Although the value of patient and public involvement and engagement (PPIE) activities in the development of new interventions and tools is well known, little guidance exists on how to perform these ...activities in a meaningful way. This is particularly true within large research consortia that target multiple objectives, include multiple patient groups, and work across many countries. Without clear guidance, there is a risk that PPIE may not capture patient opinions and needs correctly, thereby reducing the usefulness and effectiveness of new tools. Mobilise-D is an example of a large research consortium that aims to develop new digital outcome measures for real-world walking in 4 patient cohorts. Mobility is an important indicator of physical health. As such, there is potential clinical value in being able to accurately measure a person's mobility in their daily life environment to help researchers and clinicians better track changes and patterns in a person's daily life and activities. To achieve this, there is a need to create new ways of measuring walking. Recent advancements in digital technology help researchers meet this need. However, before any new measure can be used, researchers, health care professionals, and regulators need to know that the digital method is accurate and both accepted by and produces meaningful outcomes for patients and clinicians. Therefore, this paper outlines how PPIE structures were developed in the Mobilise-D consortium, providing details about the steps taken to implement PPIE, the experiences PPIE contributors had within this process, the lessons learned from the experiences, and recommendations for others who may want to do similar work in the future. The work outlined in this paper provided the Mobilise-D consortium with a foundation from which future PPIE tasks can be created and managed with clearly defined collaboration between researchers and patient representatives across Europe. This paper provides guidance on the work required to set up PPIE structures within a large consortium to promote and support the creation of meaningful and efficient PPIE related to the development of digital mobility outcomes.
It is assumed that the impact of natural and man-made hazards on society in terms of damage cannot be avoided. To reduce potential disaster levels and to assess which policies have had a positive ...outcome, a careful comparison should take place on the procedures implemented in the management of crises. The experiences with the earthquakes in the Pianura Padana area and central regions of Italy in the last ten years have been incorporated in the 'After the Damages' advanced training project. This project aims to showcase recent innovations and advancements in post-disaster management, so as to take a more proactive role in post-disaster management, and to respond more effectively when disasters occur. This volume provides insights into the dynamics and negative effects of natural and man-made hazards (i.e., earthquakes, fires, floods, droughts, volcanic eruptions, etc.), including more updated approaches to deal with post-disaster phases. The book also offers tools to deal with possible international crisis scenarios and mitigate the social impact of vulnerabilities through risk reduction. Built Heritage in post-Disaster Scenarios aims at public administration managers, government agency representatives, international organizations, researchers, and professionals in architecture, engineering, and earth science. Marcello Balzani, Architect, PhD in "Representation and Survey", Full Professor of Representation at the Department of Architecture, University of Ferrara. President of Clust-ER Building and Construction. He is author of more than 200 publications on the themes of Drawing and Architectural and Urban Surveying, Project Representation, Management and Visualisation. Federica Maietti, Architect, PhD, Associate Professor in the Scientific Sector ICAR/17 at the Department of Architecture, University of Ferrara. Member of the DIAPReM Centre, since 2005 she carries out research activities in the fields of heritage documentation, survey and diagnostic investigations, in different national and international contexts, including Pompeii, Malta, Brazil, India, and Mexico. Scientific Manager of the International Academy "After the Damages", she is involved in several research activities and she is the author of more than two hundred publications in the field of Heritage Documentation, Survey and Representation. Manlio Montuori, Architect, PhD, former assistant professor non-tenured at the University of Ferrara, Department of Architecture, where he is a member of the Labo.R.A. The main field of his research is the conservation of architectural heritage and landscape, with special emphasis on preservation procedures for traditional and industrial built heritage. His research interests also address assessment and management in the context of damage and disaster risk reduction. Scientific Manager of the International Academy "After the Damages", he is involved in several research projects implementing ICT technologies in the conservation and structural health assessment of built and cultural heritage. Fabiana Raco, Architect, PhD RTDa Researcher of Drawing at the Department of Architecture, University of Ferrara. Technical coordinator of TekneHub Laboratory. Author of more than 50 publications on the topics of Drawing, Architectural and Urban Surveying, Representation, Diagnostics, Visualization and Project Management of interventions on built heritage.
The vernacular historic cities can be defined as an ensemble of local needs and construction materials-based architectures which reflects local traditions and cultures. Very often adaptive processes ...for sustaining settlements such as the vernacular ones are based on both sustainable resources and cultural practices. This set of indigenous, ecological, biological, and cultural characteristics make vernacular historic cities valuable place for the valorization of local cultures and intangible heritage. Nowadays, dealing with the challenging task of heritage preservation in emerging countries, technologies are very often economically uncompetitive if used without the right methodology and a proper use. This study highlights the application of digital technologies for the documentation of historic city centers in fragile contexts such as global south countries by a deep case studies analysis of the Indian old cities of Ahmedabad and Jodhpur. The main aim of the research was to evaluate accuracy requirement and assess digital tools for heritage preservation end enhancement. By means of affordable use of digital technologies, the research stressed the existence of a strong relation between sustainable economy development and cultural heritage preservation even through capacity building activities carried out on field.
Non-Intubated Thoracic Surgery (NITS) is becoming increasingly adopted all over the world. Although it is mainly used for pleural operations,, non-intubated parenchymal lung surgery has been less ...frequently reported. Recently, NITS utilization seems to be increased also in Italy, albeit there are no multi-center studies confirming this finding. The objective of this survey is to assess quantitatively and qualitatively the performance of NITS in Italy.
In 2018 a web-based national survey on Non-Intubated management including both thoracic surgeons and anesthesiologists was carried out. Reference centers have been asked to answer 32 questions. Replies were collected from June 26 to November 31, 2019.
We raised feedbacks from 95% (55/58) of Italian centers. Seventy-eight percent of the respondents perform NITS but only 38% of them used this strategy for parenchymal surgery. These procedures are more frequently carried out in patients with severe comorbidities and/or with poor lung function. Several issues as obesity, previous non-invasive ventilation and/or oxygen therapy are considered contraindications to NITS. The regional anesthesia technique most used to provide intra- and postoperative analgesia was the paravertebral block (37%). Conversion to general anesthesia is not anecdotal (31% of answerers). More than half of the centers believed that NITS may reduce postoperative intensive care unit admissions. Approximately a quarter of the centers are conducting trials on NITS and, three quarters of the respondent suppose that the number of these procedures will increase in the future.
There is a growing interest in Italy for NITS and this survey provides a clear view of the national management framework of these procedures.
The Formica rufa group comprises several ant species which are collectively referred to as “red wood ants” (hereafter RWA). These species have key roles in forest ecosystems, where they are ...ecologically dominant and greatly influence the dynamics of the habitat they colonise. Various studies have shown how their trophic activity may affect other organisms, which include both other invertebrates and plants. We can therefore hypothesize that their presence could affect the taxonomic and functional composition of epiphytes, despite clear information on such an effect is lacking. This study aimed to fill this research gap by evaluating whether the presence of red wood ants could affect the structure and composition of lichen communities. We selected two sites on the Apennine Mountains in Italy, where the red wood ant F. paralugubris was introduced from the Alps more than 50 years ago. In each site, lichen assemblages on Abies alba trees located within the colonised areas were compared to those from nearby, non-occupied areas. The results allowed for the identification of significant effects of F. paralugubris on the structure of lichen communities. Although there was no detectable impact on lichen species richness, a significant difference in their community composition between colonised and control sites was detected. Furthermore, ant presence seemed to be associated with specific lichen functional traits such as asexual reproduction. We argue that RWA could affect the lichen community either directly, e.g., by actively dispersing the species capable of asexual reproduction through their movements on trees (ant-mediated dispersion), or indirectly through herbivore exclusion. Finally, we also observed differences in β-diversity among the colonised and non-colonised sites.
Aim
The aim of this study was to assess the prevalence of delirium in advanced cancer patients admitted to different palliative care services in Italy and possible related factors. The secondary ...outcome was to assess the changes of delirium after 1 week of palliative care.
Methods
A consecutive sample of patients was screened for delirium in period of 1 year in seven palliative care services. General data, including primary tumor, age, gender, concomitant disease, palliative prognostic score (
PaP
), and Karnofsky status, were collected. Possible causes or factors associated with delirium were looked for. The Edmonton Symptom Assessment Scale was used to assess physical and psychological symptoms and the Memorial Delirium Assessment Scale (MDAS) to assess the cognitive status of patients,
at admission
(
T0
)
and 1 week after palliative care
(
T7
).
Results
Of 848 patients screened, 263 patients were evaluated. Sixty-six patients had only the initial evaluation. The mean Karnofsky status was 34.1 (SD = 6.69); the mean PaP score at admission was 6.9 (SD = 3.97). The mean duration of palliative care assistance, equivalent to survival, was 38.4 days (SD = 48, range 2–220). The mean MDAS values at admission and after 1 week of palliative care were 6.9 (SD = 6.71) and 8.8 (SD = 8.26), respectively. One hundred ten patients (41.8%) and 167 patients (67.3%) had MDAS values ≥ 7 at admission and after 1 week of palliative care, respectively. Age, dehydration, cachexia, chemotherapy in the last three months, and intensity of drowsiness and dyspnea were independently associated with a MDAS > 7. A worsening of drowsiness, the use of opioids, and the use of corticosteroids were independently associated with changes of MDAS from T0 to T7.
Conclusion
Although the prevalence of delirium seems to be similar to that reported in other acute settings, delirium tended to worsen or poorly responded to a palliative care treatment. Some clinical factors were independently associated with delirium. This information is relevant for decision-making when delirium does not change despite a traditional intervention. Continuous assessment of delirium should be performed in these settings to detect deterioration of cognitive function. Further studies should elucidate whether an earlier approach to palliative care would decrease the prevalence of delirium at a late stage of disease.
As per the objectives of Project CHANGES, particularly its thematic sub-project on the use of virtual technologies for museums and art collections, our goal was to obtain a digital twin of the ...temporary exhibition on Ulisse Aldrovandi called “The Other Renaissance”, and make it accessible to users online. After a preliminary study of the exhibition, focusing on acquisition constraints and related solutions, we proceeded with the digital twin creation by acquiring, processing, modelling, optimising, exporting, and metadating the exhibition. We made hybrid use of two acquisition techniques to create new digital cultural heritage objects and environments, and we used open technologies, formats, and protocols to make available the final digital product. Here, we describe the process of collecting and curating bibliographical exhibition (meta) data and the beginning of the digital twin creation to foster its findability, accessibility, interoperability, and reusability. The creation of the digital twin is currently ongoing.
Este artigo aborda métodos integrados de diagnóstico de bens arquitetônicos e tem por objetivo evidenciar as características e potencialidades do escaneamento a laser em três dimensões, a partir da ...experiência de cooperação científica entre a Faculdade de Arquitetura e Urbanismo da Universidade de São Paulo (FAU USP) e o laboratório de pesquisa da Università degli Studi di Ferrara (Unife) – Development of Integrated Automatic Procedures for Restoration of Monuments (DIAPReM). A análise é centrada nas experiências conjuntas entre as instituições, voltadas ao Edifício Vilanova Artigas, sede da FAU USP, e ao Museu do Ipiranga da USP. Para estruturar as questões, são inicialmente apresentadas as características da colaboração entre as instituições para, depois, analisar as características dos trabalhos feitos no Edifício Vilanova Artigas e no Museu do Ipiranga. Em seguida, são examinadas as particularidades do método e a discussão sobre suas potencialidades durante os ciclos de formação de estudantes da FAU USP; depois, são apresentadas considerações sobre o escaneamento a laser e seu papel no diagnóstico integrado. O texto é encerrado com reflexões sobre o método e suas potencialidades, evidenciando a necessidade de uma abordagem crítica.
La complessità delle sorgenti morfometriche stimola
confronti e ricerche tra i dati di misura e i
gradi di visualizzazione e di interrogazione diretta.
La banca dati 3D, realizzata nel caso delle ...architetture
albertiane per lo sviluppo critico-interpretativo
degli storici dell’arte e dell’architettura,
diviene anche strumento di simulazione di soluzioni
spaziali e controllo per il cantiere.
Il restauro dell’Istituto degli Innocenti a Firenze è
infatti l’occasione per comprendere come un dato
di conoscenza morfometrica possa permettere di
sviluppare soluzioni di progetto per la nuova accessibilità
del Museo realizzato sulla “misura” di
Brunelleschi.
Attraverso questi due approcci viene sviluppato
il tema della documentazione della memoria che
si finalizza, con tecniche di interrogazione, navigazione
e rappresentazione, al restauro della materia.
Il progetto Smart Swap Building nasce in collaborazione con la Piattaforma Costruzioni della Rete Alta Tecnologia dell’Emilia-Romagna come progetto strategico in risposta alla crisi che sta duramente ...colpendo il settore delle costruzioni e che richiede l’innesco di nuove logiche di rigenerazione utili all'intera filiera, volte alla riqualificazione e alla riduzione del consumo di suolo. La congiuntura del mercato, contrassegnata da tassi di assorbimento degli immobili notevolmente inferiori al passato, capaci di generare una considerevole quantità di patrimonio invenduto di recente costruzione, e da investimenti sul costruito maggiori rispetto a quelli nel settore delle nuove costruzioni, mostra già chiaramente un crescente interesse nei confronti di strategie di produzione del valore attente alla sostenibilità, sia sul lungo che sul breve periodo, capaci di tradursi in una diffusa sensibilità per la qualità del patrimonio esistente e la sua capacità di rigenerarsi, al fine di rispondere a nuove aspettative d’uso. Integrando la forte esigenza di riqualificazione dell’esistente, nella logica di raggiungimento degli obiettivi europei di riduzione di consumo del suolo nonché di risparmio energetico, di risorse e di adeguamento del comfort abitativo, e un patrimonio immobiliare di nuova costruzione non utilizzato, Smart Swap Building necessita di opportuni strumenti informativi a supporto dei complessi processi decisionali, in grado di integrare differenti competenze, a diverse scale e in diversi momenti del ciclo di vita degli edifici. Lo strumento rappresentativo inteso come parte integrante del processo edilizio, dalla progettazione, al cantiere, fino alla gestione, diviene anch’esso elemento da valutare per definire la qualità progettuale ed effettuare ragionamenti sulla sostenibilità dell’opera ben più consapevoli ed approfonditi.Il problema scientifico della ricerca, condotta all’interno di un percorso di dottorato afferente al Laboratorio TekneHub del Tecnopolo dell’Università di Ferrara, viene pertanto circoscritto all’ambito del rilievo e della rappresentazione, rispetto all’assunzione che ogni informazione sul manufatto edilizio, generata durante l’intero ciclo di vita, si configuri come volano per il miglioramento dell’efficienza complessiva del ruolo di tutti professionisti coinvolti. Il progetto sul costruito necessita infatti di una fase di indagine e di acquisizione preventiva dei caratteri metrici e morfologici al fine di progettare l’intervento di riqualificazione. La finalità del rilievo mira dunque alla creazione di una banca dati tridimensionale che possa strutturare, archiviare e diffondere le informazioni sul manufatto edilizio in modo organico, integrato ed accessibile, attraverso la definizione di una filiera digitale inclusiva rispetto all’intero processo di riqualificazione. In linea con la strategia comunitaria H2020, finalizzata ad una crescita intelligente, sostenibile ed inclusiva, così come con la nuova direttiva europea sui lavori pubblici, la limitazione del campo di indagine della presente ricerca circoscrive l’ambito strumenti digitali raggruppabili sotto il nome di Building Information Modelling (BIM). Tali strumenti infatti permettono non solo di condurre in modo trasparente le fasi progettuali al fine di realizzare elaborati tradizionali corretti, ma si estende all’intero processo edilizio, mettendo in relazione elementi compositivi, tecnologici e strutturali con le fasi di rilievo dell’esistente, di costruzione e cantiere (BIM 4D), stima dei costi (BIM 5D), certificazione (BIM 6D) e gestione del ciclo di vita (BIM7D + CAFM).Principale prodotto di questa ricerca è quindi la definizione delle linee guida per l’implementazione dello specifico set di strumenti informativo-rappresentativi nel processo Smart Swap Building. L’applicazione delle stesse a tre casi applicativi, identificati sulla base di criteri tipologici, in relazione al sistema della proprietà e rispetto allo specifico ruolo nella filiera digitale, hanno reso possibile la verifica e la validazione delle linee guida definite per quanto riguarda l’ambito di competenza architettonica. Particolare attenzione è stata inoltre rivolta all’integrazione dei dati da rilievo laser scanner 3D per la creazione di modelli BIM, così come all’interoperabilità tra sistemi di authoring architettonico e alla condivisione del dato tra differenti professionisti orientato rispetto ai temi dell’Open BIM e l’implementazione di standard aperti di interoperabilità nella logica di preservazione del dato digitale tra le varie fasi e tra i differenti professionisti così come della definizione di un processo edilizio trasparente.
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