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

Multiple Regression Model to Predict Length of Hospital Stay for Patients Undergoing Femur Fracture Surgery at “San Giovanni di Dio e Ruggi d’Aragona” University Hospital

The economic cuts suffered by public health have in many cases led to the reduction of beds. In order to optimize the available resources, the length of stay (LOS) can be used as an efficiency parameter. The objective of this study is to predict the value of LOS using the clinical information that is generally supplied by a patient who is hospitalized following a fracture of the neck of the femur and to make a comparison with results obtained after the implementation of the new diagnostic-therapeutic-assistance pathway (DTAP). The analysis was conducted on data extrapolated from the information system of the University Hospital “San Giovanni di Dio and Ruggi d’Aragona” of Salerno (Italy). The results show promising outcome in the use of the proposed prediction models as a tool for determining an estimate of the LOS and support the decision making process and the management of hospital resources in advance. In addition, the comparison of between the two models can be used as an indicator to assess the efficiency of the implemented DTAP

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

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

GPU-accelerated multi-objective optimization of fuel treatments for mitigating wildfire hazard

Fueltreatmentis considered a suitable way to mitigate the hazard related to potential wildfires on a landscape. However, designing an optimal spatial layout oftreatment units represents a difficult optimization problem. In fact, budget constraints, probabilistic nature of fire behaviour and complex interactions among the different fuel treatment patches, give rise to challenging search spaces on typical landscapes. In this study, we formulate the design problem in terms of a bi-objective optimization: minimizing both the extension of land characterized by high fire hazard and the cost of treatment. Then, we propose a computational approach that leads to a Pareto approximation set by exploiting an adapted version of the Non-dominated Sorting Genetic Algorithm II (NSGA-II) together with General-Purpose computing on Graphics Processing Units (GPGPU). Using an application example based on a real landscape, we also show that the proposed methodology has the potential to effectively support the design of a suitable fuel treatment for a landscape

Medical Technologies Procurement, Management and Maintenance in Developing Countries: The Case of Health Challenges in Africa

Biomedical technologies are the basis of a functioning health system, in particular, medical devices are essential for the prevention, diagnosis, treatment of diseases. However, while developed country hospitals are renewing their fleet of machines by divesting large quantities of biomedical equipment annually, there is a chronic lack of biomedical technology in developing countries to support clinical activities, which could be met by the reuse of used equipment, adapted to the new hospital environment. However, even if the donations of biomedical technologies are generally made with good intentions and not-profit making as in the case under study, obtained results are not what we expected also due to a not perfect communication between donors and recipients and a lack of culture about technology maintenance in the developing countries. At the moment, there is little documented evidence to support these statements. For this reason, the aim of this paper is to quantify the donated medical equipment that are out of service in two different hospitals in Benin. The information was collected on the type of communication existing between donors and beneficiaries and on the type of support that donors provide in terms of staff training, manuals and maintenance. It was observed that more than 50% of the donated equipment is not functional. In addition in more than 70% of the cases the donors do not support the beneficiaries nor training sessions and staff formation are provided. An in-depth assessments of beneficiary structures should be carried out and all donations must be accompanied by initial user training and monitoring by donors regarding the functionality of the system. Donors-beneficiaries communication results as a key elements in the management of health technologies in low-income countries