41 research outputs found

    Use of balloon catheter dilation and steroid-eluting stent in light and severe rhinosinusitis of frontal sinus: a multicenter retrospective randomized study

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    OBJECTIVE: Frontal sinus surgery has an increased rate of re-stenosis, if compared to other sinuses, that mainly depends on recurrent inflammation and abnormal scarring at the frontal recess; its reduction represents one of the keys of therapeutic success. Balloon catheter dilation (BCD) and implantable sinus stents/spacers represent strategies to improve sinus ventilation respecting the integrity of mucosa and reducing abnormal post-surgical scarring. The purpose of this study is to evaluate the effectiveness, safety and correct indication for the use of BCD and a non-absorbable stent (Relieva Stratusℱ MicroFlow spacer) in the management of chronic rhinosinusitis (CRS) of the frontal sinus. PATIENTS AND METHODS: In this multicentric retrospective study we included a population of 76 frontal sinuses with non-polypoid CRS. Forty-one frontal sinuses were treated with BCD alone and 35 with BCD + Spacer. We analysed both radiological (Lund-McKay CT scoring modified by Zienrich) and symptomatologic results (SNOT-20 questionnaire) before surgery and after 12 months, dividing patients in two main groups: group “L” (light/mild frontal CRS) and group “S” (moderate/severe frontal CRS). RESULTS: Our results confirm a good safety and effectiveness of BCD in management of frontal CRS and show a good safety, although without significant effectiveness, of Relieva Stratusℱ MicroFlow spacer when added to BCD in the management of light and severe frontal CRS. CONCLUSIONS: BCD is an option in management of frontal CRS; the use of stents/spacers could become a new and effective tool in management of CSR, both in addition to standard therapies and in patients where the use of systemic drugs is contraindicated

    Environmental and Economic Assessment of Energy Renovation in Buildings, a Case Study in Greece

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    The environmental and economic evaluation of energy renovation in buildings plays a crucial role in achieving sustainability goals and the decarbonization of the built environment. This paper presents a case study of a student house in Athens, Greece, to assess the environmental and economic impacts of energy renovation and seismic reinforcement with a steel exoskeleton. This study utilizes a comprehensive approach that combines life cycle assessment (LCA) and life cycle costing (LCC) methodologies using One Click LCA. The LCA assesses the environmental impacts associated with energy consumption and greenhouse gas emissions, while the LCC evaluates the economic aspects, both analyses being conducted for a lifespan of 25 years from now. The results provide an evaluation of what would happen in terms of greenhouse emissions and costs in two scenarios: with and without interventions. ProGETonE strategy results in an environmental impact with a GWP of 26.78 kgCO2eq/m2y with a reduction of 30% of the pre-renovation state. Economically, the actualized energy use costs for 25 years are 50% less in the post-renovation state, but the high construction costs make the strategy seem inconvenient. In this context, it is important to consider the non-economic benefits of seismic reinforcement, such as enhanced safety and the potential lives saved, which are critical in high seismic zones. These advantages complement the strategy's environmental and energy use impacts, underscoring the holistic value of integrated seismic and energy retrofitting approaches like ProGETonE. The study underscores the importance of LCA and LCC analyses when evaluating the feasibility of renovation projects and of an evidence-based decision-making process for policymakers, building owners, and stakeholders for energy-efficient retrofitting

    The exposure of the world’s mountains to global change drivers

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    Global change affects mountain areas at different levels, with some mountains being more exposed to change in climate or environmental conditions and others acting as local refugia. We quantified the exposure of the world’s mountains to three drivers of change, climate, land use, and human population density, using two spatial-temporal metrics (velocity and magnitude of change). We estimated the acceleration of change for these drivers by comparing past (1975–2005) vs. future (2020–2050) exposure, and we also compared exposure in lowlands vs. mountains. We found Africa’s tropical mountains facing the highest future exposure to multiple drivers of change, thus requiring targeted adaptation and mitigation strategies to preserve biodiversity. European and North America’s mountains, in contrast, experience more limited exposure to global change and could act as local refugia for biodiversity. This knowledge can be used to prioritize local-scale interventions and planning long-term monitoring to reduce the risks faced by mountain biodiversity

    Inter and intra-population variability of the migratory behaviour of a short-distance partial migrant, the Eurasian Stone-curlew Burhinus oedicnemus (Charadriiformes, Burhinidae)

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    Migratory behaviour in birds shows a remarkable variability at species, population and individual levels. Short-distance migrants often adopt a partial migratory strategy and tend to have a flexible migration schedule that allows a more effective response to extreme environmental variations. Weather seasonality and environmental heterogeneity have been reported as significant factors in the diversification of migratory behaviour for Mediterranean migrants, but relatively few studies investigated the migration patterns of non-passerine birds migrating within the Mediterranean basin. In this study, we investigated the migratory strategy of 40 Eurasian Stone-curlews Burhinus oedicnemus tagged with geolocators and GPS-GSM tags and belonging to continental and Mediterranean populations of the Italian peninsula. The proportion of migrants was higher in continental populations, but we observed a significant variability also within Mediterranean populations. All birds spent the winter within the Mediterranean basin. Continental Stone-curlews departed earlier in spring and later in autumn and covered longer distances than those from Mediterranean areas. The speed of migration did not change between seasons for continental birds, while Mediterranean individuals migrated faster in spring. The likelihood of departure for autumn migration of GPS-tagged birds increased when temperatures were near or below 0 °C suggesting that Stone-curlews tend to delay departure until weather conditions worsen abruptly. As a consequence of global warming in the Mediterranean, the frequency of migratory birds in the considered populations might decrease in the near future. This could affect the distribution of species throughout the year and should be taken into account when targeting conservation measures

