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Abstract Background The usefulness of digital chest drain is still debated. We are carrying out a study to determine if the use of a digital system compared with a traditional system reduces the duration of chest drainage. To evaluate safety, benefit, or futility of this trial we planned the current interim analysis. Methods An interim analysis on preliminary data from ongoing investigator-initiated, multicenter, interventional, prospective randomized trial. Original protocol number: (NCT03536130). The interim main endpoint was overall complications; secondary endpoints were the concordance between the two primary endpoints of the RCT (chest tube duration and length of hospital stay). We planned the interim analysis when half of the patients have been randomised and completed the study. Data were described using mean and standard deviation or absolute frequencies and percentage. T-test for unpaired samples, Chi-square test, Poisson regression and absolute standardized mean difference (ASMD) were used. P-value

BackgroundRespiratory physiotherapy is reported as safe and feasible in mechanically ventilated patients with severe Coronavirus Disease (COVID-19) admitted to Intensive Care Unit (ICU), but the short-term benefits remain unclear.MethodsWe performed a retrospective observational study in four ICUs in Northern Italy. All patients with COVID-19 admitted to ICU and under invasive mechanical ventilation (MV) between March 1st and May 30th, 2020, were enrolled into the study. Overlap weighting based on the propensity score was used to adjust for confounding in the comparison of patients who had or had not been treated by physiotherapists. The primary outcome was the number of days alive and ventilator-free (VFDs). The secondary outcomes were arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio (P/F) at ICU discharge, ICU length of stay, ICU and hospital mortality, and survival at 90 days. The trial protocol was registered on clinicaltrials.gov (NCT 05067907).ResultsA total of 317 patients were included in the analysis. The median VFDs was 18 days [interquartile range (IQR) 10; 24] in patients performing physiotherapy and 21 days (IQR 0; 26) in the group without physiotherapy [incidence rate ratio (IRR) 0.86, 95% confidence interval (CI): 0.78; 0.95]. The chance of 0 VFDs was lower for patients treated by physiotherapists compared to those who were not [odds ratio (OR) = 0.36, 95% CI: 0.18–0.71]. Survival at 90 days was 96.0% in the physiotherapy group and 70.6% in patients not performing physiotherapy [hazard ratio (HR) = 0.14, 95% CI: 0.03–0.71]. Number of VFDs was not associated with body mass index (BMI), sex, or P/F at ICU admission for individuals with at least 1 day off the ventilator.ConclusionIn patients with COVID-19 admitted to ICU during the first pandemic wave and treated by physiotherapists, the number of days alive and free from MV was lower compared to patients who did not perform respiratory physiotherapy. Survival at 90 days in the physiotherapy group was greater compared to no physiotherapy. These findings may be the starting point for further investigation in this setting.

The Makgadikgadi Basin in Botswana hosts a system of salt lakes, which developed from the Upper Pleistocene onward due to the gradual shrinking of the giant Lake Palaeo-Makgadikgadi. Stratigraphic and palaeoclimatic studies of this area are difficult due to the influence of several factors, such as a complex history of regional tectonic activities, as well as climatic changes coupled with dryland diagenetic processes. This lake, in the central Kalahari, is the key to understanding the climatic variability in the southern part of Africa in the Quaternary and has played an important role in the evolution of numerous taxa, including our own. In this study, detailed sedimentological analyses (grain size and major elements distribution) of shallow sediments from the Makgadikgadi Pans were combined with the first comprehensive study of the encountered ostracod fauna to establish trends in the environmental changes in the area from the late Quaternary. Ostracod fossil assemblages from the cores of the Makgadikgadi Pans are dominated by the Limnocythere ssp., an opportunistic taxa commonly colonizing the littoral areas of shallow evaporative, ephemeral lakes, together with the subordinate occurrences of Sarcypridopsis ochracea, Sclerocypris cf. bicornis, Candonopsis spp., and Ilyocypris spp. The sediments from the pans show fluctuations in the Cl/K and Ca/Cl ratios, often in phase with the relative abundance of Limnocythere suggesting a cyclicity induced by changes of salinity and alkalinity in the water. This multi-proxy study of the cores collected from the pans suggests a Late Pleistocene shallow, playa lake environment with strongly alkaline water, interrupted by a prolonged drought with sustained aeolian conditions between ∼16 and 2 ka BP. Increasing diversity of ostracod fauna in the top 20–30 cm of the cores indicates that a temporary shift toward higher humidity occurred around 2–1.5 ka BP and lasted through the Medieval Warm Period. This humid period was followed by an overall desiccation trend that started with the Little Ice Age and continues until the present day.

Early physiotherapy could play an important role in the management of severe COVID-19 subjects with consequences of prolonged ICU stay, although its effectiveness is still unclear. Aim of this study is to describe physiotherapy performed in severe COVID-19 patients and to evaluate its safety and feasibility. Consecutive adults with confirmed SARS-CoV-2 infection, admitted to the ICU, needing invasive mechanical ventilation for >24 hours and receiving early physiotherapy, have been enrolled. Adverse events occurred during physiotherapy sessions and timing and type of physiotherapy delivered were analysed, to identify the interventions most frequently performed and to determine the time taken to first mobilize, stand and walk. Functional and clinical assessment of patients was also performed at hospital discharge. Eighty-four severe COVID-19 subjects were enrolled. Few minor adverse events were recorded. Active mobilization was promoted over passive mobilization and independence in daily life activities was supported. Time interval from patients’ intubation to the first physiotherapy treatment was 13 days and to walking was 27 days. Forty-eight (57.1%) subjects returned at home, whereas 29 (34.5%) were discharged to in-patient rehabilitation. Patients with tracheostomy experienced a delay in time from ICU admission until sit out of bed and ambulation, if compared with subjects without tracheostomy, although no differences were found in 6MWT and 1m-STST performances. This study reporting early physiotherapy during pandemic suggests that this intervention is feasible and safe for severe COVID-19 subjects, as well as healthcare workers, although delayed compared to other critically ill patients.

This study describes the case of an 18-years-old male affected by severe COVID-19, who was receiving bilateral lung transplantation (LT), after 71 days of mechanical ventilation and 55 days of veno-venous extracorporeal membrane oxygenation. From post-operative day 2, early mobilization and physiotherapy treatments were performed. Weaning from mechanical ventilation, the use of non-invasive ventilation and tracheostomy management were included in the treatment. Forty-five days after LT the patient was discharged at home, showing improvements in terms of functional and respiratory parameters, quality of life and mood. While evidences about physiotherapy treatments in lung transplantation post severe COVID-19 remain limited, early approach and a multidisciplinary team may be considered key elements for functional recovery of these subjects.

The achievement of the Sustainable Development Goals (SDGs) requires a multi-stakeholder approach, calling upon governments, international organizations, nonprofit organizations and companies to act, everyone in its own capacity and within its sphere of influence. In their efforts to adopt an effective sustainability strategy, Lavazza and Lavazza Foundation gave themselves a mission, which is summarized in the so-called “Goal Zero”: spreading the SDGs message to as many stakeholders as they can, by using all possible and efficient ways and means. The article describes how Lavazza’s people and suppliers, as well as young people and local communities, have been involved in an ambitious project to increase knowledge, understanding and achievement of the SDGs. Then, the article focuses on Lavazza’s categorization of the Goals into three levels: Priority, Impacted and Tool Goals.

While Ethiopia and South Sudan are the native habitats for Coffea arabica, Yemen is considered an important domestication center for this coffee species as most Arabica coffee grown around the world can be traced back to Yemen. Furthermore, climatic conditions in Yemen are hot and extremely dry. As such, Yemeni coffee trees likely have genetic merits with respect to climate resilience. However, until recently, very little was known about the genetic landscape of Yemeni coffee. The Yemeni coffee sector identifies coffee trees according to numerous vernacular names such as Udaini, Tufahi or Dawairi. However, the geographical landscape of these names and their correlation with the genetic background of the coffee trees have never been explored. In this study, we investigated the geographic occurrence of vernacular names in 148 coffee farms across the main coffee areas of Yemen. Then, we used microsatellite markers to genotype 88 coffee trees whose vernacular name was ascertained by farmers. We find a clear geographical pattern for the use of vernacular coffee names. However, the vernacular names showed no significant association with genetics. Our results support the need for a robust description of different coffee types in Yemen based on their genetic background for the benefit of Yemeni farmers.

There is a need of consensus about the pulmonary rehabilitation (PR) in patients with COVID-19 after discharge from acute care. To facilitate the knowledge of the evidence and its translation into practice, we developed suggestions based on experts’ opinion. A steering committee identified areas and questions sent to experts. Other international experts participated to a RAND Delphi method in reaching consensus and proposing further suggestions. Strong agreement in suggestions was defined when the mean agreement was >7 (1 = no agreement and 9 = maximal agreement). Panelists response rate was >95%. Twenty-three questions from 4 areas: Personnel protection equipment, phenotypes, assessments, interventions, were identified and experts answered with 121 suggestions, 119 of which received high level of concordance. The evidence-based suggestions provide the clinicians with current evidence and clinical experts opinion. This framework can be used to facilitate clinical decision making within the context of the individual patient. Further studies will evaluate the clinical usefulness of these suggestions.

Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR) On February 2020, Italy, especially the northern regions, was hit by an epidemic of the new SARS-Cov-2 coronavirus that spread from China between December 2019 and January 2020. The entire healthcare system had to respond promptly in a very short time to an exponential growth of the number of subjects affected by COVID-19 (Coronavirus disease 2019) with the need of semi-intensive and intensive care units.

Ostracod faunal turnover and oxygen isotope data (foraminifera) along the Valle di Manche (VdM) section are herein compiled. Specifically, the material reported in this work includes quantitative palaeoecological data and patterns of ostracod fauna framed within a high-resolution oxygen isotope stratigraphy (δ18O) from Uvigerina peregrina. In addition, the multivariate ostracod faunal stratigraphic trend (nMDS axis-1 sample score) is calibrated using bathymetric distributions of extant molluscs sampled from the same stratigraphic intervals along the VdM section. Data and analyses support the research article “Dynamics of benthic marine communities across the Early-Middle Pleistocene boundary in the Mediterranean region (Valle di Manche, Southern Italy): biotic and stratigraphic implications” Rossi et al. [1].

Understanding Quaternary dynamics of delta-coastal plains across multiple glacial-interglacial cycles in the Milankovitch band (~100 kyrs) is crucial to achieve a robust evaluation of possible environmental response to future climate-change scenarios. In this work, we document the long-term bio-sedimentary record of core 204 S16 (~205 m long), which covers a wide portion of the post-MPR (Mid-Pleistocene Revolution) interval, taking advantage of the highly subsiding context of the SE Po Plain (NE Italy). Detailed facies characterization through an integrated sedimentological and meiofauna (benthic foraminifers and ostracods) approach allowed for the identification of a repetitive pattern of alluvial deposits alternating with four fossiliferous, paralic to shallow-marine units (Units 1–4). The transgressive surfaces identified at the base of these units mark major flooding events, forced by Holocene (Unit 4), Late Pleistocene (Unit 3) and Middle Pleistocene (Units 1, 2) interglacials. Distinct stratigraphic patterns typify the Middle Pleistocene interval, which includes coastal-marine (tidal inlet and bay) deposits. In contrast, lagoonal sediments record the maximum marine influence in the Late Pleistocene-Holocene succession. As a whole, the meiofauna tracks a regressive trend, with the deepest conditions recorded by the oldest Unit 1 (MIS 9/11 age?).