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Monitoraggio strutturale e pesatura dinamica integrati
No full textGrifone è il nuovo sistema integrato sviluppato da iWIM per il monitoraggio delle infrastrutture: unisce in un’unica piattaforma la pesatura dinamica dei veicoli e il monitoraggio strutturale continuo grazie alla sensoristica in fibra ottica. Il sistema fornisce dati in tempo reale sulla risposta strutturale delle opere e sui carichi veicolari, abilitando una manutenzione predittiva basata su indicatori oggettivi. Tra le caratteristiche principali si segnalano l’intervento minimamente invasivo, la possibilità di analisi storiche, la generazione di allarmi automatici e l’interoperabilità con ambienti BIM e Digital Twin. Viene presentato il caso studio effettuato su un ponte della Tangenziale sud di Brescia, realizzato in cooperazione con il DICATAM (Dipartimento di Ingegneria Civile, Architettura, Territorio, Ambiente e di Matematica) dell’Università degli Studi di Brescia
Distance Measures for Unweighted Undirected Networks: A Comparison Study
Full text linkNetworks are mathematical structures that allow the representation of complex systems by jointly modelling the elements of the system and the relationships that exist among them. To analyse different contexts or systems, methodological tools are necessary to allow for the quantitative estimation of the differences existing between two or more networks. For this purpose, various tools have been proposed in the literature. This study is an exploratory analysis of the impacts that different methods (distances and spectral methods) have on the comparative evaluation of two networks. The analyses were conducted through a simulation study that considered three different perturbation schemes to investigate the behaviour of each method with increasing randomness in the perturbation scheme (i.e., edge removal). Results show that the distances between adjacency matrices are sensitive only to changes in the network density, while spectral methods are sensitive to changes in both the network density and the degree of the nodes
Real-world collection of secondary myeloid neoplasms after CD19 CAR-T cell therapy: first report of the ClonHema study
No full textDevelopment of an integrated indicator for assessing management impacts on soil quality: A case study in organic viticulture
Full text linkGiven that soil is an invaluable resource for viticulture, it is important to maintain its properties in order to keep it healthy and optimize ecosystem processes underpinning productivity. Although measuring sustainability poses challenges, it remains crucial for developing specific management strategies designed for a given geographic area. This study introduces the Management Impact on Soil Quality (MISQ), an integrated indicator designed to assess how common management practices influence the attributes of soil health in organic vineyards. The MISQ evaluates five key management components: soil disturbance, regeneration of soil organic matter, terrestrial eco-toxicity impact of copper, efficiency of nutrient (NPK) use, and biodiversity. This indicator was applied using data collected from an organically-managed vineyard in Franciacorta, a grape-producing area in Northern Italy over the years 2014, 2015, 2019 and 2021. The results indicate how enhanced soil function depends on increased supply of organic matter and diversified cover cropping with legumes, thereby improving soil biodiversity. However, managing potential nutrient surplus and recognizing the risks associated with tillage for row spacing management are also crucial factors. These results provide viticulturists with a valuable tool for assessing the effects of agronomic techniques on soil quality, thereby facilitating sustainable management practices. This study highlights the need to preserve the soil multifunctionality, which is critical for nutrient cycling, soil structural stability and biological population control. The straightforward approach of the MISQ makes it suitable for use in different environments, thereby promoting effective management strategies that mitigate a negative impact on soil functionality
Characteristics, Prognosis and ESC/ERS Risk Stratification in Obese Patients with Pulmonary Arterial Hypertension (PAH)
No full textBackground: The impact of obesity on pulmonary arterial hypertension (PAH) remains largely underexplored, with excess weight potentially masking symptoms and affecting the reliability of current risk stratification tools. Research question: What are the clinical characteristics and prognosis of obese patients with PAH, and how well do current risk stratification tools perform in this population? Study design and methods: We retrospectively included patients with incident PAH diagnosis enrolled at ten European tertiary care centers for PAH management and compared patients with and without obesity, defined by a BMI ≥30 kg/m2. Uni- and multivariable Cox regression models were fitted to assess the association between obesity and 5-years all-cause mortality. Accuracy of the ESC/ERS risk stratification tool for the prediction of annual mortality at baseline and follow up in patients with and without obesity was assessed by ROC curve analysis. Results: Among 581 patients included (median age 58 years, IQR 41-75; 61% females), 139 (24%) were obese. Obese patients had more comorbidities and worse symptoms/functional capacity. 5-years crude and adjusted all-cause mortality risk was similar in obese and non-obese. Both the three- (AUC 0.71, 95% CI 0.62-0.81 vs 0.64, 95%CI 0.48-0.80) and the four-strata (AUC 0.79 95% CI 0.69-0.89 vs 0.64 95% CI 0.40-0.88) ESC/ERS risk stratification tool demonstrated lower accuracy for prediction of annual mortality in obese vs non-obese patients, although not statistically significant. However, most components of the risk stratification tool lack a significant prognostic association in obese patients. Interpretation: Despite the higher burden of comorbidity and the worse functional class, prognosis is similar in obese compared with non-obese patients with PAH. Currently recommended risk stratification strategies might not be sufficient in patients with obesity claiming for focused research to improve risk stratification across subgroups of patients with PAH
Governare le democrazie nella trasformazione dei sistemi politici
No full text[IT] Il volume vuole descrivere (e interrogarsi su) un momento di grande tumultuosità della democrazia occidentale, per non dire di vera e propria messa in discussione dei suoi classici presupposti e, di contro, sulle proposte strutturali di livello costituzionale con riguardo all’ordinamento italiano rispetto al quale, peraltro, sono stati fatti, a partire dalla fine degli anni Ottanta, tentativi importanti di mutamento del sistema parlamentare vigente, tutti falliti sino ad ora. È sembrato opportuno raccontare (e ragionare “a caldo” su) eventi di una certa rilevanza istituzionale – dunque non solo politica – che si sono succeduti in Paesi (Francia e Germania) che, come il nostro, costituiscono un asse strategico per la stessa Unione Europea ovvero in un Paese, quello degli Stati Uniti d’America, considerato, in particolare dal secondo dopoguerra in avanti, un “baluardo” per la difesa dei principi e valori dell’Occidente democratico, nonostante un sistema di governo presidenziale (che ne costituisce un unicum), ben bilanciato quanto a contropoteri da opporre a pericolose derive di leaderismo estremo che, tuttavia, dopo la seconda rielezione di Donald Trump, vengono perlomeno paventate.
