Commenced in January 2007
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Edition: International
Paper Count: 14

Search results for: Gianluca Castelnuovo

14 The M Health Paradigm for the Chronic Care Management of Obesity: New Opportunities in Clinical Psychology and Medicine

Authors: Gianluca Castelnuovo, Gian Mauro Manzoni, Giada Pietrabissa, Stefania Corti, Emanuele Giusti, Roberto Cattivelli, Enrico Molinari, Susan Simpson

Abstract:

Obesity is currently an important public health problem of epidemic proportions (globesity). Moreover Binge Eating Disorder (BED) is typically connected with obesity, even if not occurring exclusively in conjunction with overweight conditions. Typically obesity with BED requires a longer term treatment in comparison with simple obesity. Rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation, due to the growing costs of a limited inpatient approach. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach. The new m health (m-health, mobile health) paradigm, defined as clinical practices supported by up to date mobile communication devices, could increase compliance- engagement and contribute to a significant cost reduction in BED and obesity rehabilitation. Five psychological components need to be considered for successful m Health-based obesity rehabilitation in order to facilitate weight-loss.1) Self-monitoring. Portable body monitors, pedometers and smartphones are mobile and, therefore, can be easily used, resulting in continuous self-monitoring. 2) Counselor feedback and communication. A functional approach is to provide online weight-loss interventions with brief weekly or monthly counselor or psychologist visits. 3) Social support. A group treatment format is typically preferred for behavioral weight-loss interventions. 4) Structured program. Technology-based weight-loss programs incorporate principles of behavior therapy and change with structured weekly protocolos including nutrition, exercise, stimulus control, self-regulation strategies, goal-setting. 5) Individually tailored program. Interventions specifically designed around individual’s goals typically record higher rates of adherence and weight loss. Opportunities and limitations of m health approach in clinical psychology for obesity and BED are discussed, taking into account future research directions in this promising area.

Keywords: obesity, rehabilitation, out-patient, new technologies, tele medicine, tele care, m health, clinical psychology, psychotherapy, chronic care management

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13 A Stepped Care mHealth-Based Approach for Obesity with Type 2 Diabetes in Clinical Health Psychology

Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

Abstract:

Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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12 Experimental Simulation Set-Up for Validating Out-Of-The-Loop Mitigation when Monitoring High Levels of Automation in Air Traffic Control

Authors: Oliver Ohneiser, Francesca De Crescenzio, Gianluca Di Flumeri, Jan Kraemer, Bruno Berberian, Sara Bagassi, Nicolina Sciaraffa, Pietro Aricò, Gianluca Borghini, Fabio Babiloni

Abstract:

An increasing degree of automation in air traffic will also change the role of the air traffic controller (ATCO). ATCOs will fulfill significantly more monitoring tasks compared to today. However, this rather passive role may lead to Out-Of-The-Loop (OOTL) effects comprising vigilance decrement and less situation awareness. The project MINIMA (Mitigating Negative Impacts of Monitoring high levels of Automation) has conceived a system to control and mitigate such OOTL phenomena. In order to demonstrate the MINIMA concept, an experimental simulation set-up has been designed. This set-up consists of two parts: 1) a Task Environment (TE) comprising a Terminal Maneuvering Area (TMA) simulator as well as 2) a Vigilance and Attention Controller (VAC) based on neurophysiological data recording such as electroencephalography (EEG) and eye-tracking devices. The current vigilance level and the attention focus of the controller are measured during the ATCO’s active work in front of the human machine interface (HMI). The derived vigilance level and attention trigger adaptive automation functionalities in the TE to avoid OOTL effects. This paper describes the full-scale experimental set-up and the component development work towards it. Hence, it encompasses a pre-test whose results influenced the development of the VAC as well as the functionalities of the final TE and the two VAC’s sub-components.

Keywords: automation, human factors, air traffic controller, MINIMA, OOTL (Out-Of-The-Loop), EEG (Electroencephalography), HMI (Human Machine Interface)

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11 Passive Attenuation with Multiple Resonator Rings for Musical Instruments Equalization

Authors: Lorenzo Bonoldi, Gianluca Memoli, Abdelhalim Azbaid El Ouahabi

Abstract:

In this paper, a series of ring-shaped attenuators utilizing Helmholtz and quarter wavelength resonators in variable, fixed, and combined configurations have been manufactured using a 3D printer. We illustrate possible uses by incorporating such devices into musical instruments (e.g. in acoustic guitar sound holes) and audio speakers with a view to controlling such devices tonal emissions without electronic equalization systems. Numerical investigations into the transmission loss values of these ring-shaped attenuators using finite element method simulations (COMSOL Multiphysics) have been presented in the frequency range of 100– 1000 Hz. We compare such results for each attenuator model with experimental measurements using different driving sources such as white noise, a maximum-length sequence (MLS), square and sine sweep pulses, and point scans in the frequency domain. Finally, we present a preliminary discussion on the comparison of numerical and experimental results.

Keywords: equaliser, metamaterials, musical, instruments

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10 Predicting Machine-Down of Woodworking Industrial Machines

Authors: Matteo Calabrese, Martin Cimmino, Dimos Kapetis, Martina Manfrin, Donato Concilio, Giuseppe Toscano, Giovanni Ciandrini, Giancarlo Paccapeli, Gianluca Giarratana, Marco Siciliano, Andrea Forlani, Alberto Carrotta

Abstract:

In this paper we describe a machine learning methodology for Predictive Maintenance (PdM) applied on woodworking industrial machines. PdM is a prominent strategy consisting of all the operational techniques and actions required to ensure machine availability and to prevent a machine-down failure. One of the challenges with PdM approach is to design and develop of an embedded smart system to enable the health status of the machine. The proposed approach allows screening simultaneously multiple connected machines, thus providing real-time monitoring that can be adopted with maintenance management. This is achieved by applying temporal feature engineering techniques and training an ensemble of classification algorithms to predict Remaining Useful Lifetime of woodworking machines. The effectiveness of the methodology is demonstrated by testing an independent sample of additional woodworking machines without presenting machine down event.

Keywords: predictive maintenance, machine learning, connected machines, artificial intelligence

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9 COVID-19 Vaccine Hesitancy: The Role of Existential Concerns in Individual’s Decisions Regarding the Vaccine Uptake

Authors: Vittoria Franchina, Laura Salerno, Rubinia Celeste Bonfanti, Gianluca Lo Coco

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This study examines the relationships between existential concerns (ECs), basic psychological needs (BPNs), vaccine hesitancy (VH), and the mediating role of negative attitudes toward COVID-19 vaccines. A cross-sectional survey was carried out on a sample of two-hundred eighty-seven adults (Mage = 36.04 (12.07); 59.9% females). Participants were recruited online through clickworker and filled in measures on existential concerns, basic psychological needs, attitudes toward COVID-19 vaccines, and vaccine hesitancy for Pfizer-BioNTech and Astrazeneca vaccines separately. Structural equation modelling showed that existential concerns were related to Pfizer-BioNTech and Astrazeneca vaccine hesitancy both directly and indirectly through negative attitudes toward possible side effects of COVID-19 vaccines. The present study has identified several predictive factors relating to the intention to uptake vaccination to protect against COVID-19 in Italy. Specifically, these findings suggest a causal link between existential concerns, attitudes, and vaccine hesitancy.

Keywords: COVID-19, existential concerns, Pfizer-BioNTech and Astrazeneca vaccines, vaccine hesitancy

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8 Exergy Analysis of a Green Dimethyl Ether Production Plant

Authors: Marcello De Falco, Gianluca Natrella, Mauro Capocelli

Abstract:

CO₂ capture and utilization (CCU) is a promising approach to reduce GHG(greenhouse gas) emissions. Many technologies in this field are recently attracting attention. However, since CO₂ is a very stable compound, its utilization as a reagent is energetic intensive. As a consequence, it is unclear whether CCU processes allow for a net reduction of environmental impacts from a life cycle perspective and whether these solutions are sustainable. Among the tools to apply for the quantification of the real environmental benefits of CCU technologies, exergy analysis is the most rigorous from a scientific point of view. The exergy of a system is the maximum obtainable work during a process that brings the system into equilibrium with its reference environment through a series of reversible processes in which the system can only interact with such an environment. In other words, exergy is an “opportunity for doing work” and, in real processes, it is destroyed by entropy generation. The exergy-based analysis is useful to evaluate the thermodynamic inefficiencies of processes, to understand and locate the main consumption of fuels or primary energy, to provide an instrument for comparison among different process configurations and to detect solutions to reduce the energy penalties of a process. In this work, the exergy analysis of a process for the production of Dimethyl Ether (DME) from green hydrogen generated through an electrolysis unit and pure CO₂ captured from flue gas is performed. The model simulates the behavior of all units composing the plant (electrolyzer, carbon capture section, DME synthesis reactor, purification step), with the scope to quantify the performance indices based on the II Law of Thermodynamics and to identify the entropy generation points. Then, a plant optimization strategy is proposed to maximize the exergy efficiency.

Keywords: green DME production, exergy analysis, energy penalties, exergy efficiency

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7 Assessing the Effects of Sub-Concussive Head Impacts on Clinical Measures of Neurologic Function

Authors: Gianluca Del Rossi

Abstract:

Sub-concussive impacts occur frequently in collision sports such as American tackle football. Sub-concussive level impacts are defined as hits to the head that do not result in the clinical manifestation of concussion injury. Presently, there is limited information known about the short-term effects of repeated sub-concussive blows to the head. Therefore, the purpose of this investigation was to determine if standard clinical measures could detect acute impairments in neurologic function resulting from the accumulation of sub-concussive impacts throughout a season of high school American tackle football. Simple reaction time using the ruler-drop test, and oculomotor performance using the King-Devick (KD) test, were assessed in 15 athletes prior to the start of the athletic season, then repeated each week of the season, and once following its completion. The mean reaction times and fastest KD scores that were recorded or calculated from each study participant and from each test session were analyzed to assess for change in reaction time and oculomotor performance over the course of the American tackle football season. Analyses of KD data revealed improvements in oculomotor performance from baseline measurements (i.e., decreased time), with most weekly comparisons to baseline being significantly different. Statistical tests performed on the mean reaction times obtained via the ruler-drop test throughout the season revealed statistically significant declines (i.e., increased time) between baseline and weeks 3, 4, 10, and 12 of the athletic season. The inconsistent and contrasting findings between KD data and reaction time demonstrate the need to identify more robust clinical measures to definitively assess if repeated sub-concussive impacts to the head are acutely detrimental to patients.

Keywords: head injury, mTBI and sport, subclinical head trauma, sub-concussive impacts

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6 Model-Based Approach as Support for Product Industrialization: Application to an Optical Sensor

Authors: Frederic Schenker, Jonathan J. Hendriks, Gianluca Nicchiotti

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In a product industrialization perspective, the end-product shall always be at the peak of technological advancement and developed in the shortest time possible. Thus, the constant growth of complexity and a shorter time-to-market calls for important changes on both the technical and business level. Undeniably, the common understanding of the system is beclouded by its complexity which leads to the communication gap between the engineers and the sale department. This communication link is therefore important to maintain and increase the information exchange between departments to ensure a punctual and flawless delivery to the end customer. This evolution brings engineers to reason with more hindsight and plan ahead. In this sense, they use new viewpoints to represent the data and to express the model deliverables in an understandable way that the different stakeholder may identify their needs and ideas. This article focuses on the usage of Model-Based System Engineering (MBSE) in a perspective of system industrialization and reconnect the engineering with the sales team. The modeling method used and presented in this paper concentrates on displaying as closely as possible the needs of the customer. Firstly, by providing a technical solution to the sales team to help them elaborate commercial offers without omitting technicalities. Secondly, the model simulates between a vast number of possibilities across a wide range of components. It becomes a dynamic tool for powerful analysis and optimizations. Thus, the model is no longer a technical tool for the engineers, but a way to maintain and solidify the communication between departments using different views of the model. The MBSE contribution to cost optimization during New Product Introduction (NPI) activities is made explicit through the illustration of a case study describing the support provided by system models to architectural choices during the industrialization of a novel optical sensor.

Keywords: analytical model, architecture comparison, MBSE, product industrialization, SysML, system thinking

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5 Chemical vs Visual Perception in Food Choice Ability of Octopus vulgaris (Cuvier, 1797)

