IoT-based air quality monitoring systems for smart cities: A systematic mapping study

The increased level of air pollution in big cities has become a major concern for several organizations and authorities because of the risk it represents to human health. In this context, the technology has become a very useful tool in the contamination monitoring and the possible mitigation of its impact. Particularly, there are different proposals using the internet of things (IoT) paradigm that use interconnected sensors in order to measure different pollutants. In this paper, we develop a systematic mapping study defined by a five-step methodology to identify and analyze the research status in terms of IoT-based air pollution monitoring systems for smart cities. The study includes 55 proposals, some of which have been implemented in a real environment. We analyze and compare these proposals in terms of different parameters defined in the mapping and highlight some challenges for air quality monitoring systems implementation into the smart city context

Cucumis metuliferus is resistant to root-knot nematode Mi1.2 gene (a)virulent populations and a promising melon rootstock

[EN] Pot experiments were carried out to characterize the response of two Cucumis metuliferus accessions against (a)virulent Meloidogyne arenaria, M. incognita or M. javanica populations, to Mi1.2 gene and to determine the compatibility and the effect on physicochemical properties of cantaloupe melon. In addition, histopathological studies were conducted. Plants were inoculated in 200 cm3 -pots with 1 J2 cm-3 24 of soil containing sterilized sand a week after transplanting and maintained in a growth chamber at 25 ºC for 40 days. The susceptible cucumber cv. Dasher II or melon cv. Paloma were included for comparison. The number of egg masses and number of eggs per plant were assessed, and the reproduction index (RI) was calculated as the percentage of eggs produced on the C. metuliferus accessions respect those produced on the susceptible cultivars. The compatibility and fruit quality was assessed grafting three scions (two of Charentais type) and one of type Piel de Sapo under commercial greenhouse conditions. The resistance level of both C. metuliferus accessions ranged from highly (RI < 1%) to resistant (1% ¿RI ¿ 10%) irrespective of Meloidogyne populations. Melon plants grafted onto C. metuliferus accession BGV11135 grew as selfgrafted plants and did not modify negatively fruit quality traits. Giant cells induced by RKN on C. metuliferus were mostly poor developed compared to those on cucumber. Furthermore, necrotic areas surrounding the nematode were observed. C. metuliferus accession BGV11135 could be a promising melon rootstock to manage Meloidogyne spp. irrespective of its (a)virulent Mi1.2 condition without melon fruit quality reduction.This work was supported by AGL2013-49040-C2-1-R, and AGL2014-53398-C2-2-R projects from the Spanish Ministry of Economy, Industry and Competitiveness, and cofounded with FEDER Funds. The authors would like to thank Semillas Fito for providing melon cv. Paloma, Dr Christine Vos (Scientia Terrae Research Institute) for her English revision and critical comments of the manuscript and Dr Nuria Escudero (Universitat Politecnica de Catalunya) for her support and critical comments on the manuscript.Expósito, A.; Munera, M.; Giné, A.; López Gómez, M.; Cáceres-Burbano, A.; Picó Sirvent, MB.; Gisbert Domenech, MC.... (2018). Cucumis metuliferus is resistant to root-knot nematode Mi1.2 gene (a)virulent populations and a promising melon rootstock. Plant Pathology. 67:1161-1167. https://doi.org/10.1111/ppa.12815S1161116767Cortada, L., Sorribas, F. J., Ornat, C., Kaloshian, I., & Verdejo-Lucas, S. (2008). Variability in infection and reproduction ofMeloidogyne javanicaon tomato rootstocks with theMiresistance gene. Plant Pathology, 57(6), 1125-1135. doi:10.1111/j.1365-3059.2008.01906.xDavis, A. R., Perkins-Veazie, P., Hassell, R., Levi, A., King, S. R., & Zhang, X. (2008). Grafting Effects on Vegetable Quality. HortScience, 43(6), 1670-1672. doi:10.21273/hortsci.43.6.1670Devran, Z., & Söğüt, M. A. (2010). Occurrence of virulent root-knot nematode populations on tomatoes bearing the Mi gene in protected vegetable-growing areas of Turkey. Phytoparasitica, 38(3), 245-251. doi:10.1007/s12600-010-0103-yDjian-Caporalino, C., Palloix, A., Fazari, A., Marteu, N., Barbary, A., Abad, P., … Castagnone-Sereno, P. (2014). Pyramiding, alternating or mixing: comparative performances of deployment strategies of nematode resistance genes to promote plant resistance efficiency and durability. BMC Plant Biology, 14(1), 53. doi:10.1186/1471-2229-14-53Giné, A., & Sorribas, F. J. (2016). Effect of plant resistance and BioAct WG (Purpureocillium lilacinumstrain 251) onMeloidogyne incognitain a tomato-cucumber rotation in a greenhouse. Pest Management Science, 73(5), 880-887. doi:10.1002/ps.4357Giné, A., & Sorribas, F. J. (2017). Quantitative approach for the early detection of selection for virulence of Meloidogyne incognita on resistant tomato in plastic greenhouses. Plant Pathology, 66(8), 1338-1344. doi:10.1111/ppa.12679Giné, A., López-Gómez, M., Vela, M. D., Ornat, C., Talavera, M., Verdejo-Lucas, S., & Sorribas, F. J. (2014). Thermal requirements and population dynamics of root-knot nematodes on cucumber and yield losses under protected cultivation. Plant Pathology, 63(6), 1446-1453. doi:10.1111/ppa.12217Giné, A., González, C., Serrano, L., & Sorribas, F. J. (2017). Population dynamics of Meloidogyne incognita on cucumber grafted onto the Cucurbita hybrid RS841 or ungrafted and yield losses under protected cultivation. European Journal of Plant Pathology, 148(4), 795-805. doi:10.1007/s10658-016-1135-zGisbert C Sorribas FJ Martínez EM Gammoudi N Bernat G Picó B 2014 Grafting melons onto potential Cucumis spp. rootstocks http://upcommons.upc.edu/bitstream/handle/2117/27982/Grafting%20melons.pdf?sequence=1Gisbert, C., Gammoudi, N., Munera, M., Giné, A., Pocurull, M., Sorribas, F. J., & Picó, M. B. (2017). Evaluation of two potentialCucumisspp. resources for grafting melons. Acta Horticulturae, (1151), 157-162. doi:10.17660/actahortic.2017.1151.25Guan, W., Zhao, X., Dickson, D. W., Mendes, M. L., & Thies, J. (2014). Root-knot Nematode Resistance, Yield, and Fruit Quality of Specialty Melons Grafted onto Cucumis metulifer. HortScience, 49(8), 1046-1051. doi:10.21273/hortsci.49.8.1046Hadisoeganda, W. W. (1982). Resistance of Tomato, Bean, Southern Pea, and Garden Pea Cultivars to Root-Knot Nematodes Based on Host Suitability. Plant Disease, 66(1), 145. doi:10.1094/pd-66-145Lee, J.-M., & Oda, M. (2010). Grafting of Herbaceous Vegetable and Ornamental Crops. Horticultural Reviews, 61-124. doi:10.1002/9780470650851.ch2Leonardi, C., Kyriacou, M. C., Gisbert, C., Oztekin, G. B., Mourão, I., & Rouphael, Y. (s. f.). Quality of grafted vegetables. Vegetable grafting: principles and practices, 216-244. doi:10.1079/9781780648972.0216Liu, B., Ren, J., Zhang, Y., An, J., Chen, M., Chen, H., … Ren, H. (2014). A new grafted rootstock against root-knot nematode for cucumber, melon, and watermelon. Agronomy for Sustainable Development, 35(1), 251-259. doi:10.1007/s13593-014-0234-5López-Gómez, M., Gine, A., Vela, M. D., Ornat, C., Sorribas, F. J., Talavera, M., & Verdejo-Lucas, S. (2014). Damage functions and thermal requirements ofMeloidogyne javanicaandMeloidogyne incognitaon watermelon. Annals of Applied Biology, 165(3), 466-473. doi:10.1111/aab.12154López-Gómez, M., Flor-Peregrín, E., Talavera, M., Sorribas, F. J., & Verdejo-Lucas, S. (2015). Population dynamics of Meloidogyne javanica and its relationship with the leaf chlorophyll content in zucchini. Crop Protection, 70, 8-14. doi:10.1016/j.cropro.2014.12.015López-Gómez, M., Talavera, M., & Verdejo-Lucas, S. (2015). Differential reproduction ofMeloidogyne incognitaandM. javanicain watermelon cultivars and cucurbit rootstocks. Plant Pathology, 65(1), 145-153. doi:10.1111/ppa.12394Omwega, C. O. (1988). A Nondestructive Technique for Screening Bean Germ Plasm for Resistance to Meloidogyne incognita. Plant Disease, 72(11), 970. doi:10.1094/pd-72-0970Ornat, C., Verdejo-Lucas, S., & Sorribas, F. J. (2001). A Population of Meloidogyne javanica in Spain Virulent to the Mi Resistance Gene in Tomato. Plant Disease, 85(3), 271-276. doi:10.1094/pdis.2001.85.3.271Seinhorst, J. W. (1965). The Relation Between Nematode Density and Damage To Plants. Nematologica, 11(1), 137-154. doi:10.1163/187529265x00582Sikora, R. A., & Fernández, E. (s. f.). Nematode parasites of vegetables. Plant parasitic nematodes in subtropical and tropical agriculture, 319-392. doi:10.1079/9780851997278.0319Sorribas, F. J., Ornat, C., Verdejo-Lucas, S., Galeano, M., & Valero, J. (2005). Effectiveness and profitability of the Mi-resistant tomatoes to control root-knot nematodes. European Journal of Plant Pathology, 111(1), 29-38. doi:10.1007/s10658-004-1982-xSoteriou, G. A., Kyriacou, M. C., Siomos, A. S., & Gerasopoulos, D. (2014). Evolution of watermelon fruit physicochemical and phytochemical composition during ripening as affected by grafting. Food Chemistry, 165, 282-289. doi:10.1016/j.foodchem.2014.04.120Talavera, M., Verdejo-Lucas, S., Ornat, C., Torres, J., Vela, M. D., Macias, F. J., … Sorribas, F. J. (2009). Crop rotations with Mi gene resistant and susceptible tomato cultivars for management of root-knot nematodes in plastic houses. Crop Protection, 28(8), 662-667. doi:10.1016/j.cropro.2009.03.015Talavera, M., Sayadi, S., Chirosa-Ríos, M., Salmerón, T., Flor-Peregrín, E., & Verdejo-Lucas, S. (2012). Perception of the impact of root-knot nematode-induced diseases in horticultural protected crops of south-eastern Spain. Nematology, 14(5), 517-527. doi:10.1163/156854112x635850Thies, J. A., Ariss, J. J., Hassell, R. L., Olson, S., Kousik, C. S., & Levi, A. (2010). Grafting for Management of Southern Root-Knot Nematode, Meloidogyne incognita, in Watermelon. Plant Disease, 94(10), 1195-1199. doi:10.1094/pdis-09-09-0640Trionfetti Nisini, P., Colla, G., Granati, E., Temperini, O., Crinò, P., & Saccardo, F. (2002). Rootstock resistance to fusarium wilt and effect on fruit yield and quality of two muskmelon cultivars. Scientia Horticulturae, 93(3-4), 281-288. doi:10.1016/s0304-4238(01)00335-1Tzortzakakis, E. A., Adam, M. A. M., Blok, V. C., Paraskevopoulos, C., & Bourtzis, K. (2005). Occurrence of Resistance-breaking Populations of Root-knot Nematodes on Tomato in Greece. European Journal of Plant Pathology, 113(1), 101-105. doi:10.1007/s10658-005-1228-6Verdejo-Lucas, S., Cortada, L., Sorribas, F. J., & Ornat, C. (2009). Selection of virulent populations ofMeloidogyne javanicaby repeated cultivation ofMiresistance gene tomato rootstocks under field conditions. Plant Pathology, 58(5), 990-998. doi:10.1111/j.1365-3059.2009.02089.xVerdejo-Lucas, S., Talavera, M., & Andrés, M. F. (2012). Virulence response to the Mi.1 gene of Meloidogyne populations from tomato in greenhouses. Crop Protection, 39, 97-105. doi:10.1016/j.cropro.2012.03.025WHITEHEAD, A. G., & HEMMING, J. R. (1965). A comparison of some quantitative methods of extracting small vermiform nematodes from soil. Annals of Applied Biology, 55(1), 25-38. doi:10.1111/j.1744-7348.1965.tb07864.xYe, D.-Y., Qi, Y.-H., Cao, S.-F., Wei, B.-Q., & Zhang, H.-S. (2017). Histopathology combined with transcriptome analyses reveals the mechanism of resistance to Meloidogyne incognita in Cucumis metuliferus. Journal of Plant Physiology, 212, 115-124. doi:10.1016/j.jplph.2017.02.002Donkers-Venne, D. T. H. M., Fargette, M., & Zijlstra, C. (2000). Identification of Meloidogyne incognita, M. javanica and M. arenaria using sequence characterised amplified region (SCAR) based PCR assays. Nematology, 2(8), 847-853. doi:10.1163/15685410075011279

Engineering the Controlled Assembly of Filamentous Injectisomes in E. coli K-12 for Protein Translocation into Mammalian Cells.

Bacterial pathogens containing type III protein secretion systems (T3SS) assemble large needle-like protein complexes in the bacterial envelope, called injectisomes, for translocation of protein effectors into host cells. The application of these molecular syringes for the injection of proteins into mammalian cells is hindered by their structural and genomic complexity, requiring multiple polypeptides encoded along with effectors in various transcriptional units (TUs) with intricate regulation. In this work, we have rationally designed the controlled expression of the filamentous injectisomes found in enteropathogenic Escherichia coli (EPEC) in the nonpathogenic strain E. coli K-12. All structural components of EPEC injectisomes, encoded in a genomic island called the locus of enterocyte effacement (LEE), were engineered in five TUs (eLEEs) excluding effectors, promoters and transcriptional regulators. These eLEEs were placed under the control of the IPTG-inducible promoter Ptac and integrated into specific chromosomal sites of E. coli K-12 using a marker-less strategy. The resulting strain, named synthetic injector E. coli (SIEC), assembles filamentous injectisomes similar to those in EPEC. SIEC injectisomes form pores in the host plasma membrane and are able to translocate T3-substrate proteins (e.g., translocated intimin receptor, Tir) into the cytoplasm of HeLa cells reproducing the phenotypes of intimate attachment and polymerization of actin-pedestals elicited by EPEC bacteria. Hence, SIEC strain allows the controlled expression of functional filamentous injectisomes for efficient translocation of proteins with T3S-signals into mammalian cells

Extending MAM5 Meta-Model and JaCalIVE Framework to Integrate Smart Devices from Real Environments

[EN] This paper presents the extension of a meta-model (MAM5) and a framework based on the model (JaCalIVE) for developing intelligent virtual environments. The goal of this extension is to develop augmented mirror worlds that represent a real and virtual world coupled, so that the virtual world not only reflects the real one, but also complements it. A new component called a smart resource artifact, that enables modelling and developing devices to access the real physical world, and a human in the loop agent to place a human in the system have been included in the meta-model and framework. The proposed extension of MAM5 has been tested by simulating a light control system where agents can access both virtual and real sensor/actuators through the smart resources developed. The results show that the use of real environment interactive elements (smart resource artifacts) in agent-based simulations allows to minimize the error between simulated and real system.This work is partially supported by the TIN2009-13839-C03-01, TIN2011-27652-C03-01, 547CSD2007-00022, COST Action IC0801, FP7-294931 and the FPI grant AP2013-01276 548 awarded to Jaime-Andres Rincon.Rincón Arango, JA.; Poza Luján, JL.; Julian Inglada, VJ.; Posadas Yagüe, JL.; Carrascosa Casamayor, C. (2016). Extending MAM5 Meta-Model and JaCalIVE Framework to Integrate Smart Devices from Real Environments. PLoS ONE. 11(2):1-27. https://doi.org/10.1371/journal.pone.0149665S127112Luck, M., & Aylett, R. (2000). Applying artificial intelligence to virtual reality: Intelligent virtual environments. Applied Artificial Intelligence, 14(1), 3-32. doi:10.1080/088395100117142Barella A, Ricci A, Boissier O, Carrascosa C. MAM5: Multi-Agent Model For Intelligent Virtual Environments. In: 10th European Workshop on Multi-Agent Systems (EUMAS 2012); 2012. p. 16–30.Omicini, A., Ricci, A., & Viroli, M. (2008). Artifacts in the