Advances in the diagnosis of acute aortic syndromes: Role of imaging techniques.

Aortic diseases include a wide range of pathological conditions: aortic aneurysms, pseudoaneurysms, acute aortic syndromes, atherosclerotic and inflammatory conditions, genetic diseases and congenital anomalies. Acute aortic syndromes have acute onset and may be life-threatening. They include aortic dissection, intramural haematoma, penetrating aortic ulcer and traumatic aortic injury. Pain is the common denominator to all acute aortic syndromes. Pain occurs regardless of age, gender and other associated clinical conditions. In this review, we deal with the main findings in the clinical setting and the most recent indications for diagnostic imaging, which are aimed to start an appropriate treatment and improve the short- and long-term prognosis of these patients. © The Author(s) 2016

energy refurbishment of a university building in cold italian backcountry part 1 audit and calibration of the numerical model

Abstract The study provides a methodological approach for designing energy refurbishment measures of buildings, enabling to understand the uncertainty of using numerical modelling and the real impacts due of adopting some energy efficiency technologies. The case study is a University building of the centre of Italy, and the reference scenario has been supported by various in-situ surveys, investigations and evaluations of the indoor comfort. Collected data, together with a comparison with energy bills, has allowed a proper calibration of a numerical model simulated by means EnergyPlus. All this phase is described in this paper, while a second part will discuss the energy retrofit and the building energy optimization

energy refurbishment of a university building in cold italian backcountry part 2 sensitivity studies and optimization

Abstract The first part of this study provided a discussion about the methodological approach for designing energy refurbishment measures of buildings. The case study is a building owned by University of Molise, in Campobasso, a cold Italian city. The reference scenario is a numerical model built after deep investigations, and thus surveys, questionnaires, documents and experimental measurements on the real building. Then, a calibrated energy model was presented. In this second part, starting from the calibrated model, some energy retrofit measures have been implemented. The obtained results allow to discuss two key points for researches in matter of energy refurbishment of buildings: a) the importance of using validated models to simulate the present performance; b) the environmental benefits and the economic implications of a deep energy refurbishment

Multidisciplinary Approach to Structural/Energy Diagnosis of Historical Buildings: A Case Study

Abstract A synergic approach for the investigations of the historical building performances - with reference to both the structural behavior and the energy performances for the space heating and cooling - is presented. The historical masonry building "Palazzo Bosco Lucarelli", located in Benevento, has been chosen as case study. The structural and energy analyses are carried out in parallel, especially during the identification of the building characteristics through tests and surveys in-situ. For the structural analysis - beyond examinations on materials - some dynamic tests have been used for better assessing a numerical Finite Element model necessary for the verification of the structure safety. Moreover, being necessary a structural refurbishment, also an energy retrofit could be realized. A rigorous evaluation procedure - aimed to guarantee the necessary reliability of numerical predictions - is performed in order to verify the technical and economical convenience of various energy retrofit solutions

nzeb target for existing buildings case study of historical educational building in mediterranean climate

Abstract A key element of the Energy Performance of Building Directive 2010/31/EU is the introduction of nearly zero energy building (NZEB) standard for new constructions. However, considering the very low rate of new built volume, the major change for achieve the sustainable grow of the European economy, appears to be the renovation of existing building stock. But, is it possible to reach very low or nearly zero energy standard during refurbishment design? Proposed paper tries to answer this question, evaluating if the refurbishment of historic architectures to very low energy need is possible and economically feasible. With reference to a case study, this paper investigates the cost-optimal energy refurbishment of a Renaissance-style palace, located in the center of Naples, South Italy. The adopted methodology consists of various steps. Firstly, a model of the building has been accurately built and calibrated. Then, it has been used to evaluate possible interventions concerning both the envelope and the energy systems. The best solutions, chosen according to the European methodology of cost-optimality, have been combined in a last simulation. The results show that great energy savings as well as economic and environmental improvements are possible, although heritage buildings present a less flexibility in the proposal of energy efficiency measures

Application of a Machine Learning Technology in the Definition of Metabolically Healthy and Unhealthy Status: A Retrospective Study of 2567 Subjects Suffering from Obesity with or without Metabolic Syndrome.

The key factors playing a role in the pathogenesis of metabolic alterations observed in many patients with obesity have not been fully characterized. Their identification is crucial, and it would represent a fundamental step towards better management of this urgent public health issue. This aim could be accomplished by exploiting the potential of machine learning (ML) technology. In a single-centre study (n = 2567), we used an ML analysis to cluster patients with metabolically healthy (MHO) or metabolically unhealthy (MUO) obesity, based on several clinical and biochemical variables. The first model provided by ML was able to predict the presence/absence of MHO with an accuracy of 66.67% and 72.15%, respectively, and included the following parameters: HOMA-IR, upper body fat/lower body fat, glycosylated haemoglobin, red blood cells, age, alanine aminotransferase, uric acid, white blood cells, insulin-like growth factor 1 (IGF-1) and gamma-glutamyl transferase. For each of these parameters, ML provided threshold values identifying either MUO or MHO. A second model including IGF-1 zSDS, a surrogate marker of IGF-1 normalized by age and sex, was even more accurate with a 71.84% and 72.3% precision, respectively. Our results demonstrated high IGF-1 levels in MHO patients, thus highlighting a possible role of IGF-1 as a novel metabolic health parameter to effectively predict the development of MUO using ML technology

Location of primary tumor and benefit from anti-epidermal growth factorreceptor monoclonalantibodies in patients with RAS and BRAF wild-typemetastatic colorectal cancer

Introduction. Right- and left-sided colorectal cancers (CRCs) differ in clinical and molecular characteristics. Some retrospective analyses suggested that patients with right-sided tumors derive less benefit from anti-epidermal growth factor receptor (EGFR) antibodies; however, molecular selection in those studies was not extensive. Patients and Methods. Patients with RAS and BRAF wild-type metastatic CRC (mCRC) who were treated with single-agent anti-EGFRs or with cetuximab-irinotecan (if refractory to previous irinotecan) were included in the study. Differences in outcome between patients with right- and left-sided tumors were investigated. Results. Of 75 patients, 14 and 61 had right- and left-sided tumors, respectively. None of the right-sided tumors responded according to RECIST, compared with 24 left-sided tumors (overall response rate: 0% vs. 41%; p 5 .0032), and only 2 patients with right-sided tumors (15%) versus 47 patients with left-sided tumors (80%) achieved disease control (p, .0001). The median duration of progression-free survival was 2.3 and 6.6 months in patients with right-sided and left-sided tumors, respectively (hazard ratio: 3.97;95%confidence interval: 2.09–7.53; p,.0001). Conclusion. Patients with right-sided RAS and BRAF wild-type mCRC seemed to derive no benefit from single-agent anti- EGFRs