Liver transplantation for transthyretin amyloidosis: experience of a single center in Italy

Liver transplantation is the only definitive treatment for transthyretin amyloidosis, with an excellent 5-year survival in endemic countries where the Met30 mutation is predominant. We report our experience of liver transplantation for transthyretin amyloidosis. We reviewed the clinical records of 17 transplanted patients (11 males, 6 females; age at liver transplant: 45.7±11.7 years). We had a wide spectrum of non-Met30 mutations (52.9%), with a predominance of Gln89 (23.5%). Five-year survival after transplantation was 43.8%; at multivariate analysis, both non-Met30 mutations (HR 17.3, 95% CI 1.03-291.7) and modified BMI (HR 0.50, 95% CI 0.29-0.87) showed significant and independent prognostic roles (P=0.048 and P=0.015, respectively). Five out of the 9 non-Met30 carriers received combined heart transplantation because of severe cardiomyopathy; they showed a trend towards a better prognosis vs. the 4 patients who did not receive combined heart transplantation (although not statistically significant; P=0.095). At follow-up, no significant improvement of transthyretin amyloidosis manifestations was observed. The results of liver transplantation for transthyretin amyloidosis in our population are poorer than those reported in the literature probably because of the high prevalence of non-Met30 mutations.

Il museo del riuso. Progetto di riqualificazione dell'ex caserma Sani a Bologna

Il progetto di riqualificazione della Caserma Sani si ispira allʼinteresse nei confronti delle tematiche del recupero edilizio e urbano. Esso nasce dallʼintenzione di reintegrare unʼarea urbana in via di dismissione nel suo contesto attraverso lʼinserimento di nuove funzioni che rispondano alle esigenze di questa parte di città e nel contempo riqualificare i fabbricati esistenti attraverso un progetto di recupero e completamento che favorisca il dialogo del complesso esistente con il sistema urbano circostante. La volontà di riuso della maggioranza degli edifici facenti parte del vecchio impianto si basa su considerazioni legate alla natura stessa del sito: lʼintenzione è quella di conservarne la memoria, non tanto per il suo valore storico-architettonico, ma perché nel caso specifico della Caserma più che di memoria è opportuno parlare di scoperta, essendo, per propria natura militare, un luogo da sempre estraneo alla comunità e al suo contesto, chiuso e oscurato dal limite fisico del muro di cinta. La caserma inoltre si compone di edifici essenzialmente funzionali, di matrice industriale, la cui versatilità si legge nella semplicità e serialità morfologica, rendendoli “organismi dinamici” in grado di accogliere trasformazioni e cambi di funzione. Il riuso si muove in parallelo ai concetti di risignificazione e riciclaggio, dividendosi in modo egualmente efficace fra presupposti teorici e pratici. Esso costituisce una valida alternativa alla pratica della demolizione, nel caso in cui questa non sia specificatamente necessaria, e alle implicazione economiche e ambientali (smaltimento dei rifiuti, impiego dei trasporti e fondi economici, ecc.) che la accompagnano. Alla pratica del riuso si affianca nel progetto quella di completamento e ampliamento, arricchendo il vecchio sistema di edifici con nuove costruzioni che dialoghino discretamente con la preesistenza stabilendo un rapporto di reciproca complementarietà. Il progetto di riqualificazione si basa su più ampie considerazioni a livello urbano, che prevedono lʼintegrazione dellʼarea ad un sistema di attraversamento pedonale e ciclabile che colleghi da nord a sud le principali risorse verdi del quartiere passando per alcuni dei principali poli attrattori dellʼarea, quali la Stazione Centrale, il Dopolavoro Ferroviario adibito a verde attrezzato, il nuovo Tecno Polo che sorgerà grazie al progetto di riqualificazione previsto per lʼex Manifattura Tabacchi di Pier Luigi Nervi e il nuovo polo terziario che sorgerà dalla dismissione delle ex Officine Cevolani. In particolare sono previsti due sistemi di collegamento, uno ciclo-pedonale permesso dalla nuova pista ciclabile, prevista dal nuovo Piano Strutturale lungo il sedime della vecchia ferrovia che correrà da nord a sud collegando il Parco della Montagnola e in generale il centro storico al Parco Nord, situato oltre il limite viario della tangenziale. Parallelamente alla pista ciclabile, si svilupperà allʼinterno del tessuto un ampio viale pedonale che, dal Dopolavoro Ferroviario (parco attrezzato con impianti sportivi) collegherà la grande area verde che sorgerà dove ora giacciono i resti delle ex Industrie Casaralta, adiacenti alla Caserma Sani, già oggetto di bonifica e in via di dismissione, incontrando lungo il suo percorso differenti realtà e funzioni: complessi residenziali, terziari, il polo culturale e le aree verdi. Allʼinterno dellʼarea della Caserma sarà integrato agli edifici, nuovi e preesistenti, un sistema di piazze pavimentate e percorsi di attraversamento che lo riuniscono al tessuto circostante e favoriscono il collegamento da nord a sud e da est a ovest di zone della città finora poco coinvolte dal traffico pedonale, in particolare è il caso del Fiera District separato dal traffico veloce di Via Stalingrado rispetto alla zona residenziale della Bolognina. Il progetto lascia ampio spazio alle aree verdi, le quali costituiscono più del 50 % della superficie di comparto, garantendo una preziosa risorsa ambientale per il quartiere. Lʼintervento assicura lʼinserimento di una molteplicità di funzioni e servizi: residenze unifamiliari e uno studentato, uffici e commercio, una biblioteca, un auditorium e un polo museale.

