SCAN-TO-BIM EFFICIENT APPROACH TO EXTRACT BIM MODELS FROM HIGH PRODUCTIVE INDOOR MOBILE MAPPING SURVEY

Building Information Modeling represents one of the most interesting developments in construction fields in the last 20 years. BIM process supports the creation of intelligent data that can be used throughout the life cycle of a construction project. Where a project involves a pre-existing structure, reality capture can provide the most critical information. The purpose of this paper is to describe an efficient approach to extract 3D models using high productive indoor Mobile Mapping Systems (iMMS) and an optimized scan-to-BIM workflow. The scan-to-BIM procedure allows reconstructing several elements within a digital environment preserving the features and reusing them in the development of the BIM project. The elaboration of the raw data acquired from the iMMS starts with the software HERON® Desktop where a SLAM algorithm runs and a 3D point cloud model is produced. The model is translated in the Gexcel Reconstructor® point cloud post processing software where a number of deliverables as orthophotos, blueprints and a filtered and optimized point cloud are obtained. In the proposed processing workflow, the data are introduced to Autodesk ReCap®, where the model can be edited and the final texturized point cloud model extracted. The identification and modeling of the 3D objects that compose the BIM model is realized in ClearEdge3D EdgeWiseTM and optimized in Autodesk Revit®. The data elaboration workflow implemented shows how an optimized data processing workflow allows making the scan-to-BIM procedure automatic and economically sustainable

Evaluating targets and costs of treatment for secondary hyperparathyroidism in incident dialysis patients: the FARO-2 study

Results: Two prominent treatment groups were identified, ie, one on oral calcitriol (n=105) and the other on intravenous paricalcitol (n=33); the intravenous calcitriol and intravenous paricalcitol + cinacalcet combination groups were not analyzed due to low patient numbers. At baseline, serum PTH levels were significantly higher in the intravenous paricalcitol group (P<0.0001). At the second survey, the intravenous paricalcitol group showed a higher percentage of patients at target for PTH than in the oral calcitriol group without changing the percentage of patients at target for phosphate. Moreover, between baseline and the second survey, intravenous paricalcitol significantly increased both the percentage of patients at target for PTH (P=0.033) and the percentage of patients at target for the combined endpoint PTH, calcium, and phosphate (P=0.001). The per-patient weekly pharmaceutical costs related to SHPT treatment, erythropoietin-stimulating agents and phosphate binders accounted for 186.32\u20ac and 219.94\u20ac at baseline for oral calcitriol and intravenous paricalcitol, respectively, while after 6 months, the costs were 180.51\u20ac and 198.79\u20ac, respectively. Either at the beginning of dialysis or 6 months later, the total cost of SHPT treatment was not significantly lower in the oral calcitriol group compared with the intravenous paricalcitol group, with a difference among groups that decreased by 46% between the two observations. The cost of erythropoietin stimulating agents at the second survey was lower ( 1222%) in the intravenous paricalcitol group than in the oral calcitriol group (132.13\u20ac versus 168.36\u20ac, respectively)

End-stage renal disease costs for patients new to hemodialysis in Italy: The FARO-2 Study

Background: Increasing incidence and prevalence of end-stage renal disease (ESRD) together with the presence of several comorbidities in chronic kidney disease patients (CKD) could be associated with a relevant economic burden. Aim: The aim of this analysis was to estimate the direct healthcare costs of ESRD and its major comorbidities in Italian patients who were na\uefve to hemodialysis (HD) recruited for the FARO-2 study. Methods: The FARO-2 study was a retrospective observational study conducted in Italy that evaluated the patterns of treatment of secondary hyperparathyroidism (SHPT) and related costs in patients na\uefve to HD. The observational period was 2006\u20132008. Costs were measured in Euros (reference year: 2008). Resource use for the first 2 periods of 6 months of HD was monetized, with reimbursement calculated for SHPT drugs, phosphate binders, and erythropoietin-stimulating agents (ESAs); HD sessions; and hospitalizations due to ESRD and its major comorbidities. The analysis was performed by the Italian National Health Service (INHS) perspective. Results: 567 patients were observed for at least 2 periods of 6 months. During the first 12 months after the initiation of HD, average direct healthcare costs were assessed using the percentage of patients treated and the average daily dosages (for drugs), the percentage of patients hospitalized and the types of hospitalizations (for inpatients), and the average weekly frequency of HD sessions. Total per-patient yearly costs totaled 34,789.9 \u20ac: HD accounted for 66.1% of expenditures, with hospitalizations and drugs accounting for 12.9% and 21.0% of expenditures, respectively (including 17.1% for ESAs). Conclusions: Patients na\uefve to HD have a significant impact on Italian National Health Service expenditures, although only the costs related to treatment of ESRD and its comorbidities were calculated in the present study. The major cost drivers were HD and ESAs, while SHPT drugs and phosphate binders together accounted for only 3.9% of direct healthcare expenditures

Sensory Stimulation-Dependent Plasticity in the Cerebellar Cortex of Alert Mice

In vitro studies have supported the occurrence of cerebellar long-term depression (LTD), an interaction between the parallel fibers and Purkinje cells (PCs) that requires the combined activation of the parallel and climbing fibers. To demonstrate the existence of LTD in alert animals, we investigated the plasticity of local field potentials (LFPs) evoked by electrical stimulation of the whisker pad. The recorded LFP showed two major negative waves corresponding to trigeminal (broken into the N2 and N3 components) and cortical responses. PC unitary extracellular recording showed that N2 and N3 occurred concurrently with PC evoked simple spikes, followed by an evoked complex spike. Polarity inversion of the N3 component at the PC level and N3 amplitude reduction after electrical stimulation of the parallel fiber volley applied on the surface of the cerebellum 2 ms earlier strongly suggest that N3 was related to the parallel fiber–PC synapse activity. LFP measurements elicited by single whisker pad stimulus were performed before and after trains of electrical stimuli given at a frequency of 8 Hz for 10 min. We demonstrated that during this later situation, the stimulation of the PC by parallel and climbing fibers was reinforced. After 8-Hz stimulation, we observed long-term modifications (lasting at least 30 min) characterized by a specific decrease of the N3 amplitude accompanied by an increase of the N2 and N3 latency peaks. These plastic modifications indicated the existence of cerebellar LTD in alert animals involving both timing and synaptic modulations. These results corroborate the idea that LTD may underlie basic physiological functions related to calcium-dependent synaptic plasticity in the cerebellum

Electrophysiological Characterization of The Cerebellum in the Arterially Perfused Hindbrain and Upper Body of The Rat

In the present study, a non-pulsatile arterially perfused hindbrain and upper body rat preparation is described which is an extension of the brainstem preparation reported by Potts et al., (Brain Res Bull 53(1):59–67), 1. The modified in situ preparation allows study of cerebellar function whilst preserving the integrity of many of its interconnections with the brainstem, upper spinal cord and the peripheral nervous system of the head and forelimbs. Evoked mossy fibre, climbing fibre and parallel fibre field potentials and EMG activity elicited in forelimb biceps muscle by interpositus stimulation provided evidence that both cerebellar inputs and outputs remain operational in this preparation. Similarly, the spontaneous and evoked single unit activity of Purkinje cells, putative Golgi cells, molecular interneurones and cerebellar nuclear neurones was similar to activity patterns reported in vivo. The advantages of the preparation include the ability to record, without the complications of anaesthesia, stabile single unit activity for extended periods (3 h or more), from regions of the rat cerebellum that are difficult to access in vivo. The preparation should therefore be a useful adjunct to in vitro and in vivo studies of neural circuits underlying cerebellar contributions to movement control and motor learning

Local Field Potential Modeling Predicts Dense Activation in Cerebellar Granule Cells Clusters under LTP and LTD Control

