Thermal analysis and energy-efficient solutions to preserve listed building façades. The INA-Casa building heritage

Energy efficiency of building heritage derived from pre-regulation period is one of the most debated topics in Europe. Building facades, through opaque walls and thermal bridges, are a major source of transmission heat losses and require sustainable and consistent solutions. Aiming to achieve an energy demand reduction, thermal features of building facades were evaluated by field measurements and simulations for one INA-Casa listed apartment building built in the 1950s. Non-destructive insulating solutions have been proposed and a comparison between transmission heat loss coefficient in the current situation and the designed intervention was made. Results show that before the renovation, opaque walls and thermal bridges respectively contributed to 25% and 44% of total transmission heat loss in the case-study building facade. After the renovation, total impact was reduced up to 70% depending on whether high performance windows were replaced; in particular, the impact of opaque walls and thermal bridges were reduced by 66% and 82%, respectively. Interventions performed primarily on the internal layer of the facade with insulation elements, when appropriately designed, strengthen the negative effects of thermal bridges in junctions. Findings show that an accurate insulation design allows for both more efficient conditions and the preservation of the heritage-listed building

Tactical block planning for intermodal rail transportation

Le mémoire présente le problème de la planification tactique des “blocks” pour le transport ferroviaire intermodal, qui a été peu étudié jusqu’à présent. Nous proposons un nouveau modèle de design de réseau en tenant compte de la spécificité du transport intermodal. La recherche se concentre sur le contexte nord-américain et fait suite à une étroite collaboration avec l’une des principales compagnies ferroviaires nord-américaines. Le “blocking” constitue une importante opération de transport ferroviaire de marchandises, par laquelle des wagons d’origines et de destinations potentiellement différentes sont regroupés pour être d´eplacés et manipulés comme une seule unité, ce qui permet des économies d’échelle. La littérature se limite aux travaux traitant le problème classique du blocage des trains, où la demande est exprimée en termes de wagons. A notre connaissance, aucun travail préalable n’a été consacrè à un contexte de transport intermodal, où la demande est exprimée en termes de conteneurs à dèplacer d’un terminal d’origine donné vers un terminal de destination donné, introduisant ainsi un processus de consolidation supplémentaire. Nous proposons un modèle de “blocking” qui prend en compte plusieurs types de conteneurs et wagons, intégrant l’affectation conteneur-wagon. Nous présentons un nouveau modèle de design de réseau à trois couches en temps continu formulé sous la forme d’un programme linéaire mixte en nombres entiers (MILP), dans le but de minimiser le coût total de transport composé par la sélection de blocs, les coûts d’exploitation et la gestion du coût de la demande. Le modèle peut être résolu en utilisant un solveur commercial pour des tailles réalistes. Nous illustrons les performances et l’intérêt de la méthode proposée à travers une étude de cas approfondie d’un important chemin de fer nord-américain.The thesis presents the tactical block-planning problem for intermodal railroads, which has been little studied so far. We propose a new block service network design model considering the specificity of intermodal rail. The research focuses on the North American context and follows a close collaboration with one of the major North American railroad companies. Blocking constitutes an important rail freight transport operation, by which cars with potentially different origins and destinations are grouped to be moved and handled as a single unit, yielding economies of scale. The literature is limited to works addressing the classical train blocking problem, where demand is given in terms of cars to be blocked among specific OD pairs. To the best of our knowledge, no prior work has been dedicated to an intermodal transportation context, where demand is expressed in terms of containers to be moved from a given origin terminal to a given destination terminal, hence introducing an additional consolidation process. We propose a blocking model that considers several types of containers and railcars, integrating the container-to-car assignment. We present a new continuous-time, three-layer service network design model formulated as a Mixed Integer Linear Program (MILP), with the objective of minimizing the total transportation cost composed by block selection, operation costs, and handling demand cost. The model can be solved using commercial solver for realistic sizes. We illustrate the performance and interest of the proposed method through an extensive case study of a major North American railroad

Trends in Surgical and Beauty Masks for a Cleaner Environment

The surgical face mask (SFM) is a sheet medical device covering the mouth, nose and chin to protect the medical staff from the spread of respiratory droplets produced by the infective coughing or sneezing of hospitalized patients. On the other hand the beauty face mask (BFM) has been made by the same sheet but with a different aim—to protect the skin from pollution, acting as a hydrating and rejuvenation agent. Currently, both masks are made principally by non-biodegradable tissues, utilized to avoid the increasing great pollution invading our planet. Due to the diffusion of the current COVID-19 infection rate and the increasing consumption of skin care and beauty products, the waste of these masks, made principally by petrol-derived polymers, is creating further intolerable waste-invaded land and oceans. After an introduction to the aims, differences and market of the various masks, their productive means and ingredients are reported. These news are believed necessary to give the reader the working knowledge of these products, in the context of the bioeconomy, to better understand the innovative tissues proposed and realized by the biobased and biodegradable polymers. Thus, the possibility of producing biodegradable SFMs and BFMs, characterized for their effective antimicrobial and skin repairing activities or hydrating and antiaging activity, respectively. These innovative smart and biodegradable masks are requested from the majority of consumers oriented towards a future green environment. Giving this new sense of direction to their production and consumption, it will be possible to reduce the current waste, ranging worldwide at about 2 billion tons per year

