A retrospective analysis of the factors associated with surgical checklist compliance using data from a local health unit in Italy, 2018–2021

Rationale: Since its publication, the World Health Organization Surgical Safety Checklist (SSC) has been progressively adopted by healthcare providers around the world to monitor and safeguard the delivery of surgeries. In one Italian region's health system, the SSC and other two surgery‐specific checklists were supplemented by a document that records any non‐conformity (NC) arising from the safety checks. Aims and Objectives: In this study, we investigated the factors associated with NCs using data from a local health unit (LHU). The secondary aim of this study was to explore the potential impact of the coronavirus crisis on surgical checklist compliance. Methods: We used data on surgical activity from the Modena LHU between 2018and 2021 and the accompanying NC documents. The primary goal was to estimate the relative risk (RR) of NCs according to several factors, including checklist incompleteness and surgery class (elective, urgent or emergency), using Poisson regression. A similar analysis was performed separately for 2018–2019 and2020–2021 to assess the COVID‐19 potential impact. Results and Conclusions: Checklist compliance in the LHU was 95%, with the presence of NCs in about 7% of surgeries. The factors that increased the RR were incompleteness of the checklist (adjusted RR = 3.12; 95% confidence interval[CI] = 2.86–3.40), urgent surgeries (adjusted RR [aRR] = 1.59; 95% CI = 1.47–1.72),emergencies (aRR = 2.09; 95% CI = 1.15–3.79), and surgeries with more than four procedures (aRR = 1.64; 95% CI = 1.41–1.92). Most notably, the RR for incomplete checklists showed a negative association with NCs before the COVID‐19 outbreak but positive afterwards. Checklist compliance was overall satisfactory, though the observation of noncompliant checklists of about 1000 per year suggests there is stillroom for improvement. Moreover, attention to the checklist best practices and organization of outpatient workload may have been affected by the exceptional circumstances of the pandemic

LTE Adaptation for Mobile Broadband Satellite Networks

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Combining OCT and NMR-MOUSE techniques to study the stratigraphy of historical violins: the thickNESS project

In this work, Optical Coherence Tomography (OCT) and Nuclear Magnetic Resonance (NMR-MOUSE) have been applied to precious historical violins made by the most renowned makers of the Italian lutherie, such as Amati, Stradivari and Guarneri ‘del Gesù’, and hosted in the Museo del Violino in Cremona. Several large fragments removed during past restorations from instruments produced by the luthiers Stainer, Gasparo da Salò, Maggini and Guadagnini, as well as laboratory models simulating musical instruments stratigraphy, were further examined. OCT study was carried out with a prototype high-resolution portable SdOCT instrument providing layer thickness measurements and information about the presence of particles, cracks and delaminations. NMR analyses were performed with a Magritek Kea spectrometer and a Profile NMR-MOUSE (PM5) giving information on the wood density and elasticity, the last one possibly related to adopted treatments. The analyses have been conducted within the MOLAB Transnational Access - EU H2020 Project IPERION CH (thickNESS Project). Data interpretation is still in progress and promising results are expected to reveal in-depth insight into the finishing violin making process. These outcomes will be integrated with the results from UVIFL, FT-IR, Raman and XRF techniques in order to set up a methodology which allowed researchers to non-invasively characterize the stratigraphy of historical violins

Combined EXAFS, XRD, DRIFTS, and DFT Study of Nano Copper-Based Catalysts for CO2 Hydrogenation

Highly monodispersed CuO nanoparticles (NPs) were synthesized via continuous hydrothermal flow synthesis (CHFS) and then tested as catalysts for CO2 hydrogenation. The catalytic behavior of unsupported 11 nm sized nanoparticles from the same batch was characterized by diffuse reflectance infrared fourier transform spectroscopy (DRIFTS), extended X-ray absorption fine structure (EXAFS), X-ray diffraction (XRD), and catalytic testing, under CO2/H2 in the temperature range 25–500 °C in consistent experimental conditions. This was done to highlight the relationship among structural evolution, surface products, and reaction yields; the experimental results were compared with modeling predictions based on density functional theory (DFT) simulations of the CuO system. In situ DRIFTS revealed the formation of surface formate species at temperatures as low as 70 °C. DFT calculations of CO2 hydrogenation on the CuO surface suggested that hydrogenation reduced the CuO surface to Cu2O, which facilitated the formation of formate. In situ EXAFS supported a strong correlation between the Cu2O phase fraction and the formate peak intensity, with the maxima corresponding to where Cu2O was the only detectable phase at 170 °C, before the onset of reduction to Cu at 190 °C. The concurrent phase and crystallite size evolution were monitored by in situ XRD, which suggested that the CuO NPs were stable in size before the onset of reduction, with smaller Cu2O crystallites being observed from 130 °C. Further reduction to Cu from 190 °C was followed by a rapid decrease of surface formate and the detection of adsorbed CO from 250 °C; these results are in agreement with heterogeneous catalytic tests where surface CO was observed over the same temperature range. Furthermore, CH4 was detected in correspondence with the decomposition of formate and formation of the Cu phase, with a maximum conversion rate of 2.8% measured at 470 °C (on completely reduced copper), supporting the indication of independent reaction pathways for the conversion of CO2 to CH4 and CO that was suggested by catalytic tests. The resulting Cu NPs had a final crystallite size of ca. 44 nm at 500 °C and retained a significantly active surface

Effetti di tipologie di suolo e colture foraggere sulle perdite per ruscellamento di azoto, fosforo e potassio in differenti areali italiani

Le colture foraggere svolgono un ruolo importante in molti areali italiani. Per una corretta pianificazione del territorio agricolo è necessario approfondire la conoscenza non solo delle caratteristiche produttive di queste colture, ma anche dei loro rapporti con l'ambiente. Questo lavoro prende in considerazione le perdite di azoto, fosforo e potassio dovute al ruscellamento in colture foraggere a diverso livello di intensificazione (dal pascolo alla coltura di erba medica, dal mais al doppio ciclo di mais e loiessa) in tre ambienti italiani: la Pianura Padana nord-occidentale, l'Appennino Toscano e la pianura sarda, con suoli varianti da franco-sabbioso a franco-argilloso. Il monitoraggio quanti-qualitativo del ruscellamento è stato fatto per periodi variabili da due a sei anni. La pendenza era dello 0,5% per gli appezzamenti in Piemonte e Sardegna e del 10% in Toscana. Per quanto riguarda l'azoto i rilasci sono risultati più bassi nei terreni più pianeggianti, anche per i ridotti volumi di ruscellamento registrati, non superando mai 15 kg di N ha -1 anno -1. Nei terreni in pendenza si sono invece registrati valori più elevati, con un massimo annuale di circa 30 kg ha -1 anno -1 di azoto, in relazione anche all'elevato ruscellamento ed erosione di un evento eccezionale. Per il fosforo solo in pochi casi si sono raggiunte perdite di 5 kg ha -1 anno -1, mentre nella maggior parte dei casi non sono stati superati 2 kg ha -1 anno -1. In Sardegna i rilasci di tale elemento sono da considerarsi pressoché trascurabili. Le perdite di potassio sono risultate minime in Sardegna e massime in Piemonte, dove si sono registrati valori dell' ordine di 10 kg ha -1 anno -1. Ove era possibile il confronto, si è verificato che le colture prative riducono il rilascio di elementi nutritivi rispetto alla coltura del mais e che la qualità delle acque di superficie appare legata piuttosto alle tecniche colturali che alla tipologia di suolo. Fodder crops play an important role in many Italian environments. The knowledge of the main productive characteristics of these crops is as important as their relationships with the environment, expecially for a proper territorial management. This paper compares nitrogen, phosphorous and potassium contents in runoff of some forage crops of different intensity (pasture, lucerne, silage maize, Italian ryegrass/maize double cropping) in different ltalian environments (north-western plain of Piemonte, Apennines hills of Tuscany and Mediterranean plain of Sardegna) on different typology of soils. Runoff data have been collected for periods ranging between two and six year, from plots of different extension and slope (0,5% in the plains, 10% in Apennine hills). Nitrogen losses, for the small amount of runoff, have been qui te low from ilat fields, being always less than 15 kg ha -1 year-1. Losses from slope fields have been higher, with a maximum of 30 kg ha -1 year-1, due to very high level of runoff and erosion in a conspicuous episode. Phosphorous losses only in a few cases were higher than 5 kg ha -I year -I, while mostly they have b>!en less than 2 kg ha -1 year-1. In the Mediterranean plain such losses have been quite insignificant. Minimum potassium 10sses were recorded in the Mediterranean plain, while in north-western plain they reached about 10 kg-1 year-1. Maize was, on average, the crop with highest nutrient losses, while quality of the runoff water was more related to agricultural practices than to soil types

"Until death do us part". A multidisciplinary study on human- Animal co- burials from the Late Iron Age necropolis of Seminario Vescovile in Verona (Northern Italy, 3rd-1st c. BCE).

Animal remains are a common find in prehistoric and protohistoric funerary contexts. While taphonomic and osteological data provide insights about the proximate (depositional) factors responsible for these findings, the ultimate cultural causes leading to this observed mortuary behavior are obscured by the opacity of the archaeological record and the lack of written sources. Here, we apply an interdisciplinary suite of analytical approaches (zooarchaeological, anthropological, archaeological, paleogenetic, and isotopic) to explore the funerary deposition of animal remains and the nature of joint human-animal burials at Seminario Vescovile (Verona, Northern Italy 3rd-1st c. BCE). This context, culturally attributed to the Cenomane culture, features 161 inhumations, of which only 16 included animal remains in the form of full skeletons, isolated skeletal parts, or food offerings. Of these, four are of particular interest as they contain either horses (Equus caballus) or dogs (Canis lupus familiaris)-animals that did not play a dietary role. Analyses show no demographic, dietary, funerary similarities, or genetic relatedness between individuals buried with animals. Isotopic data from two analyzed dogs suggest differing management strategies for these animals, possibly linked to economic and/or ritual factors. Overall, our results point to the unsuitability of simple, straightforward explanations for the observed funerary variability. At the same time, they connect the evidence from Seminario Vescovile with documented Transalpine cultural traditions possibly influenced by local and Roman customs

Calibration method and performance of a time-of-flight detector to measure absolute beam energy in proton therapy

Background: The beam energy is one of the most significant parameters in particle therapy since it is directly correlated to the particles' penetration depth inside the patient. Nowadays, the range accuracy is guaranteed by offline routine quality control checks mainly performed with water phantoms, 2D detectors with PMMA wedges, or multi-layer ionization chambers. The latter feature low sensitivity, slow collection time, and response dependent on external parameters, which represent limiting factors for the quality controls of beams delivered with fast energy switching modalities, as foreseen in future treatments. In this context, a device based on solid-state detectors technology, able to perform a direct and absolute beam energy measurement, is proposed as a viable alternative for quality assurance measurements and beam commissioning, paving the way for online range monitoring and treatment verification. Purpose: This work follows the proof of concept of an energy monitoring system for clinical proton beams, based on Ultra Fast Silicon Detectors (featuring tenths of ps time resolution in 50 μm active thickness, and single particle detection capability) and time-of-flight techniques. An upgrade of such a system is presented here, together with the description of a dedicated self-calibration method, proving that this second prototype is able to assess the mean particles energy of a monoenergetic beam without any constraint on the beam temporal structure, neither any a priori knowledge of the beam energy for the calibration of the system. Methods: A new detector geometry, consisting of sensors segmented in strips, has been designed and implemented in order to enhance the statistics of coincident protons, thus improving the accuracy of the measured time differences. The prototype was tested on the cyclotron proton beam of the Trento Protontherapy Center (TPC). In addition, a dedicated self-calibration method, exploiting the measurement of monoenergetic beams crossing the two telescope sensors for different flight distances, was introduced to remove the systematic uncertainties independently from any external reference. Results: The novel calibration strategy was applied to the experimental data collected at TPC (Trento) and CNAO (Pavia). Deviations between measured and reference beam energies in the order of a few hundreds of keV with a maximum uncertainty of 0.5 MeV were found, in compliance with the clinically required water range accuracy of 1 mm. Conclusions: The presented version of the telescope system, minimally perturbative of the beam, relies on a few seconds of acquisition time to achieve the required clinical accuracy and therefore represents a feasible solution for beam commission, quality assurance checks, and online beam energy monitoring