Wearable Sensors and Smart Devices to Monitor Rehabilitation Parameters and Sports Performance: An Overview.

A quantitative evaluation of kinetic parameters, the joint's range of motion, heart rate, and breathing rate, can be employed in sports performance tracking and rehabilitation monitoring following injuries or surgical operations. However, many of the current detection systems are expensive and designed for clinical use, requiring the presence of a physician and medical staff to assist users in the device's positioning and measurements. The goal of wearable sensors is to overcome the limitations of current devices, enabling the acquisition of a user's vital signs directly from the body in an accurate and non-invasive way. In sports activities, wearable sensors allow athletes to monitor performance and body movements objectively, going beyond the coach's subjective evaluation limits. The main goal of this review paper is to provide a comprehensive overview of wearable technologies and sensing systems to detect and monitor the physiological parameters of patients during post-operative rehabilitation and athletes' training, and to present evidence that supports the efficacy of this technology for healthcare applications. First, a classification of the human physiological parameters acquired from the human body by sensors attached to sensitive skin locations or worn as a part of garments is introduced, carrying important feedback on the user's health status. Then, a detailed description of the electromechanical transduction mechanisms allows a comparison of the technologies used in wearable applications to monitor sports and rehabilitation activities. This paves the way for an analysis of wearable technologies, providing a comprehensive comparison of the current state of the art of available sensors and systems. Comparative and statistical analyses are provided to point out useful insights for defining the best technologies and solutions for monitoring body movements. Lastly, the presented review is compared with similar ones reported in the literature to highlight its strengths and novelties.

Direct Scaling of Measure on Vortex Shedding through a Flapping Flag Device in the Open Channel around a Cylinder at Re∼103: Taylor's Law Approach.

The problem of vortex shedding, which occurs when an obstacle is placed in a regular flow, is governed by Reynolds and Strouhal numbers, known by dimensional analysis. The present work aims to propose a thin films-based device, consisting of an elastic piezoelectric flapping flag clamped at one end, in order to determine the frequency of vortex shedding downstream an obstacle for a flow field at Reynolds number Re∼103 in the open channel. For these values, Strouhal number obtained in such way is in accordance with the results known in literature. Moreover, the development of the voltage over time, generated by the flapping flag under the load due to flow field, shows a highly fluctuating behavior and satisfies Taylor's law, observed in several complex systems. This provided useful information about the flow field through the constitutive law of the device.

Nitride-Based Materials for Flexible MEMS Tactile and Flow Sensors in Robotics.

The response to different force load ranges and actuation at low energies is of considerable interest for applications of compliant and flexible devices undergoing large deformations. We present a review of technological platforms based on nitride materials (aluminum nitride and silicon nitride) for the microfabrication of a class of flexible micro-electro-mechanical systems. The approach exploits the material stress differences among the constituent layers of nitride-based (AlN/Mo, Si x N y /Si and AlN/polyimide) mechanical elements in order to create microstructures, such as upwardly-bent cantilever beams and bowed circular membranes. Piezoresistive properties of nichrome strain gauges and direct piezoelectric properties of aluminum nitride can be exploited for mechanical strain/stress detection. Applications in flow and tactile sensing for robotics are described.

[Murder. Italy-USA comparative profiles]. / L'omicidio. Profili comparatistici Italia-USA.

This paper, through illustrative cases of homicidal typologies, examines the generally accepted theories on the subject: 1) sociological ones by Lorenz to Sutherland and Cressey, by Berkowitz to Wolfgang and Ferracuti and others; 2) neurobiological ones, which include the involvement of the limbic, hippocampal and parietal lobes of the brain; 3) the psychological (psychodynamic) ones which are not disjoint from the types of individual criminal homicide and related aspects. In the discussion of the types of murders, family and extrafamilial murders are then taken into consideration, with the various meanings of revenge, challenge, other reasons linked to robbery, theft, settling scores leading to youth gangs and drive-by-shootings of marginalized adolescents, crimes related to drugs and to mental disorders. Infanticide and multiple murder, including mass murder and serial killer, conclude the work together with the statistics of murders and family murders in Italy compared to USA, specifically to the crime clock.

[Simulation of mental illness]. / Simulazione di malattia mentale.

The DSM-IV-TR defines the simulation an "intentional production of physical or psychological symptoms false or grossly exaggerated, motivated by external incentives". The first point to consider is that it has a near zero prevalence in the general population, occurring almost exclusively in people imprisoned, treated in Forensic Psychiatric Hospital, in individuals subjected to trial, or in personalities seen as deviated from a criminological point of view. Both the criteria to set diagnoses of simulation, previously examined by Foreal and Kaufman since 1943, and the relative suspicion indicators, not separated by 'reasons of simulated behavior, are taken into account. The work also addresses several other meanings of self injurious actions appointed by Bachler, as well as the associationist/mechanistic theories of the classical dynamic model and the differential diagnosis with other conditions of Psychiatric Interest and concludes with the topic of "Premeditation".

