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The policies supporting southern Italy, implemented since the Second World War o the end of the twentieth century, have contributed to reducing the gap whit the North of the country but these regions are still experiencing difficulties that are unresolved from a political and socio-economic point of view. This condition is reflected in the territorial forms, whose crisis today demands, from an urban planning point of view, pertinent reading and solution models of a strategic type and a regenerative approach. The framework that is traced with regard to public intervention in the South is centered on the role of three actors: big industry and the State, with their reciprocal intermingling, and the southern territorial milieu. From the territorial point of view, a critical relationship between the large industrial areas and the territories of medium and small towns around which the large production 'plates' were implanted, in particular, the Industrial Development Areas, was determined, among other outcomes. Through the case study of the province of Caserta, we suggest the need for an adequate analytical framework and a replicable regenerative approach where rural identities, abandonment, the historical palimpsest and a still persistent industrial vocation vie with each other, affecting the territory's future prospects

Exhaled nitric oxide (FENO) is a noninvasive marker of eosinophilic airway inflammation, therefore, highly informative in asthma. Although FENO measurement is a potentially accessible tool to many physicians, recommendations regarding its clinical utility in diagnosing or tailoring treatment have not reached the expected diffusion. More recently FENO emerged as a biomarker for type-2 asthma phenotyping and a predictor of response to biologics.The physiological discoveries and relevant acquisitions in clinical practice regarding FENO in asthma are presented. The FENO story draw a wavy path, characterized by promising findings, exciting confirmations and periods of low visibility. FENO emerged as a tool to increase the probability of asthma diagnosis. FENO predicts response to inhaled glucocorticoids (ICS), favoring the development of tailored treatment strategies and unrevealing nonadherence to ICS in difficult-to-treat or uncontrolled asthma. Finally, FENO was associated with a more severe phenotype and became a consolidated biomarker of type-2 inflammation.FENO demonstrated to be a noninvasive and very reproducible test, encompassing many applications in the field of asthma management. Its routinely use, according to international guidelines, may improve the quality of patient assistance, from difficult-to-treat cases to biologic monitoring.

Il ruolo della partecipazione e dei Living Lab nei processi di pianificazione per le aree interne

Un'analisi dei contesti periurbani del Meridione in relazione alle Aree di Sviluppo Industriale, con un approfondimento del caso casertano.

Il caso dell'Area di Sviluppo Industriale di Caserta e il rapporto con il territorio e i contesti urbani ed agricoli

Visioni progettuali tra periurbano e aree industriali nel casertano

Introduction: Asthma, along with inhaled steroids, was initially considered a risk factor for worse clinical outcomes in COVID-19. This was related to the higher morbidity observed in asthma patients during previous viral outbreaks. This retrospective study aimed at evaluating the prevalence of asthma among patients admitted due to SARS-CoV-2 infection as well as the impact of inhaled therapies on their outcomes. Furthermore, a comparison between patients with asthma, COPD and the general population was made. Methods: All COVID-19 inpatients were recruited between February and July 2020 from four large hospitals in Northwest Italy. Data concerning medical history, the Charlson Comorbidity Index (CCI) and the hospital stay, including length, drugs and COVID-19 complications (respiratory failure, lung involvement, and the need for respiratory support) were collected, as well as the type of discharge. Results: patients with asthma required high-flow oxygen therapy (33.3 vs. 14.3%, p = 0.001) and invasive mechanical ventilation (17.9 vs. 9.5%, p = 0.048) more frequently when compared to the general population, but no other difference was observed. Moreover, asthma patients were generally younger than patients with COPD (59.2 vs. 76.8 years, p < 0.001), they showed both a lower mortality rate (15.4 vs. 39.4%, p < 0.001) and a lower CCI (3.4 vs. 6.2, p < 0.001). Patients with asthma in regular therapy with ICS at home had significantly shorter hospital stay compared to those with no treatments (25.2 vs. 11.3 days, p = 0.024). Discussion: Our study showed that asthma is not associated with worse outcomes of COVID-19, despite the higher need for respiratory support compared with the general population, while the use of ICS allowed for a shorter hospital stay. In addition, the comparison of asthma with COPD patients confirmed the greater frailty of the latter, according to their multiple comorbidities.

