mHealth-based Methods for Neuromotor Assessment and Rehabilitation

Recent years observed massive growth in wearable technology, everything can be smart: phones, watches, glasses, shirts, etc. These technologies are prevalent in various fields: from wellness/sports/fitness to the healthcare domain. The spread of this phenomenon led the World-Health-Organization to define the term 'mHealth' as "medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices". Furthermore, mHealth solutions are suitable to perform real-time wearable Biofeedback (BF) systems: sensors in the body area network connected to a processing unit (smartphone) and a feedback device (loudspeaker) to measure human functions and return them to the user as (bio)feedback signal. During the COVID-19 pandemic, this transformation of the healthcare system has been dramatically accelerated by new clinical demands, including the need to prevent hospital surges and to assure continuity of clinical care services, allowing pervasive healthcare. Never as of today, we can say that the integration of mHealth technologies will be the basis of this new era of clinical practice. In this scenario, this PhD thesis's primary goal is to investigate new and innovative mHealth solutions for the Assessment and Rehabilitation of different neuromotor functions and diseases. For the clinical assessment, there is the need to overcome the limitations of subjective clinical scales. Creating new pervasive and self-administrable mHealth solutions, this thesis investigates the possibility of employing innovative systems for objective clinical evaluation. For rehabilitation, we explored the clinical feasibility and effectiveness of mHealth systems. In particular, we developed innovative mHealth solutions with BF capability to allow tailored rehabilitation. The main goal that a mHealth-system should have is improving the person's quality of life, increasing or maintaining his autonomy and independence. To this end, inclusive design principles might be crucial, next to the technical and technological ones, to improve mHealth-systems usability.

Dithienopyrrole-based materials: development of new polymeric derivatives

The possibility to control molar mass and termination of the growing chain is fundamental to create well-defined, reproducible materials. For this reason, in order to apply polydithienopyrrole (PDTP) as organic conjugated polymer, the possibility of controlled polymerization needs to be verified. Another aspect that is still not completely explored is bound to the optical activity of the PDTP, which bearing appropriate substituents may adopt a helical conformation. The configuration of the helix, built up from achiral co-monomers, can be established in an enantiopure way by using only a small percentage of the chiral monomer co-polymerized with achiral co-monomer. The effect, called “sergeants and soldiers effect”, is expressed by the nonlinear increase of the chiral response vs the ratio of the chiral co-monomer used for the polymerization. To date, this effect is still not completely explored for PDTP. In this framework the project will investigate, firstly, the possibility to obtain a controlled polymerization of PDTP. Then, monomers with different side chains and organometallic functions will be screened for a CTCP-type polymerization. Also a Lewis-acid based cationic polymerization will be performed. Moreover the chemical derivatization of dithienopyrrole DTP is explored: the research is going to concern also block copolymers, built up by DTP and monomers of different nature. The research will be extended also to the investigation of optically active derivates of PDTP, using a chiral monomer for the synthesis. The possibility to develop a supramolecular distribution of the polymeric chains, together with the “sergeants and soldiers effect” will be checked investigating a series of polymers with increasing amounts of chiral monomer.

Sensor networks optimization and software development for Structural Health Monitoring based on ultrasonic guided waves

The Structural Health Monitoring (SHM) research area is increasingly investigated due to its high potential in reducing the maintenance costs and in ensuring the systems safety in several industrial application fields. A growing demand of new SHM systems, permanently embedded into the structures, for savings in weight and cabling, comes from the aeronautical and aerospace application fields. As consequence, the embedded electronic devices are to be wirelessly connected and battery powered. As result, a low power consumption is requested. At the same time, high performance in defects or impacts detection and localization are to be ensured to assess the structural integrity. To achieve these goals, the design paradigms can be changed together with the associate signal processing. The present thesis proposes design strategies and unconventional solutions, suitable both for real-time monitoring and periodic inspections, relying on piezo-transducers and Ultrasonic Guided Waves. In the first context, arrays of closely located sensors were designed, according to appropriate optimality criteria, by exploiting sensors re-shaping and optimal positioning, to achieve improved damages/impacts localisation performance in noisy environments. An additional sensor re-shaping procedure was developed to tackle another well-known issue which arises in realistic scenario, namely the reverberation. A novel sensor, able to filter undesired mechanical boundaries reflections, was validated via simulations based on the Green's functions formalism and FEM. In the active SHM context, a novel design methodology was used to develop a single transducer, called Spectrum-Scanning Acoustic Transducer, to actively inspect a structure. It can estimate the number of defects and their distances with an accuracy of 2[cm]. It can also estimate the damage angular coordinate with an equivalent mainlobe aperture of 8[deg], when a 24[cm] radial gap between two defects is ensured. A suitable signal processing was developed in order to limit the computational cost, allowing its use with embedded electronic devices.

On the effect of confounding in linear regression models: an approach based on the theory of quadratic forms

The main topic of this thesis is confounding in linear regression models. It arises when a relationship between an observed process, the covariate, and an outcome process, the response, is influenced by an unmeasured process, the confounder, associated with both. Consequently, the estimators for the regression coefficients of the measured covariates might be severely biased, less efficient and characterized by misleading interpretations. Confounding is an issue when the primary target of the work is the estimation of the regression parameters. The central point of the dissertation is the evaluation of the sampling properties of parameter estimators. This work aims to extend the spatial confounding framework to general structured settings and to understand the behaviour of confounding as a function of the data generating process structure parameters in several scenarios focusing on the joint covariate-confounder structure. In line with the spatial statistics literature, our purpose is to quantify the sampling properties of the regression coefficient estimators and, in turn, to identify the most prominent quantities depending on the generative mechanism impacting confounding. Once the sampling properties of the estimator conditionally on the covariate process are derived as ratios of dependent quadratic forms in Gaussian random variables, we provide an analytic expression of the marginal sampling properties of the estimator using Carlson’s R function. Additionally, we propose a representative quantity for the magnitude of confounding as a proxy of the bias, its first-order Laplace approximation. To conclude, we work under several frameworks considering spatial and temporal data with specific assumptions regarding the covariance and cross-covariance functions used to generate the processes involved. This study allows us to claim that the variability of the confounder-covariate interaction and of the covariate plays the most relevant role in determining the principal marker of the magnitude of confounding.

Seemingly unrelated linear regression for contaminated data based on Gaussian mixtures

In this thesis, new classes of models for multivariate linear regression defined by finite mixtures of seemingly unrelated contaminated normal regression models and seemingly unrelated contaminated normal cluster-weighted models are illustrated. The main difference between such families is that the covariates are treated as fixed in the former class of models and as random in the latter. Thus, in cluster-weighted models the assignment of the data points to the unknown groups of observations depends also by the covariates. These classes provide an extension to mixture-based regression analysis for modelling multivariate and correlated responses in the presence of mild outliers that allows to specify a different vector of regressors for the prediction of each response. Expectation-conditional maximisation algorithms for the calculation of the maximum likelihood estimate of the model parameters have been derived. As the number of free parameters incresases quadratically with the number of responses and the covariates, analyses based on the proposed models can become unfeasible in practical applications. These problems have been overcome by introducing constraints on the elements of the covariance matrices according to an approach based on the eigen-decomposition of the covariance matrices. The performances of the new models have been studied by simulations and using real datasets in comparison with other models. In order to gain additional flexibility, mixtures of seemingly unrelated contaminated normal regressions models have also been specified so as to allow mixing proportions to be expressed as functions of concomitant covariates. An illustration of the new models with concomitant variables and a study on housing tension in the municipalities of the Emilia-Romagna region based on different types of multivariate linear regression models have been performed.

Fluorogenic hyaluronan-based probe: characterization and use in advanced microscopy

Among all, the application of nanomaterials in biomedical research and most recently in the environmental one has opened the fields of nanomedicine and nanoremediation. Sensing methods based on fluorescence optical probe are generally requested for their selectivity, sensitivity. However, most imaging methods in literature rely on a fluorescent covalent labelling of the system. Therefore, the main aim of this project was to synthetise a biocompatible fluorogenic hyaluronan probe (HA) polymer functionalised with a rhomadine B (RB) moieties and study its behaviour as an optical probe with different materials with microscopy techniques. A derivatization of HA with RB (HA-RB) was successfully obtained providing a photophysical characterization showing a particular fluorescence mechanism of the probe. Firstly, we tested the interaction with different lab-grade micro and nanoplastics in water. Thanks to the peculiar photophysical behaviour of the probe nanoplastics can be detected with confocal microscopy and more interestingly their nature can be discriminated based on the fluorescence lifetime decay with FLIM microscopy. After, the interaction of a model plant derived metabolic enzyme GAPC1 undergoing oxidative-triggered aggregation was explored with the HA-RB. We highlighted the probe interaction with the protein even at early stage of the kinetic. Moreover, nanoparticle tracking analysis (NTA) experiment demonstrates that the probe is in fact able to interact with the small pre-aggregates in the early stage of the aggregation kinetic. Ultimately, we focused on the possibility to apply the probe in a super resolution microscopy technique, PALM, exploiting its aspecific interaction to characterize the surface topography of PTFE polydisperse microplastics. Optimal conditions were reached at high concentration of the probe (70 nM) where 0.5-5 nM is always advisable for this technique. Thanks to the polymeric nature and fluorescence mechanism of the probe, this technique was able to reveal features of PTFE surface under the diffraction limit (< 250 nm).

Multiscale modeling of light-harvesting systems based on rhodamine B aggregates

Rhodamine B (RB) has been successfully exploited in the synthesis of light harvesting systems, but since RB is prone to form dimers acting as quenchers for the fluorescence, high energy transfer efficiencies can be reached only when using bulky and hydrophobic counterions acting as spacers between RBs. In this PhD thesis, a multiscale theoretical study aimed at providing insights into the structural, photophysical and optical properties of RB and its aggregates is presented. At the macroscopic level (no atomistic details) a phenomenological model describing the fluorescence decay of RB networks in presence of both quenching from dimers and exciton-exciton annihiliation is presented and analysed, showing that the quenching from dimers affects the decay only at long times, a feature that can be exploited in global fitting analysis to determine relevant chemical and photophysical information. At the mesoscopic level (atomistic details but no electronic structure) the RB aggregation in water in presence of different counterions is studied with molecular dynamics (MD) simulations. A new force field has been parametrized for describing the RB flexibility and the RB-RB interaction driving the dimerization. Simulations correctly predict the RB/counterion aggregation only in presence of bulky and hydrophobic counterion and its ability to prevent the dimerization. Finally, at the microscopic level, DFT calculations are performed to demonstrate the spacing action of bulky counterions, but standard TDDFT calculations are showed to fail in correctly describing the excited states of RB and its dimers. Moreover, also standard procedures proposed in literature for obtaining ad hoc functionals are showed to not work properly. A detailed analysis on the effect of the exact exchange shows that its short-range contribution is the crucial quantity for ameliorating results, and a new functional containing a proper amount of such an exchange is proposed and successfully tested.

Modelling and classification with quantile-based distributions

In this work, we explore and demonstrate the potential for modeling and classification using quantile-based distributions, which are random variables defined by their quantile function. In the first part we formalize a least squares estimation framework for the class of linear quantile functions, leading to unbiased and asymptotically normal estimators. Among the distributions with a linear quantile function, we focus on the flattened generalized logistic distribution (fgld), which offers a wide range of distributional shapes. A novel naïve-Bayes classifier is proposed that utilizes the fgld estimated via least squares, and through simulations and applications, we demonstrate its competitiveness against state-of-the-art alternatives. In the second part we consider the Bayesian estimation of quantile-based distributions. We introduce a factor model with independent latent variables, which are distributed according to the fgld. Similar to the independent factor analysis model, this approach accommodates flexible factor distributions while using fewer parameters. The model is presented within a Bayesian framework, an MCMC algorithm for its estimation is developed, and its effectiveness is illustrated with data coming from the European Social Survey. The third part focuses on depth functions, which extend the concept of quantiles to multivariate data by imposing a center-outward ordering in the multivariate space. We investigate the recently introduced integrated rank-weighted (IRW) depth function, which is based on the distribution of random spherical projections of the multivariate data. This depth function proves to be computationally efficient and to increase its flexibility we propose different methods to explicitly model the projected univariate distributions. Its usefulness is shown in classification tasks: the maximum depth classifier based on the IRW depth is proven to be asymptotically optimal under certain conditions, and classifiers based on the IRW depth are shown to perform well in simulated and real data experiments.

Graphene-based bioelectronic interfaces and devices and interpretative models targeting glial cells

Bioelectronic interfaces have significantly advanced in recent years, offering potential treatments for vision impairments, spinal cord injuries, and neurodegenerative diseases. However, the classical neurocentric vision drives the technological development toward neurons. Emerging evidence highlights the critical role of glial cells in the nervous system. Among them, astrocytes significantly influence neuronal networks throughout life and are implicated in several neuropathological states. Although they are incapable to fire action potentials, astrocytes communicate through diverse calcium (Ca2+) signalling pathways, crucial for cognitive functions and brain blood flow regulation. Current bioelectronic devices are primarily designed to interface neurons and are unsuitable for studying astrocytes. Graphene, with its unique electrical, mechanical and biocompatibility properties, has emerged as a promising neural interface material. However, its use as electrode interface to modulate astrocyte functionality remains unexplored. The aim of this PhD work was to exploit Graphene-oxide (GO) and reduced GO (rGO)-coated electrodes to control Ca2+ signalling in astrocytes by electrical stimulation. We discovered that distinct Ca2+dynamics in astrocytes can be evoked, in vitro and in brain slices, depending on the conductive/insulating properties of rGO/GO electrodes. Stimulation by rGO electrodes induces intracellular Ca2+ response with sharp peaks of oscillations (“P-type”), exclusively due to Ca2+ release from intracellular stores. Conversely, astrocytes stimulated by GO electrodes show slower and sustained Ca2+ response (“S-type”), largely mediated by external Ca2+ influx through specific ion channels. Astrocytes respond faster than neurons and activate distinct G-Protein Coupled Receptor intracellular signalling pathways. We propose a resistive/insulating model, hypothesizing that the different conductivity of the substrate influences the electric field at the cell/electrolyte or cell/material interfaces, favouring, respectively, the Ca2+ release from intracellular stores or the extracellular Ca2+ influx. This research provides a simple tool to selectively control distinct Ca2+ signals in brain astrocytes in neuroscience and bioelectronic medicine.

