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1.
22nd International Conference on Computational Science and Its Applications , ICCSA 2022 ; 13382 LNCS:439-456, 2022.
Article in English | Scopus | ID: covidwho-2013921

ABSTRACT

The combination of concerns about the Covid-19 pandemic and structural problems relating to social injustice, climate change, and public health requires a radical reorganisation of transport structures, urban services, and the built fabric of metropolitan regions. This need is central to the pandemic era’s public debate: more significantly, it is reflected in the stimuli to metropolitan and urban policies aimed at adapting regional and mobility plans in order to realise a model of a smart, inclusive, sustainable, competitive and resilient city. The paper proposes a comparative content analysis to investigate the SUMPs adopted by the Italian metropolitan cities of Milan and Bologna, as well as their modification via the adoption of emergency plans and adaptation strategies for the post-pandemic scenario. The study’s purpose is to deduce a set of transferable guidelines. Based on earlier research, this study selects the Metropolitan City of Cagliari as a case study for implementing the set of guidelines derived from the comparative content analysis. The study significantly contributes to urban studies by investigating the transformation of concepts and criteria that underpin transport and mobility policies in the Italian context. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

2.
Clinical and Translational Imaging ; 10(SUPPL 1):S97, 2022.
Article in English | EMBASE | ID: covidwho-1894699

ABSTRACT

Background-Aim: The inflammatory cascade in patients (pts) with COVID-19 may lead to pulmonary embolism (PE), worsening prognosis. Lung perfusion SPECT/CT (Q-scan) in symptomatic pts discharged after COVID-19 can confirm or rule out pulmonary vascular involvement, helping the differential diagnosis with other respiratory diseases. We aim to investigate an innovative methodology, based on radiomic features and formal methods, as a virtual second look able to detect perfusion abnormalities to better define appropriate patient-centered diagnostic and therapeutic strategies. Methods: A total of 23 pts with a recent history of COVID-19, without any previous pulmonary disease (e.g. lung cancer, emphysema, or pathological findings at CT such as lung bullae) were enrolled for Q-scan for persistent dyspnea 1 month after discharge. They were classified as negative (14 pts) and positive (9 pts) for lung perfusion abnormalities by visual and semiquantitative analysis. Q-Lung® software by GE Healthcare was used to obtain percent evaluation of pulmonary lobar perfusion (cts/volume % for each lobe), assuming as a normal value any defect lower than 10% for each lobe. We analysed these data using an innovative methodology based on formal methods techniques centered on mathematical logical reasoning, to build a formal and rigorous representation of a system merging patients clinical conditions and disease-specific characteristics, to confirm or exclude the disease. Results: In a comparative analysis with Q-Scan results, the model showed concordant features in 13/23 pts, identifying perfusion defects in 8/9 pts with a positive Q-Scan, and excluding perfusion defects in 5/14 pts with a negative Q-Scan. Discordant results were observed in the remaining 10/23 pts, in particular in negative pts: however, in this sub-group, the Q-Lung semiquantitative analysis revealed perfusion defects lower than 10% per lobe, which we considered unsignificant but may deserve further evaluation. Conclusions: Although our data are still preliminary and based on a limited population, this methodology based on formal methods showed promising concordance with Q-scan results and needs to be implemented with further analyses including co-registered CT data. When compared to artificial intelligence techniques, this mathematical reasoning may enable (i) to use a reduced dataset of patients and/ or images, without having any impact on the robustness of the model;(ii) to produce an intuitive model easy to understand;(iii) to represent a rigorous and formal tool that may be used by medical specialists in a clinical setting.

