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What makes a successful ship design? The most brilliant solution cannot be called a success if it is something that nobody desires. Nonetheless, if a solution can in principle fulfill customer’s needs but it is not appropriately executed, it is a failure as well. Therefore, for a successful solution, both elements are crucial: getting the right design and getting the design right. Respectively they answer the question “what is the right thing to build and why?” and “how do we build it?”. The traditional design method, represented by the “design spiral”, is a solution-oriented approach that works well when requirements have already been defined. It surely provides a feasible ship possibly fulfilling the customer’s requirements, but it is not ascertained a priori that it is the best one from all points of view. The exploration of the problem domain, necessary to select the more appropriate design, can be achieved with a problem-oriented approach such as Systems Engineering (SE) methodology. SE aims is to identify the best possible solution that satisfies customer needs in the most efficient and effective way. In this paper, a new approach that merges the traditional ship design procedure with the Systems Engineering (SE) processes will be discussed, with a special focus on the conceptual integration between the SE V-model and the design spiral. In this perspective, it will be necessary to discuss the definitions of Measures of Performance (MOPs) and Measures of Effectiveness (MOEs). MOEs are related to the achievement of the mission in the intended operational environment, while MOPs characterize the physical attributes of system/subsystems. The aim is to open a discussion within the naval architects community to define an innovative methodology that will support the decisional process in finding the best possible solution, in the specific domain of naval ships.

The planning of a "sustainable" development path for urban areas is a challenge both difficult and promising at the same time. In fact, heavily anthropized areas present the highest environmental and social criticalities and, nevertheless, are an ever-coveted source of opportunities and well-being. The book collects contributions on evaluation models in decision-making processes for the construction of circular urban systems in the digital era, with particular attention to the improvement of social and individual well-being.

Aims Patients with acute coronary syndromes (ACSs) who are managed without coronary revascularization represent a mixed and understudied population that seems to receive suboptimal pharmacological treatment. Methods and results We assessed patterns of antithrombotic therapies employed during the hospitalization and in-hospital clinical events of medically managed patients with ACS enrolled in the prospective, multicentre, nationwide EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) registry. Among the 2585 consecutive ACS patients enrolled in EYESHOT, 783 (30.3%) did not receive any revascularization during hospital admission. Of these, 478 (61.0%) underwent coronary angiography (CA), whereas 305 (39.0%) did not. The median GRACE and CRUSADE risk scores were significantly higher among patients who did not undergo CA compared with those who did (180 vs. 145, P < 0.0001 and 50 vs. 33, P < 0.0001, respectively). Antithrombotic therapies employed during hospitalization significantly differ between patients who received CA and those who did not with unfractioned heparin and novel P2Y12 inhibitors more frequently used in the first group, and low-molecular-weight heparins and clopidogrel in the latter group. During the index hospitalization, patients who did not receive CA presented a higher incidence of ischaemic cerebrovascular events and of mortality compared with those who underwent CA (1.6 vs. 0.2%, P = 0.04 and 7.9 vs. 2.7%, P = 0.0009, respectively). Conclusion Almost one-third of ACS patients are managed without revascularization during the index hospitalization. In this population, a lower use of recommended antiplatelet therapy and worse clinical outcome were observed in those who did not undergo CA when compared with those who did. Clinical Trial Registration Unique identifier: [NCT02015624][1], . [10.1093/ehjcvp/pvv017][2] [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02015624&atom=%2Fehjcardpharm%2F1%2F3%2F168.atom [2]: /lookup/doi/10.1093/ehjcvp/pvv017

Aims In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). Methods EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy. Results Over a 3-week period, a total of 2585 consecutive ACS patients have been enrolled in 203 cardiac care units across Italy. Among these patients, 1755 underwent PCI (923 with ST-elevation myocardial infarction and 832 with non-ST-elevation ACS). In the catheterization laboratory, unfractioned heparin was the most used antithrombotic drug in both ST-elevation myocardial infarction (64.7%) and non-ST-elevation ACS (77.5%) undergoing PCI and, as aspirin, bivalirudin and glycoprotein IIb/IIIa inhibitors (GPIs) more frequently employed before or during PCI compared with the postprocedural period. Any crossover of heparin therapy occurred in 36.0% of cases, whereas switching from one P2Y12 inhibitor to another occurred in 3.7% of patients. Multivariable analysis yielded several independent predictors of GPIs and of bivalirudin use in the catheterization laboratory, mainly related to clinical presentation, PCI complexity and presence of complications during the procedure. Conclusion In our contemporary, nationwide, all-comers cohort of ACS patients undergoing PCI, antithrombotic therapies were commonly initiated before the catheterization laboratory. In the periprocedural period, the most frequently employed drugs were unfractioned heparin, leading to a high rate of crossover, followed by GPIs and bivalirudin, mainly used during complex PCI. Clinical trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02015624.

We study the impact of economic uncertainty on the supply of bank credit using a\ud monthly dataset that includes all loan applications submitted by a sample of 650,000 Italian\ud firms between 2003 and 2012. We find that an increase in aggregate uncertainty has three\ud effects. First, it reduces banks' likelihood to accept new credit applications. Second, it\ud lengthens the time firms have to wait for their loans to be released. Third, it makes banks\ud less responsive to fluctuations in short-term interest rates, weakening the bank lending\ud channel of monetary policy. The influence of uncertainty is relatively stronger for poorly\ud capitalized lenders and geographically distant borrowers.

This paper aims to examine the theme of energy retrofit within the circumscribed field of refurbishment interventions on load-bearing masonry buildings built in the early 20th century. These include a remarkable share of the fabric of many European cities and, in particular, they can be found in geographical areas characterized by a Mediterranean (mild) climate. The main objective is to increase the climate resilience of the buildings by verifying the economic feasibility and the environmental sustainability of the interventions at the same time observing the specific architectural features of the buildings. We put forward alternative retrofit solutions carrying out synoptic comparisons of several technological solutions and types of materials, assisted by the use of digital tools such as BIM. In order to increase the environmental compatibility of the intervention, this article carries out a closer examination of the comparison between the employment of nanostructured, conventional – of synthetic origin –, and natural materials. The selection of the best intervention solution required the elaboration of an iterative flexible integrated process of assessment of energy, technological, economic, environmental and architectural aspects. The methodology we propose here is applied to the case study of Palazzo Utveggio (Palermo, Italy).

The new Italian Procurement Code—L.D. n. 50, 2016—implementing the 2014 European Union Directive, introduced BIM (Building Information Modeling) as an innovative approach to digitalize the construction sector. The recent Decree n. 560 of December 1st 2017 defines the methods and schedule for the gradual introduction of the BIM for the design, execution and management of construction works. BIM procedures involve a radical change in the design approach that goes from the graphical representation to the simulation of a process, both in the field of new constructions and in the field of Cultural Heritage conservation. In this perspective the article shows the results of a survey carried out on historic buildings. It aimed at verifying how much the modeling has remained confined to a low level of development (LOD A, according to the UNI 11337 standard is linked to a merely symbolic level) and those who have gone further by integrating specific and detailed information that allow real time to evaluate the sustainability of different alternatives. The article, which represents a first step of an ongoing research, starting from the regulatory framework of the BIM in Italy, highlights its potential (Sect. 1); the issue of the evaluation is deepened (Sect. 2), with particular reference to the 5D-BIM Project cost management and to the Heritage Building Information Modeling (HBIM).

An urban park provides many environmental and recreational facilities and services, and moreover it may become a catalyst for social energies and an instrument of community identification. This paper analyses whether participation and bottom-up planning may compensate institutional absences in implementation of urban parks, and how multiple criteria model may support socially shared decisions about their management. These issues are examined from the singular case of Parco Uditore in Palermo (Italy) that is located in a land which has been surprisingly undeveloped, despite the expansion of the city. The phases of promotion, planning and implementation of the park were the result of a synergistic but spontaneous collaboration of multiple actors, whereas an Analytic Network Process model has been built in the current management phase. The model has been provided for supporting a structured participatory process between promoters-managers and users for the selection of the best project among several alternatives, in order to strengthen the environmental, recreational and social role of the park.

This paper pays particular attention to one of the many participatory models present in the landscape of urban and territorial planning. Specifically, the ACTION PLANNING model was chosen; a model used in Anglo-Saxon countries to identify the problems and needs of the inhabitants of a given territory, through the involvement of interested parties or stakeholders. The model is applied in Sicily, to Villaseta, a small rural settlement, located southwest of the city of Agrigento, which consists primarily of affordable and social housing. It is a suburb without identity, left to itself, where – despite the valuable cultural, historic, scenic, and most importantly human resources – one notes the presence of degradation, hardship, and social exclusion. The quality of life is poor, the housing requires serious restoration work, and a large number of public spaces are unused due to decades of failure in the management policies of the local government.

The paper recounts the evolution of Italian urban planning, starting from 1150/42 Act, which was restricted to the technical procedures to plan local public facilities. In order to achieve the above aim, three milestones are considered: the National Planning Act, the 765/67 Act and the Territorial Government Acts, approved by regions after the 3/2001 Constitutional Act. How does one measure the local public facilities in the General Municipal Plan (GMP)? Is the diversity of different needs of the various populations groups considered? The GMP views the population demand as a unicum, ignoring almost completely age, gender, religion and social differences. The local public facilities, also called Urban Standards, have been sized and allotted based on a hypothetical demand in the various Homogeneous Territorial Zones (HTZs). Is this a further limitation of rational-comprehensive urban planning? By a critical interpretation of the regional acts, approved after the year 2000, arise various different interpretations of Urban Standards: These range from the perspective of solely quantification to quality indicators needed to respond to the new land demand, expressed by a changed (socio-economic) morphology of the communities, defined over the past two decades. Could the performance standards make a contribution to solving the problem of the various population in anthropized territories? The paper will try to make a contribution, after a description of the current state of the art, to the disciplinary discussion.

The analysis of the housing market of a city requires suitable approaches and tools, such as data mining models, to represent its complexity which derives on many elements, e.g. the type of capital asset-house is a common good and an investment good as well, the heterogeneity of the urban areas—each of them has own historical and representative values and different urban functions—and the variability of building quality. The housing market of the most densely populated area of Palermo (Italy), corresponding to ten districts, is analyzed to verify the degree of its inner homogeneity and the relations between the quality of the characteristics and the price of the properties. Five hundred sets of housing data have been collected and elaborated by cluster analysis with the aim of describing the structure of the housing market in each district and developing operational tools for the implementation of urban policies and public-private investments.