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It is widely known that the fast solar wind originates mainly from coronal holes (CHs) in the solar corona. Associations between the CH characteristics and the properties of the fast solar wind in situ have been studied throughout the years from different authors leading to diverse degrees of correlation (Nolte et al. 1976; Vršnak et al. 2007; Karachik et al. 2011; Rotter et al. 2012a; Hofmeister et al. 2018; Heinemann et al. 2020). In this work, we introduce and quantify the geometrical complexity of CHs, a parameter that has been neglected so far in similar studies. For a particular CH sample, we explore how complexity affects the peak speed of the fast solar wind at Earth and its association with other CH properties. We further compare observations of fast solar wind at Earth with forecasts from EUHFORIA. We evaluate our results, and present the efforts and restrictions we encounter towards improving our prediction capabilities by exploiting recent PSP observations.

Our current capability of space weather prediction in the Earth's radiation belts is limited to only an hour in advance using solar wind monitoring at the Lagrangian L1 point. To mitigate the impacts of space weather on telecommunication satellites, advancing the lead time of the prediction is a critical task. We develop a prototype pipeline called "Helio1D" to forecast ambient solar wind conditions (speed, density, temperature, tangential magnetic field) at L1 with a lead time of 4 days. This pipeline predicts Corotating Interaction Regions (CIRs) in which their compressed stream interfaces and high-speed streams can increase high-energy fluxes in the radiation belts. The Helio1D pipeline connects the Multi-VP model, which provides real-time solar wind emergence at 0.14 AU, and the 1D MHD model. Using the long-term data from Multi-VP, we benchmark the Helio1D pipeline for solar wind speed against the observation data in 2004 - 2013 and 2017 - 2018. We developed a framework based on the Fast Dynamic Time Warping technique that allows us to continuously compare time-series outputs containing CIRs to observations to measure the pipeline's performance. In particular, we use this framework to calibrate and improve the pipeline's performance for operational forecasting. Since the 1D MHD model is computationally inexpensive, we provide daily ensemble forecasting of 21 members, including several targets around the Earth to account for the uncertainties. This pipeline can be used to feed real-time, daily solar wind forecasting to predict the dynamics of the inner magnetosphere and the radiation belts. In this presentation, we will share the lessons from this research-to-operation project and discuss ways to effectively implement operational space weather pipelines.

Since the 1970s it has been empirically known that the area of solar coronal holes a ects the properties of high-speed solar windstreams (HSSs) at Earth. We derive a simple analytical model for the propagation of HSSs from the Sun to Earth and thereby showhow the area of coronal holes and the size of their boundary regions a ect the HSS velocity, temperature, and density near Earth.We assume that velocity, temperature, and density profiles form across the HSS cross section close to the Sun and that these spatialprofiles translate into corresponding temporal profiles in a given radial direction due to the solar rotation. These temporal distributionsdrive the stream interface to the preceding slow solar wind plasma and disperse with distance from the Sun. The HSS properties at1AU are then given by all HSS plasma parcels launched from the Sun that did not run into the stream interface at Earth distance.We show that the velocity plateau region of HSSs as seen at 1AU, if apparent, originates from the center region of the HSS closeto the Sun, whereas the velocity tail at 1AU originates from the trailing boundary region. Small HSSs can be described to entirelyconsist of boundary region plasma, which intrinsically results in smaller peak velocities. The peak velocity of HSSs at Earth furtherdepends on the longitudinal width of the HSS close to the Sun. The shorter the longitudinal width of an HSS close to the Sun, themore of its “fastest” HSS plasma parcels from the HSS core and trailing boundary region have impinged upon the stream interfacewith the preceding slow solar wind, and the smaller is the peak velocity of the HSS at Earth. As the longitudinal width is statisticallycorrelated to the area of coronal holes, this also explains the well-known empirical relationship between coronal hole areas and HSSpeak velocities. Further, the temperature and density of HSS plasma parcels at Earth depend on their radial expansion from the Sunto Earth. The radial expansion is determined by the velocity gradient across the HSS boundary region close to the Sun and gives thevelocity-temperature and density-temperature relationships at Earth their specific shape. When considering a large number of HSSs,the assumed correlation between the HSS velocities and temperatures close to the Sun degrades only slightly up to 1AU, but thecorrelation between the velocities and densities is strongly disrupted up to 1AU due to the radial expansion. Finally, we show howthe number of particles of the piled-up slow solar wind in the stream interaction region depends on the velocities and densities of theHSS and preceding slow solar wind plasma.

OBJECTIVES The aim of this study was to describe the 30-day mortality rate of patients aged 80 years and older undergoing surgical and nonsurgical procedures under anaesthesia in Europe and to identify risk factors associated with mortality. DESIGN A prospective cohort study. SETTING European multicentre study, performed from October 2017 to December 2018. Centres committed to a 30-day recruitment period within the study period. PATIENTS Nine thousand four hundred and ninety-seven consecutively recruited patients aged 80 years and older undergoing any kind of surgical or nonsurgical procedures under anaesthesia. MAIN OUTCOME MEASURES The primary outcome was all-cause mortality within 30 days after procedure described by Kaplan–Meier curves with 95% CI. Risk factors for 30-day mortality were analysed using a Cox regression model with 14 fixed effects and a random centre effect. RESULTS Data for 9497 patients (median age, 83.0 years; 52.8% women) from 177 academic and nonacademic hospitals in 20 countries were analysed. Patients presented with multimorbidity (77%), frailty (14%) and at least partial functional dependence (38%). The estimated 30-day mortality rate was 4.2% (95% CI 3.8 to 4.7). Among others, independent risk factors for 30-day mortality were multimorbidity, hazard ratio 1.87 (95% CI 1.26 to 2.78), frailty, hazard ratio 2.63 (95% CI 2.10 to 3.30), and limited mobility, hazard ratio 2.19 (95% CI 1.24 to 3.86). The majority of deaths (76%) occurred in hospital. Mortality risk for unplanned ICU admission was higher, hazard ratio 3.57 (95% CI 2.38 to 5.26) than for planned ICU admission, hazard ratio 1.92 (95% CI 1.47 to 2.50). Compared with other studies, the in-hospital complication rates of 17.4 and 3.9% after discharge were low. Admission to a unit with geriatric care within 30 days after the intervention was associated with a better survival within the first 10 days. CONCLUSIONS The estimated 30-day mortality rate of 4.2% was lower than expected in this vulnerable population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03152734, https://clinicaltrials.gov. ispartof: European Journal Of Anaesthesiology vol:39 issue:3 pages:198-209 ispartof: location:England status: published

Objective To evaluate the current landscape regarding medical liability in obstetric-gynecology (OB/GYN) physicians in Greece. Materials and methods Published court decisions of criminal, civil, administrative, and disciplinary content were searched in legal information banks for the years 1988-2021. The causes that led to the adverse outcome and the decisions were analyzed. Results A total of 184 decisions were directed against OB/GYNs. One hundred seventeen records concerned criminal cases and 67 civil cases. Thirty-four decisions concerned criminal cases of negligent homicide, 35 criminal cases of bodily harm, and 19 were acquittals. The most common causes of bodily injuries were neonatal encephalopathy, obstetric paralysis - quadriplegia and brachial plexus paralysis, and obstetric bleeding. Conclusion According to our results, there is a great need and challenge to maintain high standards in daily practice with continuous training and the use of international protocols. Furthermore, for each case, continuous monitoring of parturients and newborns and coordinated cooperation are necessary to reduce mortality and morbidity.

Coronal mass ejections (CMEs) are large scale eruptions observed close to the Sun. They are travelling through the heliosphere and possibly interacting with the Earth environment creating interruptions or even damaging new technology instruments. Most of the time their physical conditions (velocity, density, pressure) are only measured in situ at one point in space, with no possibility to have information on the variation of these parameters during their journey from Sun to Earth. Our aim is to understand the evolution of internal physical parameters of a set of three particular fast halo CMEs. These CMEs were launched between 15 and 18 July 2002. Surprisingly, the related interplanetary CMEs (ICMEs), observed near Earth, have a low, and in one case even very low, plasma density. We use the EUropean Heliosphere FORecasting Information Asset (EUHFORIA) model to simulate the propagation of the CMEs in the background solar wind by placing virtual spacecraft along the Sun--Earth line. We set up the initial conditions at 0.1 au, first with a cone model and then with a linear force free spheromak model. A relatively good agreement between simulation results and observations concerning the speed, density and arrival times of the ICMEs is obtained by adapting the initial CME parameters. In particular, this is achieved by increasing the initial magnetic pressure so that a fast expansion is induced in the inner heliosphere. This implied the develop First, we show that a magnetic configuration with an out of force balance close to the Sun mitigates the EUHFORIA assumptions related to an initial uniform velocity. Second, the over-expansion of the ejected magnetic configuration in the inner heliosphere is one plausible origin for the low density observed in some ICMEs at 1 au. The in situ observed very low density has a possible coronal origin of fast expansion for two of the three ICMEs., 20 pages