3.
Clinical and Translational Imaging ; 10(SUPPL 1):S91-S92, 2022.
Article in English | EMBASE | ID: covidwho-1894690

ABSTRACT

Background-Aim: Post-mortem studies showed that in patients with COVID-19 the poor prognosis is due not only to the worsening of the ventilation function but it can be related to the perfusion impairment due to massive pulmonary thrombosis or micro-thromboembolism. We aimed to investigate the clinical impact of lung perfusion (Q) scintigraphy in patients discharged after COVID-19 disease but still symptomatic for dyspnea. Methods: 33 patients (pts), discharged at least 1 month after COVID- 19, underwent Q scan at T0 (1-3 months after acute disease) and at T1 (after 6 months if lung perfusion defects were evident at T0). Inclusion criteria were (1) residual dyspnea: mild (12/33pts), at minimal motor activity (9/33) and after prolonged effort (12/33), (2) No thromboembolism at CT pulmonary angiography during hospitalization. Exclusion criteria were: previous history of lung disease (e.g. Cancer, COPD, emphysema) or abnormal pulmonary CT findings (e.g. lung bullae). Planar and Q-SPECT/CT images were obtained for evaluation of lobar or segmental or subsegmental peripheral perfusion defects for each bronchopulmonary segment. Perfusion images were qualitatively and semiquantitatively analysed. Q-lung software by GE Healthcare was used for SPECT/CT images for obtaining percent evaluation of pulmonary lobar perfusion (counts/volume % for each lobe), considering as normal a value of defect within: - 5%/each lobe, if represented in ≥ 1 lobe. Q-scan was then compared with high resolution CT (HRCT) obtained during hospitalization in the acute phase (T-acute) and repeated after 1-3 months (T0). Significant pulmonary perfusion defects at Q scan were considered for addressing targeted therapy. Results: At T0: preserved lung perfusion was observed in 17/33 pts, thus excluding the vascular cause for the symptoms. Lung perfusion defects were detected in 16/33 patients who underwent T0 and T1 control. Defects were scored as following: severe (7 pts with dyspnea at minimal motor activity), at least one wedge-shaped peripheral defect estimated as ≥ 50% of a pulmonary segment without corresponding HRCT abnormalities, suggesting a new CTPA within 3 months and an appropriate therapeutic strategy;moderate (6 pts with dyspnea after prolonged effort): consisting in multiple (>3) subsegmental defects;-mild: (3 pts with mild dyspnea ≤ 3 sub-segmental defects). At T1 lung perfusion improvement (≥ 10% vs pathological lobe in T0), was observed in a total of 8/16 pts. Conclusions: In the age of precision medicine, Q scan-SPECT/CT in pts with recent COVID-19 can address clinical knowledge and management of SARS-CoV-2-induced lung abnormalities, suggesting the differential diagnosis with respiratory disease of different etiology and the appropriate patient-centered therapeutic strategies.

6.
25th International Conference Living and Walking in Cities, LWC 2021 ; 60:314-321, 2022.
Article in English | Scopus | ID: covidwho-1671243

ABSTRACT

Growing spatial and social injustice, vulnerability to environmental hazards, and the Covid-19 pandemic have underlined the need of a radical re-conceptualization and transformation of Public Open Spaces (POSs). Within this perspective, the usability of the public space emerges as a fundamental condition that influences the individuals’ well-being by affecting central human capabilities, including bodily health and integrity, control over the environment, and attachment to people, objects, and places. Usability is herein defined as the potential of spaces to expand human capabilities by supporting autonomy, active mobility and utilitarian, leisure and social activities. Consequently, with a combination of space syntax and spatial analysis techniques, this study structures an analytical method to identify central spaces for pedestrian activity, assess their usability and underline major criticalities. The analytical method encompasses a set of quantitative indicators related to both intrinsic geometric, functional, social attributes and to configurational extrinsic properties of spaces. The case study concerns public spaces within the historical district of Villanova, Cagliari, Italy. The case study analysis will underline that the integration of space syntax techniques and spatial analysis methods is instrumental to the comprehensive understanding of intrinsic and extrinsic spatial attributes affecting patterns of outdoor activities, and to the identification of intervention priorities with regards to the redevelopment and regeneration of public spaces. Consequently, this study represents a valid contribution to the topic of Active mobility and urban redevelopment, in the urban planning session of the conference. In conclusion, the study underlines the relevance of the proposed analytical method as a framework supporting data-informed design solutions and smart decisions within a planning perspective centred on strengthening inclusion and equality of the urban realm. © 2022 The Authors. Published by ELSEVIER B.V. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0)

7.
Circulation ; 144(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1632481

ABSTRACT

Introduction: Neuropilin-1 has been recently identified as a co-factor needed for the entry of SARSCoV-2 in host cells and has been linked to neurologic symptoms of COVID-19 (Science 2020). Emerging evidence indicates that exosomal microRNAs (miRNAs) are involved in a number of physiologic and pathologic processes. However, to our knowledge, exosomal miRNAs have not been hitherto investigated in COVID-19. Hypothesis: Since we have recently demonstrated that miR-24 targets the 3'UTR of the gene encoding for Neuropilin-1 and this miRNA is expressed in human brain endothelial cells, we hypothesized an association between plasma levels of CD31 extracellular vesicles (EVs) enriched in miR-24 and the risk of cerebrovascular manifestations in patients hospitalized for COVID-19. Methods and Results: We obtained plasma from >300 COVID-19 patients;as control COVID-19 negative populations, we obtained plasma from healthy donors and patients hospitalized for cerebrovascular disorders. CD31 EVs were isolated from plasma on hospital admission, and miR24 levels were quantified. When comparing patients with vs without cerebrovascular disorders, we found that plasma levels of CD31 EV miR-24 were significantly different between these populations. We did not find any significant difference among groups when assessing circulating free levels of miR-24. Using a multiple regression analysis, adjusting for age, hypertension, and diabetes, the association between EV miR-24 and cerebrovascular complications in COVID-19 patients was confirmed (P<0.05). Conclusions: This is the first study showing a significant association between EV non-coding RNAs and clinical outcome in COVID-19 patients. Our results are relevant for basic researchers, because we identified an unprecedented significant association between EV miR-24 and cerebrovascular disorders, which could be helpful to better understand the molecular mechanisms underlying the pathophysiology of cerebrovascular events in COVID-19, as well as for clinicians, inasmuch as this association may help healthcare professionals in identifying COVID-19 patients who are at high risk of developing cerebrovascular disease.

8.
European Journal of Nuclear Medicine and Molecular Imaging ; 48(SUPPL 1):S404-S404, 2021.
Article in English | Web of Science | ID: covidwho-1609910
9.
21st International Conference on Computational Science and Its Applications, ICCSA 2021 ; 12958 LNCS:525-541, 2021.
Article in English | Scopus | ID: covidwho-1446084

ABSTRACT

The environmental issues and, in recent years, the Covid-19 pandemic determined an increasing consensus around the need for urban policies aimed at re-shaping the urban realm. The issue of equality and the related conditions of accessibility and usability emerge as critical requirements in the re-shaping of the urban landscape and mobility. As a consequence, the proposed article discusses a comprehensive literature review on the topics of usability and accessibility and of the complementary notions of disability and exclusion. The objectives of the literature review are to define a taxonomy of the different dimensions of usability and accessibility, to assess the relevance of the different forms of usability and accessibility across disciplinary fields related to urban and transportation studies, to identify the co-relations among specific aspects of urbanity and mobility and conditions of accessibility and usability. The proposed literature review is the preliminary stage of a study aimed at defining a methodological framework for quantitatively describing the urban environment in terms of its accessibility and usability. The proposed defines the theoretical framework of an analysis method for evaluating inequality incorporated into the urban environment and for facilitating smart decisions and holistic design in the context of urban planning. © 2021, Springer Nature Switzerland AG.

10.
Minerva Pneumologica ; 59(2):24-26, 2020.
Article in English | EMBASE | ID: covidwho-846138

ABSTRACT

BACKGROUND: High flow nasal cannula (HFNC) showed better oxygenation than standard oxygen therapy delivered through a face mask in acute respiratory failure for all causes. HFNC may offer an alternative in patients with acute hypoxemia and potentially reduce mortality. It was widely applied in China during the COVID-19 emergency. However, no data have been published about settings and protocols. The purpose of this paper was to report a single center experience on effectiveness and safety of HFNC in weaning of COVID-19 associated respiratory failure. METHODS: We retrospectively analyzed patient records from Sub-intensive Care Unit (Cotugno Hospital, Naples, Italy). Four patients (3F;age: 60±9.23 years;BMI: 27.5±5.2) were de-escalated from ventilation (3 Helmet CPAP, 1 invasive mechanical ventilation) to HFNC oxygen therapy. All patients were admitted for severe acute respiratory failure and pneumonia due to SARS-COV-2 (PaO2/Fio2 at baseline: 104±42.3 mmHg) and showed a typical progressive stage at chest imaging. Weaning was initiated following a stable period of ventilation (PaO2/Fio2 in last days of first respiratory support: 377±60.2 mmHg). HFNC was set on 34 °C, with flow ranging from 50 to 60 L/min and FiO2 from 40 to 60%. RESULTS: Right after initiation of HFNC (day 1), the mean PaO2/Fio2 was 238 mmHg (±65), without clinical signs of respiratory distress. No difference was observed on lactate. After 3 days of therapy mean PaO2/Fio2 increased to 377 mmHg (±106.3). All patients recovered from respiratory failure (PaO2>60 mmHg in room air) after 7 days (±3.2). CONCLUSIONS: HFNC might be helpful in weaning severe respiratory distress. Clinical effectiveness and comfort should be assessed within 3 days. The correct timing should be ruled by PaO2/Fio2 during ventilation and clinical signs of distress. Further evidence is required for firm conclusions.

11.
Minerva Pneumologica ; 59(2):47-48, 2020.
Article in English | EMBASE | ID: covidwho-845667
12.
Minerva Pneumologica ; 59(2):41-43, 2020.
Article in English | EMBASE | ID: covidwho-845666

ABSTRACT

The coronavirus disease 2019 (COVID-19) pneumonia was a recent worldwide outbreak. During chest computed tomography (CT) we may observe pulmonary parenchymal opacity, as sign of COVID-19. Very few have reported pneumothorax and pneumomediastinum as complications of severe COVID-19 pneumonia. We describe a 44-year-old male admitted to our department after the onset of sudden chest pain and high fever and evidence on computed tomography of spontaneous pneumothorax and pneumomediastinum, subsequently confirming COVID-19 pneumonia.

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