Asthma is a common airway disease, affecting worldwide a percentage of people between 1% and 18%. Although the proper management of asthmatic patients should be ensured by following international d...

Peri-urban is an intermediate land. On the one hand, its hybrid nature makes it particularly vulnerable to speculation, indiscriminate use of soil resources, erosion of agricultural residues, and so on; on the other hand, it is difficult to control through planning instruments and policies. Starting from this background, the chapter will investigate the territories of the large Campania Plain, in the South of Italy, between Naples and Caserta. Until the middle of twentieth century, this territory was known as Campania Felix due to its agricultural vocation. Subsequently, a series of development policies and a misinterpreted concept of valorization and modernization of the territory have changed its characteristics and identity, giving many parts of it to disorder: industrial settlements, plants, logistics, landfills, and large infrastructures that clash with the residential, agricultural, or residual areas and in-between natural ones. In this context, the chapter summarizes the first results of a research project that aims to rethink the role of the large Industrial Development Areas, established in the peri-urban contexts of the plain in the province of Caserta, in Italy.

Una riflessione sull'approccio didattico alla progettazione urbanistica a partire dalle aree industriali degradate ed in abbandono.

Una lettura urbanistica e paesaggistica di alcuni luoghi critici della metropoli napoletana

L’ampio tema delle aree interne della Penisola trova nel Meridione specificità che spesso non emergono e che, ancora più spesso, le politiche nazionali non intercettano. Il Ministero della Transizione Ecologica ha finanziato la ricerca RIPROVARE, che ha approfondito tre contesti territoriali del Sud: l’alto Casertano e l’Ufita, in Campania e l’ambito del Medio Agri in Basilicata, facendo emergere alcune priorità dal dialogo con i territori, attraverso partecipazione e Living Lab.

Le condizioni di rischio e la trasformazione dei paesaggi in Campania.

Background Clinicians are increasingly recognizing severe asthma patients in whom biologics and other add-on therapies lead to dramatic improvement. Currently, there is no agreed-upon super-responder (SR) definition. Objective To survey severe asthma experts using a modified Delphi process, to develop an international consensus-based definition of a severe asthma SR. Methods The Delphi panel was composed of 81 participants (94% specialist pulmonologists or allergists) from 24 countries and consisted of three iterative online voting rounds. Consensus on individual items, whether acceptance or rejection, required at least 70% agreement by panel members. Results Consensus was achieved that the SR definition should be based on improvement across three or more domains assessed over 12 months. Major SR criteria included exacerbation elimination, a large improvement in asthma control (two or more times the minimal clinically important difference), and cessation of maintenance of oral steroids (or weaning to adrenal insufficiency). Minor SR criteria were composed of a 75% exacerbation reduction, having well-controlled asthma, and 500 mL or greater improvement in FEV1. The SR definition requires improvement in at least two major criteria. In the future, the SR definition should be expanded to incorporate quality of life measures, although current tools can be difficult to implement in a clinical setting and further research is needed. Conclusions This international consensus-based definition of severe asthma SRs is an important prerequisite for better understanding SR prevalence, predictive factors, and the mechanisms involved. Further research is needed to understand the patient's perspective and to measure quality of life more precisely in SRs.

