Another Chance: Adaptive reuse of the built heritage strategies for circular creativity

The study delves into the realm of adaptive reuse, exploring its potential in sustainable urban development, particularly focusing on public buildings within the cultural and creative sectors. Through a multiple case study analysis, both qualitative and quantitative methods were employed to scrutinize design strategies and spatial transformations in recent adaptive reuse projects of existing structures. This research investigates the evolution of adaptive reuse, highlighting its historical and theoretical underpinnings, and subsequently examines contemporary approaches towards existing structures in cultural, creative, and public domains. The study findings reveal common characteristics and innovative design strategies employed in recent adaptive reuse projects, emphasizing the transformative potential of neglected or abandoned urban spaces. Utilizing a comprehensive methodology involving case study analyses and diverse data collection techniques, the research underscores the significance of adaptive reuse as an established practice in contemporary architectural and urban design. The article's contribution to the social and economic dimensions of urban development lies in understanding and promoting sustainable, resource-saving strategies. This work paves the way for future research, suggesting potential expansions in creating an 'atlas of adaptive reuse' and exploring comparative analyses between existing reuse and new construction, specifically focusing on public buildings with civic-cultural uses

A combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts is able to improve sexual quality of life in patient with premature ejaculation

Objective: The management of patient affected by premature ejaculation (PE) is nowadays not highly satisfactory. Here, we aimed to evaluate the tolerability and efficacy of a combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts in order to improve sexual quality of life in patients with premature ejaculation. Materials and methods: All patients attending to 5 urological centers from January 2015 to March 2015, due to premature ejaculation were enrolled in this study. At the enrolment visit, all subjects underwent self-administered IIEF-5, Male Sexual Health Questionnaire-Ejaculation Disorder (MSHQ-EjD), PEDT and IELTS (calculated as mean from that perceived by partner and that perceived by patient) and underwent urological visit and laboratory examinations. All patients received one tablet per day of a combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts for 3 months (Group A). After 3 months all patients underwent follow-up visit with the same investigations that have been carried out in the enrolment visit. The results were compared with a cohort of patients enrolled in the same period in another urological center and considered as a control group (Group B). All patients in the control group underwent counseling and sexual behavioral treatment without any pharmacological compound. Results: At the follow-up analysis, significant changes in terms of IELT in the Group A (mean difference: 31.90; p < 0.05) at 3 months and versus Group B at the intergroup analysis (mean difference: 30.30; p < 0.05) were reported. In the group A, significant differences from baseline to last follow-up were observed relative to IIEF-5 (mean difference: 1.04; p < 0.05), PEDT (mean difference: -2.57; p < 0.05) and FSH (mean difference: -16.46; p < 0.05). Conclusion: In conclusion, patients affected by PE may significantly benefit from oral therapy with a combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts in terms of IELT and PEDT scores improvement

Pancreatic fistula: A proposed percutaneous procedure

AIM: To propose a percutaneous treatment for otherwise intractable pancreatic fistula (PF). METHODS: From 2005 to 2011, 12 patients (9 men and 3 women, mean age 59 years, median 63 years, range 33-78 years) underwent radiological treatment for high-output PF associated with peripancreatic fluid collection. The percutaneous procedures were performed after at least 4 wk of unsuccessful conservative treatments. We chose either a one or two step procedure, depending on the size and characteristics of the fistula and the fluid collection (with an arbitrary cut-off of 2 cm). Initially, 2 to 6 pigtail drainages of variable size from 8.3 (8.3-Pig Duan Cook, Bloomington, Indiana, United States) to 14 Fr (Flexima, Boston Scientific, Natick, United States) were positioned inside the collection using a transgastric approach. In a second procedure, after 7-10 d, two or more endoprostheses (cystogastrostomic 8 Fr double-pigtail, Cook, Bloomington, Indiana, United States in 10 patients; covered Niti-S stent, TaeWoong Medical Co, Seoul, South Korea in 2 patients) were placed between the collection and the gastric lumen. In all cases the metal or plastic prostheses were removed within one year after positioning. RESULTS: Four out of 12 high-output fistulas fistulas were external while 8/12 were internal. The origin of the fistulous tract was visualised by computer tomography (CT) imaging studies: in 11 patients it was at the body, and in 1 patient at the tail of the pancreas. Single or multiple drainages were positioned under CT guidance. The catheters were left in place for a varying period (0 to 40 d - median 10 and 25(th)-75(th) percentile 0-14). In one case external transgastric drainages were left in place for a prolonged time (40 d) due to the presence of vancomycin-resistant bacteria (Staphylococcus) and fluconazole-resistant fungi (Candida) in the drained fluid. In this latter case systemic and local antibiotic therapy was administered. In both single and two-step techniques, when infection was present, we carried out additional washing with antibiotics to improve the likelihood of the procedure’s success. In all cases the endoprostheses were left in situ for a few weeks and endoscopically removed after remission of collections, as ascertained by CT scan. Procedural success rate was 100% as the resolution of external PF was achieved in all cases. There were no peri-procedural complications in any of the patients. The minimum follow-up was 18 mo. In two cases the procedure was repeated after 1 year, due to the onset of new fluid collections and the development of pseudocysts. Indeed, this type of endoprosthesis is routinely employed for the treatment of pseudocysts. Endoscopy was adopted both for control of the positioning of the endoprosthesis in the stomach, and for its removal after resolution of the fistula and fluid collection. The resolution of the external fistula was assessed clinically and CT scan was employed to demonstrate the resolution of peripancreatic collections for both the internal and external fistulae. CONCLUSION: The percutaneous placement of cistogastrostomic endoprostheses can be used for the treatment of PF that cannot be treated with other procedures

Quantitation of regional ejection fractions using gated tomographic imaging with Tc-99m-sestamibi

BACKGROUND: A new oro-dispersible film (ODF) formulation of sildenafil has been developed for the treatment of erectile dysfunction (ED) to overcome the drawbacks that some patients experience when taking the conventional film-coated tablet (FCT). AIM: To assess the effectiveness and safety of sildenafil ODF formulation in patients with ED who were using the conventional FCT. METHODS: From May 2017 through July 2017, 139 patients with ED were enrolled. Data from penile color-duplex ultrasound, medical history, hormonal evaluation, and patient self-administered questionnaires were collected. All patients were administered sildenafil 100-mg FCT for 4 weeks. Thereafter, they underwent a 2-week washout period and subsequently took sildenafil 75-mg ODF for 4 weeks. OUTCOMES: The International Index of Erectile Function (IIEF-15), Hospital Anxiety and Depression Scale (HADS), Patient Global Impressions of Improvement (PGI-I), and Clinician Global Impressions of Improvement (CGI-I) questionnaires were administered and severity of ED was classified as severe (IIEF-15 score ≤ 10), moderate (IIEF-15 score 11-16), or mild (IIEF-15 score = 17-25). RESULTS: All patients completed the final protocol. Differences in mean IIEF scores for erectile function, orgasmic function, sexual desire, and intercourse satisfaction were significantly in favor of sildenafil 100-mg FCT, whereas the mean score for overall satisfaction was in favor of sildenafil 75-mg ODF. A significant difference in changes in HADS score was found from washout to final follow-up (mean difference = -0.19; P < .01). For the ODF formulation, the median CGI-I score was 3.5 (interquartile range [IQR] = 2.5-4.5) and the median PGI-I score was 3.0 (IQR = 2.0-4.0). The median action time was 20.0 minutes (IQR = 15.0-30.0) and the median mouth time was 60.0 seconds (IQR = 30.0-120.0). CLINICAL IMPLICATIONS: The ODF formulation of a widely known drug, with the same safety and effectiveness of the FCT, was better appreciated by patients in overall satisfaction. STRENGTHS AND LIMITATIONS: This is the first clinical trial to assess the efficacy of a new formulation of sildenafil in patients with ED. The limitations of the study are related to the methodology used: it was not a case-control study and the patients were not drug-naïve for ED treatment. Therefore, only the "additional" side effects of the ODF formulation compared with FCT are reported. CONCLUSION: The new ODF formulation is as efficient and safe as the FCT formulation and offers a new choice of treatment to specialists for more precisely tailored therapy. Cocci A, Capece M, Cito G, et al. Effectiveness and Safety of Oro-Dispersible Sildenafil in a New Film Formulation for the Treatment of Erectile Dysfunction: Comparison Between Sildenafil 100-mg Film-Coated Tablet and 75-mg Oro-Dispersible Film. J Sex Med 2017;X:XXX-XXX

Beijng Daxing International Airport. Un progetto di Zaha Hadid Architects per l'hub aeroportuale più grande del mondo [Beijng Daxing International Airport. A project by Zaha Hadid Architects for the World's Largest Airport Hub]

Il rapporto tra masse, corpi e spazio è l'ambito in cui si colloca il contributo che indaga sia le multiformi configurazioni spaziali a cui danno vita i progetti di regolamentazione delle masse, sia gli effetti paradossali della comparsa dello sciame sulla scena urbana, e dell'uso massivo dello spazio

Post-earthquake perspectives. Prospettive di ricostruzione e riattivazione dello spazio pubblico nei comuni marchigiani colpiti dal sisma

L’esigenza di fornire risposte alle istanze delle comunità delle cosiddette aree interne e la volontà di proseguire una riflessione generale sulle dinamiche di sviluppo e sulle possibili strategie di rigenerazione dei luoghi coinvolti nello sciame sismico del 2016/2017 sono alla base delle ricerche dipartimentali, che esplorano possibili modalità di intervento che siano in grado di costituire praticabili azioni per affrontare le forti criticità che, sovrapponendosi, rischiano di compromettere l’identità di interi territori. I contributi su casi applicativi, in cui si propongono progetti di ricostruzione, sono volti a esplorare la capacità del progetto stesso di innescare nuove dinamiche virtuose e una riattivazione urbana in queste zone marginali. La situazione attuale dei territori marchigiani colpiti dal sisma può divenire impulso per attivare nuove opportunità e usi e adeguare gli spazi alle nuove esigenze dell’abitare, per introdurre innovazioni tecnologiche e coinvolgere le comunità locali in maniera più consapevole e condivisa, al fine di rivitalizzare la percezione e il sentire identitario che solo la cura del proprio patrimonio può veicolare. Tra i lavori presentati come tesi di laurea, particolarmente significativi sono quelli che riguardano i comuni di Petriolo e San Ginesio nella provincia di Macerata. Le azioni progettuali in oggetto indagano il recupero e la riqualificazione del built heritage e dello spazio pubblico, dell’open heritage, come iniettori di nuove energie per superare la crisi sistemica del cratere marchigiano: una urban legacy che passa attraverso le proposte risultanti e la ricerca di questi anni, costituenti una stratificazione e una sedimentazione sulle quali poter iniziare a tracciare dei risultati

Gianluigi Mondaini, Francesco Ascenzi. ARCHITETTURA E NATURA. Paesaggio come nuovo paradigma del progetto.

Il saggio affronta dal punto di vista del comporre la nuova attenzione da parte del progetto di architettura al paesaggio naturale che diviene vero e propria modalità concettuale di ideazione delle spazialità. Il saggio indaga quindi le relazioni tra Architettura e natura nell'interpretazione del paesaggio come nuovo paradigma del progetto monche la relazione tra progetto e verde come modalità di intervento ai fini della necessità di ricerca di strategie volte alla sostenibilità energetica