A review of daylighting strategies in schools: state of the art and expected future trends

The study of daylight conditions within educational buildings has been a topic of interest since the nineteenth century in western countries, and European ones in particular. Although it has been argued that providing a view outside—or even using daylight instead of more stable and manageable artificial light—could reduce students’ performance without providing a pleasant and healthy environment, nowadays it seems that a large consensus upon the need to design well daylit spaces is being reached. This paper reviews how the research community has tackled the task of understanding and solving the complex relationships amongst local climate, users’ needs and design constraints in school buildings by showing the different approaches used and technological solutions suggested. The reported case studies, based either on experimental measurements or on simulations, highlight the need of a comprehensive approach to the topic to fully understand the non‐trivial requirements of a daylit educational environment

Effects of Essential Hypertension on coronary Microcirculation: Focus on a Population of Hypertensives Affected by Microvascular Angina

A correlation between essential hypertension and the establishmentof myocardial ischemia is nowadays universally accepted. Coronary atherosclerosis is deemed to be the most important process through which the capability of coronary district to supply a blood flow consistent with myocardial needs can be impaired, until the onset of an anginal syndrome. In this study, we verified whether hypertensives’ coronaries, seen by performing an angiographic study, are properly definable as normal, even in presence of an overt exertional angina, or if they should rather be barely defined as “macroscopically unharmed”, through the clues of a microvascular alteratio

Study on the application of cool paintings for the passive cooling of existing buildings in Mediterranean climates

Building roofs play a very important role in the energy balance of buildings, especially in summer, when they are hit by a rather high solar irradiance. Depending on the type of finishing layer, roofs can absorb a great amount of heat and reach quite high temperatures on their outermost surface, which determines significant room overheating. However, the use of highly reflective cool materials can help to maintain low outer surface temperatures; this practice may improve indoor thermal comfort and reduce the cooling energy need during the hot season.This technology is currently well known and widely used in the USA, while receiving increasing attention in Europe. In order to investigate the effectiveness of cool roofs as a passive strategy for passive cooling in moderately hot climates, this paper presents the numerical results of a case study based on the dynamic thermal analysis of an existing office building in Catania (southern Italy, Mediterranean area). The results show how the application of a cool paint on the roof can enhance the thermal comfort of the occupants by reducing the operative temperatures of the rooms and to reduce the overall energy needs of the building for space heating and cooling

Refurbishing an existing apartment block in Mediterranean climate: towards the Passivhaus standard

The Passivhaus standard, although widely appreciated in cold regions, is seldom regarded as a reference in the energy renovation of existing buildings in warm countries. This paper evaluates the effectiveness of a series of strategies for the energy refurbishment of an existing apartment block in Southern Italy, based on dynamic energy simulations. The paper aims to show that, in warm Mediterranean areas, a building refurbishment must not be oriented towards an excessive insulation level. Conversely, if aimed to comply with the Passivhaus standard, the renovation must look above all at those strategies that mitigate the energy needs for space cooling and improve thermal comfort in summer

Clinical Appropriateness of Coronary Angiography

Background: The study evaluates the appropriateness of coronary angiography and the agreement between the used method and the presence of coronary artery disease by the indications proposed from American College of Cardiology/American Heart Association (1999). Method: The guidelines allow us to associate to Class I and IIa the judgment of appropriateness, to the Class IIb of uncertainty; to Class III of inappropriateness. Result: On 761 coronary angiography 76.74% were appropriate, 23.13% unsuitable, 0.13% uncertain. The group with the greater value of appropriateness is that one with unstable angina (97.9% appropriate); that one with the lower value is the group with non-specific symptomatology (26.7% appropriate). Conclusion: Considering the false positives, it is important the rate of the greater sensibility and the lower specificity of the not invasive tests carried before coronary angiography, as well as, the probable presence of microcircle disease. Among the false negatives, we must considered the number of patients with effective coronary artery disease which has “jumped” the intermediate stage of the not invasive diagnostic process, before the coronary angiography, but have obtained the same final benefit

A rare case of Prinzmetal angina 3 days after coronary artery stenting with a second-generation drug-eluting stent.

