5 resultados para Democratic innovations
em AMS Tesi di Dottorato - Alm@DL - Università di Bologna
Resumo:
The treatment of the Cerebral Palsy (CP) is considered as the “core problem” for the whole field of the pediatric rehabilitation. The reason why this pathology has such a primary role, can be ascribed to two main aspects. First of all CP is the form of disability most frequent in childhood (one new case per 500 birth alive, (1)), secondarily the functional recovery of the “spastic” child is, historically, the clinical field in which the majority of the therapeutic methods and techniques (physiotherapy, orthotic, pharmacologic, orthopedic-surgical, neurosurgical) were first applied and tested. The currently accepted definition of CP – Group of disorders of the development of movement and posture causing activity limitation (2) – is the result of a recent update by the World Health Organization to the language of the International Classification of Functioning Disability and Health, from the original proposal of Ingram – A persistent but not unchangeable disorder of posture and movement – dated 1955 (3). This definition considers CP as a permanent ailment, i.e. a “fixed” condition, that however can be modified both functionally and structurally by means of child spontaneous evolution and treatments carried out during childhood. The lesion that causes the palsy, happens in a structurally immature brain in the pre-, peri- or post-birth period (but only during the firsts months of life). The most frequent causes of CP are: prematurity, insufficient cerebral perfusion, arterial haemorrhage, venous infarction, hypoxia caused by various origin (for example from the ingestion of amniotic liquid), malnutrition, infection and maternal or fetal poisoning. In addition to these causes, traumas and malformations have to be included. The lesion, whether focused or spread over the nervous system, impairs the whole functioning of the Central Nervous System (CNS). As a consequence, they affect the construction of the adaptive functions (4), first of all posture control, locomotion and manipulation. The palsy itself does not vary over time, however it assumes an unavoidable “evolutionary” feature when during growth the child is requested to meet new and different needs through the construction of new and different functions. It is essential to consider that clinically CP is not only a direct expression of structural impairment, that is of etiology, pathogenesis and lesion timing, but it is mainly the manifestation of the path followed by the CNS to “re”-construct the adaptive functions “despite” the presence of the damage. “Palsy” is “the form of the function that is implemented by an individual whose CNS has been damaged in order to satisfy the demands coming from the environment” (4). Therefore it is only possible to establish general relations between lesion site, nature and size, and palsy and recovery processes. It is quite common to observe that children with very similar neuroimaging can have very different clinical manifestations of CP and, on the other hand, children with very similar motor behaviors can have completely different lesion histories. A very clear example of this is represented by hemiplegic forms, which show bilateral hemispheric lesions in a high percentage of cases. The first section of this thesis is aimed at guiding the interpretation of CP. First of all the issue of the detection of the palsy is treated from historical viewpoint. Consequently, an extended analysis of the current definition of CP, as internationally accepted, is provided. The definition is then outlined in terms of a space dimension and then of a time dimension, hence it is highlighted where this definition is unacceptably lacking. The last part of the first section further stresses the importance of shifting from the traditional concept of CP as a palsy of development (defect analysis) towards the notion of development of palsy, i.e., as the product of the relationship that the individual however tries to dynamically build with the surrounding environment (resource semeiotics) starting and growing from a different availability of resources, needs, dreams, rights and duties (4). In the scientific and clinic community no common classification system of CP has so far been universally accepted. Besides, no standard operative method or technique have been acknowledged to effectively assess the different disabilities and impairments exhibited by children with CP. CP is still “an artificial concept, comprising several causes and clinical syndromes that have been grouped together for a convenience of management” (5). The lack of standard and common protocols able to effectively diagnose the palsy, and as a consequence to establish specific treatments and prognosis, is mainly because of the difficulty to elevate this field to a level based on scientific evidence. A solution aimed at overcoming the current incomplete treatment of CP children is represented by the clinical systematic adoption of objective tools able to measure motor defects and movement impairments. A widespread application of reliable instruments and techniques able to objectively evaluate both the form of the palsy (diagnosis) and the efficacy of the treatments provided (prognosis), constitutes a valuable method able to validate care protocols, establish the efficacy of classification systems and assess the validity of definitions. Since the ‘80s, instruments specifically oriented to the analysis of the human movement have been advantageously designed and applied in the