Environmental sustainability approaches and positive energy districts: A literature review

During the last decade, increasing attention has been paid to the emerging concept of Positive Energy Districts (PED) with the aim of pushing the transition to clean energy, but further research efforts are needed to identify design approaches optimized from the point of view of sustainable development. In this context, this literature review is placed, with a specific focus on environmental sustainability within innovative and eco-sustainable districts. The findings show that some sustainability aspects such as sustainable food, urban heat islands mitigation and co-impacts, e.g., green gentrification, are not adequately assessed, while fragmented thinking limits the potential of circularity. In this regard, targeted strategies should be developed. On the other hand, the Key Performance Indicators framework needs some integrations. In this direction, indicators were suggested, among those defined in the Sustainable Development Agenda, the main European standards and initiatives and the relevant literature experiences. Future outlooks should be directed to-wards: the harmonization of the Life Cycle Assessment in PEDs with reference to modeling assump-tions and analysis of multiple impacts; the development of dynamic environmental analyses taking into account the long-term uncertainty due to climate change, data availability and energy decar-bonization; the combination of Life Cycle Assessment and Key Performance Indicators based tech-niques, from a holistic thinking perspective, for a comprehensive design environment and the analysis of the contribution of energy flexibility approaches on the environmental impact of a project

Application of a score system to evaluate the risk of malnutrition in a multiple hospital setting

Background: An increased but unpredictable risk of malnutrition is associated with hospitalization, especially in children with chronic diseases. We investigated the applicability of Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids), an instrument proposed to estimate the risk of malnutrition in hospitalized children. We also evaluated the role of age and co-morbidities as risk for malnutrition. Methods. The STRONGkids consists of 4 items providing a score that classifies a patient in low, moderate, high risk for malnutrition. A prospective observational multi-centre study was performed in 12 Italian hospitals. Children 1-18 years consecutively admitted and otherwise unselected were enrolled. Their STRONGkids score was obtained and compared with the actual nutritional status expressed as BMI and Height for Age SD-score. Results: Of 144 children (75 males, mean age 6.5 \ub1 4.5 years), 52 (36%) had an underlying chronic disease. According to STRONGkids, 46 (32%) children were at low risk, 76 (53%) at moderate risk and 22 (15%) at high risk for malnutrition. The latter had significantly lower Height for Age values (mean SD value -1.07 \ub1 2.08; p = 0.008) and BMI values (mean SD-values -0.79 \ub1 2.09; p = 0.0021) in comparison to other groups. However, only 29 children were actually malnourished. Conclusions: The STRONGkids is easy to administer. It is highly sensitive but not specific. It may be used as a very preliminary screening tool to be integrated with other clinical data in order to reliably predict the risk of malnutrition. \ua9 2013 Spagnuolo et al.; licensee BioMed Central Ltd

mHealth Applications to Monitor Lifestyle Behaviors and Circadian Rhythm in Clinical Settings: Current Perspective and Future Directions

Metabolic diseases are a global rising health burden, mainly due to the deleterious interaction of current lifestyles with the underlying biology of these diseases. Daily habits and behaviors, such as diet, sleep, and physical exercise impact the whole-body circadian system through the synchronization of the peripheral body clocks that contribute to metabolic homeostasis. The disruption of this system may promote the development of metabolic diseases, including obesity and diabetes, emphasizing the importance of assessing and monitoring variables that affect circadian rhythms. Advances in technology are generating innovative resources and tools for health care management and patient monitoring, particularly important for chronic conditions. The use of mobile health technologies, known as mHealth, is increasing and these approaches are contributing to aiding both patients and healthcare professionals in disease management and education. The mHealth solutions allow continuous monitoring of patients, sharing relevant information and data with physicians and other healthcare professionals and accessing education resources to support informed decisions. Thus, if properly used, these tools empower patients and help them to adopt healthier lifestyles. This article aims to give an overview of the influence of circadian rhythms disruption and lifestyle habits in the progression of metabolic diseases while also reviewing some of the mobile applications available to monitor lifestyle behaviors and individual chronobiology. Herein is also described the design and development of the NutriClock system, an mHealth solution developed by our team to monitor these variables

Report of a Case of Video-Assisted Thoracoscopic Resection of Bronchogenic Cyst Developed in the Aorto-Pulmonary Window

We report the case of a 28-years-old male with a bronchogenic cyst developed in the aorto-pulmonary window. Left video-assisted thoracoscopy was performed and the cyst was removed intact and completely. Operative time was 48 minutes. The postoperative course was uneventful and the patient was discharged on the third postoperative day. We believe that an uncomplicated mediastinal bronchogenic cyst can be successfully approached by video-assisted thoracoscopy. In the case of an intraparenchymal or complicated cyst, thoracoscopic resection can be technically difficult and hazardous, and open approach is preferable

Precision livestock farming : an overview of image and sound labelling

the shift in livestock farming methods from extensive to intensive poses a number of significant challenges for animal welfare, environmental sustainability and food security. automatic animal monitoring may be one method of supporting farmers in achieving farm sustainability. Precision Livestock Farming (PLF) can combine audio and video information into automated tools that serve as early warning systems for the farmer if health or welfare problems are detected. First, reliable sounds and images that indicate poor animal welfare must be identified by animal experts. then, through careful labelling of sounds or images, it is possible to create a complete database which is suitable for algorithm development. Labelling is an activity which precisely defines and interprets detailed variations in measured field signals. This study will describe sound and image labelling with the aim of developing an automated tool

MRP4 over-expression has a role on both reducing nitric oxide-dependent antiplatelet effect and enhancing ADP induced platelet activation

The impact of inhibition of multidrug resistance protein 4 (MRP4) on nitric oxide (NO) resistance and on ADP-induced platelet aggregation is unknown. The aim of this investigation was to verify whether platelet NO resistance correlates with MRP4 expression and evaluate whether this can be reduced by in vitro MRP4 inhibition mediated by cilostazol. Moreover, we assessed if inhibition of MRP4-mediated transport reduces ADP-induced platelet reactivity. The inhibitory effect of sodium nitroprusside (SNP), a NO-donor that enhances cyclic guanosine monophosphate (cGMP) cytosolic concentration, was assessed in platelets obtained from aspirin treated patients and in a control population. The inhibitory effect of SNP was evaluated by ADP-induced aggregation in SNP-treated platelets. The impact of MRP4 on ADP-induced platelet aggregation was performed in high on aspirin residual platelet reactivity (HARPR) patients and compared to healthy volunteers (HV), and a control cohort (CTR). In aspirin-treated patients with high levels of MRP4, reduced SNP inhibition was found compared to those with low levels of MRP4. MRP4 inhibition by cilostazol significantly reduced ADP-induced platelet aggregation in HARPR population, and to a lesser extent in HV and CTR populations. In conclusion, cilostazol can mitigate the hyper-reactive platelet phenotype of HARPR patients by reducing residual ADP-induced platelet aggregation and increasing NO-dependent endothelial antiplatelet effects

Ecologia e distribuzione di Chamaerops humilis L. (Arecaceae) nella Sicilia nord-orientale

I settori costieri e collinari della Sicilia nord-orientale e delle Eolie sono stati esplorati ai fini della raccolta di informazioni aggiornate sulla distribuzione dei popolamenti di palma nana e sulle caratteristiche ecologiche delle stazioni che li ospitano. I risultati delle indagini di campo sono stati integrati dalla verifica dei toponimi locali legati ai nomi dialettali della specie. Si con- ferma la totale assenza della palma nana lungo l’intero settore costiero dei Nebrodi. Dei nove popolamenti accertati, quattro si trovano alle Eolie, due sul versante ionico e tre sul versante tir- renico dei Peloritani; uno di questi ultimi, localizzato su Capo Calavà, risulta inedito. La conco- mitanza di diversi fattori di stress e l’impatto plurisecolare dell’uomo è probabilmente responsa- bile del carattere relittuale di gran parte dei popolamenti considerati, che danno vita a consorzi molto discontinui, e sono rappresentati da piccoli nuclei che formano aggruppamenti semplifi- cati sotto un profilo fisionomico e poveri in termini floristici, perlopiù confinati in contesti roc- ciosi costieri. Di contro, la recente espansione della palma nana registrata a Lipari sembra dipen- dere dalla cessazione delle attività agricole. Infine, i casi di naturalizzazione registrati a Milazzo, Tindari, Panarea, Scaletta Zanclea e Taormina derivano dal suo uso come pianta ornamentale e pongono in risalto l’urgente necessità di regolamentare la sua introduzione per evitare l’inquina- mento genetico dei nuclei autoctoni.The coastal and hilly sectors of NE Sicily and the Aeolian Archipelago have been explored, in order to obtain up-to-date information on the distribution of the populations of Chamaerops humilis and on their site conditions. In addition to the field surveys, any local toponym possibly related to the Sicilian vernacular names of the dwarf palm was checked and verified throughout the investigat- ed area. The total absence of the species along the coasts of Nebrodi Massif is confirmed. Of the 9 extant populations, 4 are located on the Aeolian Islands, 2 along the Ionian coast and 3 along the Tyrrhenian coast of Peloritani Mountains: among them, the one of Capo Calavà represents a new record. The co-occurrence of centuries-long human disturbance and several forms of envi- ronmental stresses could be the reason for the relict connotation of most of the considered popu- lations, which also are very discontinuous and consisting of small patches formed by a few indi- viduals, in simplified and species-poor assemblages, mostly found on sea-facing rocky cliffs. On the other hand, the recent spread of Chamaerops humilis in Lipari could be related to the aban- donment of agricultural practices. Finally, the naturalisation cases recorded in Milazzo, Tindari, Panarea, Scaletta Zanclea and Taormina, where the dwarf palm escaped from public and private gardens, point out the urgent need of regulating its introduction, in order to avoid the genetic pol- lution of the autochthonous populations

Rotavirus induces a biphasic enterotoxic and cytotoxic response in human-derived intestinal enterocytes, which is inhibited by human immunoglobulins.

The mechanisms of diarrhea due to rotavirus infection in humans are not fully understood; no specific therapy is available, but orally administered human serum immunoglobulins are effective in blocking stool output. We aimed to investigate the effect of rotavirus on ion transport and the role of NSP4 in human-derived enterocytes, and to test the efficacy of human serum immunoglobulin in a model of rotavirus infection. Soon after infection, rotavirus induces active chloride secretion in enterocytes. This effect is evident before viral replication leads to cell damage and correlates with NSP4 production. Inhibition of NSP4 prevents the early secretory phase but not cell damage. Incubation with human serum immunoglobulin blocks both ion secretion and cell damage. Rotavirus exerts an early NSP4-dependent ion secretion and subsequent tissue damage. The combined enterotoxic and cytotoxic effects may be responsible for the increased severity of diarrhea due to rotavirus infection, and both are counteracted by human serum immunoglobulin

Sustained low influenza vaccination in health care workers after H1N1 pandemic: A cross sectional study in an Italian health care setting for at-risk patients

Background: Despite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs). Aim of this observational two-phase study was to estimate the immunization rates for influenza in four subsequent seasons and for pandemic H1N1 influenza in HCWs of a University Hospital, and to investigate its distribution pattern and the main determinants of immunization. Phase 1 data collection was performed in 2009-2010, during the peak of H1N1 pandemic. Phase 2 data collection, aimed to investigate seasonal influenza vaccination coverage in the three seasons after pandemic, was performed in 2012-2013. Methods: The overall H1N1 vaccination rate was derived by the Hospital immunization registry. In 2010, the personnel of three Departments (Infectious Diseases, Pediatrics and Gynecology/Obstetrics) completed a survey on influenza. A second-phase analysis was performed in 2012 to investigate influenza vaccination coverage in three consecutive seasons. Results: The first-phase survey showed a low coverage for influenza in all categories (17 %), with the lowest rate in nurses (8.1 %). A total of 37 % of health care workers received H1N1 vaccine, with the highest rate among physicians and the lowest in nurses. H1N1 vaccination was closely related to the Department, being higher in the Department of Infectious Diseases (53.7 %) and Pediatrics (42.4 %) than in Gynecology/Obstetrics (8.3 %). The second-phase survey showed the lowest rate of influenza vaccination in 2012/13 season. The main reasons for not being vaccinated were "Unsure of the efficacy of vaccine" and "Feel not at-risk of getting influenza or its complications". Despite recommendations, influenza vaccine uptake remains poor. Conclusion: Immunization is largely perceived as a personal protection rather than a measure needed to prevent disease spreading to at-risk patients. Compulsory vaccination against influenza should be considered as a possible strategy, at least in health institutions where at-risk patients are admitted

Study of gender differences in VR response following cardiac surgery

Cardiac and other invasive surgical procedures cause significant anxiety and stress to patients and their family members. In this study Virtual Reality (VR) was used as a method to reduce stress, anxiety and pain in patients undergoing surgical procedures. This study compared a cohort of patients in the interval prior to and successive to the surgery, differentiating the responses achieved by males and females and comparing the effectiveness. The results are encouraging: they demonstrate the efficacy of VR treatment and the safety of the method and detection of differences in the responses based on gender