A&A meta-model for multi-agent systems. Autonomous Agents and Multi-Agent Systems, 17(3), 432-456. doi:10.1007/s10458-008-9053-xYu Ch, Nagpal R. Distributed Consensus and Self-Adapting Modular Robots. In: IROS-2008 workshop on Self-Reconfigurable Robots and Applications; 2008. Available from: http://www.isi.edu/robots/iros08wksp/Papers/iros08-wksp-paper.pdfLidoris G, Buss M. A Multi-Agent System Architecture for Modular Robotic Mobility Aids. In: European Robotics Symposium 2006; 2006. p. 15–26. Available from: http://link.springer.com/chapter/10.1007/11681120_2Yu, C.-H., & Nagpal, R. (2010). A Self-adaptive Framework for Modular Robots in a Dynamic Environment: Theory and Applications. The International Journal of Robotics Research, 30(8), 1015-1036. doi:10.1177/0278364910384753Barbero A, González-Rodríguez MS, de Lara J, Alfonseca M. Multi-Agent Simulation of an Educational Collaborative Web System. In: European Simulation and Modelling Conference; 2007. Available from: http://sistemas-humano-computacionais.wikidot.com/local--files/capitulo:colaboracao-auxiliada-por-computador/%5BBarbero%202007%5D%20Multi-Agent%20Simulation%20of%20an%20Educational%20Collaborative%20Web%20System.pdfRanathunga S, Cranefield S, Purvis MK. Interfacing a cognitive agent platform with a virtual world: a case study using Second Life. In: AAMAS; 2011. p. 1181–1182. Available from: http://www.aamas-conference.org/Proceedings/aamas2011/papers/B20.pdfAndreoli R, De Chiara R, Erra U, Scarano V. Interactive 3d environments by using videogame engines. In: Information Visualisation, 2005. Proceedings. Ninth International Conference on. IEEE; 2005. p. 515–520. Available from: http://ieeexplore.ieee.org/xpls/abs_all.jsp?arnumber=1509124Dignum, F. (2011). Agents for games and simulations. Autonomous Agents and Multi-Agent Systems, 24(2), 217-220. doi:10.1007/s10458-011-9169-2dos Santos C, Osorio F. AdapTIVE: an intelligent virtual environment and its application in e-commerce. In: Computer Software and Applications Conference, 2004. COMPSAC 2004. Proceedings of the 28th Annual International; 2004. p. 468–473 vol.1.Kazemi, A., Fazel Zarandi, M. H., & Moattar Husseini, S. M. (2008). A multi-agent system to solve the production–distribution planning problem for a supply chain: a genetic algorithm approach. The International Journal of Advanced Manufacturing Technology, 44(1-2), 180-193. doi:10.1007/s00170-008-1826-5Dimuro GP, Costa ACdR, Gonçalves LV, Hubner A. Interval-valued Hidden Markov Models for recognizing personality traits in social exchanges in open multiagent systems. Repositório Institucional da Universidade Federal do Rio Grande. 2008;.Woźniak, M., Graña, M., & Corchado, E. (2014). A survey of multiple classifier systems as hybrid systems. Information Fusion, 16, 3-17. doi:10.1016/j.inffus.2013.04.006Jia L, Zhenjiang M. Entertainment Oriented Intelligent Virtual Environment with Agent and Neural Networks. In: IEEE International Workshop on Haptic, Audio and Visual Environments and Games, 2007. HAVE 2007; 2007. p. 90–95.Corchado, E., Woźniak, M., Abraham, A., de Carvalho, A. C. P. L. F., & Snášel, V. (2014). Recent trends in intelligent data analysis. Neurocomputing, 126, 1-2. doi:10.1016/j.neucom.2013.07.001Ricci A, Viroli M, Omicini A. Give agents their artifacts: the A&amp;A approach for engineering working environments in MAS. In: Proceedings of the 6th international joint conference on Autonomous agents and multiagent systems; 2007. p. 150. Available from: http://dl.acm.org/citation.cfm?id=1329308Barella, A., Valero, S., & Carrascosa, C. (2009). JGOMAS: New Approach to AI Teaching. IEEE Transactions on Education, 52(2), 228-235. doi:10.1109/te.2008.925764Behrens, T. M., Hindriks, K. V., & Dix, J. (2010). Towards an environment interface standard for agent platforms. Annals of Mathematics and Artificial Intelligence, 61(4), 261-295. doi:10.1007/s10472-010-9215-9Ricci A, Viroli M, Omicini A. A general purpose programming model &amp; technology for developing working environments in MAS. In: 5th International Workshop Programming Multi-Agent Systems(PROMAS 2007); 2007. p. 54–69. Available from: http://lia.deis.unibo.it/~ao/pubs/pdf/2007/promas.pdfChee-Yee Chong, & Kumar, S. P. (2003). Sensor networks: Evolution, opportunities, and challenges. Proceedings of the IEEE, 91(8), 1247-1256. doi:10.1109/jproc.2003.814918Kushner D. The making of arduino. IEEE Spectrum. 2011;26.Schmidt, A., & van Laerhoven, K. (2001). How to build smart appliances? IEEE Personal Communications, 8(4), 66-71. doi:10.1109/98.944006Salzmann C, Gillet D. Smart device paradigm standardization for online labs. In: 4th IEEE Global Engineering Education Conference (EDUCON); 2013.Gonzalez-Jorge, H., Riveiro, B., Vazquez-Fernandez, E., Martínez-Sánchez, J., & Arias, P. (2013). Metrological evaluation of Microsoft Kinect and Asus Xtion sensors. Measurement, 46(6), 1800-1806. doi:10.1016/j.measurement.2013.01.011Cook, D. J., & Das, S. K. (2007). How smart are our environments? An updated look at the state of the art. Pervasive and Mobile Computing, 3(2), 53-73. doi:10.1016/j.pmcj.2006.12.001Compton, M., Barnaghi, P., Bermudez, L., García-Castro, R., Corcho, O., Cox, S., … Taylor, K. (2012). The SSN ontology of the W3C semantic sensor network incubator group. Journal of Web Semantics, 17, 25-32. doi:10.1016/j.websem.2012.05.003Munera, E., Poza-Lujan, J.-L., Posadas-Yagüe, J.-L., Simó-Ten, J.-E., & Noguera, J. (2015). Dynamic Reconfiguration of a RGBD Sensor Based on QoS and QoC Requirements in Distributed Systems. Sensors, 15(8), 18080-18101. doi:10.3390/s150818080Castrillón-Santan, M., Lorenzo-Navarro, J., & Hernández-Sosa, D. (2014). Conteo de personas con un sensor RGBD comercial. Revista Iberoamericana de Automática e Informática Industrial RIAI, 11(3), 348-357. doi:10.1016/j.riai.2014.05.006Rincon JA, Julian V, Carrascosa C. An Emotional-based Hybrid Application for Human-Agent Societies. In: 10th International Conference on Soft Computing Models in Industrial and Environmental Applications. vol. 368; 2015. p. 203–214.Rincon JA, Julian V, Carrascosa C. Applying a Social Emotional Model in Human-Agent Societies. In: Workshop WIHAS’15. Intelligent Human-Agent Societies‥ vol. 524 of CCIS; 2015. p. 377–388.Leccese, F., Cagnetti, M., & Trinca, D. (2014). A Smart City Application: A Fully Controlled Street Lighting Isle Based on Raspberry-Pi Card, a ZigBee Sensor Network and WiMAX. Sensors, 14(12), 24408-24424. doi:10.3390/s141224408Mateevitsi V, Haggadone B, Leigh J, Kunzer B, Kenyon RV. Sensing the environment through SpiderSense. In: Proceedings of the 4th Augmented Human International Conference. ACM; 2013. p. 51–57.Kavitha R, Thiyagarajan N. Distributed Intelligent Street Lamp Monitoring and Control System Based on Zigbee. International Journal of Science and Research (IJSR) PP; p. 2319–7064.Pan, M.-S., Yeh, L.-W., Chen, Y.-A., Lin, Y.-H., & Tseng, Y.-C. (2008). A WSN-Based Intelligent Light Control System Considering User Activities and Profiles. IEEE Sensors Journal, 8(10), 1710-1721. doi:10.1109/jsen.2008.2004294Villarrubia, G., De Paz, J., Bajo, J., & Corchado, J. (2014). Ambient Agents: Embedded Agents for Remote Control and Monitoring Using the PANGEA Platform. Sensors, 14(8), 13955-13979. doi:10.3390/s14081395

Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone