The History of Gin and Tonic; the Infectious Disease Specialist Long Drink. When Gin and Tonic was not Ordered but Prescribed

Winston Churchill statement promoting Gin and Tonic as a life saver during British Empire extension hides many truths. As a matter of fact, the modern cocktail is thought to be born in India where it was widely dis-tributed by Royal Navy for its anti-malarial properties. The aim of the present work is to review and unveil the history of Gin and Tonic through the centuries. As a matter of facts, primitive Gin and Tonic protective effects were well understood by physicians far before the advent of the “germ theory” and its fortunate in-vention is one of the most fascinating approaches in the history of preventive medicine. Indeed, quinine, a compound with protective effects on the replicative cycle of Plasmodium spp was discovered in 18th Century and since 19th it become the main compound of tonic beverages such as Schweppe’s ones. Interestingly, it was administered to British expatriates’ seamen and soldiers in order to prevent febrile paroxysms. Soon after, British military doctors demonstrated that the addition of lime or lemon peels to tonics was effective in preventing scurvy. While, addition of alcoholic beverages and gin contributed to make more enjoyable the bitter and unpleasant taste of this beverages. Results: The spectacular voyage of Gin and Tonic teach-es us that a popular recreational drink of our Century was a powerful prophylaxis which certainly helped British colonial expansion

COVID-19 and Spanish flu-18: review of medical and social parallelisms between two global pandemics

The intrusion of infectious diseases in everyday life forces humans to reassess their attitudes. Indeed, pandemics are able catalyze rapid transitions in scientific knowledge, politics, social behaviors, culture and arts. The current Coronavirus diesease-19 (COVID-19) outbreak has driven an unprecedented interest toward the influenza pandemic of 1918. The issue is whether history can predict our best preventive response and future scenarios. The aim of this review is to highlight the parallelism between the two pandemics. Starting from epidemiology and clinical features, but further focusing on social and cultural issues, it is possible to unreveal great similarities. Their outbreak pattern lead to hypothesize a similar duration and death burden in absence of effective vaccines or innovative treatments for COVID-19. Thus, then as now, preventive medicine represents the first and most effective tool to contain the course of the pandemic; being treatments available only supportive. Contemporary, both pandemics shared the same pattern of narration (e.g. scapegoating) and the same impact on minorities in high-income countries. Furthermore, visual art did not wait to respond with Graffiti art playing in 2020 the role that Expressionism movement had during the Spanish flu and photography capable to document both catastrophic scenarios. Thus, it is possible to find a lot of clinical and social similarities between the two pandemics. Nevertheless, if the Spanish flu was not unforseen, COVID-19 spillover was partially predictable and its global impact will not be overshadowed by a major crisis such as World War I

Tractor cabin ergonomics analyses by means of Kinect motion capture technology

Kinect is the de facto standard for real-time depth sensing and motion capture cameras. The sensor is here proposed for exploiting body tracking during driving operations. The motion capture system was developed taking advantage of the Microsoft software development kit (SDK), and implemented for real-time monitoring of body movements of a beginner and an expert tractor drivers, on different tracks (straight and with curves) and with different driving conditions (manual and assisted steering). Tests show how analyses can be done not only in terms of absolute movements, but also in terms of relative shifts, allowing for quantification of angular displacements or rotations

GNSS Autonomous Integrity Monitoring with Barometric Pressure Measurements and Weather Data

Vertical navigation is essential for new aviation operations like precision approaches and automatic landing which are expected to be primarily based on Global Navigation Satellite Systems (GNSS). However, achieving tighter vertical requirements with GNSS is challenging due to the inherent geometrical limitations. Current Aircraft-Based Augmentation Systems (ABAS) developments focus on proving that Advanced Receiver Autonomous Integrity Monitoring (ARAIM) is able to provide a robust operation for horizontal services and vertical guidance via the use of Multi-frequency and Multi-constellation GNSS. Although ARAIM can achieve high levels of integrity, the availability and continuity of the system may be compromised by the loss of satellites or high presence of cycle slips. For this reason, the support of onboard sensors like barometers is essential to guarantee all the vertical navigation requirements and extend the achievable accuracy and integrity for future even more stringent operations. This paper aims at augmenting GNSS navigation with geodetic altitude obtained from aircraft barometric pressure measurements and external weather data within a robust navigation architecture based on ARAIM. The present work describes the derivations of the threat and error models that are required for the inclusion of this barometric geodetic altitude into ARAIM. The improvement in availability is simulated world-wide with respect to the expected uncertainty of the geodetic barometric altitude. Then, real flight data is used to show the benefit of the barometer augmentation on the integrity of the navigation solution under real operational scenarios. The error models are obtained from several hours of flight data collected during a flight tests campaign performed in 2018 with the German Aerospace Center’s (DLR) Dassault Falcon aircraft

The avid eaters of lives. New and old infectious diseases in Italy at the time of World War 1: a historical overview of military medicine and public health

World War I bursted Italy from different perspectives. The one here described under an historical point of view reguards health of military and civil population, with a special focus on infective diseases. The 20th Century was the fuse of degeneration and eugenetics theories; which grew in the meliè of war and technological innovation. Indeed, war is interestingly depicted as an entity capable of blooming the differences between those who wore a uniform and those who do not. As a matter of fact, some infection spared the civilian population while others felt with greater vengeance on this subgroup. Moreover, the incidence of different feared diseases was brought back to the rates of the late 19th Century. Thanks to a statistician, Giorgio Mortara (1885-1967) the impact of infective diseases in Wolrd War I on Italian demography is well established. Moreover, different military and civilian contribute to enrich the picture of the consequences of war. In conclusion World War I could see considered as a litmus paper. The litmus paper of successes and failures of italian public health management to face new medical challenges exacerbated by the crisis

Molnupiravir, Nirmatrelvir/Ritonavir, or Sotrovimab for High-Risk COVID-19 Patients Infected by the Omicron Variant: Hospitalization, Mortality, and Time until Negative Swab Test in Real Life

Background. Several drugs which are easy to administer in outpatient settings have been authorized and endorsed for high-risk COVID-19 patients with mild–moderate disease to prevent hospital admission and death, complementing COVID-19 vaccines. However, the evidence on the efficacy of COVID-19 antivirals during the Omicron wave is scanty or conflicting. Methods. This retrospective controlled study investigated the efficacy of Molnupiravir or Nirmatrelvir/Ritonavir (Paxlovid®) or Sotrovimab against standard of care (controls) on three different endpoints among 386 high-risk COVID-19 outpatients: hospital admission at 30 days; death at 30 days; and time between COVID-19 diagnosis and first negative swab test result. Multinomial logistic regression was employed to investigate the determinants of hospitalization due to COVID-19-associated pneumonia, whereas time to first negative swab test result was investigated by means of multinomial logistic analysis as well as Cox regression analysis. Results. Only 11 patients (overall rate of 2.8%) developed severe COVID-19-associated pneumonia requiring admission to hospital: 8 controls (7.2%); 2 patients on Nirmatrelvir/Ritonavir (2.0%); and 1 on Sotrovimab (1.8%). No patient on Molnupiravir was institutionalized. Compared to controls, hospitalization was less likely for patients on Nirmatrelvir/Ritonavir (aOR = 0.16; 95% CI: 0.03; 0.89) or Molnupiravir (omitted estimate); drug efficacy was 84% for Nirmatrelvir/Ritonavir against 100% for Molnupiravir. Only two patients died of COVID-19 (rate of 0.5%), both were controls, one (aged 96 years) was unvaccinated and the other (aged 72 years) had adequate vaccination status. At Cox regression analysis, the negativization rate was significantly higher in patients treated with both antivirals—Nirmatrelvir/Ritonavir (aHR = 1.68; 95% CI: 1.25; 2.26) and Molnupiravir (aHR = 1.45; 95% CI: 1.08; 1.94). However, COVID-19 vaccination with three (aHR = 2.03; 95% CI: 1.51; 2.73) or four (aHR = 2.48; 95% CI: 1.32; 4.68) doses had a stronger effect size on viral clearance. In contrast, the negativization rate reduced significantly in patients who were immune-depressed (aHR = 0.70; 95% CI: 0.52; 0.93) or those with a Charlson index ≥ 3 (aHR = 0.63; 0.41; 0.95) or those who had started the respective treatment course 3+ days after COVID-19 diagnosis (aOR = 0.56; 95% CI: 0.38; 0.82). Likewise, at internal analysis (excluding patients on standard of care), patients on Molnupiravir (aHR = 1.74; 95% CI: 1.21; 2.50) or Nirmatrelvir/Ritonavir (aHR = 1.96; 95% CI: 1.32; 2.93) were more likely to turn negative earlier than those on Sotrovimab (reference category). Nonetheless, three (aHR = 1.91; 95% CI: 1.33; 2.74) or four (aHR = 2.20; 95% CI: 1.06; 4.59) doses of COVID-19 vaccine were again associated with a faster negativization rate. Only 64.7% of patients were immunized with 3+ doses of COVID-19 vaccines in the present study. Again, the negativization rate was significantly lower if treatment started 3+ days after COVID-19 diagnosis (aHR = 0.54; 95% CI: 0.32; 0.92). Conclusions. Molnupiravir, Nirmatrelvir/Ritonavir, and Sotrovimab were all effective in preventing hospital admission and/or mortality attributable to COVID-19. However, hospitalizations also decreased with higher number of doses of COVID-19 vaccines. Although they are effective against severe disease and mortality, the prescription of antivirals should be carefully scrutinized by double opinion, not only to contain health care costs but also to reduce the risk of generating resistant SARS-CoV-2 strains. Only 64.7% of patients were in fact immunized with 3+ doses of COVID-19 vaccines in the present study. High-risk patients should prioritize COVID-19 vaccination, which is a more cost-effective approach than antivirals against severe SARS-CoV-2 pneumonia. Likewise, although both antivirals, especially Nirmatrelvir/Ritonavir, were more likely than standard of care and Sotrovimab to reduce viral shedding time (VST) in high-risk SARS-CoV-2 patients, vaccination had an independent and stronger effect on viral clearance. However, the effect of antivirals or COVID-19 vaccination on VST should be considered a secondary benefit. Indeed, recommending Nirmatrelvir/Ritonavir in order to control VST in high-risk COVID-19 patients is rather questionable since other cheap, large spectrum and harmless nasal disinfectants such as hypertonic saline solutions are available on the market with proven efficacy in containing VST

Dracunculiasis over the centuries: the history of a parasite unfamiliar to the West

Dracunculiasis (Guinea Worm Disease) is a terrible disease limited, even historically, to the arid and poor areas of our planet and which in the West has always been seen as an exotic disease and therefore has nevertaken root in the collective imagination. This parasitosis is transmitted to humans by drinking water contaminated with crustacean harboring larvae of Dracunculus medinensis, a nematode. The natural history of the disease is caused by adult worms invading connective tissues and causing blistering, ulceration and edema. Well known in Ancient Egypt where the disease was endemic in its southern area, was known in Europe mainly from the reports of medical writers starting from the Roman imperial period but without direct knowledge. In Middle age the descriptions of this disease that physicians and surgeons could read on medical books, at the end, were attributed to veterinary parasitic disease. In Modern age only during the colonialist era dracunculiasis was perceived as a problem, however sporadic. In 1986 Guinea Worm Eradication Program (GWEP) was launch without success. Thus, the disappearance of this parasitosis should still be postponed but not abandoned

Balto and Togo during the cold winter of Alaska (1925): the two canine heroes in the fight against diphtheria

In recent years, diphtheria has re-emerged in areas with inadequate vaccination coverage, and Europe has not been spared with several cases among migrants. Diphtheria is a potentially fatal infection caused mainly by toxigenic strains of Corynebacterium diphtheriae. Due to the high mortality rate, especially among young children, the fight against diphtheria is considered one of the first conquests of immunization. In the history of medicine, there is a unique case of an unconventional response to a diphtheria outbreak in which sled dogs were used to overcome the supply difficulties of diphtheria antitoxin. The mass media followed the medical response to the outbreak and raised audience awareness of public health issues. The facts of Nome, Alaska, in 1925 can serve as a catalyst to rethink conventional responses to diphtheria outbreaks in low-income countries today and promote mass media awareness of public health importance

Vertiport Navigation Requirements and Multisensor Architecture Considerations for Urban Air Mobility

Communication, Navigation and Surveillance (CNS) technologies are key enablers for future safe operation of drones in urban environments. However, the design of navigation technologies for these new applications is more challenging compared to e.g., civil aviation. On the one hand, the use cases and operations in urban environments are expected to have stringent requirements in terms of accuracy, integrity, continuity and availability. On the other hand, airborne sensors may not be based on high-quality equipment as in civil aviation and solutions need to rely on tighter multisensor solutions, whose safety is difficult to assess. In this work, we first provide some initial navigation requirements related to precision approach operations based on recently proposed vertiport designs. Then, we provide an overview of a possible multisensor navigation architecture solution able to support these types of operations and we comment on the challenges of each of the subsystems. Finally, initial proof of concept for some navigation sensor subsystems is presented based on flight trials performed during the German Aerospace Center (DLR) project HorizonUAM

The current state of knowledge on dracunculiasis: a narrative review of a rare neglected disease

Dracunculiasis (Guinea Worm Disease) is a chronic disease that is primarily found in the arid and poor areas of our planet where water supply systems consist of open wells. This parasitic disease is transmitted to humans not only through the consumption of water contaminated with crustaceans harbouring larvae of Dracunculus medinensis, but also through the ingestion of paratenic (frogs) or transport hosts (fish). The natural progression of the disease is caused by adult worms invading connective tissues, leading to blistering and ulceration of the extremities, approximately one year after infection. In 1986, the Guinea Worm Eradication Program (GWEP) was launched and since then, the incidence of the disease has been reduced by over 99%. Indeed, the most recent global report from 2022 shows only 13 cases of human dracunculiasis worldwide, the lowest annual incidence ever reported. The new found knowledge of potential animal reservoirs and the recent discovery of possible edible paratenic hosts could pose challenges to the future eradication of this debilitating disease. Therefore, attempts to eradicate this parasitosis should not be postponed. Intensive research is needed in this neglected area of medicine, now that the goal is within reach