Dissolved major and trace elements in meteoric depositions on the flanks of Mt. Etna (Italy): the impact of volcanic activity on the environment

In the framework of the “Save the Etna World” research project, which investigates the impact of the volcanic activity on the surrounding environment, three bulk collectors were deployed on the flank of the Mt. Etna volcano to collect the meteoric depositions. The sampling sites were at distances between 5.5 and 13 km from the summit vents of the volcano on its eastern flank, that is the most exposed to the volcanic plume due to the high-altitude prevailing winds direction. The sites were selected in order to have a gradient of exposition with respect to the volcanic emissions, the most exposed being CIT, the intermediate ILI and the least NIC. Samples were collected monthly from July 2017 to July 2018 and analysed for major ions and for a large suite of trace elements. The influence of volcanic emissions is evidenced by the low pH of the collected depositions in the most exposed site, showing values mostly below 3.5 and never exceeding 5.72. The lowest values are related to high fluoride, chloride and sulfate concentrations in the collected water, deriving from the acid gases (HF, HCl and SO2) of the volcanic plume. The other two sites show pH values in range from 3.95 to 7.21. While the lowest values indicate a lower but significant volcanic influence, the highest values can be related to the dissolution of geogenic (mainly carbonate) particulate of local or regional (Saharan) origin. The latter process is evidenced by high concentrations of Ca and HCO3 in the samples with the highest pHs. Trace elements show almost all higher concentrations in the most exposed site. Highly volatile elements like Pb, Te and Tl, which are known to have strong enrichment factors in volcanic plumes with respect to the average upper crust composition, are found at CIT at concentrations always at least one order of magnitude higher than at NIC. Also lithophile elements like Si, Al, Ti and Fe are sometimes strongly enriched at CIT deriving from the interaction of the acid gases of the plume with the occasionally emitted volcanic ash. These new results confirm the importance of meteoric deposition as main carrier of volcanogenic elements to earth’s surface. “Etna World” is a fascinating natural laboratory, and the study of atmospheric depositions in this peculiar environment allows to understand better the general processes that influence the cycles of trace metals. Furthermore, the quantitative estimation of both emission and deposition of volcanogenic elements is a key factor for complementary studies on the geochemical mobility of trace elements and their distribution between atmosphere, soils, vegetation, and lastly, animals and humans in active volcanic areas

Estilos de liderazgo, manejo de conflicto y comunicación asertiva en equipos de proyectos : el caso Arquiara

Esta investigación expone los resultados obtenidos del análisis y el diagnóstico de los estilos de liderazgo, los efectos de la comunicación y la solución de conflictos de los directivos y los equipos de proyectos de la organización Arquiara. Para cumplir con el objetivo se aplicó la metodología estudio de caso, utilizando metodologías diagnósticas del modelo situacional de Hersey y Blanchard, el modelo sobre manejo de conflicto de Thomas y Kilmann, y la encuesta Rathus modificada, contrastando con las habilidades de liderazgo requeridas por el Project Management Institute (2017) para la gestión de proyectos. Se identificaron oportunidades de mejora en las habilidades de comunicación y en la solución de conflictos de los directivos e integrantes de los equipos de proyectos seleccionados como muestra de análisis, y, a su vez, en aspectos de los estilos de liderazgo. Se sugirieron acciones para el desarrollo profesional y el fortalecimiento de las habilidades de liderazgo de los directivos en los equipos adhocráticos, con el fin de alcanzar los objetivos de la organización.This research highlights the results obtained from the analysis and diagnosis of leadership styles, communication effects, and conflict resolution of managers and team projects from the Arquiara organization. The case study methodology was applied to meet the objectives, using diagnostic methodologies of the Hersey and Blanchard situational model, the Thomas and Kilmann conflict management model, and the modified Rathus survey, and then contrasted with the leadership skills required by the Project Management Institute (2017) for project management. Opportunities for improvement of both managers and team members were identified, consisting primarily in the areas of communication skills and conflict resolution, and thus in leadership styles. Various actions were suggested so as to strengthen professional development and leadership skill of managers in adhocratic teams, in order to achieve the organization's objectives

Notulae to the Italian native vascular flora: 10

In this contribution, new data concerning the distribution of native vascular flora in Italy are presented. It includes new records, confirmations, exclusions, and status changes to the Italian administrative regions for taxa in the genera Artemisia, Chaetonychia, Cirsium, Cynanchum, Genista, Hieracium, Iberis, Melica, Misopates, Myosotis, Thalictrum, Trifolium, Utricularia, Veronica, and Vicia. Nomenclatural and distribution updates, published elsewhere, and corrigenda are provided as supplementary material

Chronic constipation diagnosis and treatment evaluation: The "CHRO.CO.DI.T.E." study

Background: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. Methods: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires. In addition, gastroenterologists were also asked to record whether the patients were clinically assessed for CC for the first time or were in follow up. Diagnostic tests and prescribed therapies were also recorded. Results: Eight hundred seventy-eight consecutive CC patients (706 F) were enrolled (FC 62.5%, IBS-C 31.3%, NRC 6.2%). PAC-SYM and PAC-QoL scores were higher in IBS-C than in FC and NRC. 49.5% were at their first gastroenterological evaluation for CC. In 48.5% CC duration was longer than 10 years. A specialist consultation was requested in 31.6%, more frequently in IBS-C than in NRC. Digital rectal examination was performed in only 56.4%. Diagnostic tests were prescribed to 80.0%. Faecal calprotectin, thyroid tests, celiac serology, breath tests were more frequently suggested in IBS-C and anorectal manometry in FC. More than 90% had at least one treatment suggested on chronic constipation, most frequently dietary changes, macrogol and fibers. Antispasmodics and psychotherapy were more frequently prescribed in IBS-C, prucalopride and pelvic floor rehabilitation in FC. Conclusions: Patients with IBS-C reported more severe symptoms and worse quality of life than FC and NRC. Digital rectal examination was often not performed but at least one diagnostic test was prescribed to most patients. Colonoscopy and blood tests were the "first line" diagnostic tools. Macrogol was the most prescribed laxative, and prucalopride and pelvic floor rehabilitation represented a "second line" approach. Diagnostic tests and prescribed therapies increased by increasing CC severity

Evaluation of presumably disease causing SCN1A variants in a cohort of common epilepsy syndromes

Objective: The SCN1A gene, coding for the voltage-gated Na+ channel alpha subunit NaV1.1, is the clinically most relevant epilepsy gene. With the advent of high-throughput next-generation sequencing, clinical laboratories are generating an ever-increasing catalogue of SCN1A variants. Variants are more likely to be classified as pathogenic if they have already been identified previously in a patient with epilepsy. Here, we critically re-evaluate the pathogenicity of this class of variants in a cohort of patients with common epilepsy syndromes and subsequently ask whether a significant fraction of benign variants have been misclassified as pathogenic. Methods: We screened a discovery cohort of 448 patients with a broad range of common genetic epilepsies and 734 controls for previously reported SCN1A mutations that were assumed to be disease causing. We re-evaluated the evidence for pathogenicity of the identified variants using in silico predictions, segregation, original reports, available functional data and assessment of allele frequencies in healthy individuals as well as in a follow up cohort of 777 patients. Results and Interpretation: We identified 8 known missense mutations, previously reported as path

Cohort profile : demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Purpose: The presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports. Participants: Seven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at. Findings to date: This cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year. Future plans: Analysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared. Trial registration number: NCT03013595

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat