Comorbidities in Chronic Obstructive Pulmonary Disease from Assessment to Treatment.

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LA DIGITALIZZAZIONE PER LA DOCUMENTAZIONE, LO STUDIO E LA FRUIZIONE DI UN SITO ARCHEOLOGICO. LA VR EXPERIENCE DEL TEATRO DI RICINA

This paper presents a workflow developed thanks to the collaboration between archae- ologists and engineers, aimed at the documentation, representation and virtual fruition of an archaeological site. The purpose is to exploit the data acquired through digital solutions and the consequent elaboration of a reality 3D model to support archaeological studies and to effectively disseminate their results. The presented case study is the Roman Theatre of Ricina (Villa Potenza, MC). The building has preserved much of its masonry, but it is very different from that which could be appreciated by the audience of theatrical performances in Roman times. The work has been developed according to three steps: 1) digital documentation of the site and elaboration of a reality-based 3D model; 2) study of the archaeological finds thanks to the reality-based 3D model and design of a possible reconstruction, represented through a second 3D model elaborated by anastylosis; 3) development of a Virtual Reality environment for the fruition and the interaction with the two 3D models. The final output is therefore an immersive VR application that offers the possibility to access to the theatre both in its current form and in the original one. An experience that is not limited to a simple visualization rather presenting itself as a guided tour across the centurie

THE PALLADIOLIBRARY GEO-MODELS: AN OPEN 3D ARCHIVE TO MANAGE AND VISUALIZE INFORMATION-COMMUNICATION RESOURCES ABOUT PALLADIO

Abstract. The paper describes objectives, methods, procedures and outcomes of the development of the digital archive of Palladio works and documentation: the PALLADIOLibrary of Centro Internazionale di Studi di Architettura Andrea Palladio di Vicenza (CISAAP). The core of the application consists of fifty-one reality-based 3D models usable and navigable within a system grounded on GoogleEarth. This information system, a collaboration of four universities bearers of specific skills returns a comprehensive, structured and coherent semantic interpretation of Palladian landscape through shapes realistically reconstructed from historical sources and surveys and treated for GE with Ambient Occlusion techniques, overcoming the traditional display mode

Activity and analysis of costs in a dedicated weaning centre.

AIM: To analyse the diagnosis-related characteristics and the costs of treating patients with difficult/prolonged weaning from mechanical ventilation we have undertaken a retrospective observational study. METHODS: The study has considered all the patients admitted to our weaning unit of a regional Rehabilitation department during 3 consecutive periods since the opening date. Characteristics of the admitted patients and the DRG-related cares delivered have been recorded. A cost analysis has been obtained over time. RESULTS: The number of beds allocated to this unit (from 4 in the 1st period to 6 in the 2nd and 3rd periods) and the number of patients cared for (from 32 to 43 and to 65, respectively) increased over time. In particular, the COPD to non-COPD patient ratio (from 2.2 to 1.3 and to 1.0) and the DRG/patient weight (from 3.0 +/- 0.3 to 3.1 +/- 0.2 and to 3.3 +/- 0.2 point) changed significantly (p < 0.05). The daily reimbursement per patient from the public health care system only slightly increased, whereas the operating margin (reimbursement less costs) per patient significantly improved (from -304, to +17 and +55 Euro/pt/day, respectively, p < 0.05) due to a gradual restriction in the variable costs. Length of stay, mortality rate and weaning rate did not change over time. CONCLUSION: The weaning centre is a hospital area where economic burdens should be carefully evaluated. Given the actual reimbursement received on a national level for these patients, variable costs might be better spread, thus optimising the burdens without losing out on clinical outcomes

EXTENDING A MOBILE DEVICE WITH LOW-COST 3D MODELING AND BUILDING-SCALE MAPPING CAPABILITIES, FOR APPLICATION IN ARCHITECTURE AND ARCHAEOLOGY

One of the most challenging problem in architecture is the automated construction of 3D (and 4D) digital models of cultural objects with the aim of implementing open data repositories, scientifically authenticated and responding to well accepted standards of validation, evaluation, preservation, publication, updating and dissemination. The realization of such an ambitious objective requires the adoption of special technological instruments. In this paper we plan to use portable devices (i.e. smartphones, tablets or PDAs eventually extended to wearable ones), extended with a small plug-in, for automatically extracting 3D models of single objects and building-scale mapping of the surrounding environment. At the same time, the device will provide the capability of inserting notes and observations. Where the instrument cannot be directly applied, for example for exploring the top of a complex building, we consider mounting our device, or using equivalent existing equipment, on a drone, in a modular approach for obtaining data de-facto interchangeable. The approach based on the expansion packs has the advantage of anticipating (or even promoting) future extensions of new mobile devices, when the spectrum of possible applications justify the corresponding increased costs. In order to experiment and verify this approach we plan to test it in two specific scenarios of the cultural heritage domain in which such devices seem particularly promising: Strada Nuova in Genoa and Palazzo Ducale in Urbino, both located in Italy

THE INTEGRATED SURVEY OF NARROW SPACES AND UNDERGROUND ARCHITECTURE: THE CASE STUDY OF CAMPANA CAVES BAS-RELIEFS

Italian Cultural Heritage is rich in fascinating Underground Heritage (UH) to be protected and preserved because of its fragility and historical importance. An accurate and high-resolution 3D model is essential to reach an appropriate level of knowledge to safeguard caves but there are several obstacles to face. Underground data acquisition and following elaborations are problematic due to environmental conditions such as lack of homogeneous light sources, highly absorbing and unstable surfaces, narrow spaces and complex geometry. For these reasons, the integration of different techniques is mandatory to achieve a valid final product that could be an important basis for consolidation, preservation and valorization of the UH. In this paper, an integrated survey method is tested for a realistic digital reconstruction of hypogeal spaces. In addition to outputs for experts of conservation, the creation of multimedia products for a wider audience of non-professionals users is investigated as a way to preserve UH from decay. Thanks to VR, visitors virtually walk through the underground galleries observing and interacting, making accessible also fragile environments with forbidden access due to preservation policies

Short-Term Efficacy of Upper-Extremity Exercise Training in Patients With Chronic Airway Obstruction: A Systematic Review.

Background, Objectives, and Measurements Patients with chronic airway obstruction (CAO) frequently experience dyspnea and fatigue during activities performed by accessory muscles of ventilation, which competitively participate in arm elevation. This systematic review of randomized controlled trials (RCTs) concerning patients with CAO addresses the effects of upper-extremity exercise training (UEET), added to lower-extremity training or comprehensive pulmonary rehabilitation, on the following patient-centered outcomes: exercise capacity, symptoms, ability to perform daily activities, and health-related quality of life. METHODS:/b> Studies were retrieved using comprehensive database and hand-search strategies. Two independent reviewers determined study eligibility based on inclusion criteria. A detailed description of treatments was mandatory. Reviewers rated study quality and extracted information on study methods, design, intervention, and results. RESULTS: /b> Forty publications were evaluated. Four RCTs met the inclusion criteria but had serious methodological limitations, which introduce possible biases that reduce their internal validity. The outcomes measured were heterogeneous, and the results were inconsistent regarding maximal exercise capacity, dyspnea, and health-related quality of life. No effect of UEET was demonstrated for measures of arm fatigue. Limitations and CONCLUSIONS:/b> The limited methodological quality of the studies retrieved prevented us from performing a meta-analysis, the results of which could be misleading. This systematic review shows that there is limited evidence examining UEET and that the evidence available is of poor quality. Therefore, a recommendation for the inclusion or exclusion of UEET in pulmonary rehabilitation programs for individuals with CAO is not possible. Further research is needed to definitively ascertain the effects of this training modality on patient-centered outcomes

Impact of comprehensive pulmonary rehabilitation on anxiety and depression in hospitalized COPD patients.

To prospectively evaluate the effect of inpatient pulmonary rehabilitation (iPR) on anxiety and depression as outcome measures in patients with COPD, we studied 149 consecutive adults COPD referred to our iPR after an exacerbation. Patients were divided according to the GOLD staging into: Group 1 (stage 2a, n = 48, FEV1 63 +/- 9% pred.), Group 2 (stage 2b, n = 53, FEV1 42 +/- 6% pred.) and Group 3 (stage 3, n = 48, FEV1 25 +/- 7% pred.). The iPR consisted of twelve 3-hours daily sessions. Hospital Anxiety Depression (HAD) Scale as well as 6-minute walk (6MWD) with evaluation of dyspnea (D) and leg fatigue (F) at rest and end of effort, and health related quality of life by means of St. George Respiratory Questionnaire (SGRQ) were assessed before (T0) and after (T1) the iPR. 6MWD, D and F at end of effort and SGRQ total score similarly improved (p < 0.001) in all groups after iPR. The mean level of HAD-anxiety (from 9.1 +/- 4.0 to 7.7 +/- 3.5, from 9.0 +/- 4.6 to 7.2 +/- 4.6 and from 8.1 +/- 4.1 to 6.7 +/- 4.3 in group 1,2 and 3 respectively) and HAD-depression (from 9.4 +/- 3.5 to 8.2 +/- 3.5, from 9.1 +/- 4.2 to 8.2 +/- 4.5 and from 9.0 +/- 4.0 to 7.4 +/- 4.5 respectively) similarly changed (p < 0.0001) over time in all groups. The total percentage of patients with abnormal score (> 10) of HAD-anxiety (from 31% to 21%) and HAD-depression (from 30% to 22%) significantly decreased (p < 0.05) after the iPR. Inpatient pulmonary rehabilitation may improve levels of anxiety and depression as well as symptoms, exercise capacity and health related quality of life in moderate to severe COPD patients after an acute exacerbation

FROM TLS TO HBIM. HIGH QUALITY SEMANTICALLY-AWARE 3D MODELING OF COMPLEX ARCHITECTURE

In order to improve the framework for 3D modeling, a great challenge is to obtain the suitability of Building Information Model (BIM) platform for historical architecture. A specific challenge in HBIM is to guarantee appropriateness of geometrical accuracy. The present work demonstrates the feasibility of a whole HBIM approach for complex architectural shapes, starting from TLS point clouds. A novelty of our method is to work in a 3D environment throughout the process and to develop semantics during the construction phase. This last feature of HBIM was analyzed in the present work verifying the studied ontologies, enabling the data enrichment of the model with non-geometrical information, such as historical notes, decay or deformation evidence, decorative elements etc. The case study is the Church of Santa Maria at Portonovo, an abbey from the Romanesque period. Irregular or complex historical architecture, such as Romanesque, needs the construction of shared libraries starting from the survey of its already existing elements. This is another key aspect in delivering Building Information Modeling standards. In particular, we focus on the quality assessment of the obtained model, using an open-source sw and the point cloud as reference. The proposed work shows how it is possible to develop a high quality 3D model semantic-aware, capable of connecting geometrical-historical survey with descriptive thematic databases. In this way, a centralized HBIM will serve as comprehensive dataset of information about all disciplines, particularly for restoration and conservation. Moreover, the geometric accuracy will ensure also reliable visualization outputs

Joint statement on the role of respiratory rehabilitation in the COVID-19 crisis: the Italian position paper.

Due to an exponential growth of the number of subjects affected by coronavirus disease 2019 (COVID-19), the entire Italian healthcare system had to respond promptly and in a very short time with the need of semi-intensive and intensive care units. Moreover, trained dedicated COVID-19 teams consisting of physicians coming from different specialties (intensivists or pneumologists and infectivologists), while respiratory therapists and nurses have been recruited to work on and on with rest. However, due to still limited and evolving knowledge of COVID-19 disease, there are little recommendations for need in respiratory rehabilitation and physiotherapy interventions. The presentation of this manuscript is the result of a consensus promoted by the Italian societies of respiratory health care professionals who contacted pulmonologists directly involved in the treatment and rehabilitation of COVID-19. The aim was to formulate the more proper and common suggestions to be applied in different hospital settings in offering rehabilitative programs and physiotherapy workforce planning in COVID-19 patients. Two main areas of intervention were identified: organization and treatment, which were described in this paper to face with the emergency