Planning and design support tools for walkability: a guide for urban analysts

We present a survey of operational methods for walkability analysis and evaluation, which we hold to show promise as decision-support tools for sustainability-oriented planning and urban design. An initial overview of the literature revealed a subdivision of walkability studies into three main lines of research: transport and land use, urban health, and livable cities. A further selection of articles from the Scopus and Web of Science databases focused on scientific papers that deal with walkability evaluation methods and their suitability as planning and decision-support tools. This led to the definition of a taxonomy to systematize and compare the methods with regard to factors of walkability, scale of analysis, attention on profiling, aggregation methods, spatialization and sources of data used for calibration and validation. The proposed systematization aspires to offer to non-specialist but competent urban analysts a guide and an orienteering, to help them integrate walkability analysis and evaluation into their research and practice

Neighbourhood park vitality potential: From Jane Jacobs's theory to evaluation model

We construct a method to evaluate the neighbourhood park vitality potential (NPV-potential), inspired by Jane Jacobs's theory of urban and park vitality. The evaluation model produces an aggregate score of NPV-potential by combining information on the extrinsic factors of vitality, related to the park's surrounding urban area, with evaluative judgements on the intrinsic factors, related to the park's internal organisation and design. To showcase and submit the evaluation model to a preliminary test drive, we further present the results of an application on three parks in the city of Cagliari, Italy. The computed NPV-potential and the effective use of the three parks, obtained from direct observation, show a good degree of agreement. While far from a robust validation, which would require more extensive empirical studies with larger and more internally variable samples of parks, the reported agreement between the potential and the observed vitality on the ground is a preliminary indication of the possible usefulness of the proposed evaluation method for urban planning and design

A DECISION SUPPORT TOOL ON DERELICT BUILDINGS FOR URBAN REGENERATION

Abstract. We present a decision suppport tool for the comparison and selection of projects of integrated renovation of derelict buildings and areas for the purpose of urban regeneration. Each project is defined as a subset of derelict properties to renovate together with their respective designated use, and is scored by the decision support tool on two criteria: expected effort and estimated effectiveness in terms of improved urban capabilities in the urban area of interest. The expected effort is estimated as a global transformation cost, factoring in legal and management overhead costs as well as possible economies of scale. The effectiveness in evaluated in terms of extension of urban capabilities centred on walkable distances. We have implemented a bi-objective evolutionary search algorithm to address the computational complexity of the problem of search for efficient (non-dominated) projects over the two criteria. For the purpose of illustration, we present an example case-study application on the historical core of the city of Sassari, Italy.</p

Regression Models to Study the Total LOS Related to Valvuloplasty

Background: Valvular heart diseases are diseases that affect the valves by altering the normal circulation of blood within the heart. In recent years, the use of valvuloplasty has become recurrent due to the increase in calcific valve disease, which usually occurs in the elderly, and mitral valve regurgitation. For this reason, it is critical to be able to best manage the patient undergoing this surgery. To accomplish this, the length of stay (LOS) is used as a quality indicator. Methods: A multiple linear regression model and four other regression algorithms were used to study the total LOS function of a set of independent variables related to the clinical and demographic characteristics of patients. The study was conducted at the University Hospital “San Giovanni di Dio e Ruggi d’Aragona” of Salerno (Italy) in the years 2010–2020. Results: Overall, the MLR model proved to be the best, with an R2 value of 0.720. Among the independent variables, age, pre-operative LOS, congestive heart failure, and peripheral vascular disease were those that mainly influenced the output value. Conclusions: LOS proves, once again, to be a strategic indicator for hospital resource management, and simple linear regression models have shown excellent results to analyze it

A Fuzzy Inference System for the Assessment of Indoor Air Quality in an Operating Room to Prevent Surgical Site Infection

Indoor air quality in hospital operating rooms is of great concern for the prevention of surgical site infections (SSI). A wide range of relevant medical and engineering literature has shown that the reduction in air contamination can be achieved by introducing a more efficient set of controls of HVAC systems and exploiting alarms and monitoring systems that allow having a clear report of the internal air status level. In this paper, an operating room air quality monitoring system based on a fuzzy decision support system has been proposed in order to help hospital staff responsible to guarantee a safe environment. The goal of the work is to reduce the airborne contamination in order to optimize the surgical environment, thus preventing the occurrence of SSI and reducing the related mortality rate. The advantage of FIS is that the evaluation of the air quality is based on easy-to-find input data established on the best combination of parameters and level of alert. Compared to other literature works, the proposed approach based on the FIS has been designed to take into account also the movement of clinicians in the operating room in order to monitor unauthorized paths. The test of the proposed strategy has been executed by exploiting data collected by ad-hoc sensors placed inside a real operating block during the experimental activities of the “Bacterial Infections Post Surgery” Project (BIPS). Results show that the system is capable to return risk values with extreme precision

Blood–brain barrier impairment in patients living with hiv: Predictors and associated biomarkers

Despite the substantial changes resulting from the introduction of combination antiretroviral therapy (cART), the prevalence of HIV-associated neurocognitive disorders (HAND) remains substantial. Blood–brain barrier impairment (BBBi) is a frequent feature in people living with HIV (PLWH) and it may persist despite effective antiretroviral treatment. A cross-sectional study was performed in PLWH who underwent lumbar puncture for clinical reasons or research protocols and several cerebrospinal fluid biomarkers were studied. BBBi was defined as cerebrospinal fluid-to-serum albumin ratio (CSAR) &gt;6.5 (&lt;40 years) or &gt;8 (&gt;40 years). We included 464 participants: 147 cART-naïve and 317 on cART. Male sex was prevalent in both groups (72.1% and 72.2% respectively); median age was 44 (38–52) years in naïve and 49 (43–57) years in treated subjects. BBBi was observed in 35.4% naïve and in 22.7% treated participants; the use of integrase inhibitors was associated with a lower prevalence (18.3 vs. 30.9%, p = 0.050). At multivariate binary logistic regression (including age and sex) nadir CD4 cell count (p = 0.034), presence of central nervous system (CNS) opportunistic infections (p = 0.024) and cerebrospinal fluid (CSF) HIV RNA (p = 0.002) in naïve participants and male sex (p = 0.021), a history of CNS opportunistic infections (p = 0.001) and CSF HIV RNA (p = 0.034) in treated patients were independently associated with BBBi. CSF cells and neopterin were significantly higher in participants with BBBi. BBBi was prevalent in naïve and treated PLWH and it was associated with CSF HIV RNA and neopterin. Systemic control of viral replication seems to be essential for BBB integrity while sex and treatment influence need further studies

The manifesto of pharmacoenosis: Merging hiv pharmacology into pathocoenosis and syndemics in developing countries

Pathocoenosis and syndemics theories have emerged in the last decades meeting the frequent need of better understanding interconnections and reciprocal influences that coexistent communicable and non-communicable diseases play in a specific population. Nevertheless, the attention to pharmacokinetic and pharmacodynamics interactions of co-administered drugs for co-present diseases is to date limitedly paid to alert against detrimental pharmacological combos. Low and middle-income countries are plagued by the highest burden of HIV, tuberculosis, malaria, and helminthiasis, and they are experiencing an alarming rise in non-communicable disorders. In these settings, co-infections and comorbidities are common, but no tailored prescribing nor clinical trials are used to assess and exploit existing opportunities for the simultaneous and potentially synergistic treatment of intertwined diseases. Pharmacoenosis is the set of interactions that take place within a host as well as within a population due to the compresence of two or more diseases and their respective treatments. This framework should pilot integrated health programmes and routine clinical practice to face drug–drug interaction issues, avoiding negative co-administrations but also exploiting potential favourable ones to make the best out of the worst situations; still, to date, guiding data on the latter possibility is limited. Therefore, in this narrative review, we have briefly described both detrimental and favourable physiopathological interactions between HIV and other common co-occurring pathologies (malaria, tuberculosis, helminths, and cardiovascular disorders), and we have presented examples of advantageous potential pharmacological interactions among the drugs prescribed for these diseases from a pharmacokinetics, pharmacodynamics, and pharmacogenetics standpoint