The paper investigates a particular phenomenon of the industrialization of Southern Italy, starting from the second post-war period, and, in particular, the unsolved relationship between some large industrial areas and the territories of the medium and small cities on which such productive “plates” have been installed. The town planning policies and instruments with which the industrialization of Southern Italy was planned, on the contrary, foresaw a strong integration between urban fabric and industrial agglomerations. Through the case study of the province of Caserta, the research illustrated by the paper investigates, first of all, the policies that supported this process of industrialization and what the territorial effects of this phenomenon were. Next, the paper illustrates the method of knowledge and mapping of the territory of the case study of the industrial development area of Caserta. The data will be collected in a GIS platform that will return the following condition that is nowadays not available: analytical maps of the brownfield areas and the identification of the areas still intact, agricultural or green areas, urban areas and infrastructures, which trace a cognitive framework addressed to the project in which it will possible to experiment some possible eco-innovative and nature-based solutions.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex inflammatory disease highly impacting patient's quality of life, and associated with lower airway inflammation often evolving into asthma. Exhaled nitric oxide (FENO) is a non-invasive tool to assess Type 2 airway inflammation and its extended analysis allows to differentiate between alveolar concentration (CalvNO) and bronchial output (JawNO). It is also possible to assess the sino-nasal production of nitric oxide (nNO). We studied extended nitric oxide production in patients with CRSwNP with or without associated asthma. Consecutive adult patients with CRSwNP, with or without asthma, and 15 healthy controls were enrolled. Exclusion criteria were: smoking, uncontrolled asthma, recent upper or lower airway infections and oral corticosteroid therapy in the 4 weeks preceding clinical evaluation. Patients' demographic and clinical data were collected; patients underwent pulmonary function tests and extended nitric oxide analysis including nasal nNO assessment. A total of 125 subjects were enrolled (15 healthy controls; 69 with CRSwNP and asthma, and 41 with CRSwNP only). FENO, JawNO and CalvNO values were higher, while nNO was lower, in all patients with CRSwNP compared to healthy controls; no difference was found in CalvNO between patients with concomitant asthma and non-asthmatic subjects; in asthmatic patients, FENO and JawNO were significantly higher, while nNO values was lower, compared to patients with CRSwNP only. These results suggest that CRSwNP could be the first manifestation of a more complex systemic inflammatory pathology driven by Type 2 inflammation. An 'inflammatory gradient' hypothesis could describe a pattern of inflammation in CRSwNP patients that starts distally in the alveoli. Finally, our study indirectly reinforces the concept that novel biological drugs could become valid therapeutic options for nasal polyposis.

Introduction There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

Die Beziehung zwischen Neapel und der Stadtplanung, also jener Disziplin, die sich mit der Betrachtung und Steuerung der physischen, sozialen und wirtschaftlichen Dimension einer Stadt befasst, war schon immer sehr widersprüchlich. Historisch haben die Menschen – die Arbeiter*innen, Handwerker*innen, Tagelöhner*innen, Kleinkriminellen, Gelegenheitsdiebe (auf Neapolitanisch die mariuoli), Schwerverbrecher*innen, camorristi und Ma!osi, Politiker* innen, Ladenbesitzer*innen, bis hin zu den Schuhputzerjungen (sciuscià im gleichnamigen Film von Vittorio De Sica, ein neapolitanisches Wort, abgeleitet vom amerikanischen shoe-shine), haben Lastenträger*innen, Drogendealer*innen und Müßiggänger*innen aller Art und jeden Geschlechts die großen Umwälzungen und städtebaulichen Regeln mit einer Art Gleichgültigkeit und Fatalismus erlebt, der es ihnen erlaubte, sich anzupassen und, wenn möglich, davon zu pro!tieren. So hat sich alles von selbst geregelt. Kleine Grundstückseigentümer* innen, Grundbesitzer*innen, Bauunternehmer*innen, städtische Techniker*innen und Politiker*innen auf allen Ebenen haben sich selbst die Regeln und Gelegenheiten gegeben, die ihnen am günstigsten erschienen. Ganze Stadtteile Neapels sind auf diese Weise entstanden: Wo der Bebauungsplan besagte, dass nicht gebaut werden darf, wurde es dennoch einfach gemacht.

