RFID technology applied to the glacial environment: MALATRA electronic system design and experimental data

The higher mountains of the Alps focus in the western part of Europe and favor a high concentration of glaciers in this area. The Aosta Valley region is surrounded by mountains, more than the 50% of its territory lying above 2000 m a.s.l. In the summer, most of the water supply of the region relies on the contribution given by snowmelt and, partially, by ice melt. Study of glacial processes is thus very important in this region. In this context the MALATRÀ project (led by Fondazione Montagna Sicura and Envisens Technologies) is created to develop a low-cost instrumentation capable of measuring with continuity the physical parameters of snow and ice. The instrumentation consists of a miniaturized electronic device (tag) equipped with sensors and placed inside an ovoidal small-dimension (48 mm diameter and 180 mm length) plastic capsule. Moreover, the implementation of radio frequency identification technology (RFID) allows remote communication from the surface with the tags placed deep into the glacier, thus saving time, effort and cost in collecting data. Tags allow communication at long distance working at 315 MHz frequency. At this step, the goal is to use such devices during the annual glaciological campaigns to measure the weight of the snowpack above the tag (with a pressure sensor), in order to derive the snow water equivalent (SWE) and temperature inside the ice. As a first step, the capsules will be coupled with ablation stakes installed in the ice, placed at the bottom of boreholes. Each capsule is uniquely identified by a code and can be located in a 3-D local system via radio using a localization algorithm under development. It is then, during the installation, georeferenced absolutely using a GNSS receiver. This functionality also allows for the glacier displacement measurements. Once the device has been identified, all the data stored in the internal memory can be remotely downloaded from the reader. At the current development stage the board is equipped with a precise thermometer (PT1000) and a pressure sensor to catch ice data, a magnetometer and a tri-axial accelerometer sensor to study the movement of the capsule within the ice. The performance of the system has been tested in the glacial environment with excellent results

RFID technology applied to the glacial environment: MALATRA electronic system design and experimental data

The higher mountains of the Alps focus in the western part of Europe and favor a high concentration of glaciers in this area. The Aosta Valley region is surrounded by mountains, more than the 50% of its territory lying above 2000 m a.s.l. In the summer, most of the water supply of the region relies on the contribution given by snowmelt and, partially, by ice melt. Study of glacial processes is thus very important in this region. In this context the MALATRÀ project (led by Fondazione Montagna Sicura and Envisens Technologies) is created to develop a low-cost instrumentation capable of measuring with continuity the physical parameters of snow and ice. The instrumentation consists of a miniaturized electronic device (tag) equipped with sensors and placed inside an ovoidal small-dimension (48 mm diameter and 180 mm length) plastic capsule. Moreover, the implementation of radio frequency identification technology (RFID) allows remote communication from the surface with the tags placed deep into the glacier, thus saving time, effort and cost in collecting data. Tags allow communication at long distance working at 315 MHz frequency. At this step, the goal is to use such devices during the annual glaciological campaigns to measure the weight of the snowpack above the tag (with a pressure sensor), in order to derive the snow water equivalent (SWE) and temperature inside the ice. As a first step, the capsules will be coupled with ablation stakes installed in the ice, placed at the bottom of boreholes. Each capsule is uniquely identified by a code and can be located in a 3-D local system via radio using a localization algorithm under development. It is then, during the installation, georeferenced absolutely using a GNSS receiver. This functionality also allows for the glacier displacement measurements. Once the device has been identified, all the data stored in the internal memory can be remotely downloaded from the reader. At the current development stage the board is equipped with a precise thermometer (PT1000) and a pressure sensor to catch ice data, a magnetometer and a tri-axial accelerometer sensor to study the movement of the capsule within the ice. The performance of the system has been tested in the glacial environment with excellent results

Sex-related mortality differences in young adult septic shock patients

Septic shock survival rate and host immune response are intimately interlaced. In the last years, biological and pre-clinical studies demonstrated sex-specific differences in the immune response to infection. In the hypothesis that survival rate is related to the hormonal framework, the aim of the present study was to observe sex-specific differences in 28-day mortality rate between women of childbearing potential and same-age men. This multicenter study was conducted in six Italian intensive care units (ICUs). We enrolled consecutive patients ≤ 55 years old admitted to the Intensive Care Unit from January 2011 to January 2020, who were diagnosed with septic shock at the time of ICU admission or during the ICU stay. We gathered baseline characteristics and outcomes. The primary outcome was 28-day mortality; secondary outcomes included ICU mortality, in-hospital mortality and length of stay in the ICU and in the hospital. Moreover, data from >55 years old patients were collected and analyzed. We enrolled 361 young patients with septic shock: 215 were males (60%) and 146 females (40%). While baseline and ICU characteristics were similar between the two groups, males had a higher 28-day mortality rate (39.5% vs. 29%, p = 0.035), ICU mortality rate (49% vs. 38%, p = 0.040) and hospital mortality rate (61% vs. 50%, p = 0.040) as compared to females. Findings were confirmed in patients with septic shock at ICU admission. Young adult females developed septic shock less frequently than young males, displaying a reduced mortality rate as compared to that of their same-age male counterpart. These findings may stimulate future research and therapies

Fluid challenges in intensive care: the FENICE study A global inception cohort study

Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC.This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC.2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500-1000). The median time was 24 min (40-60 min), and the median rate of FC was 1000 [500-1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57-61 %). In 43 % (CI 41-45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34-37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20-24 %). No safety variable for the FC was used in 72 % (CI 70-74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response.The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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An ad-hoc RFID tag for glaciers monitoring

Since glaciers are an important indicator of climate changes, the studies related to glaciers environment and their physical properties have remarkably raised. In the framework of the project MALATRA, Fondazione Montagna sicura together with Envisens Technologies s.r.l., has developed an ad-hoc system able to monitor several physical properties of glaciers (e. g. their temperature and displacement during a specific time interval). The system is made up of a set of RFID “tags” placed inside the ice to perform the measurements and a handheld “reader” to collect data. Tags are equipped with several sensors and a memory in order to save data. Following an inquiring operation made by an operator, measurements are then transmitted to the reader, exploiting a dedicated radio communication link operating at 315 MHz. In order to recover the position of each tag after a certain period of time and to reconstruct the movements of the glacier, a localization scheme based on RSSI was developed. There is no limit to the number of tags that could be installed, thus allowing to measure with very high spatial resolution

An ad-hoc RFID tag for glaciers monitoring

Since glaciers are an important indicator of climate changes, the studies related to glaciers environment and their physical properties have remarkably raised. In the framework of the project MALATRA, Fondazione Montagna sicura together with Envisens Technologies s.r.l., has developed an ad-hoc system able to monitor several physical properties of glaciers (e. g. their temperature and displacement during a specific time interval). The system is made up of a set of RFID “tags” placed inside the ice to perform the measurements and a handheld “reader” to collect data. Tags are equipped with several sensors and a memory in order to save data. Following an inquiring operation made by an operator, measurements are then transmitted to the reader, exploiting a dedicated radio communication link operating at 315 MHz. In order to recover the position of each tag after a certain period of time and to reconstruct the movements of the glacier, a localization scheme based on RSSI was developed. There is no limit to the number of tags that could be installed, thus allowing to measure with very high spatial resolution