52 research outputs found
Caratteristiche e contenuti della modellazione digitale rivolta alla gestione dell’edificio/Characteristics and Contents of Digital Modeling Aimed at Building Management
No full textLa conoscenza del patrimonio architettonico esistente è l’atto culturale preliminare alla sua corretta
e adeguata conservazione e valorizzazione. La modellazione digitale dell’architettura, come noto,
offre oggi processi e metodi avanzati che vanno nella direzione di definire i supporti più adeguati agli
interventi fisici sull’esistente, agiti tramite interventi di restauro e/o manutenzione, e per gli interventi
legati agli aspetti di valorizzazione e ottimizzazione funzionale, dovuti agli usi che delle architetture
vengono fatti. Individuare le modalità e i processi di modellazione digitale, parametrica e non, più
adeguati in relazione alle finalità, tentando di partire da uno stesso modello che possa essere gestito
tramite processi e software differenti per caratteristiche, in relazione alle finalità, è l’obiettivo del
presente contributo, che costituisce la sintesi di una più ampia ricerca che vede come caso studio
il
monumentale Palazzo del Governatore di Parma, edificio di proprietà pubblica in buona parte
destinato a sede espositiva di mostre temporanee, venendo così a presentare esigenze diverse in
relazione agli aspetti di manutenzione di un patrimonio architettonico fruibile dalla comunità e alle
esigenze di funzionalizzazione che mutano al mutare di ogni evento espositivo e alle specifiche pe
culiarità allestitive. Partire da un unico modello, quindi, e poi diramarne le caratteristiche in funzione
delle finalità d’uso, nella necessaria interazione con altri software che ci aiutino a narrare gli aspetti
che di volta in volta affrontiamo
Health and Economic Advantages Associated With the Use of TachoSil: An Update of Systematic Review
No full textGiorgio Lorenzo Colombo,1,2 Andrea Droghetti,3 Sergio Di Matteo,2 Henrike Ottenjann,4 Giacomo Matteo Bruno2,5 1Center of Pharmaceuticals Economics and Medical Technologies Evaluation, Department of Drug Sciences, University of Pavia, Pavia, Italy; 2S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy; 3Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; 4Medizin & Wort, Munich, Germany; 5Department of Drug Science, University of Pavia, Pavia, ItalyCorrespondence: Giorgio Lorenzo Colombo, Studi Analisi Valutazioni Economiche (S.A.V.E.), Via Previati 74, Milan, 20149, Italy, Tel +39 02 4851 9230, Fax +39 02 7396 0369, Email [email protected]: The international scientific literature is systematically analyzed in this review over a period of nearly 10 years with respect to the use of the active hemostat and surgical sealant patch TachoSil, considering its economic effects. It`s an update of the first review published in 2014.Methods: A PubMed systematic literature review was done from Nov 2013 up to December 2022. Based on the criteria used to select, the papers were grouped in terms of study design, surgery type, reduction in the time to hemostasis, shorter hospital stay, fewer number of post-operative complications, and the impact of TachoSil to operative procedures.Results: Medical evidence of TachoSil is well documented, in different clinical studies and for several indications. In this second review 18 scientific papers were screened. In total data from 3.375 patients were analyzed, of whom 1.748 were treated with TachoSil. Nine of the 18 papers (50%) were classified as randomized clinical trials (RCTs). The time required for hemostasis following the administration of TachoSil was significantly shorter than that observed with other surgical treatment techniques, with a median time of up to four minutes. The reduction in post-operative complications was evaluated in 15 studies that were conducted on patients in a variety of surgical specialties. When using TachoSil the hospitalization duration was briefer, as observed in the past review.Conclusion: The second analysis of scientific papers demonstrates that TachoSil plays a supporting role in surgical procedures, enhancing hemostasis and facilitating tissue sealing when conventional techniques are inadequate.This approach has been linked to a reduction in post-operative complications, length of hospital stay, and consequently, hospital cost.Keywords: TachoSil, hemostasis, length of hospitalization, postoperative complications, economic evaluatio
Robot-assisted pyeloplasty with direct pyelo-ureteral anastomosis for retrocaval ureter
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Current role of focal therapy in prostate cancer
No full textBackground: Thanks to the improved accuracy of multiparametric Magnetic Resonance Imaging (mpMRI) to detect and localize the dominant index lesion on prostate cancer (PCa), the concept of minimally invasive focal treatments (FT) has gained popularity. Nevertheless, although high-quality evidence that FT has favorable functional outcomes, definitive proof of its oncological effectiveness compared to standard treatments remains underreported. Objective: This study aims to explore the efficacy, safety, oncologic and functional outcomes of different type of FT for PCa. Evidence acquisition: A non-systematic literature review was conducted by searching on PubMed “prostate cancer” AND “focal treatment” OR “HIFU” OR “irreversible electroporation” OR “cryoablation” OR “focal laser ablation.” Overall, 22 articles published in English literature from 2018 to 2023 describing FT techniques for PCa were included. Evidence synthesis: Related to the field ablated, focal therapies include hemiablation (half gland), focal ablation (zonal-base) or targeted therapy (lesion-based). FT modalities can be categorized in thermal and non-thermal energy: thermal energy techniques include high-intensity focused ultrasound (HIFU), cryotherapy, radiofrequency ablation (RFA), and focal laser ablation (FLA). Focal brachytherapy, irreversible electroporation (IRE), and vascular-targeted photodynamic therapy (VTP) are classified as non-thermal ablation. Each focal ablative treatments could be promising alternative to conventional radical therapies to treat PCa in term of mid-term oncologic and functional outcomes, however, limited data are available in comparison with standardized radical treatments. HIFU and Cryo are the most studied techniques and seem to be superior to radical treatments in term of functional outcomes despite associated with higher recurrence and retreatment rate. Conclusions: Current evidences of oncologic and functional outcomes of FT are based mainly on retrospective, non-comparative and single center studies. Thus, none of the focal therapies available should be considered safe alternative to standardized treatments in routine practice and should be offered only for well selected PCa patients with low or at least favorable-intermediate risk disease, unfit for radical options