Chitin and Lignin: Old Polymers and New Bio-Tissue- Carriers

Worldwide consumers are nowadays much more focusing on their wealth and appearance, having increased their worry caused from the pollution, plastic wastes and the earth' disasters further increased for the COVID-19 pandemic. This trend has created an heightened demand for products which, formulated with natural and functional ingredients and carried by sustainable delivery systems, should be produced and packed with biodegradable compounds. The paper suggests to formulate innovative cosmetic and medical products based on the use of carriers made by biodegradable polysaccharide-tissues embedded by micro-nano particles of chitin nano fibril-nano lignin complexes, encapsulating different active ingredients. Thus, data on chitin, lignin and their complexes are reported and discussed, focusing the attention on their possible use to make innovative products, characterized for their effectiveness, safeness, and biodegradability

Fears and perception of the impact of COVID-19 on patients with lung cancer. A mono-institutional survey

In February 2020, Italy became one of the first countries to be plagued by the SARS-CoV-2 pandemic, COVID-19. In March 2020, the Italian government decreed a lockdown for the whole country, which overturned communication systems, hospital organization, and access to patients and their relatives and carers. This issue had a particular regard for cancer patients. Our Thoracic Oncology Division therefore reorganized patient access in order to reduce the risk of contagion and, at the same time, encourage the continuation of treatment. Our staff contacted all patients to inform them of any changes in treatment planning, check that they were taking safety measures, and ascertain their feelings and whether they had any COVID-19 symptoms. To better understand patients’ fears and expectations of during the pandemic period, we created a nine-question interview, administered from April to May 2020 to 156 patients with lung cancer. Patients were classified by age, sex, comorbidity, disease stage, prior treatment, and treatment type. The survey showed that during the pandemic period some patients experienced fear of COVID-19, in particular: women (55% vs. 33%), patients with comorbidities (24% vs. 9%), and patients who had already received prior insult (radiotherapy or surgery) on the lung (30% vs. 11%). In addition, the patients who received oral treatment at home or for whom intravenous treatment was delayed, experienced a sense of relief (90% and 72% respectively). However, only 21% of the patients were more afraid of COVID-19 than of their cancer, in particular patients with long-term (> 12 months) vs. short-term cancer diagnosis (28% vs. 12.5%, respectively). Furthermore, the quarantine period or even just the lockdown period alone, worsened the quality of life of some patients (40%), especially those in oral treatment (47%). Our data demonstrate how lung cancer patients are more afraid of their disease than of a world pandemic. Also this interview indirectly highlights the clinician’s major guiding principle in correctly and appropriately managing not just the patient’s expectations of their illness and its treatment, but also and especially of the patient’s fears

Results of multilevel containment measures to better protect lung cancer patients from COVID-19. the IEO model

A novel coronavirus causing severe acute respiratory syndrome (SARS), named SARS-CoV-2, was identified at the end of 2019. The spread of coronavirus disease 2019 (COVID-19) has progressively expanded from China, involving several countries throughout the world, leading to the classification of the disease as a pandemic by the World Health Organization (WHO). According to published reports, COVID-19 severity and mortality are higher in elderly patients and those with active comorbidities. In particular, lung cancer patients were reported to be at high risk of pulmonary complications related to SARS-CoV2 infection. Therefore, the management of cancer care during the COVID-19 pandemic is a crucial issue, to which national and international oncology organizations have replied with recommendations concerning patients receiving anticancer treatments, delaying follow-up visits and limiting caregiver admission to the hospitals. In this historical moment, medical oncologists are required to consider the possibility to delay active treatment administration based on a case-by-case risk/benefit evaluation. Potential risks associated with COVID-19 infection should be considered, considering tumor histology and natural course, disease setting, clinical conditions, and disease burden, together with the expected benefit, toxicities (e.g., myelosuppression or interstitial lung disease), and response obtained from the planned or ongoing treatment. In this study, we report the results of proactive measures including social media, telemedicine, and telephone triage for screening patients with lung cancer during the COVID-19 outbreak in the European Institute of Oncology (Milan, Italy). Proactive management and containment measures, applied in a structured and daily way, has significantly aided the identification of advance patients with suspected symptoms related to COVID-19, limiting their admission to our cancer center; we have thus been more able to protect other patients from possible contamination and at the same time guarantee to the suspected patients the immediate treatment and evaluation in referral hospitals for COVID-19

Development and validation of an art-inspired multimodal interactive technology system for a multi-component intervention for older people: a pilot study

IntroductionThe World Health Organization (WHO) acknowledges the presence of a significant body of research on the positive effects of the arts on health, considering a variety of factors including physical well-being, quality of life, and social and community impact. The model that underlies cultural welfare puts the performing arts, visual arts, and cultural heritage at the service of people personal and societal well-being. The potential connections between movements of the body and artistic content have been extensively studied over time, considering movement as a non-verbal language with a universal character.MethodsThis pilot study presents the results of the validation of an innovative multimodal system, the DanzArTe-Emotional Wellbeing Technology, designed to support active and participative experience of older people providing physical and cognitive activation through a full-body physical interaction with a traditional visual work of art of religious subject. DanzArTe supports a replicable treatment protocol for multidimensional frailty, administered through a low cost and scalable technological platform capable of generating real-time visual and auditory feedback (interactive sonification) from the automated analysis of individual as well as joint movement expressive qualities. The study involved 45 participants, 23 of whom participated in the DanzArTe program and 22 who were included in the control group.ResultsThe two groups were similar in terms of age (p = 0.465) and gender (p = 0.683). The results showed that the DanzArTe program had a positive impact on participants' self-perceived psychological health and well-being (Mean Psychological General Well-Being Index—Short T1 = 19.6 ± 4.3 Vs. T2 = 20.8 ± 4.9; p = 0.029). The same trend was not observed in the control group (p = 0.389).DiscussionThe findings suggest that such programs may have a significant impact particularly on the mental and social well-being of older adults and could be a valuable tool for promoting healthy aging and improving quality of life

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes