Background: The relationship between nasal functions and middle ear surgery is still under debate. Nasal obstruction is considered as a negative prognostic factor in middle ear surgery. This is based on the theory that it may cause Eustachian tube dysfunction (ETD) by leading to reduced ventilation of the middle ear, as found in several patients with nasal septal deviation, chronic rhinitis and nasal polyps. Objectives: To assess how the subjective feeling of nasal function, evaluated by a preoperative questionnaire, may be predictive of surgical outcome and/or risk of failure in middle ear surgery. Methods: We prospectively evaluated data of patients undergoing middle ear surgery for chronic otitis media with and without cholesteatoma. All patients completed the SNOT-22 and ETDQ-7 questionnaires. They underwent surgery for their pathology, as appropriate. Results: The SNOT-22 score was higher in patients with retraction pocket and in patients whose retraction pockets recurred after surgery (p < 0.05). Patients with higher score at SNOT-22 questionnaire, were more likely to show recurrence of atelectasis aftersurgery. Conclusions: The SNOT-22 questionnaire, administrered before surgical procedure, can help in the identification of patients who are at risk of failure in the post-operative period, as well as ETDQ-7.

BACKGROUND AND PURPOSE:The aim of this study was to describe the variations in the speech range profile (SRP) of patients affected by cognitive decline.METHODS:We collected the data of patients managed for suspected voice and speech disorders, and suspected cognitive impairment. Patients underwent an Ear Nose and Throat evaluation and Mini-Mental State Examination (MMSE). To obtain SRP, we asked the patients to read 18 sentences twice, at their most comfortable pitch and loudness as they would do in daily conversation, and recorded their voice on to computer software.RESULTS:The study included 61 patients. The relationship between the MMSE score and SRP parameters was established. Increased severity of the MMSE score resulted in a statistically significant reduction in the average values of the semitones to the phonetogram, and the medium and maximum sound pressure levels (p<0.001). The maximum predictivity of MMSE was based on the highly significant values of semitones (p<0.001) and the maximum sound pressure levels (p=0.010).CONCLUSIONS:The differences in SRP between the various groups were analyzed. Specifically, the SRP value decreased with increasing severity of cognitive decline. SRP was useful in highlighting the relationship between all cognitive declines tested and speech.

This study aims to understand the factors contributing to the severity of oropharyngeal dysphagia and its persistence in the sub-acute phase of stroke. We retrospectively collected the data of all the patients suffering from a stroke in the last year. The severity of stroke was reported according to the NIHSS score. All the patients were evaluated with the Dysphagia Risk Score and with a FEES. We classified the Dysphagia Risk Score and FEES results using the PAS score and ASHA-NOMS levels. The data were analysed statistically with ANOVA test, Student’s t test and Pearson’s correlation coefficient. A series of 54 patients were evaluated. The ANOVA test did not find any difference in the mean score of Dysphagia Risk Score, PAS and ASHA-NOMS when compared with the brain area of stroke. An NIHSS at hospital admission (stroke unit) of more than 12 was predictive of ASHA-NOMS score 1–4 after 60 days (p < 0.05). A PAS score between 6 and 8 at first FEES evaluation was predictive of poor (1–4) ASHA-NOMS score after 60 days (p < 0.01). A moderate positive linear correlation was found between NIHSS score and both PAS (r 0.65) and Dysphagia Risk Score (r 0.50); a moderate negative linear correlation was recorded between NIHSS and ASHA-NOMS (r  − 0.66) scores. In the sub-acute phase of stroke, the predictive factors of persistent dysphagia are not linked to the damaged neuroanatomical region and others factors such as NIHSS value and high PAS score seem more useful.

PURPOSE:To evaluate the prevalence of oropharyngeal dysphagia in elderly patients suffering from minimal or mild cognitive decline.PATIENTS AND METHODS:We retrospectively collected the data of patients suffering from mild cognitive impairment or mild dementia and were undergoing management for suspected oropharyngeal dysphagia, in our department. All our patients were subjected to Mini Mental State Examination test, MD Anderson dysphagia inventory and caregiver mealtime and dysphagia questionnaire. We performed a mealtime observation study and endoscopic evaluation of swallowing in all our patients. Following evaluation, we then analysed the data statistically.RESULTS:Out of 708 patients who visited us for cognitive decline and suspected oropharyngeal dysphagia in the last two years, 52 patients were confirming to the inclusion criteria of this study. Classification of oropharyngeal dysphagia patients according to ASHA-NOMS scale showed that 32.7% of patients presented with grade 4 of dysphagia followed by another 32.7% with grade 5 and 30.8% presented with grade 6. Only 3.8% of our patients were considered normal (grade 7 of ASHA-NOMS scale). MD Anderson dysphagia inventory could collected swallowing alterations in only 23.1% of the cases. The caregiver mealtime and dysphagia questionnaire showed acceptable caregivers patient management in 53.8% of patients.CONCLUSION:Our study underscores the fact that oropharyngeal dysphagia is present in many cases of mild cognitive decline. While patients understate their swallowing problems, the caregivers are not competent enough to manage this situation in a great percentage of cases. Only a mealtime observation by a speech-language pathologist along with FEES is able to identify the true prevalence of the condition.

