The ancient Digital Terrain Model and the infrastructure of the Etruscan city of Kainua

This paper aims to explain the creation of the Digital Terrain Model (DTM) of Kainua, an Etruscan city founded, following a rigorous urban plan, at the beginning of the 5th century BCE. This DTM was used as the basis for the virtual reconstruction of Kainua landscape from an urban to an architectural scale in a three-dimensional digital model, visualized in an interactive and immersive approach. The DTM was developed using different sources of elevation data, in order to take into account the geo-morphological transformations occurred in that area from the Etruscan period to the present day. The causes of these changes were natural (due to erosion phenomena) and anthropic (due to excavations for construction of transport infrastructure as well as those which occurred partly due to improvements made by landowners and partly to archaeologists who first began a systematic campaign of site studies). On positioning on the DTM, an analysis of the metrology and of the infrastructure of the ancient city (streets and sewers) made it possible to create a renewed vision and to propose a hypothesis for reconstructing the incomplete, or as yet unstudied, parts of the city, which only further excavations will confirm

Louise de Keralio reads the biography of Charles V written by Christine de Pizan: a comparison of two female intellectuals who lived four centuries apart

Un'originale intellettuale donna vissuta in Francia alla fine del XVIII secolo commenta all'interno di un'opera dedicata alla produzione femminile di testi le opere scritte da Christine de Pizan. In questo articolo ci si occupa in particolare della lettura e commento della biografia di Carlo V composta da Christine de Pizan (1365-1431), prima opera storica scritta da una donna

Gestione di rifiuti acquosi ad alto carico da processi farmaceutici

Lo scopo del presente lavoro è rivolto alla valutazione dei possibili metodi di abbattimento del carico inquinante presente in quattro tipologie di reflui acquosi provenienti da determinati processi farmaceutici. Una volta elaborata l’ipotesi di processo, sarà possibile valutare il destino degli effluenti acquosi e delle specie inquinanti separate, in termini di smaltimento secondo i limiti imposti dalla normativa vigente, ovvero in termini di un loro possibile recupero e riutilizzo nei processi di sintesi

Interrelation of ST-segment depression during bicycle ergometry and extent of myocardial ischaemia by myocardial perfusion SPECT

Purpose: The aim of this study was to compare ST-segment depression (STD) during bicycle ergometry and extent of myocardial ischaemia assessed by myocardial perfusion SPECT (MPS) in a large patient cohort. Methods: Consecutive patients (n = 955) referred for MPS with bicycle ergometry and interpretable stress ECG were evaluated with respect to ECG and MPS findings of ischaemia. The maximal STD was recorded and exercise ECG was considered ischaemic if STD was horizontal or downsloping (≥1mm). MPS was interpreted using a 20-segment model with a scale of 0 to 4. A summed stress (SSS), summed rest (SRS) and summed difference score (SDS = SSS−SRS, e.g. extent of ischaemia) were derived. Ischaemia was defined as an SDS ≥ 2. Results: An exercise-induced STD was present in 215 patients (22%) and myocardial ischaemia on MPS was present in 366 patients (38%). The extent of ST-segment depression and the number of ECG leads with significant STD were each strongly and significantly associated with increasing severity of ischaemia and the number of coronary territories involved (p < 0.01 for all correlations). Conclusion: These data demonstrate a strong correlation between the extent of STD, number of ischaemic leads and severity of myocardial ischaemia as assessed by MPS during bicycle ergometr

Gate-keeper to coronary angiography: comparison of exercise testing, myocardial perfusion SPECT and individually tailored approach for risk stratification

We aimed to evaluate the differences between exercise testing (ET), myocardial perfusion SPECT (MPS) and a combination of ET and MPS based risk assessment as outlined by the guidelines with respect to their "gate-keeper” role to coronary angiography (cath) and the associated diagnostic procedural costs if prognostic considerations, as those proposed by the current guidelines and the recent literature, were taken into account. The Duke-score and the summed difference score (SDS; extent of ischemia) were assessed in 955 consecutive patients referred for MPS combined with ET. According to the guidelines and the available literature, three different algorithms for risk stratification were retrospectively applied: (1) ET based risk stratification and cath if intermediate or high risk Duke-score; (2) MPS based risk stratification and cath if SDS≥8; (3) combined approach with ET as first step and MPS in case of intermediate risk Duke-score. A cath would have been suggested in every patient with either high risk Duke-score or SDS≥8 in patients with intermediate risk Duke-score. The referral rate to cath was 27% according to the ET alone, 13% using MPS, and finally 12% applying the combined risk stratification. The cost of the diagnostic work-up including cath were: 615€, 1'299€, and 598€ per patient, respectively. The coronary angiography referral rate widely depends on the diagnostic modality used for risk stratification and according to the referral criteria provided by the guidelines. In the present study, the use of a stress imaging modality (MPS) and published prognostic data was associated with a lower referral rate to cath as compared to exercise testing alone and thus underlines the advantage of a risk based approach applying stress imaging in patients with intermediate risk Duke-scor

Individual dosage of digoxin in patients with heart failure

Backgroud: After the publication of DIG trial, the therapeutic target of serum digoxin concentration (SDC) for the treatment of heart failure (HF) has been lowered (0.40-1.00 ng/ml). However, the majority of equations to calculate digoxin dosages were developed for higher SDCs. Recently, a new equation was validated in Asian population for low SDCs by Konishi et al., but results in Caucasians are unknown. Aim: This study was aimed to test the Konishi equation in Caucasians specifically targeting low SDCs. Furthermore, the Konishi equation was compared with other frequently used equations. Design: This was a prospective, multicenter study. Methods: Clinically indicated digoxin was given in 40 HF patients. The dosage was calculated with the Konishi equation. The SDC was measured at 1 and 6 months after starting digoxin. Adherence to digoxin was monitored with a specific questionnaire. Results: After exclusion of patients admitting poor adherence, we found a reasonable correlation between predicted and measured SDC (r = 0.48; P < 0.01) by the Konishi equation. Excluding patients with poor adherence and relevant worsening of renal function, the measured SDC (n = 54 measurements) was within the pre-defined therapeutic range in 95% of the cases. The mean, maximal and minimal measured SDC were 0.69 ± 0.19, 1.00 and 0.32 ng/ml, respectively. The correlation was weaker for the Jelliffe, the Koup and Jusko, and the Bauman equations. Conclusions: This study supports the clinical validity of the Konishi equation for calculating individual digoxin dosage in Caucasians, targeting SDCs according to current HF guideline

Clothing, race and identity : sumptuary laws in colonial Spanish America

On holidays and other festive occasions, Andean peoples in the Spanish Viceroyalty of Peru liked to dress up. According to sixteenth - century documents, wealthy Amerindians in Lima, Quito and other colonial cities enjoyed wearing a combination of European and Andean garments, sometimes made of silk and other expensive, imported fabrics. Their sartorial exuberance annoyed local Spaniards, who issued repeated orders prohibiting Amerindians from wearing a range of garments containing silk, velvet, Holland cloth, lace and other embellishments. The indigenous elite did not accept these prohibitions without protest. In 1593, members of the Amerindian community in Quito wrote to Emperor Philip II to complain that ‘as conquered people it sometimes happens that officials and other people undress them and take their clothing, saying that they can wear only cotton, which causes them much trouble and vexation

Novel hydroxyapatite/carboxymethylchitosan composite scaffolds prepared through an innovative ‘‘autocatalytic’’ electroless coprecipitation route

A developmental composite scaffold for bone tissue engineering applications composed of hydroxyapatite (HA) and carboxymethylchitosan (CMC) was obtained using a coprecipitation method, which is based on the ‘‘autocatalytic’’ electroless deposition route. The results revealed that the pores of the scaffold were regular, interconnected, and possess a size in the range of 20–500 lm. Furthermore, the Fourier transform infra-red spectrum of the composite scaffolds exhibited all the characteristic peaks of apatite, and the appearance of typical bands from CMC, thus showing that coprecipitation of both organic and inorganic phases was effective. The X-ray diffraction pattern of composite scaffolds demonstrated that calciumphosphates consisted of crystalline HA. From microcomputed tomography analysis, it was possible to determine that composite scaffolds possess a 58.9% 6 6% of porosity. The 2D morphometric analysis demonstrated that on average the scaffolds consisted of 24% HA and 76% CMC. The mechanical properties were assessed using compressive tests, both in dry and wet states. Additionally, in vitro tests were carried out to evaluate the wateruptake capability, weight loss, and bioactive behavior of the composite scaffolds. The novel hydroxyapatite/ carboxymethylchitosan composite scaffolds showed promise whenever degradability and bioactivity are simultaneously desired, as in the case of bone tissue-engineering scaffolding applications.Contract grant sponsor: European Union (STREP Project HIPPOCRATES); contract grant number: NMP3-CT-2003-50575

End-of-life preferences of elderly patients with chronic heart failure

Aims Elderly heart failure (HF) patients are assumed to prefer improved quality of life over longevity, but sufficient data are lacking. Therefore, we assessed the willingness to trade survival time for quality-of-life (QoL) and the preferences for resuscitation. Methods and results At baseline and after 12 and 18 months, 622 HF patients aged ≥60 years (77 ± 8 years, 74% NYHA-class ≥III) participating in the Trial of Intensified vs. standard Medical therapy in Elderly patients with Congestive Heart Failure had prospective evaluation of end-of-life preferences by answering trade-off questions (willingness to accept a shorter life span in return for living without symptoms) and preferences for resuscitation if necessary. The time trade-off question was answered by 555 patients (89%), 74% of whom were not willing to trade survival time for improved QoL. This proportion increased over time (Month 12: 85%, Month 18: 87%, P < 0.001). In multivariable analysis, willingness to trade survival time increased with age, female sex, a reduced Duke Activity Status Index, Geriatric Depression Score, and history of gout, exercise intolerance, constipation and oedema, but even combining these variables did not result in reliable prediction. Of 603 (97%) patients expressing their resuscitation preference, 51% wished resuscitation, 39% did not, and 10% were undecided, with little changes over time. In 430 patients resuscitation orders were known; they differed from patients' preferences 32% of the time. End-of-life preferences were not correlated to 18-month outcome. Conclusion Elderly HF patients are willing to address their end-of-life preferences. The majority prefers longevity over QoL and half wished resuscitation if necessary. Prediction of individual preferences was inaccurate. Trial Registration: isrctn.org Identifier: ISRCTN4359647