A Distributed Support based on Kubeflow to Ease MLOps of Federated Learning Algorithms

The main objective of my thesis work is to exploit the Google native and open-source platform Kubeflow, specifically using Kubeflow pipelines, to execute a Federated Learning scalable ML process in a 5G-like and simplified test architecture hosting a Kubernetes cluster and apply the largely adopted FedAVG algorithm and FedProx its optimization empowered by the ML platform ‘s abilities to ease the development and production cycle of this specific FL process. FL algorithms are more are and more promising and adopted both in Cloud application development and 5G communication enhancement through data coming from the monitoring of the underlying telco infrastructure and execution of training and data aggregation at edge nodes to optimize the global model of the algorithm ( that could be used for example for resource provisioning to reach an agreed QoS for the underlying network slice) and after a study and a research over the available papers and scientific articles related to FL with the help of the CTTC that suggests me to study and use Kubeflow to bear the algorithm we found out that this approach for the whole FL cycle deployment was not documented and may be interesting to investigate more in depth. This study may lead to prove the efficiency of the Kubeflow platform itself for this need of development of new FL algorithms that will support new Applications and especially test the FedAVG algorithm performances in a simulated client to cloud communication using a MNIST dataset for FL as benchmark.

Development of an impedance based biosensor for studies of spheroids formation

Three-dimensional (3D) multicellular spheroids are exceptional in vitro cell models for their ability to accurately mimic real cell-cell interaction processes. However, the challenges in producing well-defined spheroids with controlled size together with the deficiency of techniques to monitor them significantly restrict their use. Herein, a novel device to study spheroid formation in real time is presented. By exploiting electrochemical impedance spectroscopy, a multi-electrode array (MEA) attached to a calcium alginate scaffold is able to monitor the behaviour of 36 different hydrogel wells. The scaffold contains inverted shape pyramidal microwells, which guide the aggregation of cells into spheroids with controlled dimensions. Preliminar studies on calcium alginate, optimisation of fabrication strategy are shown, together with testing of the device in the presence and the absence of the hydrogel. Lastly, the device was tested for its intended aim, i.e. to monitor the formation of a spheroid, proving its potential as an impedance biosensor.

[almost An Autobiography: A Study Of Social Scientists In Health Based On The Lattes Curriculum].

Among the various ways of adopting the biographical approach, we used the curriculum vitaes (CVs) of Brazilian researchers who work as social scientists in health as our research material. These CVs are part of the Lattes Platform of CNPq - the National Council for Scientific and Technological Development, which includes Research and Institutional Directories. We analyzed 238 CVs for this study. The CVs contain, among other things, the following information: professional qualifications, activities and projects, academic production, participation in panels for the evaluation of theses and dissertations, research centers and laboratories and a summarized autobiography. In this work there is a brief review of the importance of autobiography for the social sciences, emphasizing the CV as a form of autobiographical practice. We highlight some results, such as it being a group consisting predominantly of women, graduates in social sciences, anthropology, sociology or political science, with postgraduate degrees. The highest concentration of social scientists is located in Brazil's southern and southeastern regions. In some institutions the main activities of social scientists are as teachers and researchers with great thematic diversity in research.

Mechanisms Predisposing Penile Fracture And Long-term Outcomes On Erectile And Voiding Functions.

Purpose. To determine the mechanisms predisposing penile fracture as well as the rate of long-term penile deformity and erectile and voiding functions. Methods. All fractures were repaired on an emergency basis via subcoronal incision and absorbable suture with simultaneous repair of eventual urethral lesion. Patients' status before fracture and voiding and erectile functions at long term were assessed by periodic follow-up and phone call. Detailed history included cause, symptoms, and single-question self-report of erectile and voiding functions. Results. Among the 44 suspicious cases, 42 (95.4%) were confirmed, mean age was 34.5 years (range: 18-60), mean follow-up 59.3 months (range 9-155). Half presented the classical triad of audible crack, detumescence, and pain. Heterosexual intercourse was the most common cause (28 patients, 66.7%), followed by penile manipulation (6 patients, 14.3%), and homosexual intercourse (4 patients, 9.5%). Woman on top was the most common heterosexual position (n = 14, 50%), followed by doggy style (n = 8, 28.6%). Four patients (9.5%) maintained the cause unclear. Six (14.3%) patients had urethral injury and two (4.8%) had erectile dysfunction, treated by penile prosthesis and PDE-5i. No patient showed urethral fistula, voiding deterioration, penile nodule/curve or pain. Conclusions. Woman on top was the potentially riskiest sexual position (50%). Immediate surgical treatment warrants long-term very low morbidity.

Phylogenetics, Ancestral State Reconstruction, And A New Infrafamilial Classification Of The Pantropical Ochnaceae (medusagynaceae, Ochnaceae S.str., Quiinaceae) Based On Five Dna Regions.

Ochnaceae s.str. (Malpighiales) are a pantropical family of about 500 species and 27 genera of almost exclusively woody plants. Infrafamilial classification and relationships have been controversial partially due to the lack of a robust phylogenetic framework. Including all genera except Indosinia and Perissocarpa and DNA sequence data for five DNA regions (ITS, matK, ndhF, rbcL, trnL-F), we provide for the first time a nearly complete molecular phylogenetic analysis of Ochnaceae s.l. resolving most of the phylogenetic backbone of the family. Based on this, we present a new classification of Ochnaceae s.l., with Medusagynoideae and Quiinoideae included as subfamilies and the former subfamilies Ochnoideae and Sauvagesioideae recognized at the rank of tribe. Our data support a monophyletic Ochneae, but Sauvagesieae in the traditional circumscription is paraphyletic because Testulea emerges as sister to the rest of Ochnoideae, and the next clade shows Luxemburgia+Philacra as sister group to the remaining Ochnoideae. To avoid paraphyly, we classify Luxemburgieae and Testuleeae as new tribes. The African genus Lophira, which has switched between subfamilies (here tribes) in past classifications, emerges as sister to all other Ochneae. Thus, endosperm-free seeds and ovules with partly to completely united integuments (resulting in an apparently single integument) are characters that unite all members of that tribe. The relationships within its largest clade, Ochnineae (former Ochneae), are poorly resolved, but former Ochninae (Brackenridgea, Ochna) are polyphyletic. Within Sauvagesieae, the genus Sauvagesia in its broad circumscription is polyphyletic as Sauvagesia serrata is sister to a clade of Adenarake, Sauvagesia spp., and three other genera. Within Quiinoideae, in contrast to former phylogenetic hypotheses, Lacunaria and Touroulia form a clade that is sister to Quiina. Bayesian ancestral state reconstructions showed that zygomorphic flowers with adaptations to buzz-pollination (poricidal anthers), a syncarpous gynoecium (a near-apocarpous gynoecium evolved independently in Quiinoideae and Ochninae), numerous ovules, septicidal capsules, and winged seeds with endosperm are the ancestral condition in Ochnoideae. Although in some lineages poricidal anthers were lost secondarily, the evolution of poricidal superstructures secured the maintenance of buzz-pollination in some of these genera, indicating a strong selective pressure on keeping that specialized pollination system.

Ihwg-μnir: A Miniaturised Near-infrared Gas Sensor Based On Substrate-integrated Hollow Waveguides Coupled To A Micro-nir-spectrophotometer.

A miniaturised gas analyser is described and evaluated based on the use of a substrate-integrated hollow waveguide (iHWG) coupled to a microsized near-infrared spectrophotometer comprising a linear variable filter and an array of InGaAs detectors. This gas sensing system was applied to analyse surrogate samples of natural fuel gas containing methane, ethane, propane and butane, quantified by using multivariate regression models based on partial least square (PLS) algorithms and Savitzky-Golay 1(st) derivative data preprocessing. The external validation of the obtained models reveals root mean square errors of prediction of 0.37, 0.36, 0.67 and 0.37% (v/v), for methane, ethane, propane and butane, respectively. The developed sensing system provides particularly rapid response times upon composition changes of the gaseous sample (approximately 2 s) due the minute volume of the iHWG-based measurement cell. The sensing system developed in this study is fully portable with a hand-held sized analyser footprint, and thus ideally suited for field analysis. Last but not least, the obtained results corroborate the potential of NIR-iHWG analysers for monitoring the quality of natural gas and petrochemical gaseous products.