrary to the well-known case of a resonant energy harvester. A mesoscale prototype with a bimorph transducer is fabricated and tested to validate the computational models. The comparison shows a good agreement between numerical models and the experiments. The proposed approach is promising in the field of consumer electronics, such as wearable devices, in which the impact-based device moves at the frequencies of human movement and is much lower than those of microsystems.

Piezoelectric Energy Harvesting from Low-Frequency Vibrations Based on Magnetic Plucking and Indirect Impacts.

This work proposes a mono-axial piezoelectric energy harvester based on the innovative combination of magnetic plucking and indirect impacts, e.g., impacts happening on the package of the harvester. The harvester exploits a permanent magnet placed on a non-magnetic mass, free to move within a predefined bounded region located in front of a piezoelectric bimorph cantilever equipped with a magnet as the tip mass. When the harvester is subjected to a low-frequency external acceleration, the moving mass induces an abrupt deflection and release of the cantilever by means of magnetic coupling, followed by impacts of the same mass against the harvester package. The combined effect of magnetic plucking and indirect impacts induces a frequency up-conversion. A prototype has been designed, fabricated, fastened to the wrist of a person by means of a wristband, and experimentally tested for different motion levels. By setting the magnets in a repulsive configuration, after 50 s of consecutive impacts induced by shaking, an energy of 253.41 µJ has been stored: this value is seven times higher compared to the case of harvester subjected to indirect impacts only, i.e., without magnetic coupling. This confirms that the combination of magnetic plucking and indirect impacts triggers the effective scavenging of electrical energy even from low-frequency non-periodical mechanical movements, such as human motion, while preserving the reliability of piezoelectric components.

Wearable Ball-Impact Piezoelectric Multi-Converters for Low-Frequency Energy Harvesting from Human Motion.

Multi-converter piezoelectric harvesters based on mono-axial and bi-axial configurations are proposed. The harvesters exploit two and four piezoelectric converters (PCs) and adopt an impinging spherical steel ball to harvest electrical energy from human motion. When the harvester undergoes a shake, a tilt, or a combination of the two, the ball hits one PC, inducing an impact-based frequency-up conversion. Prototypes of the harvesters have been designed, fabricated, fastened to the wrist of a person by means of a wristband and watchband, and experimentally tested for different motion levels. The PCs of the harvesters have been fed to passive diode-based voltage-doubler rectifiers connected in parallel to a storage capacitor, Cs = 220 nF. By employing the mono-axial harvester, after 8.5 s of consecutive impacts induced by rotations of the wrist, a voltage vcs(t) of 40.2 V across the capacitor was obtained, which corresponded to a stored energy of 178 µJ. By employing the bi-axial harvester, the peak instantaneous power provided by the PCs to an optimal resistive load was 1.58 mW, with an average power of 9.65 µW over 0.7 s. The proposed harvesters are suitable to scavenge electrical energy from low-frequency nonperiodical mechanical movements, such as human motion.

Technique and Circuit for Contactless Readout of Piezoelectric MEMS Resonator Sensors.

A technique and electronic circuit for contactless electromagnetic interrogation of piezoelectric micro-electromechanical system (MEMS) resonator sensors are proposed. The adopted resonator is an aluminum-nitride (AlN) thin-film piezoelectric-on-silicon (TPoS) disk vibrating in radial contour mode at about 6.3 MHz. The MEMS resonator is operated in one-port configuration and it is connected to a spiral coil, forming the sensor unit. A proximate electronic interrogation unit is electromagnetically coupled through a readout coil to the sensor unit. The proposed technique exploits interleaved excitation and detection phases of the MEMS resonator. A tailored electronic circuit manages the periodic switching between the excitation phase, where it generates the excitation signal driving the readout coil, and the detection phase, where it senses the transient decaying response of the resonator by measuring through a high-impedance amplifier the voltage induced back across the readout coil. This approach advantageously ensures that the readout frequency of the MEMS resonator is first order independent of the interrogation distance between the readout and sensor coils. The reported experimental results show successful contactless readout of the MEMS resonator independently from the interrogation distance over a range of 12 mm, and the application as a resonant sensor for ambient temperature and as a resonant acoustic-load sensor to detect and track the deposition and evaporation processes of water microdroplets on the MEMS resonator surface.

Eight-week interval in flushing and locking port-a-cath in cancer patients: A single-institution experience and systematic review.

