Background/Objectives: Heart failure (HF) is a chronic disease with a steadily increasing prevalence, high mortality, social and economic costs. Furthermore, every hospitalisation for acute HF is associated with worsening prognosis and reduced life expectancy. In order to prevent hospitalisations, it would be useful to have instruments that can predict them well in advance. Methods: We performed a review on remote monitoring of heart failure through implantable devices.; Results: Precise multi-parameter algorithms, available for ICD and CRT-D patients, have been created, which also use artificial intelligence and are able to predict a new heart failure event more than 30 days in advance. There are also implantable pulmonary artery devices that can predict hospitalisations and reduce the impact of heart failure. proper organisation of transmission and alerts management is crucial for clinical success in using these tools. Conclusions: The full implementation of remote monitoring of implantable devices and in particular the use of new algorithms for the prediction of acute heart failure episodes represents a huge challenge but also a huge opportunity.

The increasing attendance of paediatric emergency departments becomes a serious health issue. To reduce an elevated burden of medical errors, inevitably caused by high level of stress exerted on emergency physicians, we propose potential areas for improvement in regular paediatric emergency departments. In effort to guarantee demanded quality of care to all incoming patients, the workflow in paediatric emergency departments should be sufficiently optimized. The key component remains implementing one of the validated paediatric triage systems upon patient's arrival at emergency department and fast-tracking patients with low level of risk according to the triage system. To ensure the patient's safety, emergency physicians should follow issued guidelines. Cognitive aids, such as well-designed checklists, posters or flow charts, generally improve physicians' adherence to guidelines and should be therefore available in every paediatric emergency department. To sharpen diagnostic accuracy, the use of ultrasound in paediatric emergency department, according to ultrasound protocols, should be targeted to answer specific clinical questions. Combining all mentioned improvements might reduce number of errors linked with overcrowding. The review serves not only as a blueprint for modernizing paediatric emergency departments, but also as a bin of useful literature which can be suitable in the paediatric emergency field.

This study explores the near-surface dispersion mechanisms of contaminants in coastal waters, leveraging a comprehensive method that includes using dye and drifters as tracers, coupled with diverse observational platforms like drones, satellites, in-situ sampling, and HF radar. The aim is to deepen our understanding of surface currents' impact on contaminant dispersion, thereby improving predictive models for environmental incident management, including pollutant releases. Rhodamine WT dye, chosen for its significant fluorescent properties and detectability, along with drifter data, allowed us to investigate the dynamics of near-surface physical phenomena such as the Ekman current, Stokes drift, and wind-driven currents. Our research emphasizes the importance of integrating scalar tracers and Lagrangian markers in experimental designs, revealing differential dispersion behaviors due to near-surface vertical shear caused by the Ekman current and Stokes drift. The elongation direction of the dye patch aligns with the Ekman current direction during slow current conditions. Analytical calculations of vertical shear, based on the Ekman current and Stokes drift, closely matched those derived from tracer observations. Over a 7-hour experiment, the vertical diffusivity of near-surface water was observed at 2×10-4 m2/s, and the horizontal eddy diffusivity of the dye patch and drifters reached the order of 1 m2/s and at a 1000m length scale. Particle tracking models demonstrate that while HF radar currents can effectively predict the trajectories of tracers near the surface, incorporating near-surface currents, including Ekman current, Stokes drift, and windage, is essential for a more accurate prediction of the fate of surface floats.

