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Silja Viergutz HK, Cambra-Rufino L, Apple M, Heithoff A, Lindahl G, Capolongo S, Brambilla A. Benchmarking Relevance for Hospital Design and Planning: An International Web-Based Survey. HERD 2024:19375867241239324. [PMID: 38591575 DOI: 10.1177/19375867241239324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE The study aims to investigate what design practitioners and healthcare facility managers deem as important benchmarking metrics worldwide, investigating country differences in benchmarking usage and which metrics are prioritized. BACKGROUND Benchmarking is a regular practice in the healthcare sector, both for clinical and managerial aspects to compare, measure, and improve standardized processes. However, limited knowledge is available about benchmarking procedures in hospital planning, design, and construction. METHODS A web-based survey was designed, revised, and pilot-tested in five countries; it was adjusted according to local experts' suggestions and submitted globally via SoSci multilingual platform to persons involved in hospital design, research, construction, and facility management. It was composed of closed questions on 5-point Likert-type scale ranking frequency or importance and open-ended questions divided into six sections. Two hundred and eighty full responses have been collected. Statistical analysis was performed via PowerBI and R-Studio, while qualitative analysis was performed via MAXQDA. RESULTS The findings reported allow for both specific insights per each country or category as well as enabling general considerations of a practice that is becoming always more international with 30%-50% of respondents working in the international context. The evaluation of the survey highlights the most important benchmarks, among others. For example, for respondents from the top five countries (Sweden, Spain, Germany, Italy, and the United States), the most important metric for benchmark comparability is whether the project was new construction, new construction attached to an existing hospital, or interior renovation. Construction date, client type (public vs. private), and country of location were also generally rated as the most important metrics by respondents. Other metrics that were consistently rated as important globally included inpatient unit layout, walking distances, number of floors, and whether all patient rooms are private. Space-related metrics are considered very important elements in the design and planning of healthcare facilities worldwide. Regarding cost-related metrics, all countries consider the ratio construction cost per building gross area as the most important. CONCLUSIONS Benchmarking emerges as a relevant tool for hospital design and planning as it can support efficiency, standardization, and confidence; currently, benchmarking is still underutilized due to the challenge of international comparison, access to data outside each specific company, and variation design metrics nationally. Benchmarking strategies should be further investigated to support knowledge exchange and to ensure reliable and comparable information globally.
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Affiliation(s)
| | | | | | | | - Goran Lindahl
- Department of Architecture and Civil Engineering (ACE), Center for Healthcare Architecture, Chalmers University of Technology, Goteborg, Sweden
| | - Stefano Capolongo
- Design & Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, Italy
| | - Andrea Brambilla
- Design & Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, Italy
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Zecca PA, Brambilla A, Reguzzoni M, Protasoni M, Raspanti M. Enhancing SEM positioning precision with a LEGO®-based sample fitting system. Microsc Res Tech 2024; 87:747-752. [PMID: 38037815 DOI: 10.1002/jemt.24465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
Scanning electron microscopy (SEM) is a precious tool in materials science and morphology sciences, enabling detailed examination of materials at the nanoscale. However, precise and accurate sample repositioning during different observation sessions remains a significant challenge, impacting the quality and repeatability of SEM analyses. This study aimed to develop and evaluate a LEGO®-based sample positioning system for SEM analysis. The system was designed to consistently identify and align features across multiple repositioning cycles, maintain accurate positioning along the z-axis, minimize distortion, and provide repeatable and reliable results. The results indicated a high degree of precision and accuracy in the repositioning process, as evidenced by the minimal displacements, deviations in scaling and shearing, and the highly significant results (p < 0.001) obtained from the analysis of absolute translations and rotations. Moreover, the analyses were consistently replicated across six repetitions, underscoring the reliability of the observed results. While the findings suggest that the LEGO-based sample positioning system is promising for enhancing SEM analyses' quality and repeatability, further studies are needed to optimize the system's design and evaluate its performance in different SEM applications. Ultimately, this study contributes to the ongoing efforts to develop cost-effective, customizable, and accurate solutions for sample positioning in SEM, contributing to the advancement of materials science research and all SEM analysis requiring overtime observations of the same sample. RESEARCH HIGHLIGHTS: This study focused on the development and evaluation of a novel LEGO-based sample positioning system specifically designed for SEM analysis. One of the standout features of this system is its ability to consistently identify and align features across multiple repositioning cycles, showcasing its precision and reliability. To further understand the mechanical aspects of the SEM stage, we employed the Rambold Kontroll comparator, which provided a baseline understanding of its mechanical tolerance. The registration process results were particularly noteworthy, as they revealed high accuracy with minimal displacements. Furthermore, the consistent outcomes observed across multiple repetitions emphasize the reliability and robustness of the methods we employed in this research.
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Affiliation(s)
- Piero Antonio Zecca
- Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
| | - Andrea Brambilla
- Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
| | - Marcella Reguzzoni
- Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
| | - Marina Protasoni
- Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
| | - Mario Raspanti
- Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
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Nuvolari-Duodo I, Brambilla A, Ricciardi GE, Dolcini M, Capolongo S. New Requirements for post-COVID-19 Hospital Inpatient Wards: Evidence, Design Recommendations and Assessment Tools. Ann Ig 2024; 36:182-193. [PMID: 38275084 DOI: 10.7416/ai.2024.2601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Background The evolution of hospital infrastructures highlights the need of its physical space to respond to new technological, societal and epidemiological transformations such as those following the COVID-19 pandemic experience. Although the new emerged needs of user-centeredness, comfort and wellbeing within specific functional areas, there is still a lack of measurable indications for addressing these challenges in-patient wards. Study Design The objective of this study is therefore to provide specific guidelines for the design of the in-patient ward, through measurable criteria and indicators based on evidence from the scientific literature, and to develop an assessment tool for its evaluation. Methods A five-step process has been followed: (i) performing a literature review about hospital wards and wellbeing strategies, (ii) conducting a best practice analysis and comparison of a selection of international contemporary healthcare facilities, (iii) defining some dimensional requirements from the comparison, (iv) developing an assessment tool based on extracted criteria, (v) testing the tool on an existing project. Results Amongst the criteria, several aspects have been highlighted ranging from qualitative indicators, as the clarity of wayfinding or the level of privacy, to quantitative values, as the percentage of single inpatient rooms or the distance between rooms and nursing stations. The assessment tool is composed by 20 indicators, associated to thematic areas and referred to three environmental units of the inpatient ward. Two types of scoring system are proposed. Conclusions Starting from those considerations and tool wider applications, the future design of hospital wards could follow guidelines addressing user-centeredness, comfort and wellbeing.
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Affiliation(s)
- Isabella Nuvolari-Duodo
- Design and Health Lab, Department of Architecture, Dept. of Built Environment and Construction Engineering (DABC), Politecnico di Milano, Milan, Italy
| | - Andrea Brambilla
- Design and Health Lab, Department of Architecture, Dept. of Built Environment and Construction Engineering (DABC), Politecnico di Milano, Milan, Italy
| | | | - Michele Dolcini
- Design and Health Lab, Department of Architecture, Dept. of Built Environment and Construction Engineering (DABC), Politecnico di Milano, Milan, Italy
| | - Stefano Capolongo
- Design and Health Lab, Department of Architecture, Dept. of Built Environment and Construction Engineering (DABC), Politecnico di Milano, Milan, Italy
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Brambilla A, Ergur L, Capolongo S. Application of an evaluation tool for mega-hospital site sustainability. Assessment of public private partnership large sized healthcare infrastructures in European context. Acta Biomed 2023; 94:e2023156. [PMID: 37695194 DOI: 10.23750/abm.v94is3.14281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/16/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND AIM Healthcare facilities are large and complex infrastructures designed to respond to a growing need of sanitary services in specialized environments to serve an increasing population number while containing costs. New financial and design models emerged for large sized Hospital -Facilities (Mega-hospitals) but their site sustainability is questioned. METHODS The paper focuses on a comparison -between European region case studies of Public Private Partnership (PPP) Mega-Hospitals. A total of 21 large sized hospitals in operation after 2010 have been compared with the application of the Assessment Tool for -Hospital Site Sustainability (ATHOSS). A specific focus on Turkish Hospitals has been also provided as the PPP model is widely adopted in this country. RESULTS This analysis shows that Turkish cases gets general lower scores than European ones in terms of Construction Density and Community Connectivity (28%;50%), Alternative Transportation (18%; 50%), Site Development (26%; 38%). Connection to Natural World (30%; 52%) and Heat Island Effect (33%; 43%). Only in Development Density criteria (30%; 16%) the score was higher. It also emerged that gross floor area per bed ratio is much larger for Turkish cases (334m2/bed; 198 m2/bed) which can be interpreted as one of the weaknesses related to oversizing such infrastructures. CONCLUSIONS The tool application highlighted some point of attention to be considered when designing and planning Mega-hospital facilities and improvement strategies for site sustainability are -suggested.
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Affiliation(s)
- Andrea Brambilla
- a:1:{s:5:"en_US";s:39:"Politecnico di Milano, Dipartimento ABC";}.
| | - Lara Ergur
- School of Architecture and Urban Planning (AUIC), Politecnico di Milano, Milan, Italy.
| | - Stefano Capolongo
- Design&Health Lab. Department of Architecture, Built Environment and Construction Engineering (DABC) Politecnico di Milano, Italy.
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Dolcini M, Brambilla A, Gola M, Capolongo S. Health and well-being key performance indicators in corporate sustainability disclosure. A review of sustainability reports from a sample of major European companies. Acta Biomed 2023; 94:e2023132. [PMID: 37695188 DOI: 10.23750/abm.v94is3.14334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/28/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND AIM Health and Well-Being (HWB) measurement represents a key issue for companies in all sectors and a core element of social sustainability, according to the Sustainable Development Goals (SDGs). Despite its importance for companies and in sustainability reporting, the topic has not been investigated yet from a cross-sectoral perspective. Therefore, this research aims to assess if health and well-being are disclosed in sustainability reports of the largest European companies. METHODS The disclosure of Key Performance Indicators (KPIs) has been investigated and compared according to the main international frameworks of sustainability. The research focused on sustainability reporting from a sample of the 30 largest companies in three methodological steps. First, the inclusion of HWB issues has been analyzed, identifying references to the SDGs and ISO 45001 within the documents. A second level of analysis considered the adoption of the Global Reporting Initiatives (GRI) Standards, with particular attention to Health metrics (GRI:403). The third level of analysis aimed at researching health and well-being performances, linked to specific KPIs from two selected case studies. RESULTS The review highlighted that all 30 companies generally refer to SDG 3 and SDG 8 in their sustainability reporting while 83%(n=25) of them also apply either Occupational Health and Safety ISO 45001 or Health metrics in GRI Standards; 22 (73%) companies adopted both GRI as the sustainability reporting standard and disclosed the adoption of ISO 45001 management system. Only in two cases, an additional structured framework for HWB is reported highlighting the need for more comprehensive KPIs, especially for employee's well-being. CONCLUSIONS The study highlighted that health indicators disclosure is generally limited to GRI Standards disclosure. To achieve greater transparency in sustainability reporting, there is a need to further investigate the issue. (www.actabiomedica.it).
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Affiliation(s)
| | | | - Marco Gola
- Design&Health Lab, DABC Politecnico di Milano.
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Brambilla A, Del Pio M, Ravegnani Morosini R, Capolongo S. Green space in hospital built environment. A literature review about therapeutic gardens in acute care healthcare settings before Covid-19. Acta Biomed 2023; 94:e2023137. [PMID: 37695193 DOI: 10.23750/abm.v94is3.14286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/29/2023] [Indexed: 09/12/2023]
Abstract
Background and aim Hospital facilities are one of the most stressful environments and there is evidence that during Covid-19 having outdoor and green spaces helped medical staff and nurses to decrease the stress and anxiety level. Nevertheless, knowledge about the type of green space is limited. The aim of the study is to systematize the existing scientific literature on the topic in a specific time period. Methods Scopus, Pubmed, and Cochrane library databases have been explored in a systematic way. Following the Prysma diagram 25 studies have been included. Descriptive statistics and content analysis have been performed to highlight green typologies, users and functional area involved, spatial focus, relationship between users and space and vegetation typology. The different topics have been clustered according to Kellert's biophilic framework. Results Articles reviewed included studies from the 2000 to 2020. The selection led to the analysis of 25 documents; it was significant to understand the major areas of application (pediatrics, ma-ternity, oncology, hospitalization, etc) and forms of green (images, furniture, healing gardens, vegetable gardens, etc). Conclusions The present review highlight the main characteristics of green space in hospital built environment with specific focus on pre-pandemic situation.
