Perioperative and anesthetic deaths: toxicological and medico legal aspects

Background: Anesthesia has become safer during decades, though there is still a preventable mortality; the complexity of medical and surgical interventions, increasingly older and sicker patients, has created a host of new hazards in anesthesiology. In this paper, some of these perioperative (PO) fatal adverse events are investigated in terms of health responsibility. Selective literature research in several data bases, concerning perioperative and anesthetic deaths and medical responsibility, was performed. Main text: A generally accepted definition of the anesthesia and perioperatory-related death still remains one of the major concerns in forensic pathology, and the terms “operative deaths” and “anesthetic deaths” are usually applied inaccurately within the medico-legal literature. Such events involve comprehensively PO fatalities and allow for subtle separation of natural and unnatural death, at least from the prospective of forensic pathology. Iatrogenic deaths in this field can be separated into some major categories, as attributable to previous patient’s unfavorable conditions or depending from surgical procedure per se (such as PO cardiac and cerebrovascular events). In this review, the authors carried out syntheses of specific research areas regarding epidemiology, complications of general and spinal anesthetic, failure in airway management and patient’s circulatory homeostasis, and adverse drugs reactions; analysis considering the challenge of anesthetic-related mortality, epidemiology and classifications, by indicating causal chain of death, in respect of both contributing and associated anesthetic and surgery facts. Conclusions: Perioperative quality control programs and its relevance for medico-legal evaluation are emphasized as, although mortality rates have decreased worldwide over the last decades, however, preventable drug-related deaths still happen. Such fatal events have to be considered within the field of forensic pathology experts, with regard of malpractice claims, to implement a strategy for preventing potentially fatal complications

Management of Parkia biglobosa in the field of farmers in selected sites in Burkina Faso

Parkia biglobosa is ranked as one of the most important agroforestry multipurpose tree species in Sahelo-Sudanian zone. The National Tree Seed Center (CNSF) of Burkina Faso has been involved in a breeding programme of this species for many years and has already conducted several research activities (eg. germplasm collection, provenance trials establishment, selection of the best promising trees for propagation). To better conserve and guide the breeding program, it is important to understand how farmers perceive and manage the species in their fields. A survey was conducted in two villages in southern Burkina Faso to describe the farmers' practices with regard to encouraging regeneration of tree species in their fields, with a special emphasis on Parkia biglobosa. The survey targeted 150 people categorised by gender, ethnic group and status of residence. The results show that Parkia biglobosa is the most appreciated indigenous species across ethnic and gender groups. Its maintenance in the landscape is favoured by both the protection of spontaneous regeneration by farmers when they clear the land for agriculture, and by active planting. The species is valued both for its commercial use and human consumption in the household. The survey indicated a significant difference in the practices undertaken by women and men to safeguard regeneration. With regard to the preferred traits of Parkia biglobosa individuals, also some differences between genders emerge. The level of appreciation shown by farmers for Parkia biglobosa and the indications about what traits are most preferred are useful guidance in the identification of optimal sources of reproductive material to be made available to farmers through different channels. The results also indicated the need to couple the analyses of farmers' perception of trait variation among individuals with a systematic morphological characterisation of the various morphological types identified

Heavy metal removal from aqueous solutions by sorption using natural clays from Burkina Faso

The acid-base properties of two raw and purified mixed clays from Burkina Faso were studied, as well as their potential to remove copper(II), lead(II) and chromium(III), and thereby their ability to be used to purify water from heavy metals. The purification procedure of the clays involved removal of carbonates, iron oxides and organic matter. A determination of the elemental composition of the mixed clays revealed the presence of aluminum, iron and silicon as main constituents. The high alkaline pH in one of the samples is attributable to the presence of carbonate in the raw clay. The point of zero charge (pHpzc) values of the clays, as determined by potentiometric titrations, were 6.79 and 9.52 for the raw clays, while after purification they were 6.87 and 6.76, respectively. Metal adsorption to the clay surfaces started at pH values below pHpzc, strongly indicating formation of inner-sphere complexes. With contact time of 48 h, complete removal of copper(II) was achieved at pH 8 for all samples. More than 90% of the lead(II) removal was attributed to adsorption while for chromium(III), it was 85%. Adsorption to organic matter and iron oxides, and precipitation of metal hydroxides gave significant contributions to the removal of metal ions in aqueous systems.Key words: Mixed clays, potentiometric titration, heavy metals, pHpzc