Human papillomavirus testing is increasingly central to screening programs for cervical cancer. Although HPV testing has excellent clinical sensitivity it suffers from modest clinical specificity. Cytology has taken an important role as a triage test, while more recently HPV16/18 genotyping has provided modest incremental benefits. Despite such progress issues remain to be addressed, some of which are how to: 1) improve access to the best methods, 2) decrease costs so more women can be screened, 3) simplify management algorithms, 4) Recognize the evolving diagnostic landscape created by widespread HPV vaccination. Part of the solution lies in improving the positive predictive value of the initial screen and reflex triage. An aspirational goal should be that most women attending colposcopy have true precancer; DNA methylation testing has a role to play here. Cervical cancers and CIN2/3 generally have high levels of methylation in target human and HPV genes. In contrast normal and healthy women with no intraepithelial lesions or malignancy usually have low methylation. Furthermore, there is an interesting and useful secular gradient of increasing cervical DNA methylation as women progress toward precancer and cancer. Recent results from clinical studies using commercially available routine qPCR-based DNA methylation tests have been encouraging, demonstrating the potential for higher sensitivity and specificity than current triage methods.

Cardiovascular diseases (CVDs) and chronic kidney disease (CKD) are frequently interconnected and their association leads to an exponential increase in the risk of both fatal and non-fatal events. In addition, the burden of arrhythmias in CKD patients is increased. On the other hand, the presence of CKD is an important factor that influences the decision to pursue cardiac device therapy. Data on CKD patients with device therapy is scarce and mostly derives from observational studies and case reports. Cardiac resynchronization therapy (CRT) is associated with decreased mortality, reduced heart failure symptoms and improved renal function in early stages of CKD. Implantable cardioverter defibrillators (ICDs) are associated with a significant reduction in the mortality of CKD patients only for the secondary prevention of sudden cardiac death. Cardiac resynchronization therapy defibrillator (CRT-D) is preferred in patients that meet the established criteria. The need for cardiac pacing is 3-fold higher in dialysis patients. CKD is an independent risk factor for infections associated with cardiac devices.

Stress during a pandemic increased the risk of alcohol consumption, which may require pharmacological management. The characteristics of emergency calls for alcohol-related issues for patients pharmacologically treated, admitted to, or not admitted to the emergency department (ED) were analyzed. An observational single-center retrospective study was conducted from January 1, 2018 to December 31, 2021, and divided into 2-year periods (2018–2019 and 2020–2021). This study focused on calls to one of the EDs of seven hospitals in the Bari (Italy) metropolitan area for patients requiring emergency services (ES) who were either admitted or not admitted, due to their refusal. A 30% reduction in emergency calls for alcohol-related issues and a 41.17% reduction in calls for patients who refused to be admitted to the ED were observed during the pandemic. During the pandemic, a reduced rate of pharmacological treatment for calls coded green (non-critical), and an increase in calls coded yellow (fairly critical) and red (very critical) were recorded. Metadoxine was administered in almost all alcohol-related emergencies, primarily in conjunction with drugs acting on the gastrointestinal tract, irrespective of age, the period considered, and whether patients were admitted or not admitted to the ED. ES is the first and only out-of-hospital service encountered by numerous patients with alcohol-use disorders who refuse to be admitted to the ED. These patients should be directed by ES personnel to a multidisciplinary program to receive treatment for drinking, improve their quality of life, and reduce sanitation costs.

Emergency is a health condition that poses an imminent risk to life. In this context, operations and triage protocols play an important role in the correct functioning of the Emergency Department, a key component of national health systems. The aim of the study was to explore and describe the experiences of a group of patients regarding emergency departments that use the Manchester Triage System, a triage protocol widely adopted in Europe. The research approach used was phenomenography, which allows us to explore in depth the diversity of experiences lived by a group of patients. The data was collected through semi-structured interviews and analysed to identify the categories that allows a qualitative description of patient’s experiences. The results are structured in the following categories: “Healthcare professional roles“, “Waiting time to be cared“, “Triage protocol“ and “Emergency department utilization“. These results can be used to improve the way patients experience emergency situations and to contribute to increasing knowledge about the impact of emergency departments and triage protocols on patients.

