Determinants of cesarean delivery, a population-based study in the Emilia Romagna Region

Cesarean Delivery (CD) rates are rising in many parts of the world. In order to define strategies to reduce them, it is important to explore the role of clinical and organizational factors. This thesis has the objective to describe the contemporary CD practice and study clinical and organizational variables as determinants of CD in all women who gave birth between 2005 and June 2010 in the Emilia Romagna region (Italy). All hospital discharge abstracts of women who delivered between 2005 and mid 2010 in the region were selected and linked with birth certificates. In addition to descriptive statistics, in order to study the role of clinical and organizational variables (teaching or non-teaching hospital, birth volumes, time and day of delivery) multilevel Poisson regression models and a classification tree were used. A substantial inter-hospital variability in CD rate was found, and this was only partially explained by the considered variables. The most important risk factors of CD were: previous CD (RR 4,95; 95%CI: 4,85-5,05), cord prolapse (RR 3,51; 95% CI:2,96-4,16), and malposition/malpresentation (RR 2,72; 95%CI: 2,66-2,77). Delivery between 7 pm and 7 am and during non working days protect against CD in all subgroups including those with a small number of elective CDs while delivery at a teaching hospital and birth volumes were not statistically significant risk factors. The classification tree shows that previous CD and malposition/malpresentation are the most important variables discriminating between high and low risk of CD. These results indicate that other not considered factors might explain CD variability and do not provide clear evidence that small hospitals have a poor performance in terms of CD rate. Some strategies to reduce CD could be found by focusing on the differences in delivery practice between day and night and between working and no-working day deliveries.

A Semantic-based Framework for Digital Survey of Architectural Heritage

The research aims at developing a framework for semantic-based digital survey of architectural heritage. Rooted in knowledge-based modeling which extracts mathematical constraints of geometry from architectural treatises, as-built information of architecture obtained from image-based modeling is integrated with the ideal model in BIM platform. The knowledge-based modeling transforms the geometry and parametric relation of architectural components from 2D printings to 3D digital models, and create large amount variations based on shape grammar in real time thanks to parametric modeling. It also provides prior knowledge for semantically segmenting unorganized survey data. The emergence of SfM (Structure from Motion) provides access to reconstruct large complex architectural scenes with high flexibility, low cost and full automation, but low reliability of metric accuracy. We solve this problem by combing photogrammetric approaches which consists of camera configuration, image enhancement, and bundle adjustment, etc. Experiments show the accuracy of image-based modeling following our workflow is comparable to that from range-based modeling. We also demonstrate positive results of our optimized approach in digital reconstruction of portico where low-texture-vault and dramatical transition of illumination bring huge difficulties in the workflow without optimization. Once the as-built model is obtained, it is integrated with the ideal model in BIM platform which allows multiple data enrichment. In spite of its promising prospect in AEC industry, BIM is developed with limited consideration of reverse-engineering from survey data. Besides representing the architectural heritage in parallel ways (ideal model and as-built model) and comparing their difference, we concern how to create as-built model in BIM software which is still an open area to be addressed. The research is supposed to be fundamental for research of architectural history, documentation and conservation of architectural heritage, and renovation of existing buildings.

Advanced aspects of radiation protection in the use of particle accelerators in the medical field

In this work, the well-known MC code FLUKA was used to simulate the GE PETrace cyclotron (16.5 MeV) installed at “S. Orsola-Malpighi” University Hospital (Bologna, IT) and routinely used in the production of positron emitting radionuclides. Simulations yielded estimates of various quantities of interest, including: the effective dose distribution around the equipment; the effective number of neutron produced per incident proton and their spectral distribution; the activation of the structure of the cyclotron and the vault walls; the activation of the ambient air, in particular the production of 41Ar, the assessment of the saturation yield of radionuclides used in nuclear medicine. The simulations were validated against experimental measurements in terms of physical and transport parameters to be used at the energy range of interest in the medical field. The validated model was also extensively used in several practical applications uncluding the direct cyclotron production of non-standard radionuclides such as 99mTc, the production of medical radionuclides at TRIUMF (Vancouver, CA) TR13 cyclotron (13 MeV), the complete design of the new PET facility of “Sacro Cuore – Don Calabria” Hospital (Negrar, IT), including the ACSI TR19 (19 MeV) cyclotron, the dose field around the energy selection system (degrader) of a proton therapy cyclotron, the design of plug-doors for a new cyclotron facility, in which a 70 MeV cyclotron will be installed, and the partial decommissioning of a PET facility, including the replacement of a Scanditronix MC17 cyclotron with a new TR19 cyclotron.

Città e architettura a Faenza nel Rinascimento. Progetti e strategie di rinnovamento urbano nell'età di Carlo II Manfredi (1468-77)

La tesi ha come oggetto il rinnovamento urbano che fu realizzato a Faenza per opera del suo signore Carlo II Manfredi tra il 1468 e il 1477, d’accordo con il fratello, il vescovo Federico. La prima opera realizzata da Carlo fu il portico a due livelli che dotò di una nuova facciata il suo palazzo di residenza, di origini medievali. Questa architettura sarebbe stata il preludio di un riordino generale della piazza principale della città, probabilmente allo scopo di ricreare un foro all’antica, come prescritto dai trattati di Vitruvio e di Alberti. L’aspetto originale del loggiato rinascimentale, desumibile da documentazione archivistica e iconografica, permette di attribuirlo con una certa probabilità a Giuliano da Maiano. Oltre alla piazza, Carlo riformò profondamente il tessuto urbano, demolendo molti portici lignei di origine medievale, rettificando le principali strade, completando la cerchia muraria. Federico Manfredi nel 1474 diede inizio alla fabbrica della Cattedrale, ricostruita dalle fondamenta su progetto dello stesso Giuliano da Maiano. L’architettura della chiesa ha uno stile largamente debitore all’architettura sacra di Brunelleschi, ma con significative differenze (come la navata definita da un’alternanza tra pilastri e colonne, o la copertura composta da volte a vela). L’abside della cattedrale, estranea al progetto maianesco, fu realizzata nel 1491-92 e mostra alcuni dettagli riconducibili alla coeva architettura di Bramante. A Faenza si realizza in un periodo di tempo brevissimo una profonda trasformazione del volto della città: loggiato, riforma della piazza, riordino delle strade, una nuova cattedrale, tutto contribuisce a dare lustro ai Manfredi e a fare di Faenza una città moderna e in cui si mettono in pratica, forse per la prima volta nell’Italia settentrionale, i dettami di Vitruvio e di Alberti.