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Affiliation(s)
- Andrea Brambilla
- a:1:{s:5:"en_US";s:39:"Politecnico di Milano, Dipartimento ABC";}.
| | - Matilde Del Pio
- School of Architecture Urban planning and Construction Engineeringg (AUIC), Politecnico di Milano.
| | | | - Stefano Capolongo
- Design&Health Lab. Department of Architecture, Built Environment and Construction Engineering (DABC) Politecnico di Milano.
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Mangili S, Ciaffoni L, Sun T, Brambilla A, Capolongo S. Evaluation of stakeholder opinion about Long Term Care Facilities for People with Dementia perceived quality: a web-based survey in the Italian context. Acta Biomed 2023; 94:e2023143. [PMID: 37695196 DOI: 10.23750/abm.v94is3.14283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/03/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND AIM Italy is a country where the percentage of elderly population is very high (23% over 65). The aim of the investigation is to bring out which aspects of the spaces intended to accommodate elderly People with Dementia pathologies should be most present and potentially interested in becoming cornerstones of a new model of Long-Term Care facilities (LTC). METHODS This research uses a case studies analysis followed by a web based survey as methodological tools. The questions were identified following an analysis of recent European case studies. The survey has been submitted to a panel of stakeholders (users, pratictioner, designer and manager in the healthcare sector). It is articulated in eight items touching on functional, configurational, and perceptual aspects of the LTC. RESULTS The 210 responses received provided a basis for comparison with the trend lines detected by the case study analysis, establishing continuity on some configurational aspects and providing divergent views for others. The research found a strong need to introduce new service activities and technologies aimed at the care and assistance of guests with dementia. These specific needs often involve the introduction of new spaces and environments or the redefinition of the same, where already present. CONCLUSIONS The results highlights that a new model of residence must incorporate new technological applications, outdoor spaces, that are perceived significantly by both patients and practitioners, and improve well-being of all users.
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Affiliation(s)
| | | | - Tianzhi Sun
- Design & Health Lab, DABC, Politecnico di Milano.
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Brambilla A, Mosca EI, Isabella A, Bignami DF, Buffoli M, Gola M, Mangili S, Bertulessi M, Zambrini F, Pogliani A, Boschini I, Callari L, Rebecchi A, Caldera M, Menduni G, Capolongo S. Covid-19 emergency management and preparedness in cross-border territories. Collection of experiences, needs and public health strategies in the framework of interreg GESTI.S.CO. project. Acta Biomed 2023; 94:e2023115. [PMID: 37695192 DOI: 10.23750/abm.v94is3.14287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/13/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND AIM The Covid-19 pandemic highlighted management difficulties in neighboring territories. The aim of the paper is to report the needs of different stakeholders during, before and after Covid-19 emergency with specific regard to challenges faced by public administrators in confined territories. METHODS In the framework of Interreg GESTI.S.CO. project the study has been designed with two methodological steps: i) a co-design workshop and ii) a web-based survey. The workshop includes both an audience interaction session and focus groups. Then, starting from the focus group results, the survey has been designed with 30 questions and submitted to the 227 municipalities located between Italy and Switzerland to understand the implementation of Public Health strategies in local emergency planning. RESULTS The interactive session highlighted that most of the critical issues are related to the lack of communication and planning in Public Health policies. The survey highlighted that the local emergency plans rarely integrate a section on health emergencies (30% Italy and 50% Switzerland). Only 20% of the respondents dedicated a section for Covid-19 emergency management. Most of them did not activate initiatives to support mental health. 90% of the municipalities did not cooperate with the neighboring country, but half of them think that it would have been much more useful. The 55% of the Italian respondents are currently updating their emergency plan and will implement it with some Public Health input. CONCLUSIONS The study provides insights that can support policy makers in improving their strategy in responding to future pandemic. (www.actabiomedica.it).
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Affiliation(s)
- Andrea Brambilla
- Design&Health Lab. Department of Architecture, Built environment and Construction engineering (DABC), Politecnico di Milano.
| | - Erica Isa Mosca
- Design&Health Lab. Department of Architecture, Built environment and Construction engineering (DABC), Politecnico di Milano.
| | - Arianna Isabella
- School of Architecture Urban planning and Construction Engineering (AUIC), Politecnico di Milano.
| | | | - Maddalena Buffoli
- Design&Health Lab. Department of Architecture, Built environment and Construction engineering (DABC), Politecnico di Milano.
| | - Marco Gola
- Design&Health Lab. Department of Architecture, Built environment and Construction engineering (DABC), Politecnico di Milano.
| | - Silvia Mangili
- Design&Health Lab. Department of Architecture, Built environment and Construction engineering (DABC), Politecnico di Milano.
| | - Manuel Bertulessi
- Civil and Environmental Engineering Department (DICA), Politecnico di Milano.
| | - Federica Zambrini
- Civil and Environmental Engineering Department (DICA), Politecnico di Milano.
| | - Arianna Pogliani
- Civil and Environmental Engineering Department (DICA), Politecnico di Milano.
| | - Ilaria Boschini
- Civil and Environmental Engineering Department (DICA), Politecnico di Milano.
| | | | - Andrea Rebecchi
- Design&Health Lab. Department of Architecture, Built environment and Construction engineering (DABC), Politecnico di Milano.
| | | | - Giovanni Menduni
- Civil and Environmental Engineering Department (DICA), Politecnico di Milano.
| | - Stefano Capolongo
- Design&Health Lab. Department of Architecture, Built environment and Construction engineering (DABC), Politecnico di Milano.
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Mangili S, Brambilla A, Trabucchi M, Capolongo S. Built environment impact on people with dementia (PwD) health and well-being outcomes: a systematic review of the literature. Acta Biomed 2023; 94:e2023155. [PMID: 37695195 DOI: 10.23750/abm.v94is3.14284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/29/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND AIM The number of People with Dementia (PwD) is rising worldwide and represents a complex figure because of the changes in the cognitive sphere, altering perceptions of the Built Environment (BE). Even though the role of the built environment in the health and well-being of people it's nowadays well known, few studies analyze and evaluate the impact of specific Architectural Features. To this end, this contribution provides a systematic review that will underline the impacts of BE on the Health and Well-being of PwD and set a matrix of the relationship with measurable outcomes. METHODS A literature review has been conducted on scientific databases. 40 studies that relate health outcomes and aspects of the built environment have been identified and organized on a comparison matrix that clearly shows the relationships between Architectural Features of BE and Health and Wellbeing Outcome. This matrix allows to identify which are the aspects that can impact on PwD as well as possible lacks. RESULTS Many aspects appear to be widely explored, such as BPSD or wandering. In addition, significant gaps in the relationship between recognized aspects of the built environment recognized as relevant to the well-being of people with dementia and the real impacts on health outcomes such as the location and personalization of spaces. CONCLUSIONS This study collected the most recent studies to underline the relationship between BE and dementia, providing a set of outcomes and architectural features that can be analyzed to assess the quality of BE for PwD.
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Brambilla A, Brusamolin E, Johnson AA, Scullica F, Capolongo S. Lessons from the first wave of COVID-19 in Italy: A collection of design strategies to face pandemic situations in healthcare facilities. J Opioid Manag 2023; 21:167-184. [PMID: 37154452 DOI: 10.5055/jem.0746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
OBJECTIVES This study aims to provide metadesign indications for the improvement of healthcare facilities, emphasizing the role of spatial design in the management of epidemic health emergencies. STUDY DESIGN A parallel mixed-method study including literature reviews, survey creation, and survey distribution was performed. METHODS Data were collected between August and October 2020 capturing information related to the first wave of the COVID-19 pandemic, utilizing a review of existing literature, a comparison of existing hospital planning guidelines and assessment tools, and distribution of a survey to analyze design changes within selected Italian hospitals. RESULTS Among the changes identified, the most frequently identified included the conversion of space into intensive care units, space expansion, and the usage of wayfinding strategies for the reduction of cross-contamination risks. There was limited attention given to solutions with a human-centered approach, and those that addressed physical and psychological well-being of all users, including healthcare staff. The solutions were collected and systematized into a list of metadesign guidelines. CONCLUSIONS The resulting indications represent a starting point for developing design solutions to aid healthcare facilities in facing future epidemics.
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Affiliation(s)
- Andrea Brambilla
- Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy. ORCID: https://orcid.org/0000-0001-7891-0336
| | - Erica Brusamolin
- Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy. ORCID: https://orcid.org/0000-0002-8450-098X
| | - Alexander Achille Johnson
- Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politec-nico di Milano, Milan, Italy; Columbia University Vagelos College of Physicians and Surgeons, New York, New York. ORCID: https://orcid.org/0000-0002-3107-4120
| | - Francesco Scullica
- Department of Design, Politecnico di Milano, Milan, Italy. ORCID: https://orcid.org/0000-0002-6872-5732
| | - Stefano Capolongo
- Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy. ORCID: https://orcid.org/0000-0002-4679-9829
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Pagano M, Fumagalli C, Girolami F, Passantino S, Gozzini A, Brambilla A, Spinelli V, Morrone A, Procopio E, Pochiero F, Donati MA, Olivotto I, Favilli S. Clinical profile and outcome of cardiomyopathies in infants and children seen at a tertiary centre. Int J Cardiol 2023; 371:516-522. [PMID: 36130621 DOI: 10.1016/j.ijcard.2022.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/12/2022] [Accepted: 09/15/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Due to their rare prevalence and marked heterogeneity, pediatric cardiomyopathies (CMPs) are little known and scarcely reported. We report the etiology, clinical profile and outcome of a consecutive cohort of children diagnosed with CMP and followed at Meyer Children's Hospital over a decade. PATIENTS AND METHODS We retrospectively reviewed patients consecutively referred from May 2008 to May 2019 for pediatric onset CMP (<18 years). Heart disease caused by arrhythmic disorders, toxic agents, rheumatic conditions and maternal disease were excluded. RESULTS We enrolled 110 patients (65 males), diagnosed at a median age of 27 [4-134] months; 35% had an infant onset (<1 year of age). A positive family history was more often associated with childhood-onset (38.8%). Hypertrophic cardiomyopathy (HCM; 48 patients) was the most frequent phenotype, followed by dilated cardiomyopathy (DCM; 35 patients). While metabolic and idiopathic etiologies were preponderant in infants, metabolic and sarcomeric diseases were most frequent in the childhood-onset group. Major adverse cardiac events (MACE) occurred in 31.8% of patients, including hospitalization for acute heart failure in 25.5% of patients, most commonly due to DCM. Overall, the most severe outcomes were documented in patients with metabolic diseases. CONCLUSIONS In a consecutive cohort of pediatric patients with CMP, those with infantile onset and with a metabolic etiology had the worst prognosis. Overall, MACE occurred in 41% of the entire population, most commonly associated with DCM, inborn errors of metabolism and genetic syndromes. Systematic NGS genetic testing was critical for etiological diagnosis and management.
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Affiliation(s)
- M Pagano
- Cardiology Unit, Meyer Children's Hospital, Florence, Italy.
| | - C Fumagalli
- Cardiomyopathies Unit, Careggi University Hospital (AOUC), Florence, Italy
| | - F Girolami
- Cardiology Unit, Meyer Children's Hospital, Florence, Italy
| | - S Passantino
- Cardiology Unit, Meyer Children's Hospital, Florence, Italy
| | - A Gozzini
- Cardiology Unit, Meyer Children's Hospital, Florence, Italy
| | - A Brambilla
- Cardiology Unit, Meyer Children's Hospital, Florence, Italy
| | - V Spinelli
- Cardiology Unit, Meyer Children's Hospital, Florence, Italy
| | - A Morrone
- Molecular and Cell Biology Laboratory of Neurometabolic Diseases, Meyer Children's Hospital, Neuroscience Department, Florence, Italy; Department of NEUROFARBA, University of Florence, Florence, Italy
| | - E Procopio
- Metabolic and Muscular Unit, Meyer Children's Hospital, Neuroscience Department, Florence, Italy
| | - F Pochiero
- Metabolic and Muscular Unit, Meyer Children's Hospital, Neuroscience Department, Florence, Italy
| | - M A Donati
- Metabolic and Muscular Unit, Meyer Children's Hospital, Neuroscience Department, Florence, Italy
| | - I Olivotto
- Cardiology Unit, Meyer Children's Hospital, Florence, Italy; Cardiomyopathies Unit, Careggi University Hospital (AOUC), Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - S Favilli
- Cardiology Unit, Meyer Children's Hospital, Florence, Italy
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Andriolo G, Provasi E, Brambilla A, Panella S, Soncin S, Cicero VL, Radrizzani M, Turchetto L, Barile L. Methodologies for Scalable Production of High-Quality Purified Small Extracellular Vesicles from Conditioned Medium. Methods Mol Biol 2023; 2668:69-98. [PMID: 37140791 DOI: 10.1007/978-1-0716-3203-1_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The development of an extracellular vesicles (EV)-based therapeutic product requires the implementation of reproducible and scalable, purification protocols for clinical-grade EV. Commonly used isolation methods including ultracentrifugation, density gradient centrifugation, size exclusion chromatography, and polymer-based precipitation, faced limitations such as yield efficiency, EV purity, and sample volume. We developed a GMP-compatible method for the scalable production, concentration, and isolation of EV through a strategy involving, tangential flow filtration (TFF). We applied this purification method for the isolation of EV from conditioned medium (CM) of cardiac stromal cells, namely cardiac progenitor cells (CPC) which has been shown to possess potential therapeutical application in heart failure. Conditioned medium collection and EV isolation using TFF demonstrated consistent particle recovery (~1013 particle/mL) enrichment of small/medium-EV subfraction (range size 120-140 nm). EV preparations achieved a 97% reduction of major protein-complex contaminant and showed unaltered biological activity. The protocol describes methods to assess EV identity and purity as well as procedures to perform downstream applications including functional potency assay and quality control tests. The large-scale manufacturing of GMP-grade EV represents a versatile protocol that can be easily applied to different cell sources for wide range of therapeutic areas.