Elders have a higher rate of return visits to the emergency department (ED) than other patients. It is critical to understand the risk factors for return visits to the ED by elders. The aim of this study was to determine the factors associated with return visits to the ED by elders. This study retrospectively reviewed the hospital charts of elders who return visits to the ED within 72 hours after discharge. The risk factors identified in the Triage Risk Screening Tool were applied in this study. Of the elders discharged from the ED, 8.64% made a return visit to the ED within 72 hours. The highest revisit rate occurred within 24 hours after discharge. Factors associated with return ED visits within 24 hours by elders were difficulty walking and having discharge care needs. Factors associated with ED return visits within 24–48 hours were cognitive impairment and polypharmacy. Difficulty walking, having discharge care needs and hospitalization within the past 120 days were associated with return visits made within 48–72 hours following discharge. Identifying the reasons for return visits to the ED and providing a continuous review of geriatric assessment and discharge planning could reduce unnecessary revisits.

The COVID19 pandemic had a major impact on emergency medical communication centres (EMCC). A live video facility was made available to second-line physicians in an EMCC with a first-line paramedic to receive emergency calls. The objective of this study was to measure the contribution of live video to remote medical triage. The single-centre retrospective study included all telephone assessments of patients with suspected COVID19 symptoms from 01.04.2020 to 30.04.2021 in Geneva, Switzerland. The organisation of the EMCC and the characteristics of patients who called the two emergency lines (official emergency number and COVID19 number) with suspected COVID19 symptoms were described. A prospective web-based survey of physicians was conducted during the same period to measure the indications, limitations and impact of live video on their decisions. 8,957 patients were included. 2,157 (48.0%) of the 4,493 patients assessed on the official emergency number had dyspnoea. 4,045 (90.6%) of 4,464 patients assessed on the COVID19 number had flu-like symptoms. 1,798 (20.1%) patients were reassessed remotely by a physician, including 405 (22.5%) with live video, successfully in 315 (77.8%) attempts. The web-based survey (107 forms) showed that physicians used live video to assess mainly the breathing (81.3%) and general condition (78.5%) of patients. They felt that their decision was modified in 75.7% (n=81) of cases, and caught 7 (7.7%) patients in life-threatening emergency. Medical triage decisions for suspected COVID19 patients are strongly influenced by the use of live video.

Nurses in disaster response require comprehensive understanding, training, and col-laboration among educators, researchers, and practitioners to overcome challenges and improve their capabilities. This study evaluates the impact of simulation-based training on improving nursing students' knowledge and performance in crisis management and triage during mass casualty incidents in Saudi Arabia, aiming to enhance existing pro-tocols in disaster management. This quantitative interventional pre-post study aimed to assess the impact of a training intervention on the disaster nursing skills of nursing students at Taif University in Saudi Arabia. The study involved a random sample of 101 nursing students and utilized a realistic train accident simulation with a response team comprising healthcare professionals and emergency specialists. A detailed questionnaire was used to measure emergency management skills and knowledge, and pre-test and post-test evaluations were conducted. Data analysis was performed using SPSS, and the study was conducted on a voluntary basis with necessary approvals obtained. The findings have the potential to enhance disaster management protocols and improve the preparedness of nursing professionals in Saudi Arabia. The posttest analysis revealed that a significant portion of participants achieved excellent, very good, and good levels of performance, indicating the effectiveness of the training program. In contrast, the pretest grades showed a higher percentage of participants receiving fail level grades, high-lighting the need for improvement prior to the training intervention. This study high-lights the importance of comprehensive training and education in disaster nursing for improving emergency response and patient outcomes

Chest trauma is a critical medical condition that encompasses a range of injuries and can result from various causes. Prompt and accurate diagnosis is crucial in managing chest trauma patients and radiology plays a pivotal role in this aspect. Imaging modalities in chest trauma aid in precise diagnosis and treatment planning. Especially, X-rays remain the initial imaging modality of choice due to their accessibility, speed, and ability to detect acute life-threatening conditions. Computed Tomography (CT) Scan offers detailed cross-sectional images allowing for comprehensive evaluation of chest trauma and surgical planning when necessary. Ultrasound (US) is increasingly valuable tool due to its portability and real-time imaging capabilities, aiding in rapid assessment at the bedside. Magnetic Resonance Imaging (MRI) is less commonly used due to time constraints and limited availability. Radiological imaging serves various purposes in the diagnosis and management of chest trauma such as early detection and triage, characterization and severity assessment, surgical planning, follow-up and monitoring of chest trauma. Reduction of radiation exposure, advancements in imaging technology (dual-energy CT, contrast-enhanced imaging) and Artificial Intelligence (AI) algorithms are crucial challenges and deserve attention. A multidisciplinary approach integrating radiological expertise remains fundamental in ensuring optimal outcomes for patients with chest trauma.

Background: A plethora of data supports HPV-based screening to be the preferred strategy for cervical cancer prevention. The shift to a more sensitive firstline test brings the need of effective triage up for discussion. Currently, most algorithms apply cytology as triage of HPV-DNA positive women. This study compared the performance of a 7-type HPV-mRNA test to cytology. Methods: From 2019-01-01, until 2021-12-31, cervical samples from 58,029 women were examined at the University Hospital of North Norway. 30.5% (17,684/58,029) fulfilled the criteria for HPV-DNA primary screening. All positive samples were triaged by cytology and followed-up according to national guidelines through 2022. Additionally, a 7-type HPV-mRNA test was applied. Study endpoint was histologically confirmed high grade lesion (CIN2+). Results: 5.6% (990/17,684) had positive HPV-DNA test, 97.2% (962/990) with valid HPV-mRNA results. 55.5% (534/962) had abnormal cytology (ASC-US+) and 35.1% (338/962) had positive HPV-mRNA test. 13.9% (134/962) had CIN2+. Sensitivity (CIN2+) of cytology versus the HPV-mRNA test was 76.1% (102/134)) versus 73.1% (98/134)), p=0.67. The specificity was 47.8% (396/828) versus 71.0% (588/624), p<0.001. PPV was 19.1% (102/534) and 29.0% (98/338), p<0.001 respectively. The number of colposcopies per CIN2+ detected by cytology and HPV-mRNA test was 5.2 and 3.1. Conclusion: The 7-type HPV mRNA test was significant more specific than cervical cytology in triage of HPV-DNA positive women. Using this biomarker as threshold for colposcopy may better balance the benefits and harms of screening.

Soarinho Alkaline Intrusion, southeastern Brazil, makes part of the Serra do Mar Igneous Province, and it is composed of alkali feldspar syenite, alkali feldspar trachyte, quartz syenite, and mon-zonite. Geochemical and geochronological analysis of the Soarinho were compared with data from its neighbors Rio Bonito and Tanguá. Zircon U-Pb Laser Ablation ages show that Soarinho is youngest than Rio Bonito and Tanguá. Ages obtained from the monzonite (60 ± 2 Ma), alkali feldspar syenite (58 ± 2 Ma), and quartz syenite (58 ± 2 Ma) are indistinguishable within error. Petrographic and geochemical data show a clear contrast among Soarinho, Rio Bonito, Tanguá, and Lu-Hf isotopic data for the three alkaline intrusions (all negative), point to some similarities in their sources. The data suggest an enriched mantle source for Soarinho; however, an older con-tinental crust contribution cannot be discarded.

Emergency departments (EDs) are critical in urgent care, where accurate triage optimizes patient flow and resource allocation. Manual triage faces challenges due to increasing volume and com-plexity. This study compares logistic regression, gradient boosting, neural network, and random forest models in predicting Emergency Severity Index (ESI) triage levels for non-traumatic pa-tients at Lampang Hospital's ED. Using data from January 1, 2023, to April 30, 2024, we ana-lyzed 45,245 complete records. The gradient boosting model achieved the highest accuracy (0.81), significantly outperforming logistic regression (accuracy 0.64). Pain scale, sex, and mean arterial pressure were key predictors. This is the first comparison of these models for ESI triage in a Thai hospital, highlighting their potential to improve triage accuracy and efficiency. Implementing these models could enhance patient outcomes and resource management in ED.

