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Understanding the pre-eruptive volatile contents in magmas is critical to charactering the magmatic plumbying systems that feed acative volcanoes, and is key to volcano monitoring and volcanic hazard assessment. Silicate melt inclusions (MIs) hosted in primitive minerals are a powerful tool to definite parental melt volatile contents, and to track the volatile degassing path upon magma ascent and decompression.Here, we apply different analyses (Raman Spectroscopy, Nano SIMS, Electron microprobe, Laser Ablation ICPMS) for the characterisation of major and trace elements and volatiles in silicate melt inclusions entrapped in minerals from recently erupted tephra by Fogo Volcano in Cape Verde archipelago, one of the most active intraplate volcanic systems on Earth.Our aims are to (i) characterise the pressure-dependent magma compositional changes taking place during magma storage and ascent, (ii) model magmatic degassing and (iii) constrain the magmatic source, and the rates/modes of magma ascent prior and during eruption.Seventeen MIs hosted in twelve olivine phenocrysts (Fo79-85) were examined from tephra samples of two distinct periods of the last 10 ky of activity of the volcano. In detail, we studied basanitic (SiO2 ~42 wt.%, MgO ~4.8 wt. %) and alkali-rich (Na2O + K2O = 6.9 wt.%) tephra samples of São Jorge (early Holocene activity, ~10 ka) and of the most recent eruptions (1951 and 2014/15).Results reveal high concentrations of incompatible trace elements (e.g.,˜70 ppm Nb) and dissolved volatiles ( ˜2.1 wt.% H2O and ≥1 wt.% CO2) in the parental (un-degassed) magma. We use different H2O-CO2 solubility models to estimate MI entrapment pressures along the magma plumbing system. The deepest entrapment pressures of ˜1000-1400 MPa (corresponding to ˜ 30-46 km) are recorded in Holocene products, while the inclusions from the recent eruptions indicate shallower entrapment pressures of ˜ 350-1100 MPa (˜ 11-35km). These entrapment pressure data, combined with previous independent barometric results, demonstrate a relatively deep (30-40 km) magma source for Fogo eruptions. Our results are the first to unambiguously demonstrate the CO2-rich nature of alkali-rich mafic melts feeding intraplate volcanism at Cape Verde.

Purpose During a follow-up program of patients admitted for COVID-19 at our non-ICU Unit, we found that 37% of them had decreased diffusing lung capacity for carbon monoxide (DLCO) 3–6 months after discharge. This prospective observational study aimed to evaluate the evolution of changes in DLCO and respiratory symptoms at the 1-year follow-up visit. Methods Seventeen (mean age 71 years; 8 males) of 19 eligible patients (DLCO 80% of predicted) in 6 (35%); in the other 6 (35%) it remained unchanged. The prevalence of exertional dyspnea (65–35%, P = 0.17), cough (24–18%, P = 1), and fatigue (76–35%, P = 0.04) decreased at the 1-year visit. Conclusion These results suggest that DLCO and respiratory symptoms tend to normalize or improve 1 year after hospitalization for COVID-19 in most patients. However, there is also a non-negligible number of patients (about one-third) in whom respiratory changes persist and will need prolonged follow-up.

Background Nursing home (NH) residents have been dramatically affected by COVID-19, with extremely high rates of hospitalization and mortality. Aims To describe the features and impact of an assistance model involving an intermediate care mobile medical specialist team (GIROT, Gruppo Intervento Rapido Ospedale Territorio) aimed at delivering “hospital-at-nursing home” care to NH residents with COVID-19 in Florence, Italy. Methods The GIROT activity was set-up during the first wave of the pandemic (W1, March–April 2020) and became a structured healthcare model during the second (W2, October 2020–January 2021). The activity involved (1) infection transmission control among NHs residents and staff, (2) comprehensive geriatric assessment including prognostication and geriatric syndromes management, (3) on-site diagnostic assessment and protocol-based treatment of COVID-19, (4) supply of nursing personnel to understaffed NHs. To estimate the impact of the GIROT intervention, we reported hospitalization and infection lethality rates recorded in SARS-CoV-2-positive NH residents during W1 and W2. Results The GIROT activity involved 21 NHs (1159 residents) and 43 NHs (2448 residents) during W1 and W2, respectively. The percentage of infected residents was higher in W2 than in W1 (64.5% vs. 38.8%), while both hospitalization and lethality rates significantly decreased in W2 compared to W1 (10.1% vs 58.2% and 23.4% vs 31.1%, respectively). Discussion Potentiating on-site care in the NHs paralleled a decrease of hospital admissions with no increase of lethality. Conclusions An innovative “hospital-at-nursing home” patient-centred care model based on comprehensive geriatric assessment may provide a valuable contribution in fighting COVID-19 in NH residents.

The architecture of the magma storage system underneath Fogo Volcano (Cape Verde Archipelago) is characterised using novel fluid inclusion results from fifteen basanites, spanning the last 120 thousand years of volcanic activity, and encompassing a major flank collapse event at -73 ka. Fluid inclusions, hosted in olivine and clinopyroxene, are made of pure CO2, and based on their textural characteristics, are distinguished in early (Type I) and late (Type II) stage. Inclusions homogenize to a liquid phase in the 2.8 to 30.8 degrees C temperature range. Densities values, recalculated assuming an original 10% H2O content at the time of trapping, range from 543 to 952 kg center dot m(-3), and correspond to entrapment or re-equilibration pressure ranges of 500-595 MPa, 700-740 MPa, and 245-610 MPa respectively for pre-collapse, early post-collapse, and Holocene/historical eruptions. These entrapment pressures are interpreted as reflecting the existence of two main magma accumulation zones at similar to 25 km and similar to 13-21 km depth, and a zone of fluid inclusion re-equilibration at 9-12 km depth. There is evidence of a complex temporal evolution of the magma system. Historical eruptions, and especially the three most recent ones (occurred in 1951, 1995 and 2014-25), bring fluid inclusion evidence for transient, pre-eruptive shallow (9-17 km depth) magma ponding. Early post-collapse (60 ka) volcanics, in contrast, document fast magma transport from -25 km, and suggest a reconfiguration of the magma system after the Monte Amarelo collapse event.

Lung cancer accounts for a quarter of all mortality cases worldwide. To date, numerous efforts have been done to identify the best therapeutic approach, especially in the advanced stage of the disease, and to extend the overall survival of patients. Careful surveillance of patients during therapy is essential in order to identify undesirable effects and to evaluate possible adverse reactions in case of coadministration. This study aims to compare two types of anticancer therapy, immunotherapy and chemotherapy, administered to NSCLC patients in the Medical Oncology Unit of the ARNAS “Di Cristina Benfratelli” Civic Hospital in Palermo (Italy), and to highlight the key role of clinical pharmacist in the management of anticancer therapies, by analysing the side effects in the short-term postadministration and the adverse drug reactions, in particular drug-drug interactions, in case of comorbidities.

Inpatients with hospital-acquired (HA) COVID-19 have mortality rates above 30%. Subjects with early diagnosis of COVID-19 and risk factors for disease progression are suitable for treatment with anti-SARS-CoV-2 neutralizing monoclonal antibodies (mAbs). We retrospectively assessed the outcome of a cohort of hospitalized patients with laboratory confirmed SARS-CoV-2 nosocomial infection who were admitted to the COVID-19 general ward of an acute-care Italian hospital between October 25, 2020 and April 30, 2021. Patients receiving the REGEN-COV mAb cocktail (casirivimab/imdevimab) were compared with those receiving standard care. Of 34 patients, 11 (mean age, 73.1; 9 males) underwent treatment with REGEN-COV and 23 received standard care. The 2 study groups were well balanced regarding age, sex, comorbidities, acute illness severity at diagnosis of SARS-CoV-2 infection, and all participants had at least 2 risk factors for disease progression. Five of 11 patients in the REGEN-COV group and 16 of 23 in the standard care group were asymptomatic at diagnosis; the remaining had symptoms of mild COVID-19. All patients received REGEN-COV within 3 days of infection confirmation. Treatment with REGEN-COV was inversely associated with oxygen requirement for COVID-19 during hospital stay (OR 0.02, CI 0–0.52, p=0.0174). No 28-day deaths were registered in the REGEN-COV group, compared to 8 (34.8%) in the standard care group (p=0.0339). Kaplan-Meier analysis confirmed the survival advantage of REGEN-COV group (log-rank p=0.00324). No serious adverse events related to REGEN-COV administration were recorded. Based on these findings, REGEN-COV appears safe and might prevent disease progression in high-risk inpatients with early diagnosis of HA-COVID-19.

Evidence on the effectiveness of SARS-CoV-2 vaccines in nursing home (NHs) residents is limited. We examined the impact of the BNT162b2 mRNA SARS-CoV-2 vaccine on the course of the epidemic in NHs in the Florence Health District, Italy, before and after vaccination. Moreover, we assessed survival and hospitalization by vaccination status in SARS-CoV-2-positive cases occurring during the post-vaccination period. We calculated the weekly infection rates during the pre-vaccination (1 October–26 December 2020) and post-vaccination period (27 December 2020–31 March 2021). Cox analysis was used to analyze survival by vaccination status. The study involved 3730 residents (mean age 84, 69% female). Weekly infection rates fluctuated during the pre-vaccination period (1.8%–6.5%) and dropped to zero during the post-vaccination period. Nine unvaccinated (UN), 56 partially vaccinated (PV) and 35 fully vaccinated (FV) residents tested SARS-CoV-2+ during the post-vaccination period. FV showed significantly lower hospitalization and mortality rates than PV and UV (hospitalization: FV 3%, PV 14%, UV 33%; mortality: FV 6%, PV 18%, UV 56%). The death risk was 84% and 96% lower in PV (HR 0.157, 95%CI 0.049–0.491) and FV (HR 0.037, 95%CI 0.006–0.223) versus UV. SARS-CoV-2 vaccination was followed by a marked decline in infection rates and was associated with lower morbidity and mortality among infected NH residents.

The Calabozo Formation (Cuyo Mesosequence, Neuquén Basin) is made up by a thin, up to 30-m thick Middle Jurassic carbonate-dominated sequence. The minor, thin siliciclastic facies in this formation (i.e. lowermost granule-pebble shoreface conglomerate and fine-grained sandstones interbedded among the lower carbonates) record early transgressive shoreline and shallow lagoonal-subtidal sedimentation, respectively. The major carbonate deposits have been split into six facies and seven microfacies on the base of macroscopic field observation and petrological analysis. The carbonate facies have been grouped into three major assemblages: 1) Tidal flat facies assemblage (including the planar laminated algal boundstone facies; 2) Inner platform facies assemblage (including peloidal and bioclastic wackestone, coral floatstone and bioclastic and intraclastic packstone facies; and 3) Platform margin assemblage (including oolitic-peloidal packstone-grainstone facies). Afossil algal record made up by dasycladacean species (Salpingoporella annulata, Cylindroporella sp. and Heteroporella sp.) and blue-green algae (Cayeuxia (Rivularia) piae, and Cayeuxia (Rivularia) kurdistanensis) has been reported for the first time in this unit. The analysis of the intracycle facies and microfacies arrangements, as well as the nature of the cycle bounding surfaces, enabled one to identify two kinds of cycles. 1) Widespread subtidal cycles capped by shallow to intermediate subtidal facies, with no evidence of subaerial exposure at cycle tops; and 2) a minor subtidal cycle with similar shallowing-upward trend but capped by peritidal facies. The stacking pattern and thickness trend of these cycles was studied to determine possible allocyclic and autocyclic controls on their evolution. The Fischer plots reveal that the deposition of the Calabozo Formation subtidal-peritidal cycles took place under upward decreasing accommodation space conditions which may be related to eustatic lowering.

Risk stratification of cardiac surgery patients is usually based on the Society of Thoracic Surgeons (STS) score, that has limited predictive value in older persons. We aimed assessing whether the Short Physical Performance Battery (SPPB) improves, beyond the STS score, assessment of hospital prognosis in older patients undergoing elective cardiac surgery.All patients aged 75+ years referred for elective cardiac surgery to Careggi University Hospital (Florence, Italy) from April 2013 to March 2017 were evaluated pre-operatively. Participants were classified according to the STS-Predicted Risk Of Mortality (STS-PROM): low (4%), intermediate (4 to 8%), and high risk (8%). Primary study outcomes were hospital mortality and STS-defined major morbidity. Length of hospital stay was an additional outcome.Out of 235 participants (females: 46.5%; mean age: 79.6 years), 144 (61.3%) were at low, 67 (28.5%) at intermediate and 24 (10.2%) at high risk, based on the STS-PROM. SPPB (mean±SEM) was 8.8 ± 0.2, 7.0 ± 0.5, and 6.0 ± 0.8 in participants at low, intermediate, and high risk, respectively (p0.001). The primary outcome occurred in 62 participants (26.4%). In low-risk participants, the SPPB score predicted the primary endpoint (adjusted OR 0.77, 95% CI 0.66-0.89 per each point increase; p0.001) controlling for STS-Major Morbidity or Operative Mortality (STS-MM) score. This result was not observed in the intermediate-high risk group.SPPB predicts mortality and major morbidity in older patients undergoing elective cardiac surgery, classified as low risk with the STS risk score. The SPPB, applied preoperatively, might improve risk stratification in older patients undergoing elective cardiac surgery.

The number of older people candidates for interventional cardiology, such as PCI but especially for transcatheter aortic valve implantation (TAVI) , would increase in the future. Generically, the surgical risk, the amount of complications in the perioperative period, mortality and severe disability remain significantly higher in the elderly than in younger. For this reason it's important to determine the indication for surgical intervention, using tools able to predict not only the classics outcome (length of stay, mortality), but also those more specifically geriatrics, correlate to frailty: delirium, cognitive deterioration, risk of institutionalization and decline in functional status. The majority of the most used surgical risks scores are often specialist-oriented and many variables are not considered. The need of a multidimensional diagnostic process, focused on detect frailty, in order to program a coordinated and integrated plan for treatment and long term follow up, led to the development of a specific geriatric tool: the Comprehensive Geriatric Assessment (CGA). The CGA has the aim to improve the prognostic ability of the current risk scores to capture short long term mortality and disability, and helping to resolve a crucial issue providing solid clinical indications to help physician in the definition of on interventional approach as futile. This tool will likely optimize the selection of TAVI older candidates could have the maximal benefit from the procedure.

The number of older people candidates for interventional cardiology, such as PCI but especially for transcatheter aortic valve implantation (TAVI) , would increase in the future. Generically, the surgical risk, the amount of complications in the perioperative period, mortality and severe disability remain significantly higher in the elderly than in younger. For this reason it's important to determine the indication for surgical intervention, using tools able to predict not only the classics outcome (length of stay, mortality), but also those more specifically geriatrics, correlate to frailty: delirium, cognitive deterioration, risk of institutionalization and decline in functional status. The majority of the most used surgical risks scores are often specialist-oriented and many variables are not considered. The need of a multidimensional diagnostic process, focused on detect frailty, in order to program a coordinated and integrated plan for treatment and long term follow up, led to the development of a specific geriatric tool: the Comprehensive Geriatric Assessment (CGA). The CGA has the aim to improve the prognostic ability of the current risk scores to capture short long term mortality and disability, and helping to resolve a crucial issue providing solid clinical indications to help physician in the definition of on interventional approach as futile. This tool will likely optimize the selection of TAVI older candidates could have the maximal benefit from the procedure.

Introduction Risk stratification of patients candidate to cardiac surgery is usually based on the Society of Thoracic Surgeons (STS) score or on the Euroscore II. However, these risk scores has limited predictive value in elderly patients. Purpose We conducted a study to determine whether the Short Physical Performance Battery (SPPB), a tool assessing physical performance, predicts hospital death and major morbidity, beyond STS risk score. The outcome was a composite end-point as defined by STS Major Morbidity or Operative Mortality (STS-MM) in STS Risk Model Outcomes: operative mortality, stroke, renal failure, prolonged mechanical ventilation, deep sternal wound infection, and reoperation. Methods In this prospective, single-center, cohort, hospital-based study, conducted at Careggi University Hospital, Florence, Italy, all patients aged 75+ years referred for an elective coronary aortic by-pass grafting, valvular surgery or combined cardiac surgery were evaluated pre-operatively. Assessment included SPPB, cognitive and functional status and evaluation of comorbidity. Patients receiving emergency/urgent cardiac surgery or a procedure not considered in the STS risk score calculator, who reported previous cardiac surgery or were clinically unstable were excluded. Participants were classified according to the STS-Predicted Risk Of Mortality (STS-PROM) as at low (8%). Results Out of 250 participants (females: 48.4%; mean age: 79.9 years), 148 (59.2%) were at low, 73 (29.2%) at intermediate and 29 (11.6%) at high risk, based on the STS-PROM. Mean±SEM SPPB score was 8.8±0.2, 7.1±0.4 and 6.0±0.7 in participants at low, intermediate, and high risk, respectively (p Figure 1 Conclusions SPPB predicts mortality and major morbidity in older patients undergoing elective cardiac surgery, in particular in those classified as low-risk with the STS risk score. Use of SPPB should therefore be recommended to improve preoperative risk stratification of older patients.

If the Sustainable Development Goal (SDG) target 5.3 to end child marriage by 2030 is to be met, the annual rate of reduction in the prevalence of child marriage must increase from 1.9% to 23%. Over 30 countries have developed, or are developing, national policies/programmes towards this goal. However, many are struggling to operationalise these policies/programmes, particularly at subnational levels. Thus, Girls Not Brides and the WHO commissioned a review of lessons learnt from national and subnational implementation of multi-sectoral policies/programmes targeting other issues that could be applied to the global movement to end child marriage. This review identified a number of pragmatic lessons learnt. At the national level, countries should identify and engage committed and skilled leadership, build a shared understanding of the target issue and how to address it, and delineate and clarify the roles and responsibilities of relevant stakeholders. At the subnational level, countries should establish coordination mechanisms, build awareness and capacity of staff, use subnational evidence to contextualise and tailor interventions, develop coordinated budgets and cost-sharing mechanisms, and integrate monitoring and evaluation systems. These lessons are remarkably consistent, despite coming from different target issues and contexts. The commonality of these findings reveals that various stakeholders are repeatedly and consistently failing to ensure that these fundamental requirements are in place. It is vital that the global movement to end child marriage learns from and uses these lessons if it is to meet its SDG target.

At present, the majority of cardiac surgery interventions have been performed in the elderly with successful short-term mortality and morbidity, however significant difficulties must to be underlined about our capacity to predict long-term outcomes such as disability, worsening quality of life and loss of functional capacity.The reason probably resides on inability to capture preoperative frailty phenotype with current cardiac surgery risk scores and consequently we are unable to outline the postoperative trajectory of an important patients’ centered outcome such as disability free survival. In this perspective, more than one geriatric statements have stressed the systematic underuse of patient reported outcomes in cardiovascular trials even after taking account of their relevance to older feel and wishes. Thus, in the next future is mandatory for geriatric cardiology community closes this gap of evidences through planning of trials in which patients’ centered outcomes are considered as primary goals of therapies as well as cardiovascular ones.

I diciassette contributi pubblicati negli Atti del convegno tenutosi a Cergy-Pontoise nel novembre 2014 fanno luce sulle inedite modalità di engagement messe in atto dalla scrittura di Annie Ernaux: letterario, più che militante in senso sartriano, esso ripudia ogni postura autoriale rispetto al lettore, cercando piuttosto di intervenire nel suo rapporto con il mondo attraverso un esigente lavoro sulla forma. Un «engagement d’écriture» dunque, che viene qui esplorato dagli studiosi in relazio...

This paper considers the efforts of United Nations and international agencies to address the threats to Palestinian children arising from Israeli occupation. It contains an account of the reasons why agencies have failed, over many years, to prevent systematic violations by the Israeli authorities and settlers. The discussion is organised around two inter-related domains: institutional and political. The paper argues that, in the occupied Palestinian territory (oPt), limitations to the ways in which child protection has been conceptualised and pursued in practice are abundantly evident. Nevertheless, political pressure by Western donor governments serves to constrain an approach to child protection that is more preventative in nature, that addresses more explicitly Israeli violations of international law, and that reflects the experience and aspirations of Palestinian children themselves. Ultimately, therefore, the failure to protect Palestinian children must be seen not only as a result of humanitarian miscalculation but also as a consequence of political strategy.

I diciassette contributi pubblicati negli Atti del convegno tenutosi a Cergy-Pontoise nel novembre 2014 fanno luce sulle inedite modalita di engagement messe in atto dalla scrittura di Annie Ernaux: letterario, piu che militante in senso sartriano, esso ripudia ogni postura autoriale rispetto al lettore, cercando piuttosto di intervenire nel suo rapporto con il mondo attraverso un esigente lavoro sulla forma. Un «engagement d’ecriture» dunque, che viene qui esplorato dagli studiosi in relazio...