Alessandro Mura

Clinical Assessment of Gait in Individuals with Multiple Sclerosis Using Wearable Inertial Sensors: Comparison with Patient-Based Measure

BACKGROUND This study aims to verify the feasibility of use of wearable accelerometers in an ambulatory environment to assess spatiotemporal parameters of gait in people with Multiple Sclerosis (pwMS), as well as the correlation of objective data with patient-reported outcomes. METHODS One hundred and five pwMS (Expanded Disability Status Scale, EDSS in the range 0-6.5) classified in three sub-groups (EDSS 0-1.5, EDSS 2-4, EDSS 4.5-6.5) and 47 healthy controls (HC) participated in the study. All the subjects were evaluated with the timed 25-foot walking test (T25FW) while wearing a commercially available accelerometer. PwMS also rated the impact of the disease on their walking abilities using the 12-item MS walking scale (MSWS-12). RESULTS All parameters objectively measured, except stride length, were significantly modified in pwMS with higher EDSS, with respect to HC and lower disability participants. Moderate to high correlations (r =0.57-0.79) were observed between gait parameters and MSWS-12 for pwMS of higher EDSS. The correlation was found moderate for the intermediate EDSS category (r =0.42-0.62). CONCLUSION Wearable accelerometers are a useful tool for assessing gait performance for pwMS in a clinical setting, especially in cases of mild to moderate disability. Compared with other quantitative techniques, these devices allow patient testing under realistic conditions (i.e., fully dressed, with their usual shoes) using a simple procedure with immediate availability of data.

Toward Naturalistic Self-Monitoring of Medicine Intake

Since drug actions are dose- and time-dependent, adherence to prescribed medications is essential for the effectiveness of therapies. Unfortunately, several studies show that when patients are responsible for treatment administration, poor adherence is prevalent. Hence, it is necessary to devise effective methods to remotely assess medication compliance and support self-administration of drugs. Existing methods include electronic reminders such as short message service reminders and pill reminder apps. Although those tools may help increasing adherence, they interfere with the normal routine of patients by providing unnecessary reminders, or providing the reminder at an unfortunate time. More sophisticated solutions include the use of smart packaging and ingestible sensors to quantify and monitor drug intake. While those solutions do not interfere with normal routines, currently they are restricted to patients involved in a few clinical studies. In this paper, we introduce a novel system to support self-administration of drugs without interfering with the patients routines. The system is based on a combination of cheap sensors and a smartphone. Tiny Bluetooth low energy sensors attached to medicine boxes communicate motion data to an app running on the patients smartphone. Thanks to a machine learning algorithm, the app detects intake events, and reminds the user only when needed. Active learning is used to improve recognition rates thanks to the users feedback. Preliminary experiments with a dataset acquired from volunteers show that the algorithm can detect most intake events with a few false positives. At the time of writing, we have developed a working prototype of the system, and we are beginning an experimental evaluation with a group of patients of an Italian hospital.

Nature and duration of the accounting differences between Italian and US GAAP: A case study on conservatism

Purpose - – The purpose of this paper is to focus on alternative accounting treatments over time to assess their impact on the level of conservatism in a comparison between Italian local accounting standards and USA generally accepted accounting principles. Design/methodology/approach - – A case study approach is adopted to investigate the accounting adjustments applied to net income and shareholders’ equity as included in the Form 20-F reconciliations reported by all Italian firms that were listed on a US market over the period 1999-2008. The methodology first introduced by Gray (1980) and frequently applied over 30 years to several international accounting comparisons is adapted to recognise a multi-period dimension of the accounting choice. In particular, the paper focuses on the temporal dimension of such adjustments in order to capture their attitude to reverse or become permanent over time. Findings - – The results show that the level of conservatism is visible in the measurement of net assets and is shaped by the prevailing directional effect of accounting adjustments that become permanent as their cumulative reversal is persistently delayed. Such a phenomenon arises and intensifies when the accounting differences relate to recurring operations and/or to long-term assets and liabilities. Amongst them those violating the clean surplus relation are the most controversial as they not only generate a permanent effect in the measurement of net assets, but also an opposite permanent effect in the measurement of earnings. Research limitations/implications - – Future empirical research confirming the finding in different contexts might overcome the limitations of a relatively poor number of observations in the case study. Practical implications - – Identifying the duration of alternative accounting treatments is relevant to assess their potential influence on stakeholders decision-making process as this may steadily influence the future of a firm. Originality/value - – The propositions express a sequence of the timing effects of alternative accounting treatments that highlight the primary role of permanent differences in persistently shaping the value of net assets and help to provide a less erratic interpretation of the level of conservatism.

Challenging the reliability of comparables under profit-based transfer pricing methods

Under profit-based transfer pricing methods, the selection of comparable companies is essential if detection of transfer price manipulation is to be reliable. Comparative advantage as embedded in internalisation theory argues that foreign-controlled companies (FCCs) should, in the long run, display greater profitability than domestic-controlled companies. In high-tax host countries, transfer pricing manipulation theory predicts an opposite effect on profitability. Applying a refined set of tests to a large sample of firms operating in a high-tax country such as Italy offers strong support for the internalisation prediction. Furthermore, the analysis of the interquartile range of our measure of profitability indicates that only a low percentage of FCCs would be subject to fiscal enquires, as implied by the Organisation for Economic Co-operation and Development guidelines, under the suspicious of transfer pricing manipulation. These results suggest that current comparability tests are likely to fail the identification of transfer pricing practices in countries where the comparative advantage of FCCs is particularly pronounced and question the reliability of these tests.

Transfer pricing: early Italian contributions

This paper aims at reviewing the early contributions made by Italian scholars to the field of transfer pricing, from the works of Francesco Villa (1840, 1853) to the birth of Economia Aziendale (in the first half of the twentieth century). Although this topic has been traditionally overlooked in the Italian accounting literature, this study shows how Italian accountants were familiar with different methods of transfer pricing and elaborated certain original solutions. The intensive, mainly theoretic discussion for attaching a value to goods exchanged amongst segments of the same company indicates an early recognition of the potential influence of organizational structure, intermediate markets, coordination and differentiation that may have laid the platform for a greater integration between financial and cost accounting. Unfortunately this genuine debate suddenly stopped: the diffusion of Zappas theories partly explains this phenomenon.