[EN] The volume aims to describe (and reflect upon) a moment of significant tumult in Western democracy, bordering on a thorough questioning of its classical foundations. It also examines structural proposals at the constitutional level concerning the Italian legal system, which has seen notable attempts since the late 1980s to change the current parliamentary system, all of which have so far failed. The book seeks to narrate (and critically analyze) events of institutional relevance – not merely political – that have unfolded in countries (France and Germany) pivotal to the European Union, similar to Italy. It also discusses events in the United States, traditionally viewed since the post-World War II era as a "bulwark" defending the principles and values of Western democracy, despite its unique presidential system, which is balanced with counterpowers aimed at mitigating dangerous extremes of leadership, yet concerns have been raised following Donald Trump's second re-election
Awareness of bone strength in patients with neuromuscular disorders: ERN EURO-NMD clinician survey and European patient survey
No full textBone strength is reduced In various neuromuscular disorders (NMDs). We aimed to assess the awareness and practice of bone strength management in NDMs among clinicians and patients. We performed two online surveys; among health care providers (HCPs) of the European Reference Network for Neuromuscular Disorders (ERN EURO-NMD) and among patients. The survey among 52 HCPs showed that awareness of potentially impaired bone strength in people with NMDs was reasonable to good: the vast majority of HCPs asked often or almost always about bone fractures during history-taking (81 %). Bone strength was less often assessed: often or almost always at diagnosis (50 %) and at follow-up (58 %). Medical training on this topic was considered poor to very poor in 50 % of HCPs. Prevention and treatment of reduced bone strength was variable and multidisciplinary care was sub-optimal. The survey among 581 patients provided important additional insights. Many patients were followed-up outside ERN EURO-NMD centers and treatment was variable. These parallel surveys provided a broad view on the awareness and management of bone strength in people with NMDs. The findings are expected to increase the appreciation of this important aspect of NMD care, and direct future research foci and care guidelines
Treatment of secondary hyperparathyroidism in hemodialysis patients: a comparison between two Italian centers to evaluate real-world guideline implementation
No full textBackground: Even though calcimimetics and active vitamin D are frequently used, studies using data from dialysis Registries have shown a progressive increase in parathyroid hormone (PTH) levels in the dialysis population over the last 20 years. In the relatively small sample of Italian patients included in the DOPPS phase 5 (n = 449), elevated or suppressed PTH levels were observed in 14% and 34% of patients, respectively. The aim of this study was to assess mineral metabolism parameters and treatment strategies in the hemodialysis population of two Centers in Northern Italy. Methods: We included all chronic hemodialysis patients treated between September and October 2023 at the Dialysis Centers of Cremona (n = 177) and Brescia (n = 315). Both Dialysis Units followed the KDIGO guidelines. However, differences in treatment strategies were noted. Patients in Brescia were systematically prescribed 25-OH vitamin D, while in Cremona, if 1-25 vitamin D was prescribed, 25-OH vitamin D was discontinued. In the Brescia Center, all patients used a 1.50 mmol/l calcium dialysate concentration, while in Cremona patients with hypercalcemia or suppressed PTH levels were prescribed a 1.25 mmol/l calcium dialysate concentration. Mineral metabolism parameters were evaluated and compared to KDIGO recommendations in both settings. Results: In the hemodialysis population considered, the prevalence of high (> 600 pg/ml) or suppressed (< 150 pg/ml) PTH levels was, 8.1% and 24%, respectively. Patients treated at the Brescia Center had significantly lower serum calcium and phosphate levels as compared to patients treated in Cremona. However, serum PTH and 25-vitamin D levels were higher in Brescia. In Brescia, native vitamin D was prescribed more frequently than in Cremona (81.9% vs 5.1%, p < 0.001). In Cremona, both active vitamin D and calcimimetics were prescribed more frequently than in Brescia (respectively, 62.1% and 50.9% vs 39.7% and 27.2%, p < 0.001). The prevalence of hypercalcemia (Brescia: 1.6%, Cremona: 1.7%), hypocalcemia (Brescia: 19%, Cremona: 16%), hyperphosphatemia (Brescia: 35%, Cremona: 40%), and elevated PTH levels (Brescia: 7.6%, Cremona: 9.0%) did not differ significantly. Suppressed PTH levels were more frequent in patients treated in Cremona (35% vs 20%, p < 0.001). Conclusions: Our study found, in the two clinical settings of the study, a lower prevalence of patients with elevated or suppressed PTH levels compared to the Italian patients included in DOPPS. Despite different treatment strategies, the prevalence of elevated PTH levels was similar in the two Centers. This suggests that different therapeutic strategies may be equally effective in controlling secondary hyperparathyroidism
