Publications

The combination of multiple therapies could improve the patient's prognosis by achieving objective response rate of almost 82%, disease control rate of 97% and progression free survival of 12.9 months with quadruple therapy (HAIC-TACE combined with targeted and immunotherapy).

Metabolic dysfunction-associated steatotic liver disease (MASLD) is defined by hepatic steatosis in individuals with at least one cardiometabolic risk factor, most commonly type 2 diabetes mellitus (T2DM). People with non-alcoholic fatty liver disease, even without other metabolic factors, have a higher risk of T2DM. MASLD includes isolated liver steatosis, metabolic dysfunction-associated steatohepatitis, fibrosis, cirrhosis, and MASH-related hepatocellular carcinoma. MASLD patients are also at a higher risk of developing T2DM than the general population. International guidelines recommend a stepwise approach for identifying those at high risk of fibrotic progression, using the FIB-4 index for initial screening, followed by transient elastography. The link between MASLD and T2DM is notable due to shared pathophysiological mechanisms, some of which are reversible with treatment used in T2DM. Many new glucose-lowering drugs have also proven effective in improving anthropometric and metabolic parameters, as well as the stage of hepatic steatosis and fibrosis. Recent evidence suggests that GLP-1RAs and SGLT2is have beneficial effects in MASLD patients with T2DM. Specifically, GLP-1RAs improve hepatic insulin signaling, modulate lipid metabolism, reduce inflammation, and decrease hepatocyte oxidative stress. European guidelines recommend resmetirom as a MASH-targeted therapy, if locally approved, for adults with non-cirrhotic MASH and significant liver fibrosis (stage ≥ 2) and GLP-1RAs in MASH, including compensated cirrhosis, but they should be used for their respective indications, such as T2DM and obesity. Given the post-COVID burden of MASLD and its high risk of liver fibrosis progression among T2DM patients, this review specifically provides an overview of the complex relationship between MASLD and T2DM. Additionally, it examines current understanding of liver fibrosis evaluation and the effects of novel treatment options, with a particular focus on glucose-lowering therapies and their effects on necroinflammation, hepatic fat accumulation, and fibrosis progression in patients with MASLD and T2DM.

I PEBA sono strumenti che servono alle amministrazioni pubbliche per individuare ed eliminare le barriere architettoniche, rendendo gli spazi accessibili a tutti. Anche gli ospedali sono obbligati a dotarsi di questi piani, non solo per rispettare la legge, ma soprattutto per migliorare la qualità dei servizi per gli utenti. In questo caso, l’Azienda Ospedaliero-Universitaria Pisana ha collaborato con l’Università di Firenze per sviluppare un piano di accessibilità per l’ospedale di Cisanello. L’obiettivo non era solo rispettare le norme, ma anche creare un metodo pratico per organizzare e pianificare gli interventi nel tempo. Il progetto è partito dall’analisi della situazione esistente e ha previsto la raccolta di dati, coinvolgendo anche persone con disabilità per avere una valutazione più concreta. Tutte le informazioni sono state poi inserite in una piattaforma digitale, così da poter aggiornare e monitorare gli interventi nel tempo. In sintesi, il progetto serve sia a capire lo stato attuale delle strutture, sia a definire delle linee guida per migliorare quelle future, formando anche persone in grado di gestire questi processi. È organizzato in diverse fasi e aiuta a passare dall’analisi alla realizzazione concreta del piano.

The digital survey was carried out as a part of the research project titled, “The Romanesque and the territory. Construction materials of the Sardegna Giudicale”, and coordinated by prof. Stefano Columbu. The BIM model was developed by a students’ team as part of the teaching activities of the Architectural Drawing course at the School of Engineering, University of Florence. The imagines are extracted from the drawings of the students, Valeria Siddi, Elena Pastorelli, Liuba Gabrielli, Simone Riccio, Elisa Ricotti.

Hospitals include a variety of different spaces with different requirements and levels of sensitivity to noise but also different activities and equipment that can cause high noise levels. In this article, noise disturbance in hospitals is studied with reference to a case study in a maternity ward. The analysis is carried out by means of sound insulation measurements between bedrooms and between bedroom and corridor. Equivalent sound pressure level measurements were carried out continuously for two days and nights. The number of awakening events is examined for each hour of the two nights. In addition, the results of a questionnaire conducted on more than 100 patients are reported. The results of the study show that the main cause of noise disturbance is activity in the corridors and that this kind of disturbance is usually repeated throughout the night. This is made more critical by the poor acoustic performance of the doors, but also by the habit of keeping doors open or half-open to allow doctors to always control patients. The article proposes some possible solutions to reduce noise intrusion from the corridor to the rooms.