Background and objectiveSystemic small vessel vasculitides carry an increased risk of acute arterial and venous thromboembolic events (AVTE); however, this risk has not been systematically explored in Eosinophilic Granulomatosis with Polyangiitis (EGPA). This study assessed the occurrence and main risk factors of AVTE among EGPA patients as compared to the general community from the population-based Bruneck cohort.MethodsWe conducted a retrospective multicenter cohort study on 573 EGPA patients. Clinical and serological data were collected at diagnosis. Occurrence of AVTE and time to the first AVTE after EGPA diagnosis were recorded. Age-standardized event rate (SER) of AVTE as compared to the reference cohort was assessed. Cox regression was applied to identify AVTE predictors.Results129 EGPA patients (22.5%) had AVTE, considered as potentially life-threatening in 55.8%. Seventy patients experienced an AVTE prior to diagnosis (of whom 58.6% in the two years before diagnosis) and 75 following EGPA diagnosis, of whom 56% in the two subsequent years. The SER of AVTE as compared to the reference cohort was 2.10 (95% CI 1.67-2.63). This risk was particularly increased in patients with history of AVTE and with a Birmingham Vasculitis Activity Score ≥20 at diagnosis. Patients receiving immunosuppression within 2 months of diagnosis were at lower risk, while antiplatelet or anticoagulant treatment did not confer measurable benefit.ConclusionEGPA is associated with AVTE in approximately one quarter of patients, particularly around diagnosis. Immunosuppressants seemed to exert a protective effect, while anticoagulant and antiplatelet agents did not.

Asthma prevalence in Italy is on the rise and is estimated to be over 6% of the general population. The diagnosis of asthma can be challenging and elusive, especially in children and the last two decades has brought evidences that asthma is not a single disease but consists of various phenotypes. Symptoms can be underestimated by the patient or underreported to the clinician and physical signs can be scanty. Usual objective measures, like spirometry, are necessary but sometimes not significant. Despite proper treatment asthma can be a very severe condition (even leading to death) however new drugs have recently become available which can be very effective in its control. Since asthma is currently thought to be caused by inflammation, a direct measure of the latter can be of paramount importance. For this purpose, the measurement of Fractional Exhaled Nitric Oxide (FENO) has been used since the early years of the current century as a non-invasive, easy-to-assess tool useful for diagnosing and managing asthma. This SIP-IRS/SIAAIC Position Paper is a narrative review which summarizes the evidence behind the usefulness of FENO in the diagnosis, management and phenotypization of asthma.

OBJECTIVES We conducted a systematic macroscopic and microscopic examination of occlusal and para-occlusal wear in a large dental sample (n = 3,014) from 217 individuals dated to the Early Bronze age site of Gricignano d'Aversa, Italy. We used macroscopic and microscopic techniques to document nondietary occlusal and para-occlusal wear and to analyze calculus inclusions in some of the teeth. In combining an analysis of the wear with the calculus inclusions we linked the specific wear to the likely fiber that was involved in producing it. MATERIALS AND METHODS Teeth and their high resolution epoxy casts were analyzed through SEM and reflected light microscopes. Nineteen individuals (fifteen with activity induced dental modifications and four as a control sample) were examined for the presence of calculus inclusions. RESULTS Activity induced dental modifications (AIDMs), notches, grooves and micro-striations, were found in the 62.2% of the adult females, in 21.2% of the adults of unknown sex and in a single male. We found the full spectrum of dental manipulations from very minor nonocclusal wear in some young individuals to severe attrition at the other extreme. The width of the striations and grooves, mostly on the upper incisors, suggests a craft activity involving fibers and thread production and manipulation. From the dental calculus of two females with grooves and striations, we extracted three fragments of fibers, identified as hemp (Cannabis, sp.). Previously from Gricignano woven hemp fibers were found on both surfaces of a metal blade associated with a male burial. DISCUSSION This study found the co-occurrence of tooth AIDMs and the actual fibers preserved in the dental calculus. As more work is done analyzing dental calculus in a variety of humans, it is apparent that this biological material holds rich resources documenting non-dietary habits.

This is the chemico-physical examination of 13 samples collected from the early 2nd millennium BC Linear Elamite inscribed silver gunagi vessels of the Mahboubian collection (see Desset; preceding ...

L'abstract sintetizza un percorso di piano urbanistico comunale sostenibile, resiliente e a consumo di suolo "0", integrato da alcuni affondi progettuali per definire e prefigurare la forma dei alcuni aree specifiche del comune di Capodrise guardate nello scenario dell'ambito periurbano del casertano.