Analisi storica, rilievo e riqualificazione del borgo di Montecastello

Lo studio sviluppato per il progetto di tesi di laurea specialistica si divide in tre parti fondamentali: l’analisi storica dell’antico castello, l’analisi urbanistica dell’attuale paese, il rilievo e il progetto di riqualificazione del luogo. Montecastello nasce come roccaforte militare all’inizio del XII secolo, sotto la giurisdizione del vescovo di Lucca. Trovandosi in un territorio di confine (la Valdera confinava infatti con i territori di Pisa, Lucca e Firenze) nel corso del tempo ha subito la dominazione delle tre città vicine. All’inizio del Quattrocento il castello è passato in mani fiorentine, perdendo completamente la funzione militare. Nel corso del Cinquecento vi si è stanziata l’importante famiglia pisana dei Franceschi Galletti, sostituita poi all’inizio dell’Ottocento dalla famiglia Torrigiani Malaspina, attuali proprietari della villa. Lo studio storico è continuato analizzando gli strumenti urbanistici vigenti. Montecastello è collocato all’interno del subsistema della collina e non presenta particolari rischi geomorfologici o idrologici. L’UTOE di Montecastello è divisa in quattro zone omogenee: A (centro storico), B (residenziale denso), C (uso agricolo) ed E (usi di interesse generale). Sono poi stati studiati vari aspetti dell’assetto urbanistico del borgo attraverso la creazione di undici carte tematiche: quadro storico, altezza degli edifici, tipo di copertura, destinazioni d’uso, infrastrutture, percorsi, tipologie edilizie, sistemi costruttivi, stato di conservazione, elementi attrattori, valori e criticità. La terza parte del lavoro è consistita nel rilievo geometrico di Montecastello. A livello di restituzione grafica (piante, prospetti e sezioni) l’attenzione è stata rivolta in particolare a due elementi caratterizzanti e importanti per la successiva definizione del progetto di riqualificazione: piazza Malaspina e piazza la Porta. A conclusione dello studio e come necessario punto di arrivo del grande lavoro conoscitivo compiuto, è stato redatto un progetto di riqualificazione urbana che consiste nella definizione di nuovi percorsi che ridonino vitalità e movimento all’antico castello. È stato pensato un flusso veicolare interno al centro storico controllato e limitato ai soli residenti, mentre i visitatori esterni possono sostare nell’ampio parcheggio pubblico per poi accedere pedonalmente al centro storico. Sono stati quindi definiti due diversi percorsi pedonali: uno trasversale, che dal parcheggio sale a livello di piazza Malaspina, la attraversa, sale verso la chiesa, ridiscende attraversando piazza la Porta, esce dalla porta del castello e termina nel giardino pubblico con belvedere; l’altro circolare che permette al visitatore di girare completamente il borgo sia esternamente che internamente. Sono state definite nel dettaglio le pavimentazioni (in basalto vietnamita tagliato e trattato superficialmente in modo differente a seconda della diversa funzione della superficie) e l’impianto di illuminazione (distinto in illuminazione a stelo alta, bassa e a terra)

Editorial on the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) guideline on clinical indications for CT colonography in the colorectal cancer diagnosis

European Society of Gastrointestinal Endoscopy (ESGE)-European Society of Gastrointestinal and Abdominal Radiology (ESGAR) guideline was generated jointly by a team of researchers, including gastrointestinal radiologists and endoscopists, and represents the first full collaborative effort between the two specialties after years of turf battles involving CT colonography (CTC) and colonoscopy (CS). This guideline has a main educational purpose and it represents the attempt to find a consensus about the use of CTC in clinical practice based on the best current available evidence. Thus, it should not be considered as rules for establishing a legal standard of care. Main recommendations include the use of CTC as the radiological examination of choice for the diagnosis of colorectal neoplasia, the use of CTC in the case of incomplete CS, and the possible use of CTC as an acceptable and equally sensitive alternative for patients with symptoms suggestive of colorectal cancer (CRC), when CS is contraindicated or not possible. ESGE-ESGAR guideline does not recommend CTC for population screening, but considers that CTC may be proposed as a CRC screening test on an individual basis (opportunistic screening) provided the screenee is adequately informed about test characteristics, benefits and risks. With regard to patient management, referral for endoscopic polypectomy in patients with at least one polyp ≥6 mm in diameter detected at CTC is recommended, considering surveillance only in case polyp removal is not possible. Knowledge about CTC is in continuous evolution and this means that a revision might be necessary in the future as new data appear

Exceptional scattered sequences

The concept of scattered polynomials is generalized to those of exceptional scattered sequences which are shown to be the natural algebraic counterpart of $\mathbb{F}_{q^n}$-linear MRD codes. The first infinite family in the first nontrivial case is also provided and equivalence issues are considered. As a byproduct, a new infinite family of MRD codes is obtained.Comment: 32 page

Effect of a fixed combination of nimodipine and betahistine versus betahistine as monotherapy in the long-term treatment of M\ue9ni\ue8re's disease: a 10-year experience

Despite an abundance of long-term pharmacological treatments for recurrent vertigo attacks due to M\ue9ni\ue8re's disease, there is no general agreement on the their efficacy. We present the results of a retrospective study based on a 10-year experience with two long-term medical protocols prescribed to patients affected by M\ue9ni\ue8re's disease (diagnosed according to the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium guidelines) who completed treatments in the period 1999-2009. A total of 113 medical records were analysed; 53 patients received betahistine-dihydrochloride at on-label dosage (32 mg die) for six months, and 60 patients were treated with the same regimen and nimodipine (40 mg die) as an add-therapy during the same period. Nimodipine, a 1,4-dihydropyridine that selectively blocks L-type voltage-sensitive calcium channels, has previously been tested as a monotherapy for recurrent vertigo of labyrinthine origin in a multinational, double-blind study with positive results. A moderate reduction of the impact of vertigo on quality of life (as assessed by the Dizziness Handicap Inventory) was obtained in patients after therapy with betahistine (p 0.05), whereas the fixed combination of betahistine and nimodipine was associated with a significant reduction of tinnitus annoyance and improvement of hearing loss (p < 0.005). It was concluded that nimodipine represents not only a valid add-therapy for M\ue9ni\ue8re's disease, and that it may also exert a specific effect on inner ear disorders. Further studies to investigate this possibility are needed

The Italian consensus to virtual colonoscopy

OBJECTIVES: To produce an informed consent for CT colonography (CTC), to be diffused by the Italian Society of Radiology, aimed to make patients and referring physicians aware of CTC examination protocol, advantages and disadvantages, limits and potential related risks. MATERIALS AND METHODS: Delphi method was used to create a consensus among experts on an informed consent for CTC. The overall agreement among different consulted specialists was evaluated and ranked using the Cronbach's correlation coefficient (α) at two time points: after the first and the second 'round' of consultation. RESULTS: The Cronbach index was 0.84 at the end of the first round and 0.93 at the end of the second round. The number of disagreements dropped from an overall of 11-5, from the first to the second round. CONCLUSIONS: The experts were able to produce an informed consent for CTC, hoping that this may be the beginning of a process focused on implementation of quality standards in CTC

The second ESGAR consensus statement on CT colonography

To update quality standards for CT colonography based on consensus among opinion leaders within the European Society of Gastrointestinal and Abdominal Radiology (ESGAR). A multinational European panel of nine members of the ESGAR CT colonography Working Group (representing six EU countries) used a modified Delphi process to rate their level of agreement on a variety of statements pertaining to the acquisition, interpretation and implementation of CT colonography. Four Delphi rounds were conducted, each at 2 months interval. The panel elaborated 86 statements. In the final round the panelists achieved complete consensus in 71 of 86 statements (82 %). Categories including the highest proportion of statements with excellent Cronbach's internal reliability were colon distension, scan parameters, use of intravenous contrast agents, general guidelines on patient preparation, role of CAD and lesion measurement. Lower internal reliability was achieved for the use of a rectal tube, spasmolytics, decubitus positioning and number of CT data acquisitions, faecal tagging, 2D vs. 3D reading, and reporting. The recommendations of the consensus should be useful for both the radiologist who is starting a CTC service and for those who have already implemented the technique but whose practice may need updating