Synoptic control over winter snowfall variability observed in a remote site of Apennine Mountains (Italy), 1884–2015

This work presents a new, very long snowfall time series collected in a remote site of Italian Apennine mountains (Montevergine Observatory, 1280 m a.s.l.). After a careful check, based on quality control tests and homogenization procedures, the available data (i.e. daily height of new snow) have been aggregated over winter season (December-January-February) to study the long-term variability in the period 1884–2020. The main evidences emerged from this analysis lie in (i) the strong interannual variability of winter snowfall amounts, in (ii) the absence of a relevant trend from late 19th century to mid-1970s, in (iii) the strong reduction of the snowfall amount and frequency of occurrence from mid-1970s to the end of 1990s (−45 and −17 % compared to the average recorded in 1884–1975 period, respectively), and in (iv) the increase of average snowfall amount and frequency of occurrence in the last 20 years. Moreover, this study shed light on the relationship between the snowfall variability observed in Montevergine and the large-scale atmospheric circulation. Six different synoptic types, describing the meteorological scenarios triggering the snow events in the study area, have been identified by means of a cluster analysis, using two essential atmospheric variables, the 500-hPa geopotential height and the sea level pressure (both retrieved from the third version of Twentieth Century Reanalysis dataset). Such patterns trace out scenarios characterized by the presence of a blocking high-pressure anomaly over Scandinavia or North Atlantic and by a cold air outbreak, involving both maritime and continental cold air masses. A further analysis demonstrates that the identified synoptic types are strongly related with different teleconnection patterns, i.e. the Arctic Oscillation (AO), the Eastern Atlantic Western Russia (EAWR), the Eastern Mediterranean Pattern (EMP), the North Atlantic Oscillation (NAO) and the Scandinavia pattern (SCAND), that govern the European winter atmospheric variability. The relevant decline in snowfall frequency and amounts between 1970s and 1990s can be mainly ascribed to the strong positive trend of AO and NAO indices, which determined, in turn, a decrease in the incidence of patterns associated to the advection, in central Mediterranean area, of moist and cold arctic maritime air masses. The recent increase in average snowfall amounts can be explained by the reverse trend of AO index and by the prevalence of neutral or negative EAWR pattern.

Collection of Bacterial Community Associated with Size Fractionated Aerosols from Kuwait

Airborne particles play a significant role in the spread of bacterial communities. The prevalence of both pathogenic and non-pathogenic forms in the inhalable fractions of aerosols is known. The abundance of microorganisms in the aerosols heightens the likely health hazards due to inhalation since they serve as carriers for pathogens and allergens, often acting as a vector for pulmonary/respiratory infections. Not much information is available on the occurrence and prevalence of bacterial communities in different size-fractionated aerosols in Kuwait. A high-volume air sampler with a six-stage cascade impactor was deployed for sample collection at two sites representing a remote and an urban site. A total volume of 815 ± 5 m3 of air was passed through the filters to trap the particulate matter ranging from 0.39 to >10.2 μm in size (Stage 1 to Stage 5 and base filter). Aeromonas dominated all the stages at the urban site and Stage 5 at the remote site, whereas Sphingobium was prevalent at Stages, 2, 3 and 4 at the remote site. Brevundimonas were found at Stages 1 and 5, and the base filter at the remote site. These results show that the bacterial community is altered in different size fractions of aerosols. Stages 1–4 form the respirable fraction, whereas Stage 5 and particles on the base filter are the inhalable fractions. Many species of Aeromonas cause disease, and hence their presence in inhalable fractions is a health concern, meaning that species-level identification is warranted.

Remote Site Supervision of a School Project in Rural Uganda During Covid-19 Restrictions

Engineers for Overseas Development is a UK-based charity specialising in development projects across rural Africa. Each project provides opportunities to upskill both local construction workers and UK engineer volunteers, who take responsibility for design and site supervision. In October 2021, Cardiff branch delivered the first phase of a much-needed English teaching nursery and primary school in Uganda. In a first for the charity, construction was supervised entirely remotely due to Covid-19 travel restrictions. This paper outlines how this was achieved, highlighting the challenges and solutions developed.

475. The Utility of Community-Academic Partnerships in Promoting the Equitable Delivery of COVID-19 Vaccines in Black Communities