    Designing greenhouse subsystems for a lunar mission: the LOOPS - M Project

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    The 2020s is a very important decade in the space sector, where international cooperation is moving towards the exploration of the Moon and will lead to stable lunar settlements, which will require new, innovative, and efficient technologies. In this context, the project LOOPS–M (Lunar Operative Outpost for the Production and Storage of Microgreens) was created by students from Sapienza University of Rome with the objective of designing some of the main features of a lunar greenhouse. The project was developed for the IGLUNA 2021 campaign, an interdisciplinary platform coordinated by Space Innovation as part of the ESA Lab@ initiative. The LOOPS-M mission was successfully concluded during the Virtual Field Campaign that took place in July 2021. This project is a follow-up of the V-GELM Project, which took part in IGLUNA 2020 with the realization in Virtual Reality of a Lunar Greenhouse: a simulation of the main operations connected to the cultivation module, the HORT3 , which was already developed by ENEA (Italian National Agency for New Technologies, Energy and Sustainable Economic Development) during the AMADEE-18 mission inside the HORTSPACE project. This paper will briefly describe the main features designed and developed for the lunar greenhouse and their simulation in a VR environment: an autonomous cultivation system able to handle the main cultivation tasks of the previous cultivation system, a bioconversion system that can recycle into new resources the cultivation waste with the use of insects as a biodegradation system, and a shield able of withstanding hypervelocity impacts and the harsh lunar environment. A wide overview of the main challenges faced, and lessons learned by the team to obtain these results, will be given. The first challenge was the initial inexperience that characterized all the team members, being for most the first experience with an activity structured as a space mission, starting with little to no know-how regarding the software and hardware needed for the project, and how to structure documentation and tasks, which was acquired throughout the year. An added difficulty was the nature of LOOPS-M, which included very different objectives that required different fields of expertise, ranging from various engineering sectors to biology and entomology. During the year, the team managed to learn how to handle all these hurdles and the organizational standpoint, working as a group, even if remotely due to the Covid-19 pandemic. Through careful planning, hard work and the help of supervisors, the activity was carried out through reviews, up to the prototyping phase and the test campaign with a successful outcome in each aspect of the project. By the end of the year everyone involved had acquired new knowledge, both practical and theoretical, and learned how to reach out and present their work to sponsors and to the scientific community

    Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: rapid cardiovascular magnetic resonance

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    AIMS: To evaluate the impact of a simplified, rapid cardiovascular magnetic resonance (CMR) protocol embedded in care and supported by a partner education programme on the management of cardiomyopathy (CMP) in low- and middle-income countries (LMICs). METHODS AND RESULTS: Rapid CMR focused particularly on CMP was implemented in 11 centres, 7 cities, 5 countries, and 3 continents linked to training courses for local professionals. Patients were followed up for 24 months to assess impact. The rate of subsequent adoption was tracked. Five CMR conferences were delivered (920 attendees-potential referrers, radiographers, reporting cardiologists, or radiologists) and five new centres starting CMR. Six hundred and one patients were scanned. Cardiovascular magnetic resonance indications were 24% non-contrast T2* scans [myocardial iron overload (MIO)] and 72% suspected/known cardiomyopathies (including ischaemic and viability). Ninety-eighty per cent of studies were of diagnostic quality. The average scan time was 22 ± 6 min (contrast) and 12 ± 4 min (non-contrast), a potential cost/throughput reduction of between 30 and 60%. Cardiovascular magnetic resonance findings impacted management in 62%, including a new diagnosis in 22% and MIO detected in 30% of non-contrast scans. Nine centres continued using rapid CMR 2 years later (typically 1-2 days per week, 30 min slots). CONCLUSIONS: Rapid CMR of diagnostic quality can be delivered using available technology in LMICs. When embedded in care and a training programme, costs are lower, care is improved, and services can be sustained over time. KEY QUESTION: KEY FINDING: TAKE-HOME MESSAGE

    Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

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    Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

    La vocalità dell’occhione (Burhinus oedicnemus): conoscenze attuali e nuove prospettive

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    The vocal repertoire by the Stone-curlew is broad and complex. Recent studies have shown that some adult calls are used in well-defined circumstances (e.g. in sexual or anti-predatory context), which suggests that they have specialized functions. The meaning of other calls is still unknown, but most of them are always used in non-random combination with the most typical vocalizations (gallop and kurlee call), suggesting the existence of a vocal syntax. The two typical chick calls were quantitatively described only recently; they develop well before hatching and remain almost structurally unchanged until fledging. Preliminary data on the vocal ontogeny indicate that near fledging young stone curlews undergo a process of voice breaking, consisting in the sudden emergence of new call types, which differ from the chick’s ones, while tending to take on the characteristics of adult vocalizations. In this period both chick calls and attempts to vocalize as adults coexist. The study of chick vocalizations and of the vocal relationships between parent and offspring can provide interesting insights on the presence and possibly on the mechanisms of parental recognition in this species. Future developments of bioacoustic researches on the Stone-curlew are further discussed

    Winter presence of Stone Curlew, Burhinus oedicnemus, in Grosseto province monitored by playback

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    The population size of wintering Stone Curlews was estimated along with its distribution in Grosseto province. Habitat choice was also studied
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