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"Simone, Rudy"
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Attitude and Actual Behaviour towards Water-Related Green Infrastructures and Sustainable Drainage Systems in Four North-Western Mediterranean Regions of Italy and France
Water-related green infrastructures (WrGIs), also known as blue infrastructures, and sustainable drainage systems (SuDSs) offer services such as stormwater runoff management, water purification, water storage at the intersection of the built environment, and natural systems by mimicking natural hydrological processes. While several papers document the reliability of such infrastructures in providing a variety of water-related services, few studies investigated the actual behaviour and the attitude of different stakeholders to understand the limitations and barriers in WrGIs/SuDSs implementation. In this paper, we investigated these issues by posing a set of questions to 71 qualified stakeholders in three Italian regions (Toscana, Liguria, and Sardegna) and one French region (Provence-Alpes-Côte d’Azur) in the northwestern Mediterranean. The results of the investigation largely show a lack of knowledge on these innovative solutions, although there is a general interest in their implementation both in the Italian and French regions. Barriers are also constituted by the scarcity of the demonstrators implemented, little knowledge on construction and maintenance costs, the absence of a proper regulatory framework, and of fiscal and financial incentives to support private citizens and companies. We finally suggest tools and soft measures that, in our opinion, may contribute to supporting the implementation of WrGIs/SuDSs, especially in view of adapting Mediterranean territories to the challenges posed by climate change. The results of our analyses may be reasonably up-scaled to the whole Mediterranean coastal region.
Journal Article
Diaphragmatic Endometriosis—A Single-Center Retrospective Analysis of the Patients’ Demographics, Symptomatology, and Long-Term Treatment Outcomes
Diaphragmatic endometriosis is rare and forms 0.67–4.7% of all endometriosis cases. Evidence regarding its optimal management is lacking. In this study, we retrospectively analyzed the patient characteristics and long-term treatment outcomes of diaphragmatic endometriosis patients. Over a 4-year period, 23 patients were diagnosed with diaphragmatic endometriosis. The majority of patients had coexisting deep pelvic endometriosis. Cyclic upper abdominal pain was reported by 60.9% of patients, while cyclic chest and shoulder pain were reported by 43.5% and 34.8% of patients, respectively. Most patients were treated with laparoscopic lesion ablation, while 21.1% were treated with minimally invasive excision. The mean follow-up time was 23.7 months. Long-lasting resolution of the chest, abdominal, and shoulder pain occurred in 50%, 35.7%, and 25% of patients, respectively. Nonetheless, 78.9% of patients reported major improvement in their symptoms postoperatively. Significantly higher rates of postoperative shoulder, abdominal, and chest pain were observed in patients who received postoperative hormonal therapy compared with those who did not. All patients treated expectantly remained stable. Therefore, we recommend treating diaphragmatic endometriosis only in symptomatic patients. The risk of incomplete surgery should be minimized by a multidisciplinary diagnostic and therapeutic approach with a careful assessment of the diaphragm and the thoracic cavity.
Journal Article
Stochastic Generation of District Heat Load
Modelling heat load is a crucial challenge for the proper management of heat production and distribution. Several studies have tackled this issue at building and urban levels, however, the current scale of interest is shifting to the district level due to the new paradigm of the smart system. This study presents a stochastic procedure to model district heat load with a different number of buildings aggregation. The proposed method is based on a superimposition approach by analysing the seasonal component using a linear regression model on the outdoor temperature and the intra-daily component through a bi-parametric distribution of different times of the day. Moreover, an empirical relationship, that estimates the demand variation given the average demand together with a user aggregation coefficient, is proposed. To assess the effectiveness of the proposed methodology, the study of a group of residential users connected to the district heating system of Bozen-Bolzano is carried out. In addition, an application on a three-day prevision shows the suitability of this approach. The final purpose is to provide a flexible tool for district heat load characterisation and prevision based on a sample of time series data and summary information about the buildings belonging to the analysed district.
Journal Article
Perioperative Pain Management in Total Knee Arthroplasty: A Narrative Review of Current Multimodal Analgesia Protocols
Since there is no consensus on the optimal perioperative analgesic method, the present article provides a brief and practical synthesis on current multimodal pre–postsurgery analgesia protocols for primary TKA (excluding intraoperative anesthetic techniques) reported especially in recent meta-analyses and reviews. The focus is not only on the traditional aims (pain scores and opioid sparing), but also the functional recovery and patient-reported outcomes. Multimodal analgesia (pre-emptive analgesia, local infiltration analgesia, peripheral nerve blocks, and specific systemic drugs) is considered the optimal regimen for perioperative pain management of TKA.
Journal Article
Mapping deep endometriosis in patients with ovarian endometriomas according to the #Enzian classification: a single-center retrospective analysis
Endometriosis is a multifactorial disease that affects mainly women of reproductive age. It is unclear whether each form of pelvic endometriosis is an independent entity and whether a spatial relationship between all three endometriosis forms exists. We aimed with this research to examine the distribution of deep endometriosis in patients with ovarian endometriomas. We also aimed to assess the influence of unilateral and bilateral ovarian endometriomas on the distribution of deep endometriotic nodules.
This is a retrospective single-center cohort study that included all patients with histologically-proven ovarian endometriomas. The #Enzian classification was used to classify endometriosis. The distribution of deep endometriosis in patients with endometriomas was assessed.
A total of 106 out of 121 patients with ovarian endometriomas had coexisting deep endometriosis (87.6%). Bilateral endometriomas were more common than unilateral ones. There was a statistically significant correlation between ipsilateral ovarian endometriomas and same-sided deep endometriosis of the pelvic compartment B according to the #Enzian classification. Patients with bilateral ovarian endometriomas had deep endometriosis of the left #Enzian B pelvic compartment and rectovaginal septum at a higher frequency than patients with unilateral endometriomas.
Deep Endometriosis coexists with unilateral or bilateral ovarian endometriomas in the great majority of patients. Bilateral endometriomas are associated with higher frequencies of deep endometriosis in the left #Enzian B compartment and rectovaginal septum (#Enzian A). In order to avoid incomplete surgeries and complications, patients with endometriomas should be carefully screened for deep endometriosis of the pelvis using transvaginal ultrasound or MR imaging.
Journal Article
Diagnosis and Treatment of Acute Periprosthetic Infections with the BioFire® System within a Time-Dependent and Bacterium-Dependent Protocol: Review and Prosthesis-Saving Protocol
Despite ongoing efforts to enhance diagnostic and treatment processes, the success rate for eradicating infections, particularly prosthetic joint infections (PJIs), currently stands at around 50%. For acute infections occurring shortly after arthroplasty, guidelines recommend a treatment known as DAIR (debridement, antibiotics, and implant retention). This approach is suggested for infections within 30 days post-arthroplasty or with less than 3 weeks of symptoms, provided that there is a stable implant and adequate soft-tissue mass. Several authors have suggested extending the use of DAIR beyond the initial 3-week period in specific cases. This extension practice seems increasingly feasible due to the rapid diagnostic capabilities offered by BioFire®. This technology allows for quick pathogen identification, aiding in the exclusion of cases that do not fit the criteria for the DAIR/DAPRI (debridement, antibiotic pearls and retention of the implant) protocol based on pathogen identification. The aim of this review is to re-examine the current literature on acute infections and present our proposed “prosthesis-saving” protocol, which integrates the BioFire® molecular diagnostic system. Continued research and assessment of the efficacy and safety of these protocols, especially regarding extended treatment timelines, are crucial for advancing the management of acute infections and enhancing outcomes for PJI patients.
Journal Article
Probabilistic Models for the Peak Residential Water Demand
Peak water demand is one of the most stringent operative conditions for a Water Distribution System (WDS), not only for the intensity of the event itself, but also for its recurring nature. The estimation of the maximum water demand is a crucial aspect in both the design and management processes. Studies in the past have tackled this issue with deterministic approaches, even if peak phenomena are distinctly random. In this work, probabilistic models have been developed to study and forecast the daily maximum residential water demand. Some probability distributions have been tested by means of statistical inferences on different data samples related to three monitored WDS. The parameter estimations of the proposed equations have been related to the number of supplied users. Furthermore, this work investigates time scaling effects on the effectiveness of the proposed distributions and relations. Corrective factors that take into account the effect of time averaging step on the above-mentioned parameters have been proposed.
Journal Article
The Participation of Older People in the Concept and Design Phases of Housing in The Netherlands: A Theoretical Overview
In the Netherlands, there is a growing need for collective housing for older people to bridge the gap between ageing-in-place and institutional care facilities. Participation of older people in the concept and design phases is important to tune the market supply to the needs of (future) residents, yet social entrepreneurs find it challenging to involve older people. This commentary explores various ways older people can participate in the development of new housing initiatives. The ladder of citizen participation is applied to explore different roles that (future) residents could play with levels of influence varying from non-participation to citizen power. Considerations for meaningful participation are discussed, in order to show how collaborations can be formed between (future) residents and decision makers.
Journal Article
Natural Substances for the Synthesis of Silver Nanoparticles against Escherichia coli: The Case of Megaphrynium macrostachyum (Marantaceae), Corchorus olitorus (Tiliaceae), Ricinodendron heudelotii (Euphorbiaceae), Gnetum bucholzianum (Gnetaceae), and Ipomoea batatas (Convolvulaceae)
The development of drug-resistant strains is rising and the search for new and novel ways of fighting new or reemerging microbes goes on. A hope of treating such multidrug-resistant infections came from plants mediated nanoparticles since nature is a generous source which provides a variety of chemical compounds that can be used for new drug discovery. Silver nanoparticles are reported to possess antiviral, antibacterial, antifungal, antiparasitic, larvicidal activity and anticancer properties. We reported green synthesis of silver nanoparticles mediated food plants Megaphrynium macrostachyum, Corchorus olitorus, Ricinodendron heudelotii, Gnetum bucholzianum, and Ipomoea batatas and their antibacterial efficacy against the Enterobacteriaceae Escherichia coli. The nature and size of the obtained nanoparticles are discussed as well as their Minimum Inhibitory Concentration (MIC) and the Minimum Bactericide Concentration (MBC) values considering their application in medical industry.
Journal Article