Modified mRNAs (modRNAs) are an emerging delivery method for gene therapy. In particular, the modRNA-based COVID-19 vaccines have proven that modRNA is a safe and effective therapeutic tool. Moreover, modRNA has the potential to treat various human diseases including cardiac dysfunction. Acute myocardial infarction (MI) is a major cardiac disorder that currently lacks curative treatment options. MI is commonly accompanied by fibrosis and impaired cardiac function. Our group previously demonstrated that the matricellular protein CCN5 inhibits cardiac fibrosis (CF) and improves cardiac dysfunction. However, it remains elusive whether the early intervention of CF under stress conditions is beneficial or more detrimental due to potential adverse effects such as left ventricular (LV) rupture. To obtain acute CCN5 expression, we used modRNA-mediated gene transfer in a mouse MI model. To evaluate CCN5 activity, we established two independent experimental schemes: 1) preventive intervention and 2) therapeutic intervention. Cardiac function and structural changes were measured by echocardiography and magnetic resonance imaging. Finally, fibrosis and the underlying molecular pathway were analyzed by western blotting, quantitative real-time polymerase chain reaction, and immunohistochemistry. The modRNA-CCN5 gene transfer successfully ameliorated CF and enhanced cardiac function in both preventive and therapeutic interventions without LV rupture or any adverse cardiac remodeling. Conclusively, early intervention in CF by modRNA-CCN5 gene transfer is an efficient and safe therapeutic modality for treating MI-induced heart failure without adverse structural remodeling.

The results of an LA-ICP-MS U-Pb dating and Hf isotope study of zircon crystals separated from small eclogite xenoliths found in Devonian kimberlites within the Prypyat horst, Ukraine, are reported. The studied area is located in the Central Belarusian Suture Zone, which represents a Paleoproterozoic belt extending along the boundary between the Sarmatian and Fennoscandian segments of the East European Platform. Four laser ablation sites on two zircon grains yielded Paleoproterozoic U-Pb ages between 1954 ± 24 Ma and 1735 ± 54 Ma. In contrast, three of four Hf sites revealed negative εHf values and Paleoarchean to Mesoarchean model ages, excluding the possibility that the eclogite xenoliths represent segments of a Paleoproterozoic subducted slab or younger mafic melts crystallized in the subcontinental lithospheric mantle. A single laser ablation Hf spot yielded a positive εHf value (+3) and a Paleoproterozoic model age. Two models for eclogite origin can be proposed. The first foresees the extension of the Archean lower-crustal or lithospheric roots beneath the Central Belarus Suture Zone for over 200 km from the nearest known outcrop of Archean rocks. The second model is that the Central Belarus Suture Zone represents a rifted-out fragment of the Kola-Karelian craton that was accreted to Sarmatia before the actual collision of these two segments of Baltica.

Early stroke diagnosis remains a big challenge in healthcare partly due to the lack of reliable diagnostic blood biomarkers, which in turn leads to increased rates of mortality and disability. Current screening methods are optimised to identify patients with a high risk of cardio-vascular disease, especially among the elderly. However, in young adults and children, these methods suffer low sensitivity and specificity and contribute to further delays in their triage and diagnosis. Accordingly, there is an urgent need to develop reliable blood biomarkers for triaging patients suspected of stroke in all age groups, especially children and young adults. This review explores some of the existing blood biomarkers, as single biomarkers, or biomarker panels, and examine their sensitivity and specificity for predicting stroke. A review was performed on PubMed and Web of Science for journal articles published in English during the period 2001 to 2021 which contained information regarding biomarkers of stroke. In this review article, we provide comparative information on the availability, clinical usefulness, and time-window periods of eight single blood biomarkers and six biomarker panels that have been used for predicting stroke in emergency situations. The outcomes of this review can be used in future research for developing more effective stroke biomarkers.

Insulin resistance/hyperinsulinemia as an independent risk factor for the development and worsening of HFpEF. Serafino Fazio MD¹, Valentina Mercurio MD, PhD2, Valeria Fazio MD3, Antonio Ruvolo MD⁴, Flora Affuso MD, PhD⁵. Authors’ Affiliation: ¹ Department of Internal Medicine (retired Professor). Federico II University, Via Sergio Pansini 5. 80135 Naples, Italy. 2 Department of Translational Medical Sciences. Federico II University. Via Sergio Pasini 5. 80135 Naples, Italy. ³ UOC Medicina Interna, Azienda Ospedaliera di Caserta, 81100 Caserta, Italy, ⁴ UOC Cardiologia AORN dei colli PO CTO, Viale Colli Aminei 21, 80100 Naples, Italy. ⁵ Independent researcher, Viale Raffaello 74, 80129 Naples, Italy. Abstract Heart failure (HF) has become a subject of continuous interest since it has been declared new pandemic in 1997 because of the exponential increase in hospitalizations for HF in the latest years. HF is the final state to which all heart diseases of different etiologies lead if not adequately treated, therefore it is highly prevalent worldwide, with a progressive increase with age, reaching a prevalence of 10% in subjects over the age of 65 years. It should also be underlined that lately, while the prevalence of HF with left ventricular reduced ejection fraction (HFrEF) is slowly decreasing, the incidence of HF with left ventricular preserved ejection fraction (HFpEF) is progressively increasing. In deed, among patients consecutively hospitalized for HF between 1987 and 2001 in a study from the Mayo Clinic Hospitals in Olmsted County, Minnesota, prevalence of HFpEF increased from 38% to 54%. HFpEF is typically characterized by concentric remodeling of the left ventricle (LV) with impaired diastolic function and increased filling pressures. Over the years, also the prevalence of insulin resistance/hyperinsulinemia in the general adult population has progressively increased, primarily due to lifestyle changes, particularly in developed and developing countries, with a range that globally ranges between 15.5% and 46.5%. Notably, insulin resistance (IR)/hyperinsulinemia (Hyperins) is present in up to 60% of patients with HF and is significantly higher in subjects with HfpEF. In the scientific literature it has been well highlighted that the increased circulating levels of insulin are associated with conditions of insulin resistance are responsible for progressive cardiovascular alterations over the years. In the setting of HFpEF, insulin stimulates the concentric remodeling of the left ventricle with associated diastolic dysfunction, which, coincidentally. Unfortunately, IR/Hyperins, despite being a well-known cardiovascular risk factor, is still not screened in the general population and is not treated as promptly as it should be, and this could at least in part concur in the progressive increase in prevalence of HFpEF in the general adult population. The aim of this manuscript was to review scientific literature that support a pathophysiologic connection between IR/Hyperins and HFpEF to stimulate the scientific community towards the identification of hyperinsulinemia associated with insulin resistance as an independent cardiovascular risk factor in development and worsening of HF, believing that its adequate screening in the general population and appropriate treatment could reduce the prevalence of HFpEF and improve its progression.

The visual appearance of humans derives significantly from our skin and hair color. While melanin from epidermal melanocytes protects our skin from the damaging effects of ultraviolet radiation, the biological value of pigmentation in the hair follicle, particularly in the scalp, is less clear. In this study, we explore the heterogeneity of pigment cells in the human scalp anagen hair follicle bulb, a site conventionally viewed to be focused solely on pigment production for transfer to the hair shaft. Using c-KIT/CD117 microbeads, we isolated bulbar c-KIT-positive and c-KIT-negative melanocytes. While both subpopulations expressed MITF, only the c-KIT-positive fraction expressed SOX10. We further localized bulbar melanocyte subpopulations (expressing c-KIT, SOX10, MITF, and DCT) that exhibited distinct/variable expression of downstream differentiation-associated melanosome markers (e.g., gp100 and Melan-A). Localization of a second ‘immature’ SOX10 negative melanocyte population, which was c-KIT/MITF double positive, was identified outside of the melanogenic zone in the most peripheral/proximal matrix. These studies describe an approach to purifying human scalp anagen hair bulb melanocytes, allowing us to identify unexpected levels of melanocyte heterogeneity. The function of the more immature melanocytes in this part of the hair follicle remains to be elucidated. Could they be in-transit migratory cells destined to synthesize mela-nin ultimately or could they contribute to the hair follicle in non-melanogenic ways.

