Evaluating The Potential Energy Savings Of An Urban Green Infrastructure Through Environmental Simulation

Green infrastructure is a very important aspect to be considered in designing and preparing cities to adapt and mitigate climate change impacts on the built environment. Green based solutions have a strong impact on many aspects, such as controlling storm-water, reducing urban heat island effect, stabilizing soils, facing earthquakes, etcetera. In this paper an environmental analysis is performed by simulation with TRNSYS Studio tool. The cooling potential that can be obtained by trees in residential compounds is assessed, considering shadowing effect, changes in air movement, sky view factor reduction and other simulation-parameter changes. Results show that a reduction of 30 to 50% in cooling demand can be obtained by using a raw of trees on South, East and especially West façades. Two types of trees are tested, showing different cooling performances depending on the height and form of the trees

Farmers as data sources: Cooperative framework for mapping soil properties for permanent crops in South Tyrol (Northern Italy)

Abstract Detailed knowledge of agricultural soil properties is a key element for high-quality food production. However, high-resolution soil data covering a large agricultural region are generally unavailable. This study explores a demand-driven cooperative framework for soil data sourcing that connects individual farmers to several stakeholders by means of a centralised database containing more than 16,000 records of soil information collected within the framework of an integrated production program for intensively managed permanent crops in the Adige/Etsch and Venosta/Vinschgau valleys in South Tyrol, Italy. Data for soil pH, soil organic matter (SOM), and soil texture were used to produce digital soil maps with a RMSE of 0.21, 1.25% and a cross-validation of 43%, respectively. Spatialisation was conducted using either regression-kriging or multinomial logistic regression. Collaboration among farmers, public administrators, and researchers provided a successful cooperative framework for digital soil mapping. The maps highlight the complex interplay of the postglacial evolution of these valleys due to the presence of a cluster of large alluvial fans and the anthropogenic influences of intense farming on pH, SOM, and soil texture. This study regarded a subset of the available soil properties, which can be dealt with using the geostatistical approaches presented herein. Thus, a long-term soil monitoring program and the combination of all available variables will allow digital assessment of the spatial patterns of nutrient availability, ecological risk assessments, change detection studies, and an overall long-term plan for soil security at larger spatial scales

Decision Support System for smart urban management: resilience against natural phenomena and aerial environmental assessment

A new concept of Decision Support System (DSS) is presented. It is able to account for and support all phases of the risk analysis process: event forecast, prediction of reliable and accurate damage scenarios, estimate of their impact on Critical Infrastructures (CI), estimate of the possible consequences. It also provides an estimate of the consequences in terms of service degradation and of impact on citizens, on urban area and on production activities, essential for the mitigation of the adverse events. It can be used in two different modes, either in an operational mode (on a 24/7 basis) or in a simulation mode to produce risk analysis, setting up synthetic natural hazards and assessing the resulting chain of events (damages, impacts and consequences). Among the various possible external data sources an aerial, drone based one is presented. The system may capture both thermal and visual images of CI, processing them into 3D models or collect chemical pollutants concentrations for the monitoring of dangerous air quality due to catastrophic events such as volcano eruptions or large fires. The obtained models and the chemical data can be easily displayed within the framework of the DSS

Integrated Management of Childhood Illness (IMCI) in the practice of nurses graduated from USP

