Background Italy was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children’s hospital, composed by two different pediatric centers, one located in Rome’s city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED’s) and urgent hospitalizations compared to prepandemic period. Methods The study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics. Results The reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access. Conclusions In the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn’t demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.
The 87Sr/86Sr ratio is a proxy of the hydrologic structure of marginal basins characterized by the mixing between marine and continental waters. This reliable paleoceanographic and paleoclimatic tool is considered a key to the reconstruction of high‐amplitude hydrologic changes that governed the evolution of the Mediterranean region during the Messinian salinity crisis (MSC), when reduced connections with the global ocean resulted in the deposition of the most studied Earth's salt giant. Paleohydrological dynamics leading to the deposition of the Primary Lower Gypsum during the first stage of the MSC were revealed by the study of the 87Sr/86Sr composition of 114 samples from the Vena del Gesso basin (Northern Apennines, Italy). The analysis of seven high‐resolution 87Sr/86Sr profiles from individual gypsum beds suggests a climatic influence of precessional‐scale orbital parameters during evaporite deposition. The variations of Sr isotope ratios over time indicate that gypsum precipitation started from a seawater body dominated by continental contributions, followed by a relative increase of marine input. The overall results show a gradual upward detachment from the global ocean 87Sr/86Sr curve, with crucial steps corresponding to the most extreme eccentricity minima, suggesting an orbital influence on the hydrological balance of the basin. Given the sedimentological and geochemical analogies shared by the Mediterranean marginal basins that hosted the Primary Lower Gypsum deposition, the 87Sr/86Sr evolution of the Vena del Gesso basin may be considered as indicative of Mediterranean‐scale hydrologic dynamics, driven by gradual reduction of exchanges with the Atlantic and variable freshwater input.
New palaeontologic, sedimentologic, and Sr isotope data allow to reconstruct a high‐resolution chronostratigraphic and palaeoenvironmental framework of the continental‐marine transition at the Miocene–Pliocene boundary in the Sorbas Basin (Betic Cordillera, South‐eastern Spain). The presence of Reticulofenestra zancleana, Ceratolithus acutus, and R. pseudoumbilicus in a marine horizon sharply overlying the continental deposits of the Zorreras Member indicates that the Messinian salinity crisis ended in the Sorbas Basin synchronously with the other Mediterranean basins at the base of the Zanclean, within the MNN12a biozone. Our results suggest that the Zanclean flooding turned the Sorbas Basin into a shallow bay with limited exchange with the main Mediterranean basin, probably through narrow seaways connecting also the Almeria, Nijar, and Vera basins. Our results do not confirm previous hypotheses envisaging an older age for the return to fully marine conditions in the Sorbas Basin and is in a good agreement with the reconstructions suggesting that the Zorreras Mb. continental deposits are the local time‐equivalent of the latest Messinian Lago‐Mare phase during the last stage of the salinity crisis.
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