Effects of polluted air-masses advection on atmospheric particles in a semi-rural site in south Italy by SEM-EDX analysis

The variation of aerosol properties under polluted air masses advection was studied in a semi-rural site in South Italy, by means of SEM-EDX analysis performed on particles collected on 13-stages impactor filters. Radiometric measurements, HYSPLIT back-trajectories and NAAPS maps helped to choose four measurement days of polluted air mass circulation, two of them collected in the warm season (31 July 2008, 16 September 2010) and two in the cold one (16 April 2009, 18 March 2010). Polluted aerosol characteristics were compared to those under background (BG) conditions (8 February 2011), highlighting differences in the particles chemical and morphological properties. One of the signatures of the air mass transport in the coarse fraction was the higher content of particles containing S, i.e., S-reacted, (27.5% on average) in comparison with BG conditions (1%). Two main sources of transported aerosols were identified: industrial processes and biomass burning, with fly ash, metal and S-rich particles in the first case, and K-salts and nitrate-coated Ca-bearingparticles in the second. Single particle analysis on the coarse fraction allowed large agglomerates of soot to be identified, with inclusions of silicate particles rich in Cu and Zn, Ca-S, fly ash and metals particles that are a clear indication of extensive modifications of aerosol size, chemical composition and, likely, radiative properties. In finer stages (EAD ≤ 0.94 μm) concurrent collection of organic and inorganic particles originated an agglomerate state matter mainly characterized by K and S for polluted conditions and by K only for BG

Mercury speciation in the colloidal fraction of a soil polluted by a chlor-alkali plant: a case study in the South of Italy

Mercury (Hg) speciation in different size fractions of a soil sample collected near an industrial area located in the South of Italy, which had been polluted by the dumping of Hg-containing wastes from a chlor-alkali plant, was investigated by XANES spectroscopy. In particular, a special procedure has been developed to study the soil colloidal fraction, both for sample preparation and for XANES data collection. In this soil, Hg was speciated in quite insoluble inorganic forms such as cinnabar (alpha-HgS), metacinnabar (beta-HgS), corderoite (Hg3S2Cl2), and some amorphous Hg, S and Cl-containing species, all derived from the land-disposal of K106 Hg-containing wastes. The contribution of the above-mentioned chemical forms to Hg speciation changed as a function of particle size. For the fraction corderoite (26%) > cinnabar (20%) = metacinnabar (20%); for the fraction metacinnabar (24%) > corderoite (20%) > cinnabar (16%); and for the fraction 430-650 nm, where most of the colloidal Hg was concentrated: amorphous Hg-S-Cl (56%) > metacinnabar (33%) > corderoite (6%) > cinnabar (5%). From these data it emerged that, even if Hg was speciated in quite insoluble forms, the colloidal fraction, which is the most mobile and thus the most dangerous, was enriched in relatively more soluble species (i.e. amorphous Hg-S-Cl and metacinnabar), as compared with cinnabar. This aspect should be seriously taken into account when planning environmental risk assessment, since the small particle size in which Hg is concentrated and the changing speciation passing from millimetre to nanometre size could turn apparently safe conditions into more hazardous ones

Collection of substantial amount of fine and ultrafine particles during the combustion of miscanthus and forest residues in small and medium scale boilers for morphological and chemical characterizations

Renewable energies are destined to play a very important role in the future world energy balance. Among these energies, biomass production and utilization is growing considerably since it offers the possibility to provide partial substitution of fossil fuels. If health impacts of fine particles (PM2.5) from diesel combustion are well documented (Gangwar et al., 2012), those from biomass combustion need substantial information and improvements. Size fractionations of PM2.5 have to be performed in order to both determine morphological and chemical characteristics, these properties being essential for biological effects. Particulate matter was sampled during combustion of miscanthus and forest residues in medium and small scale biomass boilers (400 kW from Köb Pyrot and 40 kW from REKA). Fly ashes from medium scale boiler were sampled with a cyclone device and their granulometry was studied with both optical microscope and Malvern laser granulometer. PM2.5 (sized in the range of 0.4 μm to 2.07 μm) from low scale boiler were sampled using a DEKATI DGI impactor modified for substantial PM collection. A quick overview of setup modifications for manual impactor will be developed. Particles were observed using fluorescence microscopy. A semi-quantitative method to compare fly ashes fluorescence was developped using ImageJ (Schneider et al., 2012). Speciation of organic compounds Polycyclic Aromatic Hydrocarbon (PAH) and Humic Like Substances (HULIS) was determined on PM2.5 and fly ashes. A correlation between observed fluorescence and concentration was attempted

COVID-19-related absence among surgeons: development of an international surgical workforce prediction model

Background: During the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks. Methods: An international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent). Results Based on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7–12, this decreased to 9.2–13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19. Conclusion: This framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans.

BACKGROUND: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. METHODS: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. RESULTS: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. CONCLUSION: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires

The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of $t\overline{t}$, $W+b\overline{b}$ and $W+c\overline{c}$ is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 $\pm$ 0.02 \mbox{fb}^{-1}. The $W$ bosons are reconstructed in the decays $W\rightarrow\ell\nu$, where $\ell$ denotes muon or electron, while the $b$ and $c$ quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research