Embodied energy and operational energy evaluation in tall buildings according to different typologies of façade

Abstract Although recent studies demonstrate the importance of including the Embodied Energy (EE) in building analysis, only the Operational Energy (OE) is currently taken into account in building energy demand calculation method. In particular, the EE plays an important role in tall buildings evaluation, because the energy demand increases with building height. Aim of this study was to assess the Embodied Energy in evaluation of different types of tall building facade systems performances along with the Operational Energy, pointing out the importance of taking into account both these aspects. Within the research activity here presented, 8 glazed envelope typologies, in 5 different climate zones, have been evaluated

Micro-scale {UHI} risk assessment on the heat-health nexus within cities by looking at socio-economic factors and built environment characteristics: The Turin case study (Italy)

Today the most substantial threats facing cities relate to the impacts of climate change. Extreme temperature such as heat waves and the occurrence of Urban Heat Island (UHI) phenomena, present the main challenges for urban planning and design. Climate deterioration exacerbates the already existing weaknesses in social systems, which have been created by changes such as population increases and urban sprawl. Despite numerous attempts by researchers to assess the risks associated with the heat-health nexus in urban areas, no common metrics have yet been defined yet. The objective of this study, therefore, is to provide an empirical example of a flexible and replicable methodology to estimate the micro-scale UHI risks within an urban context which takes into account all the relevant elements regarding the heat-health nexus. For this purpose, the city of Turin has been used as a case study. The methodological approach adopted is based on risk assessment guidelines suggested and approved by the most recent scientific literature. The risk framework presented here used a quantitative estimate per each census tract within the city based on the interaction of three main factors: hazard, exposure, and vulnerability. Corresponding georeferenced maps for each indicator have been provided to increase the local knowledge on the spatial distribution of vulnerability drivers. The proposed methodology and the related findings represent an initial stage of the urban risk investigation within the case study. This will include participatory processes with local policymakers and health-stakeholders with a view to guiding the local planning agenda of climate change adaptation and resilience strategies in the City of Turin

Maternal and fetal outcomes of intraplacental choriocarcinoma complicated by fetomaternal hemorrhage: a systematic review

Introduction: Intraplacental choriocarcinoma is a gestational trophoblastic neoplasia located within the placenta. Due to the usual silent presentation, more than half of the cases are diagnosed incidentally. It has been demonstrated that this pathology is linked to feto-maternal hemorrhage (FMH), stillbirth, and intrauterine growth restriction. The aim of our review was to establish if there are recurrent signs that might lead to an early diagnosis and better management in cases complicated by FMH. Materials and methods: We performed a systematic review of the literature from 2000 up to March 2023. The adopted research strategy included the following terms: (gestational choriocarcinoma obstetrics outcome) AND (intraplacental choriocarcinoma) AND (gestational choriocarcinoma). The MEDLINE (PubMed), Google Scholar, and Scopus databases were searched. Results: The research strategy identified 19 cases of FMH coexisting with intraplacental choriocarcinoma (IC), as described in 17 studies. The perinatal mortality rate was 36.8%. In eight cases, histological diagnosis of IC was made post-delivery. Metastatic lesions were found in 75% (6/8) of described cases. One case of maternal death has been described. Chemotherapy was necessary in seven cases. Sporadical prenatal ultrasound signs were described. Discussion: The diagnosis of IC is usually delayed, mostly due to aspecific symptoms and signs. Histological analysis of the placenta, when not routinely performed, should be performed when warning symptoms are encountered. The maternal prognosis was good, with a mortality rate of 5.5%. A fertility-sparing approach is always possible even in the presence of metastasis. Chemotherapy seems to be useful in cases of maternal and neonatal metastasis

Primi studi sull'interazione tra stato di micorrizazione e danni da incendio in una pineta siciliana

Nell’ambito di uno studio sulle simbiosi micorriziche delle conifere in ambienti siciliani, è stata avviata un’indagine preliminare sulla interazione tra danni da incendio e stato di micorrizazione in un rimboschimento artificiale di Pinus halepensis Mill. In particolare, nel bosco di Casaboli (Monreale, PA) estesamente interessato da incendi dolosi nell’estate 2017, sono state delimitate tre aree contigue di circa 700 m2, comprendenti una ventina di piante coetanee (30-40 anni) e con differente entità di danno: 1) vegetazione apparentemente sana (S); danni di media entità (M); danni ingenti (I). In ogni area, dopo aver condotto opportuni rilievi dendrometrici, sono stati individuati 5 punti per il prelievo di carote di suolo a due profondità (5-15; 20-30 cm); i campionamenti sono stati ripetuti tre volte nel biennio 2018-19 (giugno e novembre 2018, maggio 2019) e saranno completati a novembre 2019. I frammenti radicali di P. halepensis, recuperati sotto un leggero flusso d’acqua corrente, sono stati osservati allo stereo microscopio, valutando l’Indice di Micorrizazione (IM = n° totale di apici micorrizici/cm di radice) e rilevando, sul numero totale di apici micorrizici, la percentuale di quelli attivi e non (necrotici). Sebbene l’indagine sia ancora in corso, i primi risultati sembrerebbero evidenziare valori di IM maggiori nell’area S, decrescenti in funzione del livello di deperimento. Nel contempo, nel profilo di suolo compreso tra 20 e 30 cm sono stati rilevati i maggiori livelli di micorrizazione, che rimane sensibile anche nelle aree più danneggiate. Ulteriori dati acquisiti nel corso dell’attività di ricerca potranno fornire utili indicazioni per la definizione degli effetti di tale fattore di disturbo nell’ecosistema oggetto di studio