It has long been known that the high-speed stream (HSS) peak velocity at Earth directly depends on the area of the coronal hole (CH) on the Sun. Different degrees of association between the two parameters have been shown by many authors. In this study, we revisit this association in greater detail for a sample of 45 nonpolar CHs during the minimum phase of solar cycle 24. The aim is to understand how CHs of different properties influence the HSS peak speeds observed at Earth and draw from this to improve solar wind modeling. The characteristics of the CHs of our sample were extracted based on the Collection of Analysis Tools for Coronal Holes (CATCH) which employs an intensity threshold technique applied to extreme-ultraviolet (EUV) filtergrams. We first examined all the correlations between the geometric characteristics of the CHs and the HSS peak speed and duration at Earth, for the entire sample. The CHs were then categorized in different groups based on morphological criteria, such as the aspect ratio, the orientation angle and the geometric complexity, a parameter which is often neglected when the formation of the fast solar wind at Earth is studied. Our results, confirmed also by the bootstrapping technique, show that all three aforementioned morphological criteria play a major role in determining the HSS peak speed at 1 AU. Therefore, they need to be taken into consideration for empirical models that aim to forecast the fast solar wind at Earth based on the observed CH solar sources., Accepted by the Astronomy & Astrophysics journal

Symptoms of psychological distress and disorder have been widely reported in people under quarantine during the COVID-19 pandemic;in addition to severe disruption of peoples’ daily activity and sleep patterns This study investigates the association between physical-activity levels and sleep patterns in quarantined individuals An international Google online survey was launched in April 6th, 2020 for 12-weeks Forty-one research organizations from Europe, North-Africa, Western-Asia, and the Americas promoted the survey through their networks to the general society, which was made available in 14 languages The survey was presented in a differential format with questions related to responses “before” and “during” the confinement period Participants responded to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the short form of the International Physical Activity Questionnaire 5056 replies (59 4% female), from Europe (46 4%), Western-Asia (25 4%), America (14 8%) and North-Africa (13 3%) were analysed The COVID-19 home confinement led to impaired sleep quality, as evidenced by the increase in the global PSQI score (4 37 ± 2 71 before home confinement vs 5 32 ± 3 23 during home confinement) (p

We report two cases of transient intraoperative mydriasis in left ventricular assist device (LVAD) patients with no profound underlining neurological pathology. Both cases concern females on LVAD for more than 30 months, due to dilated cardiomyopathy, as a bridge to transplant. A possible pathophysiology mechanism is suggested. As LVAD patients’ life expectancy increases, more and more physiological alterations due to laminar flow will be revealed and must be taken into consideration for the better care of this patient group.

During recent decades, numerous studies were devoted to improve our understanding of the origin and the propagation of the fast solar wind, and its accurate modelling. The solar wind characteristics were poorly mapped up to now by the in situ observations, available mostly only at about 1AU. The novel Parker Solar Probe (PSP) observations, that are employed in this study, allow us to map the solar wind characteristics in the low solar corona at only few tens of solar radii, and to study the solar wind characteristics. These observations are also very important for understanding how accurately we can model the solar wind characteristics employing models such as EUHFORIA (European heliospheric forecasting information asset, Pomoell & Poedts, 2018), at distances rather close to the Sun.In this study, we inspect the solar wind characteristics during the first eight closest PSP approaches to the Sun. The solar wind plasma characteristics observed by PSP are compared with the modelling results using the default set-up of EUHFORIA. We also calibrate the inner boundary (0.1 AU) conditions in EUHFORIA, but without changing the Wang-Sheeley-Arge formula which describes the solar wind characteristics at the inner boundary. The aim is to better model the solar wind at distances close to the Sun. We also use a magnetic connectivity tool (developed by ESA’s MADAWG group) to better associate the fast solar wind with its source region on the Sun.

Since the 1970s it has been empirically known that the area of solar coronal holes affects the properties of high-speed solar wind streams (HSSs) at Earth. We derive a simple analytical model for the propagation of HSSs from the Sun to Earth and thereby show how the area of coronal holes and the size of their boundary regions affect the HSS velocity, temperature, and density near Earth. We assume that velocity, temperature, and density profiles form across the HSS cross section close to the Sun and that these spatial profiles translate into corresponding temporal profiles in a given radial direction due to the solar rotation. These temporal distributions drive the stream interface to the preceding slow solar wind plasma and disperse with distance from the Sun. The HSS properties at 1 AU are then given by all HSS plasma parcels launched from the Sun that did not run into the stream interface at Earth distance. We show that the velocity plateau region of HSSs as seen at 1 AU, if apparent, originates from the center region of the HSS close to the Sun, whereas the velocity tail at 1 AU originates from the trailing boundary region. Small HSSs can be described to entirely consist of boundary region plasma, which intrinsically results in smaller peak velocities. The peak velocity of HSSs at Earth further depends on the longitudinal width of the HSS close to the Sun. The shorter the longitudinal width of an HSS close to the Sun, the more of its “fastest” HSS plasma parcels from the HSS core and trailing boundary region have impinged upon the stream interface with the preceding slow solar wind, and the smaller is the peak velocity of the HSS at Earth. As the longitudinal width is statistically correlated to the area of coronal holes, this also explains the well-known empirical relationship between coronal hole areas and HSS peak velocities. Further, the temperature and density of HSS plasma parcels at Earth depend on their radial expansion from the Sun to Earth. The radial expansion is determined by the velocity gradient across the HSS boundary region close to the Sun and gives the velocity-temperature and density-temperature relationships at Earth their specific shape. When considering a large number of HSSs, the assumed correlation between the HSS velocities and temperatures close to the Sun degrades only slightly up to 1 AU, but the correlation between the velocities and densities is strongly disrupted up to 1 AU due to the radial expansion. Finally, we show how the number of particles of the piled-up slow solar wind in the stream interaction region depends on the velocities and densities of the HSS and preceding slow solar wind plasma.

European journal of anaesthesiology : EJA 39(3), 210-218 (2022). doi:10.1097/EJA.0000000000001638, Published by Lippincott Williams & Wilkins, Philadelphia, Pa.

The novel coronavirus infection has spread worldwide, causing a wide spectrum of clinical manifestations. Most patients develop moderate clinical illness, but a substantial number will experience severe pneumonia, which may rapidly progress to acute respiratory distress syndrome and multiple organ failure. In this population, soluble urokinase plasminogen activator receptor (suPAR) could serve as a quick triage test and independent marker of clinical severity, hospital and intensive care unit admission, complications, and mortality.

The purpose of the research was to assess the current situation regarding medical liability in Neurosurgery in Greece, the involvement of Anesthesiologists in court decisions, the impact of court cases and decisions, the time until the final decision, and the relationship between these issues and judicial results.Published court decisions of criminal, civil, administrative and disciplinary content were searched in legal information banks, from 1985 to 2021.A total of 52 court decisions were retrieved, 11 criminal court cases and 10 civil cases, involving 7 cases of negligent homicide and 14 bodily injuries were retrieved. The duration of litigation in 17 cases was 5.5 years, while in 4 cases the duration was 14.5 years. The average compensation paid was € 101,701.Neurosurgery has a relatively small number of reported complaints of medical negligence compared to other surgical specialties in Greece. Complications of spinal surgeries represent the majority of court cases. There is a need for immediate judicial - legislative reform of the framework for seeking medical liability of doctors.

Space weather has the difficult task to try to anticipate the propagation of eruptive events such as coronal mass ejections (CMEs) in order to assess their possible impact on the Earth’s space environment. This requires an accurate description of the background in which CMEs propagate, mainly the continuum ejecta of particles that is the solar wind and the dynamo-generated heliospheric magnetic field. This proves challenging as the solar wind and dynamo magnetic field are interacting with each other depending on the activity cycle of our star, both at large and small scales. To be able to model accurately such a wide variety of scales and parameter regimes, the approach used by the EUHFORIA 2.0 project is to use a chain of models, taking advantage of existing codes to combine their strengths through numerical coupling across the heliosphere. The first step of this chain is the data-driven modeling of the inner corona, from photosphere measurements up until 0.1 AU, and it proves especially critical as it serves as boundary condition for the rest of the models. In that regard, we will present here two coronal MHD models implemented as an alternative to the semi-empirical WSA and SCS models used so far in EUHFORIA. By using the COOLFluiD framework, we developed a new coronal model with implicit solving methods and unstructured meshes, which proves faster than traditional explicit methods on regular grids. We used the coronal code Wind-Predict to benchmark this new model for the simple polytropic approximation in the first place, and we present the similarities and differences obtained for data-driven configurations and compare them with observations (white-light images, coronal hole boundaries, in-situ data at 1 AU after coupling with EUHFORIA). We then present the improvements foreseen for each codes, especially for the heating terms: Wind-Predict will incorporate self-consistent Alfvén waves while COOLFluiD will use ad-hoc heating terms and a multi-species treatment. We will finally discuss the implications for the coupling with EUHFORIA and the CME propagation between 0.1 and 1 AU.

We report a case of chronic left flank neuropathic pain after a renal cyst removal in a 54-year old female. The patient was treated with a single application of capsaicin 8% dermal patch, with satisfactory results at an eight week follow up visit. Capsaicin 8% dermal patch could be a suitable alternative in the conservative management of post laparoscopy neuropathic pain, as it can be effective and has a well-tolerated safety profile.

ΣΚΟΠΟΣ: Σκοπός της μελέτης μας ήταν η διερεύνηση της επίδρασης της γενικής και της υπαραχνοειδούς αναισθησίας στη μετεγχειρητική έκπτωση των νευρογνωσιακών λειτουργιών σε ηλικιωμένους ασθενείς με κάταγμα ισχίου. ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΣ: Μετά από έγκριση της επιστημονικής επιτροπής του νοσοκομείου και ενυπόγραφη δήλωση συγκατάθεσης των ασθενών, μελετήθηκαν 70 ασθενείς ηλικίας, 76,16 ± 6,7 ετών, κατηγορίας ASA I-III, που επρόκειτο να υποβληθούν σε επέμβαση αποκατάστασης κατάγματος ισχίου. Οι ασθενείς χωρίστηκαν τυχαία σε δύο ομάδες, την ομάδα Α (n=33) που υποβλήθηκε σε γενική αναισθησία και την ομάδα Β (n=37) που υποβλήθηκε σε υπαραχνοειδή αναισθησία. Οι ασθενείς αξιολογήθηκαν προεγχειρητικά και μετεγχειρητικά με μια σειρά νευρογνωσιακών δοκιμασιών. ΑΠΟΤΕΛΕΣΜΑΤΑ: Σε έκβαση 30 μέρες μετεγχειρητικά οι ασθενείς που υποβλήθηκαν σε γενική αναισθησία παρουσίασαν χειροτέρευση στην ενεργό μνήμη. Οι ασθενείς που υποβλήθηκαν σε περιοχική αναισθησία παρουσίασαν επιδείνωση στην ενεργό μνήμη, στην αδρή νευρογνωσιακή κατάσταση, στην οπτικοκινητική ικανότητα, τη σύνθετη προσοχή και τη λεκτική ευχέρεια και μάθηση. Μεταξύ των δυο ομάδων καταγράφηκε σημαντική διαφορά στη σύνθετη προσοχή, με την ομάδα των ασθενών που υποβλήθηκε σε γενική αναισθησία να σημειώνει καλύτερες επιδόσεις. ΣΥΜΠΕΡΑΣΜΑΤΑ: Οι ασθενείς που υποβάλλονται σε γενική αναισθησία σε έκβαση 30 μέρες μετεγχειρητικά έχουν καλύτερη νευρογνωσιακή λειτουργία στο επίπεδο της σύνθετης προσοχής από τους ασθενείς που υποβάλλονται σε υπαραχνοειδή αναισθησία. Περισσότερες έρευνες είναι ωστόσο αναγκαίες.

Many scientists use coronal hole (CH) detections to infer open magnetic flux. Detection techniques differ in the areas that they assign as open, and may obtain different values for the open magnetic flux. We characterize the uncertainties of these methods, by applying six different detection methods to deduce the area and open flux of a near-disk center CH observed on 9/19/2010, and applying a single method to five different EUV filtergrams for this CH. Open flux was calculated using five different magnetic maps. The standard deviation (interpreted as the uncertainty) in the open flux estimate for this CH was about 26%. However, including the variability of different magnetic data sources, this uncertainty almost doubles to 45%. We use two of the methods to characterize the area and open flux for all CHs in this time period. We find that the open flux is greatly underestimated compared to values inferred from in-situ measurements (by 2.2-4 times). We also test our detection techniques on simulated emission images from a thermodynamic MHD model of the solar corona. We find that the methods overestimate the area and open flux in the simulated CH, but the average error in the flux is only about 7%. The full-Sun detections on the simulated corona underestimate the model open flux, but by factors well below what is needed to account for the missing flux in the observations. Under-detection of open flux in coronal holes likely contributes to the recognized deficit in solar open flux, but is unlikely to resolve it., 28 pages, 10 figures, submitted to ApJ

Αντικείμενο μελέτης της παρούσας διδακτορικής διατριβής αποτελούν οι Έλληνες που ταξιδεύουν στο εξωτερικό για τουρισμό τουλάχιστον μία φορά τον χρόνο, μεμονωμένα ή οργανωμένα και στόχος της είναι να αναδείξει την ιδιαίτερη σχέση που αναπτύσσουν οι άνθρωποι που ταξιδεύουν με το ταξίδι, σχέση την οποία αξιολογούν ως κομβική στη διαδικασία συγκρότησης της ταυτότητάς τους. Μέσα από συμμετοχική έρευνα και ημιδομημένες συνεντεύξεις, η έρευνα στοχεύει στη διερεύνηση των τρόπων με τους οποίους βιώνεται η εμπειρία του ταξιδιού, αλλά και του τρόπου με τον οποίο αυτή γίνεται αντιληπτή αναστοχαστικά στην επιστροφή. Πώς, δηλαδή, η εμπειρία του ταξιδιού μετατρέπεται σε αντικείμενο αφήγησης και παρουσίασης σε σημαντικούς και μη σημαντικούς Άλλους.Πιο συγκεκριμένα, τα βασικά ερωτήματα που στα οποία επιχειρεί να απαντήσει η διατριβή μπορούν να συνοψιστούν ως εξής: Αν και σε ποιο βαθμό οι άνθρωποι που συμμετέχουν σε οργανωμένα ταξίδια ανταποκρίνονται στις κυρίαρχες αναπαραστάσεις των τουριστών-καταναλωτών. Κατά πόσο το ταξίδι αποτελεί «εξαιρετική εμπειρία», όπως την ορίζει ο Dilthey, απόλυτα διακριτή από την καθημερινότητα των ανθρώπων που ταξιδεύουν ή μήπως αποτελεί απλώς συνέχεια της καθημερινότητάς τους. Με ποιον τρόπο επιτελείται και βιώνεται η υποκειμενικότητα στο ταξίδι μέσα από καταναλωτικές πρακτικές και πώς αυτές οι πρακτικές ερμηνεύονται από τους ταξιδιώτες και χρησιμοποιούνται ως μέσο της κατά Bourdieu διάκρισης, όταν γίνονται αντικείμενο αφήγησης. Τέλος, ποιες είναι οι εννοιολογήσεις που αποδίδουν οι πληροφορητές μου στο ταξίδι, ποιος ο ρόλος της κατανάλωσης και η σημασία των αντικειμένων που αποκτώνται κατά τη διάρκειά του και με ποιον τρόπο αυτά εμπλέκονται στις παραπάνω υποθέσεις έρευνας.Η εθνογραφική αυτή μελέτη, υιοθετώντας ορισμένες από τις βασικές υποθέσεις του υπαρξισμού, αντλεί από τις θεωρητικές αναζητήσεις πεδίων όπως η Ανθρωπολογία του Τουρισμού, η Ανθρωπολογία της Εμπειρίας, η μελέτης της Κατανάλωσης και του Υλικού Πολιτισμού.

During the 2020 Mars opposition, we observe from Earth the occurrence of a non-typical large-scale high-altitude clouds system, extending over thousands of km from the equator to 50°S. Over 3 hours, they emerge from the night side at an altitude of 90 (-15/+30) km and progressively dissipate in the dayside. They occur at a solar longitude of 316°, west of the magnetic anomaly and concomitantly to a regional dust storm. Despite their high altitude, they are composed of relatively large particles, suggesting a probable CO2 ice composition, although H2O cannot be totally excluded. Such ice clouds were not reported previously. We discuss the formation of this new type of clouds and suggest a possible nucleation from cosmic particle precipitation.

Chronic prostatic inflammation may be classified into three types that share similar symptoms and are distinguished on the basis of microbiological findings. In the present study, consecutive cases of chronic prostatic inflammation and infection were retrospectively reviewed in order to explore the clinical course and long-term outcomes. The cohort consisted of patients with symptoms of prostatitis who visited the Urology Clinic of the Tzaneion Hospital (Piraeus, Greece) between March 2009 and March 2019. The patients were subjected to the Meares and Stamey '4-glass' test and patients with febrile prostatitis were evaluated with a single mid-stream 'clean' urine sample culture. Bacterial identification was performed using the Vitek 2 Compact system and the sensitivity test with the disc and the Vitek 2 system. A total of 656 patients with prostatitis-like symptoms with 1,783 visits for investigation and follow-up were reviewed and patients were divided into two major groups. Group 1 consisted of 549 cases with a single set of chronic prostatitis (CP)-like symptoms assessed in up to three visits. National Institutes of Health (NIH) category II CP (NIH-II) was most frequently diagnosed in those patients (37,6%). At the follow-up, 125 patients were identified as having a type of CP different from that determined initially. Group 2 (107 cases) had recurring episodes of prostatitis-like symptoms assessed or confirmed over the course of 4-18 visits. Most patients (54.2%) were initially diagnosed with NIH-II followed by disease-free periods and recurrence/reinfection or by shifts to NHI-IIIB. In conclusion, CP remains a poorly understood n medical condition characterized by a variety of clinical manifestations and by transitions between different CP classes during its course.

Introduction Surgery can be dangerous not only for patients, but it also carries a risk for the surgeon in case of medical error, which can affect their future medical career. The purpose of our research is to assess the current situation regarding medical liability in General Surgery in Greece, the reasons for the allegations of medical malpractice as well as the relationship between these issues and the court results. Methods Published court decisions of criminal, civil, administrative and disciplinary content were searched in legal information banks, between year 1973 and 2020. Court decisions were analyzed by an expert, a specialist general surgeon and an anesthesiologist, for the causes of death and the correctness of the court decision in collaboration with the lawyers of the investigation. Results 588 court decisions were retrieved, out if which 103 (17.751%) criminal (n = 81), or civil and administrative decisions (n ​​= 22) for surgeons. Out of a total of 81 first and second instance criminal cases and appellate court decisions of the Supreme Court, 27 cases concerned negligent homicide, 16 cases concerned negligent bodily harm and seven were acquittals. Out of 22 civil cases decisions, awarding or not awarding compensation, three cases concerned negligent homicide, seven bodily harm and two were acquittals. 11 cases of negligent homicide concerned laparoscopic and bariatric surgical procedures. Conclusions Laparoscopic surgery represents one of the most important surgical developments in the last 30 years. However, they represent a great proportion of the cases concerning medical malpractice in the greek legal system. It is important to have a national center for reporting misdiagnosis and complications and a medical liability system that will facilitate improved diagnosis, learning from diagnostic errors and delays in diagnosis, in order to avoid similar cases of malpractice in the future.

Background Hip fracture is common and morbid in elderly patients. Postoperative cognitive dysfunction (POCD) is also very common in these subjects undergoing surgery with an incidence which exceeds 40% in some reports. To date, the evidence is ambiguous as to whether anesthetic technique may affect the patients’ outcome as far as postoperative cognitive function is concerned. Objective The aim of this study was to compare the effect of general and subarachnoid (spinal) anesthesia on the development of POCD up to 30 days after surgery in elderly patients undergoing hip fracture surgery. Methods Subjects over 65 years with hip fracture undergoing surgery were recruited for this study. They were enrolled and randomized to receive either general anesthesia (GA group) or subarachnoid (spinal) anesthesia (S group). Cognitive function was assessed using a battery of neuropsychological tests undertaken preoperatively and at 30 days postoperatively. The incidence of delirium was examined during the same period and their functional status, in terms of activities of daily living was also recorded. Results A total of seventy patients, 33 men and 37 females, mean age of 76 years were analyzed. Thirty-three patients received general anesthesia (GA group) and 37 subarachnoid (spinal) anesthesia (S group). The two groups of patients were similar with respect to baseline characteristics, comorbidities and perioperative data. The results of neuropsychological testing showed that there were no significant differences between the groups in eight out of ten neurocognitive tests at baseline and 30 days after surgery. There was a statistically significant decline of the Instrumental Activities of Daily Living Scale score in S group compared with group GA on the 30th postoperative day (p = 0.043). A significant decline was also present in Color-Word Task test in S group compared with group GA at baseline (p = 0.014) and 30 days postoperatively (p = 0.003). Postoperative delirium was present in four patients (12%) for the GA group, and in 10 patients (27%) for the group receiving subarachnoid anesthesia. Conclusion We concluded that the choice of anesthesia modality does not appear to influence the emergence of postoperative cognitive dysfunction in elderly patients undergoing hip fracture surgery.

Background. The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults. Methods. A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses “pre” and “during” the lockdown period. Participants responded to the Short Warwick–Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire. Results. Replies from older adults (aged &gt, 55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p &lt, 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p &lt, 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p &lt, 0.001, R2: 0.20). Conclusion. COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.

Sugammadex is routinely used as an effective neuromuscular blockade reversal agent. Several studies have indicated that it may prolong the prothrombin time (PT) and the activated partial thromboplastin time (aPTT). This review gathers the relevant in vivo studies to accumulate knowledge on the subject. Nine studies were included. According to the results, sugammadex seems to lead to a transient increase in aPTT and PT values, compared to standard care. However, the clinical impact seems to be trivial. Nevertheless, the trials’ findings reveal great heterogeneity, preventing a meta-analysis. Therefore, more well-designed studies are needed to lead to prudent conclusions.

Shortly after reaching the first perihelion, the Energetic Particle Detector (EPD) onboard Solar Orbiter measured a low-energy ( 17 MeV/nuc ion measurements. On the other hand, no electron increases were detected. As seen from 1 au, there is no clear evidence of solar activity from the visible disk that could be associated with the origin of this ion event. We hypothesize about the origin of this event as due to either a possible solar eruption occurring behind the visible part of the Sun or to an interplanetary spatial structure. We use interplanetary magnetic field data from the Solar Orbiter Magnetometer (MAG), solar wind electron density derived from measurements of the Solar Orbiter Radio and Plasma Waves (RPW) instrument to specify the in-situ solar wind conditions where the ion event was observed. In addition, we use solar wind plasma measurements from the Solar Orbiter Solar Wind Analyser (SWA) suite gathered during the following solar rotation, for comparison purposes. In order to seek for possible associated solar sources, we use images from the Extreme Ultraviolet Imager (EUI) instrument onboard Solar Orbiter. Together with the lack of electron observations and Type III radio bursts, the simultaneous response of the ion intensity-time profiles at various energies indicates an interplanetary source for the particles. The two-step FD shape observed during this event suggests that the first step early on June 18 was due to a transient structure, whereas the second step on June 19, together with the ~50 –1000 keV/nuc ion enhancement, was due to a solar wind stream interaction region. The observation of a similar FD in the next solar rotation favours this interpretation, although a more complex structure cannot be discarded due to the lack of concurrent solar wind temperature and velocity observations.Different parts of this research have received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 870405 (EUHFORIA 2.0) and grant agreement No 01004159 (SERPENTINE).

