Computational LEED: computational thinking strategies and Visual Programming Languages to support environmental design and LEED credits achievement

Since environmental and energy issues and challenges continues to emerge as key global concerns, Green Building Certification Systems are becoming increasingly relevant in the construction industry. In this regard, LEED (Leadership in Energy and Environmental Design) is considered one of the most widely recognized environmental assessment methods used globally in the construction industry today. However, due to the high level of complexity of the LEED system, the tools usually used to verify the achievement of the credits lack of “design friendliness” and hardly communicate effectively with the conventional tools used by architects and engineers (e.g. CAD, BIM). This makes difficult to fully take into account, especially at the early design stage, the many interconnected aspects that contribute to the green certification, with consequent issues often arising in the design validation and/or construction phases, resulting in time delays and cost increments. The application of innovative problem-solving methods, such as computational thinking, together with coding techniques, represents an effective way to deal with this issue. This kind of methodology, in fact, allows the requirements of a specific LEED credit to be digitally parametrised and flexibly incorporated into a “designer friendly” working environment. In particular, Visual Programming Languages (VPLs), due to their high simplicity of usage, allow architects and engineers to develop algorithms and thus implement their technical knowledge in the field of environmental design with computer programming skills, useful to improve their tools and keep them constantly updated. The aim of this paper is to illustrate a methodology through which, by merging computational thinking strategies with VPL tools, is possible to keep under control, in the same working environment, all the parameters required to verify in real time the achievement of LEED credits. To demonstrate the flexibility of the approach, dedicated tools developed for the verification of some specific credits at different scales – neighbourhood and building – are illustrated as operational examples of the proposed methodology

Body growth assessment in children with IgE-mediated cow's milk protein allergy fed with a new amino acid-based formula

Amino acid-based formula (AAF) is a relevant dietary option for non-breastfed children. The present study was designed to evaluate the body growth pattern in cow's milk protein allergy (CMPA) children treated for 6 months with a new AAF

Therapeutic Effects of Butyrate on Pediatric Obesity: A Randomized Clinical Trial

Importance: The pediatric obesity disease burden imposes the necessity of new effective strategies. Objective: To determine whether oral butyrate supplementation as an adjunct to standard care is effective in the treatment of pediatric obesity. Design, setting, and participants: A randomized, quadruple-blind, placebo-controlled trial was performed from November 1, 2020, to December 31, 2021, at the Tertiary Center for Pediatric Nutrition, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy. Participants included children aged 5 to 17 years with body mass index (BMI) greater than the 95th percentile. Interventions: Standard care for pediatric obesity supplemented with oral sodium butyrate, 20 mg/kg body weight per day, or placebo for 6 months was administered. Main outcomes and measures: The main outcome was the decrease of at least 0.25 BMI SD scores at 6 months. The secondary outcomes were changes in waist circumference; fasting glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, ghrelin, microRNA-221, and interleukin-6 levels; homeostatic model assessment of insulin resistance (HOMA-IR); dietary and lifestyle habits; and gut microbiome structure. Intention-to-treat analysis was conducted. Results: Fifty-four children with obesity (31 girls [57%], mean [SD] age, 11 [2.91] years) were randomized into the butyrate and placebo groups; 4 were lost to follow-up after receiving the intervention in the butyrate group and 2 in the placebo group. At intention-to-treat analysis (n = 54), children treated with butyrate had a higher rate of BMI decrease greater than or equal to 0.25 SD scores at 6 months (96% vs 56%, absolute benefit increase, 40%; 95% CI, 21% to 61%; P < .01). At per-protocol analysis (n = 48), the butyrate group showed the following changes as compared with the placebo group: waist circumference, -5.07 cm (95% CI, -7.68 to -2.46 cm; P < .001); insulin level, -5.41 μU/mL (95% CI, -10.49 to -0.34 μU/mL; P = .03); HOMA-IR, -1.14 (95% CI, -2.13 to -0.15; P = .02); ghrelin level, -47.89 μg/mL (95% CI, -91.80 to -3.98 μg/mL; P < .001); microRNA221 relative expression, -2.17 (95% CI, -3.35 to -0.99; P < .001); and IL-6 level, -4.81 pg/mL (95% CI, -7.74 to -1.88 pg/mL; P < .001). Similar patterns of adherence to standard care were observed in the 2 groups. Baseline gut microbiome signatures predictable of the therapeutic response were identified. Adverse effects included transient mild nausea and headache reported by 2 patients during the first month of butyrate intervention. Conclusions and relevance: Oral butyrate supplementation may be effective in the treatment of pediatric obesity. Trial registration: ClinicalTrials.gov Identifier: NCT04620057