Conscious Sedation for Dental Treatments in Subjects with Intellectual Disability: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis was aimed to investigate the conscious sedation efficiency in patients with intellectual disability undergoing dental treatment (PROSPERO CRD42022344292). Four scientific databases were searched by ad-hoc prepared strings. The literature search yielded 731 papers: 426 were selected, 42 were obtained in full-text format, and 4 more were added after hand searching. Fourteen studies were finally included, 11 of which were included in the meta-analysis (random effect model). A high heterogeneity in the drugs used and route of administration was retrieved. Success rate, occurrence of side effects, and deep sedation occurrence were combined to give an overall efficiency of each drug. N2O/O2 reported the highest efficiency (effect size = 0.90; p < 0.01) and proved to be more efficient when used alone. Nine papers reported a success rate of sedation of 80% or more. The prevalence of side effects (6 studies) ranged from 3% to 40%. Enteral and parenteral benzodiazepines showed the same overall efficiency (effect size = 0.86). No meta-analysis has yet been conducted to define the most effective and safest way to achieve conscious sedation in patients with intellectual disability; nitrous oxide appears to be the best choice to perform conscious sedation in patients with intellectual disability undergoing dental treatment

How to promote changes in primary care? The Florentine experience of the House of Community

Primary care (PC) has a central role in promoting health and preventing diseases, even during health emergencies. The COVID-19 pandemic has shown how strengthening comprehensive primary healthcare (c-PHC) services is key to ensuring community health. The Italian government decided to support PHC by investing resources from the Next Generation EU (NextGenEu) plan in the development of local health districts (LHDs) and local PC centers called “Houses of Community (HoC)”. The Florence LHD (Tuscany)—in direct collaboration with the University of Florence—has represented the experimental context in which a c-PHC-inspired organizational model has been proposed and included the HoC as the nearest access point to PC services. Through multiprofessional collaboration practices, HoCs provide continuity of care as well as health and social integration. Different levels of action must coexist to initiate, implement, and sustain this new PC model: the organizational and managerial level, the experimentation of a new model of care, and the research level, which includes universities and LHD through participatory research and action approaches. This process benefits from health professionals' (HPs) participation and continuous assessment, the care for working relationships between HPs and services, an appropriate research methodology together with a “permeable” multidisciplinary research group, and educational programs. In this context, the HoC assumes the role of a permanent laboratory of experimentation in PC, supporting the effectiveness of care and answering what the Next Gen EU plan has been foreseeing for the rethinking of Italian territorial services

Assessment of congenital coronary artery fistulas by transesophageal color Doppler echocardiography

PURPOSE: Coronary angiography is the gold standard for imaging the coronary tree, but the relation of coronary artery fistulas to other structures, and their origin and course, may not be apparent. We evaluated the ability of multiplane color Doppler transesophageal echocardiography to identify coronary fistulas. PATIENTS AND METHODS: Twenty-one patients with angiographically confirmed coronary artery fistulas were investigated by transesophageal echocardiography in four Italian hospitals between January 1997 and May 2001. RESULTS: Transesophageal echocardiography correctly diagnosed fistulous connection in all 21 patients. This included 6 patients with connections from the left circumflex artery (into the right chambers of the heart in 5 patients, and into the left ventricle in 1 patient), 10 patients with a fistula arising from the left anterior descending artery or left main coronary artery (with drainage into the right ventricle or main pulmonary artery), and 5 patients with a fistula from the right coronary artery (with drainage sites in the lateral aspect of the right ventricle, the low posterior right atrium, or the superior vena cava). In 4 of the 21 patients, angiography did not identify the precise site of a fistula into the coronary sinus or right ventricle. CONCLUSION: Color Doppler transesophageal echocardiography is useful in the diagnosis and in the precise localization of coronary artery fistulas