context of CP with the aim of measuring motor deficits and, especially, gait deviations. The gait analysis (GA) technique has been increasingly used over the years to assess, analyze, classify, and support the process of clinical decisions making, allowing for a complete investigation of gait with an increased temporal and spatial resolution. GA has provided a basis for improving the outcome of surgical and nonsurgical treatments and for introducing a new modus operandi in the identification of defects and functional adaptations to the musculoskeletal disorders. Historically, the first laboratories set up for gait analysis developed their own protocol (set of procedures for data collection and for data reduction) independently, according to performances of the technologies available at that time. In particular, the stereophotogrammetric systems mainly based on optoelectronic technology, soon became a gold-standard for motion analysis. They have been successfully applied especially for scientific purposes. Nowadays the optoelectronic systems have significantly improved their performances in term of spatial and temporal resolution, however many laboratories continue to use the protocols designed on the technology available in the ‘70s and now out-of-date. Furthermore, these protocols are not coherent both for the biomechanical models and for the adopted collection procedures. In spite of these differences, GA data are shared, exchanged and interpreted irrespectively to the adopted protocol without a full awareness to what extent these protocols are compatible and comparable with each other. Following the extraordinary advances in computer science and electronics, new systems for GA no longer based on optoelectronic technology, are now becoming available. They are the Inertial and Magnetic Measurement Systems (IMMSs), based on miniature MEMS (Microelectromechanical systems) inertial sensor technology. These systems are cost effective, wearable and fully portable motion analysis systems, these features gives IMMSs the potential to be used both outside specialized laboratories and to consecutive collect series of tens of gait cycles. The recognition and selection of the most representative gait cycle is then easier and more reliable especially in CP children, considering their relevant gait cycle variability. The second section of this thesis is focused on GA. In particular, it is firstly aimed at examining the differences among five most representative GA protocols in order to assess the state of the art with respect to the inter-protocol variability. The design of a new protocol is then proposed and presented with the aim of achieving gait analysis on CP children by means of IMMS. The protocol, named ‘Outwalk’, contains original and innovative solutions oriented at obtaining joint kinematic with calibration procedures extremely comfortable for the patients. The results of a first in-vivo validation of Outwalk on healthy subjects are then provided. In particular, this study was carried out by comparing Outwalk used in combination with an IMMS with respect to a reference protocol and an optoelectronic system. In order to set a more accurate and precise comparison of the systems and the protocols, ad hoc methods were designed and an original formulation of the statistical parameter coefficient of multiple correlation was developed and effectively applied. On the basis of the experimental design proposed for the validation on healthy subjects, a first assessment of Outwalk, together with an IMMS, was also carried out on CP children. The third section of this thesis is dedicated to the treatment of walking in CP children. Commonly prescribed treatments in addressing gait abnormalities in CP children include physical therapy, surgery (orthopedic and rhizotomy), and orthoses. The orthotic approach is conservative, being reversible, and widespread in many therapeutic regimes. Orthoses are used to improve the gait of children with CP, by preventing deformities, controlling joint position, and offering an effective lever for the ankle joint. Orthoses are prescribed for the additional aims of increasing walking speed, improving stability, preventing stumbling, and decreasing muscular fatigue. The ankle-foot orthosis (AFO), with a rigid ankle, are primarily designed to prevent equinus and other foot deformities with a positive effect also on more proximal joints. However, AFOs prevent the natural excursion of the tibio-tarsic joint during the second rocker, hence hampering the natural leaning progression of the whole body under the effect of the inertia (6). A new modular (submalleolar) astragalus-calcanear orthosis, named OMAC, has recently been proposed with the intention of substituting the prescription of AFOs in those CP children exhibiting a flat and valgus-pronated foot. The aim of this section is thus to present the mechanical and technical features of the OMAC by means of an accurate description of the device. In particular, the integral document of the deposited Italian patent, is provided. A preliminary validation of OMAC with respect to AFO is also reported as resulted from an experimental campaign on diplegic CP children, during a three month period, aimed at quantitatively assessing the benefit provided by the two orthoses on walking and at qualitatively evaluating the changes in the quality of life and motor abilities. As already stated, CP is universally considered as a persistent but not unchangeable disorder of posture and movement. Conversely to this definition, some clinicians (4) have recently pointed out that movement disorders may be primarily caused by the presence of perceptive disorders, where perception is not merely the acquisition of sensory information, but an active process aimed at guiding the execution of movements through the integration of sensory information properly representing the state of one’s body and of the environment. Children with perceptive impairments show an overall fear of moving and the onset of strongly unnatural walking schemes directly caused by the presence of perceptive system disorders. The fourth section of the thesis thus deals with accurately defining the perceptive impairment exhibited by diplegic CP children. A detailed description of the clinical signs revealing the presence of the perceptive impairment, and a classification scheme of the clinical aspects of perceptual disorders is provided. In the end, a functional reaching test is proposed as an instrumental test able to disclosure the perceptive impairment. References 1. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002 Set;44(9):633-640. 2. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005 Ago;47(8):571-576. 3. Ingram TT. A study of cerebral palsy in the childhood population of Edinburgh. Arch. Dis. Child. 1955 Apr;30(150):85-98. 4. Ferrari A, Cioni G. The spastic forms of cerebral palsy : a guide to the assessment of adaptive functions. Milan: Springer; 2009. 5. Olney SJ, Wright MJ. Cerebral Palsy. Campbell S et al. Physical Therapy for Children. 2nd Ed. Philadelphia: Saunders. 2000;:533-570. 6. Desloovere K, Molenaers G, Van Gestel L, Huenaerts C, Van Campenhout A, Callewaert B, et al. How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study. Gait Posture. 2006 Ott;24(2):142-151.
Resumo:
The present work is a collection of three essays devoted at understanding the determinants and implications of the adoption of environmental innovations EI by firms, by adopting different but strictly related schumpeterian perspectives. Each of the essays is an empirical analysis that investigates one original research question, formulated to properly fill the gaps that emerged in previous literature, as the broad introduction of this thesis outlines. The first Chapter is devoted at understanding the determinants of EI by focusing on the role that knowledge sources external to the boundaries of the firm, such as those coming from business suppliers or customers or even research organizations, play in spurring their adoption. The second Chapter answers the question on what induces climate change technologies, adopting regional and sectoral lens, and explores the relation among green knowledge generation, inducement in climate change and environmental performances. Chapter 3 analyzes the economic implications of the adoption of EI for firms, and proposes to disentangle EI by different typologies of innovations, such as externality reducing innovations and energy and resource efficient innovations. Each Chapter exploits different dataset and heterogeneous econometric models, that allow a better extension of the results and to overcome the limits that the choice of one dataset with respect to its alternatives engenders. The first and third Chapter are based on an empirical investigation on microdata, i.e. firm level data extracted from innovation surveys. The second Chapter is based on the analysis of patent data in green technologies that have been extracted by the PATSTAT and REGPAT database. A general conclusive Chapter will follow the three essays and will outline how each Chapter filled the research gaps that emerged, how its results can be interpreted, which policy implications can be derived and which are the possible future lines of research in the field.
Resumo:
This dissertation looks at three widely accepted assumptions about how the patent system works: patent documents disclose inventions; this disclosure happens quickly, and patent owners are able to enforce patents. The first chapter estimates the effect of stronger trade secret protection on the number of patented innovations. When firms find it easier to protect business information, there is less need for patent protection, and accordingly less need for the disclosure of technical information that is required by patent law. The novel finding is that when it is easier to keep innovations, there is not only a reduction in the number of patents but also a sizeable reduction in disclosed knowledge per patent. The chapter then shows how this endogeneity of the amount of knowledge per patent can affect the measurement of innovation using patent data. The second chapter develops a game-theoretic model to study how the introduction of fee-shifting in US patent litigation would influence firms’ patenting propensities. When the defeated party to a lawsuit has to bear not only their own cost but also the legal expenditure of the winning party, manufacturing firms in the model unambiguously reduce patenting, with small firms affected the most. For fee-shifting to have the same effect as in Europe, the US legal system would require shifting of a much smaller share of fees. Lessons from European patent litigation may, therefore, have only limited applicability in the US case. The third chapter contains a theoretical analysis of the influence of delayed disclosure of patent applications by the patent office. Such a delay is a feature of most patent systems around the world but has so far not attracted analytical scrutiny. This delay may give firms various kinds of strategic (non-)disclosure incentives when they are competing for more than a single innovation.
Resumo:
Since the turn of the century, fisheries have maintained a steady growth rate, while aquaculture has experienced a more rapid expansion. Aquaculture can offer EU consumers more diverse, healthy, and sustainable food options, some of which are more popular elsewhere. To develop the sector, the EU is investing heavily. The EU supports innovative projects that promote the sustainable development of seafood sectors and food security. Priority 3 promotes sector development through innovation dissemination. This doctoral dissertation examined innovation transfer in the Italian aquaculture sector, specifically the adoption of innovative tools, using a theoretical model to better understand the complexity of these processes. The work focused on innovation adoption, emphasising that it is the end of a well-defined process. The Awareness Knowledge Adoption Implementation Effectiveness (AKAIE) model was created to better analyse post-adoption phases and evaluate technology adoption implementation and impact. To identify AKAIE drivers and barriers, aquaculture actors were consulted. "Perceived complexity"—barriers to adoption that are strongly influenced by contextual factors—has been used to examine their perspectives (i.e. socio-economic, institutional, cultural ones). The new model will contextualise the sequence based on technologies, entrepreneur traits, corporate and institutional contexts, and complexity perception, the sequence's central node. Technology adoption can also be studied by examining complexity perceptions along the AKAIE sequence. This study proposes a new model to evaluate the diffusion of a given technology, offering the policy maker the possibility to be able to act promptly across the process. The development of responsible policies for evaluating the effectiveness of innovation is more necessary than ever, especially to orient strategies and interventions in the face of major scenarios of change.
Resumo:
My PhD research focused on the development of environmentally sustainable methods for peptide synthesis. The traditional and toxic solvents and bases used in solid-phase peptide synthesis (SPPS) were replaced with eco-friendly alternatives to reduce the environmental impact. In particular, N-octylpyrrolidone was found to be an effective green solvent in combination with dimethyl carbonate, resulting in a 63-66% reduction in process mass intensity (PMI). In addition, a green base, DEAPA, was identified for Fmoc removal, which showed comparable results to piperidine, while being less regulated and toxic, and able to better control aspartimide-related side reactions. The study extended beyond SPPS to explore liquid-phase peptide synthesis (LPPS) and solution-phase peptide synthesis (SolPPS) using propylphosphonic anhydride (T3P®) as a coupling reagent. The developed green SolPPS using Cbz amino acids achieved exceptional efficiency, minimal racemisation and a PMI of 30 to introduce a single amino acid in the iterative process. This PMI value is the lowest ever reported for an oligopeptide synthesis protocol. This technique was extended to N-Boc amino acids in DCM, requiring aqueous workups and achieving 95% purity of Leu-Enkephalin. Finally, T3P® was found to be suitable for LPPS. An anchor, mimicking a resin, was used to allow precipitation or solubilisation of the growing anchored-peptide, depending on the polarity of the solvent used. Anisole and DCM resulted in a pentapeptide purity of over 95%. While at Oxford University, I synthesized a cleavable fragment that is sensitive to cathepsin B (CatB) and incorporated it into a cyclic antisense oligonucleotide (ASO) targeting the metastasis-associated lung adenocarcinoma transcript 1 (MALAT1). ASO demonstrated good stability in a simulated in vivo environment using human serum and high affinity with complementary RNA. The Cyclic-ASO was opened by CatB in optimal conditions. Experiments highlight therapeutic potential and a novel method for controlling cyclic oligonucleotide activity, potentially enhancing cellular uptake.