Reviviendo la historia: la reconstrucción digital del convento de Santa María de las Gracias en Milán

[EN] Can we preserve cultural heritage and, consequently, the memory of the past? To answer this question, one should look at the digital revolution that the world has gone through in recent decades and analyse the complex and the dialectical relationship between cultural heritage and new technologies. Thanks to these, increasingly accurate reconstructions of archaeological sites and historical monuments are possible. The resulting digital replicas are fundamental to experience and understand cultural heritage in innovative ways: they have complex and dynamic relationships with the original objects. This research paper highlights the importance and the scientific validity of digital replicas aimed at understanding, enhancing and protecting cultural heritage. The study focuses on the virtual reconstruction of the constructive phases, from the mid-15th century to date, of one of the most emblematic Gothic-Renaissance buildings in the city of Milan (Italy): the convent of Santa Maria delle Grazie, famous worldwide for hosting Leonardo da Vinci's Last Supper painting. This site proved to be an ideal case study because of its troubled and little-known history that led to numerous changes over the centuries. Thanks to a methodological approach based on the analysis of the documentary sources and three-dimensional (3D) modelling, it was possible to outline the chronological succession of the convent transformations; the way in which these overlapped the pre-existing structures was described starting from the Renaissance harmonious and organic interventions, to finally reach 18th -19th centuries inhomogeneous and incompatible additions. Finally, the research was completed by mapping the 3D models based on the sources used and their different levels of accuracy. The 3D models have thus become a valid tool for checking and verifying the reconstruction hypotheses.[ES] ¿Podemos preservar el patrimonio cultural y, por consiguiente, la memoria del pasado? Para responder a esta pregunta, es necesario examinar la revolución digital que ha experimentado el mundo en las últimas décadas y analizar la compleja relación dialéctica entre el patrimonio cultural y las nuevas tecnologías. Gracias a estas, son posibles reconstrucciones precisas de los sitios arqueológicos y de los monumentos históricos. Las réplicas digitales son fundamentales para experimentar el patrimonio cultural de forma innovadora; de ellas destaca también que juegan un papel importante en la comprensión del patrimonio cultural, y que poseen complejas y dinámicas relaciones con los objetos originales. Este artículo de investigación destaca la importancia y la validez científica de las réplicas digitales destinadas a comprender, mejorar y proteger el patrimonio cultural. El estudio se centró en la reconstrucción virtual de las fases constructivas, desde mediados del siglo XV hasta la actualidad, de uno de los edificios gótico-renacentistas más emblemáticos de la ciudad de Milán (Italia): el convento de Santa María de las Gracias, famoso en todo el mundo por ser la sede de la pintura mural de la Última Cena de Leonardo da Vinci. Este sitio demostró ser un caso de estudio ideal debido a su problemática y poco conocida historia que llevó a numerosos cambios a lo largo de los siglos. Gracias a un enfoque metodológico basado en el análisis de las fuentes documentales y en la modelización tridimensional (3D), fue posible esbozar la sucesión cronológica de las transformaciones; se trabajó desde las intervenciones armoniosas y orgánicas del renacimiento, hasta alcanzar las adiciones desiguales e incompatibles de los siglos XVIII y XIX. Por último, la investigación se completó con el mapeado de los modelos 3D sobre la base de las fuentes utilizadas y sus diferentes niveles de precisión. Los modelos 3D se han convertido así en un instrumento válido para comprobar y verificar las hipótesis reconstructivas.Aiello, D.; Bolognesi, C. (2020). Reliving history: the digital reconstruction of the convent of Santa Maria delle Grazie in Milan. Virtual Archaeology Review. 11(23):106-126. https://doi.org/10.4995/var.2020.13706OJS1061261123Addison, A. C., 2001. Virtual heritage: technology in the service of culture. 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Implementing Gehl’s Theory to Study Urban Space. The Case of Monotowns

The paper presents a method to operationalize Jan Gehl’s questions for public space into metrics to map Russian monotowns’ urban life in 2017. With the use of social media data, it becomes possible to scale Gehl’s approach from the survey of small urban areas to the analysis of entire cities while maintaining the human scale’s resolution. When underperforming public spaces are detected, we propose a matrix for urban design interventions using Jane Jacobs’ typologies for good city life. Furthermore, this method was deployed to improve the conditions of public spaces in Russian monotowns through a series of architectural briefs for design competitions and urban design guidelines for local administrations.publishedVersionPeer reviewe

The Phenotypic Characterization of the Cammalleri Sisters, an Example of Exceptional Longevity

This article shows demographic, clinical, anamnestic, cognitive, and functional data as well as biochemical, genetic, and epigenetic parameters of two exceptional siblings: Diega (supercentenarian) and Filippa (semisupercentenarian) Cammalleri. The purpose of this study is to provide new insights into the extreme phenotypes represented by semisupercentenarians and supercentenarians. Different studies have been published on supercentenarians, but to the best of our knowledge, this is the only concerning two sisters and the most detailed from a phenotypic point of view. Our findings agree with the suggestion that supercentenarians have an increasing relative resistance to age-related diseases, approximating the limits of the functional human reserve to address successfully the acute causes of death. More interestingly, our data agree with, and extend, the suggestion that inflammation and oxidative stress predict centenarian mortality

THE VALUE OF DIAGNOSTIC ULTRASOUND FOR DETECTING OCCULT INGUINAL HERNIA IN PATIENTS WITH GROIN PAIN

Aims: chronic groin pain caused by an occult hernia can be a difficult clinical diagnosis and may require additional investiga- tive modalities. The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing occult hernia in patients with recurrent inguinal pain and a negative clinical examination. Patients and methods: over a period of three years, a total of 76 patients were referred for ultrasound examination with clini- cally suspected occult inguinal hernia. Patients with positive US scans were offered surgery, while those with negative US findings were offered further imaging or other diagnostic tests. The ultrasound examination of the inguinal region was conducted using a 5- 10 MHz linear probe. The scan was performed with the patient in the supine and erect positions, in a relaxed state, as well as during coughing and during a Valsalva manoeuvre. Results: overall, ultrasound diagnosed 31 inguinal hernias and all 31 patients with positive scans underwent surgery. Surgery confirmed the ultrasound diagnosis in 30 patients, having only 1/31 no hernia at operation (100% ultrasound sensitivity and 96.9% specificity). Patients undergoing surgery showed complete symptom resolution at a three-month follow-up. Conclusions: this study confirms that ultrasound is capable of accurately diagnosing groin hernia and this may justify its use in patients with chronic groin pain due to a suspected occult herni

THE VALUE OF DIAGNOSTIC ULTRASOUND FOR DETECTING OCCULT INGUINAL HERNIA IN PATIENTS WITH GROIN PAIN

Aims: chronic groin pain caused by an occult hernia can be a difficult clinical diagnosis and may require additional investiga- tive modalities. The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing occult hernia in patients with recurrent inguinal pain and a negative clinical examination. Patients and methods: over a period of three years, a total of 76 patients were referred for ultrasound examination with clini- cally suspected occult inguinal hernia. Patients with positive US scans were offered surgery, while those with negative US findings were offered further imaging or other diagnostic tests. The ultrasound examination of the inguinal region was conducted using a 5- 10 MHz linear probe. The scan was performed with the patient in the supine and erect positions, in a relaxed state, as well as during coughing and during a Valsalva manoeuvre. Results: overall, ultrasound diagnosed 31 inguinal hernias and all 31 patients with positive scans underwent surgery. Surgery confirmed the ultrasound diagnosis in 30 patients, having only 1/31 no hernia at operation (100% ultrasound sensitivity and 96.9% specificity). Patients undergoing surgery showed complete symptom resolution at a three-month follow-up. Conclusions: this study confirms that ultrasound is capable of accurately diagnosing groin hernia and this may justify its use in patients with chronic groin pain due to a suspected occult herni

Differential diagnosis of neurodegenerative dementias with the explainable MRI based machine learning algorithm MUQUBIA

Biomarker-based differential diagnosis of the most common forms of dementia is becoming increasingly important. Machine learning (ML) may be able to address this challenge. The aim of this study was to develop and interpret a ML algorithm capable of differentiating Alzheimer's dementia, frontotemporal dementia, dementia with Lewy bodies and cognitively normal control subjects based on sociodemographic, clinical, and magnetic resonance imaging (MRI) variables. 506 subjects from 5 databases were included. MRI images were processed with FreeSurfer, LPA, and TRACULA to obtain brain volumes and thicknesses, white matter lesions and diffusion metrics. MRI metrics were used in conjunction with clinical and demographic data to perform differential diagnosis based on a Support Vector Machine model called MUQUBIA (Multimodal Quantification of Brain whIte matter biomArkers). Age, gender, Clinical Dementia Rating (CDR) Dementia Staging Instrument, and 19 imaging features formed the best set of discriminative features. The predictive model performed with an overall Area Under the Curve of 98%, high overall precision (88%), recall (88%), and F1 scores (88%) in the test group, and good Label Ranking Average Precision score (0.95) in a subset of neuropathologically assessed patients. The results of MUQUBIA were explained by the SHapley Additive exPlanations (SHAP) method. The MUQUBIA algorithm successfully classified various dementias with good performance using cost-effective clinical and MRI information, and with independent validation, has the potential to assist physicians in their clinical diagnosis

Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study

Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores. Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs. Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice