New functional and biomechanical assessments for the improvement of the surgical navigation systems for joint replacement in the human lower limb

In case of severe osteoarthritis at the knee causing pain, deformity, and loss of stability and mobility, the clinicians consider that the substitution of these surfaces by means of joint prostheses. The objectives to be pursued by this surgery are: complete pain elimination, restoration of the normal physiological mobility and joint stability, correction of all deformities and, thus, of limping. The knee surgical navigation systems have bee developed in computer-aided surgery in order to improve the surgical final outcome in total knee arthroplasty. These systems provide the surgeon with quantitative and real-time information about each surgical action, like bone cut executions and prosthesis component alignment, by mean of tracking tools rigidly fixed onto the femur and the tibia. Nevertheless, there is still a margin of error due to the incorrect surgical procedures and to the still limited number of kinematic information provided by the current systems. Particularly, patello-femoral joint kinematics is not considered in knee surgical navigation. It is also unclear and, thus, a source of misunderstanding, what the most appropriate methodology is to study the patellar motion. In addition, also the knee ligamentous apparatus is superficially considered in navigated total knee arthroplasty, without taking into account how their physiological behavior is altered by this surgery. The aim of the present research work was to provide new functional and biomechanical assessments for the improvement of the surgical navigation systems for joint replacement in the human lower limb. This was mainly realized by means of the identification and development of new techniques that allow a thorough comprehension of the functioning of the knee joint, with particular attention to the patello-femoral joint and to the main knee soft tissues. A knee surgical navigation system with active markers was used in all research activities presented in this research work. Particularly, preliminary test were performed in order to assess the system accuracy and the robustness of a number of navigation procedures. Four studies were performed in-vivo on patients requiring total knee arthroplasty and randomly implanted by means of traditional and navigated procedures in order to check for the real efficacy of the latter with respect to the former. In order to cope with assessment of patello-femoral joint kinematics in the intact and replaced knees, twenty in-vitro tests were performed by using a prototypal tracking tool also for the patella. In addition to standard anatomical and articular recommendations, original proposals for defining the patellar anatomical-based reference frame and for studying the patello-femoral joint kinematics were reported and used in these tests. These definitions were applied to two further in-vitro tests in which, for the first time, also the implant of patellar component insert was fully navigated. In addition, an original technique to analyze the main knee soft tissues by means of anatomical-based fiber mappings was also reported and used in the same tests. The preliminary instrumental tests revealed a system accuracy within the millimeter and a good inter- and intra-observer repeatability in defining all anatomical reference frames. In in-vivo studies, the general alignments of femoral and tibial prosthesis components and of the lower limb mechanical axis, as measured on radiographs, was more satisfactory, i.e. within ±3°, in those patient in which total knee arthroplasty was performed by navigated procedures. As for in-vitro tests, consistent patello-femoral joint kinematic patterns were observed over specimens throughout the knee flexion arc. Generally, the physiological intact knee patellar motion was not restored after the implant. This restoration was successfully achieved in the two further tests where all component implants, included the patellar insert, were fully navigated, i.e. by means of intra-operative assessment of also patellar component positioning and general tibio-femoral and patello-femoral joint assessment. The tests for assessing the behavior of the main knee ligaments revealed the complexity of the latter and the different functional roles played by the several sub-bundles compounding each ligament. Also in this case, total knee arthroplasty altered the physiological behavior of these knee soft tissues. These results reveal in-vitro the relevance and the feasibility of the applications of new techniques for accurate knee soft tissues monitoring, patellar tracking assessment and navigated patellar resurfacing intra-operatively in the contest of the most modern operative techniques. This present research work gives a contribution to the much controversial knowledge on the normal and replaced of knee kinematics by testing the reported new methodologies. The consistence of these results provides fundamental information for the comprehension and improvements of knee orthopedic treatments. In the future, the reported new techniques can be safely applied in-vivo and also adopted in other joint replacements.

Model-driven Usability: alcuni approcci e un prototipo.

Questa tesi si occupa degli aspetti di usabilità nell'interazione degli utenti con le applicazioni, usando le tecniche di generazione automatica della Model-Driven Architecture. Viene prodotto un generatore di applicazioni model-driven, basato su un modello di progettazione Goal-Oriented, con risultati apprezzabili nel fornire all'utente un'interazione dinamica con l'applicazione prodotta.