Background In the U.S., non-Hispanic Black individuals are disproportionately represented amongst COVID-19 mortalities. The COVID-19 vaccines are poised to change this outcome; however, inequitable access and decades of medical mistreatment have resulted in healthcare mistrust and an associated low uptake within this group. Loma Linda University (LLU) houses the largest mass vaccination site in San Bernardino County (SBC) California; nevertheless, there has been a perpetual low representation of Black vaccinees. To increase the number of Black persons vaccinated, a selected team at LLU leveraged a community-academic partnership model to address vaccine hesitancy and increase access to the COVID-19 vaccines. The objective of this study was to evaluate the number of Black persons vaccinated in community settings compared to the mass clinic. Methods LLU developed a tiered approach to increase COVID-19 vaccinations within Black SBC communities. The first tier engaged faith leaders with the academic community in disseminating COVID-19 health information, the second included culturally representative LLU healthcare professionals in the delivery of COVID-19 educational webinars, and the third was to conduct low barrier, remote-site vaccination clinics, within targeted Black communities. Following these efforts, we compared the number of Black individuals vaccinated in the LLU mass clinic to those vaccinated in the community remote-site clinics. Results The remote-site COVID-19 vaccination clinics commenced in February 2021. From February 1 until April 30, 2021, 24,808 individuals were vaccinated in the LLU mass clinic with a first dose (Pfizer or Moderna) or single dose (Janssen) of a COVID-19 vaccine, however, only 908 (3.7%) were Black vaccinees. Contrastingly, the LLU remote site clinics vaccinated 1,542 individuals with a first or single dose of a COVID-19 vaccine. Of those vaccinees, 675 (44%) were Black. Conclusion The multi-tiered community approach (remote-site vaccination clinics) resulted in a necessary overrepresentation of Black vaccinees, previously underrepresented in the LLU traditional mass vaccination clinic effort (44% vs. 3.7%, respectively). Further research is warranted to examine the key elements to increase vaccinations amongst minoritized groups. COVID-19 Vaccination Comparisons Between Models This table includes data from the Loma Linda University Mass Vaccination Clinic and the Remote-Site Vaccination Efforts compared to the San Bernardino County Demographics Disclosures All Authors: No reported disclosures

Pilot-administered anaesthesia and the Royal Flying Doctor Service of Australia: An interview with Captain Keith Galloway

The lack of radio navigational aids in early Royal Flying Doctor Service aircraft in Australia occasionally resulted in aircraft being stranded at a remote site with a critically injured patient due to weather and other conditions. For a brief period in the 1950s, at least one Royal Flying Doctor Service pilot was trained to administer anaesthesia to critically ill patients who could not be immediately evacuated. The aim of this paper is to describe the circumstances in which this arose and how it worked in practice. This is based largely on the recollections of pilot anaesthetist Captain Keith Galloway, who shared his recollections during interviews with the authors.

Spectrum of remote site extradural hematomas following decompressive craniectomy: Does fracture always co-exist?

Background: Remote-site extradural hematomas (EDHs) after decompressive-surgeries for traumatic brain injury (TBI) are rarely encountered. Typically, they form contralateral to the injured side, with an overlying fracture. We present a subset which developed EDH immediately after decompressive-hemi-craniectomy for TBI, most without an evidence of fracture, and not limited to contralateral location. Methods: Nine such patients were retrospectively identified. Plausible mechanisms, management issues and outcomes have been discussed. Results: All nine patients were victims of severe-TBI. Six did not have any skull-fractures. Eight showed hemispheric-injuries while one had bifrontal-contusions. In hemispheric-injuries, midline-shift was at least 8 mm except one with midline-shift of 6 mm. The EDH was straddling the midline in 2 (bifrontal-1, bi-occipital-1), and juxtaposed to the previous craniectomy in 1, apart from a contralateral-bleed in 6; all, except one, needed evacuation. In most patients, venous-source of bleed was identified. All had improved from their preoperative Glasgow coma scale (GCS) at follow-up. Conclusion: A fracture need not always co-exist in EDH following decompressive craniectomy. However, an extra-caution is suggested in its presence. Given the need for surgical-evacuation in most patients and an inability to assess immediate postoperative-GCS in severely head-injured, a routine postoperative-computed tomography is recommended to avoid overlooking such potentially treatable condition.

Remote extradural hematoma after supratentorial brain tumor surgery: A rare complication of a routine surgery

Background: Hemorrhages in the surgical cavity post resection of tumor aren’t uncommon and neurosurgeons are well versed with this entity, however occurrence of an Extra Dural Hematoma(EDH), that too at a site remote to the surgical cavity, is rare. The study presents 3 cases of post operative remote site EDH after tumor resection with review of literature and an attempt to define and discuss the variables which play a role in determining the occurrence, extent and prognosis of the same. Methods: The study investigated 601 patients who underwent tumor resection in the Department of Neurosurgery, Dr D Y Patil Hospital, from January 2017 to December 2019. All patients had a normal coagulation profile preoperatively. Postoperative remote EDH occurred in 3 patients whose data was examined closely in terms of age, sex, location, final diagnosis and treatment. Results: Of the 601 patients who underwent tumor resection from Jan 2017 to Dec 2019, a total of 3 patients in our study were found to have a post-operative remote site EDH. Two of these patients were male and 1 female. The age range was 35 to 46 years with a mean of 41 years. Neither did any of these patients have a pre-existing hydrocephalus nor were they subjected to a CSF diversion procedure preoperatively. All 3 patients developed EDH on the ipsilateral side wherein 2 of our patients had a hematoma in the ipsilateral frontal region anterior to the surgical cavity while 1 patient developed hematoma in ipsilateral parietal region posterior to surgical cavity. Hematomas were unilateral with no extension to opposite side. Two patients had to be re-operated in an emergency setting while one patient was conservatively managed. Conclusion: In patients with an expected volume loss via large tumor size, excess blood and CSF loss and a large craniotomy, remote EDH may develop and the neurosurgeon must have a high index of suspicion for this entity