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Affiliation(s)
- Gabriella Andriolo
- Lugano Cell Factory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Elena Provasi
- Lugano Cell Factory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Andrea Brambilla
- Lugano Cell Factory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Stefano Panella
- Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Laboratories for Translational Research, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Sabrina Soncin
- Lugano Cell Factory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Viviana Lo Cicero
- Lugano Cell Factory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Marina Radrizzani
- Lugano Cell Factory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Lucia Turchetto
- Lugano Cell Factory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Lucio Barile
- Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Laboratories for Translational Research, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
- Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland.
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13
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Mangili S, Brambilla A, Capolongo S. Long‐term care Facilities and Dementia. Development of a framework to assess design quality in healthcare structures for people with dementia. Alzheimers Dement 2022. [DOI: 10.1002/alz.065844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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14
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Rebecchi A, Johnson AA, Brambilla A, Buffoli M, Russo AG, Capolongo S. Bridging Epidemiological Data with Features of the Urban Context: An experience of Urban Public Health within the City of Milan, Italy. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Referring to the Research Project “Enhancing Healthcare and Well-Being Through the Potential of Big Data: An Integration of Survey, Administrative, and Open Data to Assess Health Risk in the City of Milan with Data Science” the Authors present preliminary results regarding a survey distributed to a sample of citizens across all neighborhoods of Milano city. This survey sought to collect data regarding health risk factors of this population, including both individual (e.g. socio-demographic characteristics, behaviors, etc.) and community (e.g. environmental/morphological features, available social services, etc.) data. A digital survey was designed to collect information on the health conditions, risk factors, and lifestyle characteristics of a representative sample of the Milanese population at the neighborhood level, with reference to the census tracts and Local Identity Units (NIL). Collected survey data are entered into a system containing corresponding individual health information acquired from the Local Health Authority databases, creating a synthesized information profile with each respondent's state of health, including existing conditions, health services used, and drug therapies. The disseminated survey was developed from comparisons with similar experiences at the national/international level and divided into 60 multiple choice questions (6 for Sociodemographic profile; 8 for Context of residence; 12 for Functional limitations; 25 for Behaviors and lifestyles; 9 for Access to health services). The data from urban analysis conducted on the NIL of the City of Milan are assessed with particular reference to the theme of bicycle-pedestrian accessibility (Walkability) in the urban context and repercussions on the adoption of Healthy Lifestyles. The models developed through this research are expected to provide critical insight for designing health promotion, health protection, and disease prevention interventions aimed both at individual and community level.
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Affiliation(s)
- A Rebecchi
- Design & Health Lab, DABC - Politecnico di Milano , Milan, Italy
| | - AA Johnson
- Columbia University, Vagelos College of Physicians and Surgeons , New York, USA
| | - A Brambilla
- Design & Health Lab, DABC - Politecnico di Milano , Milan, Italy
| | - M Buffoli
- Design & Health Lab, DABC - Politecnico di Milano , Milan, Italy
| | - AG Russo
- ATS della Città Metropolitana di Milano , Milan, Italy
| | - S Capolongo
- Design & Health Lab, DABC - Politecnico di Milano , Milan, Italy
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15
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Casagranda I, Gola M, Bellone A, Coen D, Brambilla A, Guiddo G, Paolillo C, Lerza R, Capolongo S, Boeri S. Challenges of the next generation hospitals: Rethinking the Emergency Department. Emer Care J 2022. [DOI: 10.4081/ecj.2022.10840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The COVID 19 outbreak dramatically highlighted the inadequacy of the Emergency Department (ED) settings in dealing with events that can acutely affect a wide range of population. The immediate urgency to create strictly distinct pathways became also a strategic aspect for reducing possible sources of contagion inside the hospital.1 This need has often clashed with inadequate structural conditions of the hospital: in fact, the rigidity of many EDs is due to the hospital typology and its localization (affected by functional program);2,3 and it prevents them from being quickly adapted to new needs in the case of maxi-emergencies.4 In several recent international projects, the presence of a multifunctional space and/or a buffer area guarantees different scenarios in relation to the healthcare/emergency needs.5 [...]
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16
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Brambilla A, Brusamolin E, Johnson AA, Scullica F, Capolongo S. Lessons from the first wave of COVID-19 in Italy: A collection of design strategies to face pandemic situations in healthcare facilities. Am J Disaster Med 2022; 17:227-244. [PMID: 37171567 DOI: 10.5055/ajdm.2022.0437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVES This study aims to provide metadesign indications for the improvement of healthcare facilities, emphasizing the role of spatial design in the management of epidemic health emergencies. STUDY DESIGN A parallel mixed-method study including literature reviews, survey creation, and survey distribution was performed. METHODS Data were collected between August and October 2020 capturing information related to the first wave of the COVID-19 pandemic, utilizing a review of existing literature, a comparison of existing hospital planning guidelines and assessment tools, and distribution of a survey to analyze design changes within selected Italian hospitals. RESULTS Among the changes identified, the most frequently identified included the conversion of space into intensive care units, space expansion, and the usage of wayfinding strategies for the reduction of cross-contamination risks. There was limited attention given to solutions with a human-centered approach, and those that addressed physical and psycho-logical well-being of all users, including healthcare staff. The solutions were collected and systematized into a list of metadesign guidelines. CONCLUSIONS The resulting indications represent a starting point for developing design solutions to aid healthcare facilities in facing future epidemics.
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Affiliation(s)
- Andrea Brambilla
- Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy. ORCID: https://orcid.org/0000-0001-7891-0336
| | - Erica Brusamolin
- Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy. ORCID: https://orcid.org/0000-0002-8450-098X
| | - Alexander Achille Johnson
- Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy; Columbia University Vagelos College of Physicians and Surgeons, New York, New York. ORCID: https://orcid.org/0000-0002-3107-4120
| | - Francesco Scullica
- Department of Design, Politecnico di Milano, Milan, Italy. ORCID: https://orcid.org/0000-0002-6872-5732
| | - Stefano Capolongo
- Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy. ORCID: https://orcid.org/0000-0002-4679-9829
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17
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Brambilla A, Venezia S, Latella M, Garavaglia A, Grillo E. 463 New era in hypercholesterolemia treatment, inclisiran: early and sustained LDL-C reduction with a twice per year administration. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Inclisiran is a synthetic small-interfering RNA (siRNA) that works with the RNA interference (RNAi) mechanism. SiRNA binds its target mRNA, leading to silencing the protein synthesis by the related mRNA degradation. Inclisiran is designed to bind solely PCSK9 mRNA, decreasing PCSK9 expression, thus leading to lower LDL-C level. Several chemical modifications were added to obtain a stable compound delivering a rapid effect and generally well tolerated [Khvorova A. Oligonucleotide therapeutics—a new class of cholesterol-lowering drugs. N Engl J Med 2017;
376
4–7]. High cholesterol levels and prolonged time of exposure enhance risk of new or recurrent CV events, therefore also timing became crucial for atherosclerotic cardiovascular disease (ASCVD) patients [Ference BA, Graham I, Tokgozoglu L, et al. Impact of lipids on cardiovascular health: JACC health promotion series. J Am Coll Cardiol 2018;
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1141–1156]. Therefore, an early and effective LDL-C lowering effect is positively correlated with CV risk reduction, together with the life-long LDL-C reduction that will impact definitively on the global CV risk [Cohen JC, Boerwinkle E, Mosley TH Jr, et al. Sequence variations in PCSK9, low LDL, and protection against coronary heart disease. N Engl J Med 2006;
354
1264–1272]. The siRNA conjugation with a triantennary GalNAC leads to a specific targeted hepatic delivery therefore, the 284 mg inclisiran dose is undetectable in blood stream after 24–48 h from the subcutaneous injection [Wright RS, Collins MG, StoekenbroekRM, et al. Effects of renal impairment on the pharmacokinetics, efficacy, and safety of inclisiran: an analysis of the ORION-7 and ORION-1 studies. Mayo Clin Proc 2020;
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77–89]. The LDL-C lowering effect starts early upon the hepatic cell entry (24–48 h) and the LDL-C level drop is already significant at 14 days post injection, and by Day 30 the mean reduction is about 50%, as shown in the ORION-1 phase II trial [Ray KK, Landmesser U, Leiter LA, et al. Inclisiran in patients at high cardiovascular risk with elevated LDL cholesterol. N Engl J Med 2017;
376
1430–1440]. Other chemical modifications at the siRNA back-bone level, protect inclisiran from degradation by liver nucleases, which may occur upon the hepatic cell uptake. In the cytoplasm, RNAi mechanism occurs by the siRNA—RISC protein complex coupling. Physiologically, this bond last for long and the inclisiran back-bone modifications further enhance the complex stability [Khvorova A. Oligonucleotide therapeutics—a new class of cholesterol-lowering drugs. N Engl J Med 2017;
376
4–7]. Moreover, one siRNA-RISC complex has an effect on multiple PCSK9 mRNA units, allowing inclisiran administration twice per year (after initial dose at baseline and 3 months), granting an early, sustained and effective LDL-C level reduction that lasts for 6 months. A pooled analysis of the 3 phase III trials (ORION-9/10/11) shows a time averaged (18 months) LDL-C reduction of 50.5% on top of therapy with statins±ezetimibe [Wright RS, Ray KK, Raal FJ, et al. Pooled patient-level analysis of inclisiran trials in patients with familial hypercholesterolemia or atherosclerosis. J Am Coll Cardiol 2021;
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1182–1193]. Inclisiran provides effective evidence-based results on lowering LDL-C levels in different high CV risk populations (HeFH/established ASCVD/ASCVD-risk equivalent), which is demonstrated to be crucial for the reduction of patients’ CV risk. Furthermore, the twice per year administrations may positively improve adherence, thereby simplifying patient management and control during follow-up. Based on these findings, we are stepping into a new era of biologic therapeutics, where inclisiran represents the new, effective and safe therapeutic candidate for lowering LDL-C levels.
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Affiliation(s)
| | - Serena Venezia
- Medical Department, Cardio-Renal-Metabolic Area, Novartis Farma
| | - Maura Latella
- Medical Department, Cardio-Renal-Metabolic Area, Novartis Farma
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18
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Brambilla A, Sun TZ, Elshazly W, Ghazy A, Barach P, Lindahl G, Capolongo S. Flexibility during the COVID-19 Pandemic Response: Healthcare Facility Assessment Tools for Resilient Evaluation. Int J Environ Res Public Health 2021; 18:ijerph182111478. [PMID: 34769993 PMCID: PMC8583089 DOI: 10.3390/ijerph182111478] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/15/2021] [Accepted: 10/24/2021] [Indexed: 11/16/2022]
Abstract
Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.
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Affiliation(s)
- Andrea Brambilla
- Design and Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, 20133 Milan, Italy; (T.-z.S.); (P.B.); (G.L.); (S.C.)
- Center for Healthcare Architecture (CVA), Division of Building Design, Department Architecture and Civil Engineering (ACE), Chalmers University of Technology, SE-412 96 Goteborg, Sweden
- Correspondence: ; Tel.: +39-0223995140
| | - Tian-zhi Sun
- Design and Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, 20133 Milan, Italy; (T.-z.S.); (P.B.); (G.L.); (S.C.)
| | - Waleed Elshazly
- School of Architecture and Urban Planning (AUIC), Politecnico di Milano, 20133 Milan, Italy; (W.E.); (A.G.)
| | - Ahmed Ghazy
- School of Architecture and Urban Planning (AUIC), Politecnico di Milano, 20133 Milan, Italy; (W.E.); (A.G.)
| | - Paul Barach
- Design and Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, 20133 Milan, Italy; (T.-z.S.); (P.B.); (G.L.); (S.C.)
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA
- School of Medicine and Law, Sigmund Freud University, 1020 Vienna, Austria
| | - Göran Lindahl
- Design and Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, 20133 Milan, Italy; (T.-z.S.); (P.B.); (G.L.); (S.C.)
- Center for Healthcare Architecture (CVA), Division of Building Design, Department Architecture and Civil Engineering (ACE), Chalmers University of Technology, SE-412 96 Goteborg, Sweden
| | - Stefano Capolongo
- Design and Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, 20133 Milan, Italy; (T.-z.S.); (P.B.); (G.L.); (S.C.)
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19
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Brambilla A, Lindahl G, Capolongo S. Evidence-informed health care infrastructures: test of SustHealthv2 tool on hospital pilot cases. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Healthcare facilities are important node of health systems and several scholars from Public Health and health service field highlighted that high quality and sustainable built environment is fundamental in providing high quality health care services. Nevertheless, most hospital buildings are obsolete, not adequate to contemporary organizational models; additionally, none of the existing quality improvement tools systematically evaluate the built environment. Therefore, the study develops an evidence-informed weighted multicriteria tool and tested it on two pilot case study.
Methods
Starting from previous literature reviews and scenario analysis, different indicators for hospital quality assessment have been grouped in 17 criteria and 3 macro areas, validated through semi-structured interviews and weighted with Multicriteria Simon Roy Figueras (MCDA-SRF) and Deck Card Method (DCM). The weighted tool SustHealthv2 has been tested on two medium sized hospital pilot case studies (H1 and H2) in northern Italy.
Results
The tool is composed by three macro areas: Social, Environmental and Organizational qualities respectively accounting for 22%, 29% and 49%. The application and test of the tool highlighted transversal criticalities such as Sustainable Accessibility (H1=0.04/0.16; H2=0.11/0.16), Sensitization and Education (H1=0.06/0.18; H2=0.10/0.18). The most recent case study (H1) was able to achieve higher scores in energy (0.15/0.0.19), waste management (0.07/0.07), as well as future proofing characteristics (0.20/0.23) compared to the older one. Overall H1 scored higher in all the macro areas reaching a total fulfillment of 72/100, while H2 scored 52/100.
Conclusions
The application of SustHealth v2 on operating health care facilities can support hospital management in defining strategic area of improvements and investments for hospital building renovation providing higher level of services to patients, users and staff.
Key messages
Built environment for healthcare needs systematic evaluation frameworks to improve and contribute to health service quality. SustHealth v2 is an evidence-informed multicriteria framework for hospital built environment sustainability and quality assessment from social, environmental and organizational perspective.
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Affiliation(s)
- A Brambilla
- Design & Health Lab, Department ABC, Politecnico di Milano, Milan, Italy
| | - G Lindahl
- Center for Healthcare Architecture, Department ACE, Chalmers University of Technology, Goteborg, Sweden
| | - S Capolongo
- Design & Health Lab, Department ABC, Politecnico di Milano, Milan, Italy
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Brambilla A, Mangili S, Macchi M, Trucco P, Perego A, Capolongo S. Covid-19 Massive Vaccination Center Layouts. Acta Biomed 2021; 92:e2021446. [PMID: 34739468 PMCID: PMC8851002 DOI: 10.23750/abm.v92is6.12229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/21/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK The rapid evolution of Covid-19 and the availability of numerous vaccines led countries to set up Massive Vaccination campaign in a very short time. Since December 2020, due to the lack of specific guidelines, multidisciplinary groups started to investigate the minimum requirements for Massive Vaccination Centers (MVC). The aim of the paper is to shed light on the process of development of a scalable model for MVC layout design and implementation. METHODS The methodology included two phases and six steps: 1)Study of MVC with i) acquisition of process data from experimental study on an early set up vaccination hub; ii) review of scientific literature on MVC; iii) review of existing available guidelines and international examples; 2) Design proposal with iv) functional and space requirements collection; v) standard MVC layout design and vi) scalable model definition. RESULTS The resulting layout is compact, has a good wayfinding and address safety reducing cross-contamination risks. Different vaccine lines have been designed with a central dilution area for process efficiency. Healthcare staff wellbeing is guaranteed by the provision of resting spaces, short distances, and the correct sizing of space for the different activities. To ensure optimal vaccination capacity at the peak of vaccination, a modular and scalable model of different sizes has been designed ranging from 400 to 12000 m2. CONCLUSIONS The modular layout has been used as basic model in the regional legislation, disclosed with the Deliberation n° XI / 4353 of 24/02/2021. Further research is encouraged to compare different national and international layouts.
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Affiliation(s)
- Andrea Brambilla
- Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design & Health Lab, Milano, Italy.
| | - Silvia Mangili
- Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design & Health Lab, Milano, Italy.
| | - Marco Macchi
- Politecnico di Milano, Department of Department of Management, Economics and Industrial Engineering (DIG), Milano, Italy.
| | - Paolo Trucco
- Politecnico di Milano, Department of Department of Management, Economics and Industrial Engineering (DIG), Milano, Italy.
| | - Alessandro Perego
- Politecnico di Milano, Department of Department of Management, Economics and Industrial Engineering (DIG), Milano, Italy.
| | - Stefano Capolongo
- Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design & Health Lab, Milano, Italy.
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21
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Sdino L, Brambilla A, Dell’Ovo M, Sdino B, Capolongo S. Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview. Healthcare (Basel) 2021; 9:healthcare9070888. [PMID: 34356266 PMCID: PMC8303202 DOI: 10.3390/healthcare9070888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/26/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
The need for 24/7 operation, and the increasing requests of high-quality healthcare services contribute to framing healthcare facilities as a complex topic, also due to the changing and challenging environment and huge impact on the community. Due to its complexity, it is difficult to properly estimate the construction cost in a preliminary phase where easy-to-use parameters are often necessary. Therefore, this paper aims to provide an overview of the issue with reference to the Italian context and proposes an estimation framework for analyzing hospital facilities' construction cost. First, contributions from literature reviews and 14 case studies were analyzed to identify specific cost components. Then, a questionnaire was administered to construction companies and experts in the field to obtain data coming from practical and real cases. The results obtained from all of the contributions are an overview of the construction cost components. Starting from the data collected and analyzed, a preliminary estimation tool is proposed to identify the minimum and maximum variation in the cost when programming the construction of a hospital, starting from the feasibility phase or the early design stage. The framework involves different factors, such as the number of beds, complexity, typology, localization, technology degree and the type of maintenance and management techniques. This study explores the several elements that compose the cost of a hospital facility and highlights future developments including maintenance and management costs during hospital facilities' lifecycle.
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Affiliation(s)
- Leopoldo Sdino
- Department Architecture Built Environment Construction Engineering (DABC), Politecnico di Milano, via G. Ponzio, 31, 20133 Milan, Italy; (L.S.); (A.B.); (S.C.)
| | - Andrea Brambilla
- Department Architecture Built Environment Construction Engineering (DABC), Politecnico di Milano, via G. Ponzio, 31, 20133 Milan, Italy; (L.S.); (A.B.); (S.C.)
| | - Marta Dell’Ovo
- Department of Architecture and Urban Studies (DAStU), Politecnico di Milano, via E. Bonardi, 3, 20133 Milan, Italy;
| | - Benedetta Sdino
- Department Architecture Built Environment Construction Engineering (DABC), Politecnico di Milano, via G. Ponzio, 31, 20133 Milan, Italy; (L.S.); (A.B.); (S.C.)
- Correspondence: ; Tel.: +39-022-399-5176
| | - Stefano Capolongo
- Department Architecture Built Environment Construction Engineering (DABC), Politecnico di Milano, via G. Ponzio, 31, 20133 Milan, Italy; (L.S.); (A.B.); (S.C.)
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22
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Jolivet F, Lesaint J, Fournier C, Garcin M, Brambilla A. An Efficient One-Step Method for Spectral CT Based on an Approximate Linear Model. IEEE Trans Radiat Plasma Med Sci 2021. [DOI: 10.1109/trpms.2020.3015598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Abstract Starting from the minimum requirements indicated by Lombardy Region, a validation checklist has been developed by experts in design, healthcare layout planning, hygiene and public health, planning and compliance, in order to provide managers of COVID-19 massive vaccination centers with a useful and easy-to-use tool to ensure quality, safety and efficiency of the different activities performed.
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Affiliation(s)
- S Capolongo
- Politecnico di Milano, Department Architecture Built environment Construction engineering (DABC), Design & Health Lab, Milan, Italy
| | - A Brambilla
- Politecnico di Milano, Department Architecture Built environment Construction engineering (DABC), Design & Health Lab, Milan, Italy
| | | | - C Signorelli
- Università Vita-Salute San Raffaele, School of Public Health, Milan, Italy
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24
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Villa I, Villa C, Crapanzano R, Secchi V, Tawfilas M, Trombetta E, Porretti L, Brambilla A, Campione M, Torrente Y, Vedda A, Monguzzi A. Functionalized Scintillating Nanotubes for Simultaneous Radio- and Photodynamic Therapy of Cancer. ACS Appl Mater Interfaces 2021; 13:12997-13008. [PMID: 33719410 PMCID: PMC8153399 DOI: 10.1021/acsami.1c02504] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
As a model radio-photodynamic therapy (RPDT) agent, we developed a multicomponent nanomaterial by anchoring conjugated chromophores on the surface of scintillating chrysotile nanotubes. Its ultimate composition makes the system a scintillation-activated photosensitizer for the singlet oxygen production. This nanomaterial shows a remarkable ability to enhance the production of singlet oxygen in an aqueous environment, under X-ray irradiation, boosting its production by almost 1 order of magnitude. Its efficiency as a coadjutant for radiotherapy has been tested in vitro, showing a striking efficacy in enhancing both the prompt cytotoxicity of the ionizing radiation and the long-term cytotoxicity given by radiation-activated apoptosis. Notably, the beneficial activity of the RPDT agent is prominent at low levels of delivered doses comparable to the one employed in clinical treatments. This opens the possibility of effectively reducing the therapy exposure and consequently undesired collateral effects due to prolonged exposure of patients to high-energy radiation.
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Affiliation(s)
- Irene Villa
- Dipartimento
di Scienza dei Materiali, Università
degli Studi Milano-Bicocca, via R. Cozzi 55, 20125 Milano, Italy
| | - Chiara Villa
- Stem
Cell Laboratory, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione
IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Centro Dino
Ferrari, via F. Sforza
35, 20122 Milan, Italy
| | - Roberta Crapanzano
- Dipartimento
di Scienza dei Materiali, Università
degli Studi Milano-Bicocca, via R. Cozzi 55, 20125 Milano, Italy
| | - Valeria Secchi
- Dipartimento
di Scienza dei Materiali, Università
degli Studi Milano-Bicocca, via R. Cozzi 55, 20125 Milano, Italy
| | - Massimo Tawfilas
- Dipartimento
di Scienza dei Materiali, Università
degli Studi Milano-Bicocca, via R. Cozzi 55, 20125 Milano, Italy
| | - Elena Trombetta
- Servizio
di Citofluorimetria, Laboratorio Analisi, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy
| | - Laura Porretti
- Servizio
di Citofluorimetria, Laboratorio Analisi, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy
| | - Andrea Brambilla
- Stem
Cell Laboratory, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione
IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Centro Dino
Ferrari, via F. Sforza
35, 20122 Milan, Italy
| | - Marcello Campione
- Dipartimento
di Scienze dell’Ambiente e della Terra, Università degli Studi Milano-Bicocca, Piazza della Scienza, 20126 Milano, Italy
| | - Yvan Torrente
- Stem
Cell Laboratory, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione
IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Centro Dino
Ferrari, via F. Sforza
35, 20122 Milan, Italy
| | - Anna Vedda
- Dipartimento
di Scienza dei Materiali, Università
degli Studi Milano-Bicocca, via R. Cozzi 55, 20125 Milano, Italy
| | - Angelo Monguzzi
- Dipartimento
di Scienza dei Materiali, Università
degli Studi Milano-Bicocca, via R. Cozzi 55, 20125 Milano, Italy
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Abstract
AIM The research sheds light on the challenges and limitations of Spanish and Italian hospital design by looking at the gaps between education and practice. BACKGROUND Hospital design plays an important role in providing high-quality and cost-effective facilities for any healthcare system. Spain and Italy face contemporary challenges (i.e., elderly population, staff retention, and obsolete healthcare facilities) and have similar issues of life expectancy, health expenditure, hospital beds provision, and decentralized tax-financed healthcare systems. METHOD A cross-sectional, mixed-method study was used. This involved two different data collection strategies and analysis for each area of investigation: (i) education and (ii) practice. For the former, educational programs were reviewed via a web search; for the latter, an online survey of 53 architectural/engineering offices involved in hospital design was conducted. RESULTS Hospital design education is limited to 0/58 in Spanish and 2/60 courses in Italian universities, although each country offers three postgraduate courses. The practitioners' survey shows that even though their offices have a long history of healthcare design, only 48% in Spain and 60% in Italy have received specific university training. Office staff lack employees with medical backgrounds, which hinders any partnership between health and design fields either for design practice or the education fields. Laws, national regulations, technical guidelines, and previous experience are the most useful information sources, while international scientific publications appear underused by practitioners. CONCLUSIONS Italian and Spanish healthcare architecture could be improved by promoting multidisciplinary teams (in practice and education) and improving the education offer by tailoring it to national needs.
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Affiliation(s)
- Laura Cambra-Rufino
- Departamento de Construcción y Tecnología Arquitectónicas, Escuela Técnica Superior de Arquitectura de Madrid, Universidad Politécnica de Madrid, Spain
| | - Andrea Brambilla
- Department ABC-Architecture, Built environment, and Construction engineering, Design & Health Lab, Politecnico di Milano, Via Ponzio 31, 20133 Milano, Italy
| | | | - Stefano Capolongo
- Department ABC-Architecture, Built environment, and Construction engineering, Design & Health Lab, Politecnico di Milano, Via Ponzio 31, 20133 Milano, Italy
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26
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Andriolo G, Provasi E, Brambilla A, Lo Cicero V, Soncin S, Barile L, Turchetto L, Radrizzani M. GMP-Grade Methods for Cardiac Progenitor Cells: Cell Bank Production and Quality Control. Methods Mol Biol 2021; 2286:131-166. [PMID: 33381854 DOI: 10.1007/7651_2020_286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Cardiac explant-derived cells (cEDC), also referred as cardiac progenitors cells (CPC) (Barile et al., Cardiovasc Res 103(4):530-541, 2014; Barile et al., Cardiovasc Res 114(7):992-1005, 2018), represent promising candidates for the development of cell-based therapies, a novel and interesting treatment for cardioprotective strategy in heart failure (Kreke et al., Expert Rev Cardiovasc Ther 10(9):1185-1194, 2012). CPC have been tested in a preclinical setting for direct cell transplantation and tissue engineering or as a source for production of extracellular vesicles (EV) (Oh et al., J Cardiol 68(5):361-367, 2016; Barile et al., Eur Heart J 38(18):1372-1379, 2017; Rosen et al., J Am Coll Cardiol 64(9):922-937, 2014). CPC cultured as cardiospheres derived cells went through favorable Phase 1 and 2 studies demonstrating safety and possible efficacy (Makkar et al., Lancet 379(9819):895-904, 2012; Ishigami et al., Circ Res 120(7):1162-1173, 2017; Ishigami et al., Circ Res 116 (4):653-664, 2015; Tarui et al., J Thorac Cardiovasc Surg 150(5):1198-1207, 1208 e1191-1192, 2015). In this context and in view of clinical applications, cells have to be prepared and released according to Good Manufacturing Practices (GMP) (EudraLex-volume 4-good manufacturing practice (GMP) guidelines-Part I-basic requirements for medicinal products. http://ec.europa.eu/health/documents/eudralex/vol-4 ; EudraLex-volume 4-good manufacturing practice (GMP) guidelines-Part IV-guidelines on good manufacturing practices specific to advanced therapy medicinal products. http://ec.europa.eu/health/documents/eudralex/vol-4 ). This chapter describes GMP-grade methods for production and testing of a CPC Master Cell Bank (MCB), consisting of frozen aliquots of cells that may be used either as a therapeutic product or as source for the manufacturing of Exo for clinical trials.The MCB production method has been designed to isolate and expand CPC from human cardiac tissue in xeno-free conditions (Andriolo et al., Front Physiol 9:1169, 2018). The quality control (QC) methods have been implemented to assess the safety (sterility, endotoxin, mycoplasma, cell senescence, tumorigenicity) and identity/potency/purity (cell count and viability, RT-PCR, immunophenotype) of the cells (Andriolo et al., Front Physiol 9:1169, 2018).
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Affiliation(s)
- Gabriella Andriolo
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Elena Provasi
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Andrea Brambilla
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Viviana Lo Cicero
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Sabrina Soncin
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Lucio Barile
- Laboratory for Cardiovascular Theranostics, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Lucia Turchetto
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Marina Radrizzani
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
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27
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Capra M, Lodesani A, Brambilla A, Finazzi M, Duò L, Ciccacci F, Picone A. Reversible metamorphosis from Fe 3O 4 to FeO of epitaxial iron oxide films grown on the Fe-p(1 × 1)O surface. RSC Adv 2021; 11:11513-11518. [PMID: 35423610 PMCID: PMC8698807 DOI: 10.1039/d0ra10650j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/12/2021] [Indexed: 01/08/2023] Open
Abstract
The reduction and oxidation of epitaxial Fe3O4 films grown by reactive deposition on a Fe-p(1 × 1)O surface have been investigated by means of Auger electron spectroscopy (AES), low energy electron diffraction (LEED) and scanning tunneling microcopy (STM). The as-grown iron oxide samples display a square LEED pattern with a lattice constant compatible with a p(1 × 1) bulk terminated Fe3O4(001) surface. STM topographic images of Fe3O4 are characterized by atomically flat terraces separated by highly oriented steps running along the (010) and (100) crystallographic directions of the substrate. Upon annealing at 800 K in an ultra-high vacuum, AES reveals that magnetite transforms to FeO. The sample exposes the (001) surface of the rock salt structure, with a lattice parameter close to that of bulk wüstite. The Fe3O4 phase can be recovered by oxidation at 10−6 mbar of molecular oxygen. The reduction and oxidation of epitaxial Fe3O4 films grown by reactive deposition on a Fe-p(1 × 1)O surface have been investigated by means of surface science techniques.![]()
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Affiliation(s)
- M. Capra
- Department of Physics
- Politecnico di Milano
- I-20133 Milano
- Italy
| | - A. Lodesani
- Department of Physics
- Politecnico di Milano
- I-20133 Milano
- Italy
| | - A. Brambilla
- Department of Physics
- Politecnico di Milano
- I-20133 Milano
- Italy
| | - M. Finazzi
- Department of Physics
- Politecnico di Milano
- I-20133 Milano
- Italy
| | - L. Duò
- Department of Physics
- Politecnico di Milano
- I-20133 Milano
- Italy
| | - F. Ciccacci
- Department of Physics
- Politecnico di Milano
- I-20133 Milano
- Italy
| | - A. Picone
- Department of Physics
- Politecnico di Milano
- I-20133 Milano
- Italy
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28
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Amerio A, Bertuccio P, Santi F, Bianchi D, Brambilla A, Morganti A, Odone A, Costanza A, Signorelli C, Aguglia A, Serafini G, Capolongo S, Amore M. Gender Differences in COVID-19 Lockdown Impact on Mental Health of Undergraduate Students. Front Psychiatry 2021; 12:813130. [PMID: 35069298 PMCID: PMC8766745 DOI: 10.3389/fpsyt.2021.813130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Prolonged university closures and social distancing-imposed measures due to the COVID-19 pandemic obliged students to at-home learning with online lectures and educational programs promoting potential social isolation, loneliness, hopelessness, and episodes of clinical decompensation. Methods: A web-based cross-sectional survey was carried out in a university institute in Milan, Northern Italy, to assess the COVID-19 lockdown impact on the mental health of the undergraduate students. We estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) using adjusted logistic regression models. Results: Of the 8,177 students, 12.8% reported depressive symptoms, 25.6% anxiety, 8.7% insomnia, and 10.6% reported impulsive tracts, with higher proportions among females than males. Mental health symptoms were positively associated with caring for a person at home, a poor housing quality, and a worsening in working performance. Among males compared with females, a poor housing quality showed a stronger positive association with depressive symptoms and impulsivity, and a worsening in the working performance was positively associated with depressive and anxiety symptoms. In addition, the absence of private space was positively associated with depression and anxiety, stronger among males than females. Conclusions: To our knowledge, this is the first multidisciplinary consortium study, involving public mental health, environmental health, and architectural design. Further studies are needed to confirm or refute our findings and consequent recommendations to implement well-being interventions in pandemic conditions.
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Affiliation(s)
- Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Paola Bertuccio
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Francesca Santi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Davide Bianchi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Brambilla
- Politecnico di Milano, Department of Architecture, Built Environment and Construction Engineering, Design and Health Lab, Milan, Italy
| | - Alessandro Morganti
- Politecnico di Milano, Department of Architecture, Built Environment and Construction Engineering, Design and Health Lab, Milan, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefano Capolongo
- Politecnico di Milano, Department of Architecture, Built Environment and Construction Engineering, Design and Health Lab, Milan, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
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29
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Pagano M, Fumagalli C, Girolami F, Spinelli V, Passantino S, Brambilla A, Morrone A, Donati M, Olivotto I, Favilli S. Prevalence of adverse cardiovascular events in pediatric cardiomyopathies: an analysis of 110 patients followed at a long-standing tertiary care paediatric centre. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Pediatric cardiomyopathies (CMP) are disorders of the morphology and function of the heart, with a greater heterogeneity concerning etiology and clinical presentation than adult CMP. The assessment of etiology and genetic status is of paramount importance for prognosis, family screening, and therapeutic choices.
Purpose
To report clinical presentation, etiology, and outcome of a cohort of children diagnosed with CMP followed at tertiary care pediatric referral centre.
Methods
We retrospectively reviewed clinical, laboratory and imaging data of all patients referred to our cardiomyopathy centre from May 2008 to May 2019 for pediatric CMP (<18 years). CMP due to arrhythmic disorders, toxic agents' exposure, rheumatic conditions and maternal disease (i.e. maternal diabetes) were excluded. Primary endpoint was a composite of major adverse cardiovascular events (MACE: cardiovascular death, heart failure [HF] hospitalization, arrhythmic events, need for surgery or heart transplant referral).
Results
We enrolled 110 patients (65 males, age at diagnosis 67±71 months). Hypertrophic cardiomyopathy (HCM, N=48, 44%) was most frequent, followed by dilated cardiomyopathy (DCM, N=35 32%) and left ventricular non-compaction phenotype (LVNC, N=12, 11%). Mixed phenotype (N=7, 6%) and restrictive cardiomyopathy (RCM, N=3, 3%) were less common. No cases of arrhythmogenic right ventricular cardiomyopathy (ARVC) were detected. Five genotype-positive patients presented with negative clinical phenotype. A diagnosis was confirmed in all patients; the most common was sarcomere disease (30%, N=33) followed by metabolic (28%,N=31) disease, genetic syndromes (11%, N=12), neuromuscular (7,3%, N=8) diseases, and post-myocarditis cases (4,5%,N=5). Twenty-one patients (19%) were identified as idiopathic. At referral, 4,5% of children presented with NYHA class III/IV.
At 35 [14–72] months, 4 (3.7%) patients required ICD implantation, 8 (7.4%) underwent cardiac surgery, and 1 (1%) underwent heart transplant. Furthermore, 28 (26%) patients required hospitalization due to acute HF, with DCM patients being at higher risk (p<0.01), 7 (6.8%) experienced arrhythmic events and 4 (3.9%) had syncope. Overall, 13 (12%) died (7 with metabolic disorders, 3 with genetic syndromes, 1 with a sarcomeric mutation, 1 post myocarditis, and 1 idiopathic).
Conclusions
In our cohort, HCM was the most common cause of pediatric CMP followed by DCM and non-compaction. MACE were present in 41% of patients. While HCM had a less severe phenotype (characterized by a higher arrhythmic burden), DCM was characterized by a higher prevalence of HF hospitalizations. DCM, inborn errors in metabolism and genetic syndromes had the worst outcome in terms mortality and heart failure long term.
Widespread availability of genetic testing provides several benefits to the clinician, confirming diagnosis in ambiguous cases and defining etiology in order to guide management and identifying relatives at risk.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Pagano
- Meyer Children's Hospital, Cardiology Department, Florence, Italy
| | - C Fumagalli
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - F Girolami
- Meyer Children's Hospital, Cardiology Department, Florence, Italy
| | - V Spinelli
- Meyer Children's Hospital, Cardiology Department, Florence, Italy
| | - S Passantino
- Meyer Children's Hospital, Cardiology Department, Florence, Italy
| | - A Brambilla
- Meyer Children's Hospital, Cardiology Department, Florence, Italy
| | - A Morrone
- Meyer University Hospital, Molecular and Cell Biology Laboratory of Neurometabolic Diseases, Neuroscience Department, Florence, Italy
| | - M.A Donati
- Meyer Children's Hospital, Metabolic Disease and Newborn Screening Clinical Unit, Neuroscience Department,, Florence, Italy
| | - I Olivotto
- Careggi University Hospital (AOUC), Cardiomyopathies Unit, Florence, Italy
| | - S Favilli
- Meyer Children's Hospital, Cardiology Department, Florence, Italy
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30
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Morganti A, Brambilla A, Amerio A, Aguglia A, Odone A, Costanza A, Signorelli C, Serafini G, Amore M, Capolongo S. COVID-19 lockdown: housing built environment’s effects on mental health. Eur J Public Health 2020. [PMCID: PMC7543536 DOI: 10.1093/eurpub/ckaa165.426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Since the World Health Organization (WHO) declared the coronavirus infectious disease 2019 (COVID-19) outbreak a pandemic on March 11th, severe 'lockdown' measures have been adopted by the Italian Government. For over two months of stay-at-home, houses became the only place where people slept, ate, worked, practiced sports, and socialized. As consolidated evidence exists on housing as a determinant of health, it is of great interest to explore the impact that COVID-19 response-related lockdown measures had on mental health and wellbeing.
