18 research outputs found
Efficient constitutive model for continuous micro-modeling of masonry structures
No full textThis is an Accepted Manuscript of an article published by Taylor & Francis Group in International Journal of Architectural Heritage on 2023, available online at: http://www.tandfonline.com/10.1080/15583058.2022.2124133.Masonry is a composite material often modeled as an equivalent homogenous material. However, the complexity of its micro-structure leads to complex mechanical responses, which are almost impossible to capture accurately with homogenous constitutive models. Micro-modeling can be used in these scenarios, allowing for the explicit modeling of microstructural components, leading to an accurate capturing of their interaction. Its main drawback is the computational cost, which often makes this approach suitable only for the simulation of small specimens. This is especially true due to strain-softening leading to severe instabilities and non-convergence of the solution. The objective of this work is to propose a simple yet effective constitutive plastic-damage model for the microstructural components of masonry. It is based on a damage model previously developed by the authors. For a better representation of the cyclic response of masonry, plasticity is added using a simplified implementation that does not strictly follow the rules of standard elastoplasticity, allowing an explicit computation of the stress tensor from the strain tensor without the need for an iterative loop at the material level. To reduce the numerical issues related to strain-softening and thus improve the stability of the solution, an IM-PLEX integration algorithm is adopted.The last author gratefully acknowledges the financial support from the Ministry of Science, Innovation and Universities of the Spanish Government (MCIU), the State Agency of Research (AEI), as well as that of the ERDF (European Regional Development Fund) through the project SEVERUS (Multilevel evaluation of seismic vulnerability and risk mitigation of masonry buildings in resilient historical urban centres, ref. num. RTI2018-099589-B-I00).Peer ReviewedObjectius de Desenvolupament Sostenible::11 - Ciutats i Comunitats SosteniblesObjectius de Desenvolupament Sostenible::11 - Ciutats i Comunitats Sostenibles::11.4 - Redoblar els esforços per a protegir i salvaguardar el patrimoni cultural i natural del mónObjectius de Desenvolupament Sostenible::13 - Acció per al ClimaObjectius de Desenvolupament Sostenible::13 - Acció per al Clima::13.1 - Enfortir la resiliència i la capacitat d’adaptació als riscos relacionats amb el clima i els desastres naturals a tots els païsosPostprint (author's final draft
Utility of High Flow Nasal Cannula during Pulmonary Rehabilitation in COVID-19 Patients in Acute Respiratory Failure
No full textHigh-flow nasal cannula (HFNC) has often been used in the treatment of acute respiratory failure during pulmonary rehabilitation setting. The aim of this retrospective study was to investigate the utility of HCFN during the early rehabilitation in COVID-19 pneumonia. Twenty-two patients (10 males and 12 females, mean age 64.5 ± 5.9 years) with COVID-19 pneumonia were considered. Medical data and rehabilitative scales were used to evaluate acute hypoxemic respiratory failure (PaO2/FiO2 < 300), treated with HFNC three times during evaluation. Overall clinical outcomes from the evaluation of the synergy between HFNC strategy and rehabilitation were evaluated. A statistically significant improvement was observed at T2 (and of treatment) in 1 minute sit to stand test (1STST) (4 ± 3 vs. 17 ± 5, p < 0.05), short physical performance battery (SPPB) (4.3 ± 2.81 vs. 9.15 ± 2.39, p < 0.05), SpO2% post effort (93 ± 1.26 vs. 98 ± 1.01, p < 0.05), respiratory rate post effort (RR) (24 ± 3.91 vs. 20 ± 3.13, p < 0.05), heart rate (HR) (97 ± 11.9 vs. 87 ± 9.17, p < 0.05), P/F rate (235 ± 7.35 vs. 331 ± 10.91, p < 0.05), SpO2 (86 ± 4.54 vs. 97 ± 1.01 p < 0.05), RR (20 ± 4 vs. 12 ± 1.39, p < 0.05). Then, treated HFNC patients showed a good improvement in physical performance at T2 and a good compliance with treatments proved to be extremely useful in the control and reduction of dyspnea and fatigue symptoms
Altered breathing pattern of lowlanders sleeping at high altitude: Novel insights from home sleep apnoea tests procedures