Local field-potentials (LFPs) are generated by neuronal ensembles and contain information about the activity of single neurons. Here, the LFPs of the cerebellar granular layer and their changes during long-term synaptic plasticity (LTP and LTD) were recorded in response to punctate facial stimulation in the rat in vivo. The LFP comprised a trigeminal (T) and a cortical (C) wave. T and C, which derived from independent granule cell clusters, co-varied during LTP and LTD. To extract information about the underlying cellular activities, the LFP was reconstructed using a repetitive convolution (ReConv) of the extracellular potential generated by a detailed multicompartmental model of the granule cell. The mossy fiber input patterns were determined using a Blind Source Separation (BSS) algorithm. The major component of the LFP was generated by the granule cell spike Na+ current, which caused a powerful sink in the axon initial segment with the source located in the soma and dendrites. Reproducing the LFP changes observed during LTP and LTD required modifications in both release probability and intrinsic excitability at the mossy fiber-granule cells relay. Synaptic plasticity and Golgi cell feed-forward inhibition proved critical for controlling the percentage of active granule cells, which was 11% in standard conditions but ranged from 3% during LTD to 21% during LTP and raised over 50% when inhibition was reduced. The emerging picture is that of independent (but neighboring) trigeminal and cortical channels, in which synaptic plasticity and feed-forward inhibition effectively regulate the number of discharging granule cells and emitted spikes generating “dense” activity clusters in the cerebellar granular layer

Costs of patients suffering from multiple sclerosis in piedmont region: Evidence from administrative databases

Multiple Sclerosis (MS) is a chronic and disabling disease characterized by demyelination of the central nervous system, which can lead to physical and cognitive impairment. The literature on MS cost-of-illness shows that (i) cost per patient is rather high; (ii) informal care and loss of productivity are the major cost components; (iii) health care costs have been showing a steady increase, mostly due to high costs of immunomodulator drugs launched into the market in the last fifteen years. The objective of this research is to estimate health resources consumption and costs of patients suffering from MS in Piedmont Region relying on administrative databases, that include information on drugs, outpatient and inpatient services consumed and covered by the Regional Government to patients affected by MS. Databases show (i) in 2008 a number of 109.9 patients per 100,000 population, (ii) a cost per patient of h6,103, with a 67% drugs incidence, (iii) a huge and significant decrease in costs from the younger to the elderly population, (iv) a small but statistically significant impact of co-morbidities on unit costs, and (v) a very costly proximity to death. Despite its limitations - e.g. database incompleteness, which did not allow us covering all health care services - this study shows that resource use and cost analysis may rely on administrative databases, thus avoiding (or integrating) prospective studies, which may be long and costly. © 2012 Springer International Publishing AG

Overt hepatic encephalopathy in Italy: clinical outcomes and healthcare costs

Daniela Paola Roggeri,1 Alessandro Roggeri,1 Elisa Rossi,2 Elisa Cinconze,2 Antonio Gasbarrini,3 PierAlessandro Monici Preti,4 Marisa De Rosa,2 1ProCure Solutions, Nembro, Bergamo, 2CINECA, Interuniversity Consortium, Bologna, 3Catholic University of Sacred Heart, Policlinic A Gemelli, Rome, 4Alfa Wassermann, Bologna, Italy Purpose: Hepatic encephalopathy (HE) is a recurrent severe complication of progressive hepatic cirrhosis. The aim of this study is to evaluate the average annual direct healthcare costs for the treatment of patients with overt HE in Italy. Patients and methods: This retrospective, observational study analyzed information from the database of ARNO Observatory. Patients with at least one hospitalization due to overt HE in the period from January 1, 2011 to December 31, 2011, were selected and observed during the year following the hospitalization. Costs for drugs, diagnostic and therapeutic procedures, and hospitalizations were estimated from the Italian National Health Service perspective. Results: Out of a population of 2,678,462 subjects, 381 patients were identified, of whom, 21.5% died during the first hospitalization and 5.8% during the follow-up; the survival rate was 72.7% at the end of the observation period. The direct healthcare costs per patient amounted to &euro;13,393/year (15,295 USD) (88% for hospitalizations, 8% for drugs, and 4% for diagnostic procedures). During the follow-up, 42.5% of patients had at least one rehospitalization due to HE. Patients readmitted for HE had an average annual cost of &euro;21,272 (24,293 USD), almost doubled if compared to patients without readmissions (&euro;12,098 [13,816 USD]). Conclusion: This analysis showed that patients with HE had relevant direct healthcare costs, in which hospitalizations were the most important cost drivers. Keywords: hepatic encephalopathy, costs, hospitalizations, relapse