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1.
International Journal of Environmental Research and Public Health ; 19(24):16741, 2022.
Article in English | MDPI | ID: covidwho-2163366

ABSTRACT

Introduction: The COVID-19 pandemic stressed the necessity of a new resilience of the human population and health system. The "WeCare Generation" program is a new proposal of territorial intervention, with a new paradigm, on the diseases of the human body and mind. Background: In recent decades, the independent strands of investigation on brain plasticity and early trauma consequences have demonstrated that traumatic experiences in the period from pregnancy to the age of 3 years have an enormous impact on an individual's future development, and both physical and mental health. Research shows that adverse child experiences (ACEs) are associated with a strong risk of conditions such as: harmful alcohol use, smoking, illicit drug use, high body-mass index, depression, anxiety, interpersonal violence, cancer, type 2 diabetes, cardiovascular diseases, stroke respiratory diseases and, as a consequence, to a high financial cost in Italy and also across Europe (1-9% GDP) and the USA (total annual costs estimated to be USD 581 billion in Europe and USD 748 billion in North America). All this suggests that an early intervention on that traumatized-slice of population leads to multiplied savings. Methods: A multi-center, randomized, controlled trial was designed. The parents of the future neonatal population (from pregnancy to delivery) with trauma will be enrolled, and randomized to treatment, or control arm. The article describes in detail how the primary outpoint (cost to the national health system), and some secondary outpoints, will be collected. Discussion: An overall rate of return on investment (ROI) statistically significant 13.0% per annum with an associated benefit/cost ratio (BCR) of 6.3 is expected as the primary outcome of the "WeCare Generation" program. Our proposed model predicts a new medical paradigm aiming to empower new generations, with a strong return on economy and health.

3.
Applied Sciences ; 12(15):7614, 2022.
Article in English | MDPI | ID: covidwho-1969073

ABSTRACT

The advent of modern digital technologies offers new opportunities to improve the performance of manufacturing systems from design to monitoring and control during operation. At the same time, the recent COVID-19 pandemic has highlighted the fragility of all global supply chains and manufacturing systems. In this paper, a simulation-based framework, exploiting the benefits of the digital model concept, is proposed. It aims at: (1) supporting manufacturing design to effectively start a new business, (2) assessing the resilience of a manufacturing system in the face of disruptions, (3) evaluating the goodness of possible strategies to deal with COVID-like crises. The validity of the proposed framework is successfully demonstrated through a real-life case study, referring to the wood sector. The results show that a lack of system preparedness can lead to productivity reductions of up to 31.8%. At the same time, having the ability to react to unexpected events can limit damage and increase productivity by 26% compared to not reacting.

4.
Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale ; 42(Suppl 1):S20-S35, 2022.
Article in English | EuropePMC | ID: covidwho-1871870

ABSTRACT

SUMMARY Only a few studies have assessed smell and taste in Coronavirus Disease 2019 (COVID-19) patients with psychophysical tests, while the majority performed self-rating evaluations. Given the heterogeneity of the published literature, the aim of this review was to systematically analyse the articles on this topic with a focus on psychophysical testing. A search on PubMed and Web of Science from December 2019, to November 2021, with cross-references, was executed. The main eligibility criteria were English-language articles, investigating the clinical features of olfaction and gustation in COVID-19 patients using self-rating assessment, psychophysical testing and imaging techniques. A total of 638 articles were identified and 66 were included. Self-rating assessment was performed in 31 studies, while psychophysical testing in 30 and imaging techniques in 5. The prevalence of chemosensory dysfunction was the most investigated topic, followed by the recovery time. About the psychophysical assessment, the extended version of the Sniffin’ Sticks was used in 11 articles and the Connecticut Chemosensory Clinical Research Center test in another 11. The olfactory threshold performance was the most impacted compared to the discrimination and identification capacities in accordance with the hypothesis of a tropism of SARS-CoV-2 for the olfactory mucosa. The timing significantly influenced the results of the psychophysical testing with 20% of patients presenting olfactory dysfunction at one month after infection.

6.
Comput Ind Eng ; 169: 108158, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1778038

ABSTRACT

During the SARS-CoV-2 pandemic (also known as COVID-19), workforce downsizing needs, safety requirements, supply chain breaks and inventory shortages affected manufacturing systems' and supply chain's responsiveness and resilience. Companies wandered in a disrupted scenario because recommended actions/strategies to survive - and thrive - were not available an improvised actions to keep their operations up and running. This paper analyzes the COVID-19 impacts on the workforce and supply resilience in a holistic manner. The following research questions are discussed: (i) how can manufacturing firms cope with urgent staff deficiencies while sustaining at the same time a healthy and safe workforce in the perspective of socially sustainable and human-centric cyber-physical production systems?; (ii) is remote working (cf. smart working) applicable to shop-floor workers?; (iii) is it possible to overcome supply chain breaks without stopping production? In the first part, we propose three Industry 4.0-driven solutions that would increase the workforce resilience, namely: (i) the Plug-and-Play worker; (ii) the Remote Operator 4.0; (iii) the Predictive Health of the Operational Staff. In the second part, the concepts of (i) Digital & Unconventional Sourcing, i.e. Additive Manufacturing, and (ii) Product/Process Innovation are investigated from a novel business continuity and integration perspective. We ultimately argue that forward-looking manufacturing companies should turn a disruptive event like a pandemic in an opportunity for digital and technological innovation of the workplace inspired by the principles of harmonic digital innovation (that places the human well-being at the center). These aspects are discussed with use cases, system prototypes and results from research projects carried out by the authors and real-world examples arising lessons learned and insights useful for scientists, researchers and managers.

7.
Acta Biomed ; 93(1): e2022015, 2022 03 14.
Article in English | MEDLINE | ID: covidwho-1754146

ABSTRACT

Platypnea-Orthodeoxia Syndrome (POS) is a clinical entity defined as positional dyspnoea (platypnea) and arterial desaturation (orthodeoxia) that occurs when sitting or standing up and usually resolves by lying down. Up to April 25th 2021, eleven cases of POS after SARS-CoV-2 pneumonia have been reported on Pubmed. Accordingly, SARS-CoV-2 infection may be considered as an emergent cause of POS due to an increase in ventilation/perfusion (V/Q) mismatch. In this article we provide an update on the patient with POS after fibrotic evolution of SARS-CoV-2 interstitial pneumonia, which we previously reported and we discuss the case reports of POS due to SARS-CoV-2 infection.


Subject(s)
COVID-19 , Lung Diseases, Interstitial , COVID-19/complications , Dyspnea/etiology , Humans , Lung Diseases, Interstitial/complications , Lung Diseases, Interstitial/diagnosis , Posture , SARS-CoV-2
8.
Exp Ther Med ; 22(5): 1298, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1448966

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the recent Coronavirus Disease 2019 (COVID-19) pandemic, which has spread all over the world over the past year. Comorbidities appear to affect the prognosis of patients with such diseases, but the impact of cancer on the course of SARS-CoV2 has remained largely elusive. The aim of the present study is to analyze the outcome of patients affected by squamous cell carcinoma of the head and neck (SCCHN) and a number of their comorbidities, if infected with SARS-CoV2. The clinical data of 100 patients affected by SCCHN, who were undergoing treatment or who had finished their oncologic treatment in the past 6 months, were retrospectively collected and analysed. For each patient, the Charlson Comorbidity Index (CCI) was calculated to provide a score assessing the real weight of comorbidities on the patient's outcome at the time of diagnosis. It was discovered that these patients, besides the SCCHN, frequently presented at diagnosis with several other comorbidities, including hypertension, type 2 diabetes, cardiac arrhytmia, chronic obstructive pulmonary disease and various forms of vasculopathy (and thus a poor CCI). This feature suggest that, given the high frequency of various comorbidities in patients with SCCHN, additional SARS-CoV2 infection could have particularly devastating consequences.

9.
Acta Biomed ; 91(3): ahead of print, 2020 08 10.
Article in English | MEDLINE | ID: covidwho-1389954

ABSTRACT

Platypnea-orthodeoxia syndrome (POS) is a clinical entity characterized by positional dyspnoea (platypnea) and arterial desaturation (orthodeoxia) that occurs when sitting or standing up and usually resolves by lying down. POS may result from some cardiopulmonary disorders or from other miscellaneous aetiologies. We report a case of POS in a patient after fibrotic evolution of SARS-CoV-2 interstitial pneumonia associated with pulmonary embolism. The patient did not have any evidence of an intracardiac/intrapulmonary shunt.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Dyspnea/etiology , Lung Diseases, Interstitial/complications , Lung/diagnostic imaging , Pneumonia, Viral/complications , Aged , COVID-19 , Coronavirus Infections/diagnosis , Dyspnea/diagnosis , Female , Humans , Lung Diseases, Interstitial/diagnosis , Pandemics , Pneumonia, Viral/diagnosis , SARS-CoV-2 , Tomography, X-Ray Computed
10.
Acta Biomed ; 92(2): e2021207, 2021 05 12.
Article in English | MEDLINE | ID: covidwho-1229618

ABSTRACT

BACKGROUND AND AIM: The aim of this research was to review the articles published by the Otolaryngology (ORL) departments of the Italian University Hospitals in 2019 and in 2020 in order to analyze the impact of the COVID-19 pandemic on the academic production. METHODS: PubMed and Scopus were searched for the articles published by the ORL departments of the Italian Universities in 2019 and in 2020. The main eligibility criteria were English-language articles, while there were no exclusion criteria related to topic. The articles were classified into seven domains corresponding to the main ORL subspecialties. RESULTS: There was an overall increase in the number of articles by the 42.2% in 2020. Publications pertaining Rhinology and Laryngology increased more significantly in 2020, respectively by the 50.5% and 72.2%. Additionally, there was an increase in the number of articles concerning topics of general interest, by the 95.2% in 2020. Also, the citation trends of the articles published by the Italian University Hospitals increased remarkably in 2020. CONCLUSIONS: These results evidenced an overall increase in the number of ORL articles. Although 2020 is going to be remembered as a year to forget, it should be acknowledged for being the "golden year of research".


Subject(s)
COVID-19 , Otolaryngology , Humans , Italy , Language , Pandemics , SARS-CoV-2
11.
Infect Agent Cancer ; 16(1): 9, 2021 Feb 05.
Article in English | MEDLINE | ID: covidwho-1067250

ABSTRACT

BACKGROUND: The medical community has been deeply involved in fighting the Coronavirus disease 2019 (COVID-19) pandemic and, as a consequence, the care of non-COVID-19 patients has been impacted. However, the treatment of head and neck cancer patients is not deferrable, and an integrated strategy is required. The aim of the current article is to present the experience in the management of head and neck patients during the COVID-19 pandemic at the research hospital "Casa Sollievo della Sofferenza". This review contains replicable and widely usable instructions on how to avoid delays in the diagnosis and treatment of head and neck tumors and to ensure a gradual return to elective procedures. MAIN TEXT: The Head and Neck Department of the research hospital "Casa Sollievo della Sofferenza" includes an Otolaryngology and a Maxillofacial Surgery Unit, both of which deal with the diagnosis and treatment of benign and malignant pathologies of the head and neck, as well as urgent/emergent consultations and surgical procedures that necessitate time sensitive operative management, such as cochlear implantation (CI). Given these premises and the complexity of the Department, the "COVID-19 organizing protocol" of the research hospital "Casa Sollievo della Sofferenza" was divided into two phases in accordance with the different stages of the pandemic and the priority of treatment. Special attention was given to the medical surveillance of health care workers and hospitalized patients, to the organization of the outpatient clinic and the operating setting as well as to the implementation of telehealth systems. CONCLUSIONS: The COVID-19 pandemic is going to be a long-term situation with lasting effects on the public health and the entire society. Therefore, an efficient health care system has to adopt a double strategy: always being ready for a "new wave" of the pandemic and not forgetting non-COVID-19 patients, among whom head and neck cancer patients represent a priority. More than 1 year since the first outbreak in Wuhan, this review offers a unique and helpful perspective that incorporates awareness of the disease.

12.
Acta Biomed ; 91(3): e2020035, 2020 09 07.
Article in English | MEDLINE | ID: covidwho-982594

ABSTRACT

The novel coronavirus SARS-CoV-2 was first identified in China in December 2019 and has since spread worldwide. People with Cystic Fibrosis (CF) have reduced survival mainly because of respiratory failure due to chronic pulmonary infections. Therefore, CF patients should be considered to have an increased risk of developing severe manifestations in case of SARS-CoV-2 infection. Surprisingly, the results of recent studies concerning SARS-CoV-2 infection in patients with CF show that in these patients the infection rate was lower than that of the general population. Various factors have been considered to explain a possible protective effect of CF against SARS-CoV-2 infection.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Cystic Fibrosis/epidemiology , Lung/diagnostic imaging , Pandemics , Pneumonia, Viral/epidemiology , Tomography, X-Ray Computed/methods , COVID-19 , Comorbidity , Cystic Fibrosis/diagnosis , Humans , SARS-CoV-2
13.
Health Econ Policy Law ; 16(3): 340-354, 2021 07.
Article in English | MEDLINE | ID: covidwho-962233

ABSTRACT

This paper argues that a certain level of indeterminacy in policy design may be a factor facilitating rather than hindering system-level change in welfare governance arrangements, provided it is combined with the triggering of specific concatenations of social mechanisms shaping the dynamics of the change process. The argument is illustrated by an analysis of a case of systemic change in chronic disease management occurred in the Italian region of Lombardy over 2016-2017, when a radically novel governance of chronic disease for the 10 million population was put in place (a health care system that was later tested to its limits by the COVID-19 pandemic outburst which reached dramatic intensity in this region). This represented a major change in a key area of social and health policy. We claim that such change processes may be studied by means of the conceptual tools of social mechanisms. The analysis of social mechanisms represents a lively research agenda for explaining change in public governance and public policy.


Subject(s)
Delivery of Health Care/organization & administration , Government , Health Policy , Public Policy , Social Welfare , Chronic Disease , Disease Management , Humans , Italy , Organizational Innovation
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