Treatment of acute appendicitis with one-port transumbilical laparoscopic-assisted appendectomy: A six-year, single-centre experience

Background: Laparoscopic appendectomy is a feasible and safe alternative to open appendectomy for uncomplicated appendicitis. In the past decade several laparoscopic procedures have been described using one or more ports. We report our experience in treating acute appendicitis with one-port transumbilical laparoscopic-assisted appendectomy (TULAA). Patients and Methods: We performed 231 TULAA on patients in the period from November 2001 to September 2007. We introduced an 11 mm Hasson′s port using open technique; an operative channel with 10 mm telescope and an atraumatic grasper were used. After intra-abdominal laparoscopic dissection, the appendix was exteriorised through the umbilical access. The appendectomy was performed outside the abdomen as in the open procedure; the operation was completed using only one port in 227 patients (98%), two and three ports in two patients (1%) while conversion to open surgery was needed in two patients (1%). Results: The average operating time was 38 minutes and the median time to discharge was three days. Four (1, 7%) early postoperative complications (two suppuration of the umbilical wound) with no major complications were observed. Conclusions: Our results demonstrate that TULAA, which combines the advantages of both open and laparoscopic procedures, is a valid alternative form of treating uncomplicated appendicitis. If appendectomy cannot be completed with only one port, insertion of one or more ports may be necessary to safely conclude the procedure

A multi-cellular 3D bioprinting approach for vascularized heart tissue engineering based on HUVECs and iPSC-derived cardiomyocytes

The myocardium behaves like a sophisticated orchestra that expresses its true potential only if each member performs the correct task harmonically. Recapitulating its complexity within engineered 3D functional constructs with tailored biological and mechanical properties, is one of the current scientific priorities in the field of regenerative medicine and tissue engineering. In this study, driven by the necessity of fabricating advanced model of cardiac tissue, we present an innovative approach consisting of heterogeneous, multi-cellular constructs composed of Human Umbilical Vein Endothelial Cells (HUVECs) and induced pluripotent cell-derived cardiomyocytes (iPSC-CMs). Cells were encapsulated within hydrogel strands containing alginate and PEG-Fibrinogen (PF) and extruded through a custom microfluidic printing head (MPH) that allows to precisely tailor their 3D spatial deposition, guaranteeing a high printing fidelity and resolution. We obtained a 3D cardiac tissue compose of iPSC-derived CMs with a high orientation index imposed by the different defined geometries and blood vessel-like shapes generated by HUVECs which, as demonstrated by in vivo grafting, better support the integration of the engineered cardiac tissue with host's vasculature

In vivo organized neovascularization induced by 3D bioprinted endothelial-derived extracellular vesicles

Extracellular vesicles (EVs) have become a key tool in the biotechnological landscape due to their well-documented ability to mediate intercellular communication. This feature has been explored and is under constant investigation by researchers, who have demonstrated the important role of EVs in several research fields ranging from oncology to immunology and diagnostics to regenerative medicine. Unfortunately, there are still some limitations to overcome before clinical application, including the inability to confine the EVs to strategically defined sites of interest to avoid side effects. In this study, for the first time, EV application is supported by 3D bioprinting technology to develop a new strategy for applying the angiogenic cargo of human umbilical vein endothelial cell-derived EVs in regenerative medicine. EVs, derived from human endothelial cells and grown under different stressed conditions, were collected and used as bioadditives for the formulation of advanced bioinks. After in vivo subcutaneous implantation, we demonstrated that the bioprinted 3D structures, loaded with EVs, supported the formation of a new functional vasculature in situ, consisting of blood-perfused microvessels recapitulating the printed pattern. The results obtained in this study favour the development of new therapeutic approaches for critical clinical conditions, such as the need for prompt revascularization of ischaemic tissues, which represent the fundamental substrate for advanced regenerative medicine applications

Treatment of acute appendicitis with one-port transumbilical laparoscopic-assisted appendectomy: A sixyear, single-centre experience

Background: Laparoscopic appendectomy is a feasible and safe alternative to open appendectomy for uncomplicated appendicitis. In the past decadeseveral laparoscopic procedures have been described using one or more ports. We report our experience in treating acute appendicitis with one-port transumbilical laparoscopic-assisted appendectomy (TULAA).Patients and Methods: We performed 231 TULAA on patients in the period from November 2001 to September 2007. We introduced an 11 mm Hasson’s port using open technique; an operative channel with 10 mm telescope and an atraumatic grasper were used. After intra-abdominal laparoscopic dissection, the appendix was exteriorised through the umbilical access. The appendectomy was performed outside the abdomen as in the open procedure; the operation was completed using only one port in 227 patients (98%), two and three ports in two patients (1%) while conversion to open surgery was needed in two patients (1%). Results: The average operating time was 38 minutes and the median time to discharge was three days. Four (1, 7%) early postoperative complications (two suppuration of the umbilical wound) with no major complications were observed. Conclusions: Our results demonstrate that TULAA, which combines the advantages of both open and laparoscopic procedures, is a valid alternative form of treating uncomplicated appendicitis. If appendectomy cannot be completed with only one port, insertion of oneor more ports may be necessary to safely conclude the procedure

On Venetian Campi Resilience to Climate Change

Venice is known for its history and beauty and its fragility and potential demise. The city is experiencing an increase in yearly average temperatures affecting outdoor - indoor comfort and average energy expenditure. Owing to existing literature demonstrating how local microclimate depends on urban density, shape, and orientation of buildings and materials, the work studies the influence of changing Venice temperatures by targeting such issues, focusing on an urban fabric typical form, known as Campi. Based on IPCC's future weather predictions for 2050 scenario A1B, the work highlights how the urban fabric configuration affects the local microclimate and outdoor conditions to define how buildings will mitigate and adapt to environmental transitions. The method couples microclimate and outdoor comfort users' perception of Physiological Equivalent Temperature (PET), via ENVI-met. Preliminary results show that the compactness of the urban fabric in Venetian Campi significantly reduces outdoor temperatures due to the increased density of shadow areas in the courtyard or in narrow Venice streets. The role of water is also simulated via ENVI-met, as buildings' materials and indoor energy consumption are assumed as invariant to evaluate the historic urban fabric climate resilience. The results constitute a first step towards understanding to what extent a particular urban fabric type is thermally resilient.Environmental Technology and Desig

SPACERGY: Space-Energy Patterns for Smart Energy Infrastructures, Community Reciprocities and Related Governance

SPACERGY builds upon the need for planning authorities to develop new models to implement energy transition strategies in the urban environment, departing from the exploitation or reciprocity between space and energy systems. Several policies have been made by each EU nation, but effective and practical tools to guide the urban transformations towards a carbon-neutral future present several challenges. The first challenge is to confront long term changes in envisioning how a specific socio-cultural context can respond to the application of solutions for energy efficiency. Secondly, the engagement of communities in bottom-up approaches mainly includes the sphere of urban planning that underestimates the importance of relating spatial transformations with the energy performances generated in the urban environment. The third challenge regards the tools used for the assessment of the energy performance and the necessity of enlarging the scale in which energy demand is analyzed, from the scale of the building to that of the district. In this context, the project explores the role of mobility, spatial morphologies, infrastructural elements and local community participation in regards to the smart use of local resources. The project addresses a knowledge gap in relation to interactions and synergies between spatial programming, energy and mobility systems planning and stakeholder involvement necessary to improve models of development and governance of urban transformations.Based on detailed spatial morphology and energy use modeling, SPACERGY develops new toolsets and guidelines necessary to advance the implementation of energy-efficient urban districts. New toolsets are tested in three urban areas under development in the cities of Zurich, Almere, and Bergen, acting as living laboratories for real-time research and action in collaboration with local stakeholders. The results of this research project support planners and decision-makers to facilitate the transition of their communities to more efficient, livable and thus prosperous urban environments

Climate change and indoor temperature variation in Venetian buildings: The role of density and urban form

Although the influence of urban form on microclimate and building thermal processes has been acknowledged, few studies have addressed the influence of overheating mechanisms on heterogeneous urban fabrics for existing historical cities. This study investigates the impact of changing urban climate on indoor temperatures by focusing on three Venice morphological patterns. Through microclimate modelling techniques, outdoor and indoor temperatures are simulated in 2020 and 2050 scenarios. Results show that the compactness of the urban fabric contributes to reducing indoor building temperatures. The analysis suggests that the increased density of shadow areas can mitigate the outdoor temperature values and reduce direct radiation on façades. When comparing the two climate scenarios 2020 and 2050, average indoor temperatures increase in the latter. However, the analysis highlights that the absence of insulation and the relatively high thermal mass of typical Venetian envelopes plays a crucial role in the building thermal processes preserving indoor comfort in a warmer climate future.Environmental Technology and Desig