Optimized Flight Preparation Process for the First Vega Ride-Share Mission

The first European ride-share mission will be carried out by the Vega launch system in mid 2019. The VEGA PoC (Proof of Concept) flight using the SSMS (Small Satellite Mission Service) hardware was conceived in the context of ESA LLL Initiative. This paper describes the Light Sats aggregate selection process and the preparation of the first European ride-share mission with Vega launcher, update on the hardware preparation status and provide insight on the methods and tools used for its implementation. Based on Vega flights accumulated experience, the development of multi-Payload mission concept started from analysis of the activities currently foreseen to fly a single payload mission adapted to the needs multi payload rideshare missions. Evaluation of impacts in terms of technical feasibility, missioning schedule and related programmatic and cost elements where considered for the missioning of the Light Sats launch service. Major elements of the process described in this paper envelope mission analysis, launch preparation including AIT approach and launch service aspects with customers, before and after launch service agreement signature. The described process is intended to constitute a first step using the Vega launch system, useful towards the ultimate goal to support the definition of a finally optimized process applicable to all European launchers

Diagnostic and Therapeutic Approach to Children and Adolescents with Obstructive Sleep Apnea Syndrome (OSA): Recommendations in Emilia-Romagna Region, Italy

Obstructive sleep apnoea syndrome (OSA) in paediatrics is a rather frequent pathology caused by pathophysiological alterations leading to partial and prolonged obstruction (hypoventilation) and/or intermittent partial (hypopnoea) or complete (apnoea) obstruction of the upper airways. Paediatric OSA is characterised by daytime and night-time symptoms. Unfortunately, there are few data on shared diagnostic-therapeutic pathways that address OSA with a multidisciplinary approach in paediatric age. This document summarizes recommendations from the Emilia-Romagna Region, Italy, developed in order to provide the most appropriate tools for a multidisciplinary approach in the diagnosis, treatment and care of paediatric patients with OSA. The multidisciplinary group of experts distinguished two different 'step' pathways, depending on the age group considered (i.e., under or over two years). In most cases, these pathways can be carried out by the primary care paediatrician, who represents the first filter for approaching the problem. For this reason, it is essential that the primary care paediatrician receives adequate training on how to formulate the diagnostic suspicion of OSA and on what criteria to use to select patients to be sent to the hospital centre. The relationship between the paediatrician of the patient and her/his parents must see a synergy of behaviour between the various players in order to avoid uncertainty about the diagnostic and therapeutic decisions as well as the follow-up phase. The definition and evaluation of the organizational process and outcome indicators of the developed flow-chart, and the impact of its implementation will remain fundamental

Relationship between Pharmacokinetic/Pharmacodynamic Target Attainment and Microbiological Outcome in Critically Ill COVID-19 Patients with Documented Gram-Negative Superinfections Treated with TDM-Guided Continuous-Infusion Meropenem

Objectives: The objective of this study was to explore the relationship between pharmacokinetic/pharmacodynamic (PK/PD) target attainment of continuous-infusion (CI) meropenem and microbiological outcome in critical COVID-19 patients with documented Gram-negative superinfections. Methods: Patients receiving CI meropenem for documented Gram-negative infections at the COVID ICU of the IRCCS Azienda Ospedaliero-Universitaria di Bologna and undergoing therapeutic drug monitoring from January 2021 to February 2022 were retrospectively assessed. Average steady-state meropenem concentrations (C-ss) were calculated and the C-ss/MIC ratio was selected as a pharmacodynamic parameter of meropenem efficacy. The C-ss/MIC ratio was defined as optimal if >= 4, quasi-optimal if between 1 and 4, and suboptimal if <1. The relationship between C-ss/MIC and microbiological outcome was assessed. Results: Overall, 43 critical COVID-19 patients with documented Gram-negative infections were retrieved. Combination therapy was implemented in 26 cases. C-ss/MIC ratios were optimal in 27 (62.8%), quasi-optimal in 7 (16.3%), and suboptimal in 9 cases (20.9%). Microbiological failure occurred in 21 patients (48.8%), with no difference between monotherapy and combination therapy (43.8% vs. 53.8%; p = 0.53). The microbiological failure rate was significantly lower in patients with an optimal C-ss/MIC ratio compared to those with a quasi-optimal or suboptimal C-ss/MIC ratio (33.3% vs. 75.0%; p = 0.01). Conclusion: Suboptimal attainment of meropenem PK/PD targets may be a major determinant impacting on microbiological failure in critical COVID-19 patients with Gram-negative superinfections

The First Vega Ride-Share Mission Flight

The first European ride-share mission will be carried out by the Vega launch system in September 2019. The VEGA PoC (Proof of Concept) flight using the SSMS (Small Satellite Mission Service) hardware was conceived in the context of ESA LLL Initiative. This paper reports on the highlights of the preparation of the first European rideshare mission with Vega launcher and on the development of the related launch system. Based on Vega flights accumulated experience, the development of multi-Payload mission concept started from analysis of the activities currently foreseen to fly a single payload mission adapted to the needs of multi payload rideshare missions. After evaluation of impacts in terms of technical feasibility, missioning schedule and related programmatic and cost elements for the missioning of the Light Sats launch service, the implementation phase was initiated and description of its major tasks is the focus of this paper. The described hardware development and processes to reach SSMS PoC flight using the Vega launch system, are the first step towards the ultimate goal of a finally optimized process for Light Sats ride-share missions applicable to all European launchers

"Dynamic Mediterranean”: an educational path through Earth science and geophysical research at Genova Science Festival 2010

Science Festivals are events world wide organized, and they have became more and more one of the most effective playground where science meet people. Genova Science Festival, held since 2003, is the Italian most interesting event of that type. The Istituto Nazionale di Geofisica e Vulcanologia (INGV), one of the largest European scientific institution deal- ing with Earth Sciences research and real-time surveillance, early warning, and forecast activities in geophysics and volcanology, participates every year developing a specific educational path, concerning some of its research areas. For the 2010 Genova Science Festival, the INGV has produced an educational exhibition called “Mediterraneo Dinamico” (Dynamic Mediterranean). This is a journey in the geodynamical history of the Mediterranean region from 200 million years ago till present. This long process took place also through some instantaneous dramatic events as eruptions, tsunami, earthquakes, whose studies have revealed their strong impact on cultural Mediterranean evolution as well as on environmental aspects as climate. The exhibition path aim is to illustrate and explain to general public, and especially to teachers and students, the results from researches conducted by INGV also in collaboration with other Italian and International partners, as well as from the real time Mediterranean sea water monitoring. The chosen exhibition instruments are wide colourful illustrated posters, greatly illustrated, together with smart interactive exhibits. In particular the path starts with a “Time Machine”, that allows visitors to retrace the main steps of the Mediterranean geological evolution, supported by posters. The following section concerning the “Mediterranean catastrophic event” welcome visitors with a glass pyramid projecting a virtual eruption almost as an “ologramma”, and side panels with two short videos explaining two great explosive eruptions and a tsunami event. The section on Mediterranean Tsunami are equipped with an interactive large map of the location of Mediteranean where occurred tsunami events, illustrated posters and also a microscope with a camera where visitors can analyse a core with a tsunami deposits. Also an interactive model of a GEOSTAR - Geophisical and Oceanographic Station of Abyssal Research provide visitors an entertaining approach on how a submarine observatory works with all his sensors, while a computer station permits visitors to read real time measures of some marine environmental indicators. The exhibition journey trough the Mediterranean geo-history and Earth Science and Geophysical research shows how the continuous knowledge and monitoring of to this Region dynamics are fundamental to design a future bearable development for the 30 million people living along the Mediterranean shores

Molecular characterization of Pseudomonas fluorescens isolates involved in the Italian "blue mozzarella" event.

Between June and September 2010, widespread Italian consumer reports of unusual blue spoilage on fresh dairy products were publicized, resulting in the so-called blue mozzarella event. An inordinately high number of samples from mozzarella and whey cheese products of Italian and German production subsequently tested positive for Pseudomonas fluorescens. The aim of this study was to verify whether a selected P. fluorescens strain was responsible for this apparently unusual event. Molecular characterization of 181 isolated P. fluorescens strains was conducted using a newly optimized pulsed-field gel electrophoresis protocol. Although a high number of pulsotypes was found (132), only four pulsotypes were associated with more than one production plant, and only one German isolate had the same pulsotype as was detected in two Italian plants. This is the only evidence of possible cross-contamination among cheeses from the two countries. The overall results did not support the spread of contamination from German to Italian plants or the presence of one environmental strain that spread in both countries

Cardiology referral during the COVID-19 pandemic

OBJECTIVES: This study presents the cardiology referral model adopted at the University of Sa˜o Paulo-Hospital das Clı´nicas complex during the initial period of the coronavirus disease (COVID-19) pandemic, main reasons for requesting a cardiologic evaluation, and clinical profile of and prognostic predictors in patients with COVID-19. METHODS: In this observational study, data of all cardiology referral requests between March 30, 2020 and July 6, 2020 were collected prospectively. A descriptive analysis of the reasons for cardiologic evaluation requests and the most common cardiologic diagnoses was performed. A multivariable model was used to identify independent predictors of in-hospital mortality among patients with COVID-19. RESULTS: Cardiologic evaluation was requested for 206 patients admitted to the ICHC-COVID. A diagnosis of COVID-19 was confirmed for 180 patients. Cardiologic complications occurred in 77.7% of the patients. Among these, decompensated heart failure was the most common complication (38.8%), followed by myocardial injury (35%), and arrhythmias, especially high ventricular response atrial fibrillation (17.7%). Advanced age, greater need of ventilatory support on admission, and pre-existing heart failure were independently associated with inhospital mortality. CONCLUSIONS: A hybrid model combining in-person referral with remote discussion and teaching is a viable alternative to overcome COVID-19 limitations. Cardiologic evaluation remains important during the pandemic, as patients with COVID-19 frequently develop cardiovascular complications or decompensation of the underlying heart disease

The Importance of Mortality Risk Assessment: Validation of the Pediatric Index of Mortality 3 Score

Objective: To evaluate the performance of the newest version of the Pediatric Index of Mortality 3 score and compare it with the Pediatric Index of Mortality 2 in a multicenter national cohort of children admitted to PICU. Design: Retrospective, prospective cohort study. Setting: Seventeen Italian PICUs. Patients: All children 0 to 15 years old admitted in PICU from January 2010 to October 2014. Interventions: None. Measurement and main results: Eleven thousand one hundred nine children were enrolled in the study. The mean Pediatric Index of Mortality 2 and 3 values of 4.9 and 3.9, respectively, differed significantly (p < 0.05). Overall mortality rate was 3.9%, and the standardized mortality ratio was 0.80 for Pediatric Index of Mortality 2 and 0.98 for Pediatric Index of Mortality 3 (p < 0.05). The area under the curve of the receiver operating characteristic curves was similar for Pediatric Index of Mortality 2 and Pediatric Index of Mortality 3. The Hosmer-Lemeshow test was not significant for Pediatric Index of Mortality 3 (p = 0.21) but was highly significant for Pediatric Index of Mortality 2 (p < 0.001), which overestimated death mainly in high-risk categories. Conclusions: Mortality indices require validation in each country where it is used. The new Pediatric Index of Mortality 3 score performed well in an Italian population. Both calibration and discrimination were appropriate, and the score more accurately predicted the mortality risk than Pediatric Index of Mortality 2