We present the solar wind forecast pipeline that is being implemented as part of the H2020 SafeSpace project. The Goal of this project is to use several tools in a modular fashion to address the physics of Sun – interplanetary space – Earth’s magnetosphere. This presentation focuses on the part of the pipeline that is dedicated to the forecasting – from solar measurements – of the solar wind properties at the Lagrangian L1 point. The modeling pipeline puts together different mature research models: determination of the background coronal magnetic field, computation of solar wind acceleration profiles (1 to 90 solar radii), propagation across the heliosphere (for regular solar wind, CIRs and CMEs), and comparison to spacecraft measurements. Different magnetogram sources (WSO, SOLIS, GONG, ADAPT) can be combined, as well as coronal field reconstruction methods (PFSS, NLFFF), wind (MULTI-VP) and heliospheric propagation models (CDPP 1D MHD, EUHFORIA). We aim at providing a web-based service that continuously supplies a full set of bulk physical parameters of the solar wind at 1 AU several days in advance, at a time cadence compatible with space weather applications. This work has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 870437.

In this work, the Dynamic Time Warping (DTW) technique is presented as an alternative method to assess the performance of modeled solar wind time series at Earth (or at any other point in the heliosphere). This method can quantify how similar two time series are by providing a temporal alignment between them, in an optimal way and under certain restrictions. It eventually estimates the optimal alignment between an observed and a modeled series, which we call the warping path, by providing a single number, the so-called DTW cost. A description on the reasons why DTW should be applied as a metric for the assessment of solar wind time series, is presented. Furthermore, examples on how exactly the technique is applied to our modeled solar wind datasets with EUHFORIA, are shown and discussed.This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 870437 (SafeSpace).

With more than 4,300 confirmed exoplanets and counting, the next milestone in exoplanet research is to determine which of these newly found worlds could harbor life. Coronal Mass Ejections (CMEs), spawn by magnetically active, superflare-triggering dwarf stars, pose a direct threat to the habitability of terrestrial exoplanets as they can deprive them from their atmospheres. Here we develop a readily implementable atmosphere sustainability constraint for terrestrial exoplanets orbiting active dwarfs, relying on the magnetospheric compression caused by CME impacts. Our constraint focuses on a systems understanding of CMEs in our own heliosphere that, applying to a given exoplanet, requires as key input the observed bolometric energy of flares emitted by its host star. Application of our constraint to six famous exoplanets, (Kepler-438b, Proxima-Centauri b, and Trappist-1d, -1e, -1f and -1g), within or in the immediate proximity of their stellar host's habitable zones, showed that only for Kepler-438b might atmospheric sustainability against stellar CMEs be likely. This seems to align with some recent studies that, however, may require far more demanding computational resources and observational inputs. Our physically intuitive constraint can be readily and en masse applied, as is or generalized, to large-scale exoplanet surveys to detect planets that could be sieved for atmospheres and, perhaps, possible biosignatures at higher priority by current and future instrumentation., Comment: Accepted for publication by ApJ Letters

Chronic prostatitis (CP) is a common health condition in men. Albeight obvious, a relationship between microbial induced prostatic inflammation and sexual function has not been as thoroughly investigated. Aiming to investigate possible associations between sexuality/sexual orientation and chronic bacterial prostatitis, we retrospectively evaluated 1783 visits (2009-2019) owing to investigation of prostatitis-like symptoms and routine follow up. A total of 389 patients, provided information regarding sexual orientation and sexuality. The mean age was 45,5 years. According their report, 92.28% were heterosexual, 6.16% homosexual and 1.54% bisexual. Regarding sexuality, 26,6% reported multiple sexual partnerships while 73,4% reported single sexual partnerships. There was a statistically significant association between chronic bacterial prostatitis as initial diagnosis and having multiple sexual partnerships. In contrast, the association between CBP and sexual orientation was not statistically significant Similarly, no significant association between any therapy outcome and having multiple sexual partners was established. Our findings suggest a connection between sexual practices and the onset of CBP which should be further investigated in order to reach to scientific conclusions.