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IntroductionHealthcare-associated infections are the main reported adverse event in healthcare, with significant economic costs that include those caused by medical malpractice claims. In Italy, there is a fault-based compensation system, but in this specific field, the burden of proof on the hospitals is particularly heavy. Hence, we aimed to verify the economic impact of the inclusion of experts in hospital infection surveillance into internal committees for claims assessment and to evaluate what would have been the economic impact of a mandatory no-fault system rather than the current system.Materials and methodsWe compared two 4-year periods (T1: 2015–2018 and T2: 2019–2022), investigating the medical malpractice claims related to healthcare-associated infections in a large tertiary public hospital in Florence, Italy. Decisions of the internal committee, evolutions of the claims after the decision, and conclusions of the claims were registered. No-fault system simulations were used to evaluate the cost-effectiveness of the model.ResultsWe observed a decrease in the number of claims after the implementation of infection prevention and control (IPC) experts into the committee (a 24% decrease in rejections and a 19% increase in admissions). We found a 6806.98 euros difference (not statistically significant) in compensations in T1 and T2. Moreover, our simulations found that a no-fault compensation system – if alternative to the traditional fault-based approach – could lead to gains or losses for the plaintiffs depending on the approach chosen. (We observed a 52% mean decrease in compensations with a 150000 euros maximal indemnity and a 134% mean increase with an indemnity tailored considering also life expectancy).DiscussionIntroducing experts in IPC into hospital committees for medico-legal claims management has proven to be cost-effective, offering a no-fault compensation system as an alternative to the traditional fault-based approach, supported by a properly evaluated maximal indemnity. Due to the limitations of our models, multicentric studies are recommended to verify our results.

Several diseases affect the alveoli, and the efficacy of medical treatments and pharmaceutical therapies is hampered by the lack of pre-clinical models able to recreate in vitro the diseases. Microfluidic devices, mimicking the key structural and compositional features of the alveoli, offer several advantages to medium and high-throughput analysis of new candidate therapies. Here, we developed an alveolus-on-a-chip recapitulating the microanatomy of the physiological tissue by including the epithelium, the fibrous interstitial layer and the capillary endothelium. A PDMS device was obtained assembling a top layer and a bottom layer obtained by replica molding. A polycaprolactone/gelatin (PCL-Gel) electrospun membrane was included within the two layers supporting the seeding of 3 cell phenotypes. Epithelial cells were grown on a fibroblast-laden collagen hydrogel located on the top side of the PCL-Gel mats while endothelial cells were seeded on the basolateral side of the membrane. The innovative design of the microfluidic device allows to replicate both cell-cell and cell-extracellular matrix interactions according to the in vivo cell arrangement along with the establishment of physiologically relevant air-liquid interface conditions. Indeed, high cell viability was confirmed for up to 10 days and the formation of a tight endothelial and epithelial barrier was assessed by immunofluorescence assays.

Nowadays, additive manufacturing technologies have impacted different engineering sectors. Three- and four-dimensional printing techniques are increasingly used in soft and flexible electronics thanks to the possibility of working contemporarily with several materials on various substrates. The materials portfolio is wide, as well as printing processes. Shape memory polymers, together with composites, have gained great success in the electronic field and are becoming increasingly popular for fabricating pH, temperature, humidity, and stress sensors that are integrated into wearable, stretchable, and flexible devices, as well as for the fabrication of communication devices, such as antennas. Here, we report an overview of the state of the art about the application of 4D printing technologies and smart materials in electronics.

MEMS devices are more and more commonly used as sensors, actuators, and microfluidic devices in different fields like electronics, opto-electronics, and biomedical engineering. Traditional fabrication technologies cannot meet the growing demand for device miniaturisation and fabrication time reduction, especially when customised devices are required. That is why additive manufacturing technologies are increasingly applied to MEMS. In this review, attention is focused on the Italian scenario in regard to 3D-printed MEMS, studying the techniques and materials used for their fabrication. To this aim, research has been conducted as follows: first, the commonly applied 3D-printing technologies for MEMS manufacturing have been illustrated, then some examples of 3D-printed MEMS have been reported. After that, the typical materials for these technologies have been presented, and finally, some examples of their application in MEMS fabrication have been described. In conclusion, the application of 3D-printing techniques, instead of traditional processes, is a growing trend in Italy, where some exciting and promising results have already been obtained, due to these new selected technologies and the new materials involved.

This study proposes a redesign of asymmetric single-chamber microbial fuel cells (a-SCMFCs) with the goal of optimizing energy production. In the present work, the new approach is based on the introduction of a novel intermediate microfluidic septum (IMS) inside the electrolyte chamber. This IMS was designed as a relatively simple and inexpensive method to optimize both electrolyte flow and species transfer inside the devices. a-SCMFCs, featuring the IMS, are compared to control cells (IMS-less), when operated with sodium acetate as the carbon energy source. Performances of cells are evaluated in terms both of maximum output potential achieved, and energy recovery (Erec) as the ratio between the energy yield and the inner electrolyte volume. The a-SCMFCs with the novel IMS are demonstrated to enhance the energy recovery compared to control cells exhibiting Erec values of (37 ± 1) J/m3, which is one order of magnitude higher than that achieved by control cells (3.0 ± 0.3) J/m3. Concerning the maximum output potential, IMS cells achieve (2.8 ± 0.2) mV, compared to control cells at (0.68 ± 0.07) mV. Furthermore, by varying the sodium acetate concentration, the Erec and maximum potential output values change accordingly. By monitoring the activity of a-SCMFCs for over one year, the beneficial impact of the IMS on both the initial inoculation phase and the long-term stability of electrical performance are observed. These improvements support the effectiveness of IMS to allow the development of efficient biofilms, likely due to the reduction in oxygen cross-over towards the anode. Electrochemical characterizations confirm that the presence of the IMS impacts the diffusion processes inside the electrolytic chamber, supporting the hypothesis of a beneficial effect on oxygen cross-over.

Biocompatible gold nanoparticles (AuNPs) are particularly interesting for photo-thermal therapy (PTT) of cancer treatment because of their ability to convert light into heating efficiently. Nevertheless, the random accumulation of AuNPs in tissues, mainly determined by their retention time in the bloodstream, is one of the main limiting factors for their use in PTT applications. For this reason, efficient targeting and monitoring of AuNPs in the selected tissues is of paramount importance. This manuscript reports on a new generation of 99mTc-labeled AuNPs coated with keratin (Ker-AuNPs) and their spatial localization investigated by nuclear imaging techniques on an animal-free model. The effective radiolabeling of Ker-AuNPs with 99mTc is achieved using the chelating agent diethylenetriaminepentaacetic acid (DTPA), resulting in the 99mTc-DTPA-Ker-AuNPs nanoconjugate. The 99mTc-DTPA-Ker-AuNPs display a radiochemical purity of 90.7% and excellent photo-thermal properties. In addition, the biocompatibility of the 99mTc-DTPA-Ker-AuNPs with healthy human embryonic kidney (HEK293T) cells is shown. A Lab-On-a-Chip (LoC) approach is used to localize and study the stability of 99mTc-DTPA-Ker-AuNPs under dynamic conditions. To this end, the nanoconjugates are injected into a polydimethylsiloxane microfluidic chip mimicking the renal filtering unit, the nephron, and monitored via radio-imaging and thermo-optical experiments. These detailed studies establish that DTPA-assisted 99mTc-labeled Ker-AuNPs are excellent candidates as biocompatible and non-invasive radiolabeled nanotherapeutic for PTT-based applications.

The global COVID-19 pandemic has had severe consequences from the social and economic perspectives, compelling the scientific community to focus on the development of effective diagnostics that can combine a fast response and accurate sensitivity/specificity performance. Presently available commercial antigen-detecting rapid diagnostic tests (Ag-RDTs) are very fast, but still face significant criticisms, mainly related to their inability to amplify the protein signal. This translates to a limited sensitive outcome and, hence, a reduced ability to hamper the spread of SARS-CoV-2 infection. To answer the urgent need for novel platforms for the early, specific and highly sensitive detection of the virus, this paper deals with the use of organic electrochemical transistors (OECTs) as very efficient ion–electron converters and amplifiers for the detection of spike proteins and their femtomolar concentration. The electrical response of the investigated OECTs was carefully analyzed, and the changes in the parameters associated with the transconductance (i.e., the slope of the transfer curves) in the gate voltage range between 0 and 0.3 V were found to be more clearly correlated with the spike protein concentration. Moreover, the functionalization of OECT-based biosensors with anti-spike and anti-nucleocapside proteins, the major proteins involved in the disease, demonstrated the specificity of these devices, whose potentialities should also be considered in light of the recent upsurge of the so-called “long COVID” syndrome.

Platelets are emerging as a promising source of blood biomarkers for several pathologies, including cancer. New automated techniques for easier manipulation of platelets in the context of lab-on-a-chips could be of great support for liquid biopsy. Here, several polymeric materials were investigated for their behavior in terms of adhesion and activation of human platelets. Polymeric materials were selected among the most used in microfabrication (PDMS, PMMA and COC) and commercial and home-made resins for 3D printing technology with the aim to identify the most suitable for the realization of microdevices for human platelets isolation and analysis. To visualize adherent platelets and their activation state scanning, electron microscopy was used, while confocal microscopy was used for evaluating platelets’ features. In addition, atomic force microscopy was employed to further study platelets adherent to the polymeric materials. Polymers were divided in two main groups: the most prone to platelet adhesion and materials that cause few or no platelets to adhere. Therefore, different polymeric materials could be identified as suitable for the realization of microdevices aimed at capturing human platelets, while other materials could be employed for the fabrication of microdevices or parts of microdevices for the processing of platelets, without loss on surfaces during the process.

In this paper, a three-layer dielectric structure is presented as innovative unit-cell element for transmitarray (TA) antennas with enhanced bandwidth. It consists of a central layer, with a varying size square hole, used to compensate the phase of the incident field and located between two other identical layers with linearly tapered square holes, acting as matching circuits. The effectiveness of this unit-cell is demonstrated by the numerical and the experimental results here presented. As a first step, three different TAs with increasing size are designed and simulated: their 1-dB gain bandwidth, centered at 30 GHz, varies from the 30.9% of the smallest configuration, having size of 10λ0 x 10λ0, to the 17.5% of the 20λ0 x20λ0 TA. A slightly modified unit-cell is then designed, with the aim of realizing a prototype with an additive manufacturing (AM) technique. A 3D-printed dielectric TA with a size of 15.6λ0 x15.6λ0 has been manufactured and experimentally characterized. The measured prototype shows excellent performances, achieving a 1-dB gain bandwidth of 21.5%: these results prove the enhanced features of the introduced unit-cell and demonstrate the TA feasibility with AM techniques.

We report on the preparation and stereolithographic 3D printing of a resin based on the composite between a poly(ethylene glycol) diacrylate (PEGDA) host matrix and a poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS) filler, and the related cumulative volatile organic compounds’ (VOCs) adsorbent properties. The control of all the steps for resin preparation and printing through morphological (SEM), structural (Raman spectroscopy) and functional (I/V measurements) characterizations allowed us to obtain conductive 3D objects of complex and reproducible geometry. These systems can interact with chemical vapors in the long term by providing a consistent and detectable variation of their structural and conductive characteristics. The materials and the manufacture protocol here reported thus propose an innovative and versatile technology for VOCs monitoring systems based on cumulative adsorption effects.