Port-a-cath (PAC) system is one of the most frequently employed venous accesses for administration of chemotherapy and supportive care. To prevent late complications, the latest guidelines recommend flushing/locking procedures every four weeks. In this retrospective study, we evaluate the frequencies of late complications with a eight-week flushing/locking procedure compared to the standard one. This study retrospectively compares the frequency of complications occurred using standard versus delayed flushing schedules. We performed a systematic review of the published studies about PAC complications associated with longer flushing intervals. Three hundred and ninety fully available patients were enrolled. One hundred and six patients had their PAC flushed/locked every month, 347 patients performed the flushing/locking procedures every eight weeks, 63 patients switched from the four to the eight-week schedule. No difference was seen in the number of occlusions, infections and mechanical dysfunctions between the two patient groups. The systematic literature review confirmed, in a total of 1,347 patients, the absence of an increased proportion of complications with delayed schedules. PAC flushing and locking every eight weeks are feasible and safe. This delayed schedule may improve patients' quality of life and decrease both nursing workload and costs for the national health system.

Middle Phalangectomy for the Correction of Toe Clinodactyly With Longitudinal Epiphyseal Bracket in Young Children.

Toe clinodactyly is often owed to the presence of a longitudinal epiphyseal bracket. We developed middle phalangectomy as a simple surgical solution for correction of toe clinodactyly because of longitudinal epiphyseal bracket in childhood. Ten children (ages 1-5 years) were operated on by the same surgeon between October 2007 and May 2012 (n = 15 feet). The same surgical technique was used in all the cases. A clinical evaluation included the appearance of the foot, the parents' level of satisfaction, and the presence or absence of bothersome symptoms (such as pain and discomfort when wearing footwear). A radiological evaluation under weight-bearing conditions enabled us to 1) rate the achievement of a natural-looking toe parabola and 2) detect the recurrence of clinodactyly (defined as an angle of >40° between 2 adjacent phalanges). The mean follow-up period was 5.4 (range 3.3 to 8.1) years. Nine sets of parents (90%) were satisfied with the results of the procedure. None had difficulties wearing boots, and only 1 child (10%) had residual pain during sports activities. Clinodactyly recurred in 3 feet in 3 patients (20% of feet, 30% of patients). Two (20%) of the latter patients underwent repeat surgery and achieved a lasting, satisfactory outcome. Middle phalangectomy is an appropriate procedure for the treatment of toe clinodactyly because of longitudinal epiphyseal bracket in young children. However, the patients' long-term outcomes (notably once bone growth has ended) must be assessed.

Hepatoprotective effect of N-acetylcysteine in trabectedin-induced liver toxicity in patients with advanced soft tissue sarcoma.

PURPOSE: Trabectedin is one of the few active agents in soft tissue sarcoma (STS) but hepatotoxicity is frequent and represents a dose-limiting factor. Protective strategies aiming at counteracting this important side effect have a crucial clinical impact. Due to its antioxidant properties, N-acetylcysteine (NAC) has a recognized hepatoprotective effect and this provides the rationale for testing NAC in the management of trabectedin-induced hepatotoxicity. METHODS: Patients with recurrent or metastatic soft tissue sarcoma, consecutively observed at our institution, who were considered eligible to trabectedin, received concomitant NAC if they had impaired hepatic or renal function at baseline or developed hepatotoxicity during treatment. The study aim was to retrospectively explore trabectedin administration in terms of number of cycles, mean dose, and dose intensity (DI) in patients who received NAC as compared with those who did not. Secondary end points were progression-free survival (PFS) and overall survival (OS). RESULTS: A total number of 18 patients were enrolled in this study. Nine received NAC and nine did not. The median number of administered trabectedin cycles, mean trabectedin dose/cycles, and median DI was comparable in the two groups (p = 0.450, p = 0.534, and p = 0.450, respectively). The PFS and OS curves overlapped. CONCLUSION: This explorative study suggests that NAC can have a hepatoprotective activity in patients receiving trabectedin allowing to maintain an adequate dose intensity and continuative administration in patients with impaired liver and renal function or developing treatment-induced hepatotoxicity. A prospective randomized trial is warranted.

Behavior Discovery and Alignment of Articulated Object Classes from Unstructured Video.

We propose an automatic system for organizing the content of a collection of unstructured videos of an articulated object class (e.g., tiger, horse). By exploiting the recurring motion patterns of the class across videos, our system: (1) identifies its characteristic behaviors, and (2) recovers pixel-to-pixel alignments across different instances. Our system can be useful for organizing video collections for indexing and retrieval. Moreover, it can be a platform for learning the appearance or behaviors of object classes from Internet video. Traditional supervised techniques cannot exploit this wealth of data directly, as they require a large amount of time-consuming manual annotations. The behavior discovery stage generates temporal video intervals, each automatically trimmed to one instance of the discovered behavior, clustered by type. It relies on our novel motion representation for articulated motion based on the displacement of ordered pairs of trajectories. The alignment stage aligns hundreds of instances of the class to a great accuracy despite considerable appearance variations (e.g., an adult tiger and a cub). It uses a flexible thin plate spline deformation model that can vary through time. We carefully evaluate each step of our system on a new, fully annotated dataset. On behavior discovery, we outperform the state-of-the-art improved dense trajectory feature descriptor. On spatial alignment, we outperform the popular SIFT Flow algorithm.

Amiloride Is Effective in the Management of Abiraterone-Induced Mineralocorticoid Excess Syndrome without Interfering with Its Antineoplastic Activity.

BACKGROUND: The administration of abiraterone acetate (abiraterone) leads to an adrenocorticotropic hormone (ACTH)-driven increase in mineralocorticoid hormones, requiring glucocorticoid supplementation that may stimulate the growth of prostate cancer (PCa). Amiloride is a drug that selectively reduces the aldosterone-sensitive Na+/K+ exchange and could be effective in the management of mineralocorticoid excess syndrome (MCES). METHODS: The efficacy of amiloride + hydrochlorothiazide (HCT) in the clinical management of abiraterone-induced MCES was assessed in 5 consecutive patients with castration-resistant PCa (CRPC). Then, using the in vitro experimental model of PCa cell lines, the possible effects of drugs usually used in the clinical management of CRPC patients on PCa cell viability were investigated. RESULTS: Amiloride/HCT led to a complete disappearance of all clinical and biochemical signs of abiraterone-induced MCES in the 5 treated patients. The in vitro study showed that abiraterone treatment significantly decreased cell viability of both androgen receptor (AR)-expressing VCaP (vertebral-cancer of the prostate) and LNCaP (lymph node carcinoma of the prostate) cells, with no effect on AR-negative PC-3 cells. Prednisolone, spironolactone, and eplerenone increased LNCaP cell viability, while amiloride reduced it. The non-steroid aldosterone antagonist PF-03882845 did not modify PCa cell viability. CONCLUSIONS: The combination of amiloride/HCT was effective in the management of abiraterone-induced MCES. Amiloride did not negatively interfere with the abiraterone inhibition of PCa cell viability in vitro.

Analysis and Validation of Contactless Time-Gated Interrogation Technique for Quartz Resonator Sensors.

A technique for contactless electromagnetic interrogation of AT-cut quartz piezoelectric resonator sensors is proposed based on a primary coil electromagnetically air-coupled to a secondary coil connected to the electrodes of the resonator. The interrogation technique periodically switches between interleaved excitation and detection phases. During the excitation phase, the resonator is set into vibration by a driving voltage applied to the primary coil, whereas in the detection phase, the excitation signal is turned off and the transient decaying response of the resonator is sensed without contact by measuring the voltage induced back across the primary coil. This approach ensures that the readout frequency of the sensor signal is to a first order approximation independent of the interrogation distance between the primary and secondary coils. A detailed theoretical analysis of the interrogation principle based on a lumped-element equivalent circuit is presented. The analysis has been experimentally validated on a 4.432 MHz AT-cut quartz crystal resonator, demonstrating the accurate readout of the series resonant frequency and quality factor over an interrogation distance of up to 2 cm. As an application, the technique has been applied to the measurement of liquid microdroplets deposited on a 4.8 MHz AT-cut quartz crystal. More generally, the proposed technique can be exploited for the measurement of any physical or chemical quantities affecting the resonant response of quartz resonator sensors.

Autonomous Sensors Powered by Energy Harvesting from von Karman Vortices in Airflow.

In this paper an energy harvesting system based on a piezoelectric converter to extract energy from airflow and use it to power battery-less sensors is presented. The converter is embedded as a part of a flexure beam that is put into vibrations by von Karman vortices detached from a bluff body placed upstream. The vortex street has been investigated by Computational Fluid Dynamics (CFD) simulations, aiming at assessing the vortex shedding frequency as a function of the flow velocity. From the simulation results the preferred positioning of the beam behind the bluff body has been derived. In the experimental characterization the electrical output from the converter has been measured for different flow velocities and beam orientations. Highest conversion effectiveness is obtained by an optimal orientation of the beam, to exploit the maximum forcing, and for flow velocities where the repetition frequency of the vortices allows to excite the beam resonant frequency at its first flexural mode. The possibility to power battery-less sensors and make them autonomous has been shown by developing an energy management and signal conditioning electronic circuit plus two sensors for measuring temperature and flow velocity and transmitting their values over a RF signal. A harvested power of about 650 µW with retransmission intervals below 2 min have been obtained for the optimal flow velocity of 4 m/s.

Safety and efficacy of sunitinib in patients from Italy with metastatic renal cell carcinoma: final results from an expanded-access trial.

OBJECTIVES: Patients with metastatic renal cell carcinoma (mRCC) received sunitinib in a global expanded-access program (EAP). Here, we report the efficacy and safety results for the EAP subpopulation in Italy. METHODS: Patients ≥18 years old with previously treated or treatment-naïve mRCC received oral sunitinib 50 mg/day on a 4-weeks-on/2-weeks-off schedule. Tumor measurements were scheduled per local practice (using Response Evaluation Criteria in Solid Tumors). Safety was regularly assessed. RESULTS: A total of 521 patients participated, including 40% aged ≥65 years, 11% with an Eastern Cooperative Oncology Group performance status ≥2, 14% with non-clear cell RCC, and 11% with brain metastases. The median treatment duration and posttreatment follow-up were 7.4 and 12.3 months, respectively. The objective response rate was 12%, and the median progression-free and overall survival was 9.1 and 27.2 months, respectively. 514 patients (99%) discontinued treatment; reasons included death (17%), nonresponse (46%), or adverse events (AEs; 13%). The most common any-grade treatment-related AEs were asthenia (44%, plus 15% reporting fatigue), thrombocytopenia and stomatitis (both 37%), diarrhea (36%), mucosal inflammation (29%), hypertension (26%), and dysgeusia (25%). The most common grade 3/4 treatment-related AEs were thrombocytopenia (10%), asthenia (9%, plus 3% reporting fatigue), neutropenia, stomatitis (both 6%), and hypertension (5%). CONCLUSION: In a large population of Italian mRCC patients, sunitinib had a manageable safety profile and encouraging efficacy.

Sorafenib as first- or second-line therapy in patients with metastatic renal cell carcinoma in a community setting.

AIM: The Italian Retrospective Analysis of Sorafenib as First or Second Target Therapy study assessed the efficacy and safety of sorafenib in metastatic renal cell carcinoma patients treated in the community. PATIENTS & METHODS: Patients receiving first- or second-line single-agent sorafenib between January 2008 and December 2010 were eligible. Retrospective data collection started in 2012 and covers at least 1-year follow-up. The primary end point was overall survival (OS). RESULTS: Median OS was 17.2 months (95% CI: 15.5-19.6): 19.9 months (95% CI: 15.9-25.3) in patients treated with first-line sorafenib and 16.3 months (95% CI: 13.1-18.2) with second-line sorafenib. Overall median (95% CI) progression-free survival was 5.9 months (95% CI: 4.9-6.7): 6.6 (95% CI: 4.9-9.3) and 5.3 months (95% CI: 4.3-6.0) in first- and second-line patients, respectively. CONCLUSION: The efficacy and safety of sorafenib in routine community practice was generally good, especially in relation to OS in patients treated in the second line, where results were similar to those seen in recent prospective clinical trials.

Idiopathic intracranial hypertension: a possible complication in the natural history of advanced prostate cancer.

Idiopathic intracranial hypertension is a variety of intracranial hypertension that is extremely rare in men. Obesity and hypogonadism are the most important predictive factors. Etiological hypotheses include increased central venous pressure, and various hormonal and metabolic changes commonly found in obese patients. We described the case of an obese man with prostate cancer who showed a consistent bodyweight increase during treatment with taxanes and prednisone. He was hospitalized because of a severe loss of vision as a consequence of idiopathic intracranial hypertension. A complete symptom remission was obtained after 3 weeks of anti-edema therapies (steroids, acetazolamide). Castration-resistant prostate cancer is a risk factor for idiopathic intracranial hypertension. Long-term androgen deprivation therapy, bodyweight increase, and fluid retention during chronic steroid administration and taxane chemotherapy might favor the disease onset. This severe complication has a good outcome, and should be suspected in the presence of symptoms and signs of intracranial hypertension.

Vid2CAD: CAD Model Alignment Using Multi-View Constraints From Videos.

We address the task of aligning CAD models to a video sequence of a complex scene containing multiple objects. Our method can process arbitrary videos and fully automatically recover the 9 DoF pose for each object appearing in it, thus aligning them in a common 3D coordinate frame. The core idea of our method is to integrate neural network predictions from individual frames with a temporally global, multi-view constraint optimization formulation. This integration process resolves the scale and depth ambiguities in the per-frame predictions, and generally improves the estimate of all pose parameters. By leveraging multi-view constraints, our method also resolves occlusions and handles objects that are out of view in individual frames, thus reconstructing all objects into a single globally consistent CAD representation of the scene. In comparison to the state-of-the-art single-frame method Mask2CAD that we build on, we achieve substantial improvements on the Scan2CAD dataset (from 11.6% to 30.7% class average accuracy).

Flexible Passive Sensor Patch with Contactless Readout for Measurement of Human Body Temperature.

A passive flexible patch for human skin temperature measurement based on contact sensing and contactless interrogation is presented. The patch acts as an RLC resonant circuit embedding an inductive copper coil for magnetic coupling, a ceramic capacitor as the temperature-sensing element and an additional series inductor. The temperature affects the capacitance of the sensor and consequently the resonant frequency of the RLC circuit. Thanks to the additional inductor, the dependency of the resonant frequency from the bending of the patch has been reduced. Considering a curvature radius of the patch of up to 73 mm, the maximum relative variation in the resonant frequency has been reduced from 812 ppm to 7.5 ppm. The sensor has been contactlessly interrogated by a time-gated technique through an external readout coil electromagnetically coupled to the patch coil. The proposed system has been experimentally tested within the range of 32-46 °C, giving a sensitivity of -619.8 Hz/°C and a resolution of 0.06 °C.

Objective Evaluation of Active Interactions between the Operator and Display Screen Equipment Using an Innovative Acquisition System.

The occupational risk of operators using display screen equipment (DSE) is usually evaluated according to the extent of time spent in active operator-DSE interactions. Risk assessment is based on activity data collected through questionnaires. We evaluated an original and innovative system that can objectively assess active operator-DSE interactions by collecting electrical impulses generated by the activation of mouse, keyboard and a camera that collects attentive eye-screen fixation. The main aim of this study was to evaluate the system's performance on an employee sample involved in the task of active reading and copying at a DSE workstation connected to the system. In the context of mandatory health surveillance at work, we enrolled 38 DSE operators with normal neuropsychological and eye assessments who were required to complete two predefined reading and writing tasks. The obtained results show that the system is able to collect activity data derived from operator-DSE interactions through screen fixation, keyboard tapping and mouse handling. In the copying task, the session duration as recorded by the system was highly related to the screen fixation time. In the copying task, mouse and keyboard activities were more strongly related to session duration than screen fixation. For the copying task, it was also possible to obtain individual profiles of operator-DSE interactions while performing the same standardized tasks. Collected data can allow an objective evaluation of active time spent by DSE operators at their workstations, thus allowing a more accurate occupational health risk assessment and management. Prospective analysis of individual operator-DSE interaction profiles can favor the setup of targeted preventive and organizational interventions from an of even wider worker wellbeing perspective.

Precocious puberty under stressful conditions: new understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic.

Neuro-biological variations in the timing of sexual maturation within a species are part of an evolved strategy that depend on internal and external environmental conditions. An increased incidence of central precocious puberty (CPP) has been described in both adopted and "covid-19 pandemic" children. Until recently, it was hypothesised that the triggers for CPP in internationally adopted children were likely to be better nutrition, greater environmental stability, and improved psychological wellbeing. However, following data collected during and after the coronavirus (COVID-19) global pandemic, other possibilities must be considered. In a society with high levels of child wellbeing, the threat to life presented by an unknown and potentially serious disease and the stressful environment created by lockdowns and other public health measures could trigger earlier pubertal maturation as an evolutionary response to favour early reproduction. The main driver for increased rates of precocious and rapidly progressive puberty during the pandemic could have been the environment of "fear and stress" in schools and households. In many children, CPP may have been triggered by the psychological effects of living without normal social contact, using PPE, being near adults concerned about financial and other issues and the fear of getting ill. The features and time of progression of CPP in children during the pandemic are similar to those observed in adopted children. This review considers the mechanisms regulating puberty with a focus on neurobiological and evolutionary mechanisms, and analyses precocious puberty both during the pandemic and in internationally adopted children searching for common yet unconsidered factors in an attempt to identify the factors which may have acted as triggers. In particular, we focus on stress as a potential factor in the early activation of the hypothalamic-pituitary-gonadal axis and its correlation with rapid sexual maturation.