Solid Organ Transplantation During COVID-19 Pandemic: An International Web-based Survey on Resources’ Allocation

Background. Solid organ transplants (SOTs) are life-saving interventions, recently challenged by coronavirus disease 2019 (COVID-19). SOTs require a multistep process, which can be affected by COVID-19 at several phases. Methods. SOT-specialists, COVID-19-specialists, and medical ethicists designed an international survey according to CHERRIES guidelines. Personal opinions about continuing SOTs, safe managing of donors and recipients, as well as equity of resources' allocation were investigated. The survey was sent by e-mail. Multiple approaches were used (corresponding authors from Scopus, websites of scientific societies, COVID-19 webinars). After the descriptive analysis, univariate and multivariate ordinal regression analysis was performed. Results. There were 1819 complete answers from 71 countries. The response rate was 49%. Data were stratified according to region, macrospecialty, and organ of interest. Answers were analyzed using univariate- multivariate ordinal regression analysis and thematic analysis. Overall, 20% of the responders thought SOTs should not stop (continue transplant without restriction); over 70% suggested SOTs should selectively stop, and almost 10% indicated they should completely stop. Furthermore, 82% agreed to shift resources from transplant to COVID-19 temporarily. Briefly, main reason for not stopping was that if the transplant will not proceed, the organ will be wasted. Focusing on SOT from living donors, 61% stated that activity should be restricted only to "urgent"cases. At the multivariate analysis, factors identified in favor of continuing transplant were Italy, ethicist, partially disagreeing on the equity question, a high number of COVID-19- related deaths on the day of the answer, a high IHDI country. Factors predicting to stop SOTs were Europe except-Italy, public university hospital, and strongly agreeing on the equity question. Conclusions. In conclusion, the majority of responders suggested that transplant activity should be continued through the implementation of isolation measures and the adoption of the COVID-19-free pathways. Differences between professional categories are less strong than supposed

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

The ABC130 barrel module prototyping programme for the ATLAS strip tracker

For the Phase-II Upgrade of the ATLAS Detector, its Inner Detector, consisting of silicon pixel, silicon strip and transition radiation sub-detectors, will be replaced with an all new 100 % silicon tracker, composed of a pixel tracker at inner radii and a strip tracker at outer radii. The future ATLAS strip tracker will include 11,000 silicon sensor modules in the central region (barrel) and 7,000 modules in the forward region (end-caps), which are foreseen to be constructed over a period of 3.5 years. The construction of each module consists of a series of assembly and quality control steps, which were engineered to be identical for all production sites. In order to develop the tooling and procedures for assembly and testing of these modules, two series of major prototyping programs were conducted: an early program using readout chips designed using a 250 nm fabrication process (ABCN-25) and a subsequent program using a follow-up chip set made using 130 nm processing (ABC130 and HCC130 chips). This second generation of readout chips was used for an extensive prototyping program that produced around 100 barrel-type modules and contributed significantly to the development of the final module layout. This paper gives an overview of the components used in ABC130 barrel modules, their assembly procedure and findings resulting from their tests.Comment: 82 pages, 66 figure

La violence politique dans les élections au Moyen-Orient : les cas de l’Égypte, de la Turquie et du Liban

Elections are a form of non-violent confrontation other than being a peaceful decision making mechanism, especially in democracies. However, when elections are not perceived as free and transparent, there are strong possibilities that political conflict erupts in electoral violence. Elections can also be an accelerator of latent conflicts that have as root causes ethnic tensions or sectarianism. Other times, it is political violence, which breaks out during the electoral cycle, to influence the electoral process and its results. In this paper, we are going to analyze the cases of Egypt, Lebanon and Turkey in order to explain the relation between violence and elections and electoral violence stricto and largo sensu in the Middle East.Les élections sont une forme de confrontation non-violente et une modalité de prise de décisions pacifique, surtout en démocratie. Toutefois, quand elles ne se déroulent pas de manière libre et transparente, les élections peuvent donner lieu au phénomène de la violence électorale. Parfois, les élections accélèrent aussi des conflits latents de nature ethnique ou confessionnelle. D’autres fois, c’est la violence politique qui se manifeste au cours du cycle électoral à influencer le bon déroulement et les résultats électoraux. Dans ce mémoire, on présentera les cas de l’Égypte, du Liban et de la Turquie pour analyser la relation entre violence et élections au Moyen-Orient et la violence électorale stricto et largo sensu

Improvement of the actimetry agreement among sites by proper choice of signal processing stages

Physical activity (PA) has been identified as a key health indicator and has been assessed in multiple studies as the study of cardiovascular diseases, diabetes mellitus, obesity and psychological conditions. For this reason the use of accelerometers to quantify PA is widely accepted in either clinical/laboratory settings as well as in freeliving environments. The use of accelerometers in the measurement of PA is a relatively new technique and, therefore, has been not standardized. The aim of this work is to study the influence of signal processing stages in the estimation of PA while measuring simultaneously in three different sites to provide robust indicators of activity in front of changes in site measurement. With our measurement we show that a proper choice of signal processing steps can improve the agreement among activity indices measured from different sites on the same individual. The results also show that the most suited index is the time above threshold. In this case, the best combination of axes is by applying the quadratic mean, the best filtering of axes is using a cut-off frequency of around 1.5 Hz and a threshold to compute the index of 0.04 g.Peer ReviewedPostprint (published version

Improvement of the actimetry agreement among sites by proper choice of signal processing stages

Physical activity (PA) has been identified as a key health indicator and has been assessed in multiple studies as the study of cardiovascular diseases, diabetes mellitus, obesity and psychological conditions. For this reason the use of accelerometers to quantify PA is widely accepted in either clinical/laboratory settings as well as in freeliving environments. The use of accelerometers in the measurement of PA is a relatively new technique and, therefore, has been not standardized. The aim of this work is to study the influence of signal processing stages in the estimation of PA while measuring simultaneously in three different sites to provide robust indicators of activity in front of changes in site measurement. With our measurement we show that a proper choice of signal processing steps can improve the agreement among activity indices measured from different sites on the same individual. The results also show that the most suited index is the time above threshold. In this case, the best combination of axes is by applying the quadratic mean, the best filtering of axes is using a cut-off frequency of around 1.5 Hz and a threshold to compute the index of 0.04 g.Peer Reviewe

Early perfusion changes in patients with recurrent high-grade brain tumor treated with Bevacizumab: preliminary results by a quantitative evaluation

Abstract Background To determine whether early monitoring of the effects of bevacizumab in patients with recurrent high-grade gliomas, by a Perfusion Computed Tomography (PCT), may be a predictor of the response to treatment assessed through conventional MRI follow-up. Methods Sixteen patients were enrolled in the present study. For each patient, two PCT examinations, before and after the first dose of bevacizumab, were acquired. Areas of abnormal Cerebral Blood Volume (CBV) were manually defined on the CBV maps, using co-registered T1- weighted images, acquired before treatment, as a guide to the tumor location. Different perfusion metrics were derived from the histogram analysis of the normalized CBV (nCBV) maps; both hyper and hypo-perfused sub-volumes were quantified in the lesion, including tumor necrosis. A two-tailed Wilcoxon test was used to establish the significance of changes in the different perfusion metrics, observed at baseline and during treatment. The relationships between changes in perfusion and morphological MRI modifications at first follow-up were investigated. Results Significant reductions in mean and median nCBV were detected throughout the entire patient population, after only a single dose of bevacizumab. The nCBV histogram modifications indicated the normalization effect of bevacizumab on the tumor abnormal vasculature. An improvement in hypoxia after a single dose of bevacizumab was predictive of a greater reduction in T1-weighted contrast-enhanced volumes at first follow-up. Conclusions These preliminary results show that a quantification of changes in necrotic intra-tumoral regions could be proposed as a potential imaging biomarker of tumor response to anti-VEGF therapies.</p

Improvement of the actimetry agreement among sites by proper choice of signal processing stages

Physical activity (PA) has been identified as a key health indicator and has been assessed in multiple studies as the study of cardiovascular diseases, diabetes mellitus, obesity and psychological conditions. For this reason the use of accelerometers to quantify PA is widely accepted in either clinical/laboratory settings as well as in freeliving environments. The use of accelerometers in the measurement of PA is a relatively new technique and, therefore, has been not standardized. The aim of this work is to study the influence of signal processing stages in the estimation of PA while measuring simultaneously in three different sites to provide robust indicators of activity in front of changes in site measurement. With our measurement we show that a proper choice of signal processing steps can improve the agreement among activity indices measured from different sites on the same individual. The results also show that the most suited index is the time above threshold. In this case, the best combination of axes is by applying the quadratic mean, the best filtering of axes is using a cut-off frequency of around 1.5 Hz and a threshold to compute the index of 0.04 g.Peer Reviewe