A series of precise data consisting of zircon U–Pb ages, whole-rock geochemistry and Sr–Nd–Hf isotope compositions from the Huhetaoergai granitic pluton was collected in this study and combined with data from the western Huhetaoergai, Zhuxiaogubuhe and Yagan granitic plutons to constrain the petrogenesis and tectonic setting of granitic plutons in the northern Ya-Gan fault zone, North Alxa, China. The Huhetaoergai pluton is composed of hornblende diorite, medium- to coarse-grained biotite adamellite and coarse-grained biotite adamellite with K-feldspar megacrysts. The U–Pb zircon ages of biotite adamellite are 220.5 ± 1.9 Ma and 226.5 ± 2.4 Ma. These granitoids are I-type granites with highly radiogenic initial ⁸⁷Sr/⁸⁶Sr of 0.708085–0.735470, negative eNd(t) average values of −2.98–3.23 and high eHf(t) of 9–11.05. These features indicate the granitoids were formed from magmas generated from juvenile crust. We speculate that the granitoids of the Huhetaoergai pluton were emplaced during an episode of intense intraplate orogenic movement evolution in an extrusional setting after a period of extensional postcollisional intraplate evolution.

Zircon xenocrysts from alkali basalts in Ratanakiri Province, Cambodia, represent a unique low-Hf zircon, within a 12,000 km long Indo-Pacific megacryst zone. Colourless, yellow, brown and red crystals ({100}, {101}, subordinate {211}, {1103}), with hopper growth and corrosion features, range up to 20 cm in size. Zircon chemistry implicates juvenile, Zr-saturated, mantle-derived alkaline melt (Hf 0.6–0.7 wt%, Y <0.2 wt%, U+Th+REE <600 ppm, Zr/Hf 66–92, Eu/Eu*_N ~ 1, positive Ce/Ce*_N, HREE enrichment). Incompatible element depletion with increasing Yb/Sm_N from core to rim at ~ constant Hf suggests single stage growth. Ti-in-zircon temperatures (~570–740 °C) are lower than predicted by crystal morphology (800–900 °C) and decrease from core to rim (D_T = 10–50 °C). The d¹⁸O values (4.88 to 5.01‰ VSMOW) are relatively low for xenocrysts from the zircon Indo-Pacific zone (ZIP). The ¹⁷⁶Hf/¹⁷⁷Hf values (+ εHf 4.5–10.2) give T_{Depleted Mantle} model source ages of 260–462 Ma and T_Crustal ages of 391–754 Ma. The source magmas reflect variably depleted lithospheric mantle with little supracrustal input. Zircon U-Pb (0.88–1.56 Ma) and (U-Th)/He (0.86–1.02 Ma) ages are older than host basalt ages (~0.7 Ma), suggesting limited residence before transport. Zircon genesis suggests Zr-saturated, Al-undersaturated, carbonatitic-influenced, low-degree partial melting (<1%) of peridotitic mantle at ~60 km beneath the Indochina terrane.