Non previsto

Different strategies for improving summer thermal comfort in heavyweight traditional buildings

In order to exploit the passive energy potential of the building envelope, it is important to provide a right combination of insulation thickness, heat capacity and night-time ventilation. In this paper, this issue will be tackled with reference to an historic building in Catania (Southern Italy). The building was built at the end of the XIX century, and its opaque envelope is entirely made with lava stones, which is typical of traditional architecture in this area. Starting from the current configuration of the building, many hypotheses for refurbishment are considered, combined with different strategies for passive cooling, such as night-time ventilation, use of shading devices and adoption of highly-reflective coatings. The effectiveness of each solution in terms of summer thermal comfort is evaluated through dynamic thermal simulations carried out with EnergyPlus. The results show the synergic effect of these strategies, as well as their individual impact, and allow to draw some general conclusions about the behaviour of heavyweight buildings under moderately hot weather conditions

Microvascular angina in diabetic patients with uninjured coronary arteries

Abstrac

CAROTID INTIMAL-MEDIA THICKNESS AND ENDOTHELIAL FUNCTION IN YOUNG PATIENTS WITH HISTORY OF MYOCARDIAL INFARCTION.

AIM: The aim of the study was to evaluate the prevalence of carotid atherosclerosis and endothelial dysfunction in 45 young patients (38 mens and 7 females) with myocardial infarction (MI), age 29-45, mean age 42+/-3 years, to verify its possible role as a marker of coronary atherosclerosis. METHODS: Vascular echography was performed to verify the presence of carotid atherosclerosis and/or endothelial dysfunction in 45 young patients with MI and in 45 healthy control subjects well matched for age and sex. RESULTS: We observed a normal intima media thickness (IMT) only in 30% of patients with juvenile myocardial infarction (JMI) compared with 66% in the control group (P<0.0001) and 34% of patients showed an increased IMT compared with 24% of healthy subjects (P<0.0001). Compared with control subjects, patients with JMI had lower flow-mediated reactivity of the brachial arteries (P<0.05). There was a negative linear relationship between flow-mediated dilation and IMT (P<0.001). The severity of coronary artery disease (CAD) was correlated with increased IMT and with a lower flow-mediated dilation. Finally, multiple regression analysis, demonstrated that both brachial-artery reactivity and carotid IMT were significantly and independently correlated with severity of CAD. CONCLUSIONS: Structural (carotid atherosclerosis) and functional changes (endothelial dysfunction) were present at an early age in the arteries of persons with history of JMI

Intravascular lithotripsy (IVL) enabled the percutaneous closure of a severely calcified paravalvular leak regurgitation following implantation of a self-expandable transcatheter aortic valve: a case report

BackgroundClosure of paravalvular leak (PVL) regurgitation after self-expandable (SE) transcatheter aortic valve implantation (TAVI) may be more challenging than after balloon-expandable (BE) valve implantation.Case summaryAn 85-year-old woman suffering from long-standing atrial fibrillation and severe symptomatic aortic stenosis underwent SE TAVI (26 mm Evolut™ R®, Medtronic Inc., MN, USA). A total of eighteen months after TAVI she was admitted for congestive heart failure and two-dimensional (2D) transesophageal echocardiography (TEE) color Doppler showed moderate-severe PVL regurgitation due to a long and heavily calcified leak located below the left coronary sinus. The patient was deemed to be at prohibitive surgical risk and a catheter-based PVL closure procedure was planned. A first attempt to cross the PVL from the femoral artery was unsuccessful due to an inappropriate angle between the catheter and the entry site of this hard-to-approach calcified leak. A Terumo hydrophilic guidewire 0.35 inch-260 cm from the right radial artery was then successfully advanced across the leak to the left ventricle (LV); however, of most of the catheters used, only a Glidecath 4-Fr could cross the leak over the hydrophilic wire. The hydrophilic guidewire was replaced with a stiffer guidewire that, after creating a loop in the LV, was advanced across the self-expandable valve into the descending aorta where it was snared and externalized through the left femoral artery, thus creating an arterio-arterial (AA) loop. A 6-Fr Multipurpose guiding catheter was advanced over the exchange wire and the leak was crossed with an additional 0.0014 coronary guidewire (PILOT, Abbott Vascular), predilated with two non-compliant balloon dilatation catheters, and finally, the PVL was engaged with a 3.0 mm × 12 mm Shockwave balloon (Shockwave Medical Inc, Santa Clara, California, USA). Intravascular lithotripsy (IVL) application to this highly calcified leak and the increased support provided by the stiff guidewire finally allowed the progression of the 6-Fr dedicated delivery sheath (ODS III) into the LV. A 5 mm square twist (ST) device (PLD, Occlutech, Helsingborg, Sweden) was successfully deployed within the leak and the final echocardiographic and angiographic control confirmed the effective PVL closure.DiscussionIn patients at high surgical risk with moderate to severe regurgitation after SE TAVI due to a hard-to-approach calcified long tract, an extra AA support loop is mandatory during percutaneous PVL closure. Furthermore, IVL application greatly facilitates the progression of the delivery sheath and occluder which is key to a successful procedure