[Liability, moral consciousness and psychopatology. International comparative profiles]. / Imputabilità, coscienza morale e psicopatologia. Profili comparatistici internazionali.

The paper considers the concepts of intentionality, judgment, desire, awareness and the relative scientific, psychological, psychiatric and neurophysiological studies, including the concept of "moral consciousness" and the evolution of moral standards, marked out by Piaget and Kolberg. There are several references to a psychopathology point of view, for which mental infirmity is independent from the verification of an organic substrate and classification in official nosology (it is said, then, that "it is true that mental infirmity can exist even in the absence of a typical disease of the mind, framed in the scientific classification of mental illness, it is still necessary that a defect in part descended from a morbid state, dependent on a pathological changes in clinically ascertained" (as Cass, Sec. I, n. 9739/1997). The concept of illness, then widens to include not only the organic psychoses, but psychic morbid disorders such as psychopathy, neuroses, disorders of affect too: under investigation, therefore, it is no longer the person-body, but the person-psyche. In psychiatry there are existing guidelines which assert an "integrated model" of mental illness, able to explain mental disorder based on different explanatory hypotheses of its nature and origin: essentially consisting of "an integrated vision that takes into account all the variables, biological, psychological, social, relational, that come into play in causing the disease", in such a manner developing from the monocausal etiology of mental illness vision, to a "multifactorial integrated" conception.

[Some Italian research on the phenomenon of filicide]. / Alcune ricerche italiane sul fenomeno del figlicidio.

In this work on the phenomenon of filicide, structured on the basis of the examination of hundreds of cases from 1880 to 2010, the five causes were taken into account: the altruistic filicide, the high psychotic component, that of the unwanted child, accidental filicide, and the spouse revenge filicide. Following the observation of Resnick's (1969) 530 psycho-biographiesss, a more structured typing was developed which on the basis of their motive and/or psychopathology divides mother infanticide into 20 categories: the first 10 imply full imputability, stessor events, for piety, immaturity of the mother, hyperactivity of the child, the son of the blame, Medea syndrome, disturbance dependent, narcissistic, or histrionic personality, unwanted child, depression, behavioral disorders involved in the recruitment of drugs. The remaining 10 are those where there may be impairment of traceability for postpartum psychosis (Brief psychotic disorder), Fundus hysterical plus precipitating factors, major depression, schizophrenia, twilight state, psychotic disorder due to a general medical condition, epilepsy, oligophrenia, multiple sclerosis and multiple personality, which however appears to be quite rare. An examination of the causes of death concludes the work.

[The investigative and adversarial process in Italy and the United States]. / Il processo investigativo e accusatorio negli Stati Uniti d'America e in Italia.

The structure of the US legal system, which relies on the presence of different courts to provide for the impartial administration of justice, both civil and criminal is discussed. Therefore, all the steps to conviction or acquittal of the American criminal trial, are taken into consideration. However, there is the presumption of innocence of the accused and the prosecution must prove his guilt beyond any reasonable doubt. Another important procedure in the US trial is the jury selection (voir dire), 12 jurors: 6 for the defense and 6 for the prosecution. In Italy it was observed that the autonomy of the police would squeeze the steering function of the prosecutor, and the practice of "under cover" investigation has granted an extension of police activity.

[Stalking: clinical and criminological considerations through the results of a research contribution]. / Stalking: considerazioni clinico-criminologiche tramite i risultati di un contributo di ricerca.

Among the extensive results supplied by the psychiatric literature on the subject of stalking, few studies focus on the analysis of persecutory behaviors carried out against mental health professionals, who also identified as one of the most affected sample of victims. Particularly, for studies conducted in this way, further examination requires differentiation according to gender type into the social and personal characteristics of the authors' behavior patterns displayed towards the victims. Aim. To obtaine results by an epidemiological survey conducted in public and private psychiatric care structures in the city of Rome, to assess the incidence of the phenomenon as well as gender differences in behavior patterns practised out by the author for the two sample considered. Methods. Administration of a questionnaire to a sample make up by psychiatrists working in out-patient services for the Departments of Mental Health (ASL) of Rome and to a sample of psychiatrists who practise their professional activity in the private sector. Results. Regarding the incidence of the phenomenon, an increased presence has been found in private mental health care settings in comparison to the public service; regarding to the distribution of the phenomenon according to the sexual identity of the authors among the two samples analyzed, a statistical prevalence of female authors has been found in the sample of private sector. Discussion. The health's professionals, so much liable of victimization, are poorly formed on the phenomenon. So it's urgent to operate with integrated approaches (informative trainings; strengthening of administrative and clinical policies of the profession; multidimensional assessment).

Conformable AlN Piezoelectric Sensors as a Non-invasive Approach for Swallowing Disorder Assessment.

Deglutition disorders (dysphagia) are common symptoms of a large number of diseases and can lead to severe deterioration of the patient's quality of life. The clinical evaluation of this problem involves an invasive screening, whose results are subjective and do not provide a precise and quantitative assessment. To overcome these issues, alternative possibilities based on wearable technologies have been proposed. We explore the use of ultrathin, compliant, and flexible piezoelectric patches that are able to convert the laryngeal movement into a well-defined electrical signal, with extremely low anatomical obstruction and high strain resolution. The sensor is based on an aluminum nitride thin film, grown on a soft Kapton substrate, integrated with an electrical charge amplifier and low-power, wireless connection to a smartphone. An ad-hoc designed laryngeal motion simulator (LMS), which is able to mimic the motions of the laryngeal prominence, was used to evaluate its performances. The physiological deglutition waveforms were then extrapolated on a healthy volunteer and compared with the sEMG (surface electromyography) of the submental muscles. Finally, different tests were conducted to assess the ability of the sensor to provide clinically relevant information. The reliability of these features permits an unbiased evaluation of the swallowing ability, paving the way to the creation of a system that is able to provide a point-of-care automatic, unobtrusive, and real-time extrapolation of the patient's swallowing quality even during normal behavior.

Piezoelectricity and Biocompatibility of Flexible ScxAl(1-x)N Thin Films for Compliant MEMS Transducers.

There is huge research activity in the development of flexible and biocompatible piezoelectric materials for next-generation compliant micro electro-mechanical systems (MEMS) transducers to be exploited in wearable devices and implants. This work reports for the first time on the development of flexible ScxAl(1-x)N films deposited by sputtering technique onto polyimide substrates, assessing their piezoelectricity and biocompatibility. Flexible ScxAl(1-x)N films have been analyzed in terms of morphological, structural, and piezoelectric properties. ScxAl(1-x)N layer exhibits a good surface roughness of 4.40 nm and moderate piezoelectricity with an extracted effective piezoelectric coefficient (d33eff) value of 1.87 ± 0.06 pm/V, in good agreement with the diffraction pattern analysis results. Cell viability assay, performed to study the interaction of the ScxAl(1-x)N films with human cell lines, shows that this material does not have significant effects on tested cells. Furthermore, the ScxAl(1-x)N layer, integrated onto a flexible device and analyzed by bending/unbending measurements, shows a peak-to-peak open-circuit voltage (VOC) of 0.32 V and a short-circuit current (ISC) of 0.27 µA, with a generated power of 19.28 nW under optimal resistive load, thus demonstrating the potential of flexible ScxAl(1-x)N films as active layers for next-generation wearable/implantable piezoelectrics.

Reliability of Protective Coatings for Flexible Piezoelectric Transducers in Aqueous Environments.

Electronic devices used for marine applications suffer from several issues that can compromise their performance. In particular, water absorption and permeation can lead to the corrosion of metal parts or short-circuits. The added mass due to the absorbed water affects the inertia and durability of the devices, especially for flexible and very thin micro-systems. Furthermore, the employment of such delicate devices underwater is unavoidably subjected to the adhesion of microorganisms and formation of biofilms that limit their reliability. Thus, the demand of waterproofing solutions has increased in recent years, focusing on more conformal, flexible and insulating coatings. This work introduces an evaluation of different polymeric coatings (parylene-C, poly-dimethyl siloxane (PDMS), poly-methyl methacrylate (PMMA), and poly-(vinylidene fluoride) (PVDF)) aimed at increasing the reliability of piezoelectric flexible microdevices used for sensing water motions or for scavenging wave energy. Absorption and corrosion tests showed that Parylene-C, while susceptible to micro-cracking during prolonged oscillating cycles, exhibits the best anti-corrosive behavior. Parylene-C was then treated with oxygen plasma and UV/ozone for modifying the surface morphology in order to evaluate the biofilm formation with different surface conditions. A preliminary characterization through a laser Doppler vibrometer allowed us to detect a reduction in the biofilm mass surface density after 35 days of exposure to seawater.

[Family communication and primary prevention]. / Comunicazione in famiglia e prevenzione primaria.

A good communication within the family is the basis for the primary prevention of discomfort and deviance. With the aim of prevention of the frequent acts of violence within the family, the present article responds to the request of behavioural guidelines in schools, families, communities, and other pedagogical settings. Thus, the delicate issue of self-esteem in adolescents, the dysfunctional parental behaviour and the symptoms of discomfort of the teenagers are discussed. Besides the behavioural strategies for parents, the hot topic of alcohol abuse, which is cause of a significant number of car accidents, is briefly mentioned.

Stalking of psychiatrists: psychopathological characteristics and gender differences in an Italian sample.

Research has indicated that medical doctors and paramedics are at higher risk of being stalked than the general population. In particular, mental health care professionals alone represent one third of the victims of harassment. Because of the lack of studies in this specific sector, especially in Italy, in this study, we examined the stalking of psychiatrists by their patients, considering gender differences and the incidence of stalking in private practice and public mental health clinics in Rome. We found that the rate of stalking in private mental health settings is higher than that in public settings and that the perpetrators of stalking are mainly women who mostly target mental health professionals working in private practice. Implications of the findings are noted and discussed.