Il settore delle costruzioni si sta trasformando profondamente sotto la spinta della digitalizzazione del processo edilizio, che nella gestione informativa del ciclo di vita dell’edificio ha trovato nel Building Information Modelling il ‘driver’ fondamentale di sviluppo di efficaci strumenti e metodologie per la gestione di patrimoni immobiliari pubblici e privati. L’implementazione di Asset Information Models (AIM) permette infatti di creare repository strutturati di contenuti informativi, evitando ridondanze e perdita di dati, garantendo la tracciabilità delle procedure di produzione e validazione delle informazioni, migliorando la collaborazione tra gli operatori coinvolti. Il presente studio propone alcuni risultati di una ricerca svolta sul tema della gestione informativa con l’adozione del BIM per il patrimonio immobiliare dell’Università di Firenze nella fase di esercizio. La necessità di integrazione con le piattaforme di Computer Aided Facility Management (CAFM) e Computerized Maintenance Management System (CMMS), già in uso da parte dell’ente, ha orientato la ricerca verso approcci interoperabili e open BIM per superare i ‘gap’ informativi tra i software di modellazione e quelli di gestione, e per garantire inoltre un agevole workflow verso applicazioni di raccolta dinamica dei dati provenienti da sensoristica IoT per il monitoraggio della qualità ambientale degli edifici. Il contributo intende proporre un framework di lavoro replicabile, scalabile e interopera-bile per la gestione informativa di patrimoni immobiliari pubblici e privati.

Although noise in indoor environments is considered one of the most important factors affecting health and life quality of users, it is often overlooked during design; several studies highlight how noise pollution in hospitals has increased significantly over the past sixty years, and how exposure to inadequate noise levels causes stress and disturbance for all users.In patients, who represent the most vulnerable group of users within hospitals, excessive noise, especially during the night, is a cause of stress and awakenings that can affect the psychophysical healing process.Interviews conducted with patients highlight that the most disturbing sources of noise that cause awakening during the night are from activities outside the room.In this paper, starting from the typical configuration (two-bed coupled rooms with toilet), different possible configurations of materials and distributive layouts will be shown, in order to contribute to the reduction of noise transmission from the corridor into the patient room.

There is a number of different factors and data that require knowledge and responsibilities in the requalification and reorganization of a hospital building system. For the process to be successful and for its full implementation, there must be an inter-operation between this information and knowledge. This paper aims at contributing to this process by illustrating the experience of a multidisciplinary research laboratory consisting of architects belonging to the technological area, and computer/biomedical engineers, who defined and prepared a set of tools for an effective management of structural assets by using the “Policlinico di Careggi” hospital of Florence, that can be a reference for other similar contexts

The process of digitization of the cultural heritage is crucial for the conservation and valorization of historical buildings. The paper presents some results of a research project carried out as part of a collaboration agreement between the Bargello Museums and the DICEA and DIDA Departments of University of Florence aimed at the geometric survey and structural analysis of the “Sagrestia Nuova” of Michelangelo within the architectural complex of the Basilica of San Lorenzo in Florence. The study focused on the Exchange Information Requirements (EIR) for H-BIM modelling of the monument with the aim of carrying out a structural analysis of the historic building. The research consisted of several phases, starting with the geometric data capturing, developed using digital acquisition techniques. A 3D laser scanner was employed to generate a point cloud, which was combined with a photogrammetric campaign using handheld cameras and UAV drones to process 3D mesh models, facilitating the acquisition of dimensional and material characteristics in the form of raw data. The authoring modelling of the architectural and structural discipline was carried out to optimize interoperability with the specific structural analysis software, DIANA FEA, which posed several challenges and required innovative solutions to improve data exchange between the two different software. The structural model was then subjected to seismic analysis in accordance with guidelines for assessing the structural integrity of monumental historic masonry buildings, using the knowledge gained from the BIM model. The result of this research is a digital model that provides a wealth of information for the management, conservation and restoration of the historic building. Specifically, the digital model can serve as a database for restoration projects and structural analysis of the historic building. Furthermore, the objective of this endeavour is to foster collaboration among actors from diverse disciplinary backgrounds, thereby enhancing mutual comprehension of interoperability concerns.

The territory and the contemporary city require a dynamic approach capable of embracing the life cycles of the different functions and their relationships. The article discusses tools developed in three case studies in which some factors that determine the evolution of tourist and healthcare functions in a historical centre and recreational functions in a protected natural park can be observed and interpreted. The research presented aims to provide the territorial conservation, transformation and enhancement project with tools capable of interacting with new social demands for inclusiveness, identity, accessibility and sharing, favouring new forms of administration as well as participation and collaboration between different knowledge and skill sets.