Fluid circulation pattern inside La Soufrière volcano (Guadeloupe) inferred from combined electrical resistivity tomography, self-potential, soil temperature and diffuse degassing measurements

International audienceAfter a drastic decline in 1983, hydrothermal activity at La Soufrière lava dome (Guadeloupe, Lesser Antilles) has been progressively increasing in the summit area since 1992, raising the threat of a renewed eruptive activity. To better constrain the geometry of the hydrothermal system, an extensive high-resolution self-potential survey was performed on the dome and three multi-method profiles combining electrical resistivity tomography, self-potential, ground thermometry and soil CO 2 diffuse degassing measurements were carried out to cover its southern periphery in January 2011. Results indicate that hydrothermal ascending flows are currently restricted to a proximal area including the dome and its very vicinity. The extension of hydrothermal alteration inferred from electrical resistivity tomography reflects the presence of a heat source just below the dome. A first-order correction of topography-related self-potential variations allows the identification of major hydrothermal fluid circulations pathways, as well as significant meteoric infiltration zones. Local shifting of hydrothermal fluids towards the dome periphery is favored by the presence of major axes. The regional La Ty fault appears as the major axis draining large volumes of hydrothermal and magmatic fluids. However hydrothermal activity remains confined inside a collapse structure surrounding the dome, that formed in the last 9000 years as a result of recurrent edifice collapses, the latest occurring at the onset of the 1530 AD eruption. The combination of these qualitative results with structural analysis leads to a synthetic model of magmatic and hydrothermal fluids circulation inside the dome, which may be useful for the assessment of potential hazards associated with a renewal of fluid pres-surization, and a possibly associated partial flank-failure

Heat flux-based strategies for the thermal monitoring of sub-fumarolic areas: Examples from Vulcano and La Soufrière de Guadeloupe

Although it is relatively easy to set-up, the monitoring of soil temperature in sub-fumarolic areas is quite rarely used to monitor the evolution of hydrothermal systems. Indeed, measurements are highly sensitive to environmental conditions, in particular daily and seasonal variations of atmospheric temperatures and rainfalls, which can be only partially filtered by the established statistical analysis. In this paper, we develop two innovative processingmethods, both based on the computation of the heat flux in the soil. The upward heat flux method (UHF), designed for dry environments, consists in computing both the conductive and convective components of the heat flux between two thermocouples placed vertically. In the cases of wet environments, the excess of total heat method (ETH) allows the integration of rain gauges data in order to correct the heat balance fromthe superficial cooling effect of the precipitations. The performances of both processing techniques are faced to established methods (temperature gradient and coefficient of determination) on soil temperature time series from two test volcanoes. At La Fossa di Vulcano (Italy), the UHF method undoubtedly detects three thermal crises between 2009 and 2012, enabling to quantify not only the intensity but also the precise timing of the heat flux increase with respect to corresponding geochemical and seismic crises. At La Soufrière de Guadeloupe (French Lesser Antilles), despite large rainfalls dramatically influencing the thermal behavior of the soil, a constant geothermal heat flux is retrieved by the ETH method, confirming the absence of fumarolic crisis during the observation period (February–August 2010). Being quantitative, robust, and usable in almost any context of sub-fumarolic zones, our two heat flux-based methods increase the potential of soil temperature for the monitoring, but also the general interpretation of fumarolic crises together with geochemical and seismological observations. A spreadsheet allowing direct computation of UHF and ETH is provided as supplemental material.Published122-1342V. Struttura e sistema di alimentazione dei vulcaniJCR Journa

Sensitivity and Specificity of Soluble Triggering Receptor Expressed on Myeloid Cells-1, Midregional Proatrial Natriuretic Peptide and Midregional Proadrenomedullin for Distinguishing Etiology and to Assess Severity in Community-Acquired Pneumonia

This study aimed to evaluate the diagnostic accuracy of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), midregional proatrial natriuretic peptide (MR-proANP) and midregional proadrenomedullin (MR-proADM) to distinguish bacterial from viral community-acquired pneumonia (CAP) and to identify severe cases in children hospitalized for radiologically confirmed CAP. Index test results were compared with those derived from routine diagnostic tests, i.e., white blood cell (WBC) counts, neutrophil percentages, and serum C-reactive protein (CRP) and procalcitonin (PCT) levels.This prospective, multicenter study was carried out in the most important children’s hospitals (n = 11) in Italy and 433 otherwise healthy children hospitalized for radiologically confirmed CAP were enrolled. Among cases for whom etiology could be determined, CAP was ascribed to bacteria in 235 (54.3%) children and to one or more viruses in 111 (25.6%) children. A total of 312 (72.2%) children had severe disease.CRP and PCT had the best performances for both bacterial and viral CAP identification. The cut-off values with the highest combined sensitivity and specificity for the identification of bacterial and viral infections using CRP were ≥7.98 mg/L and ≤7.5 mg/L, respectively. When PCT was considered, the cut-off values with the highest combined sensitivity and specificity were ≥0.188 ng/mL for bacterial CAP and ≤0.07 ng/mL for viral CAP. For the identification of severe cases, the best results were obtained with evaluations of PCT and MR-proANP. However, in both cases, the biomarker cut-off with the highest combined sensitivity and specificity (≥0.093 ng/mL for PCT and ≥33.8 pmol/L for proANP) had a relatively good sensitivity (higher than 70%) but a limited specificity (of approximately 55%).This study indicates that in children with CAP, sTREM-1, MR-proANP, and MR-proADM blood levels have poor abilities to differentiate bacterial from viral diseases or to identify severe cases, highlighting that PCT maintains the main role at this regard

Gout management in Swiss primary care - a retrospective observational study

BACKGROUND Gout is the most common form of inflammatory arthritis worldwide and its prevalence is rising. In Switzerland, there are no data available on the characteristics and treatment of gout patients. In this study, we aimed to describe numbers of patients affected by gout and hyperuricaemia and unveil approaches Swiss primary care physicians (PCPs) use for the management. METHODS This was a retrospective observational study using electronic medical routine  data provided from 242 Swiss PCPs. Included were all their patients receiving urate-lowering therapy (ULT), with a diagnostic code for gout or who had a serum uric acid (SUA) measurement. According to their disease status, patients were classified into four subgroups (normal urate, hyperuricaemia, untreated gout, treated gout). For treatment analysis, patients with SUA measurements before and after ULT initiation were included. Comorbidities and risk factors for secondary causes relevant in the context of gout were collected. Outcomes were prevalence of gout and hyperuricaemia, characteristics of patients according to subgroup, number of SUA measurements, levels of SUA and patients who reached the treatment goal of a SUA level <360 µmol/l. RESULTS We assessed 15,808 patients and classified them into the subgroups. This yielded a prevalence of 1.0% for gout and 1.2% for hyperuricaemia. 2642 patients were diagnosed with gout of whom 2420 (91.6%) received a ULT. Overall; 41.3% of patients with a gout treatment had at least one SUA measurement; 15.0% of patients with treated gout had a record of SUA measurements before and after ULT initiation; and 57.5% reached the treatment goal of <360 µmol/l after allopurinol treatment. CONCLUSION Swiss gout patients received comprehensive treatment, which is reflected in a high number of patients treated with ULT, laboratory tests per person and a high treatment success rate, although there is no systematic approach to the treatment of gout

Effects of a DRG-based hospital reimbursement on the health care utilization and costs in Swiss primary care: A retrospective "quasi-experimental" analysis

INTRODUCTION In Switzerland, a nationwide Swiss Diagnosis related Groups (Swiss DRG) system for hospital reimbursement was introduced in 2012. However, the impact of DRG systems on primary care is still unclear with respect to number of consultations and costs. The aim of this study was to investigate the effect of the implementation of DRG on costs and volumes in the primary care sector, on a nationwide basis in Switzerland. METHODS The study retrospectively analysed yearly data, from 2008 to 2014, of almost 60 Swiss health insurers that covered almost all Swiss general practitioners, with a total number of patients which represented approximately 76% of the Swiss population. GP consultations, total numbers and rates, and the relative costs reimbursed (TARMED tariff values) in the Swiss federal states, cantons, which already introduced a DRG-like system before 2012 (AP-DRG), were compared to the GP consultations and costs reimbursed in the other cantons (DRG-naive). Regression discontinuity design analysis and mixed regression models, at cantonal level, were performed to evaluate the effect of the nationwide implementation of the Swiss DRG on health care demand and costs in the primary care setting. Change in outcome level and yearly trend pattern difference between groups (AP-DRG vs. DRG-naive) were examined. RESULTS Overall, the total number of GP consultations and the relative TARMED values increased from 2008 to 2014. In the DRG naive, 15 cantons: in 2008, the number of GP consultations were 13,114,126, with a TARMED value of 1,194,957,157 CHF, and in 2014, the GP consultation were 13,752,511, with a TARMED value of 1,513,861,260 CHF. In the AP-DRG group, 11 cantons, the total number of GP consultations increased from 8,787,646, in 2008, to 9,347,168 in 2014 and the TARMED value increased from 896,673,657 CHF in 2008, to 1,100,203,508 CHF in 2014. The yearly trend pattern of GP consultations and TARMED values, in the AP-DRG group, were not significantly different from the respective trends in the DRG- naive and, overall, no significant change was detected in consultations and costs trends before and after 2012. DISCUSSION/CONCLUSION This study found no evidence of any effect of the introduction of the SwissDRG on the yearly trend of primary care consultations and costs. Nevertheless, potential negative impacts on vulnerable patients, as chronically ill patients, could not be excluded and further investigation is required