Essays in Applied Health Economics: Evidence on Health and Health Care in Italy and UK

This thesis is the result of my experience as a PhD student taking part in the Joint Doctoral Programme at the University of York and the University of Bologna. In my thesis I deal with topics that are of particular interest in Italy and in Great Britain. Chapter 2 focuses on the empirical test of the existence of the relationship between technological profiles and market structure claimed by Sutton’s theory (1991, 1998) in the specific economic framework of hospital care services provided by the Italian National Health Service (NHS). In order to test the empirical predictions by Sutton, we identify the relevant markets for hospital care services in Italy in terms of both product and geographic dimensions. In particular, the Elzinga and Hogarty (1978) approach has been applied to data on patients’ flows across Italian Provinces in order to derive the geographic dimension of each market. Our results provide evidence in favour of the empirical predictions of Sutton. Chapter 3 deals with the patient mobility in the Italian NHS. To analyse the determinants of patient mobility across Local Health Authorities, we estimate gravity equations in multiplicative form using a Poisson pseudo maximum likelihood method, as proposed by Santos-Silva and Tenreyro (2006). In particular, we focus on the scale effect played by the size of the pool of enrolees. In most of the cases our results are consistent with the predictions of the gravity model. Chapter 4 considers the effects of contractual and working conditions on selfassessed health and psychological well-being (derived from the General Health Questionnaire) using the British Household Panel Survey (BHPS). We consider two branches of the literature. One suggests that “atypical” contractual conditions have a significant impact on health while the other suggests that health is damaged by adverse working conditions. The main objective of our paper is to combine the two branches of the literature to assess the distinct effects of contractual and working conditions on health. The results suggest that both sets of conditions have some influence on health and psychological well-being of employees.

Atmospheric corrosion of quaternary bronzes (Cu-Sn-Zn-Pb): laboratory tests (accelerated ageing in wet & dry conditions)and field studies (the Bottego monument in Parma, Italy).

The interactions between outdoor bronzes and the environment, which lead to bronze corrosion, require a better understanding in order to design effective conservation strategies in the Cultural Heritage field. In the present work, investigations on real patinas of the outdoor monument to Vittorio Bottego (Parma, Italy) and laboratory studies on accelerated corrosion testing of inhibited (by silane-based films, with and without ceria nanoparticles) and non-inhibited quaternary bronzes are reported and discussed. In particular, a wet&dry ageing method was used both for testing the efficiency of the inhibitor and for patinating bronze coupons before applying the inhibitor. A wide range of spectroscopic techniques has been used, for characterizing the core metal (SEM+EDS, XRF, AAS), the corroded surfaces (SEM+EDS, portable XRF, micro-Raman, ATR-IR, Py-GC-MS) and the ageing solutions (AAS). The main conclusions were: 1. The investigations on the Bottego monument confirmed the differentiation of the corrosion products as a function of the exposure geometry, already observed in previous works, further highlighting the need to take into account the different surface features when selecting conservation procedures such as the application of inhibitors (i.e. the relative Sn enrichment in unsheltered areas requires inhibitors which effectively interact not only with Cu but also with Sn). 2. The ageing (pre-patination) cycle on coupons was able to reproduce the relative Sn enrichment that actually happens in real patinated surfaces, making the bronze specimens representative of the real support for bronze inhibitors. 3. The non-toxic silane-based inhibitors display a good protective efficiency towards pre-patinated surfaces, differently from other widely used inhibitors such as benzotriazole (BTA) and its derivatives. 4. The 3-mercapto-propyl-trimethoxy-silane (PropS-SH) additivated with CeO2 nanoparticles generally offered a better corrosion protection than PropS-SH.

Farm tourism: a cross-country empirical study in Germany and Italy

PROBLEM In the last few years farm tourism or agritourism as it is also referred to has enjoyed increasing success because of its generally acknowledged role as a promoter of economic and social development of rural areas. As a consequence, a plethora of studies have been dedicated to this tourist sector, focusing on a variety of issues. Nevertheless, despite the difficulties of many farmers to orient their business towards potential customers, the contribution of the marketing literature has been moderate. PURPOSE This dissertation builds upon studies which advocate the necessity of farm tourism to innovate itself according to the increasingly demanding needs of customers. Henceforth, the purpose of this dissertation is to critically evaluate the level of professionalism reached in the farm tourism market within a marketing approach. METHODOLOGY This dissertation is a cross-country perspective incorporating the marketing of farm tourism studied in Germany and Italy. Hence, the marketing channels of this tourist sector are examined both from the supply and the demand side by means of five exploratory studies. The data collection has been conducted in the timeframe of 2006 to 2009 in manifold ways (online survey, catalogues of industry associations, face-to-face interviews, etc.) according to the purpose of the research of each study project. The data have been analyzed using multivariate statistical analysis. FINDINGS A comprehensive literature review provides the state of the art of the main differences and similarities of farm tourism in the two countries of study. The main findings contained in the empirical chapters provide insights on many aspects of agritourism including how the expectations of farm operators and customers differ, which development scenarios of farm tourism are more likely to meet individuals’ needs, how new technologies can impact the demand for farm tourism, etc. ORIGINALITY/VALUE The value of this study is in the investigation of the process by which farmers’ participation in the development of this sector intersects with consumer consumption patterns. Focusing on this process should allow farm operators and others including related businesses to more efficiently allocate resources.

Falegnami e muratori a Bologna nel Medioevo: statuti e matricole (1248-1377)

La finalità della tesi è stata quella d'improntare una riflessione sulle società legate all'edilizia nel momento di apice politico ed economico di una città, attiva e importante nel basso Medioevo, come Bologna. Questo tipo di studio, già intrapreso per alcune città dell'Italia centro settentrionale, risulta necessario per comprendere alcune dinamiche politiche, economiche e produttive della realtà cittadina. In particolare, gli obiettivi sono stati quelli di coniugare la vita corporativa dell'arte all'organizzazione lavorativa, individuando gli aspetti legati all'ambito produttivo e valutando, l'evoluzione della società nel passaggio dal Duecento al Trecento. Gli statuti e le matricole, principali fonti compilate dalle due società delle arti e giunte ai nostri giorni, salvo rare eccezioni, completamente inedite sono stati il principale punto di partenza dello studio. Il risultato è la sintesi di alcuni spunti di riflessione emersi dai documenti, quali la mentalità degli uomini che si approcciavano alle arti, le gerarchie nate all'interno delle stesse società, il loro cambiamento e quello legato alla percezione di comunità nel corso dei secoli oltre agli aspetti più prettamente lavorativi e artigianali.

