PROGETTAZIONE DELLA CITTADELLA DELLA MUSICA A PONTE A EGOLA (PI) E ANALISI ACUSTICA DI UNA SALA ACCORDABILE

Finalità della Tesi è la riqualificazione dell’area a sud di Ponte a Egola, nel comune di San Miniato, l’esigenza è quella di creare una nuova centralità urbana in un’area piena di detrattori ambientali. La Tesi affronta le fasi preliminari della progettazione delle Cittadella della Musica, si è concentrata in una prima fase sullo studio dell’evoluzione storica degli ambienti per lo spettacolo, sui tipi edilizi, sulle scuole di musica, sulla descrizioni di alcuni recenti progetti. Successivamente è stato analizzato il contesto urbano in cui si sviluppa l’intervento. È stato redatto il Dpp, precisando gli obiettivi che si intendono raggiungere, i bisogni e le esigenze da soddisfare. Sono state analizzate le classi di esigenza della UNI 8289:1981, tutti i vincoli di legge, le prestazioni attese e i requisiti da soddisfare. E’ stata eseguita un’analisi funzionale individuando gli AFO, che sono stati tradotti in ASO, che definiscono dimensionalmente il progetto, sono stati presi in considerazione i costi globali dell’opera. Si è sviluppata poi la fase di progettazione vera e propria. E’ stata effettuata la progettazione acustica della sala accordabile con l’utilizzo del software di modellazione acustica Raynoise 3.0, per tre destinazioni d’uso: musica sinfonica, musica da camera, il parlato. La sala è stata resa accordabile mediante l’impiego di un sistema ruotante a tre facce, Triffusor®. Per le tre destinazioni d’uso sono stati ottimizzati con Raynoise i valori dei principali indici di qualità acustici: Tempo di Riverberazione, SPL, D, C,STI, RASTI. The purpose of the thesis is the requalification of the souther area in Ponte a Egola, in the municipality of San Miniato. The requirement is that to create a new urban centrality. The thesis deals with the preliminary phases of the planning of the citadel of music: historical analysis, analysis of the context, introductory document to the start of the planning, the plan. The acoustic planning of the room has been the carried out making use of raynoise 3.0, software of acoustic moulding, the analysis is lead for three main destinations: symphony music, chamber music, the spoken one. For this purpose it has been employed a three faces rotating system, Triffusor®. The values of the main acoustic quality indexes have been optimized thanking to raynoise; Reverberation Time, SPL, D, C, STI, RASTI

Bowel obstruction from benign adnexal mass i an elderly patient

Bowel obstruction resulting from ovarian masses is a serious complication of these diseases. This may be caused by bulky masses filling the pelvis and the abdomen, and should be carefully worked out by pre-operative imaging because of their non-specific clinical signs that may be confused with those due to other conditions such as: volvulus, cancer or adhesions. We report the case of a 70 years old woman with a bulky pelvic-abdominal mass of 27 × 20 cm that was found to be an “ovarian serous cystadenoma” and clinical signs of intestinal obstruction, which was treated by uterus sparing surgery

Structured reporting for fibrosing lung disease: a model shared by radiologist and pulmonologist

Objectives: To apply the Delphi exercise with iterative involvement of radiologists and pulmonologists with the aim of defining a structured reporting template for high-resolution computed tomography (HRCT) of patients with fibrosing lung disease (FLD). Methods: The writing committee selected the HRCT criteria\ue2\u80\u94the Delphi items\ue2\u80\u94for rating from both radiology panelists (RP) and pulmonology panelists (PP). The Delphi items were first rated by RPs as \ue2\u80\u9cessential\ue2\u80\u9d, \ue2\u80\u9coptional\ue2\u80\u9d, or \ue2\u80\u9cnot relevant\ue2\u80\u9d. The items rated \ue2\u80\u9cessential\ue2\u80\u9d by < 80% of the RP were selected for the PP rating. The format of reporting was rated by both RP and PP. Results: A total of 42 RPs and 12 PPs participated to the survey. In both Delphi round 1 and 2, 10/27 (37.7%) items were rated \ue2\u80\u9cessential\ue2\u80\u9d by more than 80% of RP. The remaining 17/27 (63.3%) items were rated by the PP in round 3, with 2/17 items (11.7%) rated \ue2\u80\u9cessential\ue2\u80\u9d by the PP. PP proposed additional items for conclusion domain, which were rated by RPs in the fourth round. Poor consensus was observed for the format of reporting. Conclusions: This study provides a template for structured report of FLD that features essential items as agreed by expert thoracic radiologists and pulmonologists

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Alla ricerca di uno spiraglio di luce nel mare di ombre di Haiti. Una proposta di traduzione di "Soleil à coudre" di Jean d'Amérique.

Il presente lavoro di tesi propone la traduzione dal francese verso l’italiano del romanzo "Soleil à coudre". Il primo capitolo funge da approfondimento sul contesto storico-culturale haitiano, patria dello scrittore Jean d’Amérique, in cui si ripercorrono le principali tappe della storia di Haiti, dalla colonizzazione fino alla contemporaneità, prendendo in esame l’evoluzione di una letteratura nazionale autentica sviluppatasi a partire dall’imitazione dei modelli francesi, con un focus sul romanzo haitiano. Si è ritenuto indispensabile raccogliere nel secondo capitolo tutte le curiosità sull’autore, riguardanti sia la biografia e le opere sia la concezione di Jean d'Amérique sulla letteratura. Una prima analisi del romanzo sotto il profilo dell’ambientazione, dei personaggi, della trama e delle tematiche è stata svolta nel terzo capitolo, che precede il capitolo quarto in cui è stata inserita la proposta di traduzione del romanzo con relativo testo a fronte. Il quinto e ultimo capitolo è invece dedicato al commento alla traduzione in cui sono indagati tutti gli aspetti tecnici sulla traduzione, vale a dire la spiegazione della macrostrategia adottata, le scelte traduttive messe in atto e i punti di resistenza incontrati. Si è posta così particolare attenzione all’analisi linguistica, sintattica e agli elementi culturali. Nell’appendice è possibile leggere l’intervista a cui l’autore ha gentilmente accettato di sottoporsi per fugare i dubbi sulla traduzione degli antroponimi e dei toponimi e sull’ambiguità di alcune frasi. Per concludere, sono stati presentati i documenti e i materiali cartacei e digitali consultati nel corso della stesura della traduzione e del suddetto lavoro di tesi

Use of fusarium oxysporum f.sp. dianthi transformed with marker genes to follow colonization of carnation roots

A highly pathogenic strain of F. oxysporum f.sp. dianthi (Fod) has been transformed with genes coding for Green Fluorescent Protein (GFP) and Red Fluorescent Protein (DsRedFP). Expression of GFP and DsRedFP resulted in bright green or red cytoplasmic fluorescence of mycelium when excited by fluorescent light. Stable transformants, selected on the basis of brightness and stability of fluorescence, were inoculated on roots of a partially resistant cultivar of carnation. Root and vessel colonization was evaluated, at regular times, by fluorescent microscopic observation of plant tissue sections. Autofluorescence of the carnation root was very high at the emission wavelength of the DsRed-Express, so that it was not possible to distinguish infecting hyphae within plant tissues. GFP-transformed Fod was easily visualized on and within root tissues. The fungus invaded the root tip and its growth seemed to proceed randomly in the sub-apical zone. The hyphae were confined within the vascular cylinder by the endodermal cells beginning from the zone of differentiation of vascular tissues, and were able to grow inside vessels

Fusarium oxysporum f. sp. dianthi transformed with marker genes as a tool for studying resistance in Dianthus

A F. oxysporum f. sp. dianthi strain, transformed with genes coding for fluorescent proteins (GFP or DsRedFP) as markers, was used to study the first host/pathogen interaction on carnation roots. The transformants’ mycelium observed under fluorescent light displayed a high expression of GFP and DsRedFP as a bright green or red cytoplasmic fluorescence. The root apparatus of a partially resistant cultivar of carnation was artificially inoculated by stable transformants and local colonization of plant tissues was monitored by means of fluorescence microscopy. A GFP transformed strain of F. oxysporum f. sp. dianthi allowed to follow first colonization steps on and within host root tissues. Implication of this research in studying resistance processes in carnation is discussed

Adhesions small bowel obstruction in emergency setting: conservative or operative treatment?

Adhesions small bowel obstructions (aSBO) are among the leading causes of emergency operative intervention. About the 80% of aSBO cases resolve without a surgical treatment. It's important to identify which patients could undergo a conservative treatment to prevent an useless surgery The aim of this study is to determine findings that can indicate whether patients with aSBO should undergo a conservative or a surgical treatment. 313 patients with diagnosis of submission of aSBO were restudied. Patients were divided into two groups based on the different type of treatment received, 225 patients who underwent surgical treatment within 24 hours after admission, 88 patients which underwent conservative treatment successfully. For each patient, clinical, hematochemical and radiological findings have been analysed. The treatment of aSBO should be, at the beginning, conservative except that cases that presents clinical and/or CT-scan findings predictive for a surgical treatment (free peritoneal fluid, mesenterial edema, transitional point) or a peritonitis (pneumatosis intestinalis, pneumoperitoneum)

3T diffusion-weighted MRI in the response assessment of colorectal liver metastases after chemotherapy: Correlation between ADC value and histological tumour regression grading

Purpose The purpose of the study was to correlate the apparent diffusion coefficient (ADC) values of diffusion-weighted MR imaging (DW-MRI) by 3T device with the histological tumour regression grading (TRG) analysis of colorectal liver metastases after preoperative chemotherapy. Materials and methods Our study included thirty-five patients with colorectal liver metastases who had undergone MRI by 3T device (GE DISCOVERY MR750; GE Healthcare) after preoperative chemotherapy. DW-MRI was performed using a single-shot spin-echo echo-planar sequence with multiple b-values (0, 150, 500, 1000, 1500 s/mm2), thus obtaining an ADC map. For each liver lesion (more than 1 cm in diameter) the fitted ADC values were calculated by two radiologists in conference and three ROIs were drawn: around the entire tumour (ADCe), at the tumour periphery (ADCp) and at the tumour center (ADCc). All ADC values were correlated with histopathological findings after surgery. Hepatic metastases were pathologically classified into five groups on the basis of TRG. Statistical analysis was performed on a per-lesion basis utilizing the one-way analysis of variance (ANOVA). This retrospective study was approved by our institutional review board; written informed consent was obtained from all patients. Results A total of 106 colorectal liver metastases were included for image analysis. TRG1, TRG2, TRG3, TRG4 and TRG5 were observed in 4, 14, 36, 35 and 17 lesions, respectively. ADCeand ADCpvalues were significantly higher in lesions classified as TRG1 (2.40 ± 0.12 Ã\u97 10â\u88\u929 m2/s and 2.28 ± 0.26 Ã\u97 10â\u88\u929 m2/s, respectively) and as TRG2 (1.40 ± 0.31 Ã\u97 10â\u88\u929 m2/s and 1.44 ± 0.35 Ã\u97 10â\u88\u929 m2/s), compared to TRG3 (1.16 ± 0.13 Ã\u97 10â\u88\u929 m2/s and 1.01 ± 0.18 Ã\u97 10â\u88\u929 m2/s), TRG4 (1.10 ± 0.26 Ã\u97 10â\u88\u929 m2/s and 0.97 ± 0.24 Ã\u97 10â\u88\u929 m2/s), and TRG5 (0.93 ± 0.17 Ã\u97 10â\u88\u929 m2/s and 0.82 ± 0.28 Ã\u97 10â\u88\u929 m2/s). ADCe, ADCpand ADCcvalues were significantly different in TRG classes (p < 0.0001). Statistical correlations were found between the ADCe, ADCp, ADCcvalues and the TRG classes (Spearman correlation coefficient were â\u88\u920.568, â\u88\u920.542 and â\u88\u920.554, respectively). Conclusion Our study showed a significant correlation between ADC values of 3T DW-MRI and histological TRG of colorectal liver metastases after preoperative chemotherapy