161 research outputs found

    Annual and seasonal grid-point cloud cover anomaly series over Italy (1951-2018)

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    These datasets contain annual and seasonal anomaly series of total cloud cover over Italy. The anomaly series are expressed as additive anomalies with respect to the period 1961-1990. The series are gridded series with a resolution of 1¬į √ó 1¬į. They are obtained interpolating by means of an Inverse Distance Weighting approach a quality-checked and homogenized dataset of human observations of total cloud cover series over the 1951-2018 period and referred to 12 UTC

    Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

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    Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10‚Äą232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77¬∑1%) patients underwent at least one separation attempt and 3817 (65¬∑0%) patients were successfully weaned from ventilation at day 90. 237 (4¬∑0%) patients were transferred before any separation attempt, 153 (2¬∑6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28¬∑3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22¬∑4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77¬∑1%) patients with separation attempts, 2927 (64¬∑7%) had a short wean (‚ȧ1 day), 457 (10¬∑1%) had intermediate weaning (2-6 days), 433 (9¬∑6%) required prolonged weaning (‚Č•7 days), and 706 (15¬∑6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31¬∑8%) of 5479 patients died in the intensive care unit and 2095 (38¬∑3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

    Measurement of the

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    Neutron cross section measurements are often made relative to a neutron cross section standard. Thus, the accuracy of the neutron standards determines the best possible accuracy of the neutron measurements. The 235U(n,f) cross section is widely used as reference, while it is considered a standard at thermal point and between 0.15 to 200 MeV. For this reason, additional cross section data for the 235U(n,f) reaction are useful in order to improve the accuracy and to extend the energy range of the standard. In this work, preliminary results of the measurement of the 235U(n,f) cross-section relative to the standard 10B(n,a) reaction are presented. The high accuracy measurement was performed at the experimental area EAR-1 of the n_TOF facility at CERN, aiming at covering the energy range from the thermal region up to approximately 100 keV. The samples were produced at JRC-Geel in Belgium, while the experimental setup was based on Micromegas detectors

    Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

    No full text
    Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10‚Äą232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77¬∑1%) patients underwent at least one separation attempt and 3817 (65¬∑0%) patients were successfully weaned from ventilation at day 90. 237 (4¬∑0%) patients were transferred before any separation attempt, 153 (2¬∑6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28¬∑3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0‚Äď4), and 1013 (22¬∑4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77¬∑1%) patients with separation attempts, 2927 (64¬∑7%) had a short wean (‚ȧ1 day), 457 (10¬∑1%) had intermediate weaning (2‚Äď6 days), 433 (9¬∑6%) required prolonged weaning (‚Č•7 days), and 706 (15¬∑6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31¬∑8%) of 5479 patients died in the intensive care unit and 2095 (38¬∑3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

    Unprecedented snow-drought conditions in the Italian Alps during the early 2020s

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    Snow represents a fundamental water resource for mountain and lowland areas. Changes in the frequency and magnitude of snow droughts can significantly impact societies and ecosystems that rely on snowmelt to satisfy their water demands. Here we documented and quantified the snow drought that affected the Italian Alps during the early 2020s. We used 15 long-term snow-depth series (period 1930‚Äď2023, elevation range: 864‚Äď2200 m a.s.l.) to simulate the snow water equivalent (SWE), in conjunction with climatic reanalysis data and river discharge observations. We found that the March SWE anomaly in 2022 reached the lowest value in the last century, due to an unprecedented combination of drier- and warmer-than-normal conditions in the period December 2021‚ÄďMarch 2022. This event contributed to causing critical hydrological conditions in the Po and Adige rivers which, during summer 2022, experienced the worst hydrological drought ever recorded. Despite its unprecedented magnitude, the snow drought in 2022 is part of a recent pattern of increased intensity and frequency of snow-drought events since the 1990s, due to the combined increasing occurrence of warmer- and drier-than-normal climatic conditions during the snow season. Remarkably, three out of the five most severe snow-drought events occurred in the last five years, with exceptional snow-drought conditions even occurring in the last two consecutive winters, 2022 and 2023. The snow-drought conditions that occurred in the early 2020s in the Italian Alps warn of the pressing need for the implementation of impact mitigation measures to adapt to the fast changing snow and climatic conditions
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