LIFE15 ENV/IT/000392 − LIFE VITISOM Project, viticulture innovation technology and GHG emission monitoring

The main aim of the LIFE VITISOM Project is to promote an innovative solution for the management of the organic fertilisation in the viticultural sector. In parallel, different activities of monitoring of impacts have been planned. Specifically, a deep study about GHG emissions has been organised. In this context, different studies are being carried out: a continuous monitoring of net carbon fluxes (NEE) through the Eddy Covariance method, followed by University of Padua which allows data to be obtained at vineyard ecosystem level; a spatial monitoring of CH4, N2O and CO2, through a mobile instrument for measuring the variation of GHG developed by West Systems within the LIFE+ IPNOA Project. In the first case, two Eddy Covariance towers have been installed, one at Guido Berlucchi (Franciacorta, Lombardy) and one at Bosco del Merlo (Lison, Veneto). Additionally, spatial monitoring is being carried out in five testing sites involved in the LIFE VITISOM project. In this case, different organic fertilisation managements are compared

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

LIFE15 ENV/IT/000392 − LIFE VITISOM Project, viticulture innovation technology and GHG emission monitoring

The main aim of the LIFE VITISOM Project is to promote an innovative solution for the management of the organic fertilisation in the viticultural sector. In parallel, different activities of monitoring of impacts have been planned. Specifically, a deep study about GHG emissions has been organised. In this context, different studies are being carried out: a continuous monitoring of net carbon fluxes (NEE) through the Eddy Covariance method, followed by University of Padua which allows data to be obtained at vineyard ecosystem level; a spatial monitoring of CH4, N2O and CO2, through a mobile instrument for measuring the variation of GHG developed by West Systems within the LIFE+ IPNOA Project. In the first case, two Eddy Covariance towers have been installed, one at Guido Berlucchi (Franciacorta, Lombardy) and one at Bosco del Merlo (Lison, Veneto). Additionally, spatial monitoring is being carried out in five testing sites involved in the LIFE VITISOM project. In this case, different organic fertilisation managements are compared

Relative survival scenarios: an application to undersized common sole (Solea solea L.) in a beam trawl fishery in the Mediterranean Sea

Fishery discard survival depends on multiple conditions; caution is essential when survival study outputs are employed to support management decisions. The study presents a stepwise procedure, devised to estimate discard survival, that accounts for the variability characterizing commercial fishing practices. The procedure was applied to the first survival study performed onboard rapido trawlers targeting Solea solea in the Mediterranean Sea. Undersized specimens collected during sorting were assessed for vitality; some were retained for captive observation. The main drivers affecting discard survival at the time of catch sorting (immediate survival) were identified and used to outline four different operational conditions set (scenarios). Immediate survival in each scenario was subsequently modified by applying a hazard coefficient of survival after 5 days of captive observation in relation to each vitality class, thus obtaining relative survival estimates following discarding. Temperature and air exposure duration were found to exert a major effect on survival, with catch weight and seabed type being additional important factors. The relative survival rate showed an aggregate value of 22.9% (10.5\u201333.4%). Scenario approach can enhance our understanding of the stressors influencing discard survival. The outcomes are discussed to explore the potential applications of the procedure to the identification of mitigation strategies

Tocilizumab for treatment of severe covid-19 patients: Preliminary results from smatteo covid19 registry (smacore)

Objective: This study aimed to assess the role of Tocilizumab therapy (TCZ) in terms of ICU admission and mortality rate of critically ill patients with severe COVID-19 pneumonia. Design: Patients with COVID-19 pneumonia were prospectively enrolled in SMAtteo COvid19 REgistry (SMACORE). A retrospective analysis of patients treated with TCZ matched using propensity score to patients treated with Standard Of Care (SOC) was conducted. Setting: The study was conducted at IRCCS Policlinico San Matteo Hospital, Pavia, Italy, from March 14, 2020 to March 27, 2020. Participants: Patients with a confirmed diagnosis of COVID-19 hospitalized in our institution at the time of TCZ availability. Interventions: TCZ was administered to 21 patients. The first administration was 8 mg/kg (up to a maximum 800 mg per dose) of Tocilizumab intravenously, repeated after 12 h if no side effects were reported after the first dose. Main Outcomes and Measures: ICU admission and 7-day mortality rate. Secondary outcomes included clinical and laboratory data. Results: There were 112 patients evaluated (82 were male and 30 were female, with a median age of 63.55 years). Using propensity scores, the 21 patients who received TCZ were matched to 21 patients who received SOC (a combination of hydroxychloroquine, azithromycin and prophylactic dose of low weight heparin). No adverse event was detected following TCZ administration. This study found that treatment with TCZ did not significantly affect ICU admission (OR 0.11; 95% CI between 0.00 and 3.38; p = 0.22) or 7-day mortality rate (OR 0.78; 95% CI between 0.06 and 9.34; p = 0.84) when compared with SOC. Analysis of laboratory measures showed significant interactions between time and treatment regarding C-Reactive Protein (CRP), alanine aminotransferase (ALT), platelets and international normalized ratio (INR) levels. Variation in lymphocytes count was observed over time, irrespective of treatment. Conclusions: TCZ administration did not reduce ICU admission or mortality rate in a cohort of 21 patients. Additional data are needed to understand the effect(s) of TCZ in treating patients diagnosed with COVID-19