A data fusion based approach for damage detection in linear systems

The aim of the present paper is to propose innovative approaches able to improve the capability of classical damage indicators in detecting the damage position in linear systems. In particular, starting from classical indicators based on the change of the flexibility matrix and on the change of the modal strain energy, the proposed approaches consider two data fusion procedures both based on the Dempster-Shafer theory. Numerical applications are reported in the paper in order to assess the reliability of the proposed approaches considering different damage scenarios, different sets of modes of vibration and the presence of errors affecting the accounted modes of vibrations

A Frame Element Model for the Nonlinear Analysis of FRP-Strengthened Masonry Panels Subjected to In-Plane Loads

A frame element model for evaluating the nonlinear response of unstrengthened and FRP-strengthened masonry panels subjected to in-plane vertical and lateral loads is presented. The proposed model, based on some assumptions concerning the constitutive behaviour of masonry and FRP material, considers the panel discretized in frame elements with geometrical and mechanical properties derived on the basis of the different states characterizing the sectional behaviour. The reliability of the proposed model is assessed by considering some experimental cases deduced from the literature

Numerical simulation of the de-bonding phenomenon of FRCM strengthening systems

Aim of the paper is to present a one dimensional simple model for the study of the bond behavior of Fabric Reinforced Cementitious Matrix (FRCM) strengthening systems externally applied to structural substrates. The equilibrium of an infinitesimal portion of the reinforcement and the mortar layers composing the strengthening systems allows to derive the governing equations. An analytical solution is determined solving the system of differential equations. In particular, in the first part of the paper a nonlinear shear-stress slip law characterized by a brittle post-peak behavior with a residual shear strength in the post peak phase is introduced for either the lower reinforcement-mortar interface (approach 1) or both the lower and the upper interface (approach 2). In the latter approach, a calibration of the shear strength of the upper interface is proposed in order to implicitly account for the effect of the damage of the mortar on the bond behavior. In the second part of the paper it is presented the solution of the problem in the case of softening behavior by approximating the shear-stress slip law throughout a step function. Comparisons with experimental data, available in literature, are presented in order to assess the reliability of the proposed approach

Numerical simulation of the de-bonding phenomenon of FRCM strengthening systems

Aim of the paper is to present a one dimensional simple model for the study of the bond behavior of Fabric Reinforced Cementitious Matrix (FRCM) strengthening systems externally applied to structural substrates. The equilibrium of an infinitesimal portion of the reinforcement and the mortar layers composing the strengthening systems allows to derive the governing equations. An analytical solution is determined solving the system of differential equations. In particular, in the first part of the paper a nonlinear shear-stress slip law characterized by a brittle post-peak behavior with a residual shear strength in the post peak phase is introduced for either the lower reinforcement-mortar interface (approach 1) or both the lower and the upper interface (approach 2). In the latter approach, a calibration of the shear strength of the upper interface is proposed in order to implicitly account for the effect of the damage of the mortar on the bond behavior. In the second part of the paper it is presented the solution of the problem in the case of softening behavior by approximating the shear-stress slip law throughout a step function. Comparisons with experimental data, available in literature, are presented in order to assess the reliability of the proposed approach

an application of damage detection methods to a real world structure subjected to ground motion excitation

This paper aims at investigating the efficacy of different state-of-art damage detection methods when applied to real world structures subjected to ground motion excitations, for which the literature contributions are, at present, still not fully comprehensive. To this purpose the paper analyses two test structures: (1) a four-story scaled steel frame tested on a shake table in a controlled laboratory conditions, and (2) a seven-story reinforced concrete building monitored during the seismic excitations of the 1999 Chi-Chi (Taiwan) Earthquake main shock and numerous fore and aftershocks. Some model based damage approaches and statistics based damage indexes are reviewed. The different methodologies and indexes are, then, applied to the two test structures with the final aim of analysing their performance and validity within the case of a laboratory scaled model and a real world structure subjected to input ground motion

Molecular mechanisms of skin wound healing in non-diabetic and diabetic mice in excision and pressure experimental wounds

Experimental models for chronic skin lesions are excision and pressure ulcer, defined as "open" and "closed" lesions, respectively, only the latter characterized by tissue hypoxia. Moreover, systemic diseases, such as diabetes mellitus, affect wound repair. Thus, models for testing new therapies should be carefully selected according to the expected targets. In this study, we present an extensive and comparative histological, immunohistochemical, and molecular characterization of these two lesions in diabetic (db/db) and non-diabetic (C57BL/6 J) mice. In db/db mice, we found significant reduction in PGP9.5-IR innervation, reduction of capillary network, and reduced expression of NGF receptors. We found an increase in VEGF receptor Kdr expression, and the PI3K-Akt signaling pathway at the core of the altered molecular network. Db/db mice with pressure ulcers showed an impairment in the molecular regulation of hypoxia-related genes (Hif1a, Flt1, and Kdr), while extracellular matrix encoding genes (Itgb3, Timp1, Fn1, Col4a1) were upregulated by hyperglycemia and lesions. Overall, the molecular analysis suggests that db/db mice have a longer inflammatory phase of the wound repair process, delaying the progression toward the proliferation and remodeling phases

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

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

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population