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This paper examines a workflow aimed at creating tactile models that enhance the accessibility and understanding of cultural heritage for a broader audience, including individuals with visual impairments. The process involves creating replicas through subtractive prototyping, specifically milling, of a Corinthian marble capital. The replica construction starts with a detailed photogrammetric survey, which is used to guide the milling process for an accurate wooden reproduction.The study emphasises the importance of fidelity between the replica and the original, verifying accuracy by comparing photogrammetric surveys of both. The research highlights the role of tactile models not only as tools for social inclusion but also as a means of preserving cultural heritage by replacing original artefacts exposed to deterioration risks. The methodology demonstrates that combining advanced surveying techniques with CNC prototyping can result in high-quality replicas, suitable for enhancing museum experiences and promoting inclusive cultural participation in line with the Faro Convention and Universal Design principles.

Prevention of infections is crucial in solid organ transplant (SOT) candidates and recipients. These patients are exposed to an increased infectious risk due to previous organ insufficiency and to pharmacologic immunosuppression. Besides infectious-related morbidity and mortality, this vulnerable group of patients is also exposed to the risk of acute decompensation and organ rejection or failure in the pre- and post-transplant period, respectively, since antimicrobial treatments are less effective than in the immunocompetent patients. Vaccination represents a major preventive measure against specific infectious risks in this population but as responses to vaccines are reduced, especially in the early post-transplant period or after treatment for rejection, an optimal vaccination status should be obtained prior to transplantation whenever possible. This review reports the currently available data on the indications and protocols of vaccination in SOT adult candidates and recipients.

Background: Pancreatic ductal adenocarcinoma (PDAC) becomes a systemic disease from an early stage. Complete surgical resection remains the only validated and potentially curative treatment; disappointingly only 20% of patients present with a resectable tumour. Although a complete pathological regression (pCR) after the preoperative chemotherapy could intuitively lead to better outcomes and prolonged survival some reports highlighted significant rates of recurrence. Cases Presentation: We describe three cases of pCR following preoperative chemotherapy for PDAC. The first two cases received neoadjuvant mFOLFIRINOX and PAX-G scheme for borderline resectable PDAC. Recurrence appeared 9 and 12 months after surgery. Although both patients started adjuvant therapy straight after the diagnosis of recurrence, the disease rapidly progressed and led them to death 12 and 15 months after surgery. The third case was characterized by germline BRCA2 mutation. The patient presented with PDAC of the body, intrapancreatic biliary stenosis and suspected peritoneal metastasis. One year later, after first and second-line chemotherapy, she underwent explorative laparoscopy and total spleno-pancreatectomy without evidence of viable tumour cells in the surgical specimen. At six months she is recurrence-free. Conclusions: Very few reports describe a complete pathological response following preoperative chemotherapy in pancreatic cancer. We observed three cases in the last three years with disappointing oncological results. Further investigations are needed to predict PDAC prognosis in pCR after chemotherapy.

The potential role of cultural heritage in local development has been extensively recognized, both at the academic and institutional level. Its conservation and valorization, however, have been at the center of a lively debate between those who see preservation policies as a mere moral duty and those who see them as part of a wider forward-looking strategy to support economic evolution and performance. This is especially the case now, with the Covid-19 pandemic casting additional doubts on the most effective schemes to face and overcome the current crisis. Within this context, the present paper aims at discussing the relationship between cultural heritage and local development in an original manner. Overcoming the traditional idea that the linkage takes place merely through touristic activities, this work puts forward the idea that Cultural Heritage represents one of the multiple elements of what is called “territorial capital” (TC), i.e. the set of territorial assets - material and immaterial, public and private, cognitive and relational - that generates endogenous development. The effects of Cultural Heritage on local development stem from its interaction with the other elements of TC, and in particular from the intermediation of intangible territorial elements like creativity, identity and quality of governance. The paper explains the reasons for such linkages and provides empirical evidence in this sense. Il ruolo potenzialmente ricoperto dal patrimonio culturale nell’influenzare lo sviluppo economico locale è stato ampiamente riconosciuto sia a livello accademico che istituzionale. Tuttavia, conservazione e valorizzazione del patrimonio culturale sono al centro di un vivo dibattito tra coloro che considerano le politiche di conservazione come mero dovere morale e coloro che invece riconoscono tale attività all’interno di una più ampia e lungimirante strategia a supporto delle dinamiche di sviluppo economico. La pandemia di Covid-19 ha insinuato ulteriori dubbi riguardo le strategie più efficaci per affrontare e superare l’attuale crisi. Il lavoro proposto in questo articolo ha l’obiettivo, all’interno di questo contesto, di discutere il legame tra patrimonio culturale e sviluppo locale proponendo un approccio originale. Superando la tradizionale idea secondo cui tale legame si concretizza esclusivamente attraverso le attività turistiche, il nostro lavoro suggerisce l’idea di patrimonio culturale come uno dei molteplici elementi facenti parte del cosiddetto “capitale territoriale” e cioè quell’insieme di elementi territoriali – materiali e immateriali, pubblici e privati, cognitivi e relazionali – che genera sviluppo endogeno. Gli effetti del patrimonio culturale sullo sviluppo locale derivano dalle sue interazioni con gli altri elementi di capitale territoriale, e in modo particolare dalla mediazione di elementi territoriali intangibili quali la creatività, l’identità e la qualità della governance locale. L’articolo spiega le ragioni di questi legami e ne fornisce una corrispondente evidenza empirica.

The generation of synthetic CT for carbon ion radiotherapy (CIRT) applications is challenging, since high accuracy is required in treatment planning and delivery, especially in an anatomical site as complex as the abdomen. Thirty-nine abdominal MRI-CT volume pairs were collected and a three-channel cGAN (accounting for air, bones, soft tissues) was used to generate sCTs. The network was tested on five held-out MRI volumes for two scenarios: (i) a CT-based segmentation of the MRI channels, to assess the quality of sCTs and (ii) an MRI manual segmentation, to simulate an MRI-only treatment scenario. The sCTs were evaluated by means of similarity metrics (e.g., mean absolute error, MAE) and geometrical criteria (e.g., dice coefficient). Recalculated CIRT plans were evaluated through dose volume histogram, gamma analysis and range shift analysis. The CT-based test set presented optimal MAE on bones (86.03 ± 10.76 HU), soft tissues (55.39 ± 3.41 HU) and air (54.42 ± 11.48 HU). Higher values were obtained from the MRI-only test set (MAEBONE = 154.87 ± 22.90 HU). The global gamma pass rate reached 94.88 ± 4.9% with 3%/3 mm, while the range shift reached a median (IQR) of 0.98 (3.64) mm. The three-channel cGAN can generate acceptable abdominal sCTs and allow for CIRT dose recalculations comparable to the clinical plans.

The present work is suggested as a contribution to the debate on Reverse Modeling (RM) topic in the Cultural Heritage field. It wants to test the methodology, the limits and the bottlenecks of the RM pipeline in the architectural field, with particular attention to the geometric shapes reading and interpretation. The mathematical reconstruction of architectural models represents an overlaid result of anthropic and natural transformations framed inside a complex process of shape simplification and surface generation. This pipeline must be supported by a careful Heritage reading by means of architecture rules, both preserving the actual shape and the original intent of the building designer. The integration of these last two aspects make the process of RM applied to CH extremely complex. It involves a cognitive activity aimed at choosing on the one hand the best 3D survey technique to obtain reliable 3D data, on the other hand reaching a suitable architectural knowledge for achieving a plausible modeling result. The research presented describes a RM process applied to an ecclesiastical architecture, highlighting some key passages: an integrated survey approach to extract geometrical information, data analysis and generation of a mathematical 3D model, reliable from both a formal and cultural point of view.

Purpose: The main purpose of the paper is to highlight some limits of the traditional theoretical interpretation of the relationships between the city and economic activities. This interpretation usually makes reference to two elements: agglomeration economies, cumulatively generating gains in efficiency and consequently in competitiveness and attractiveness and external connectivity, linked to multiple networks of both physical and immaterial nature. This approach, mainly functional and geographical, nowadays looks quite reductionist and overlooks crucial aspects of the urban realm that explain urban economic success The first aspect concerns the social and cultural nature of the main inter-personal and inter-institutional relationships taking place inside the city, conducive to crucial processes of cooperation, collective learning, creativity and innovation. In addition to this, the growing concentration on (mainly large) cities of command and control functions which not only witnesses the presence of their political power – underlined by a growing literature in geography and political science – but also widely determines income distribution in space, at the local, national and global scale. The functional interpretation of the city should be complemented by a relational-cognitive and hierarchical-distributive approach. The latter one is particularly interesting for the interpretation of the development of ‘monopolistic’ cities which operate on economic functions in which they can benefit from a captive market: capital cities and art cities in particular. Methodology/Approach: While the first part of the paper is mainly theoretical, it presents also an empirical side in the second issue, namely the destiny of medium-sized cities. The last section of the paper concerns a logical turnaround: ‘cities as businesses’ where high surpluses are generated in the real estate field, taking advantage of the economic success of the cities themselves and appropriating a consistent share of the generated profits in the form of land rents. Findings: The traditional view is that medium-sized cities cannot take full advantage of agglomeration economies and therefore will necessarily show lower growth rates in the long term. This paper argues against this view, on both theoretical and empirical grounds, looking at the evidence of European cities in the last twenty years. In many countries, this process should be more appropriately taxed in order to allow sustainable and socially equilibrated development: a fairer sharing of these surplus-values between private and public parties is justified by the collective nature of urban externalities. Originality/Value of paper: The implications of the arguments presented here are relevant on both the interpretative and policy ground. The sources of urban economic success are not linked only to functional or efficiency elements but also to cultural-psychological and to power elements. The former ones require subtler policy strategies and the latter more appropriate policy tools oriented towards the widely ignored challenge of income distribution in space.

The initiation of the Metropolitan Cities is certainly a great opportunity for the effectiveness of governance in large urban areas, however, there are concerns about the poverty of attributed competences, the silence on resources and the desirable competences on local taxation on urban developments, the weakness of wide area planning. Beyond that, doubts persist on the potential interest conflict in the coexistence of the position of Metropolitan and municipality Mayor on the same person and the absurd condition of a break inf up of the central municipality into small municipalities for the transition to a direct election of the Major by citizens. There is still a chance to recover: the wise formulation of the Statutes metropolitan. There is still a chance to recover: the wise formulation of the Statutes metropolitan.

The article offers some reflections on the important changes that local development has experienced along the last decades. In particular, it emphasizes the strong and increasing presence of uncertainties and the complex character of the actual urban and territorial problems. All this must be confronted to the requirements of governability, the importance of institutions and social co-operation. The article underline some positive aspects of the innovative milieux as an example of creating «social capital», this concept particularly understood as «relationships capital». The final section of the article emphasizes the advantages of the urban strategic plans, built through very participative processes aiming to get cooperation agreements between the economic agents, the citizens and the local authorities. According to the author, the urban strategic plans are an excellent instrument leading to new forms of self-organization and better governability because it helps the city, the citizens and not only the local administration to be placed into the center of the decision processes and the local transformations.

El artículo presenta un conjunto de reflexiones sobre los cambios que se han producido en los últimos años en cuanto a los problemas de desarrollo local. En particular, enfatiza la fuerte presencia y aumento de incertidumbres y la aceptación de que los problemas territoriales y urbanos son cada vez más complejos. Todo ello se pone en relación con los requerimientos actuales de gobernabilidad y la necesidad de potenciar las instituciones y la cooperación a todos los niveles. Uno de los ejemplos positivos que contempla el artículo es el de los milieux innovateurs, cuyas características revisa como posible referencia para la generación de «capital social», aunque este concepto se toma con un sentido distinto del tradicional en Economía ya que se enfatiza su carácter de «capital de relación». En su parte final, el trabajo subraya las ventajas de la planificación estratégica que se está llevando a cabo en algunas ciudades, entendida como un proceso muy participativo, con acuerdos de cooperación entre los agentes económicos, los ciudadanos y las autoridades locales. La planificación estratégica aplicada a las ciudades, concluye el autor, constituye un excelente instrumento que permite generar nuevas formas de auto-organización y de gobernabilidad de la comunidad que colocan al conjunto de la ciudad, a los ciudadanos y no sólo a la administración local, en el centro de los procesos de decisión y de las transformaciones locales.

Pediatric lung transplantation is performed in highly experienced centers due to the peculiar population characteristics. The literature is limited and not representative of individual countries' differences. The purpose of this study was to analyze the Italian experience. A multicentric retrospective analysis was performed on 110 pediatric patients (<18 years old) who underwent lung transplantation from 1992 to 2019 at 9 Italian centers. Heart–lung transplantations and lung retransplantations were excluded. The population was composed of 44 male and 66 female patients, with a median age of 15 years. The most frequent indication was cystic fibrosis (83%). One quarter of patients were transplanted in an emergency setting. Median donors' Oto score and age were 1 and 15 years, respectively, with 43% of adult donors. In 17% of patients a graft reduction was performed. Postoperatively, the median duration of mechanical ventilation, intensive care unit, and in-hospital stay were 48 hours, 11 and 35 days, respectively. Thirty-day mortality was 6%, and 1-, 5-, and 10-year survival was 72%, 52%, and 33%, respectively. Risk factors for mortality were Oto score and recipients' body mass index. The outcomes of pediatric lung transplantation in Italy are comparable with current literature. Particular attention should be paid to the Oto score and recipient body mass index. Conversely, adult donors and graft reductions can be safely used to expand the donor pool. Shown are study's methods, results, and conclusions. [Display omitted] [ABSTRACT FROM AUTHOR]

Primary sclerosing cholangitis (PSC) represents 5% of the indications for liver transplantation (LT). Recurrence of PSC (rPSC) is reported to occur in 8-27% and it has a great impact on both graft and patient survival. the clinical data of 35 patients with PSC who underwent LT at our center in the last 20 years were retrospectively evaluated. Twentyfive were male (71,4%) with a history of IBD before OLT (67%). Tacrolimus+steroid was the most frequent immunosoppressive schedule (84.8%). Five patients (15.1%) underwent re-OLT (3 for rPSC, 2 for immunological damage). Graft and patient survival at 5 years were 73.6% and 88%. A female transplanted for the first time at the age of 17 years, redeveloped aggressive rPSC, with the need for a third LT. The time interval between second and third LT was much shorter than between the first and second LT (2015-2019-2021). In order to modulate the patient's immune reactivity, within 3 months from the 3rdLT, stem cell mobilization (cyclophosphamide+G-CSF) was performed, and CD34+ cells were selected: the patient eventually underwent autologous hematopoietic stem cell transplantation (aHSCT), preceded by a conditioning regimen (melphalan+rabbit antithymocyte globulin). In the immediate post-aHSCT, the patient experienced a E. Coli -related sepsis. The full immunosuppressive regimen was reintroduced 18days after aHSTC. Three and 14 months after aHSCT, she underwent follow-up liver biopsies which excluded rPSC and showed a picture of mild ectasia of centrolobular veins and pericentral sinusoids, associated with initial aspects of sclero-atrophy of the bile ducts, consistent with liver injury secondary to chemotherapy. Liver test were maintained normal. ReLT is the only treatment option for aggressive rPSC. Our patient succesfully underwent 3rd R-LT combined with aHSCT with no evidence of rPSC at over 14 months follow-up: this may represent a successful approach as a preemptive strategy in selected cases of reLT for rPSC. [ABSTRACT FROM AUTHOR]