Authors: Al Sayed Al Soudy, Valeria Maselli, Gianluca Polese, Anna Di Cosmo

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Cephalopods are considered as a model organism with a rich behavioral repertoire. Sophisticated behaviors were widely studied and described in different species such as Octopus vulgaris, who has evolved the largest and more complex nervous system among invertebrates. In O. vulgaris, cognitive abilities in problem-solving tasks and learning abilities are associated with long-term memory and spatial memory, mediated by highly developed sensory organs. They are equipped with sophisticated eyes, able to discriminate colors even with a single photoreceptor type, vestibular system, ‘lateral line analogue’, primitive ‘hearing’ system and olfactory organs. They can recognize chemical cues either through direct contact with odors sources using suckers or by distance through the olfactory organs. Cephalopods are able to detect widespread waterborne molecules by the olfactory organs. However, many volatile odorant molecules are insoluble or have a very low solubility in water, and must be perceived by direct contact. O. vulgaris, equipped with many chemosensory neurons located in their suckers, exhibits a peculiar behavior that can be provocatively described as 'smell by touch'. The aim of this study is to establish the priority given to chemical vs. visual perception in food choice. Materials and methods: Three different types of food (anchovies, clams, and mussels) were used, and all sessions were recorded with a digital camera. During the acclimatization period, Octopuses were exposed to the three types of food to test their natural food preferences. Later, to verify if food preference is maintained, food was provided in transparent screw-jars with pierced lids to allow both visual and chemical recognition of the food inside. Subsequently, we tested alternatively octopuses with food in sealed transparent screw-jars and food in blind screw-jars with pierced lids. As a control, we used blind sealed jars with the same lid color to verify a random choice among food types. Results and discussion: During the acclimatization period, O. vulgaris shows a higher preference for anchovies (60%) followed by clams (30%), then mussels (10%). After acclimatization, using the transparent and pierced screw jars octopus’s food choices resulted in 50-50 between anchovies and clams, avoiding mussels. Later, guided by just visual sense, with transparent but not pierced jars, their food preferences resulted in 100% anchovies. With pierced but not transparent jars their food preference resulted in 100% anchovies as first food choice, the clams as a second food choice result (33.3%). With no possibility to select food, neither by vision nor by chemoreception, the results were 20% anchovies, 20% clams, and 60% mussels. We conclude that O. vulgaris uses both chemical and visual senses in an integrative way in food choice, but if we exclude one of them, it appears clear that its food preference relies on chemical sense more than on visual perception.

Keywords: food choice, Octopus vulgaris, olfaction, sensory organs, visual sense

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4 A New Model to Perform Preliminary Evaluations of Complex Systems for the Production of Energy for Buildings: Case Study

Authors: Roberto de Lieto Vollaro, Emanuele de Lieto Vollaro, Gianluca Coltrinari

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The building sector is responsible, in many industrialized countries, for about 40% of the total energy requirements, so it seems necessary to devote some efforts in this area in order to achieve a significant reduction of energy consumption and of greenhouse gases emissions. The paper presents a study aiming at providing a design methodology able to identify the best configuration of the system building/plant, from a technical, economic and environmentally point of view. Normally, the classical approach involves a building's energy loads analysis under steady state conditions, and subsequent selection of measures aimed at improving the energy performance, based on previous experience made by architects and engineers in the design team. Instead, the proposed approach uses a sequence of two well known scientifically validated calculation methods (TRNSYS and RETScreen), that allow quite a detailed feasibility analysis. To assess the validity of the calculation model, an existing, historical building in Central Italy, that will be the object of restoration and preservative redevelopment, was selected as a case-study. The building is made of a basement and three floors, with a total floor area of about 3,000 square meters. The first step has been the determination of the heating and cooling energy loads of the building in a dynamic regime by means of TRNSYS, which allows to simulate the real energy needs of the building in function of its use. Traditional methodologies, based as they are on steady-state conditions, cannot faithfully reproduce the effects of varying climatic conditions and of inertial properties of the structure. With TRNSYS it is possible to obtain quite accurate and reliable results, that allow to identify effective combinations building-HVAC system. The second step has consisted of using output data obtained with TRNSYS as input to the calculation model RETScreen, which enables to compare different system configurations from the energy, environmental and financial point of view, with an analysis of investment, and operation and maintenance costs, so allowing to determine the economic benefit of possible interventions. The classical methodology often leads to the choice of conventional plant systems, while RETScreen provides a financial-economic assessment for innovative energy systems and low environmental impact. Computational analysis can help in the design phase, particularly in the case of complex structures with centralized plant systems, by comparing the data returned by the calculation model RETScreen for different design options. For example, the analysis performed on the building, taken as a case study, found that the most suitable plant solution, taking into account technical, economic and environmental aspects, is the one based on a CCHP system (Combined Cooling, Heating, and Power) using an internal combustion engine.