Coastal flood vulnerability assessment with geomatic methods: Test sites of western Thailand, Sydney (Australia) and aeolian islands (south tyrrhenian sea, Italy)

The work undertaken in this PhD thesis is aimed at the development and testing of an innovative methodology for the assessment of the vulnerability of coastal areas to marine catastrophic inundation (tsunami). Different approaches are used at different spatial scales and are applied to three different study areas: 1. The entire western coast of Thailand 2. Two selected coastal suburbs of Sydney – Australia 3. The Aeolian Islands, in the South Tyrrhenian Sea – Italy I have discussed each of these cases study in at least one scientific paper: one paper about the Thailand case study (Dall’Osso et al., in review-b), three papers about the Sydney applications (Dall’Osso et al., 2009a; Dall’Osso et al., 2009b; Dall’Osso and Dominey-Howes, in review) and one last paper about the work at the Aeolian Islands (Dall’Osso et al., in review-a). These publications represent the core of the present PhD thesis. The main topics dealt with are outlined and discussed in a general introduction while the overall conclusions are outlined in the last section.

Velocity structure and seismic anisotropy in the crust and upper mantle from Receiver Function analysis: three case studies in Italy

The research for this PhD project consisted in the application of the RFs analysis technique to different data-sets of teleseismic events recorded at temporary and permanent stations located in three distinct study regions: Colli Albani area, Northern Apennines and Southern Apennines. We found some velocity models to interpret the structures in these regions, which possess very different geologic and tectonics characteristics and therefore offer interesting case study to face. In the Colli Albani some of the features evidenced in the RFs are shared by all the analyzed stations: the Moho is almost flat and is located at about 23 km depth, and the presence of a relatively shallow limestone layer is a stable feature; contrariwise there are features which vary from station to station, indicating local complexities. Three seismic stations, close to the central part of the former volcanic edifice, display relevant anisotropic signatures­­­ with symmetry axes consistent with the emplacement of the magmatic chamber. Two further anisotropic layers are present at greater depth, in the lower crust and the upper mantle, respectively, with symmetry axes directions related to the evolution of the volcano complex. In Northern Apennines we defined the isotropic structure of the area, finding the depth of the Tyrrhenian (almost 25 km and flat) and Adriatic (40 km and dipping underneath the Apennines crests) Mohos. We determined a zone in which the two Mohos overlap, and identified an anisotropic body in between, involved in the subduction and going down with the Adiratic Moho. We interpreted the downgoing anisotropic layer as generated by post-subduction delamination of the top-slab layer, probably made of metamorphosed crustal rocks caught in the subduction channel and buoyantly rising toward the surface. In the Southern Apennines, we found the Moho depth for 16 seismic stations, and highlighted the presence of an anisotropic layer underneath each station, at about 15-20 km below the whole study area. The moho displays a dome-like geometry, as it is shallow (29 km) in the central part of the study area, whereas it deepens peripherally (down to 45 km); the symmetry axes of anisotropic layer, interpreted as a layer separating the upper and the lower crust, show a moho-related pattern, indicated by the foliation of the layer which is parallel to the Moho trend. Moreover, due to the exceptional seismic event occurred on April 6th next to L’Aquila town, we determined the Vs model for two station located next to the epicenter. An extremely high velocity body is found underneath AQU station at 4-10 km depth, reaching Vs of about 4 km/s, while this body is lacking underneath FAGN station. We compared the presence of this body with other recent works and found an anti-correlation between the high Vs body, the max slip patches and earthquakes distribution. The nature of this body is speculative since such high velocities are consistent with deep crust or upper mantle, but can be interpreted as a as high strength barrier of which the high Vs is a typical connotation.