EuroGammaS gamma characterisation system for ELI-NP-GBS: The nuclear resonance scattering technique

A Gamma Beam Characterisation System has been designed by the EuroGammaS association for thecommissioning and development of the Extreme Light Infrastructure-Nuclear Physics Gamma Beam System(ELI-NP-GBS) to be installed in Magurele, Romania. The characterisation system consists of four elements: aCompton spectrometer, a sampling calorimeter, a nuclear resonant scattering spectrometer (NRSS) and a beamprofile imager. In this paper, the nuclear resonant scattering spectrometer system, designed to perform anabsolute energy calibration for the gamma beam, will be describe

Solar cycle variation of the statistical distribution of the solar wind ε parameter and its constituent variables

We use 20 years of Wind solar wind observations to investigate the solar cycle variation of the solar wind driving of the magnetosphere. For the first time, we use generalized quantile-quantile plots to compare the statistical distribution of four commonly used solar wind coupling parameters, Poynting flux, B 2, the ε parameter, and vB ,between the maxima and minima of solar cycles 23 and 24. We find the distribution is multicomponent and has the same functional form at all solar cycle phases; the change in distribution is captured by a simple transformation of variables for each component. The ε parameter is less sensitive than its constituent variables to changes in the distribution of extreme values between successive solar maxima. The quiet minimum of cycle 23 manifests only in lower extreme values, while cycle 24 was less active across the full distribution range

Epidemiology of Coxiella burnetii infection in Africa: a OneHealth systematic review

Background: Q fever is a common cause of febrile illness and community-acquired pneumonia in resource-limited settings. Coxiella burnetii, the causative pathogen, is transmitted among varied host species, but the epidemiology of the organism in Africa is poorly understood. We conducted a systematic review of C. burnetii epidemiology in Africa from a “One Health” perspective to synthesize the published data and identify knowledge gaps.<p></p> Methods/Principal Findings: We searched nine databases to identify articles relevant to four key aspects of C. burnetii epidemiology in human and animal populations in Africa: infection prevalence; disease incidence; transmission risk factors; and infection control efforts. We identified 929 unique articles, 100 of which remained after full-text review. Of these, 41 articles describing 51 studies qualified for data extraction. Animal seroprevalence studies revealed infection by C. burnetii (≤13%) among cattle except for studies in Western and Middle Africa (18–55%). Small ruminant seroprevalence ranged from 11–33%. Human seroprevalence was <8% with the exception of studies among children and in Egypt (10–32%). Close contact with camels and rural residence were associated with increased seropositivity among humans. C. burnetii infection has been associated with livestock abortion. In human cohort studies, Q fever accounted for 2–9% of febrile illness hospitalizations and 1–3% of infective endocarditis cases. We found no studies of disease incidence estimates or disease control efforts.<p></p> Conclusions/Significance: C. burnetii infection is detected in humans and in a wide range of animal species across Africa, but seroprevalence varies widely by species and location. Risk factors underlying this variability are poorly understood as is the role of C. burnetii in livestock abortion. Q fever consistently accounts for a notable proportion of undifferentiated human febrile illness and infective endocarditis in cohort studies, but incidence estimates are lacking. C. burnetii presents a real yet underappreciated threat to human and animal health throughout Africa.<p></p&gt

Climate adaptation and agriculture: Solutions to successful national adaptation plans

The purpose of this brief is to share insights on agriculture and NAPs with national-level decision makers in developing countries and Least Developed Countries (LDCs), multilateral agencies, UNFCCC negotiators and donors. This brief explores how countries are overcoming the biggest challenges in developing NAPs, outlines examples of successful cross-sector adaptation planning, explores influence and leverage necessary for successful NAP processes, and offers specific recommendations