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Patients with acute aortic dissection (AD) remain at risk for long-term complications and thus are recommended to adhere closely to American College of Cardiology and American Heart Association aorta guideline-based follow-up imaging and clinic visits. The long-term outcomes of compliance with such a model are not well understood. This was a retrospective cohort study of patients at a regional AD center who survived hospital discharge for AD and who were analyzed by compliance with initial follow-up at 3 months and long term after AD. The primary end point was death. A total of 172 (66% type A; 33% type B) patients survived hospitalization and were followed up over 48 months (interquartile range [IQR], 21, 88 months). Of these patients, 122 (71%) attended the first follow-up appointment, and 90 (52%) attended more than two-thirds of recommended appointments. Patients who attended the first follow-up visit had improved long-term follow-up compliance (75% [IQR, 50%, 91%]) compared with patients who did not attend the first visit (18% [IQR, 0%, 57%]). Noncompliance with the scheduled long-term follow-up was associated with a 50% increase in the risk of death (hazard ratio, 1.6; 95% confidence interval, 1.2, 2.1; P <.001). Furthermore, in patients with low compliance (consistently attending less than one-third of follow-up appointments), the lifetime risk of death after AD was more than double that of patients with high compliance (consistently attending more than two-thirds of appointments) (hazard ratio, 2.2; 95% confidence interval, 1.5, 3.1; P <.001). Nearly one-third of patients with AD do not attend the first recommended follow-up visit, and such failure was associated with later noncompliance with subsequent follow-up. Low-compliant patients have double the lifetime risk of death after AD than do high-compliant patients. [ABSTRACT FROM AUTHOR]

Over the last decade, preoperative anemia has become recognized as a clinical condition in need of management. Although the etiology of preoperative anemia can be multifactorial, two thirds of anemic elective surgical patients have iron deficiency anemia. At the same time, one third of nonanemic elective surgical patients are also iron deficient. Modified RAND Delphi methodology was used to identify areas of consensus among an expert panel regarding the management of iron deficiency in patients undergoing cardiac surgery. A list of statements was sent to panel members to respond to using a five-point Likert scale. All panel members subsequently attended a face-to-face meeting. The initial survey was presented and discussed, and panel members responded to each statement on the Likert scale again. Based on the second survey, the panel came to a consensus on recommendations. The panel recommended all patients undergoing cardiac surgery be evaluated for iron deficiency, whether or not anemia is present. Evaluation should include iron studies and reticulocyte hemoglobin content. If iron deficiency is present, with or without anemia, patients should receive parenteral iron. Erythropoietin-stimulating agents may be appropriate for some patients. Consensus of an expert panel resulted in a standardized approach to diagnosing and managing iron deficiency in patients undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]

Many of the UNESCO World Heritage Sites face geological threats which could have negative effects on the value, integrity and accessibility of their heritage assets. A relevant example is the Derwent Valley Mills UNESCO World Heritage site, one of the key sites of Britain's industrial revolution of the 18th century and located along the Derwent River Valley. Individual susceptibility scenarios of natural hazards in the area like collapsible deposits, compressible ground, debris flow, landslide, running sands, shrink-swell, soluble rock and flooding (both riverine and groundwater) are available, but a comprehensive product able to support disaster mitigation measurement and land planning still does not exist. On this basis, a multi-hazard susceptibility analysis was completed with the added benefit of reducing the complexity and providing a methodological framework for multi-hazard estimation. The analysis was completed in a GIS environment through an Analytical Hierarchy Process (AHP) multicriteria decision-making process. Since the AHP method is affected by a user selection bias, a quantitative Relative significance index was derived to rank the AHP factors during the susceptibility estimation. This index suggests that flooding is the principal natural hazard for the Derwent Valley Mills UNESCO World Heritage site. The multi-hazard susceptibility map also indicates that most of the areas where the mills are located are subject to significant susceptibility to natural hazards. [ABSTRACT FROM AUTHOR]

This paper presents a new open-source and physically based model for Spatial Prediction of Rainfall-Induced Shallow Landslides (SPRIn-SL) through the Quantum GIS (QGIS) software. SPRIn-SL consists of a set of shell scripts developed using the Python language that can be directly run from the QGIS processing toolbox through a user-friendly graphical interface. The tool implements the infinite slope method by incorporating the TOPOG and the Green-Ampt models to consider groundwater flow and transient rainfall infiltration, respectively. Furthermore, DEM pre-processing procedures to extract reliable terrain morphometric features, a new statistical method for modelling soil depth and a procedure for predictive accuracy evaluation, were implemented. By using a 1-m resolution DEM, the developed model was tested in a small coastal catchment of Cinque Terre (Liguria, Italy), providing accurate outcomes, and proving to be an easy-to-use tool for landslide susceptibility zoning which can have useful implications on the risk reduction. • QGIS module written in Python for spatially predicting shallow landslides. • DEM pre-processing procedures to extract reliable morphometric predisposing factors. • A new statistical method for modelling soil depth is implemented. • High accuracy in simulating rainfall-induced shallow landslides in a test basin. • Easy-to-use physically based tool for landslide susceptibility zoning. [ABSTRACT FROM AUTHOR]

Natural hazards such as landslides, soil erosion and floods are increasingly affecting many regions of the world in relation to ongoing climate change and the abandonment of rural areas. In the last decades, the need to mitigate such phenomena and preserve natural resources, including landscapes, has motivated a number of local and national authorities to promote the use of soil bioengineering techniques. Consequently, these techniques have been increasingly used with variable success rates. This study analysed the efficiencies of different bioengineering structures to mitigate geo-hydrological risks by examining the interventions installed between 2007 and 2013 in the Avellino Province southern Italy. To this end, a specific project consistency analysis and functionality classification were carried out and the causes of inefficiencies were identified. The analysis showed that after a few years, only a small number of the installed bioengineering structures were fully functional and efficient. Overall, the installed structures were generally affected by maintenance issues and in many cases they suffered from design and execution issues, inducing a generally lower degree of efficiency, with most of them classified as 'not very efficient'. The conclusions of this work are that i) the long-term efficiency of a bioengineering structure is related to its correct design, installation, and maintenance; ii) the design of a bioengineering structure should account for the geological, geotechnical and hydrological characteristics of the area of interest, and iii) maintenance must not affect the short-term efficiency of a structure, but may affect the long-term efficiency. • The efficiency of bioengineering structure was analysed. • Bioengineering structure functionality was estimated three years after the installation. • A matrix-based approach accounting for causes of inefficiency was used. • Only 7% of the interventions were fully working and integrated with the landscape. • Most of the bioengineering structures were affected by design and installation issues. [ABSTRACT FROM AUTHOR]