Landslides in a changing climate

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A tool for the automatic calculation of rainfall thresholds for landslide occurrence

Abstract Empirical rainfall thresholds are commonly used to forecast landslide occurrence in wide areas. Thresholds are affected by several uncertainties related to the rainfall and the landslide information accuracy, the reconstruction of the rainfall responsible for the failure, and the method to calculate the thresholds. This limits the use of the thresholds in landslide early warning systems. To face the problem, we developed a comprehensive tool, CTRL–T ( C alculation of T hresholds for R ainfall-induced L andslides− T ool) that automatically and objectively reconstructs rainfall events and the triggering conditions responsible for the failure, and calculates rainfall thresholds at different exceedance probabilities. CTRL−T uses a set of adjustable parameters to account for different morphological and climatic settings. We tested CTRL−T in Liguria region (Italy), which is highly prone to landslides. We expect CTRL−T has an impact on the definition of rainfall thresholds in Italy, and elsewhere, and on the reduction of the risk posed by rainfall-induced landslides

Rainfall thresholds for possible landslide occurrence in Italy

Abstract The large physiographic variability and the abundance of landslide and rainfall data make Italy an ideal site to investigate variations in the rainfall conditions that can result in rainfall-induced landslides. We used landslide information obtained from multiple sources and rainfall data captured by 2228 rain gauges to build a catalogue of 2309 rainfall events with – mostly shallow – landslides in Italy between January 1996 and February 2014. For each rainfall event with landslides, we reconstructed the rainfall history that presumably caused the slope failure, and we determined the corresponding rainfall duration D (in hours) and cumulated event rainfall E (in mm). Adopting a power law threshold model, we determined cumulated event rainfall–rainfall duration (ED) thresholds, at 5% exceedance probability, and their uncertainty. We defined a new national threshold for Italy, and 26 regional thresholds for environmental subdivisions based on topography, lithology, land-use, land cover, climate, and meteorology, and we used the thresholds to study the variations of the rainfall conditions that can result in landslides in different environments, in Italy. We found that the national and the environmental thresholds cover a small part of the possible DE domain. The finding supports the use of empirical rainfall thresholds for landslide forecasting in Italy, but poses an empirical limitation to the possibility of defining thresholds for small geographical areas. We observed differences between some of the thresholds. With increasing mean annual precipitation (MAP), the thresholds become higher and steeper, indicating that more rainfall is needed to trigger landslides where the MAP is high than where it is low. This suggests that the landscape adjusts to the regional meteorological conditions. We also observed that the thresholds are higher for stronger rocks, and that forested areas require more rainfall than agricultural areas to initiate landslides. Finally, we observed that a 20% exceedance probability national threshold was capable of predicting all the rainfall-induced landslides with casualties between 1996 and 2014, and we suggest that this threshold can be used to forecast fatal rainfall-induced landslides in Italy. We expect the method proposed in this work to define and compare the thresholds to have an impact on the definition of new rainfall thresholds for possible landslide occurrence in Italy, and elsewhere

Academy of Emergency Medicine and Care-Society of Clinical Biochemistry and Clinical Molecular Biology consensus recommendations for clinical use of sepsis biomarkers in the emergency department.

Increasing evidence is emerging that the measurement of circulating biomarkers may be clinically useful for diagnosing and monitoring sepsis. Eight members of AcEMC (Academy of Emergency Medicine and Care) and eight members of SIBioC (Italian Society of Clinical Biochemistry and Laboratory Medicine) were identified by the two scientific societies for producing a consensus document aimed to define practical recommendations about the use of biomarkers for diagnosing of sepsis and managing antibiotic therapy in the emergency department (ED). The cumulative opinions allowed defining three grade A recommendations (i.e., highly recommended indications), entailing ordering modality (biomarkers always available on prescription), practical use (results should be interpreted according to clinical information) and test ordering defined according to biomarker kinetics. Additional grade B recommendations (i.e., potentially valuable indications) entailed general agreement that biomarkers assessment may be of clinical value in the diagnostic approach of ED patients with suspected sepsis, suggestion for combined assessment of procalcitonin (PCT) and Creactive protein (CRP), free availability of the selected biomarker(s) on prescription, adoption of diagnostic threshold prioritizing high negative predictive value, preference for more analytically sensitive techniques, along with potential clinical usefulness of measuring PCT for monitoring antibiotic treatment, with serial testing defined according to biomarker kinetics. PCT and CRP were the two biomarkers that received the largest consensus as sepsis biomarkers (grade B recommendation), and a grade B recommendation was also reached for routine assessment of blood lactate. The assessment of biomarkers other than PCT and CRP was discouraged, with exception of presepsin for which substantial uncertainty in favor or against remained

Anaesthesiological strategies in elective craniotomy: randomized, equivalence, open trial – The NeuroMorfeo trial

<p>Abstract</p> <p>Background</p> <p>Many studies have attempted to determine the <it>"best" </it>anaesthetic technique for neurosurgical procedures in patients without intracranial hypertension. So far, no study comparing intravenous (IA) with volatile-based neuroanaesthesia (VA) has been able to demonstrate major outcome differences nor a superiority of one of the two strategies in patients undergoing elective supratentorial neurosurgery. Therefore, current practice varies and includes the use of either volatile or intravenous anaesthetics in addition to narcotics. Actually the choice of the anaestesiological strategy depends only on the anaesthetists' preferences or institutional policies.</p> <p>This trial, named NeuroMorfeo, aims to assess the equivalence between volatile and intravenous anaesthetics for neurosurgical procedures.</p> <p>Methods/Design</p> <p>NeuroMorfeo is a multicenter, randomized, open label, controlled trial, based on an equivalence design. Patients aged between 18 and 75 years, scheduled for elective craniotomy for supratentorial lesion without signs of intracranial hypertension, in good physical state (ASA I-III) and Glasgow Coma Scale (GCS) equal to 15, are randomly assigned to one of three anaesthesiological strategies (two VA arms, sevoflurane + fentanyl or sevoflurane + remifentanil, and one IA, propofol + remifentanil). The equivalence between intravenous and volatile-based neuroanaesthesia will be evaluated by comparing the intervals required to reach, after anaesthesia discontinuation, a modified Aldrete score ≥ 9 (primary end-point). Two statistical comparisons have been planned:</p> <p>1) sevoflurane + fentanyl vs. propofol + remifentanil;</p> <p>2) sevoflurane + remifentanil vs. propofol + remifentanil.</p> <p>Secondary end-points include: an assessment of neurovegetative stress based on (a) measurement of urinary catecholamines and plasma and urinary cortisol and (b) estimate of sympathetic/parasympathetic balance by power spectrum analyses of electrocardiographic tracings recorded during anaesthesia; intraoperative adverse events; evaluation of surgical field; postoperative adverse events; patient's satisfaction and analysis of costs.</p> <p>411 patients will be recruited in 14 Italian centers during an 18-month period.</p> <p>Discussion</p> <p>We presented the development phase of this anaesthesiological on-going trial. The recruitment started December 4^th, 2007 and up to 4^th, December 2008, 314 patients have been enrolled.</p

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 &lt; 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p &lt; 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 &lt; 0.0001) or urgent (20.4% vs. 38.5%; p &lt; 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 &lt; 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

Computer Simulations of Nematic Displays

Monte Carlo simulations of electroptical devices based on a nematic Lebwohl-Lasher liquid crystal model with suitable boundary conditions are presented. The simplicity of the model allows an investigation of various e#ects like the influence of an external field strength and that of anchoring at the oriented surfaces of the display cell. Moreover suitable order parameters are introduced to facilitate an understanding of the molecular organisation inside the electoptical cells