Descreveu-se a incorporação da estratégia Atenção Integrada às Doenças Prevalentes na Infância (AIDPI) na prática de enfermeiros egressos da Escola de Enfermagem da Universidade de São Paulo (EE-USP). Desenvolveu-se estudo de caso de abordagem qualitativa, com coleta de dados em grupo focal e análise de conteúdo do tipo temática. A estratégia AIDPI foi considerada ferramenta importante na atenção à saúde infantil, porém apenas o módulo de avaliação fazia parte da prática profissional. Destacam-se como dificuldades para sua utilização: não implantação nos serviços, desconhecimento por parte de colegas e barreiras institucionais. Ainda que com uso restrito e não sistematizado, a AIDPI possibilita ao enfermeiro prestar atenção integrada e integral à criança o que justifica sua abordagem na graduação. Manutenção do vídeo didático, ampliação da prática, integração das disciplinas e otimização dos conteúdos e da carga horária foram apontadas como relevantes para o aperfeiçoamento do ensino da AIDPI na graduação.Se describió la incorporación de la estrategia Atención Integrada a las Enfermedades Prevalentes de la Infancia (AIEPI) en la práctica de enfermeros formados en la Escuela de Enfermería de la Universidad de São Paulo (EE-USP). Estudio de caso de carácter cualitativo, con recogida de datos en grupos focales y análisis de contenido temático. AIEPI fue considerada importante herramienta en el cuidado del niño, pero sólo el módulo de evaluación hacía parte de la práctica profesional. Dificultades en el uso de AIEPI fueron: no implantación en los servicios, desconocimiento de la estrategia por parte de colegas, barreras institucionales. Aunque con uso restringido y no sistematizado, cuando utilizado AIEPI permite a los enfermeros prestar atención integrada y integral al niño, lo que justifica su contenido en la graduación. Mantenimiento de vídeo educativo, expansión de práctica, integración de disciplinas y optimización del contenido y carga horaria fueron destacados como importantes para mejorar la enseñanza de AIEPI en el pregrado.We described the use of the Integrated Management of Childhood Illness (IMCI) strategy in the professional practice of nurses graduated from the School of Nursing of University of São Paulo (EE-USP). A case study of qualitative approach was conducted. Data were collected from focus groups and we did thematic content analysis. IMCI strategy was considered an important tool in child health care, but only the assessment module was part of professional practice. Difficulties in the use of the IMCI were: the strategy was not implanted at health services, it was unknown to part of co-workers and institutional obstacles. Despite of the limited and non-systematic use of IMCI, it has allowed nurses to provide integrated and comprehensive attention to the child, which justifies its teaching on undergraduate courses. Maintenance of the tutorial video, expansion of the practice, integration of disciplines and optimization of content and workload were suggested for improving the teaching of IMCI in undergraduate courses.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

O cuidado da criança e o direito à saúde: perspectivas de mães adolescentes

OBJECTIVETo analyze child health care and the defense of their rights from the perspective of adolescent mothers.METHODSAn exploratory study with qualitative thematic analysis of data, based on conceptual aspects of care and the right to health, from semi-structured interviews with 20 adolescent mothers ascribed by Family Health teams.RESULTSMaternal reports indicate that child health care requires responsibility and protection, with health practices that promote child advocacy. Gaps in assistance which preclude the full guarantee of the right to child health care were also highlighted.CONCLUSIONThe right to health care assumed different meanings, and the forms to guarantee them were linked to individual behavior in detriment to broader actions that consider health as a social product, connected to the guarantee of other fundamental rights.OBJETIVOAnalisar os cuidados à saúde da criança e a defesa de seus direitos na perspectiva de mães adolescentes.MÉTODOEstudo exploratório com análise qualitativa temática dos dados, fundamentado em aspectos conceituais do cuidado e do direito à saúde, a partir de entrevistas semiestruturadas com 20 mães adolescentes adscritas por equipes de Saúde da Família.RESULTADOSOs relatos maternos apontam que o cuidado à saúde da criança requer responsabilidade e proteção, com práticas de saúde que promovam a defesa da criança. São também ressaltadas lacunas assistenciais que impedem a plena garantia do direito à saúde da criança.CONCLUSÃOO direito à saúde assumiu diferentes significados e as formas de garanti-lo estiveram vinculadas a condutas individuais em detrimento de ações em rede que consideram a saúde como um produto social, interligada com a garantia de outros direitos fundamentais.OBJETIVOAnalizar los cuidados sanitarios del niño y la defensa de sus derechos bajo la perspectiva de madres adolescentes.MÉTODOEstudio exploratorio con análisis cualitativo temático de los datos, fundado en aspectos conceptuales del cuidado y el derecho a la salud, mediante entrevistas semiestructuradas a 20 madres adolescentes adscritas por equipos de Salud de la Familia.RESULTADOSLos relatos maternos señalan que el cuidado a la salud del niño requiere responsabilidad y protección, con prácticas sanitarias que promocionen la defensa del niño. Se subrayan también los hiatos asistenciales que impiden la plena garantía del derecho a la salud del niño.CONCLUSIÓNEl derecho a la salud asumió distintos significados y las formas de asegurarlo estuvieron vinculadas a conductas individuales en detrimento de acciones en red que consideran la salud como un producto social, interconectada con la garantía de otros derechos fundamentales

Dissemination of patient blood management practices in Swiss intensive care units: a cross-sectional survey

BACKGROUND Patient blood management (PBM) promotes the routine detection and treatment of anaemia before surgery, optimising the management of bleeding disorders, thus minimising iatrogenic blood loss and pre-empting allogeneic blood utilisation. PBM programmes have expanded from the elective surgical setting to nonsurgical patients, including those in intensive care units (ICUs), but their dissemination in a whole country is unknown. METHODS We performed a cross-sectional, anonymous survey (10 October 2018 to 13 March 2019) of all ordinary medical members of the Swiss Society of Intensive Care Medicine and the registered ICU nurses from the 77 certified adult Swiss ICUs. We analysed PBM-related interventions adopted in Swiss ICUs and related them to the spread of PBM in Swiss hospitals. We explored blood test ordering policies, blood-sparing strategies and red blood cell-related transfusion practices in ICUs. RESULTS A total of 115 medical doctors and 624 nurses (response rates 27% and 30%, respectively) completed the surveys. Hospitals had implemented a PBM programme according to 42% of physicians, more commonly in Switzerland's German-speaking regions (Odds Ratio [OR] 3.39, 95% confidence interval [CI] 1.23-9.35; p = 0.018) and in hospitals with more than 500 beds (OR 3.91, 95% CI 1.48-10.4; p = 0.006). The PBM programmes targeted the detection and correction of anaemia before surgery (79%), minimising perioperative blood loss (94%) and optimising anaemia tolerance (98%). Laboratory tests were ordered in 70.4% by the intensivist during morning rounds; the nurses performed arterial blood gas analyses autonomously in 48.4%. Blood-sparing techniques were used by only 42.1% of nurses (263 of 624, missing: 6) and 47.0% of physicians (54 of 115). Approximately 60% of respondents used an ICU-specific transfusion guideline. The reported haemoglobin threshold for the nonbleeding ICU population was 70 g/l and, therefore, was at the lower limit of current guidelines. CONCLUSIONS Based on this survey, the estimated proportion of the intensivists working in hospitals with a PBM initiative is 42%, with significant variability between regions and hospitals of various sizes. The risk of iatrogenic anaemia is relevant due to liberal blood sample collection practices and the underuse of blood-sparing techniques. The reported transfusion threshold suggests excellent adherence to current international ICU-specific transfusion guidelines

Epilepsy in adult patients with Down syndrome : a clinical-video EEG study

Patients with Down syndrome are now living longer and the overall prevalence of epilepsy is increasing, however, full characterisation of epilepsy in adult age is still incomplete. We describe the electroclinical characteristics of epilepsy in 22 adult patients with Down syndrome (11 males, 11 females), with a mean age of 46 years (range: 28-64 years), followed at the Epilepsy Centre, San Paolo Hospital in Milan. Mean age at epilepsy onset was 36.8 years (range: 6-60 years). Nine out of 22 patients had focal epilepsy, while nine had late-onset myoclonic epilepsy. In four patients, epilepsy was unclassified. The EEG pattern of our patients was characterised by a progressive slowing of the background activity with sharp-and-slow waves with frontal predominance. In the patients diagnosed with late-onset myoclonic epilepsy, the EEGs showed generalised polyspike waves. Three subjects had an episode of myoclonic status epilepticus at the beginning or in the course of the disorder. After the first descriptions of late-onset myoclonic epilepsy by Genton and Paglia (1994), this is one of the largest patient cohorts reported. Our data confirm that epilepsy in adult patients with Down syndrome presents peculiar electroclinical characteristics which should be recognized early as prompt, effective treatment may be beneficial. [Published with video sequences]

Genetic investigations on 8 patients affected by ring 20 chromosome syndrome

<p>Abstract</p> <p>Background</p> <p>Mosaic Chromosome 20 ring [r(20)] is a chromosomal disorder associated with a rare syndrome characterized by a typical seizure phenotype, a particular electroclinical pattern, cognitive impairment, behavioural problems and absence of a consistent pattern of dysmorphology. The pathogenic mechanism underlying seizures disorders in r(20) syndrome is still unknown. We performed a detailed clinical and genetic study on 8 patients with r(20) chromosome, aimed at detecting the genetic mechanism underlying r(20) syndrome.</p> <p>Methods</p> <p>We submitted 8 subjects with a previous diagnosis of ring 20 chromosome mosaicism to a clinical re-evaluation, followed by cytogenetic, FISH, array-CGH and molecular analyses. The genetic study was also extended to their available parents.</p> <p>Results</p> <p>FISH and array-CGH experiments indicate that cryptic deletions on chromosome 20 are not the cause of the r(20) chromosome associated disease. Moreover, no evidence of chromosome 20 uniparental disomy was found. Analysis of FISH signals given by variant in size alphoid tandem repeats probes on the normal chromosome 20 and the r(20) chromosome in the mosaic carriers suggests that the r(20) chromosome is the same chromosome not circularized in the "normal" cell line.</p> <p>Conclusions</p> <p>Higher percentages of r(20) chromosome cells were observed to be related with precocious age at seizure onset and with resistance to antiepileptic drug treatment. Behavioural problems also seem to be associated with higher percentages of r(20) chromosome cells. Our results suggest that an epigenetic mechanism perturbing the expression of genes close to the telomeric regions, rather than deletion of genes located at the distal 20p and/or 20q regions, may underlie the manifestation of r(20) syndrome.</p

Expression of Mutant or Cytosolic PrP in Transgenic Mice and Cells Is Not Associated with Endoplasmic Reticulum Stress or Proteasome Dysfunction

The cellular pathways activated by mutant prion protein (PrP) in genetic prion diseases, ultimately leading to neuronal dysfunction and degeneration, are not known. Several mutant PrPs misfold in the early secretory pathway and reside longer in the endoplasmic reticulum (ER) possibly stimulating ER stress-related pathogenic mechanisms. To investigate whether mutant PrP induced maladaptive responses, we checked key elements of the unfolded protein response (UPR) in transgenic mice, primary neurons and transfected cells expressing two different mutant PrPs. Because ER stress favors the formation of untranslocated PrP that might aggregate in the cytosol and impair proteasome function, we also measured the activity of the ubiquitin proteasome system (UPS). Molecular, biochemical and immunohistochemical analyses found no increase in the expression of UPR-regulated genes, such as Grp78/Bip, CHOP/GADD153, or ER stress-dependent splicing of the mRNA encoding the X-box-binding protein 1. No alterations in UPS activity were detected in mutant mouse brains and primary neurons using the UbG76V-GFP reporter and a new fluorogenic peptide for monitoring proteasomal proteolytic activity in vivo. Finally, there was no loss of proteasome function in neurons in which endogenous PrP was forced to accumulate in the cytosol by inhibiting cotranslational translocation. These results indicate that neither ER stress, nor perturbation of proteasome activity plays a major pathogenic role in prion diseases