Effects of the Mediterranean Diet during pregnancy on the onset of allergy in at risk children: A study protocol of a multi-center, randomized- controlled, parallel groups, prospective trial (the PREMEDI study)

Maternal diet during pregnancy has been linked to offspring allergy risk and it could represent a potential target for allergy prevention. The Mediterranean Diet (MD) is considered one of the healthiest dietary models. Randomized-controlled trials on the effect of MD in preventing pediatric allergic diseases are still needed

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Background: In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods: Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results: The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions: We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research

MAGMA: Multiparametric dAtabase GUI for Monitoring and Administration

I vulcani attivi della Campania sono, come è noto, tra quelli a più alto rischio nel mondo a causa del loro stile eruttivo prevalentemente esplosivo e della presenza, nelle loro prossimità, di vaste aree urbanizzate. Gestire le informazioni riguardanti il parco strumentale delle Reti di monitoraggio sismico, geodetico e geochimico dell’Osservatorio Vesuviano, nonché dei sistemi di acquisizione dei dati, è di cruciale importanza per consentire lo svolgimento delle numerose attività ad essi correlate. Negli ultimi anni, le Reti di monitoraggio sono andate incontro ad un notevole aggiornamento tecnologico, ad esempio con sostituzione di sistemi analogici con quelli digitali di moderna generazione, e installazione di nuove stazioni digitali multi-parametriche. Tale aggiornamento richiede al tempo stesso un’attività non indifferente, nell’inserire, mantenere e aggiornare le informazioni del parco strumentale installato. L’esigenza di migliorare la fruibilità di tali informazioni ha portato alla nascita di un database delle reti di monitoraggio e contestualmente di MAGMA, interfaccia web nata per la consultazione, l’inserimento e l’aggiornamento delle informazioni contenute nel database. Gli utenti cui si rivolge MAGMA sono il personale preposto alla gestione della manutenzione delle stazioni. Oltre alla gestione delle informazioni sulla strumentazione in uso in ognuna delle singole stazioni, MAGMA consente la consultazione dello stato di funzionamento della strumentazione e della sua ubicazione, ad esempio se la strumentazione è installata ed in esercizio, se in magazzino o se in riparazione. Inoltre è possibile anche la gestione della componente amministrativa legata ai permessi di concessione delle aree scelte per l’ubicazione delle stazioni

The Step-Down approach in children with Cow's Milk Allergy: results of a randomized controlled trial

Background: The Step-Down Approach for Cow's Milk Allergy (SDACMA) trial evaluated the tolerability and the rate of immune tolerance acquisition in CMA children starting dietary treatment with amino acid-based formula(AAF) and then switching to EHCF containing the probiotic L. rhamnosus GG(EHCF+LGG). Methods: Randomized controlled trial involving IgE-mediated CMA children receiving AAF from at least 4 weeks. EHCF+LGG tolerance was evaluated by the results of double-blind placebo-controlled food challenge (DBPCFC). Subjects tolerating EHCF+LGG were randomly allocated to remain on AAF, or to switch to EHCF+LGG. Immune tolerance acquisition to cow's milk proteins was evaluated with DBPCFC after 12 months of treatment. Allergy screening tests and body growth were also monitored. Results: 60 IgE-mediated CMA children were enrolled. The proportion of children treated with AAF tolerant to the first exposure of EHCF+LGG was 0.98(exact 95% CI 0.91 to 0.99). The rate of the immune tolerance acquisition to cow milk proteins after 12 months treatment was higher in the EHCF+LGG (0.48, 95% exact CI 0.29 to 0.67, n/N=14/29) than in the AAF group (0.03, 95% exact CI 0.001 to 0.17, n/N=1/30). There was an absolute benefit increase(ABI) of tolerance rate equal to 0.45(95% CI, 0.23 to 0.63, Newcombe method 10) for EHCF+LGG vs AAF, corresponding to a NNT of 2 (2 to 4, Bender's method). A normal body growth pattern was observed in the two study groups. Conclusion: In IgE-mediated CMA children the step-down from AAF to EHCF+LGG is well tolerated and could facilitate the immune tolerance acquisition