The C.A.S.E. project was a large engineering realisation, designed and built in very short time in L'Aquila after the strong earthquake of April 2009, to supply long-term provisional houses for people having lost their homes during the seismic event. Three-storey houses were built on about 180 reinforced concrete plates supported by concrete or steel columns and base seismic isolators (about 7000 curved surface sliding devices). The Court of L'Aquila opened a preliminary investigation to ascertain the consistency of complaints about the quality of the isolating devices with respect to the contractual agreement and the technical norms. The author of the present paper was in charge of the technical aspects of such preliminary investigation. A report on the project and execution of the technical investigation is subject of this contribution.

The architectural heritage in the world represents a fundamental resource and a sign of the national cultural background. Its maintenance and preservation require a balance between the structural safety needs and the respect for their architectural and cultural value. Structural health monitoring (SHM) is increasingly emerging as a unique tool to achieve such a balance, through a proper combination of traditional and innovative techniques. This paper presents some recent experiences of SHM applied to the historical heritage in Italy, discussing relevant tools and reporting some of the most significant case studies.

In this paper, novel hybrid methodologies for modal parameters extraction using Empirical Mode Decomposition (EMD) based techniques combined with classic signal processing spectral analysis are presented. The modal frequencies are extracted by a methodology that combines EMD and Fast Fourier Transform (FFT). The damping factor is obtained by another methodology that uses FFT as a time-frequency estimator. The proposed methodologies were applied to real signals. Results have shown very good accuracy, precision, and low dispersion in comparison with other conventional methods.

A method for structural health monitoring of cable-stayed bridges based on the dynamic distributed sensing of bridge deck strains is introduced in this article. The objective is to detect the location and the magnitude of the cables that have totally or partially lost their tensile load-carrying capacities. Dynamic sensing provides a realistic approach for condition assessment of the bridge under operational conditions. A Brillouin scattering optical time domain analysis (BOTDA) fiber-optic sensor was used to monitor the distributed strain in the deck of a scaled model cable-stayed bridge in the laboratory. The formulations developed in the present study take advantage of the dynamic distributed sensing capability of the BOTDA in amplitude transfer (AT) mode for the establishment of a relationship between the redistribution of deck strains and the tension loss in the individual cables of cable-stayed bridges. The experimental program involved single cable and multicable damage scenarios. The applicability of the method was independently evaluated by the direct measurement of cable forces and nonlinear finite-element analysis of the bridge. (C) 2016 American Society of Civil Engineers.

This prospective study was designed to evaluate the differences between immediate and delayed canal re-entry of otoliths after therapeutic manoeuvres in patients with benign paroxysmal positional vertigo (BPPV). A total of 196 patients with BPPV were visited and 127 matched our inclusion criteria. The mean age was 54.74 years. The horizontal semicircular canal (HSC) was involved in 30 cases and the posterior semicircular canal (PSC) in 97 patients. Patients with hearing loss in the ear affected by BPPV have a more recurrent form, compared to those with normal hearing. An immediate canal re-entry was recorded in 3 patients with HSC BPPV, all with geotropic nystagmus. In 7 patients with PSC BPPV, the immediate canal re-entry was detected and the delayed form was noted in 5 patients. The patients with the delayed canal re-entry underwent more than 2 previous manoeuvres. The canal re-entry was not related to the manoeuvre performed. The timing of the Dix-Hallpike test to verify the resolution of the BPPV had a significant role in immediate canal re-entry. A recurrence in the follow-up at least one month after treatment was recorded in 20 patients and was more frequent in patients that had canal re-entry. The canal re-entry or canal switch is a clinical entity that should be kept in mind of the neurotologist when approaching BPPV patients. It is important to distinguish it from recurrence when delayed and from manoeuvre failure when immediate. The timing of manoeuvre performing, in particular the final verification test after therapeutic sessions, is important to prevent the immediate reflux of particles into canals.

