Implications of early respiratory support strategies on disease progression in critical COVID-19: a matched subanalysis of the prospective RISC-19-ICU cohort.

Uncertainty about the optimal respiratory support strategies in critically ill COVID-19 patients is widespread. While the risks and benefits of noninvasive techniques versus early invasive mechanical ventilation (IMV) are intensely debated, actual evidence is lacking. We sought to assess the risks and benefits of different respiratory support strategies, employed in intensive care units during the first months of the COVID-19 pandemic on intubation and intensive care unit (ICU) mortality rates. Subanalysis of a prospective, multinational registry of critically ill COVID-19 patients. Patients were subclassified into standard oxygen therapy ≥10 L/min (SOT), high-flow oxygen therapy (HFNC), noninvasive positive-pressure ventilation (NIV), and early IMV, according to the respiratory support strategy employed at the day of admission to ICU. Propensity score matching was performed to ensure comparability between groups. Initially, 1421 patients were assessed for possible study inclusion. Of these, 351 patients (85 SOT, 87 HFNC, 87 NIV, and 92 IMV) remained eligible for full analysis after propensity score matching. 55% of patients initially receiving noninvasive respiratory support required IMV. The intubation rate was lower in patients initially ventilated with HFNC and NIV compared to those who received SOT (SOT: 64%, HFNC: 52%, NIV: 49%, p = 0.025). Compared to the other respiratory support strategies, NIV was associated with a higher overall ICU mortality (SOT: 18%, HFNC: 20%, NIV: 37%, IMV: 25%, p = 0.016). In this cohort of critically ill patients with COVID-19, a trial of HFNC appeared to be the most balanced initial respiratory support strategy, given the reduced intubation rate and comparable ICU mortality rate. Nonetheless, considering the uncertainty and stress associated with the COVID-19 pandemic, SOT and early IMV represented safe initial respiratory support strategies. The presented findings, in agreement with classic ARDS literature, suggest that NIV should be avoided whenever possible due to the elevated ICU mortality risk

The CAESAR project for the ASI space weather infrastructure

This paper presents the project Comprehensive spAce wEather Studies for the ASPIS prototype Realization (CAESAR), which aims to tackle the relevant aspects of Space Weather (SWE) science and develop a prototype of the scientific data centre for Space Weather of the Italian Space Agency (ASI) called ASPIS (ASI SPace Weather InfraStructure). To this end, CAESAR involves the majority of the SWE Italian community, bringing together 10 Italian institutions as partners, and a total of 92 researchers. The CAESAR approach encompasses the whole chain of phenomena from the Sun to Earth up to planetary environments in a multidisciplinary, comprehensive, and unprecedented way. Detailed and integrated studies are being performed on a number of well-observed “target SWE events”, which exhibit noticeable SWE characteristics from several SWE perspectives. CAESAR investigations synergistically exploit a great variety of different products (datasets, codes, models), both long-standing and novel, that will be made available in the ASPIS prototype: this will consist of a relational database (DB), an interface, and a wiki-like documentation structure. The DB will be accessed through both a Web graphical interface and the ASPIS.py module, i.e., a library of functions in Python, which will be available for download and installation. The ASPIS prototype will unify multiple SWE resources through a flexible and adaptable architecture, and will integrate currently available international SWE assets to foster scientific studies and advance forecasting capabilities

Torsional oscillations within a magnetic pore in the solar photosphere

Spectropolarimetric observations of a solar pore at high temporal and spatial resolution identify the presence of magnetic field torsional oscillations. Simulations suggest that such oscillations are triggered by a photospheric kink mode, which can contribute substantially to upward energy transport within the solar atmosphere.Alfven waves have proven to be important in a range of physical systems due to their ability to transport non-thermal energy over long distances in a magnetized plasma. This property is of specific interest in solar physics, where the extreme heating of the atmosphere of the Sun remains unexplained. In an inhomogeneous plasma such as a flux tube in the solar atmosphere, they manifest as incompressible torsional perturbations. However, despite evidence in the upper atmosphere, they have not been directly observed in the photosphere. Here, we report the detection of antiphase incompressible torsional oscillations observed in a magnetic pore in the photosphere by the Interferometric Bidimensional Spectropolarimeter. State-of-the-art numerical simulations suggest that a kink mode is a possible excitation mechanism of these waves. The excitation of torsional waves in photospheric magnetic structures can substantially contribute to the energy transport in the solar atmosphere and the acceleration of the solar wind, especially if such signatures will be ubiquitously detected in even smaller structures with the forthcoming next generation of solar telescopes

Quo vadis, European Space Weather community?

This paper was written by a group of European researchers believing that now is the right time to frame the Space Weather and Space Climate discipline in Europe for future years. It is devoted to openly discussing the organisation and sustainability of the European Space Weather community and its assets in the (near) future. More specifically, we suggest that the European Space Weather community lacks a uniting organisation to help the community to sustain and develop the successful efforts made thus far. Our aim is not to draw a complete and exhaustive panorama of Space Weather throughout the world, nor even throughout Europe. It is not a new white paper on the science and applications: there exist many (e.g. Tsurutani et al., 2020 Nonlinear Processes Geophys 27(1): 75-119); nor another roadmap: several important have been published recently (e.g. Schrijver et al., 2015. Adv Space Res 55(12): 2745-2807; Opgenoorth et al., 2019. J Space Weather Space Clim 9: A37). Our aim is to question our practices and organisation in front of several changes that have occurred in the recent years and to set the ground to provide coordinated answers to these questions being posed in Europe, and to make these answers discussed throughout the world. This group was assembled first through a series of sessions devoted to the sustainability of Space Weather research during the European Space Weather Week (ESWW) series of meetings, specifically: ESWW 14 (2017), ESWW 15 (2018), and ESWW 16 (2019). It then grew from discussions and personal contacts. The authors do not pretend to identify the full range of opinions in Europe, although they do come from 13 different European countries with a large span of ages (around half are below the age of 40 years old at the time of writing) with a good gender balance ending with a diverse mix of young and motivated scientists and senior people who have played a role in shaping the Space Weather community in Europe. The questions and the propositions to organise Space Weather in Europe in the future result from their discussions through these meetings and through remote meetings during the pandemic. We wish to share them with all those who consider themselves as members of the European Space Weather community and/or are interested in its future and to propose actions. We do this, bearing in mind that Europe plays a key international role in Space Weather which extends beyond the ESA and EU/EC geographic area.Peer reviewe

Quo vadis, European Space Weather community?

status: accepte