Electronic Health Records: From the Management of Patients to the Research Use of Clinical Data

Paper based medical records are still widespread in Italian hospitals and the workflow to manage outpatients\u2019 visits is critical. Too many isolated software programs coexist in hospital wards and cause confusion and disorganization. A computerized medical record that unifies all the data contained in the various applications should be of fundamental importance in supporting physician\u2019s daily activities. Moreover, with the digital clinical record, data can be re-used for research purposes. The aim of this project is to create a web application for the management of outpatient visits to the Infectious Diseases Unit of the San Martino Hospital in Genoa. In order to orchestrate all the software programs acting in the visit workflow, a client application was developed to speed up the work of the medical staff at the time of the visits, ameliorating the quantity and quality of relevant information from a clinical point of view. A further extension allows standard data exchange between the developed application and the Ligurian HIV Network, which is the main regional research platform

Monitoring and modeling the invasion of the fast spreading alien Senecio inaequidens DC. in an alpine region

We modeled the distribution of the South African alien Senecio inaequidens DC. in the Aosta Valley, Western Italian Alps, using data extracted from the Regional floristic database and from an intensive field survey carried out in years 2009-2010. The aims of the work were (1) to evaluate whether the species is in the introduction, colonization, or establishment stage of invasion, (2) to detect the environmental factors that drive the invasion process, and (3) to highlight the potential range of distribution of the alien species. The modeling framework was a stepwise generalized linear model (GLM), using gridded presence/absence data and environmental predictors such as topography, climate, land use, and anthropogenic and natural disturbances. GLM were fit both with and without an additional independent variable to take into account current dispersal limitations. S. inaequidens displayed a very fast spread in the Aosta Valley in the years 1990-2010. The species was positively associated with roads and rivers, southern slopes, and negatively with elevation. However, it was found at an elevation of 1600 m, showing the ability to reach higher elevations than those observed for other invasive alien species, and confirming to be pre-adapted to mountain conditions. The difference between the species distribution models, with and without dispersal constraints, suggested that the availability of seed sources still limits the potential distribution of the species, rather than the environmental variables, and that the realized regional niche differs to a great extent from the equilibrium niche. When limitations to the seed source cease (i.e., in the establishment stage), the species will likely invade large areas that are currently characterized by pastures and grasslands with native species of high agricultural importance. The invasion of S. inaequidens should therefore be considered a serious threat, due to its potential to invade mountain regions, and in particular to colonize habitats used for grazing and forage, thus leading to a high risk for cattle and human health. We discuss the relevance of the results both concerning communication with the public and to support local eradication and control activities. The inclusion of S. inaequidens in the "black list" of the regional law for the conservation of alpine flora (L.R. 45/2009) will help to transfer the information and support invasion control, in particular at medium elevations

RFID technology applied to the glacial environment: MALATRA electronic system design and experimental data

The higher mountains of the Alps focus in the western part of Europe and favor a high concentration of glaciers in this area. The Aosta Valley region is surrounded by mountains, more than the 50% of its territory lying above 2000 m a.s.l. In the summer, most of the water supply of the region relies on the contribution given by snowmelt and, partially, by ice melt. Study of glacial processes is thus very important in this region. In this context the MALATRÀ project (led by Fondazione Montagna Sicura and Envisens Technologies) is created to develop a low-cost instrumentation capable of measuring with continuity the physical parameters of snow and ice. The instrumentation consists of a miniaturized electronic device (tag) equipped with sensors and placed inside an ovoidal small-dimension (48 mm diameter and 180 mm length) plastic capsule. Moreover, the implementation of radio frequency identification technology (RFID) allows remote communication from the surface with the tags placed deep into the glacier, thus saving time, effort and cost in collecting data. Tags allow communication at long distance working at 315 MHz frequency. At this step, the goal is to use such devices during the annual glaciological campaigns to measure the weight of the snowpack above the tag (with a pressure sensor), in order to derive the snow water equivalent (SWE) and temperature inside the ice. As a first step, the capsules will be coupled with ablation stakes installed in the ice, placed at the bottom of boreholes. Each capsule is uniquely identified by a code and can be located in a 3-D local system via radio using a localization algorithm under development. It is then, during the installation, georeferenced absolutely using a GNSS receiver. This functionality also allows for the glacier displacement measurements. Once the device has been identified, all the data stored in the internal memory can be remotely downloaded from the reader. At the current development stage the board is equipped with a precise thermometer (PT1000) and a pressure sensor to catch ice data, a magnetometer and a tri-axial accelerometer sensor to study the movement of the capsule within the ice. The performance of the system has been tested in the glacial environment with excellent results

RFID technology applied to the glacial environment: MALATRA electronic system design and experimental data

The higher mountains of the Alps focus in the western part of Europe and favor a high concentration of glaciers in this area. The Aosta Valley region is surrounded by mountains, more than the 50% of its territory lying above 2000 m a.s.l. In the summer, most of the water supply of the region relies on the contribution given by snowmelt and, partially, by ice melt. Study of glacial processes is thus very important in this region. In this context the MALATRÀ project (led by Fondazione Montagna Sicura and Envisens Technologies) is created to develop a low-cost instrumentation capable of measuring with continuity the physical parameters of snow and ice. The instrumentation consists of a miniaturized electronic device (tag) equipped with sensors and placed inside an ovoidal small-dimension (48 mm diameter and 180 mm length) plastic capsule. Moreover, the implementation of radio frequency identification technology (RFID) allows remote communication from the surface with the tags placed deep into the glacier, thus saving time, effort and cost in collecting data. Tags allow communication at long distance working at 315 MHz frequency. At this step, the goal is to use such devices during the annual glaciological campaigns to measure the weight of the snowpack above the tag (with a pressure sensor), in order to derive the snow water equivalent (SWE) and temperature inside the ice. As a first step, the capsules will be coupled with ablation stakes installed in the ice, placed at the bottom of boreholes. Each capsule is uniquely identified by a code and can be located in a 3-D local system via radio using a localization algorithm under development. It is then, during the installation, georeferenced absolutely using a GNSS receiver. This functionality also allows for the glacier displacement measurements. Once the device has been identified, all the data stored in the internal memory can be remotely downloaded from the reader. At the current development stage the board is equipped with a precise thermometer (PT1000) and a pressure sensor to catch ice data, a magnetometer and a tri-axial accelerometer sensor to study the movement of the capsule within the ice. The performance of the system has been tested in the glacial environment with excellent results

Study of the stability analysis of rock slopes on the alps

The paper reports the described methodology applied to a case study of stability evaluation of a rock slope at high elevation (Monte Bianco) where instability phenomena where observed. Stability analysis were performed using both Limit Equilibrium Method (LEM) and Distinct Element Method (DEM) in 3Dimensional field based on accurate non contact surveys. The surveys are supported and validated by traditional in situ measurements of the discontinuity orientation and other rock mass features. The required discontinuity shear strength has been validated by direct shear tests performed in laboratory on specimens taken on the slope. Furthermore, the paper presents some considerations on the influence of climate changes on the rock mechanical features and examines the effect of temperature variation on the stability conditions of rock slopes; this is done by means of several parametrical analysis of the Aguille Marbrèe rock outcrop carried out modifying the rock discontinuity saturation, persistence and frequency, shear strength etc.. These analysis are showing how a different water regime in the rock mass, caused by climate variation, can strongly influence the stability condition of the slope; on the other hand, the DEM analysis are used to better understand the complex and progressive instability phenomenon that was observed on site. The comparison between the shape of the unstable blocks and their volume as computed by DEM and those measured on site at the base of the slope, validate the DEM results

Nutrient flows in lowland dairy farms in the Italian Alps

A traditional dairy production system is still common today in the mountain environment of the Italian Alps, enhancing the economic valorisation of milk through the production of quality cheese such as Fontina PDO (Protected Designation of Origin), and favouring the agro-environmental management of marginal areas. This type of dairy system depends mainly on summer grazing: farmers set up the farm stock on the basis of the high-altitude grassland areas available. For the rest of the year, the livestock is housed on the farm lowland, consequently reaching high stocking rates. Since grassland areas are limited in size here, animal feeding is largely based on acquired forages. In order to study the environmental sustainability of the lowland farm areas, agronomic management, nitrogen (N) and phosphorus (P) farm-gate balances were calculated for 22 livestock farms in the Valle d’Aosta region. Lowland surfaces show a quite high variability, with an average value of 6.8 ha. An unbalanced stocking rate referred to the lowland is common showing an average value of 5.7 L.U. ha-1, but reaching a maximum of 26.8 L.U. ha-1. Lowland milk production is approximately 1700 kg per L.U. per year, but some farms could reach 3500 kg per L.U. The feed efficiency varies from 1.1 to 4.7 kg milk per kg feed, depending on the farm feeding strategy. The average N farm-gate balance is equal to 75 kg N ha-1. The two main input components are represented by purchased hay and feed, both showing the highest variability between farms. The output data also differ substantially between farms. The manure sold is the most important output component and represents 70% of the total output on average. The P farm gate balance surplus is equal to 6 kg ha-1, but more than 25% of the farms considered show a negative value. The surpluses calculated in this work can be compared with the values belonging to a distribution calculated for bovine farms under different management and environmental conditions in Italy and Europe. They occupy the lower part of the distribution and are similar to those measured in mountains or other extensive environments

Actes de la journée d’échange : récolte et utilisation des semences locales de montagne

[Departement_IRSTEA]Territoires [TR1_IRSTEA]SEDYVINNational audienceDepuis 2013, Irstea et ses collaborateurs étudient, dans le cadre du projet Alp’Grain, la pertinence et la faisabilité de créer une filière de récolte de semences locales en y associant les agriculteurs rhônalpins. L’objectif est double : diversifier les revenus agricoles et revégétaliser les prairies d’une manière durable. Cette journée, qui a réuni de nombreux acteurs de la revégétalisation en Europe, a été réalisée dans le cadre du Feader Rhône-Alpes

Terrestrial Photogrammetry and Numerical Modelling for the Stability Analysis of Rock Slopes in High Mountain Areas: Aiguilles Marbrées case

Several high-altitude slope instability phenomena, involving rock blocks of different volumes, have been observed in recent years. The increase in these phenomena could be correlated to climatic variations and to a general increase in temperature that has induced both ice melting with consequent water seepage and glacial lowering, with a consequent loss of support of the rock face. The degradation of the high-altitude thermal layer, which is known as "permafrost", can determine the formation of highly fractured rock slopes where instabilities can concentrate. The present research has developed a methodology to improve the understanding and assessment of rock slope stability conditions in high mountain environments where access is difficult. The observed instabilities are controlled by the presence of discontinuities that can determine block detachments. Consequently, a detailed survey of the rock faces is necessary, both in terms of topography and geological structure, and in order to locate the discontinuities on the slope to obtain a better geometric reconstruction and subsequent stability analysis of the blocky rock mass. Photogrammetric surveys performed at different times allow the geostructure of the rock mass to be determined and the rock block volumes and detachment mechanisms to be estimated, in order to assess the stability conditions and potential triggering mechanisms. Photogrammetric surveys facilitate both the characterisation of the rock mass and the monitoring of slope instabilities over time. The methodology has been applied in a case study pertaining to the North Face of Aiguilles Marbrées in the Mont Blanc massif, which suffers from frequent instability phenomena. A slope failure that occurred in 2007 has been back-analysed using both the limit equilibrium method (LEM) and 3D distinct element modelling (DEM). The method has been supported and validated with traditional in situ surveys and measurements of the discontinuity orientation and other rock mass features