Computational Intelligence and Citizen Communication in the Smart City

Information and communication are at the core of the intelligent city of tomorrow, and the key components of a smart city cannot prescind from data exchanges and interconnectedness. Citizen communication is an integral part of the smart city’s development plans: freedom of information and involvement in collective decisions, e-democracy and decision-making feedback can be greatly enhanced in an intelligent city, and, among other smart city components, foster a new era of participation and wise decisions. In this contribution we describe the methodologies that can be implemented in order to correctly develop automatic recognition systems for citizen communication, paying special attention to computational intelligence approaches, and how such methodologies could be usefully employed in the essential task of understanding linguistic registers, and suggest how the use of argumentation techniques can be beneficial to citizen communication

Computational Intelligence and Citizen Communication in the Smart City

Information and communication are at the core of the intelligent city of tomorrow, and the key components of a smart city cannot prescind from data exchanges and interconnectedness. Citizen communication is an integral part of the smart city’s development plans: freedom of information and involvement in collective decisions, e-democracy and decision-making feedback can be greatly enhanced in an intelligent city, and, among other smart city components, foster a new era of participation and wise decisions. In this contribution we describe the methodologies that can be implemented in order to correctly develop automatic recognition systems for citizen communication, paying special attention to computational intelligence approaches, and how such methodologies could be usefully employed in the essential task of understanding linguistic registers, and suggest how the use of argumentation techniques can be beneficial to citizen communication

Effects of a DRG-based hospital reimbursement on the health care utilization and costs in Swiss primary care: A retrospective "quasi-experimental" analysis.

IntroductionIn Switzerland, a nationwide Swiss Diagnosis related Groups (Swiss DRG) system for hospital reimbursement was introduced in 2012. However, the impact of DRG systems on primary care is still unclear with respect to number of consultations and costs. The aim of this study was to investigate the effect of the implementation of DRG on costs and volumes in the primary care sector, on a nationwide basis in Switzerland.MethodsThe study retrospectively analysed yearly data, from 2008 to 2014, of almost 60 Swiss health insurers that covered almost all Swiss general practitioners, with a total number of patients which represented approximately 76% of the Swiss population. GP consultations, total numbers and rates, and the relative costs reimbursed (TARMED tariff values) in the Swiss federal states, cantons, which already introduced a DRG-like system before 2012 (AP-DRG), were compared to the GP consultations and costs reimbursed in the other cantons (DRG-naive). Regression discontinuity design analysis and mixed regression models, at cantonal level, were performed to evaluate the effect of the nationwide implementation of the Swiss DRG on health care demand and costs in the primary care setting. Change in outcome level and yearly trend pattern difference between groups (AP-DRG vs. DRG-naive) were examined.ResultsOverall, the total number of GP consultations and the relative TARMED values increased from 2008 to 2014. In the DRG naive, 15 cantons: in 2008, the number of GP consultations were 13,114,126, with a TARMED value of 1,194,957,157 CHF, and in 2014, the GP consultation were 13,752,511, with a TARMED value of 1,513,861,260 CHF. In the AP-DRG group, 11 cantons, the total number of GP consultations increased from 8,787,646, in 2008, to 9,347,168 in 2014 and the TARMED value increased from 896,673,657 CHF in 2008, to 1,100,203,508 CHF in 2014. The yearly trend pattern of GP consultations and TARMED values, in the AP-DRG group, were not significantly different from the respective trends in the DRG- naive and, overall, no significant change was detected in consultations and costs trends before and after 2012.Discussion/conclusionThis study found no evidence of any effect of the introduction of the SwissDRG on the yearly trend of primary care consultations and costs. Nevertheless, potential negative impacts on vulnerable patients, as chronically ill patients, could not be excluded and further investigation is required