Michela Franzò

(1) Background: Thermal radiofrequency ablation (RFA) is an innovative treatment for benign thyroid nodules. This study aims to identify morphological and texture-based cytological parameters through radiomic and cytological analysis of fine-needle aspiration cytology (FNAC) images to support the prediction of the nodules’ response to RFA. (2) Methods: The study, conducted in collaboration with EOC—Ente Ospedaliero Cantonale (Lugano, Switzerland), analyzed FNAC images from three patients with benign thyroid nodules treated with RFA. Radiomic features were extracted in PyRadiomics and analyzed through Principal Component Analysis (PCA). A MATLAB (R2024b)-based workflow was implemented for automated chromatic and morphological analysis. (3) Results: Chromatic Analysis correctly identified separated nuclei with approximately 5% remaining unrecognized. Radiomics revealed robust connections between nuclear shape descriptors and texture-based features, showing the potential of a combined morphological-radiomic approach. PCA indicated that texture and first order features played a significant role in cytological heterogeneity. (4) Conclusions: A combination between radiomics, chromatic, and morphological analysis provides a deeper understanding of thyroid nodule characteristics. By capturing texture and intensity variations often missed by traditional methods, radiomics may enhance prediction of post-RFA behavior. The proposed methodology provides a foundation for predictive models of Volume Reduction Ratio (VRR), improving personalized diagnosis, treatment planning, and follow-up.

Registries require standardized component libraries based on predefined taxonomies to ensure detailed and structured descriptions of implanted devices, enabling effective monitoring of implant safety. Considering the growing use of spinal implantable devices, we aimed to propose a comprehensive classification framework for spinal devices, to be integrated into the Italian Spine registry framework. The taxonomy was created using a detailed process that included reviewing existing literature, analyzing technical documents, selecting important device characteristics, obtaining feedback from manufacturers, and converting the information into a format suitable for IT systems. Our findings showed the lack of a globally accepted classification system. We identified four primary categories, further refined into subcategories, complemented by attributes for device identification, traceability, and characterization, then structured them using XSD schemas. Our proposal represents the first known attempt to implement a taxonomy for spinal implants, with the potential to serve as an international reference. A structured classification system would enhance registry interoperability, facilitate cross-registry comparability, and improve the early detection of adverse events, thereby strengthening patient safety and clinical outcomes. Furthermore, the adoption of a unified classification framework would improve surgeons’ clinical practice and support policymakers in developing early prevention strategies, ultimately improving patient care.

Background: Clinical assessment of balance and postural disorders is usually carried out through several common practices including tests such as the Subjective Visual Vertical (SVV) and Limit of Stability (LOS). Nowadays, several cutting-edge technologies have been proposed as supporting tools for stability evaluation. Extended Reality (XR) emerges as a powerful instrument. This proof-of-concept study aims to assess the feasibility and potential clinical utility of a novel MR-based framework integrating HoloLens 2, Wii Balance Board, and Azure Kinect for multimodal balance assessment. An innovative test is also introduced, the Innovative Dynamic Balance Assessment (IDBA), alongside an MR version of the SVV test and the evaluation of their performance in a cohort of healthy individuals. Results: All participants reported SVV deviations within the clinically accepted ±2° range. The IDBA results revealed consistent sway and angular profiles across participants, with statistically significant differences in posture control between opposing target directions. System outputs were consistent, with integrated parameters offering a comprehensive representation of postural strategies. Conclusions: The MR-based framework successfully delivers integrated, multimodal measurements of postural control in healthy individuals. These findings support its potential use in future clinical applications for balance disorder assessment and personalized rehabilitation.

Background: Serious videogames have already demonstrated their positive impact on rehabilitation and of particular interest is the virtual reality (VR) technology. This immersive technology has been used in this study to create a neuroaesthetic experience based on the Michelangelo effect for the rehabilitation of patients with spinal cord injury. The aim of this study was to test the usability of a system for virtual art therapy and its capacity to assess patients’ deficits performances. Methods: A VR headset was worn by the participants who experienced a painting simulation of famous artworks (artistic stimuli) against a coloring canvas (non-artistic stimuli). The trajectories of the hand were studied to obtain different kinematic and spectral parameters to evaluate the user performances. A total of 13 healthy subjects and 13 patients with spinal cord injury participated in this study. Results: Significative differences were obtained for most of the parameters between the two groups, except for the normalized jerk and energy of the spectrum. Analysis in the frequency domain showed that both groups preferred horizontal movements for painting the canvas. The NASA and USEQ scores reported a comfortable and user-friendly system according to the patients’ point of view. Conclusions: The system can be a usable tool, the rehabilitative efficacy of which should be tested in patients with spinal cord injury. The kinematic and spectral parameters would allow for the evaluation of the performances alongside the clinical scales, distinguish pathological and physiological performances.

Background: serious videogames have already demonstrated their positive impact on rehabilitation and of particular interest is the virtual reality (VR) technology. This immersive technology has been used in this study for a neuroaesthetic experience based on Michelangelo effect for rehabilitation of patients with spinal cord injury. The aim of this study was to test the usability of this system and its capacity to assess patients’ deficits performances. Methods: a VR headset was worn by the participants who experienced a painting simulation of famous paintings (experimental stimuli) versus colored (control stimuli). Trajectories of the hand were studied to obtained different kinematic and spectral parameters to evaluate the user performances. 13 healthy subjects and 13 patients with spinal cord injury participated to the study. Results: significative differences were obtained for most of the parameters between the two groups, except for normalized jerk and energy of the spectrum. Analysis in frequency domain showed that both groups prefer the horizontal movements to discover the canvas. NASA and USEQ scores reported a comfortable and user-friendly system according to patients’ point of view. Conclusions: the system can be a usable tool, the rehabilitative efficacy of which should be tested in patients with spinal cord injury. The kinematic and spectral parameters would allow to evaluate the performances alongside the clinical scales, distinguish pathological and physiological performances.

This study aims to investigate the gap in perceptions of parents and children on the use of videogames in childhood. Methods: A survey was conducted with 75 pairs formed by a son or daughter and one parent. The data collected contradict the prejudice that playing video games reduces study time and leads to lower grades at school (R < 0.13). Our results support the idea that playing together fosters bonding and facilitates conversation. The impact of videogames on mood showed the most substantial differences in perception, with parents mainly reporting negative mood changes, while children reported similar frequencies of negative, neutral, and positive ones. In relation to the educational and informative potential of videogames, children had slightly more positive opinions than their parents (p < 0.001). Finally, more than half of the participants potentially agreed with the possibility of using videogames as academic tools. In conclusion, there is a gap between parents’ and children’s perceptions about videogaming, especially concerning their effects on children’s mood. Playing together and developing deeper knowledge about videogames could enhance positive effects on children’s development as well as their relationships with peers, parents, and at school.

Background: While several studies investigate the utility and clinical value of 3D printing in aiding diagnosis, medical education, preoperative planning, and intraoperative guidance of surgical interventions, there is a scarcity of literature regarding concrete applications of mixed reality in the cardiovascular domain due to its nascent stage of study and expansion. This study goes beyond a mere three-dimensional visualization of the cardiac district, aiming to visualize the intracardiac structures within the scope of preoperative planning for cardiac surgery. Methods: The segmentation of the heart was performed through an open-source and a professional software and by applying different procedures. Each anatomical component of the heart, including the aortic valve, was accurately segmented and a 3D model was built to represent the entire heart. Results: Beyond the three-dimensional visualization of the cardiac region, the intracardiac structures were also segmented. A mixed-reality app was implemented with the possibility of exploding the model, interacting with it, and freely sectioning it with a plane. Conclusions: The proposed segmentation methodology allows a segmentation of the valve and the intracardiac structures. Furthermore, the mixed-reality app has confirmed the potential of this technology in diagnostic and preoperative planning, although some limitations should still be overcome.