Investigation of tectonically affected groundwater systems through a multidisciplinary approach

This study uses a multidisciplinary approach to obtain a complete picture of the groundwater system of complex mountain aquifers. An Alpine region (the north-western area of Lake Como, Italy), characterized by two regional fault systems (The Breglia and Grona fault systems) containing different lithologies, was investigated using the multidisciplinary approach described here. The use of Principal Components Analysis (PCA), classical geochemical bivariate and trivariate diagrams of major and trace elements, and geostructural data, including remote sensing, permitted the identification of three principal groups of water. The first group, characterized by an enrichment of Ca2+ and HCO3-, flow in limestone. The second group is enriched in HCO3-, Ca2+ and Mg2+ and circulates through dolomite rocks. The third group, characterized by a decrease of Ca2+ and Mg2+, an increase of Na++K+ and a high Si/electrical conductivity (EC) ratio, flow in the basement rocks. Nevertheless, some peculiarities were evident. The matching of PCA, hydrochemical and geostructural information explains the role played by faults in water circulation. In particular, the Breglia fault permits the rise of deep water from crystalline basement and dolomite. Similarly, the Grona fault plays a role on drainage in proximity to the contact between the crystalline basement and the sedimentary cover. The springs located near the Grona fault rise into the crystalline basement but reflect a dolomite water chemistry. The multidisciplinary approach allowed understanding of the groundwater system and identification of fault systems not detectable with a geostructural survey

Diachronic and Synchronic Analysis for Knowledge Creation: Architectural Representation Geared to XR Building Archaeology (Claudius-Anio Novus Aqueduct in Tor Fiscale, the Appia Antica Archaeological Park)

This study summarises research progress to identify appropriate quality methodologies for representing, interpreting, and modelling complex contexts such as the Claudian Aqueduct in the Appian Way Archaeological Park. The goal is to intrinsically integrate (embed) geometric survey (Laser scanning and photogrammetric) with the materials and construction techniques (Stratigraphic Units-SU), semantic models in order to support the design with a better understanding of the artefact considered, and also to give indications that can be implemented in the future in a continuous cognitive process. Volume stratigraphic units in the form of architectural drawings, heritage building information modelling (HBIM) and extended reality (XR) environments have been oriented to comparative analyses based on the research case study's complex morphology. Analysis of geometries' intersection, construction techniques and materials open up new cognitive scenarios, self-feeding a progressive knowledge and making different studies correlatable, avoiding diaspora or incommunicability. Finally, an extended reality (XR) platform aims to enhance tangible and intangible values through new human-computer interaction and information sharing levels

Immersive Appian Way health infrastructure: human centric Digital Twin (The PAAA Archeological Park of the Appian Way 12km State-Own Section, Unesco Candidature)

From Rome to Benevento, the Appian Way (Via Appia Antica) was born as a military road, 'Regina Viarum'. In 312 b.C., consul Appio Claudio extended the infrastructure for 132 miles to Capua. Many transformations and integration occurred across the centuries, resulting in a unique multi-stratified world heritage (landscape, architecture, archaeological remains and tombs along the military way). In the 19th century, Luigi Canina conceived the Appian Way as an outdoor museum, realizing a first state-own section along the 12km here surveyed and described. This year, the Ministry of Culture (MIC) has launched the UNESCO nomination for the road. The article discusses aspects of the mass digitization undertaken by the Parco Archeologico dell'Appia Antica (PAAA, the Archaeological Park of the Appian Way). The aim is to build a Digital Twin of the infrastructure supporting knowledge enhancement, preservation, design, communication and fruition. A virtual space where digital technologies and eXtended Reality are the digital arms of the contemporary Vitruvian humanistic mission and vision of the PAAA Appian Way as a source of wealth and healthiness for all the users and visitors

REPRESENTING INTANGIBLE CULTURAL HERITAGE OF HUMANITY: FROM THE DEEP ABYSS OF THE PAST TO DIGITAL TWIN AND XR OF THE NEANDERTHAL MAN AND LAMALUNGA CAVE (ALTAMURA, APULIA)

The Altamura Man and the paleontological remains are situated within a complex context encompassing logistical, geological, paleoenvironmental, and cultural perspectives. This context is exceptionally well-preserved but also fragile, requiring its preservation due to its unique nature. Unresolved inquiries exist in various disciplines, such as archaeology, biocultural studies, ecology, and geology, pertaining to karst formation, taphonomic dynamics, and the cultural and ecological context of the Neanderthal individual found in the cave. Interdisciplinary research was necessary to address these complex questions and understand the broader context of the Lamalunga Cave. Climate change also necessitated attention to preserving the cave’s microclimate and monitoring potential biodegradation. Digital technologies, including photogrammetry and laser scanning, were crucial for monitoring and safeguarding the cave’s cultural heritage. Digital representation, 3D modelling and Digital Twin were essential for managing the cave’s intricacies, analysing its values, and enhancing visual communication. The management of the Lamalunga cave aimed to promote scientific interpretation, safeguard the cave, and provide tools for understanding, storytelling, and further investigation. It was essential to utilise available methodologies and technologies while avoiding destructive interventions. Contemporary technologies have revolutionised the archaeological and paleoanthropological domains, enabling remote study and preservation. Protecting and comprehending the cultural heritage of the cave is linked to its usability, which can be enhanced through digital documentation methodologies to inform visitors about the karst context and promote social and economic development

Fisheye Photogrammetry to Survey Narrow Spaces in Architecture and a Hypogea Environment

Nowadays, the increasing computation power of commercial grade processors has actively led to a vast spreading of image-based reconstruction software as well as its application in different disciplines. As a result, new frontiers regarding the use of photogrammetry in a vast range of investigation activities are being explored. This paper investigates the implementation of fisheye lenses in non-classical survey activities along with the related problematics. Fisheye lenses are outstanding because of their large field of view. This characteristic alone can be a game changer in reducing the amount of data required, thus speeding up the photogrammetric process when needed. Although they come at a cost, field of view (FOV), speed and manoeuvrability are key to the success of those optics as shown by two of the presented case studies: the survey of a very narrow spiral staircase located in the Duomo di Milano and the survey of a very narrow hypogea structure in Rome. A third case study, which deals with low-cost sensors, shows the metric evaluation of a commercial spherical camera equipped with fisheye lenses

Head and neck diseases and disorders causing oropharyngeal dysphagia

The swallowing mechanism requires the coordinated movements of several structures of the head and neck region; it is therefore not surprising that diseases of the mouth, pharynx, larynx and cervical spine can lead to dysphagia. Although each disorder per se is relatively rare, the combination of all clinical situation represents an important group of clinical conditions that can not be overlooked. Self-perception of dysphagia is usually high as the impairment often involves the oral phase or is due to pain or obstruction. This review focus on the most common and important clinical conditions of the head and neck districts associated with dysphagia: head and neck cancer and impairments associated with its treatment, Zenker\u2019s diverticulum, head and neck infections, cervical spine disorders and cranial nerves deficits. Head and Neck disorders may impair swallowing through different mechanisms; symptoms, dysphagia severity, treatment options and prognosis for this variety of clinical situations vary enormously. Clinicians involved in the management of oro-pharyngeal dysphagia should be aware of the different diseases of this area and build teams or connections with different medical specialists in order to guarantee the best treatment option for each patient

Safety of occasional ingestion of gluten in patients with celiac disease: a real-life study

Background Gluten-free diet (GFD) decreases the quality of life of celiac disease (CD) patients, who frequently ask to occasionally ingest gluten-containing food. We evaluated CD patients reporting voluntary and occasional transgressions to their GFD. Methods From October 2017 to September 2018, the patients reporting occasional and voluntary gluten ingestion (GFD-noncompliant) were prospectively enrolled. These patients underwent clinical examination, blood tests, duodenal biopsy, capsule enteroscopy (CE), and a validated food-frequency questionnaire (FFQ) assessing the frequency and quantity of gluten intake. Mortality was calculated and compared to the general population. A group of patients on strict GFD (GFD-adherent) acted as controls. Results One thousand three hundred seventy-eight CD patients were evaluated during the study period. One hundred nine (8%) reported occasional (weekly or monthly) voluntary ingestion of gluten. The mean gluten intake was 185.2 +/- 336.9 g/year, and the duration of their incorrect GFD was 8.6 +/- 6.9 years. Among the noncompliant patients, 57% did not present any histological alteration; furthermore, the Marsh score profile was not different between compliant and noncompliant patients. Seventy percent did not present any alteration at CE. Seventy-five percent of patients reported no gastrointestinal symptoms after gluten ingestion. Twenty-three percent of patients in the GFD-noncompliant group presented positive tTG-IgA. No association was found between gluten intake, clinical symptoms, and biomarkers. Mortality was not different between the groups and the general population. Conclusions Our results are that in a real-life scenario, a group of CD patients on long-term gluten intake showed no significant clinical symptoms or small bowel damage, thus suggesting that a degree of tolerance towards gluten consumption can be reached

Current and future roles of meltwater–groundwater dynamics in a proglacial Alpine outwash plain

Glacierized alpine catchments are rapidly evolving due to glacier retreat and consequent geomorphological and ecological changes. As more terrain becomes ice-free, reworking of exposed terrain by the river as well as thawing of the top layer may lead to an increase in surface and subsurface water exchanges, leading to potential changes in water storage and release, which in turn may impact ecological, geomorphological and hydrological processes. In this study, we aim to understand the current and future hydrological functioning of a typical outwash plain in a Swiss Alpine catchment. As with many other fluvial aquifers in alpine environments, this outwash plain is located at the valley bottom, where catchment-wide water and sediment fluxes tend to gather from multiple sources, may store water and provide specific habitats for alpine ecosystems. Their dynamics are however rarely studied in post Little Ice Age proglacial zones. Based on geophysical investigations as well as year-round stream and groundwater observations, we developed a simplified physically based 3D MODFLOW model and performed an optimized automatic calibration using PEST HP. We highlight the strong interactions between the upstream river and the aquifer, with stream infiltration being the dominant process of recharge. Groundwater exfiltration occurs in the lower half of the outwash plain, balancing out the amount of river infiltration at a daily timescale. We show that hillslope contributions from rain and snowmelt have little impact on groundwater levels. We also show that the outwash plain acts as a bedrock-dammed aquifer and can maintain groundwater levels close to the surface during dry periods lasting months, even in the absence of glacier meltwater, but may in turn provide only limited baseflow to the stream. Finally, we explore how new outwash plains may form in the future in this catchment due to glacier recession and discuss from a hydrological perspective which cascading impacts the presence of multiple outwash plains may have. For this case study, we estimate the total dynamic storage of future outwash plains to be about 20 mm, and we demonstrate their limited capacity to provide more stream water than that which they infiltrate upstream, except for very low river flows (&lt;150 to 200 L s−1). Below this limit, they can provide limited baseflow on timescales of weeks, thus maintaining moisture conditions that may be beneficial for proglacial ecosystems. Their role in attenuating floods also appears limited, as less than 0.5 m3 s−1 of river water can be infiltrated. The studied outwash plain appears therefore to play an important role for alpine ecosystems but has a marginal hydrological effect on downstream river discharge.</p

Histological evaluation of duodenal biopsies from coeliac patients : the need for different grading criteria during follow-up

Background: Coeliac disease is characterised by villous atrophy, which usually normalises after gluten withdrawal. Sometimes the revaluation of duodenal histology is required during follow-up, even if the methodology for comparing duodenal histology before and after introducing a gluten-free diet is not yet established. Our aim was to evaluate a novel criterion to compare duodenal histology in coeliac disease before and after gluten withdrawal. Methods: Duodenal biopsies from coeliac patients were retrospectively reviewed to compare duodenal histology at diagnosis and after at least one year on a gluten-free diet. Two different methods were used: the first was represented by the classical Marsh-Oberhuber score, the second compared the areas covered by each Marsh-Oberhuber grade and expressed as percentages, the final grade being calculated from the analysis of ten power fields per duodenal biopsy. Results: Sixty-nine patients (17 males 52 females, age at diagnosis 36\ub115 years) who underwent duodenal biopsies, were considered. According to the classical Marsh-Oberhuber scale, 32 patients did not present atrophy during follow-up while 37 showed duodenal atrophy, among whom 26 improved the grade of severity and 11 retained the same one. Of these latter, according to the second method, eight patients were considered improved, two showed a worsened duodenal damage and only one remained unchanged; the evaluation changed in 91 % of cases. Conclusions: The proposed semi-quantitative approach (i.e. the second method) for the evaluation of histology at follow-up provides additional information about the progression/regression of the mucosal damage

The mortality of colorectal cancer in relation to the initial symptom at presentation to primary care and to the duration of symptoms: a cohort study using medical records

The association between the staging of colorectal cancer and mortality is well known. Much less researched is the relationship between the duration of symptoms and outcome, and whether particular initial symptoms carry a different prognosis. We performed a cohort study of 349 patients with primary colorectal cancer in whom all their prediagnostic symptoms and investigation results were known. Survival data for 3–8 years after diagnosis were taken from the cancer registry. Six features were studied: rectal bleeding, abdominal pain, diarrhoea, constipation, weight loss, and anaemia. Two of these were significantly associated with different staging and mortality. Rectal bleeding as an initial symptom was associated with less advanced staging (odds ratio from one Duke's stage to the next 0.50, 95% confidence interval 0.31, 0.79; P=0.003) and with reduced mortality (Cox's proportional hazard ratio (HR) 0.56 (0.41, 0.79); P=0.001. Mild anaemia, with a haemoglobin of 10.0–12.9 g dl−1, was associated with more advanced staging (odds ratio 2.2 (1.2, 4.3); P=0.021) and worse mortality (HR 1.5 (0.98, 2.3): P=0.064). When corrected for emergency admission, sex, and the site of the tumour, the HR for mild anaemia was 1.7 (1.1, 2.6); P=0.015. No relationship was found between the duration of symptoms and staging or mortality