In New Orleans, Louisiana the population’s poor baseline health led to its establishment as an early epicenter for severe acute COVID-19. Antici-pating future outbreaks of COVID-19 and other respiratory viruses, we need to identify correlates of outcome, from real clinical experience. 89 patients were recruited into the ClinSeqSer acute COVID-19 longitudinal observational study, from the beginning of the outbreak in March to July 2020. Patients admitted for acute COVID-19 were enrolled in person. The cohort is unique as it is 68% Black, 53% female, of average age of early 60s, and prevalence of obesity and hypertension respectively of 55% and 83%. The outcomes are: 53% severe (20% fatal, 33% non-fatal) and 47% non-severe, with severe defined as death or requiring mechanical ventila-tion or high flow oxygen. Obesity and admit systolic blood pressure (SBP) >140mmHg are each associated with severe outcome and, despite respective sensitivity of 71% and 76%, specificity ~66% for both, and ac-curacy of 60% and 70% by ROC analysis, would likely provide useful predictors of outcome in critically stressed health care systems. We discuss pathophysiologic hypotheses to explain why high admit SBP is observed only in half of patients with pre-COVID hypertension and is associated with severe outcome.

A novel method has been developed based on the amplitude data of the EM waves measured by Digisondes to calculate and investigate the relative ionospheric absorption changes. The effect of 13 solar flares (> C4.8) that occurred between 06:00 and 16:30 UT from 04 to 10 September 2017 have been studied at three European Digisonde stations (Juliusruh (54.63° N, 13.37° E), Průhonice (49.98° N, 14.55° E) and San Vito (40.6° N, 17.8° E)). Present study compares the results of the amplitude method with the absorption changes measured by the Finnish Riometer Network and determined by the NOAA D-RAP model during the same events. The X-class flares caused 1.5–2.5 dB attenuation at 30–32.5 MHz based on riometer data, while the absorption changes were between 10 and 15 dB in the 2.5–4.5 MHz frequency range according to the amplitude data. The impact caused by the energetic particles after the solar flares are clearly seen in the riometer data, while it can be observed only at Juliusruh (~55°) at some certain cases among the Digisonde stations. Comparing the results of the amplitude method with the D-RAP model it seems evident that the observed values exceed the values given by the model both at 2.5 MHz and at 4 MHz almost always during the investigated period. According to the comparison between the riometer data with the D-RAP, the model underestimates the values obtained from the riometers during the X-class solar flares, while it overestimates the caused impact during the particle events.

This strategy had a very fast and good impact on the patient’s health; the CCM improved heart failure symptoms, hemodynamics flow and cardiac functionality. Moreover, after a relatively short time, the patient comes from persistent AF to Sinus Rhythm, although he starts with a severe bi-atrial dilatation. These parameters were stable during an extended follow-up of 18 months.

Emerging data processing techniques brought back into attention the HF range communication as an interesting alternative to third-party solutions for IoT applications, such as data transmission in distributed energy production facilities. The physical size of HF antennas, often comparable to the surrounding objects, require in-situ radiation measurements. Drone-borne measuring systems are already known as a flexible solution, but mostly restricted to higher frequency ranges. In this work, we propose to use an electrically small, folded dipole as a probe for drone-borne measurements on HF antennas. We also propose a calibration approach for the effects related to the near-field zone, and to the drone body proximity. The impact of ground reflection is also investigated. We show that despite its low, realized gain figure such a probe can provide stable results for near-field measurements, even at low input power levels.

Background and Objectives: The relevance of red flags in serious spinal pathology (SSP) evolved throughout the last years. Recently, new considerations have been proposed to expand the consideration of red flags. The purpose of this study was to determine, approve and test a model for the triage and manage-ment process of SSP based on the latest data available in the literature. Materials and Methods: The SSP model was initially built on the basis of a literature re-view. The model was further determined and approved by an expert panel us-ing a Delphi process. Finally, clinical scenario were used to test the applicabil-ity of the model. Results: After three rounds of Delphi process, panellists reached a consensus on a final version of the model. The use of clinical scenari-os by experts bring about reflexive elements both on the determined model and on the evocative SSP of the clinical cases. Conclusions: The validation of the model and its implementation in the clinical field could help assess the skills of first-line practitioners managing spinal painful patients. To this end, the devel-opment of additional clinical scenarios fitting with the determined model should be further considered.