A Snapshot on MRSA epidemiology in a neonatal intensive care unit network, Palermo, Italy

Objectives: We performed a 1-year prospective surveillance study on MRSA colonization within the five NICUs of the metropolitan area of Palermo, Italy. The purpose of the study was to assess epidemiology of MRSA in NICU from a network perspective. Methods: Transfer of patients between NICUs during 2014 was traced based on the annual hospital discharge records. In the period February 2014-January 2015, in the NICU B, at the University teaching hospital, nasal swabs from all infants were collected weekly, whereas in the other four NICUs (A, C, D, E) at 4 week-intervals of time. MRSA isolates were submitted to antibiotic susceptibility testing, SCCmec typing, PCR to detect lukS-PV and lukF-PV (lukS/F-PV) genes and the gene encoding the toxic shock syndrome toxin (TSST-1), multilocus variable number tandem repeat fingerprinting (MLVF), and multilocus sequence typing (MLST). Results: In the period under study, 587 nasal swabs were obtained from NICU B, whereas 218, 180, 157, and 95 from NICUs A, C, D, and E, respectively. Two groups of NICUs at high prevalence and low prevalence of MRSA colonization were recognized. Overall, 113 isolates of MRSA were identified from 102 infants. Six MLVF types (A-F) were detected, with type C being subdivided into five subtypes. Five sequence types (STs) were found with ST22-IVa being the most frequent type in all NICUs. All the MRSA molecular subtypes, except for ST1-IVa, were identified in NICU B. Conclusions: Our findings support the need to approach surveillance and infection control in NICU in a network perspective, prioritizing referral healthcare facilities

System modelling of very low Earth orbit satellites for Earth observation

The operation of satellites in very low Earth orbit (VLEO) has been linked to a variety of benefits to both the spacecraft platform and mission design. Critically, for Earth observation (EO) missions a reduction in altitude can enable smaller and less powerful payloads to achieve the same performance as larger instruments or sensors at higher altitude, with significant benefits to the spacecraft design. As a result, renewed interest in the exploitation of these orbits has spurred the development of new technologies that have the potential to enable sustainable operations in this lower altitude range. In this paper, system models are developed for (i) novel materials that improve aerodynamic performance enabling reduced drag or increased lift production and resistance to atomic oxygen erosion and (ii) atmosphere-breathing electric propulsion (ABEP) for sustained drag compensation or mitigation in VLEO. Attitude and orbit control methods that can take advantage of the aerodynamic forces and torques in VLEO are also discussed. These system models are integrated into a framework for concept-level satellite design and this approach is used to explore the system-level trade-offs for future EO spacecraft enabled by these new technologies. A case-study presented for an optical very-high resolution spacecraft demonstrates the significant potential of reducing orbital altitude using these technologies and indicates possible savings of up to 75% in system mass and over 50% in development and manufacturing costs in comparison to current state-of-the-art missions. For a synthetic aperture radar (SAR) satellite, the reduction in mass and cost with altitude were shown to be smaller, though it was noted that currently available cost models do not capture recent commercial advancements in this segment. These results account for the additional propulsive and power requirements needed to sustain operations in VLEO and indicate that future EO missions could benefit significantly by operating in this altitude range. Furthermore, it is shown that only modest advancements in technologies already under development may begin to enable exploitation of this lower altitude range. In addition to the upstream benefits of reduced capital expense and a faster return on investment, lower costs and increased access to high quality observational data may also be passed to the downstream EO industry, with impact across a wide range of commercial, societal, and environmental application areas

Intake design for an Atmosphere-Breathing Electric Propulsion System (ABEP)

Challenging space missions include those at very low altitudes, where the atmosphere is source of aerodynamic drag on the spacecraft. To extend the lifetime of such missions, an efficient propulsion system is required. One solution is Atmosphere-Breathing Electric Propulsion (ABEP) that collects atmospheric particles to be used as propellant for an electric thruster. The system would minimize the requirement of limited propellant availability and can also be applied to any planetary body with atmosphere, enabling new missions at low altitude ranges for longer times. IRS is developing, within the H2020 DISCOVERER project, an intake and a thruster for an ABEP system. The article describes the design and simulation of the intake, optimized to feed the radio frequency (RF) Helicon-based plasma thruster developed at IRS. The article deals in particular with the design of intakes based on diffuse and specular reflecting materials, which are analysed by the PICLas DSMC-PIC tool. Orbital altitudes and the respective species based on the NRLMSISE-00 model (O, , , He, Ar, H, N) are investigated for several concepts based on fully diffuse and specular scattering, including hybrid designs. The major focus has been on the intake efficiency defined as , with the incoming particle flux, and the one collected by the intake. Finally, two concepts are selected and presented providing the best expected performance for the operation with the selected thruster. The first one is based on fully diffuse accommodation yielding to and the second one based on fully specular accommodation yielding to . Finally, also the influence of misalignment with the flow is analysed, highlighting a strong dependence of in the diffuse-based intake while, for the specular-based intake, this is much lower finally leading to a more resilient design while also relaxing requirements of pointing accuracy for the spacecraft

Intake Design for an Atmosphere-Breathing Electric Propulsion System (ABEP)

Challenging space missions include those at very low altitudes, where the atmosphere is source of aerodynamic drag on the spacecraft. To extend the lifetime of such missions, an efficient propulsion system is required. One solution is Atmosphere-Breathing Electric Propulsion (ABEP) that collects atmospheric particles to be used as propellant for an electric thruster. The system would minimize the requirement of limited propellant availability and can also be applied to any planetary body with atmosphere, enabling new missions at low altitude ranges for longer times. IRS is developing, within the H2020 DISCOVERER project, an intake and a thruster for an ABEP system. The article describes the design and simulation of the intake, optimized to feed the radio frequency (RF) Helicon-based plasma thruster developed at IRS. The article deals in particular with the design of intakes based on diffuse and specular reflecting materials, which are analysed by the PICLas DSMC-PIC tool. Orbital altitudes $h=150-250$ km and the respective species based on the NRLMSISE-00 model (O, $N_2$, $O_2$, He, Ar, H, N) are investigated for several concepts based on fully diffuse and specular scattering, including hybrid designs. The major focus has been on the intake efficiency defined as $\eta_c=\dot{N}_{out}/\dot{N}_{in}$, with $\dot{N}_{in}$ the incoming particle flux, and $\dot{N}_{out}$ the one collected by the intake. Finally, two concepts are selected and presented providing the best expected performance for the operation with the selected thruster. The first one is based on fully diffuse accommodation yielding to $\eta_c<0.46$ and the second one based un fully specular accommodation yielding to $\eta_c<0.94$. Finally, also the influence of misalignment with the flow is analysed, highlighting a strong dependence of $\eta_c$ in the diffuse-based intake while, ...Comment: Accepted Versio

RF Helicon-based Inductive Plasma Thruster (IPT) Design for an Atmosphere-Breathing Electric Propulsion system (ABEP)

Challenging space missions include those at very low altitudes, where the atmosphere is source of aerodynamic drag on the spacecraft. To extend such missions lifetime, an efficient propulsion system is required. One solution is Atmosphere-Breathing Electric Propulsion (ABEP). It collects atmospheric particles to be used as propellant for an electric thruster. The system would minimize the requirement of limited propellant availability and can also be applied to any planet with atmosphere, enabling new mission at low altitude ranges for longer times. Challenging is also the presence of reactive chemical species, such as atomic oxygen in Earth orbit. Such species cause erosion of (not only) propulsion system components, i.e. acceleration grids, electrodes, and discharge channels of conventional EP systems. IRS is developing within the DISCOVERER project, an intake and a thruster for an ABEP system. The paper describes the design and implementation of the RF helicon-based inductive plasma thruster (IPT). This paper deals in particular with the design and implementation of a novel antenna called the birdcage antenna, a device well known in magnetic resonance imaging (MRI), and also lately employed for helicon-wave based plasma sources in fusion research. This is aided by the numerical tool XFdtd®. The IPT is based on RF electrodeless operation aided by an externally applied static magnetic field. The IPT is composed by an antenna, a discharge channel, a movable injector, and a solenoid. By changing the operational parameters along with the novel antenna design, the aim is to minimize losses in the RF circuit, and accelerate a quasi-neutral plasma plume. This is also to be aided by the formation of helicon waves within the plasma that are to improve the overall efficiency and achieve higher exhaust velocities. Finally, the designed IPT with a particular focus on the birdcage antenna design procedure is presented

Transposition of the great arteries and aortopulmonary window in the same patient: Clinical report and follow-up

Trasnposition of great arteries (TGA) Has been reported in combination with several congenital defects. Only one case of TGA has been described in association with aortopulmonary window (APW)

Early precursors of low attention and hyperactivity in children born late and very preterm at preschool age

Moderately preterm birth seems to be an evolutional risk condition at cognitive, behavioural and socio-relational levels. The study is aimed to investigate the likely occurrence of precursors of Attention Deficit Hyperactivity Disorder (ADHD) in moderately preterm children at preschool age. The research involved an experimental group made up of 50 moderately preterm children (mean: 34.6 weeks’ gestational age, standard deviation [SD]: 2) without any medical and neurologic neonatal complications and low birth weight (mean:2100g., SD: 350g.) and a check group of 50 full term born children. Parents and teachers of children were administered specific questionnaires to detect ADHD. The outcomes show a risk of ADHD highlighting statically significant differences related to gender [F(2, 99) = 2.99, p = .04], birth [F(2, 99) = 9.6, p = .03] and interaction [F(2, 99) = 2.2, p = .01]. The moderately preterm children showed deficit in self-regulation [F(2, 99) = 1.14, p = .04] and attention deficit in daily life both in family [F(2, 99) = 7.8, p = .04] and school contexts [F(1, 99) = 3.3, p = .04]. The outcomes hint assessment paths aimed to monitor the aspects of cognitive, motor, behavioural development of moderately preterm children recognised as signs of problematic functioning profiles. Therefore, specific training will have been designed since preschool age in order to control the ADHD risk factors