No full textLowlanders sojourning at high altitude often experience sleep disturbances, which are driven by blood gases alterations and manifest as stress-related patterns, including frequent awakenings, apnoeas, reduction in sleep duration and possibly with the occurrence of periodic breathing. This study demonstrated clinical evidence of sleep disturbances at high altitude by using portable device during a Himalayan expedition. The home sleep apnoea test was conducted on 10 participants taking part in the "Lobuche Peak - Pyramid Exploration & Physiology". The longitudinal design included five assessments, before the expedition, at pre-expedition at Kathmandu (≈1400 m), at a peak altitude of ≈ 5000 m, upon return to Kathmandu and one month after return in Italy. Total sleep time was below 7 h of duration at the highest altitude in all participants. Nocturnal SpO2 dropped below daytime measurement and was greatly reduced at high altitude; conversely, heart rate increased. All participants experienced an increase in apnea-hypopnea index at high altitude, with seven out of 10 falling in moderate-to-severe grade. Periodic breathing pattern was clearly observed in two participants, of whom one developed acute mountain sickness and one did not. All the impairments were fully reversible once back at low altitude. Translationally, our findings underscore the importance of conducting home sleep apnoea tests at living altitude. Sleep-disordered breathing arises from a complex pattern that can be due to a wide range of responses, and the overall functions revealed by home sleep apnoea testing during a field expedition have the potential to increase the safety of high altitude sojourners, while advancing our knowledge of hypoxia as the red line linking respiratory and environmental physiology
Ventilatory function and oxygen delivery at high altitude in the Himalayas
No full textThis study aimed to evaluate changes in lung function assessed by spirometry and blood gas content in healthy high-altitude sojourners during a trek in the Himalayas. A group of 19 Italian adults (11 males and 8 females, mean age 43 ± 15 years, and BMI 24.2 ± 3.7 kg/m2) were evaluated as part of a Mount Everest expedition in Nepal. Spirometry and arterial blood gas content were evaluated at baseline in Kathmandu (≈1400 m), at the Pyramid Laboratory - Observatory (peak altitude of ≈5000 m), and on return to Kathmandu 2-3 days after arrival at each site. All participants took 250 mg of acetazolamide per os once daily during the ascent. We found that arterial hemoglobin saturation, O2 and CO2 partial pressures, and the bicarbonate level all decreased (in all cases, p < 0.001 with R2 =0.70-0.90), while pHa was maintained stable at the peak altitude. Forced vital capacity (FVC) remained stable, while forced expiratory volume in 1 s (FEV1) decreased (p = 0.010, n2p =0.228), resulting in a lower FEV1/FVC ratio (p < 0.001, n2p =0.380). The best predictor for acute mountain sickness was the O2 partial pressure at the peak altitude (p = 0.004, R2 =0.39). Finger pulse oximetry overestimated peripheral saturation relative to arterial saturation. We conclude that high-altitude hypoxia alters the respiratory function and the oxygen saturation of the arterial blood hemoglobin. Additionally, air rarefaction and temperature reduction, favoring hypoxic bronchoconstriction, could affect respiration. Pulse oximetry seems not enough to assist medical decisions at high altitudes
Efficacy of orofacial myofunctional therapy combined with myofascial release in patients with mild obstructive sleep apnoea: a randomized controlled trial
No full textBackground: Obstructive sleep apnoea (OSA) is characterized by repetitive narrowing and collapse of pharyngeal airway during sleep, leading to apnoea or hypopnoea. In this context, myofunctional therapy and myofascial release might be effective, despite the literature on the combination of these approaches is still scarce.Objectives: This randomized controlled trial aimed to assess the efficacy of oro-facial myofunctional therapy combined with myofascial release in terms of functioning in patients with mild OSA.Methods: Patients aged from 40 to 80 years with diagnosis of mild OSA were randomly allocated into intervention group (oro-facial myofunctional therapy plus myofascial release) and control group (only oro-facial myofunctional therapy). At the baseline (T0), after 4 weeks (T1), and after 8 weeks (T2), the following outcomes were assessed: apnoea/hypopnoea index (AHI), average oxygen saturation (SpO(2)), sleep time spent with oxygen saturation < 90% (T90), snoring index, and Pittsburgh Sleep Quality Index (PSQI).Results: Out of the 60 patients enrolled, 28 (aged 61.46 +/- 8.74 years) complete the treatment in the intervention group and 24 (aged 60.42 +/- 6.61 years) in the control group. There were no significant differences in AHI between groups. A significant difference was reported for Delta T0-T1 SpO(2) (p = .01), T90 (p = .030), Delta T0-T1 and Delta T0-T2 snoring index (p = .026 and <.001 respectively), and Delta T0-T1 and Delta T0-T2 Pittsburgh Sleep Quality Index (p = .003 and <.001 respectively).Conclusion: Taken together, a combination of oro-facial myofunctional therapy and myofascial release showed a potential treatment for sleep quality in patients with mild OSA. Future studies are necessary to better investigate the role of these interventions in OSA patients
Tailored patient self-management and supervised, home-based, pulmonary rehabilitation for mild and moderate chronic obstructive pulmonary disease
No full text: [Purpose] Our study aimed to estimate the effects of a supervised, intensive, home-based-pulmonary-rehabilitation (HBPR) program for mild and moderate chronic-obstructive-pulmonary-disease (COPD) patients. [Participants and Methods] A retrospective, case-control study. Forty-three (N=43) patients were observed, divided into Treatment-Group (TG) and Control-Group (CG). The TG (N=23) underwent a 4-week training program, consisting of endurance and strength training sessions, performed 4-times per week. In addition, inspiration muscle training was performed, with a threshold device. The primary outcome was dyspnea improvements, measured by the modified-Borg-scale (mBS), and the secondary outcome was the determination of diaphragm excursion and function, using ultrasound (US) assessment to measure clinical parameters. [Results] The results suggested significantly improved mBS scores, measured for the ΔT0-T1 and ΔT0-T2 time points; improved diaphragm-excursion (Dia-Ex) at ΔT0-T1 and ΔT0-T2; and improved maximum Dia-Ex at ΔT0-T1 and ΔT1-T2 in the TG compared with the CG. Moreover, the results showed improvements over time for all parameters in the TG versus CG, suggesting a constant improvement in respiratory pathology. [Conclusion] A supervised HBPR plan was effective in reducing dyspnea by the mBS, and improving diaphragmatic function, as determined by US evaluation, and lastly improving quality of life in patients with mild-to-moderate COPD
Assessing the impact of seismic risk mitigation at the urban scale on community resilience and housing recovery
No full textEuropean historical city centers are particularly prone to natural disasters. This is due to the fragility of structures that often times do not comply with seismic codes; the high constructions’ density that causes induced damage; and the historical relevance of buildings that makes difficult the enacting of mitigation strategies. In Italy, major earthquake caused extensive damages over the last century. Seismic events have a huge impact on the Nation’s economy growth due to direct and indirect impacts, such as for example the high reconstruction costs or the business interruption spread out over a long period, respectively. In addition, the duration of recovery can affect the population wellbeing and cause permanent displacement. For this reason, the preventive planning of disaster management strategies are crucial to mitigate the damage and enhance resilience. Proposed strategies have to be effective and economically sustainable. In this paper, two towns affected by the 2012 Northern Italy Earthquake are chosen to analyze the reconstruction process. Using information published on the town journal, relevant aspects of the community resilience are highlighted. In particular, the housing recovery, i.e. the return of displaced people to a permanent housing solution is investigated. Then, a suite of seismic mitigation strategies is proposed for both cities, taking into account the peculiarity of the built environment and the damage distribution available thanks to the post-event buildings’ inspection. The effectiveness of the proposed strategies is assessed through a cost-benefit analysis, highlighting optimal solutions to reduce the economic and social losses.This work was supported by the FAR funding of the University of Ferrara, 2015, “Historical Centers Livable and Sustainable” (HC-LIVE)” and by the scholarship of the University “G. D’Annunzio” Chieti-Pescara, 2019, “Risk Assessment of the Built Heritage at the Urban Scale” (Ref. Num. 0002299). The fourth Author would like to acknowledge the Ministry of Science, Innovation and Universities (MCIU) of the Spanish Government, the State Agency of Research (AEI), and the European Regional Development Fund (ERDF) through the SEVERUS project (Multilevel evaluation of seismic vulnerability and risk mitigation of masonry buildings in resilient historical urban centres, Ref. Num. RTI2018-099589-B-I00).Objectius de Desenvolupament Sostenible::11 - Ciutats i Comunitats SosteniblesObjectius de Desenvolupament Sostenible::11 - Ciutats i Comunitats Sostenibles::11.4 - Redoblar els esforços per a protegir i salvaguardar el patrimoni cultural i natural del mónObjectius de Desenvolupament Sostenible::13 - Acció per al ClimaObjectius de Desenvolupament Sostenible::13 - Acció per al Clima::13.1 - Enfortir la resiliència i la capacitat d’adaptació als riscos relacionats amb el clima i els desastres naturals a tots els païsosPostprint (published version
Caratteristiche distintive e strategie di prevenzione e intervento sul cyber-bullismo in Italia [Distinctive features, prevention and intervention strategies on cyberbullying in Italy]
No full textNel corso degli ultimi anni la continua evoluzione dei mezzi di comunicazione ha fatto sì che una parte significativa della comunicazione e delle relazioni interpersonali si spostasse su un piano virtuale. La familiarità di bambini e adolescenti con i nuovi strumenti di comunicazione, tuttavia, può avere conseguenze dannose a causa di un utilizzo non consapevole della tecnologia, ponendo questi soggetti in una condizione di vulnerabilità. Il cyberbullismo si configura come una nuova forma di comportamento aggressivo, per certi aspetti più dannosa rispetto al bullismo tradizionale, perché difficilmente controllabile dalla vittima che ha un’oggettiva difficoltà nel difendersi rispetto a un autore che si muove in un mondo contraddistinto dall’immaterialità ed è spesso protetto dall’anonimato della rete. Il presente lavoro si propone di fornire una revisione critica della letteratura sul cyberbullismo analizzandone le definizioni disponibili, le relative concettualizzazioni teoriche e le loro criticità, in- dividuando le caratteristiche distintive a confronto con il bullismo tradizionale ed esaminando le evidenze scientifiche disponibili circa le strategie di intervento e prevenzione nel contesto italiano.During the last years, the continuous evolution of the social media has led to a shift of the communication and interpersonal relationships towards a virtual level. However, the familiarity of children and adolescents with the new communication tools can have harmful consequences due to an unaware use of technology, making these subjects more vulnerable for new forms of aggression. Cyberbullying is a new form of aggressive behaviour, in some respects more harmful than traditional bullying, because the victim has an objective difficulty defending himself/herself against an author who moves in a world characterized by immateriality and is often protected by network anonymity. This paper aims to provide a critical review of the literature on cyberbullying by analysing the available theoretical conceptualizations, identifying the distinctive features in comparison with traditional bullying and examining the scientific evidence about intervention and prevention strategies in the Italian context
Delirium and risk factors in patients undergoing non-invasive ventilation for de novo acute respiratory failure: an observational multicenter trial.
No full textBackground- Noninvasive ventilation (NIV) still has high failure rate when used for de novo acute respiratory failure (ARF). Delirium may impact the outcome, however data regarding its incidence, timing of occurrence and clinical predictors in this subset of patients are scarce.
Methods- Consecutive patients with de novo ARF subjected to NIV were recruited in 10 Italian Respiratory Intensive Care Units (RICUs) and Intensive Care Units (ICUs). Demographics and clinical features, including tolerance to interface and NIV setting were recorded on admission and during stay, whereas delirium onset and type was assessed by the (Confusion Assessment Method for ICU (CAM-ICU)-7 scale and Richmond Agitation Sedation Scale (RASS) twice/per day up to a week. The association between clinical variables and the occurrence of delirium and its influence on NIV failure and other clinical outcomes were analyzed.
Results- Thirty-two out of 90 enrolled patients (36%) developed delirium over 7 days upon admission; median time to onset was 48 hours (24–60). Older age (OR=2.7 [1.9–9], p=0.01), the presence of cancer OR=3.7 [2–5.4], p=0.002), sepsis (OR=1.7 [1.1–3.4], p=0.01), SOFA score (OR=1.8 [1.1–3.1], p=0.01), low tolerance to interface (OR=3.2 [2.1–5], p=0.002), use of helmet (OR=1.9 [1.2–4.3] p=0.04), and higher pre-DELIRIC (OR=3.5 [1.3–15], p=0.03) and BORG (OR=1.7 [1.1–4.6], p=0.02] scores were significantly associated with delirium. Delirium had high risk for NIV failure (HR = 3.5 95%CI [1.4–8.6], p=0.0002) and it significantly associated with longer RICU/ICU stay and higher mortality.
Conclusion- Delirium onset in acute hypoxic patients undergoing NIV is frequent and negatively affects the outcome. Multiple related clinical factors should be addressed early on admission to prevent the delirium-related risk of NIV failure in these patients
