Search Results (17)

Objectives: We aimed to quantify the damage burden measured using the Damage Index for Antiphospholipid Syndrome (DIAPS) in patients with antiphospholipid syndrome (APS) and identify patients with high damage as well as any correlations of damage with subclinical atherosclerosis. Methods: Patient damage was assessed via DIAPS. Based on demographic, clinical and laboratory characteristics, patients were divided into two subgroups: thrombotic APS patients with high vs. low damage, and non-thrombotic aPL-positive patients with vs. without damage. Participants underwent carotid/femoral ultrasound for atherosclerotic plaque detection and carotid–femoral and carotid-radial pulse wave velocity (PWV). Results: We included 112 patients with an APS diagnosis, 57 (50.9%) with primary APS and 55 (49.1%) with associated SLE. Cardiovascular (CVD) risk factors and complications were significantly more frequent in the thrombotic group, as well as in patients with high damage within the thrombotic group. We did not identify any risk factors for increased damage in the non-thrombotic group. Atherosclerotic plaque presence was present in 27 (24%) of the patients in this study with the same frequency in the APS and APS/SLE groups (p = 0.5446). Pulse wave velocity (PWV) was elevated in 27–32% patients according to analyzed arteries. Elevated PWV was more frequent in the APS group in comparison to APS/SLE only between carotid and radial arteries (p = 0.0012). Both atherosclerotic plaque presence and PWV did not correlate with damage severity. Conclusions: DIAPS indicates substantial damage in APS patients in our study. High organ damage mainly affected thrombotic patients and was related to CVD complications. At the same time, screening of subclinical atherosclerosis seems not to predict higher damage in APS patients. Full article

Background/objectives: Despite advancements in early diagnosis and clinical practices guided by standardized care protocols, Merkel cell carcinoma (MCC) is marked by an unfavorable prognosis with a 5-year relative survival rate of 65%, based primarily on data collected prior to the introduction of immunotherapy. Regional nodal metastases affect 40–50% of MCC patients, while approximately 33% experience distant dissemination. Among these, bone and bone marrow metastases are particularly notable, although the characteristics and clinical implications of this metastatic disease in MCC remain poorly understood. Methods: A comprehensive review was conducted using the Medline database (via PubMed) up to January 2025. The search strategy included the string “(Merkel cell carcinoma AND (bone OR marrow))”. Results: A total of 1133 (69.3% male and 30.7% female) patients diagnosed with advanced MCC were collected. The median (IQR) age at diagnosis was 67.5 (12.65) years old. Overall, 201 (20.8%) cases of bone and/or bone marrow metastases were identified and linked to a primary known MCC in 75.7% of cases. Bone metastases (BMs) appear as the third most common metastatic site, following the liver (second) and lymph nodes (first). They show mixed biological and radiological behavior, with a marked preference for the axial skeleton over the appendicular one. Addressing the characteristics of metastatic bone disease, neurological symptoms were the most documented, whereas bone marrow involvement and leukemic spread seemed to be primarily related to immunosuppression. Multimodal treatment strategies, including platinum-based chemotherapy and radiotherapy, were the primary approaches adopted, reflecting therapeutic practices from the pre-immunotherapy era. Conclusions: The pattern of metastatic spread in MCC differs among studies, with the bones resulting as the third most common site of distant spread. Excluding head and neck MCC, which seems to be more regularly associated with liver metastases, the relationship between the primary tumor site and the development of bone or bone marrow metastases appears inconsistent. Overall, BMs mostly correlated with advanced MCC stages and poorer survival outcomes, with a median overall survival (OS) of 8 months (range 12.75–4). The integration of international guidelines, evolving evidence from clinical trials, and the expanding role of immune checkpoint inhibitors (ICIs) will contribute to improving systemic disease control and enhance patient care. Full article

Focusing on the agricultural area of “Capo Due Rami” in Rome, this research aims to interpret the architectural features of the rural dwellings through a typological analysis. Drawing on data collected from direct surveys, historical records, cartographic materials, and documentary sources, the morphological and settlement evaluation of agricultural constructions refines traditional methods and techniques used in the analysis of residential models. Using specifically designed observation sheets, the study highlights how the reclamation and drainage works carried out predominantly between the 19th and 20th centuries in the area have influenced the typology of buildings and their relationship with the agricultural environment. The findings underscore that the morphotype of the dwellings in “Capo Due Rami” derives from the practical demands of agriculture and the functional requirements of rural life, incorporating targeted architectural solutions to address sanitary and environmental concerns. The observation sheets were designed to integrate qualitative indicators, drawing on previous investigative experiences in typological analysis. While adhering to established methodologies, they have been modified to reflect the cartographic and documentary data specific to “Capo Due Rami”. This approach has made it possible to highlight the distinctive features of the area, such as the proximity between buildings and reclamation canals. Full article

Among the land use–land cover products, tree cover maps are essential tools for assessing forest functionality and ecosystem services, and implementing sustainable forest management. By combining open-source and ancillary high-resolution cartographic datasets, this study aims to map trees and forests in the Latium region in central Italy, highlighting their spatial configuration, function, and forest typology. The main findings show that trees cover 44.2% of the regional land area. Forests cover 508,056 ha, forming the core matrix of the Latium mountain landscape, providing significant ecological and socio-economic value for forest management and the regional wood supply chain. Although trees outside the forest represent only 3.1% of regional tree cover, they play a crucial role in enhancing ecological connectivity and landscape resilience. Approximately 2% of the tree and forest cover occurs in urban areas, contributing significantly to climate regulation and air quality in densely populated environments. The dominant forest types in Lazio include Turkey oak, temperate broadleaf, beech, downy oak, and Holm oak, which together account for 58.6% of the total tree cover. The accuracy tests confirm the feasibility of using open-source data for reliable, cost-effective forest mapping. Regular updates of these maps can support continuous monitoring and promote sustainable forest management practices. Full article

Historical building reuse is aimed at preservation, where buildings are recovered for new uses connected to cultural activities. This paper presents the analysis of the impact of thermo-fluid dynamics due to a 500 kW electrical power transformer installed inside a historical building. The analysis is performed using computational fluid dynamics simulations validated through measurement campaigns carried out during the summer period. High temperatures and wide humidity variations can damage building plasters and cause malfunctions in power equipment. To avoid these situations, two different installation layouts were studied. One consists of the power transformer directly installed in the environment and cooled by an inlet fan, and the other consists of the power transformer being insulated from the external environment by an enclosure connected to a forced ventilation system. The second layout showed better results both inside and outside the transformer enclosure. The maximum indoor condition was about 4.3 °C, with a −7.2% RH and an airflow rate of 1100 m³/h, and the maximum outdoor air condition was 3.3 °C, with a −1.39% RH and a flow rate of 2200 m³/h. However, the temperatures and humidity inside the building and outside the transformer enclosure were almost the same. Full article

This paper aims to track the evolution of urban morphology studies, focusing on a graphical understanding of transformation phenomena in historical and contemporary city fabrics. It points out similarities in urban morphology studies by authors like Aldo Rossi, Carlo Oswald W. Ungers, Hans Kollhoff, Saverio Muratori, Gianfranco Caniggia, and Giancarlo de Carlo. These studies developed within a supportive cultural environment, aligning with analogical procedures and anticipating the contemporary concept of urban acupuncture. Urban acupuncture denotes episodic and locally impactful interventions countering grand, self-celebratory architectural projects. These interventions are promoted both by liberal and capitalist culture as well as by socialist-inspired culture. Lastly, these interventions, promoted by various cultural backgrounds, highlight the multi-scale nature of urban morphology studies and urban acupuncture projects. Each change in form corresponds to a morphological adaptation and a redefinition of urban rules and grammar usable in projects with territorial significance. Today, enhanced by digital tools, these studies confirm insights and syntheses, presenting urban acupuncture interventions in real-time socio-economic flows and dynamics. Full article

Gaze is a significant behavioral characteristic that can be used to reflect a person’s attention. In recent years, there has been a growing interest in estimating gaze from facial videos. However, gaze estimation remains a challenging problem due to variations in appearance and head poses. To address this, a framework for 3D gaze estimation using appearance cues is developed in this study. The framework begins with an end-to-end approach to detect facial landmarks. Subsequently, we employ a normalization method and improve the normalization method using orthogonal matrices and conduct comparative experiments to prove that the improved normalization method has a higher accuracy and a lower computational time in gaze estimation. Finally, we introduce a dual-branch convolutional neural network, named FG-Net, which processes the normalized images and extracts eye and face features through two branches. The extracted multi-features are then integrated and input into a fully connected layer to estimate the 3D gaze vectors. To evaluate the performance of our approach, we conduct ten-fold cross-validation experiments on two public datasets, namely MPIIGaze and EyeDiap, achieving remarkable accuracies of 3.11° and 2.75°, respectively. The results demonstrate the high effectiveness of our proposed framework, showcasing its state-of-the-art performance in 3D gaze estimation. Full article

Coronavirus disease-19 (COVID-19), caused by SARS-CoV-2, is a systemic disease that affects not only the respiratory system, but also other systems, including gastrointestinal. A great number of different drugs have been used on hospitalized patients for the management of COVID-19, and acute pancreatitis (AP) has been reported as a complication or side effect of these drugs. The development of drug-induced acute pancreatitis (DIAP) follows a complex of pathophysiological mechanisms, and particular risk factors play a key role. Diagnosis of DIAP depends on specific criteria, and based on these, a drug may be characterized as having a definite, probable or possible connection with AP. The aim of this review is to present the medications that are used for COVID-19 management and are associated with AP in hospitalized patients. The list of these drugs mainly includes corticosteroids, glucocorticoids, non-steroidal anti-inflammatory drugs (NSAIDs), antiviral agents, antibiotics, monoclonal antibodies, estrogens and anesthetic agents. Moreover, the prevention of the development of DIAP is vital, especially for critically ill patients who may receive multiple drugs. DIAP management is mainly non-invasive and the first step concerns the exception of the suspicious drug from patients therapy. Full article

We describe the risk factors for the development, timing, and severity of doxycycline induced acute pancreatitis (DIAP) in two case reports and a review of prior published cases, to better understand DIAP. Clinicians must maintain a high level of suspicion for DIAP in patients presenting with acute pancreatitis, while on doxycycline therapy. The latency and severity of DIAP are variable, making diagnosis challenging. Treatment includes bowel rest, hydration, and discontinuation of doxycycline. Full article

In recent decades, the relationship between soil and water has been at the center of many landscape architecture projects and, more in general, of urban transformation. With an ever-increasing recurrence, the interventions reflect on the positive effects of this dialectic, to the point of making it the constitutive element, both in terms of morphologies and of the reciprocal conditions of quality and resilience, combining ecosystem effects and cultural values. This paper thus examines some cases where the use of these elements has assumed the role of “raw material” in those design processes where they are called to specifically question the relationship between nature and human settlements. Three case studies, which with different declinations represent turning points and paradigmatic passages in this context, are here analyzed: the Cultuurpark Westergasfabriek in Amsterdam, the Cheong Gye Cheon canal in Seoul, and the Candlestick Park in the San Francisco Bay. Full article

Soil is one of the fundamental components for life on Earth, but today, as a consequence of humans’ unsustainable actions, soil is polluted, distressed and spoiled. In contemporary practice design, we recognize the importance of the soil quality to structure new discourses in landscape practice. The central role in this process is undoubtedly played by the value a healthy soil has for the community and for the environment. The strategic design of wet and hydric landscapes is certainly an essential aspect for the regular and exceptional management of the effects produced by pollution and climate change. The research develops the soil as a key subject in the landscape design, specifically in hydric environments where water represents an important factor. The essay is divided into three parts: resources and opportunities of disturbed wet soil, successfully built public space where soil remediation transformed heavy polluted industrial urban sites in fertile public ecosystems within the dense urban structures, and soil design as a domain of urban resilience. The landscape project as an integrated project has spread the seeds of a new approach to the consideration of the contemporary city in an ecological manner. Full article

During the past decades the Italian rural landscape has undergone drastic alterations as a result of complex and contradictory transformation dynamics. This paper aims to investigate and evaluate these alterations in Sardinia, one of the most rural Italian regions. Land-use maps from different years were studied to identify the dominant rural landscape features of the region and the transformations they were subjected to over the course of time. The analysis investigates changes on three geographical scales: region, provinces, and “agrarian regions”. An overall economic balance of landscape changes was calculated from the value ascribed to types of land use on the basis of the allowances (compensation for expropriation) provided by the local authorities (Provincial Commissions). This economic balance was considered in light of the regional policies which accompanied it. Results partially confirm the national and European general trend of loss of agricultural land when it is converted to new forms of exploitation. The analysis at different geographical scales has, in some cases, revealed data against the general trend, especially for some agricultural regions and for certain agricultural products. There is consistent with economic balance. This shows the need of a deep ex post evaluation of the effects of policies financed by regional and national community funds on the evolution of Sardinian landscapes. Full article

Rapid and unplanned urban growth is responsible for the continuous conversion of green or generally natural spaces into artificial surfaces. The high degree of imperviousness modifies the urban microclimate and no studies have quantified its influence on the surface temperature (ST) nearby residential building. This topic represents the aim of this study carried out during summer in different urban zones (densely urbanized or park/rural areas) of Parma (Northern Italy). Daytime and nighttime ASTER images, the local urban cartography and the Italian imperviousness databases were used. A reproducible/replicable framework was implemented named “Building Thermal Functional Area” (BTFA) useful to lead building-proxy thermal analyses by using remote sensing data. For each residential building (n = 8898), the BTFA was assessed and the correspondent ASTER-LST value (ST_BTFA) and the imperviousness density were calculated. Both daytime and nighttime ST_BTFA significantly (p < 0.001) increased when high levels of imperviousness density surrounded the residential buildings. These relationships were mostly consistent during daytime and in densely urbanized areas. ST_BTFA differences between urban and park/rural areas were higher during nighttime (above 1 °C) than daytime (about 0.5 °C). These results could help to identify “urban thermal Hot-Spots” that would benefit most from mitigation actions. Full article

In the major U.S. and European cities (e.g., Detroit, Seattle, San Francisco, London, Paris, etc.) that since 2007 have been feeling the effects of the international economic crisis, regeneration processes have been set up thanks, among other things, to the synergic impact generated by urban agriculture (UA). There are numerous and greatly varied effects, linked to localization, that are consistent with the paradigm of sustainable development, although the sporadic, spontaneous, and discontinued nature of UA conditions its capacity to strongly influence an entire community. With a view to enhancing the efficiency and effectiveness of urban agriculture, and to facilitating its planning, this study puts forward the implementation of an organized and multifunctional agro-urban system. The consent of the population involved is vital for the creation and implementation of the system, therefore ascertaining not only the existence but also the level of social appreciation of this resource is of paramount importance. With the aim of providing a suitable methodology for ascertaining the social appreciation of the stakeholders in the agro-urban system, the paper puts forward a deliberative monetary appraisal that combines an economic valuation based on hypothetic scenarios with direct, inclusive, and dialogic approaches. In this paper we present: (1) a general overview of the main characteristics of urban agriculture and related problems; (2) the principal methodological elements for defining and planning an agro-urban system; and (3) guidelines for a deliberative appraisal procedure related to an agro-urban system. Full article