Enhancing electron correlation at a 3D ferromagnetic surface
No full textSpin-resolved momentum microscopy and theoretical calculations are combined beyond the one-electron approximation to unveil the spin-dependent electronic structure of the interface formed between iron (Fe) and an ordered oxygen (O) atomic layer, and an adsorbate-induced enhancement of electronic correlations is found. It is demonstrated that this enhancement is responsible for a drastic narrowing of the Fe d-bands close to the Fermi energy (EF) and a reduction of the exchange splitting, which is not accounted for in the Stoner picture of ferromagnetism. In addition, correlation leads to a significant spin-dependent broadening of the electronic bands at higher binding energies and their merging with satellite features, which are manifestations of a pure many-electron behavior. Overall, adatom adsorption can be used to vary the material parameters of transition metal surfaces to access different intermediate electronic correlated regimes, which will otherwise not be accessible. The results show that the concepts developed to understand the physics and chemistry of adsorbate–metal interfaces, relevant for a variety of research areas, from spintronics to catalysis, need to be reconsidered with many-particle effects being of utmost importance. These may affect chemisorption energy, spin transport, magnetic order, and even play a key role in the emergence of ferromagnetism at interfaces between non-magnetic systems
Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols
No full textVideo-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the first-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors' experiences on perioperative multimodal analgesia principles for implementing an ERAS program after VATS lobectomy
Robust organic radical molecular junctions using acetylene terminated groups for c-au bond formation
No full textOrganic paramagnetic and electroactive molecules are attracting interest as core components of molecular electronic and spintronic devices. Currently, further progress is hindered by the modest stability and reproducibility of the molecule/electrode contact. We report the synthesis of a persistent organic radical bearing one and two terminal alkyne groups to form Au-C σ bonds. The formation and stability of self-assembled monolayers and the electron transport through single-molecule junctions at room temperature have been studied. The combined analysis of both systems demonstrates that this linker forms a robust covalent bond with gold and a better-defined contact when compared to traditional sulfur-based linkers. Density functional theory and quantum transport calculations support the experimental observation highlighting a reduced variability of conductance values for the C-Au based junction. Our findings advance the quest for robustness and reproducibility of devices based on electroactive molecules.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.QN/van der Zant LabQN/Afdelingsburea
Beyond multiparametric MRI and towards radiomics to detect prostate cancer: A machine learning model to predict clinically significant lesions
No full textPostoperative outcomes of Fast Track enhanced recovery protocol in open radical cystectomy: comparison with standard management in a high-volume center and Trifecta proposal
No full textBACKGROUND: We aimed at comparing perioperative outcomes in patients submitted to radical cystectomy followed by Fast Track (FT) protocol or standard management, and propose a definition of Trifecta, to improve standardized quality assessment for RC.METHODS: We considered 191 patients submitted to RC between January 2017 and January 2019. Patients followed FT or standard management according to surgeon's preference. Preoperative and intraoperative characteristics, alongside with postoperative outcomes were compared between the two groups. Trifecta was defined as follows: inhospital stay (HS) ≤ 10 days, time to defecation (TtD) below the overall mean and no major (≥ Clavien-Dindo grade III) complications. Finally, Trifecta achievement rates were assessed in both groups.RESULTS: 75 patients (39%) followed the FT protocol and 116 (61%) standard management. The two groups were homogeneous for preoperative, intraoperative and pathological characteristics. Patients in the FT group had shorter TtD (5 vs. 6 days p=0.006), HS (12 vs. 14 days p=0.008) and lower readmission rate (8% vs. 19% p=0.04). Early complication rates and grades were similar, while less late complications were found in FT group (6.7% vs. 21.6% p=0,006). Trifecta achievement rate was higher for FT group (31% vs. 8% p<0.001). Single-item failure percentages for HS, TtD and major grade complications were respectively 90%, 60% and 19%, with no difference between the two groups.CONCLUSIONS: FT protocol can safely consent faster bowel recovery and earlier discharge after RC, plus reducing readmission rates. Using a Trifecta incorporating essential perioperative outcomes, could improve standardized quality assessment for RC
How does 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography impact the management of patients with prostate cancer recurrence after surgery?
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