Very Long Baseline Interferometry in Italy Wide-field VLBI imaging and astrometry and prospects for an Italian VLBI network including the Sardinia Radio Telescope

In this thesis the use of widefield imaging techniques and VLBI observations with a limited number of antennas are explored. I present techniques to efficiently and accurately image extremely large UV datasets. Very large VLBI datasets must be reduced into multiple, smaller datasets if today’s imaging algorithms are to be used to image them. I present a procedure for accurately shifting the phase centre of a visibility dataset. This procedure has been thoroughly tested and found to be almost two orders of magnitude more accurate than existing techniques. Errors have been found at the level of one part in 1.1 million. These are unlikely to be measurable except in the very largest UV datasets. Results of a four-station VLBI observation of a field containing multiple sources are presented. A 13 gigapixel image was constructed to search for sources across the entire primary beam of the array by generating over 700 smaller UV datasets. The source 1320+299A was detected and its astrometric position with respect to the calibrator J1329+3154 is presented. Various techniques for phase calibration and imaging across this field are explored including using the detected source as an in-beam calibrator and peeling of distant confusing sources from VLBI visibility datasets. A range of issues pertaining to wide-field VLBI have been explored including; parameterising the wide-field performance of VLBI arrays; estimating the sensitivity across the primary beam both for homogeneous and heterogeneous arrays; applying techniques such as mosaicing and primary beam correction to VLBI observations; quantifying the effects of time-average and bandwidth smearing; and calibration and imaging of wide-field VLBI datasets. The performance of a computer cluster at the Istituto di Radioastronomia in Bologna has been characterised with regard to its ability to correlate using the DiFX software correlator. Using existing software it was possible to characterise the network speed particularly for MPI applications. The capabilities of the DiFX software correlator, running on this cluster, were measured for a range of observation parameters and were shown to be commensurate with the generic performance parameters measured. The feasibility of an Italian VLBI array has been explored, with discussion of the infrastructure required, the performance of such an array, possible collaborations, and science which could be achieved. Results from a 22 GHz calibrator survey are also presented. 21 out of 33 sources were detected on a single baseline between two Italian antennas (Medicina to Noto). The results and discussions presented in this thesis suggest that wide-field VLBI is a technique whose time has finally come. Prospects for exciting new science are discussed in the final chapter.

Il teatro sugli scaffali. Genesi e storia di una biblioteca specialistica (1931-2009)

la ricerca ha avuto per oggetto la ricostruzione della storia e del patrimonio della biblioteca privata specializzata di San Genesio fondata nel 1931 presso la Casa "Lyda Borelli" per artisti drammatici di Bologna. La biblioteca si presenta oggi come uno dei centri di documentazione teatrale più antichi e significativi del panorama italiano: oltre 10.000 monografie, per la maggior parte concernenti testi e studi specialistici, un fondo antico (pre 1831) di oltre 2.000 volumi, una ricca collezione di periodici sul mondo dello spettacolo in collezione completa, una raccolta di copioni teatrali manoscritti e dattiloscritti di oltre 1.000 unità. La biblioteca, inoltre, comprende l'archivio storico della Casa che conserva la documentazione riguardante la vita dell'Istituto dalla sua nascita, nel 1917, numerosi fondi aggregati appartenuti a rilevanti personaggi dello spettacolo e un patrimonio fotografico unico in Italia. La tesi sintetizza i due principali filoni di ricerca seguiti durante il percorso dottorale. Il primo è quello della ricognizione delle fonti archivistiche, sia interne sia esterne all'istituto, al fine di dettagliare la lunga storia della biblioteca San Genesio, mai oggetto di altra ricostruzione complessiva. Questo obiettivo è stato raggiunto mediante la consultazione dell'intero patrimonio documentario conservato presso l'Archivio storico di Casa "Lyda Borelli" e di numerosi fondi archivistici, concernenti attori e personaggi in rapporto con la Casa, presenti in altri istituti pubblici e privati. I documenti interni alla Casa sono stati intrecciati con altri con cui sono speculari, conservati in altre istituzioni. La seconda parte della ricerca si è concentrata sull'analisi del fondo librario antico. La ricchezza della collezione, costituita da oltre trecento testi teatrali pubblicati nel XVI e XVII secolo, ha offerto un ampio campione d'indagine per ricostruire l'evoluzione dell'editoria specializzata nei primi secoli della stampa tipografica. A tal fine è stato redatto un catalogo, in cui la descrizione bibliografica è accompagnata dall'analitica registrazione degli elementi paratestuali presenti, quali dediche, avvisi ai lettori, indici, errata corrige, marginalia, note di possesso ed ex libris, elementi oggetto di forte interesse nei più accreditati e moderni studi bibliologici e di storia del libro sia italiani sia stranieri. A completamento del catalogo sono stati compilati numerosi indici al fine di moltiplicare le chiavi d'accesso e di lettura del fondo (per autori secondari, luoghi di stampa, editori e tipografi, marche tipografiche e possessori), dotando il catalogo di un apparato fotografico dei frontespizi. Questi elementi aggiuntivi rendono l'elaborato un repertorio unico per le edizioni teatrali e una fonte importante per gli studiosi della stampa in antico regime tipografico.

Eco-Management and Audit Scheme (EMAS): An evaluation of success factors in the agricultural sector. The case of Italy's Emilia Romagna region.

Different tools have been used to set up and adopt the model for the fulfillment of the objective of this research. 1. The Model The base model that has been used is the Analytical Hierarchy Process (AHP) adapted with the aim to perform a Benefit Cost Analysis. The AHP developed by Thomas Saaty is a multicriteria decision - making technique which decomposes a complex problem into a hierarchy. It is used to derive ratio scales from both discreet and continuous paired comparisons in multilevel hierarchic structures. These comparisons may be taken from actual measurements or from a fundamental scale that reflects the relative strength of preferences and feelings. 2. Tools and methods 2.1. The Expert Choice Software The software Expert Choice is a tool that allows each operator to easily implement the AHP model in every stage of the problem. 2.2. Personal Interviews to the farms For this research, the farms of the region Emilia Romagna certified EMAS have been detected. Information has been given by EMAS center in Wien. Personal interviews have been carried out to each farm in order to have a complete and realistic judgment of each criteria of the hierarchy. 2.3. Questionnaire A supporting questionnaire has also been delivered and used for the interviews . 3. Elaboration of the data After data collection, the data elaboration has taken place. The software support Expert Choice has been used . 4. Results of the Analysis The result of the figures above (vedere altro documento) gives a series of numbers which are fractions of the unit. This has to be interpreted as the relative contribution of each element to the fulfillment of the relative objective. So calculating the Benefits/costs ratio for each alternative the following will be obtained: Alternative One: Implement EMAS Benefits ratio: 0, 877 Costs ratio: 0, 815 Benfit/Cost ratio: 0,877/0,815=1,08 Alternative Two: Not Implement EMAS Benefits ratio: 0,123 Costs ration: 0,185 Benefit/Cost ratio: 0,123/0,185=0,66 As stated above, the alternative with the highest ratio will be the best solution for the organization. This means that the research carried out and the model implemented suggests that EMAS adoption in the agricultural sector is the best alternative. It has to be noted that the ratio is 1,08 which is a relatively low positive value. This shows the fragility of this conclusion and suggests a careful exam of the benefits and costs for each farm before adopting the scheme. On the other part, the result needs to be taken in consideration by the policy makers in order to enhance their intervention regarding the scheme adoption on the agricultural sector. According to the AHP elaboration of judgments we have the following main considerations on Benefits: - Legal compliance seems to be the most important benefit for the agricultural sector since its rank is 0,471 - The next two most important benefits are Improved internal organization (ranking 0,230) followed by Competitive advantage (ranking 0, 221) mostly due to the sub-element Improved image (ranking 0,743) Finally, even though Incentives are not ranked among the most important elements, the financial ones seem to have been decisive on the decision making process. According to the AHP elaboration of judgments we have the following main considerations on Costs: - External costs seem to be largely more important than the internal ones (ranking 0, 857 over 0,143) suggesting that Emas costs over consultancy and verification remain the biggest obstacle. - The implementation of the EMS is the most challenging element regarding the internal costs (ranking 0,750).