Liver involvement in patients with COVID-19 infection: A comprehensive overview of diagnostic imaging features

During the first wave of the pandemic, coronavirus disease 2019 (COVID-19) infection has been considered mainly as a pulmonary infection. However, different clinical and radiological manifestations were observed over time, including involvement of abdominal organs. Nowadays, the liver is considered one of the main affected abdominal organs. Hepatic involvement may be caused by either a direct damage by the virus or an indirect damage related to COVID-19 induced thrombosis or to the use of different drugs. After clinical assessment, radiology plays a key role in the evaluation of liver involvement. Ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) may be used to evaluate liver involvement. US is widely available and it is considered the first-line technique to assess liver involvement in COVID-19 infection, in particular liver steatosis and portal-vein thrombosis. CT and MRI are used as second- and third-line techniques, respectively, considering their higher sensitivity and specificity compared to US for assessment of both parenchyma and vascularization. This review aims to the spectrum of COVID-19 liver involvement and the most common imaging features of COVID-19 liver damage

Echocardiography findings in COVID-19 patients admitted to intensive care units: a multi-national observational study (the ECHO-COVID study)

Purpose: Severely ill patients affected by coronavirus disease 2019 (COVID-19) develop circulatory failure. We aimed to report patterns of left and right ventricular dysfunction in the first echocardiography following admission to intensive care unit (ICU). Methods: Retrospective, descriptive study that collected echocardiographic and clinical information from severely ill COVID-19 patients admitted to 14 ICUs in 8 countries. Patients admitted to ICU who received at least one echocardiography between 1st February 2020 and 30th June 2021 were included. Clinical and echocardiographic data were uploaded using a secured web-based electronic database (REDCap). Results: Six hundred and seventy-seven patients were included and the first echo was performed 2 [1, 4] days after ICU admission. The median age was 65 [56, 73] years, and 71% were male. Left ventricle (LV) and/or right ventricle (RV) systolic dysfunction were found in 234 (34.5%) patients. 149 (22%) patients had LV systolic dysfunction (with or without RV dysfunction) without LV dilatation and no elevation in filling pressure. 152 (22.5%) had RV systolic dysfunction. In 517 patients with information on both paradoxical septal motion and quantitative RV size, 90 (17.4%) had acute cor pulmonale (ACP). ACP was associated with mechanical ventilation (OR > 4), pulmonary embolism (OR > 5) and increased PaCO2. Exploratory analyses showed that patients with ACP and older age were more likely to die in hospital (including ICU). Conclusion: Almost one-third of this cohort of critically ill COVID-19 patients exhibited abnormal LV and/or RV systolic function in their first echocardiography assessment. While LV systolic dysfunction appears similar to septic cardiomyopathy, RV systolic dysfunction was related to pressure overload due to positive pressure ventilation, hypercapnia and pulmonary embolism. ACP and age seemed to be associated with mortality in this cohort

How to support cultural heritage-led development in Italian inner areas: a multi-methodological evaluation approach

The marginal areas, in continuous depopulation, require policies addressed towards sustainable development for territories as well as for local communities. This work, inspired by the urgent need of inner area regeneration, proposes the application of a multidimensional spatial decision support system (MC-SDSS) aimed at investigating both the territorial attractiveness and vulnerability of fragile areas. Supported by a spatial analysis, the model exploits the potentials of the Multicriteria Decision Aiding techniques (MCDA) within the G.I.S. domain. The research discusses the results of a first application of the MC-SDSS with a focus on the development of the Attractiveness and Vulnerability value maps. The analysis has been developed for the Italian provinces of Alessandria and Vercelli, both crossed by the VENTO project, one of the longest Italian cycle routes and with a great potential to boost slow tourism. The paper is divided into several sections: an introduction on inner areas; the description of the MC-SDSS; the test of the evaluation model on a case study; the measurement of territorial attractiveness and vulnerability, and finally hints from the results and discussion of future research lines

Beyond food: Framing ecosystem services value in peri-urban farming in the post-Covid era with a multidimensional perspective. The case of Cascina Biblioteca in Milan (Italy)

The idea that it is possible to overcome the post-covid crisis starting from urban projects is becoming increasingly popular (Balducci, 2020). This moment becomes a precious opportunity to experiment with innovative, multidisciplinary and multi-scalar methodologies for an urban planning and design capable of condensing apparently distant concepts and approaches that are nonetheless congenial to the same goals. In this sense, multifunctional agriculture (MFA) recognizes multiple functions including food production, environmental preservation and social inclusion, which can be identified as Ecosystem Services (ESs). In our contribution, the case study of a multifunctional farmhouse in the Milan suburban area is proposed as an opportunity to test an integrated preliminary evaluation model to support decisions concerning urban planning and design, with the goal of maximizing the performance of the ecosystem services provided in MFA field

The slow line as an opportunity to regenerate heritage in the fragile areas: the case of VENTO project

The topic dealt with is the tangible and intangible widespread heritage located in the fragile areas of the northern Italy, crossed by the river Po. Here the idea of the line is defined through its thickness, that is the heritage that we want to discover and evaluate, and for which the line represents an opportunity to become a hinge, an anchor and a flywheel, in order to regenerate fragile territories. To undertake this investigation, we will use the VENTO cycle route as case study for applying this analytical approach. VENTO is a territorial project, designed by Politecnico di Milano and part of a network of paths on a national scale decided by the Italian Ministry, that uses a cycle route along the river Po as an opportunity to regenerate fragile areas from Venice to Turin. In this research VENTO proposes itself as an experimental laboratory which provides the possibility of reversing the work perspective on territory. This research, by identifying, mapping and trying to evaluate the heritage along VENTO, will investigate ontologically the relationship between fragility and heritage and how it can change according to this new perspective of the line

The slow line as an opportunity to regenerate heritage in the fragile areas: the case of VENTO project

The topic dealt with is the tangible and intangible widespread heritage located in the fragile areas of the northern Italy, crossed by the river Po. Here the idea of the line is defined through its thickness, that is the heritage that we want to discover and evaluate, and for which the line represents an opportunity to become a hinge, an anchor and a flywheel, in order to regenerate fragile territories. To undertake this investigation, we will use the VENTO cycle route as case study for applying this analytical approach. VENTO is a territorial project, designed by Politecnico di Milano and part of a network of paths on a national scale decided by the Italian Ministry, that uses a cycle route along the river Po as an opportunity to regenerate fragile areas from Venice to Turin. In this research VENTO proposes itself as an experimental laboratory which provides the possibility of reversing the work perspective on territory. This research, by identifying, mapping and trying to evaluate the heritage along VENTO, will investigate ontologically the relationship between fragility and heritage and how it can change according to this new perspective of the line

Observatory of Resilience Practices: strategies and perspectives

In recent years there has been a remarkable expansion in use of resilience concept, which is used as a key concept in many local practices, but mainly should be better considered a reference approach for the new development project at local community level. In such perspective some institutions decided to invest in this; one of these projects is the experience presented in this essay. The essay presents the strategy, the main goals and the most important initiatives of the first year of activity of the Italian Observatory of Resilience Practices (ORP). The ORP was officially launched in April 2015 and it is supported and funded by the Italian bank foundation “Fondazione Cariplo”. Partners of ORP are the Department of Architecture and Urban Studies of Politecnico di Milano (the leader partner), the Department DIST of Politecnico di Torino, the CURSA Consortium and the REsilienceLAB Association. The Observatory is based on a project in which four main working axes may be recognized in this essay: _Mapping resilience practices at national level or the “Practices path” _Tools for resilience or the “Methodological path” _Resilience thinking or the “Cultural path” _Actors of resilience or the “Networking path” The approach adopted is incremental and innovative. It plays a role of facilitation in supporting and promoting the resilience practices and, at the same time, it integrates different knowledge sources and adaptive approaches. During the process of the ORP, some assets of research were identified, based on the needs of different stakeholders. The ORP aim is to connect and contaminate different approaches and “cultures”, being an “exchange and useful” platform promoting and supporting the diffusion of resilience practices. One of the aims of ORP is also to continuously offering best practices, tools, approaches and all others supports needed to enhanced and improved local communities and territories. ORP will develop several activities, for example: promote and improve the activities of local and thematic workgroups, organize an International Conference in September 2016 and develop an On-line platform. ORP has organized the first “National Forum on Resilience Practices” (Milan, January 29th 2016), involving in an exposition about 50 practices collected through an open call. The Forum is a moment of networking, but also a moment of debate in order to identify the main critical points and innovative strategies and solutions

Observatory of Resilience Practices: strategies and perspectives

In recent years there has been a remarkable expansion in use of resilience concept, which is used as a key concept in many local practices, but mainly should be better considered a reference approach for the new development project at local community level. In such perspective some institutions decided to invest in this; one of these projects is the experience presented in this essay. The essay presents the strategy, the main goals and the most important initiatives of the first year of activity of the Italian Observatory of Resilience Practices (ORP). The ORP was officially launched in April 2015 and it is supported and funded by the Italian bank foundation “Fondazione Cariplo”. Partners of ORP are the Department of Architecture and Urban Studies of Politecnico di Milano (the leader partner), the Department DIST of Politecnico di Torino, the CURSA Consortium and the REsilienceLAB Association. The Observatory is based on a project in which four main working axes may be recognized in this essay: _Mapping resilience practices at national level or the “Practices path” _Tools for resilience or the “Methodological path” _Resilience thinking or the “Cultural path” _Actors of resilience or the “Networking path” The approach adopted is incremental and innovative. It plays a role of facilitation in supporting and promoting the resilience practices and, at the same time, it integrates different knowledge sources and adaptive approaches. During the process of the ORP, some assets of research were identified, based on the needs of different stakeholders. The ORP aim is to connect and contaminate different approaches and “cultures”, being an “exchange and useful” platform promoting and supporting the diffusion of resilience practices. One of the aims of ORP is also to continuously offering best practices, tools, approaches and all others supports needed to enhanced and improved local communities and territories. ORP will develop several activities, for example: promote and improve the activities of local and thematic workgroups, organize an International Conference in September 2016 and develop an On-line platform. ORP has organized the first “National Forum on Resilience Practices” (Milan, January 29th 2016), involving in an exposition about 50 practices collected through an open call. The Forum is a moment of networking, but also a moment of debate in order to identify the main critical points and innovative strategies and solutions