Keywords: energy, system, building, cooling, electrical

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3 The Interactive Wearable Toy "+Me", for the Therapy of Children with Autism Spectrum Disorders: Preliminary Results

Authors: Beste Ozcan, Valerio Sperati, Laura Romano, Tania Moretta, Simone Scaffaro, Noemi Faedda, Federica Giovannone, Carla Sogos, Vincenzo Guidetti, Gianluca Baldassarre

Abstract:

+me is an experimental interactive toy with the appearance of a soft, pillow-like, panda. Shape and consistency are designed to arise emotional attachment in young children: a child can wear it around his/her neck and treat it as a companion (i.e. a transitional object). When caressed on paws or head, the panda emits appealing, interesting outputs like colored lights or amusing sounds, thanks to embedded electronics. Such sensory patterns can be modified through a wirelessly connected tablet: by this, an adult caregiver can adapt +me responses to a child's reactions or requests, for example, changing the light hue or the type of sound. The toy control is therefore shared, as it depends on both the child (who handles the panda) and the adult (who manages the tablet and mediates the sensory input-output contingencies). These features make +me a potential tool for therapy with children with Neurodevelopmental Disorders (ND), characterized by impairments in the social area, like Autism Spectrum Disorders (ASD) and Language Disorders (LD): as a proposal, the toy could be used together with a therapist, in rehabilitative play activities aimed at encouraging simple social interactions and reinforcing basic relational and communication skills. +me was tested in two pilot experiments, the first one involving 15 Typically Developed (TD) children aged in 8-34 months, the second one involving 7 children with ASD, and 7 with LD, aged in 30-48 months. In both studies a researcher/caregiver, during a one-to-one, ten-minute activity plays with the panda and encourages the child to do the same. The purpose of both studies was to ascertain the general acceptability of the device as an interesting toy that is an object able to capture the child's attention and to maintain a high motivation to interact with it and with the adult. Behavioral indexes for estimating the interplay between the child, +me and caregiver were rated from the video recording of the experimental sessions. Preliminary results show how -on average- participants from 3 groups exhibit a good engagement: they touch, caress, explore the panda and show enjoyment when they manage to trigger luminous and sound responses. During the experiments, children tend to imitate the caregiver's actions on +me, often looking (and smiling) at him/her. Interesting behavioral differences between TD, ASD, and LD groups are scored: for example, ASD participants produce a fewer number of smiles both to panda and to a caregiver with respect to TD group, while LD scores stand between ASD and TD subjects. These preliminary observations suggest that the interactive toy +me is able to raise and maintain the interest of toddlers and therefore it can be reasonably used as a supporting tool during therapy, to stimulate pivotal social skills as imitation, turn-taking, eye contact, and social smiles. Interestingly, the young age of participants, along with the behavioral differences between groups, seem to suggest a further potential use of the device: a tool for early differential diagnosis (the average age of a child

Keywords: autism spectrum disorders, interactive toy, social interaction, therapy, transitional wearable companion

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2 A Model to Assess Sustainability Using Multi-Criteria Analysis and Geographic Information Systems: A Case Study

Authors: Antonio Boggia, Luisa Paolotti, Gianluca Massei, Lucia Rocchi, Elaine Pace, Maria Attard

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The aim of this paper is to present a methodology and a computer model for sustainability assessment based on the integration of Multi-criteria Decision Analysis (MCDA) with a Geographic Information System (GIS). It presents the result of a study for the implementation of a model for measuring sustainability to address the policy actions for the improvement of sustainability at territory level. The aim is to rank areas in order to understand the specific technical and/or financial support that is required to develop sustainable growth. Assessing sustainable development is a multidimensional problem: economic, social and environmental aspects have to be taken into account at the same time. The tool for a multidimensional representation is a proper set of indicators. The set of indicators must be integrated into a model, that is an assessment methodology, to be used for measuring sustainability. The model, developed by the Environmental Laboratory of the University of Perugia, is called GeoUmbriaSUIT. It is a calculation procedure developed as a plugin working in the open-source GIS software QuantumGIS. The multi-criteria method used within GeoUmbriaSUIT is the algorithm TOPSIS (Technique for Order Preference by Similarity to Ideal Design), which defines a ranking based on the distance from the worst point and the closeness to an ideal point, for each of the criteria used. For the sustainability assessment procedure, GeoUmbriaSUIT uses a geographic vector file where the graphic data represent the study area and the single evaluation units within it (the alternatives, e.g. the regions of a country, or the municipalities of a region), while the alphanumeric data (attribute table), describe the environmental, economic and social aspects related to the evaluation units by means of a set of indicators (criteria). The use of the algorithm available in the plugin allows to treat individually the indicators representing the three dimensions of sustainability, and to compute three different indices: environmental index, economic index and social index. The graphic output of the model allows for an integrated assessment of the three dimensions, avoiding aggregation. The presence of separate indices and graphic output make GeoUmbriaSUIT a readable and transparent tool, since it doesn’t produce an aggregate index of sustainability as final result of the calculations, which is often cryptic and difficult to interpret. In addition, it is possible to develop a “back analysis”, able to explain the positions obtained by the alternatives in the ranking, based on the criteria used. The case study presented is an assessment of the level of sustainability in the six regions of Malta, an island state in the middle of the Mediterranean Sea and the southernmost member of the European Union. The results show that the integration of MCDA-GIS is an adequate approach for sustainability assessment. In particular, the implemented model is able to provide easy to understand results. This is a very important condition for a sound decision support tool, since most of the time decision makers are not experts and need understandable output. In addition, the evaluation path is traceable and transparent.

Keywords: GIS, multi-criteria analysis, sustainability assessment, sustainable development

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1 Stent Surface Functionalisation via Plasma Treatment to Promote Fast Endothelialisation

Authors: Irene Carmagnola, Valeria Chiono, Sandra Pacharra, Jochen Salber, Sean McMahon, Chris Lovell, Pooja Basnett, Barbara Lukasiewicz, Ipsita Roy, Xiang Zhang, Gianluca Ciardelli

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Thrombosis and restenosis after stenting procedure can be prevented by promoting fast stent wall endothelialisation. It is well known that surface functionalisation with antifouling molecules combining with extracellular matrix proteins is a promising strategy to design biomimetic surfaces able to promote fast endothelialization. In particular, REDV has gained much attention for the ability to enhance rapid endothelialization due to its specific affinity with endothelial cells (ECs). In this work, a two-step plasma treatment was performed to polymerize a thin layer of acrylic acid, used to subsequently graft PEGylated-REDV and polyethylene glycol (PEG) at different molar ratio with the aim to selectively promote endothelial cell adhesion avoiding platelet activation. PEGylate-REDV was provided by Biomatik and it is formed by 6 PEG monomer repetitions (Chempep Inc.), with an NH2 terminal group. PEG polymers were purchased from Chempep Inc. with two different chain lengths: m-PEG6-NH2 (295.4 Da) with 6 monomer repetitions and m-PEG12-NH2 (559.7 Da) with 12 monomer repetitions. Plasma activation was obtained by operating at 50W power, 5 min of treatment and at an Ar flow rate of 20 sccm. Pure acrylic acid (99%, AAc) vapors were diluted in Ar (flow = 20 sccm) and polymerized by a pulsed plasma discharge applying a discharge RF power of 200 W, a duty cycle of 10% (on time = 10 ms, off time = 90 ms) for 10 min. After plasma treatment, samples were dipped into an 1-(3-dimethylaminopropyl)-3- ethylcarbodiimide (EDC)/N-hydroxysuccinimide (NHS) solution (ratio 4:1, pH 5.5) for 1 h at 4°C and subsequently dipped in PEGylate-REDV and PEGylate-REDV:PEG solutions at different molar ratio (100 μg/mL in PBS) for 20 h at room temperature. Surface modification was characterized through physico-chemical analyses and in vitro cell tests. PEGylated-REDV peptide and PEG were successfully bound to the carboxylic groups that are formed on the polymer surface after plasma reaction. FTIR-ATR spectroscopy, X -ray Photoelectron Spectroscopy (XPS) and contact angle measurement gave a clear indication of the presence of the grafted molecules. The use of PEG as a spacer allowed for an increase in wettability of the surface, and the effect was more evident by increasing the amount of PEG. Endothelial cells adhered and spread well on the surfaces functionalized with the REDV sequence. In conclusion, a selective coating able to promote a new endothelial cell layer on polymeric stent surface was developed. In particular, a thin AAc film was polymerised on the polymeric surface in order to expose –COOH groups, and PEGylate-REDV and PEG were successful grafted on the polymeric substrates. The REDV peptide demonstrated to encourage cell adhesion with a consequent, expected improvement of the hemocompatibility of these polymeric surfaces in vivo. Acknowledgements— This work was funded by the European Commission 7th Framework Programme under grant agreement number 604251- ReBioStent (Reinforced Bioresorbable Biomaterials for Therapeutic Drug Eluting Stents). The authors thank all the ReBioStent partners for their support in this work.

Keywords: endothelialisation, plasma treatment, stent, surface functionalisation

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