Development and performance testing of a miniaturized multi-sensor system combining MOX and PID for potential UAV application in TIC, VOC and CWA dispersion scenarios

The development of a tool to reduce the exposure of personnel in case of inten- tional or accidental toxic chemicals dispersion scenarios opens the field to new operational perspectives in the domain of operator safety and of critical infrastructure monitoring. The use of two sensors with different operating principles, metal oxide and photo-ionization detector, allows to confirm the presence of specific classes of chemicals in a contaminated area. All instruments are expected to be integrated into the payload of an unmanned aerial vehicle (UAV) and used for different purposes such as critical infrastructure surveillance focused on the volatile organic chemical and chemical warfare agents (CWA) detection and the post-incident of contamination level monitoring. In this paper, the authors presented the hardware set-up implemented and the test realized with CWAs simulants and will discuss the results obtained presenting advantages and disadvantages of this system in an application such as a UAV for the detection of chemical substances

Tropospheric Delay Calibration System Performance During the First Two BepiColombo Solar Conjunctions

Media propagation delay and delay-rate induced by the water vapor within the Earth's troposphere represent one of the main error sources for radiometric measurements in deep space. In preparation for the BepiColombo and JUICE missions, the European Space Agency has installed and operates the prototype of a tropospheric delay calibration system (TDCS) at the DSA-3 ground station located in Malargüe, Argentina. An initial characterization of the TDCS performance was realized using two-way Doppler measurements at X-band to perform the orbit determination of the Gaia spacecraft. This work will further characterize the system by analyzing two-way Doppler and range data at X- and Ka-band for 31 tracking passes of the BepiColombo spacecraft, which were recorded between March 2021 and February 2022 during the first two solar conjunction experiments. The performance exceeds the expectations based on the previous analysis, with a reduction of the Doppler noise of 51% on average and up to 73% when using the TDCS measurements in place of standard calibrations based on global navigation satellite system data. Furthermore, the campaign serves as validation of the TDCS operations during superior solar conjunctions, with most of the tracking passes at low elongation now satisfying the Mercury orbiter radioscience experiment requirements on two-way Doppler stability. These results, which are in line with those of similar instruments installed at other Deep Space Network antennas, are obtained using a commercial microwave radiometer with significantly lower installation and maintenance costs

Moving Toward a Strategy for Addressing Climate Displacement of Marine Resources: A Proof-of-Concept

Realistic predictions of climate change effects on natural resources are central to adaptation policies that try to reduce these impacts. However, most current forecasting approaches do not incorporate species-specific, process-based biological information, which limits their ability to inform actionable strategies. Mechanistic approaches, incorporating quantitative information on functional traits, can potentially predict species- and population-specific responses that result from the cumulative impacts of small-scale processes acting at the organismal level, and can be used to infer population-level dynamics and inform natural resources management. Here we present a proof-of-concept study using the European anchovy as a model species that shows how a trait-based, mechanistic species distribution model can be used to explore the vulnerability of marine species to environmental changes, producing quantitative outputs useful for informing fisheries management. We crossed scenarios of temperature and food to generate quantitative maps of selected mechanistic model outcomes (e.g., Maximum Length and Total Reproductive Output). These results highlight changing patterns of source and sink spawning areas as well as the incidence of reproductive failure. This study demonstrates that model predictions based on functional traits can reduce the degree of uncertainty when forecasting future trends of fish stocks. However, to be effective they must be based on high spatial- and temporal resolution environmental data. Such a sensitive and spatially explicit predictive approach may be used to inform more effective adaptive management strategies of resources in novel climatic conditions

Copernicus Ocean State Report, issue 6

The 6th issue of the Copernicus OSR incorporates a large range of topics for the blue, white and green ocean for all European regional seas, and the global ocean over 1993–2020 with a special focus on 2020

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries