Between Community Spaces. Squares of Minor Centers of Calabria

The theme of open “community spaces” in recent years has to the development of important interdisciplinary issues. Nevertheless, the reading of smaller towns, in urbanistic, historical-anthropological and geographical terms appears less extended, considering the declination of public spaces as "squares." Starting from this declension we would like to introduce the first results of a research. The research had the aim of (re)interpreting the particular characteristics of these areas in specific areas such as small towns, using the region of Calabria for the case of analytic application. These communities have diverse and stratified living cultures, altered by settlement processes that have triggered two different types of urban contexts. The former often lead either to urban areas in depopulated decay or, in contrast, in places of memories: empty containers of relationships, sterile and crystallized museum objects, reduced to scenarios on which passing groups of visitors move necessarily from those realities. The latter often encircle primitive nuclei, asphyxiating them, or characterizing the so-called "dual" or "satellites" towns, completely detached from the original urban center in which all public functions are decentralized. The applied methodology is based on the reading of the historical-functional evolution of squares by the identification of codified compositional criteria. Through this research we seek to verify how urban planning, in synergy with other disciplines, can define processes of regeneration aimed at restoring the meaning of "center", and thus of an urban-community reference center

The emergency plan for the use and management of the territory

The issue of emergency planning in areas exposed to natural hazards cannot yet be considered as a focus within the scientific literature, probably because it has been judged as “too operative” for the interest of academic research. The topic of land use planning, spatial planning, and urban planning in risky areas, conversely, has gained attention in recent years. Nevertheless, the examples of good practices that involve ordinary master plans embedding mitigation concerns are still limited. &nbsp

Glycemic Variability Assessed by Continuous Glucose Monitoring and Short-Term Outcome in Diabetic Patients Undergoing Percutaneous Coronary Intervention: An Observational Pilot Study

Poor glycemic control is associated with unfavorable outcome in patients undergoing percutaneous coronary intervention (PCI), irrespective of diabetes mellitus. However a complete assessment of glycemic status may not be fully described by glycated hemoglobin or fasting blood glucose levels, whereas daily glycemic fluctuations may influence cardiovascular risk and have even more deleterious effects than sustained hyperglycemia. Thus, this paper investigated the effectiveness of a continuous glucose monitoring (CGM), registering the mean level of glycemic values but also the extent of glucose excursions during coronary revascularization, in detecting periprocedural outcome such as renal or myocardial damage, assessed by serum creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and troponin I levels. High glycemic variability (GV) has been associated with worse postprocedural creatinine and NGAL variations. Moreover, GV, and predominantly hypoglycemic variations, has been observed to increase in patients with periprocedural myocardial infarction. Thus, our study investigated the usefulness of CGM in the setting of PCI where an optimal glycemic control should be achieved in order to prevent complications and improve outcome

Hydroxyapatite–Silicon Scaffold Promotes Osteogenic Differentiation of CGF Primary Cells s

Simple Summary: The aim of this study was to identify new and innovative strategies to improve the tissue-regeneration process. Concentrated growth factor (CGF) is an autologous biomaterial rich in growth factors and multipotent stem cells. The purpose of our study was to evaluate the osteogenic differentiation of CGF primary cells in the presence of a hydroxyapatite–silicon scaffold, which represents a very interesting material in the field of bone reconstructive surgery. Our findings showed that the hydroxyapatite–silicon scaffold provided support to primary CGF cells by enhancing osteogenic differentiation. These data suggest interesting perspectives in the use of CGF together with scaffolds in the field of regenerative medicine. Abstract: The application of scaffolding materials together with stem cell technologies plays a key role in tissue regeneration. Therefore, in this study, CGF (concentrated growth factor), which represents an autologous and biocompatible blood-derived product rich in growth factors and multipotent stem cells, was used together with a hydroxyapatite and silicon (HA-Si) scaffold, which represents a very interesting material in the field of bone reconstructive surgery. The aim of this work was to evaluate the potential osteogenic differentiation of CGF primary cells induced by HASi scaffolds. The cellular viability of CGF primary cells cultured on HA-Si scaffolds and their structural characterization were performed by MTT assay and SEM analysis, respectively. Moreover, the matrix mineralization of CGF primary cells on the HA-Si scaffold was evaluated through Alizarin red staining. The expression of osteogenic differentiation markers was investigated through mRNA quantification by real-time PCR. We found that the HA-Si scaffold was not cytotoxic for CGF primary cells, allowing their growth and proliferation. Furthermore, the HASi scaffold was able to induce increased levels of osteogenic markers, decreased levels of stemness markers in these cells, and the formation of a mineralized matrix. In conclusion, our results suggest that HA-Si scaffolds can be used as a biomaterial support for CGF application in the field of tissue regeneration

IGFBP-2 and -3 co-ordinately regulate IGF1 induced matrix mineralisation of differentiating human dental pulp cells

Human dental pulp cells (DPCs), which are known to contain a subset of stem cells capable of reforming a dentin and pulp-like complex upon in vivo transplantation, were isolated from third molars of three healthy donors and differentiated to a matrix mineralisation phenotype using by culture in dexamethasone and l-ascorbic acid. qRT-PCR analysis of insulin-like growth factor ( IGF) axis gene expression indicated that all genes, except insulin-like growth factor1 (IGF1) and insulin-like growth factor binding protein-1 ( IGFBP-1), were expressed in DPCs. During differentiation upregulation of insulin-like growth factor binding protein-2 (IGFBP-2) and downregulation of insulin-like growth factor binding protein-3 (IGFBP-3) expression was observed. Changes in IGFBP-2 and IGFBP-3 mRNA expression were confirmed at the protein level by ELISA of DPC conditioned medium functional analysis indicated that IGF1 stimulated the differentiation of DPCs and that the activity of the growth factor was enhanced by pre-complexation with IGFBP-2 but inhibited by pre-complexation with IGFBP-3. Therefore changes in IGFBP-2 and -3 expression during differentiation form part of a co-ordinated functional response to enhance the pro-differentiative action of IGF1 and represent a novel mechanism for the regulation of DPC differentiation

Defining Kawasaki disease and pediatric inflammatory multisystem syndrome-temporally associated to SARS-CoV-2 infection during SARS-CoV-2 epidemic in Italy: results from a national, multicenter survey

Background: There is mounting evidence on the existence of a Pediatric Inflammatory Multisystem Syndrome-temporally associated to SARS-CoV-2 infection (PIMS-TS), sharing similarities with Kawasaki Disease (KD). The main outcome of the study were to better characterize the clinical features and the treatment response of PIMS-TS and to explore its relationship with KD determining whether KD and PIMS are two distinct entities. Methods: The Rheumatology Study Group of the Italian Pediatric Society launched a survey to enroll patients diagnosed with KD (Kawasaki Disease Group - KDG) or KD-like (Kawacovid Group - KCG) disease between February 1st 2020, and May 31st 2020. Demographic, clinical, laboratory data, treatment information, and patients' outcome were collected in an online anonymized database (RedCAP®). Relationship between clinical presentation and SARS-CoV-2 infection was also taken into account. Moreover, clinical characteristics of KDG during SARS-CoV-2 epidemic (KDG-CoV2) were compared to Kawasaki Disease patients (KDG-Historical) seen in three different Italian tertiary pediatric hospitals (Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste; AOU Meyer, Florence; IRCCS Istituto Giannina Gaslini, Genoa) from January 1st 2000 to December 31st 2019. Chi square test or exact Fisher test and non-parametric Wilcoxon Mann-Whitney test were used to study differences between two groups. Results: One-hundred-forty-nine cases were enrolled, (96 KDG and 53 KCG). KCG children were significantly older and presented more frequently from gastrointestinal and respiratory involvement. Cardiac involvement was more common in KCG, with 60,4% of patients with myocarditis. 37,8% of patients among KCG presented hypotension/non-cardiogenic shock. Coronary artery abnormalities (CAA) were more common in the KDG. The risk of ICU admission were higher in KCG. Lymphopenia, higher CRP levels, elevated ferritin and troponin-T characterized KCG. KDG received more frequently immunoglobulins (IVIG) and acetylsalicylic acid (ASA) (81,3% vs 66%; p = 0.04 and 71,9% vs 43,4%; p = 0.001 respectively) as KCG more often received glucocorticoids (56,6% vs 14,6%; p < 0.0001). SARS-CoV-2 assay more often resulted positive in KCG than in KDG (75,5% vs 20%; p < 0.0001). Short-term follow data showed minor complications. Comparing KDG with a KD-Historical Italian cohort (598 patients), no statistical difference was found in terms of clinical manifestations and laboratory data. Conclusion: Our study suggests that SARS-CoV-2 infection might determine two distinct inflammatory diseases in children: KD and PIMS-TS. Older age at onset and clinical peculiarities like the occurrence of myocarditis characterize this multi-inflammatory syndrome. Our patients had an optimal response to treatments and a good outcome, with few complications and no deaths

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

Spatial analysis for territorial marginality mapping. GIS-based application to the case of Southern and Insular Italy

The authors defined a methodology based on geo-statistical analysis techniques implemented in a GIS environment that measures and maps the territorial gaps at the sub-regional level. The measurement activity is based on the construction of a system of quantitative indicators sampled at the municipal level. The mapping activity is based on the calculation of the Moran correlation index and the elaboration of LISA cluster maps. The proposed presentation shows the results of the application of the methodology to the regions of Southern and Insular Italy (Abruzzo, Basilicata, Calabria, Campania, Molise, Puglia, Sicily and Sardinia)

Fruizioni immateriali per la promozione territoriale

Al fine di consentire ad un contesto territoriale di diventare competitivo è necessario che lo stesso promuova altresì la propria immagine con una presenza intelligente sul web (fruizione immateriale); l’obiettivo principale è quello di favorire la virtualizzazione del patrimonio territoriale restituendolo in rete come “bene comune” per i cittadini e per i visitatori, permettendo alle amministrazioni di internazionalizzare la conoscenza dello stesso bene e dell’intero territorio, nonché migliorando lo stato dell’arte sia in termini di ricaduta scientifica che di prodotto territoriale. Tale obiettivo di ricerca necessita l’adozione di tecniche avanzate, modelli condivisi di indicizzazione e identificazione univoca, utili a produrre anche percorsi e “mappature” tematiche in grado di rendere facilmente fruibile e di promuovere un’offerta territoriale coordinata ed intelligente, a garanzia di un facile accesso alla rete dei servizi in linea con le esigenze dei residenti e dei turisti, permettendo, contestualmente, agli stessi di interagire e di integrare direttamente le informazioni. Particolare riguardo, inoltre, deve essere riservato ai rapporti intercorrenti tra città-campagna e tra aree interne-costa, anche al fine di ottimizzare delle connessioni tra il miglioramento dei bilanci energetici e ambientali dei territori e la gestione delle risorse naturalistiche e socio-culturali, secondo principi di equità e sostenibilità

Re-generate resilience to deal with climate change

Cities are vulnerable to the effects of the climate. Building resilience to contain the risks for inhabitants, businesses and infrastructures deriving from the impact of climate change represents a challenge for local planners and public decision-makers. To win it, it is necessary to include the most suitable adaptation actions to contain the conditions of vulnerability in the local urban regeneration processes. To this end, the authors have increased and applied a methodology for defining and mapping climatic vulnerability, with a particular focus on the built environment. The main element of integration and updating concerns the use of Copernicus satellite remote sensing data. The application to the case study demonstrates the adequacy of such data for the research needs and the relative utility in terms of spatial resolution of the results. The vulnerability map into a more accurate definition scale helps the planner to integrate the common regeneration goals with more specific climatic resilience goals. In fact, basing on the results obtained for the case study, the authors define adaptive design solutions aimed at regenerating local resilience in terms of liveability, efficiency and safety