Identifikation und Charakterisierung molekularer Komponenten des Verbindungsciliums der Photorezeptoren von Vertebraten

Photorezeptorzellen sind aus funktionell und morphologisch unterschiedlichen Kompartimenten aufgebaut: Einem lichtsensitiven Außensegment, das über ein nichtmotiles modifiziertes Cilium mit dem metabolisch aktiven Innensegment verbunden ist. Die Membranen des Außensegments werden kontinuierlich erneuert. Diese Prozesse erfordern die Translokation von Proteinen der Signaltransduktionskaskade vom Syntheseort im Innensegment in das Außensegment. Der intrazelluläre Transport der Proteine erfolgt durch das Verbindungscilium als einzige direkte cytoplasmatische Brücke zwischen den beiden Kompartimenten. Die Cytoskelettproteine des Verbindungsciliums sind maßgeblich an diesen Transportprozessen, sowie an der Ausbildung der Disk-Membranen und Funktion des Ciliums als Diffusionsbarriere beteiligt. Trotz dieser, für die Aufrechterhaltung der Photorezeptorzelle wichtigen Funktionen, sind bislang nur wenige molekulare Strukturkomponenten des Verbindungsciliums bekannt und funktionell charakterisiert. Um weitere Proteinkomponenten des Ciliums zu identifizieren, wurde eine biochemisch-molekularbiologische Strategie angewandt. Detergenzextrahierte Cilienapparate von Rinderphotorezeptorzellen wurden zur Immunisierung eines Kaninchens eingesetzt. Das affinitätsgereinigte Antiserum, mit Antikörpern gegen Epitope der unterschiedlichen Proteine des Verbindungsciliums, wurde anschließend zur Durchmusterung einer Rattenretina cDNA-Expressionsbank verwendet. Positive Klone wurden isoliert, sequenziert, und deren 3´- und 5´-terminale cDNA-Sequenzen in Datenbankrecherchen analysiert. Neben Klonen, die für Fragmente von bereits bekannten photorezeptorspezifischen Proteinen kodieren, Klonen mit Homologien zu EST´s, und Klonen ohne Homologien zu in Datenbanken enthaltenen Einträgen, wurden 8 cDNA-Klone isoliert, die für bisher unbekannte Cytoskelettproteine des Verbindungsciliums kodieren. Zwei dieser Proteine wurden näher charakterisiert: Das Mikrotubuli-Bindungsprotein EB2p und das Aktin-Bindungsprotein Flightless (Flip). Indirekte Immunofluoreszenzmarkierungen mit Antikörpern gegen EB1p, die mit EB2p kreuzreagieren, wurden EB-Proteine im Verbindungscilium und Basalkörper der Rezeptorzellen lokalisiert. Funktionell trägt Rn EB2p vermutlich zur Stabilisierung der axonemalen Mikrotubuli bei, und dürfte durch Interaktion mit cytoplasmatischem Dynein an retrograden Transportprozessen im Verbindungscilium beteiligt sein. Das Aktin-Bindungsprotein Flightless ist ein cytoplasmatisches Protein mit einer N-terminalen LRR-Domäne, die Protein-Protein- und Protein-Lipid-Interaktionen vermittelt. C-terminal weist Flip zwei Segmente mit Homologien zu Gelsolin auf. Indirekte Immunofluoreszenzmarkierungen und immuno-elektronenmikroskopische Analysen zeigen, daß Flip im Verbindungscilium in der subzellulären Domäne zwischen den axonemalen Mikrotubulipaarringen und der Plasmamembran lokalisiert ist. Im Außensegment der Photorezeptorzellen liegt Flip an den Disk-Membranen assoziiert vor. Flip verfügt vermutlich über zwei Funktion: Membran-assoziiert dürfte es Aktinfilamente an den Membranen der Außensegmente verankern. Im Verbindungscilium hingegen könnte es die ciliären Aktinfilamente modifizieren, die Transportwege für aktin-assoziierte Motorproteine sind. Flip und EB2p sind möglicherweise an den intrazellulären Transportprozessen durch das Verbindungscilium beteiligt.Die in der vorliegenden Arbeit angewandte Methode konnte erfolgreich zur Isolierung bislang unbekannter Proteine des Verbindungsciliums eingesetzt werden. Darüberhinaus wurde Flip auch in den ciliären Sinneszellen des Riechepithels und den mechanorezeptiven Haarzellen des Innenohrs identifiziert. Erkenntnisse über die molekulare Zusammensetzung des ciliären Cytoskeletts von Photorezeptorzellen können daher auch auf andere ciliäre Sinneszellen angewandt werden. Dies ermöglicht einen besseren Einblick in die allgemeine Funktion cilärer Cytoskelettstrukturen sensorischer Zellen.

La rocca di Fossombrone. Progetto di conservazione e valorizzazione della rovina.

L'oggetto della tesi è la rocca feltresca di Fossombrone, cittadina in provincia di Pesaro-Urbino, in parte attribuita a Francesco di Giorgio Martini. Dopo un'approfondita analisi storica ed evolutiva dell'oggetto, si sono studiati attentamente i suoi sistemi costruttivi, al fine di delineare un progetto di restauro principalmente conservativo. Il progetto propone anche la realizzazione di una copertura che abbia lo scopo sia di contribuire alla conservazione e protezione dei resti di murature antiche, sia di consentire un'accesso protetto in una ritrovata fruibilità della rocca.

La musa bambina. 1911-2011: un secolo di letteratura mitologica per ragazzi in Italia tra storia, educazione e narrazione

Questa ricerca mostra l’evoluzione della letteratura mitologica per ragazzi in Italia. Il primo libro italiano di mitologia per bambini è stato pubblicato nel 1911 (lo stesso anno di un’importante e violenta guerra coloniale tra l’Italia e la Libia): la scrittrice italiana Laura Orvieto pubblicò allora “Storie della storia del mondo”, in cui riunì antichi racconti greci per giovani lettori. Queste storie erano ispirate al libro mitologico per bambini “Il libro delle meraviglie” di Hawthorne (titolo originale “A Wonder Book for Girls and Boys”). In seguito molti scrittori italiani scrissero libri mitologici per giovani lettori: serie importanti di libri di mitologia per bambini furono pubblicate durante il regime mussoliniano – talvolta per diffondere l’ideologia fascista della superiorità romana. Durante questo periodo, i libri mitologici spesso mostravano uno stile letterario solenne. Dopo la seconda guerra mondiale, la letteratura mitologica per bambini cambiò lentamente prospettiva: gli scrittori italiani cominciarono ad usare il mito per parlare di problemi sociali (p.e. Gianni Rodari descriveva re Mida come un capitalista) e per spiegare le diverse condizioni umane (p.e. Beatrice Masini fa riferimento alle dee e alle eroine greche per descrivere la condizione femminile). La ricerca analizza anche la relazione tra mito e scuola in Italia: i racconti mitologici hanno sempre fatto parte dei programmi scolastici italiani per bambini dagli 8 agli 11 anni. Le riforme scolastiche – deliberate negli anni ’20 e ’40 – fissarono pratiche didattiche sui miti ancora oggi in uso. I racconti mitologici erano soprattutto un supporto per gli studi storici e letterari. Tuttavia, negli ultimi decenni, i miti sono divenuti un importante aiuto per gli insegnamenti scientifici e artistici.

Role of SP-A gene polymorphism in lung transplantation

Lung transplantation is a widely accepted therapeutic option for end stage lung disease. Clinical outcome is yet challenged by primary graft failure responsible for the majority of the early mortality, by chronic allograft dysfunction and chronic rejection accounting for more than 30% of deaths after the third postoperative year. Pulmonary surfactant proteins (SP) A, B, C and D are one of the first host defense mechanisms the lung can mount. SP-A in particular, produced by the type II pneumocytes, is active in the innate and adaptive immune system being an opsonin, but also regulating the macrophage and lymphocyte response. The main hypothesis for this project is that pulmonary surfactant protein A polymorphism may determine the early and long term lung allograft survival. Of note SP-A biologic activity seems to be genetically determined and SP-A polymorphisms have been associated to various lung disease. The two SP-A genes SP-A1 and SP-A2 have several polymorphisms within the coding region, SP-A1 (6A, 6A2-20), and SP-A2(1A, 1A0-13). The SP-A gene expression is regulated by cAMP, TTF-1 and glucocorticoids. In vitro studies have indicated that SP-A1 and SP-A2 gene variants may have a variable response to glucocorticoids. We proposed to determine if SP-A gene polymorphism predicts primary graft dysfunction and/or chronic lung allograft dysfunction and if SP-A may serve as a biomarker of lung allograft dysfunction. We also proposed to study the interaction between immunosuppressive drugs and SP-A expression and determine whether this is dependent on SP-A polymorphisms. This study will generate novel information improving our understanding of lung allograft dysfunction. It is conceivable that the information will stimulate the interest for a multi centre study to investigate if SP-A polymorphism may be integrated in the donor lung selection criteria and/or to implement post transplant tailored immunosuppression.

Synthesis and characterization of Poly(vinylphosphonic acid) for proton exchange membranes in fuel cells

Vinylphosphonic acid (VPA) was polymerized at 80 ºC by free radical polymerization to give polymers (PVPA) of different molecular weight depending on the initiator concentration. The highest molecular weight, Mw, achieved was 6.2 x 104 g/mol as determined by static light scattering. High resolution nuclear magnetic resonance (NMR) spectroscopy was used to gain microstructure information about the polymer chain. Information based on tetrad probabilities was utilized to deduce an almost atactic configuration. In addition, 13C-NMR gave evidence for the presence of head-head and tail-tail links. Refined analysis of the 1H NMR spectra allowed for the quantitative determination of the fraction of these links (23.5 percent of all links). Experimental evidence suggested that the polymerization proceeded via cyclopolymerization of the vinylphosphonic acid anhydride as an intermediate. Titration curves indicated that high molecular weight poly(vinylphosphonic acid) PVPA behaved as a monoprotic acid. Proton conductors with phosphonic acid moieties as protogenic groups are promising due to their high charge carrier concentration, thermal stability, and oxidation resistivity. Blends and copolymers of PVPA have already been reported, but PVPA has not been characterized sufficiently with respect to its polymer properties. Therefore, we also studied the proton conductivity behaviour of a well-characterized PVPA. PVPA is a conductor; however, the conductivity depends strongly on the water content of the material. The phosphonic acid functionality in the resulting polymer, PVPA, undergoes condensation leading to the formation of phosphonic anhydride groups at elevated temperature. Anhydride formation was found to be temperature dependent by solid state NMR. Anhydride formation affects the proton conductivity to a large extent because not only the number of charge carriers but also the mobility of the charge carriers seems to change.

Synthesis and characterization of structurally well-defined polymer-layered silicate nanocomposites

Zusammenfassung Nanokomposite aus Polymeren und Schichtsilikaten werden zumeist auf der Basis natürlicher Tone wie Montmorillonit hergestellt. Für NMR- und EPR-Untersuchungen der Tensidschicht, die das Silikat mit dem Polymer kompatibilisiert, ist der Eisengehalt natürlicher Tone jedoch abträglich, weil er zu einer Verkürzung der Relaxationszeiten und zu einer Linienverbreiterung in den Spektren führt. Dieses Problem konnte überwunden werden, indem als Silikatkomponente eisenfreies, strukturell wohldefiniertes Magadiit hydrothermal synthetisiert und für die Kompositbildung eingesetzt wurde. Die Morphologie des Magadiits wurde durch Rasterelektronenmikroskopie charakterisiert und der Interkalationsgrad von schmelzinterkalierten Polymer-Nanokompositen wurde durch Weitwinkelröntgenstreuung bestimmt. Polymere mit Carbonylgruppen scheinen leichter zu interkalieren als solche ohne Carbonylgruppen. Polycaprolacton interkalierte sowohl in Oragnomagadiite auf der Basis von Ammoniumtensiden als auch in solche auf der Basis von Phosphoniumtensiden. Die Dynamik auf einer Nanosekundenzeitskala und die Struktur der Tensidschicht wurden mittels ortsspezifisch spinmarkierter Tensidsonden unter Nutzung von Dauerstrich- (CW) und Puls-Methoden der elektronenparamagnetischen Resonanzspektroskopie (EPR) untersucht. Zusätzlich wurde die statische 2H-Kernmagnetresonanz (NMR) an spezifisch deuterierten Tensiden angewendet, um die Tensiddynamik auf einer komplementären Zeitskala zwischen Mikrosekunden und Millisekunden zu erfassen. Sowohl die CW-EPR- als auch die 2H-NMR-Ergebnisse zeigen eine Beschleunigung der Tensiddynamik durch Interkalation von Polycaprolacton auf, während sich in den nichtinterkalierten Mikrokompositen mit Polystyrol die Tensiddynamik verlangsamt. Die Rotationskorrelationszeiten und Aktivierungsenergien offenbaren verschiedene Regime der Tensiddynamik. In Polystyrol-Mikrokompositen entspricht die Übergangstemperatur zwischen den Regimen der Glasübergangstemperatur von Polystyrol, während sie in Polycaprolacton-Nanokompositen bei der Schmelztemperatur von Polycaprolacton liegt. Durch die erhebliche Verlängerung der Elektronenspin-Relaxationszeiten bei Verwendung von eisenfreiem Magadiit können Messdaten hoher Qualität mit Puls-EPR-Experimenten erhalten werden. Insebsondere wurden die Vier-Puls-Elektron-Elektron-Doppelresonanz (DEER), die Elektronenspinechoenveloppenmodulation (ESEEM) und die Elektronen-Kern-Doppelresonanz (ENDOR) an spinmarkierten sowie spezifisch deuterierten Tensiden angewandt. Die ENDOR-Ergebnisse legen ein Model der Tensidschicht nahe, in dem zusätzlich zu den Oberflächenlagen auf dem Silikat eine wohldefinierte mittlere Lage existiert. Dieses Modell erklärt auch Verdünnungseffekte durch das Polymer in Kompositen mit Polycaprolacton und Polystyrol. Die umfangreiche Information aus den Magnetresonanztechniken ergänzt die Information aus konventionellen Charakterisierungstechniken wie Röntgendiffraktion und Transmissionselektronenmikroskopie und führt so zu einem detaillierteren Bild der Struktur und Dynamik der Tensidschicht in Nanokompositen aus Polymeren und Schichtsilikaten.

CFD modeling of two-phase boiling flows in the slug flow regime with an interface capturing technique

The objective of this thesis was to improve the commercial CFD software Ansys Fluent to obtain a tool able to perform accurate simulations of flow boiling in the slug flow regime. The achievement of a reliable numerical framework allows a better understanding of the bubble and flow dynamics induced by the evaporation and makes possible the prediction of the wall heat transfer trends. In order to save computational time, the flow is modeled with an axisymmetrical formulation. Vapor and liquid phases are treated as incompressible and in laminar flow. By means of a single fluid approach, the flow equations are written as for a single phase flow, but discontinuities at the interface and interfacial effects need to be accounted for and discretized properly. Ansys Fluent provides a Volume Of Fluid technique to advect the interface and to map the discontinuous fluid properties throughout the flow domain. The interfacial effects are dominant in the boiling slug flow and the accuracy of their estimation is fundamental for the reliability of the solver. Self-implemented functions, developed ad-hoc, are introduced within the numerical code to compute the surface tension force and the rates of mass and energy exchange at the interface related to the evaporation. Several validation benchmarks assess the better performances of the improved software. Various adiabatic configurations are simulated in order to test the capability of the numerical framework in modeling actual flows and the comparison with experimental results is very positive. The simulation of a single evaporating bubble underlines the dominant effect on the global heat transfer rate of the local transient heat convection in the liquid after the bubble transit. The simulation of multiple evaporating bubbles flowing in sequence shows that their mutual influence can strongly enhance the heat transfer coefficient, up to twice the single phase flow value.

Ripensare il limite a Buenos Aires. Proposta di un nuovo spazio urbano lungo il Riachuelo.

Nella progettazione degli edifici, si è posta molta attenzione al contesto urbano. Le varie proposte nascono dalla volontà di ricucire il tessuto urbano, trasformando quello che ora rappresenta un limite, nella vera soluzione al problema. Si propongono quindi isolati dalle più diverse forme, dimensioni e significati, andando ad attingere alle più svariate tipologie, che non intendono essere progetti in sé compiuti, ma possibili risposte.