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In the shift toward sustainable energy production, offshore wind power has experienced notable expansion. Several projects to install floating offshore wind farms in European waters, ranging from a few to hundreds of turbines, are currently in the planning stage. The underwater operational sound generated by these floating turbines has the potential to affect marine ecosystems, although the extent of this impact remains underexplored. This study models the sound radiated by three planned floating wind farms in the Strait of Sicily (Italy), an area of significant interest for such developments. These wind farms vary in size (from 250 MW to 2800 MW) and environmental characteristics, including bathymetry and seabed substrates. Propagation losses were modeled in one-third-octave bands using JASCO Applied Sciences' Marine Operations Noise Model, which is based on the parabolic equation method, combined with the BELLHOP beam-tracing model. Two sound speed profiles, corresponding to winter and summer, were applied to simulate seasonal variations in sound propagation. Additionally, sound from an offshore supply ship was incorporated with one of these wind farms to simulate maintenance operations. Results indicate that sound from operating wind farms could reach a broadband sound pressure level (Lp) of 100 dB re 1 µPa as far as 67 km from the wind farm. Nevertheless, this sound level is generally lower than the ambient sound in areas with intense shipping traffic. The findings are discussed in relation to local background sound levels and current guidelines and regulations. The implications for environmental management include the need for comprehensive monitoring and mitigation strategies to protect marine ecosystems from potential acoustic disturbances. [ABSTRACT FROM AUTHOR]

Patients with autoimmune disorders are at an increased risk of venous thromboembolism (VTE), but this association has not been consistently evaluated. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) database to compare the rates of VTE recurrences, major bleeding, and death during the course of anticoagulation, according to the presence or absence of autoimmune disorders. Of 71 625 patients with VTE recruited in February 2018, 1800 (2.5%) had autoimmune disorders. Median duration of anticoagulant therapy was slightly longer in patients with autoimmune disorders (median, 190 vs 182 days; P =.001). On multivariable analysis, patients with autoimmune disorders had a similar risk of VTE recurrences (hazard ratio [HR]: 0.93; 95% confidence interval [CI]: 0.68-1.27) or major bleeding (HR: 1.07; 95% CI: 0.82-1.40) and a lower risk to die (HR: 0.66; 95% CI: 0.54-0.81) than those without autoimmune disorders. Patients with giant cell arteritis had the highest rates of major bleeding (8.6 events per 100 patient-years) and the lowest rate of recurrences (zero). In other subgroups, the rates of both events were more balanced. During anticoagulation, patients with or without autoimmune disorders had similar rates of VTE recurrences or major bleeding. However, there were some differences between subgroups of patients with autoimmune disorders. [ABSTRACT FROM AUTHOR]

Several letters to the editor are presented regarding repetitive pneumonia and breathing difficulty in elderly patients following radiation therapy, iliopsoas hematoma in elderly patients with back pain and sever anemia, and the risk of developing dysphagia in older adults.

A letter to the editor is presented which discusses three cases of elderly people with fatal spontaneous extraperitoneal hematoma, who were administered with low molecular weight heparins (LMWHs).