Methods
We conducted a large web-based survey on 9261 subjects in Northern Italy, one of the Regions most heavily hit by the pandemic in Europe. Participants were recruited among university staff, faculty and students. The questions included socio-demographic features of the participants; international evaluation scales designed to recognize depressive-, anxiety- and sleep-related symptoms, impulsivity, quality of life; architectural parameters investigating housing physical characteristics.
Results
As emerges from our analysis poor housing is associated with increased risk of depressive symptoms during lockdown. In particular, living in apartments < 60 m2, with poor quality view and indoor area is associated with, respectively, 1.31 (95CI), 1.368 (95CI), and 2.253 (95CI) time the risk of moderate/severe and severe depressive symptoms. Subjects reporting worsened working performance from home were over four times more likely to also report depression (OR = 4.28, 95%CI).
Conclusions
Our findings suggest housing played a major role in influencing people mental health and wellbeing during COVID-19 pandemic. We argue strengthened multi-interdisciplinary approach involving urban planning, public mental health, environmental health, epidemiology, and sociology, is needed to inform the planning implementation and monitoring of housing policies centered on population health.
Key messages
COVID-19 lockdown mitigation measures strongly impacted on Mental Health. Living in apartments < 60 m2, with poor quality view and indoor area significatively increase the risk of moderate and severe depressive symptoms.
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Affiliation(s)
- A Morganti
- DABC, Politecnico di Milano, Milan, Italy
| | | | - A Amerio
- DINOGMI, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Psychiatry, Tufts University, Boston, USA
| | - A Aguglia
- DINOGMI, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Odone
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Clinical Epidemiology and HTA, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Costanza
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - C Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - G Serafini
- DINOGMI, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Amore
- DINOGMI, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Brambilla A, Lindahl G, Dell'Ovo M, Capolongo S. Validation of a multiple criteria tool for healthcare facilities quality evaluation. F 2020. [DOI: 10.1108/f-06-2020-0070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Several healthcare quality assessment tools measure the processes and outcomes of the care system. The actual physical infrastructure (buildings and organizational) aspects are, however, rarely considered. The purpose of this paper is to describe the process of validation and weighting of an evidence-informed framework for the quality assessment of hospital facilities from social, environmental and organizational perspectives to complement other assessments.
Design/methodology/approach
Sustainable High-quality Healthcare version 2 (SustHealth v2) is the updated version of an existing framework composed of three domains (social, environmental and organizational quality). To validate and establish a relevant weighting, interviews were conducted with 15 professionals within the field of healthcare planning, design, research and management. The study has been conducted through semi-structured interviews and the application of the Simon Roy Figueras (SRF) procedure for the elicitation of weights criteria. The data collected have been processed through the DecSpace web platform.
Findings
Among the three domains, the organizational qualities appear to be the most important (W = 49%), followed by the environmental (W = 29%) and social aspects (W = 22%). Relevant indicators such as future-proofing, wayfinding and users’ space control emerged as the most important within each macro-area. Those results are confirmed by the outcome of the interviews that highlight user/patient-centeredness, wayfinding strategies and space functionality as the most important concepts to foster in existing healthcare facilities improvement.
Practical implications
The study highlights important structural and organizational aspects that hospital managers and planners can consider when dealing with healthcare facilities’ quality improvement.
Originality/value
The use of the SRF multicriteria method is novel in this context when used to weight an assessment tool with a focus on hospital built environment.
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Capolongo S, Barach P, Brambilla A, Gola M, Signorelli C. The challenges in training and education of hospital designers and planners. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The designed hospital environment is one of the most complex endeavors of work and there is a growing need of specialization. Scientific, technological and research developments and innovation along with new discoveries within health promotion and prevention strategies are increasingly requiring a multidisciplinary and interdisciplinary approach to the design and management of hospitals. Therefore, it is likely that the current professions will be replaced and flanked by more specialized ones.
Objectives
The scope of the paper is to display an overview of the current educational courses of the emerging Hospital Planner, referring to the worldwide available training courses (BSc, MSc, specialization and PhD courses) related to healthcare design. The focus relates to the fields of Medicine and Nursing sciences, Architecture and Engineering.
Results
A preliminary investigation has been conducted of websites and snowballing technique. The search was limited to active training programs and courses. Currently several institutions offer BSc, MSc courses and PhD programs in Healthcare Design, Environmental and Building Hygiene and Public Health. As well, there are several professional postgraduate courses either in classroom or using hybrid programs including webinars. Clemson University, USA and Ontario College of Art and Design University, Canada, offer a full MSc degree in Architecture and Health. In addition, there are several joint degree programs such as physician-engineer, physician-architect, nurse-architect or engineer.
Conclusions
From the preliminary study emerged a considerable number of international experiences addressing the topic of Hospital Planner training. Further in-depth investigations will examine the topic through questionnaires and interviews of the course organization, students' experiences, outcomes and professional careers, fields of interest and collaborations with other institutions.
Key messages
Hospital environments are the most complex field of work and require many years of specialization and multidisciplinarity and influence the quality of patient outcomes. The academic stream of the built environment is evolving toward proving specific multidisciplinary courses and hands-on experiences to support a degree in hospital planning, design and management.
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Affiliation(s)
- S Capolongo
- Architecture, Built environment and Construction engineering, Politecnico di Milano, Milan, Italy
| | - P Barach
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, USA
| | - A Brambilla
- Architecture, Built environment and Construction engineering, Politecnico di Milano, Milan, Italy
| | - M Gola
- Architecture, Built environment and Construction engineering, Politecnico di Milano, Milan, Italy
| | - C Signorelli
- Biomedical, Biotechnological, and Translational Sciences, Università Vita-Salute San Raffaele, Milan, Italy
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Gola M, Brambilla A, Barach P, Signorelli C, Capolongo S. Educational Challenges in Healthcare Design: Training Multidisciplinary Professionals for Future Hospitals and Healthcare. Ann Ig 2020; 32:549-566. [PMID: 32744586 DOI: 10.7416/ai.2020.2375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Healthcare environments are one of the most complex and demanding fields of work. Scientific, technological and research developments along with new discoveries within health promotion and prevention strategies are increasingly requiring a multidisciplinary and interdisciplinary approach. Therefore, it is likely that the current professions will need to be significantly adapted to accommodate new and more specialized roles. OBJECTIVES To present an overview of the current educational and training courses of the emerging professions, such as hospital planner, physician-engineer, doctor-architect, nurse-architect or engineer, we review the present global training courses (BSc, MSc, specialization and PhD courses) related to healthcare design focusing on the fields of Medicine and Nursing, Architecture and Engineering sciences. RESULTS The paper analyses the literature review and website analysis about active teaching programs and courses. Several academic institutions offer BSc, MSc and PhD degree programs in Healthcare Design, Environmental and Building Hygiene, and Public Health. In addition, there are several professional postgraduate courses, either in classroom, hybrid-based or online. CONCLUSIONS A considerable number of international training experiences addresses the topic of training multidisciplinary professionals. Further in-depth investigations are needed to examine the content, teaching format and impact of the courses, student outcomes and professional careers, fields of interest and the degree of collaborations with other institutions.
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Affiliation(s)
- M Gola
- Department of Architecture, Built environment and Construction engineering, Politecnico di Milano, Milan, Italy - Design & Health LAB, Politecnico di Milano, Milan, Italy
| | - A Brambilla
- Department of Architecture, Built environment and Construction engineering, Politecnico di Milano, Milan, Italy - Design & Health LAB, Politecnico di Milano, Milan, Italy
| | - P Barach
- Jefferson College of Population Health, Philadelphia, PA, USA- Wayne State University, Detroit, MI, USA - Sigmund Freud University, Vienna, Austria
| | - C Signorelli
- University Vita-Salute San Raffaele, Milan, Italy
| | - S Capolongo
- Department of Architecture, Built environment and Construction engineering, Politecnico di Milano, Milan, Italy - Design & Health LAB, Politecnico di Milano, Milan, Italy
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Capolongo S, Gola M, Brambilla A, Morganti A, Mosca EI, Barach P. COVID-19 and Healthcare Facilities: a Decalogue of Design Strategies for Resilient Hospitals. Acta Biomed 2020; 91:50-60. [PMID: 32701917 PMCID: PMC8023092 DOI: 10.23750/abm.v91i9-s.10117] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM The COVID-19 pandemic has upended the global healthcare systems. The surge in infections and sick critically ill patients has tested the resilience of healthcare infrastructures and facilities forcing organizations to quickly adapt and embrace emergency solutions. The paper proposes a decalogue of design strategies applicable both to new hospitals and to the refurbishment of existing hospitals. METHODS The authors conducted observations at hospitals, during public health webinars and through experts working groups from March to May 2020. RESULTS In this commentary, the authors present a list of strategies for creating critical care surge capacity and exploring design strategies for healthcare design for resilient hospital facilities. The strategies are organized into two tiers: I) design and II) operations. The (I) Design phase strategies are: 1) Strategic Site Location; 2) Typology Configuration; 3) Flexibility; 4) Functional program; 5) User-centerdness. The (II) Operation phase strategies are: 6) Healthcare network on the territory; 7) Patient safety; 8) HVAC and indoor air quality; 9) Innovative finishing materials and furniture; 10) Healthcare digital innovation. CONCLUSIONS Hospitals, health care systems, and institutions urgently need to assess their resources, identify potential bottlenecks, and create strategies for increasing critical care surge capacity. The COVID-19 pandemic disrupted healthcare operations and accelerated the processes of innovation and transformation. The design and operational strategies can enable the achievement of resilient hospital facilities. Further multidisciplinary researches is needed to validate the strategies empirically.
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Affiliation(s)
- Stefano Capolongo
- Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy .
| | - Marco Gola
- Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy .
| | - Andrea Brambilla
- Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy .
| | - Alessandro Morganti
- Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy .
| | - Erica Isa Mosca
- Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy .
| | - Paul Barach
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, United States of America; Jefferson College of Population Health, Philadelphia, PA, United States of America; Sigmund Freud University, Wien, Austria.
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Brambilla A, Rebecchi A, Capolongo S. Evidence Based Hospital Design. A literature review of the recent publications about the EBD impact of built environment on hospital occupants' and organizational outcomes. Ann Ig 2020; 31:165-180. [PMID: 30714614 DOI: 10.7416/ai.2019.2269] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Healthcare facilities are complex infrastructures where different features from technological, social, clinical and architectural field interact. In modern healthcare systems there is a growing attention to the need of quality in terms of process and outcome, while the structural (physical) aspects are not often considered. Since the Nineties the theory of the Evidence Based Design (EBD) states that there is significant relationship between built environment and health related outcome. OBJECTIVE Aim of this paper is to investigate, in the recent scientific literature, which are the most important occupants' and organizational outcomes influenced by EBD hospital built environment qualities. METHODOLOGY A Literature Review based on Scopus and PubMed databases has been run in order to understand the existing situation in terms of hospital quality evaluation from the physical and architectural point of view and to highlight the current trends. The results of the different reviews, empirical studies and post Occupancy Evaluations have been analyzed according to Ulrich's EBD conceptual framework. RESULTS 35 peer reviewed papers from the last 2 years were included. The methodologies adopted are very different and data are mainly collected through structured interviews or observations and elaborated with qualitative (33%), quantitative (26%) or mixed (41%) methodologies. The topic is mostly investigated in USA, Australia, Canada, UK and in the Scandinavian region; few contributions come also from Italy. Built environment variables that affect user's or organizational outcomes are mainly the Visual Environment (29%), the Audio Environment (20%) and the Patient Room Design (20%). DISCUSSION AND CONCLUSION The most recurrent outcomes found to be affected by the built environmental qualities are staff job satisfaction (n=11), patients' stress reduction (n=9), patients' satisfaction (n=6) and patients' fall reduction (n=6). Organizational outcomes are mentioned only two times. Although EBD is an old theory, the topic is both contemporary and relevant. Due to the diversity of the contributions and the limitations of the research, a deep comparison is challenging. Further investigation is necessary to deepen each of the variables identified.
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Affiliation(s)
- A Brambilla
- Department of Architecture, Built Environment, Construction Engineering, Politecnico di Milano, Milan Ital
| | - A Rebecchi
- Department of Architecture, Built Environment, Construction Engineering, Politecnico di Milano, Milan Ital
| | - S Capolongo
- Department of Architecture, Built Environment, Construction Engineering, Politecnico di Milano, Milan Ital
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Azzopardi-Muscat N, Brambilla A, Caracci F, Capolongo S. Synergies in Design and Health. The role of architects and urban health planners in tackling key contemporary public health challenges. Acta Biomed 2020; 91:9-20. [PMID: 32275262 PMCID: PMC7975902 DOI: 10.23750/abm.v91i3-s.9414] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 12/31/2022]
Abstract
Background and aim: Important public health improvements have been achieved over the past decades, but new challenges are emerging and progress cannot be taken for granted. Urban settlements host most of the global population, but they are also sources of several threats. The aim of the paper is to investigate the role of architects and planners in contributing to overcome these critical health challenges and propose strategic actions for collaboration with the public health workforce. Methods: Taking global trends and public health challenges as starting point, a scoping literature review has been conducted to illustrate the possible synergies that architecture and public health workforce should exploit to support population health improvement and tackle key public health challenges. Results: The built environment affects climate change and public health through the use of resources, site location, and green spaces. In architecture curricula, limited space is devoted to health and vice versa. There is an urgent need for recognition of the benefits of collaboration and cross-fertilisation between public health and planning workforce from local to global levels. Conclusion: Public health is evolving from a bio-medical to a socio-anthropological approach and architects/planners have fundamental roles; further collaboration, research and training are needed.
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Affiliation(s)
- Natasha Azzopardi-Muscat
- University of Malta, Department of Health Services Management, Faculty of Health Science, Malta.
| | - Andrea Brambilla
- Politecnico di Milano, Department Architecture Built environment Construction engineering (ABC), Italy.
| | - Francesca Caracci
- University of Palermo, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), Italy.
| | - Stefano Capolongo
- Politecnico di Milano, Department Architecture Built environment Construction engineering (ABC), Italy.
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Quitadamo P, Giannetti E, Andreozzi M, Mancusi V, Caprio MG, Brambilla A, Esposito F, Vallone G, Siani P, Staiano A. Clinical significance and sonographic evolution of enlarged abdominal lymph nodes in children. Acta Paediatr 2019; 108:1857-1860. [PMID: 30929258 DOI: 10.1111/apa.14804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/25/2019] [Accepted: 03/27/2019] [Indexed: 11/29/2022]
Abstract
AIM Paediatric evidence about the clinical implications of enlarged abdominal lymph nodes (EALN) is not univocal. The main purpose of our study was to evaluate the clinical significance and the morphological evolution of enlarged abdominal nodes in children with recurrent abdominal pain. METHODS All children with recurrent abdominal pain diagnosed with EALN were enrolled at the involved centres between September 2017 and June 2018. Number, size, localisation, shape and architecture of nodes were accurately recorded along with clinical and laboratory data at enrolment and after three and six months. RESULTS A total of 38 children were enrolled. After the six-month study period, 58% of them had lymph nodes reduced in size, 13% had unchanged lymph nodes, and 29% had lymph nodes increased in size. Overall, we observed a gradual, albeit slight reduction in the average size of enlarged nodes over the six-month period. The extent of size changes was not correlated with any clinical parameter. CONCLUSION Our data suggest that EALN are a non-specific finding, which is not worth a change in the diagnostic and therapeutic management of children with abdominal pain.
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Affiliation(s)
- Paolo Quitadamo
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
- Department of Pediatrics A.O.R.N. Santobono‐Pausilipon Naples Italy
| | - Eleonora Giannetti
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
| | - Marialuisa Andreozzi
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
| | - Valeria Mancusi
- Department of Advanced Biomedical Sciences “Federico II” University of Naples Naples Italy
| | - Maria Grazia Caprio
- Institute of Biostructure and Bioimaging IBB Italian National Research Council CNR Naples Italy
| | - Andrea Brambilla
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
| | | | - Gianfranco Vallone
- Department of Advanced Biomedical Sciences “Federico II” University of Naples Naples Italy
| | - Paolo Siani
- Department of Pediatrics A.O.R.N. Santobono‐Pausilipon Naples Italy
| | - Annamaria Staiano
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
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Brambilla A, Buffoli M, Capolongo S. Measuring hospital qualities. A preliminary investigation on Health Impact Assessment possibilities for evaluating complex buildings. Acta Biomed 2019; 90:54-63. [PMID: 31517890 PMCID: PMC7233655 DOI: 10.23750/abm.v90i9-s.8713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK World Health Organization states that is possible evaluating projects' qualities via Health Impact Assessment (HIA) but there are not specific HIA tools on hospital buildings assessment. Researchers show significant relationships between built environment and health. The research purpose is investigating how existing tools for healthcare building assessment are encouraging the development of possible hospital HIA evaluation. METHODS Based on previous works, 13 assessment tools have been included and a comparison of the criteria has been conducted to understand which the most prevalent topics are. The tools have been analyzed through literature, technical manuals and official websites. The authors identified 12 thematic categories where criteria from different tools have been clustered and discussed. RESULTS The most prevalent criteria are related to Indoor Environmental Quality (IEQ) (20%). In the oldest tools the evaluation was mainly on technical features while in recent instruments several indicators are related to Architectural features and innovation (48%), Education (23%) and Food (11%). CONCLUSIONS There is growing interest in tools capable of addressing healthy hospitals encouraging IEQ, physical activity and healthy food provision related to occupants' health outcomes. This preliminary study set the basis for further development on hospital facility HIA tools.
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Andriolo G, Provasi E, Lo Cicero V, Brambilla A, Soncin S, Torre T, Milano G, Biemmi V, Vassalli G, Turchetto L, Barile L, Radrizzani M. Exosomes From Human Cardiac Progenitor Cells for Therapeutic Applications: Development of a GMP-Grade Manufacturing Method. Front Physiol 2018; 9:1169. [PMID: 30197601 PMCID: PMC6117231 DOI: 10.3389/fphys.2018.01169] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/03/2018] [Indexed: 12/15/2022] Open
Abstract
Exosomes, nanosized membrane vesicles secreted by cardiac progenitor cells (Exo-CPC), inhibit cardiomyocyte apoptosis under stress conditions, promote angiogenesis in vitro, and prevent the early decline in cardiac function after myocardial infarction in vivo in preclinical rat models. The recognition of exosome-mediated effects has moved attempts at developing cell-free approaches for cardiac repair. Such approaches offer major advantages including the fact that exosomes can be stored as ready-to-use agents and delivered to patients with acute coronary syndromes. The aim of the present work was the development of a good manufacturing practice (GMP)-grade method for the large-scale preparation of Exo-CPC as a medicinal product, for a future clinical translation. A GMP-compliant manufacturing method was set up, based on large-scale cell culture in xeno-free conditions, collection of up to 8 l of exosome-containing conditioned medium and isolation of Exo-CPC through tangential flow filtration. Quality control tests were developed and carried out to evaluate safety, identity, and potency of both cardiac progenitor cells (CPC) as cell source and Exo-CPC as final product (GMP-Exo-CPC). CPC, cultured in xeno-free conditions, showed a lower doubling-time than observed in research-grade condition, while producing exosomes with similar features. Cells showed the typical phenotype of mesenchymal progenitor cells (CD73/CD90/CD105 positive, CD14/CD20/CD34/CD45/HLA-DR negative), and expressed mesodermal (TBX5/TBX18) and cardiac-specific (GATA4/MESP1) transcription factors. Purified GMP-Exo-CPC showed the typical nanoparticle tracking analysis profile and expressed main exosome markers (CD9/CD63/CD81/TSG101). The GMP manufacturing method guaranteed high exosome yield (>1013 particles) and consistent removal (≥97%) of contaminating proteins. The resulting GMP-Exo-CPC were tested for safety, purity, identity, and potency in vitro, showing functional anti-apoptotic and pro-angiogenic activity. The therapeutic efficacy was validated in vivo in rats, where GMP-Exo-CPC ameliorated heart function after myocardial infarction. Our standardized production method and testing strategy for large-scale manufacturing of GMP-Exo-CPC open new perspectives for reliable human therapeutic applications for acute myocardial infarction syndrome and can be easily applied to other cell sources for different therapeutic areas.
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Affiliation(s)
- Gabriella Andriolo
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland
| | - Elena Provasi
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland
| | - Viviana Lo Cicero
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland
| | - Andrea Brambilla
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland
| | - Sabrina Soncin
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland
| | - Tiziano Torre
- Division of Cardiac Surgery, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Giuseppina Milano
- Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland.,Laboratory of Molecular and Cellular Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Department of Heart and Vessels, Laboratory of Cardiovascular Research, Lausanne University Hospital, Lausanne, Switzerland
| | - Vanessa Biemmi
- Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland.,Laboratory of Molecular and Cellular Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Giuseppe Vassalli
- Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland.,Laboratory of Molecular and Cellular Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Lucia Turchetto
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland
| | - Lucio Barile
- Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland.,Laboratory of Molecular and Cellular Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Marina Radrizzani
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.,Swiss Institute for Regenerative Medicine, Torricella-Taverne, Switzerland
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Rogora M, Frate L, Carranza ML, Freppaz M, Stanisci A, Bertani I, Bottarin R, Brambilla A, Canullo R, Carbognani M, Cerrato C, Chelli S, Cremonese E, Cutini M, Di Musciano M, Erschbamer B, Godone D, Iocchi M, Isabellon M, Magnani A, Mazzola L, Morra di Cella U, Pauli H, Petey M, Petriccione B, Porro F, Psenner R, Rossetti G, Scotti A, Sommaruga R, Tappeiner U, Theurillat JP, Tomaselli M, Viglietti D, Viterbi R, Vittoz P, Winkler M, Matteucci G. Assessment of climate change effects on mountain ecosystems through a cross-site analysis in the Alps and Apennines. Sci Total Environ 2018; 624:1429-1442. [PMID: 29929254 DOI: 10.1016/j.scitotenv.2017.12.155] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/11/2017] [Accepted: 12/14/2017] [Indexed: 06/08/2023]
Abstract
Mountain ecosystems are sensitive and reliable indicators of climate change. Long-term studies may be extremely useful in assessing the responses of high-elevation ecosystems to climate change and other anthropogenic drivers from a broad ecological perspective. Mountain research sites within the LTER (Long-Term Ecological Research) network are representative of various types of ecosystems and span a wide bioclimatic and elevational range. Here, we present a synthesis and a review of the main results from ecological studies in mountain ecosystems at 20 LTER sites in Italy, Switzerland and Austria covering in most cases more than two decades of observations. We analyzed a set of key climate parameters, such as temperature and snow cover duration, in relation to vascular plant species composition, plant traits, abundance patterns, pedoclimate, nutrient dynamics in soils and water, phenology and composition of freshwater biota. The overall results highlight the rapid response of mountain ecosystems to climate change, with site-specific characteristics and rates. As temperatures increased, vegetation cover in alpine and subalpine summits increased as well. Years with limited snow cover duration caused an increase in soil temperature and microbial biomass during the growing season. Effects on freshwater ecosystems were also observed, in terms of increases in solutes, decreases in nitrates and changes in plankton phenology and benthos communities. This work highlights the importance of comparing and integrating long-term ecological data collected in different ecosystems for a more comprehensive overview of the ecological effects of climate change. Nevertheless, there is a need for (i) adopting co-located monitoring site networks to improve our ability to obtain sound results from cross-site analysis, (ii) carrying out further studies, in particular short-term analyses with fine spatial and temporal resolutions to improve our understanding of responses to extreme events, and (iii) increasing comparability and standardizing protocols across networks to distinguish local patterns from global patterns.
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Affiliation(s)
- M Rogora
- CNR Institute of Ecosystem Study, Verbania Pallanza, Italy.
| | - L Frate
- DIBT, Envix-Lab, University of Molise, Pesche (IS), Italy
| | - M L Carranza
- DIBT, Envix-Lab, University of Molise, Pesche (IS), Italy
| | - M Freppaz
- DISAFA, NatRisk, University of Turin, Grugliasco (TO), Italy
| | - A Stanisci
- DIBT, Envix-Lab, University of Molise, Pesche (IS), Italy
| | - I Bertani
- Graham Sustainability Institute, University of Michigan, 625 E. Liberty St., Ann Arbor, MI 48104, USA
| | - R Bottarin
- Eurac Research, Institute for Alpine Environment, Bolzano (BZ), Italy
| | - A Brambilla
- Alpine Wildlife Research Centre, Gran Paradiso National Park, Degioz (AO) 11, Valsavarenche, Italy; Department of Evolutionary Biology and Environmental Studies, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - R Canullo
- School of Biosciences and Veterinary Medicine, Plant Diversity and Ecosystems Management Unit, University of Camerino (MC), Italy
| | - M Carbognani
- Department of Chemistry, Life Sciences and Environmental Sustainability University of Parma, Parma, Italy
| | - C Cerrato
- Alpine Wildlife Research Centre, Gran Paradiso National Park, Degioz (AO) 11, Valsavarenche, Italy
| | - S Chelli
- School of Biosciences and Veterinary Medicine, Plant Diversity and Ecosystems Management Unit, University of Camerino (MC), Italy
| | - E Cremonese
- Environmental Protection Agency of Aosta Valley, ARPA VdA, Climate Change Unit, Aosta, Italy
| | - M Cutini
- Department of Science, University of Roma Tre, Viale G. Marconi, 446-00146 Rome, Italy
| | - M Di Musciano
- Department of Life Health & Environmental Sciences, University of L'Aquila Via Vetoio, 67100 L'Aquila, Italy
| | - B Erschbamer
- University of Innsbruck, Institute of Botany, Sternwartestr 15, A-6020 Insbruck, Austria
| | - D Godone
- CNR IRPI Geohazard Monitoring Group, Strada delle Cacce, 73, 10135 Torino, Italy
| | - M Iocchi
- Department of Science, University of Roma Tre, Viale G. Marconi, 446-00146 Rome, Italy
| | - M Isabellon
- DISAFA, University of Turin, Grugliasco (TO), Italy; Environmental Protection Agency of Aosta Valley, ARPA VdA, Climate Change Unit, Aosta, Italy
| | - A Magnani
- DISAFA, University of Turin, Grugliasco (TO), Italy
| | - L Mazzola
- Sciences and Technologies for Environment and Resources, University of Parma, Italy
| | - U Morra di Cella
- Environmental Protection Agency of Aosta Valley, ARPA VdA, Climate Change Unit, Aosta, Italy
| | - H Pauli
- GLORIA Coordination, Institute for Interdisciplinary Mountain Research, Austrian Academy of Sciences & Center for Global Change and Sustainability, University of Natural Resources and Life Sciences Vienna (BOKU), Silbergasse 30/3, 1190 Vienna, Austria
| | - M Petey
- Environmental Protection Agency of Aosta Valley, ARPA VdA, Climate Change Unit, Aosta, Italy
| | - B Petriccione
- Carabinieri, Biodiversity and Park Protection Dpt., Roma, Italy
| | - F Porro
- Department of Earth and Environmental Sciences, University of Pavia, via Ferrata 1, 27100 Pavia, Italy
| | - R Psenner
- Eurac Research, Institute for Alpine Environment, Bolzano (BZ), Italy; Lake and Glacier Research Group, Institute of Ecology, University of Innsbruck, Technikerstr, 25, 6020 Innsbruck, Austria
| | - G Rossetti
- Department of Environmental Sciences, University of Parma, Parco Area delle Scienze, 33/A, 43100 Parma, Italy
| | - A Scotti
- Eurac Research, Institute for Alpine Environment, Bolzano (BZ), Italy
| | - R Sommaruga
- Lake and Glacier Research Group, Institute of Ecology, University of Innsbruck, Technikerstr, 25, 6020 Innsbruck, Austria
| | - U Tappeiner
- Eurac Research, Institute for Alpine Environment, Bolzano (BZ), Italy
| | - J-P Theurillat
- Centre Alpien de Phytogéographie, Fondation J.-M. Aubert, 1938 Champex-Lac, Switzerland, & Section of Biology, University of Geneva, 1292 Chambésy, Switzerland
| | - M Tomaselli
- Department of Chemistry, Life Sciences and Environmental Sustainability University of Parma, Parma, Italy
| | - D Viglietti
- DISAFA, NatRisk, University of Turin, Grugliasco (TO), Italy
| | - R Viterbi
- Alpine Wildlife Research Centre, Gran Paradiso National Park, Degioz (AO) 11, Valsavarenche, Italy
| | - P Vittoz
- Institute of Earth Surface Dynamics, University of Lausanne, Geopolis, 1015 Lausanne, Switzerland
| | - M Winkler
- GLORIA Coordination, Institute for Interdisciplinary Mountain Research, Austrian Academy of Sciences & Center for Global Change and Sustainability, University of Natural Resources and Life Sciences Vienna (BOKU), Silbergasse 30/3, 1190 Vienna, Austria
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Pavia Y, Brambilla A, Rebuffel V, Freud N, Létang JM, Verger L. Breast density and iodine quantification in spectral mammography. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa8f59] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Agrawal DK, Bizzarri F, Brambilla A, Seshia AA. Numerical Verification of an Analytical Model for Phase Noise in MEMS Oscillators. IEEE Trans Ultrason Ferroelectr Freq Control 2016; 63:1204-1207. [PMID: 27295660 DOI: 10.1109/tuffc.2016.2575364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A new analytical formulation for phase noise in MEMS oscillators was recently presented encompassing the role of essential nonlinearities in the electrical and mechanical domains. In this paper, we validate the effectiveness of the proposed analytical formulation with respect to the unified theory developed by Demir et al. describing phase noise in oscillators. In particular, it is shown that, over a range of the second-order mechanical nonlinear stiffness of the MEMS resonator, both models exhibit an excellent match in the phase diffusion coefficient calculation for a square-wave MEMS oscillator.
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Brambilla A, Cosi A, Rosati A, Guerrini R, Cimaz R, Simonini G. FRI0505 Long-Term Efficacy and Safety of Mycophenolate Mofetil in Childhood Primary Central Nervous System Vasculitis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Calloni A, Berti G, Brambilla A, Riva M, Picone A, Bussetti G, Finazzi M, Ciccacci F, Duò L. Electron spectroscopy investigation of the oxidation of ultra-thin films of Ni and Cr on Fe(0 0 1). J Phys Condens Matter 2014; 26:445001. [PMID: 25213009 DOI: 10.1088/0953-8984/26/44/445001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We investigated the room temperature oxidation of ultra-thin Ni and Cr films grown on Fe(0 0 1). In particular, we characterized the degree of crystallinity and the stoichiometry of the oxide layers and addressed the chemical stability of the interface with the highly reactive Fe substrate by means of low-energy electron diffraction and x-ray and UV photoemission spectroscopy. In the Ni case we detected, upon oxidation, the formation of a Fe(3)O(4) layer covering the Ni oxide, due to the diffusion of Fe cations towards the surface. At high temperature and in ultra-high vacuum conditions, the Ni oxide dissolved and the Fe oxide layer was reduced to FeO. In the Cr case, we observed the formation of a thin Cr(2)O(3) oxide layer, showing a diffraction pattern compatible with a defective γ-Cr(2)O(3) phase. A thicker Cr oxide layer could be produced by oxidizing the sample at 300 °C, at the expense of the incorporation of trace amounts of Fe cations.
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Brambilla A, Calloni A, Berti G, Bussetti G, Duò L, Ciccacci F. Epitaxial growth of thin TiO 2films on the Au covered Fe(100) surface. Crystal Research and Technology 2014. [DOI: 10.1002/crat.201300416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A. Brambilla
- CNISM and Dipartimento di Fisica; Politecnico di Milano Piazza Leonardo Da Vinci 32; 20133 Milano Italy
| | - A. Calloni
- CNISM and Dipartimento di Fisica; Politecnico di Milano Piazza Leonardo Da Vinci 32; 20133 Milano Italy
| | - G. Berti
- CNISM and Dipartimento di Fisica; Politecnico di Milano Piazza Leonardo Da Vinci 32; 20133 Milano Italy
| | - G. Bussetti
- CNISM and Dipartimento di Fisica; Politecnico di Milano Piazza Leonardo Da Vinci 32; 20133 Milano Italy
| | - L. Duò
- CNISM and Dipartimento di Fisica; Politecnico di Milano Piazza Leonardo Da Vinci 32; 20133 Milano Italy
| | - F. Ciccacci
- CNISM and Dipartimento di Fisica; Politecnico di Milano Piazza Leonardo Da Vinci 32; 20133 Milano Italy
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Picone A, Riva M, Fratesi G, Brambilla A, Bussetti G, Finazzi M, Duò L, Ciccacci F. Enhanced atom mobility on the surface of a metastable film. Phys Rev Lett 2014; 113:046102. [PMID: 25105635 DOI: 10.1103/physrevlett.113.046102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Indexed: 06/03/2023]
Abstract
A remarkable enhancement of atomic diffusion is highlighted by scanning tunneling microscopy performed on ultrathin metastable body-centered tetragonal Co films grown on Fe(001). The films follow a nearly perfect layer-by-layer growth mode with a saturation island density strongly dependent on the layer on which the nucleation occurs, indicating a lowering of the diffusion barrier. Density functional theory calculations reveal that this phenomenon is driven by the increasing capability of the film to accommodate large deformations as the thickness approaches the limit at which a structural transition occurs. These results disclose the possibility of tuning surface diffusion dynamics and controlling cluster nucleation and self-organization.
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Affiliation(s)
- A Picone
- CNISM-Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - M Riva
- CNISM-Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - G Fratesi
- ETSF, CNISM, Dipartimento di Scienza dei Materiali, Università di Milano-Bicocca, via Cozzi 55, I-20125 Milano, Italy and Dipartimento di Fisica, Università degli Studi di Milano, via Celoria 16, I-20133 Milano, Italy
| | - A Brambilla
- CNISM-Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - G Bussetti
- CNISM-Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - M Finazzi
- CNISM-Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - L Duò
- CNISM-Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - F Ciccacci
- CNISM-Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
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Berti G, Calloni A, Brambilla A, Bussetti G, Duò L, Ciccacci F. Direct observation of spin-resolved full and empty electron states in ferromagnetic surfaces. Rev Sci Instrum 2014; 85:073901. [PMID: 25085146 DOI: 10.1063/1.4885447] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We present a versatile apparatus for the study of ferromagnetic surfaces, which combines spin-polarized photoemission and inverse photoemission spectroscopies. Samples can be grown by molecular beam epitaxy and analyzed in situ. Spin-resolved photoemission spectroscopy analysis is done with a hemispherical electron analyzer coupled to a 25 kV-Mott detector. Inverse photoemission spectroscopy experiments are performed with GaAs crystals as spin-polarized electron sources and a UV bandpass photon detector. As an example, measurements on the oxygen passivated Fe(100)-p(1×1)O surface are presented.
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Affiliation(s)
- G Berti
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133, Milano, Italy
| | - A Calloni
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133, Milano, Italy
| | - A Brambilla
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133, Milano, Italy
| | - G Bussetti
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133, Milano, Italy
| | - L Duò
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133, Milano, Italy
| | - F Ciccacci
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133, Milano, Italy
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Abstract
Representation of molecular surfaces is a well established way to study the interaction of molecules. The state-of-the-art molecular representation is the SES model, which provides a detailed surface visualization. Nevertheless, it is computationally expensive, so the less accurate Gaussian model is traditionally preferred. We introduce a novel surface representation that resembles the SES and approaches the rendering performance of the Gaussian model. Our technique is based on the iterative blending of implicit functions and avoids any pre-computation. Additionally, we propose a GPU-based ray-casting algorithm that efficiently visualize our molecular representation. A qualitative and quantitative comparison of our model with respect to the Gaussian and SES models is presented. As showcased in the paper, our technique is a valid and appealing alternative to the Gaussian representation. This is especially relevant in all the applications where the cost of the SES is prohibitive.
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Calloni A, Brambilla A, Berti G, Bussetti G, Canesi EV, Binda M, Petrozza A, Finazzi M, Ciccacci F, Duò L. X-ray photoemission spectroscopy investigation of the interaction between 4-mercaptopyridine and the anatase TiO2 surface. Langmuir 2013; 29:8302-8310. [PMID: 23725023 DOI: 10.1021/la400998r] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In polymer-metal oxide hybrid solar cells, an extremely careful engineering of the interface is required to ensure good device performances. Recently, very promising results have been obtained by functionalizing titanium dioxide (TiO2) by means of 4-mercaptopyridine (4-MPy) molecules, showing the beneficial effect of these molecules on the interface morphology. This study investigates the nature of the interaction of 4-MPy molecules with the TiO2 surface by means of X-ray photoemission spectroscopy. In order to mimic the device processing conditions, our analysis is carried out on molecules adsorbed from solution on a nanocrystalline surface. According to our analysis, 4-MPy molecules (C5H5NS) are likely bound with the oxide through the nitrogen atom. The bonding precedes either via a covalent interaction with Lewis surface sites, or via hydrogen mediation, possibly in the form of hydrogen bonds. Interestingly, in the latter case, we also observe strong changes in the spectroscopic features attributed to the thiol group.
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Affiliation(s)
- A Calloni
- CNISM and Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133 Milano, Italy.
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Brambilla A, Philippidis A, Nevin A, Comelli D, Valentini G, Anglos D. Adapting and testing a portable Raman spectrometer for SERS analysis of amino acids and small peptides. J Mol Struct 2013. [DOI: 10.1016/j.molstruc.2012.12.060] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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