Urban sustainability : complex interactions and the measurement of risk

This paper focuses on the concept of a sustainable city and its theoretical implications for the urban system. Urban sustainability is based on positive interactions among three different urban sub-systems : social, economic and physical, where social well-being coexists with economic development and environmental quality. This utopian scenario doesn’t appear. Affluent economy is often associated with poverty and criminality, labour variety and urban efficiency coexist with pollution and congestion. The research subject is the analysis of local risk and opportunity conditions, based on the application of a special definition of risk elaborated and made operative with the production of a set of maps representing the multidimensional facets of spatial organisation in urban sustainability. The interactions among the economic/social and environmental systems are complex and unpredictable and present the opportunity for a new methodology of scientific investigation : the connectionistic approach, processed by Self-Reflexive Neural Networks (SRNN). These Networks are a useful instrument of investigation and analogic questioning of the Data Base. Once the SRNN has learned the structure of the weights from the DB, by querying the network with the maximization or minimization of specific groups of attributes, it is possible to read the related properties and to rank the areas. The survey scale assumed by the research is purposefully aimed at the micro-scale and concerns the Municipality of Milan which is spatially divided into 144 zones

Biosensors for measuring matrix metalloproteinases: An emerging research field.

Matrix metalloproteinases (MMPs) have been proposed as markers of many pathological conditions for their ability to degrade extracellular matrix components and remodel tissues. This review presents an overview of biosensors for the measurement of MMPs in serum, sputum and cell cultures. Major benefits and limitations of these technologies are discussed with respect to zymography and immunoassays, which are the reference methods to measure MMP activity and concentration. The paper also compares the analytical performances of sensors to the specific requirements for the application in clinical research, and comments on future trends in this field

Effects of pre‐operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or >= 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease