Regarding “Understanding the ‘Scope’ of the Problem: Why Laparoscopy Is Considered Safe during the COVID-19 Pandemic”

SARS-CoV-2 range in size from 0.06 to 0.125 μm, falling squarely within the particle-size range that HEPA filters capture with extraordinary efficiency: 0.01 micron and above. It is incorrect to state that HEPA filters are not able to catch particles below 0.3 micron, like SARS-CoV-2 virus. This belief is based on a misunderstanding of how HEPA filters work. The particles size of 0.3 micron is used as a standard to measure the effectiveness of HEPA filters, but this does not mean they are not able to catch smaller particles. A paper from the NASA1 well explains that HEPA filters are highly effective in capturing a very high proportion, up to 100%, of nanoparticulate contaminants, ranging in size from 0.1 to 0.001 micron (diffusion regime) because they don’t fly straight, collide with other fast-moving molecules, move around in random pathways and hit the filter fibers remaining stuck in them. This is known as the Brownian movement. The intersecting regime has just a small drop in efficiency that affects the particles of around 0.3 μm, defined as most penetrating particle size (MPPS). This value for a typical HEPA filter varies from 0.2 to 0.3 micron, depending on flow rate, and lowering the flow speed, a simple HEPA will perform as an ULPA filter

Impact of SARS-CoV-2 on elective surgical volume in Tuscany: effects on local planning and resource prioritization

No abstract availabl

Following the Problem Organisation: A Design Strategy for Engineering Emergence

To support the development of self-organising systems, we explain and rationalise the following architectural strategy: directly mapping the solution decomposition on the problem organisation and only relying on the problem abstractions for the design. We illustrate this with an example from swarm robotics

The impact of the number of episodes on the outcome of Bipolar Disorder

Background: Bipolar disorder is a highly recurrent severe psychiatric dis- order. The number of episodes has been found consistently associated with poor outcome. It has been suggested that bipolar patients with long duration of illness and highly recur- rent course show great impairment of global functioning. Objectives: The aim of this study is to assess the clinical course and outcome of patients with bipolar disorder I and II with a high number of mood episodes. Methods: We compared a group of bipolar I and II subjects whose number of episode w as higher than ten (N = 167) with a similar-size representative sample of bipolar patients whose number of episodes was lower or equal than ten (N = 131). Results: Bipolar patients with more than 10 episodes have a more severe outcome of bipolar disorder. Qualification and occupational status was clearly worse for the highly recurrent group which showed a predominance of depressive polarity. Conclusions: These data suggest that bipolar patients with a highly recurrent course have significant functional impairment. With the passing of time, bipolar illness tends to be ruled by depressive features. Treatment strategies may need to address this issue

Early Blockade of CB1 Receptors Ameliorates Schizophrenia-like Alterations in the Neurodevelopmental MAM Model of Schizophrenia

In agreement with the neurodevelopmental hypothesis of schizophrenia, prenatal exposure of Sprague-Dawley rats to the antimitotic agent methylazoxymethanol acetate (MAM) at gestational day 17 produces long-lasting behavioral alterations such as social withdrawal and cognitive impairment in adulthood, mimicking a schizophrenia-like phenotype. These abnormalities were preceded at neonatal age both by the delayed appearance of neonatal reflexes, an index of impaired brain maturation, and by higher 2-arachidonoylglycerol (2-AG) brain levels. Schizophrenia-like deficits were reversed by early treatment [from postnatal day (PND) 2 to PND 8] with the CB1 antagonist/inverse agonist AM251 (0.5 mg/kg/day). By contrast, early CB1 blockade affected the behavioral performance of control rats which was paralleled by enhanced 2-AG content in the prefrontal cortex (PFC). These results suggest that prenatal MAM insult leads to premorbid anomalies at neonatal age via altered tone of the endocannabinoid system, which may be considered as an early marker preceding the development of schizophrenia-like alterations in adulthood

Drivers of Small-Scale Fishers’ Acceptability across Mediterranean Marine Protected Areas at Different Stages of Establishment

The success of marine protected areas (MPAs) in achieving conservation and sustainable development goals hinges on, among other things, their social acceptability by local communities. Small-scale fishing communities represent a key stakeholder category within and around MPAs. Although many authors have examined the social acceptability of MPAs, relatively few studies have addressed this issue by considering how MPA acceptability is built and can be preserved. This study assessed the latent structure of MPA social acceptability and identified the individual and institutional variables driving stakeholders’ acceptability. Using questionnaire surveys, 124 small-scale fishers’ perceptions of MPAs and their social acceptability were explored in six Mediterranean MPAs (three were implemented, and three were designated). The results show that MPA acceptability is positively related to fishers’ age. The findings also highlight that the formal establishment of MPAs is not a sufficient condition for increasing MPA acceptability among fishers. Considerations about the possibility that MPA acceptability can be increased by building support and compliance emerged. MPA managers should implement successful long-term stakeholder engagement initiatives to increase commitment around conservation measures and to improve overall MPA effectiveness

Will the COVID-19 pandemic transform infection prevention and control in surgery? Seeking leverage points for organizational learning

Abstract Background In response to the coronavirus disease of 2019 (COVID-19) pandemic, healthcare systems worldwide have stepped up their infection prevention and control efforts in order to reduce the spread of the infection. Behaviours, such as hand hygiene, screening and cohorting of patients, and the appropriate use of antibiotics have long been recommended in surgery, but their implementation has often been patchy. Methods The current crisis presents an opportunity to learn about how to improve infection prevention and control and surveillance (IPCS) behaviours. The improvements made were mainly informal, quick and stemming from the frontline rather than originating from formal organizational structures. The adaptations made and the expertise acquired have the potential for triggering deeper learning and to create enduring improvements in the routine identification and management of infections relating to surgery. Results This paper aims to illustrate how adopting a human factors and ergonomics perspective can provide insights into how clinical work systems have been adapted and reconfigured in order to keep patients and staff safe. Conclusion For achieving sustainable change in IPCS practices in surgery during COVID-19 and beyond we need to enhance organizational learning potentials

A crustal seismic profile across Sicily

A crustal reflection seismic profile, more than 100 km long, was recorded across central Sicily, from the Tyrrhenian shore to the Sicily Channel, to understand the deep structures and the collision mechanisms between Europe and Africa and the subsequent geodynamic evolution. The profile was acquired using explosive sources and 240 active channels recorded by a Sercel 408-XL, 24 bits A/D converter, with a 12 km spread and a 24-fold coverage. The data were processed following a non-conventional procedure in order to preserve the relative amplitudes of the reflections and to better investigate the Sicily deep structures down to the Moho. The main highlighted structures are the dramatic flexure of the Iblean crust, the huge, deeper than expected, trough of Caltanissetta consisting of deep seated thrusts and nappes, and the imbricate thrust system of rigid bodies characterizing the northern Maghrebian chain. We designed an ad hoc acquisition and processing in order to highlight these main geological features in the seismic stacked section. Moreover, the deepest parts of the Caltanissetta trough are imaged for the first time, and its bottom is now fixed at more than 7 s TWT. The giant crustal wedge flexuring the Iblean foreland and the Moho geometries are examinated