Accurate finite element models are needed in many applications of Civil Engineering. Non-structural elements (NSEs) often interfere with the main structure, altering its stiffness and modal signature. Neglecting such interaction, although a common practice in design, may lead to unreliable predictions of the structural dynamic response and to biased interpretations of experimental vibrational tests. In the literature, the role of NSEs in vibration-based finite element model calibration is well documented for NSEs working “in parallel” with the main structure (e.g. masonry infills in buildings, pavements or railings in bridges) but remains essentially unexplored for NSEs working “in series” with the main structure (e.g. non-structural appendages like suspended ceilings, piping systems, storage tanks and antennas, but also partitions and façades in their out-of-plane modes). Through the analysis of numerical and experimental case studies, this paper shows that “in series” NSEs accidentally resonating with some structural mode may deeply contaminate the overall modal behaviour and severely invalidate model calibration, unless their role is properly addressed while performing experimental modal analysis and structural modelling. Two alternative calibration strategies are finally discussed which prove effective in the presence of resonant NSEs, based on, respectively, excluding/including the NSEs from/into the model structure.

An innovative base isolation system has been recently proposed for the retrofitting of existing buildings, in which the isolation layer is inserted under the building foundations so that the building, along with its foundations, is isolated from the surrounding soil.The isolation layer resides in closely-spaced micro-tunnels, constructed under the entire width of the building.These micro-tunnels, along with the trenches around the building, isolate the structure from the surrounding soil.The execution of these micro-tunnels is the most critical construction stage, because it may result in settlements which can damage the structure.In this paper, the behaviour of an existing structure, consisting of a masonry wall subjected to tunnelling-induced ground subsidence, is analysed.A parametric study is conducted using 2-D nonlinear finite element analyses to understand the role of key factors such as strength and stiffness of soil and masonry, roughness of soil-structure interface, excavation sequence of tunnels, wall dimensions and openings configuration.The study identifies the design variables which influence the most the risk of structural damage and suggests the most effective damage symptoms to be monitored during construction.

More than 23,000 structures, located in over 30 countries, have been so far protected by passive anti-seismic (AS) systems, mainly by the seismic isolation (SI) and energy dissipation (ED) ones. The use of such systems is going on increasing everywhere, although its extent is strongly influenced by earthquake lessons and the features of the design rules used. As to the latter, SI is considered as an additional safety measure (with consequent significant additional construction costs) in some countries (Japan, USA, etc.), while, in others (including Italy), the codes allow to partly take into account the reduction of the seismic forces acting on the superstructure that is induced by SI. Applications of the AS systems have been made to both new and existing civil and industrial structures of all kinds. The latter include some high risk (HR) plants (nuclear reactors and chemical installations). The applications in a civil context already include not only strategic and public structures, but also residential buildings and even many small private houses. In Italy, the use of the AS systems has become more and more popular especially after the 2009 Abruzzo earthquake (nowadays more than 400 Italian buildings are seismically isolated). Based on the information provided by the authors at the ASSISi 13th World Conference, held in Sendai (Japan) in September 2013, and on more recent data, the paper summarizes the state-of-the-art of the development and application of the AS systems and devices at worldwide level, by devoting particular attention to SI of buildings in Italy, in the context of recent seismic events. Moreover, it outlines the benefits of the aforesaid systems for ensuring the indispensable absolute integrity of strategic and public structures, as, primarily, schools, hospitals and HR plants, but also (for an adequate protection of cultural heritage) museums. Finally, based on Italian experience, it provides some remarks on costs of SI, stresses the conditions for the correct use of this technique and mentions some recent initiatives of the Italian Parliament to ensure such a correct use and to widely extend such an use to the HR chemical plants too (for which only very few applications already exist in Italy).

1.The seventh author's name should read as follows: “Min-Beom Kim”.2.The affiliation for authors Jae Ho Ban and Min-Beom Kim should read as follows: “Department of Otolaryngology, Sungkyunkwan University School of Medicine, Seoul, South Korea”. 1.The seventh author's name should read as follows: “Min-Beom Kim”.2.The affiliation for authors Jae Ho Ban and Min-Beom Kim should read as follows: “Department of Otolaryngology, Sungkyunkwan University School of Medicine, Seoul, South Korea”. A multicenter observational study on the role of comorbidities in the recurrent episodes of benign paroxysmal positional vertigoAuris Nasus LarynxVol. 41Issue 1PreviewPrimary objective of this study was to find a statistical link between the most worldwide comorbidities affecting the elderly population (hypertension, diabetes, osteoarthrosis, osteoporosis and depression) and recurrent episodes of BPPV. Secondary objective was defining possible “groups of risk” for people suffering recurrent positional vertigo related to the presence of a well documented comorbidity. Full-Text PDF