AbstractAn increased secretion of procalcitonin (PCT) is primarily due to systemic inflammation of bacterial origin, as PCT is used to diagnose and manage sepsis. However, other conditions can induce ...high plasma levels of PCT, and hemorrhagic shock may be one of these as we found in clinical practice. The aim of this pilot, observational and prospective study was to investigate the role of PCT in hemorrhagic shock and if it could help in distinguishing between different types of shock. We enrolled 15 patients who entered the shock room of our Emergency Department (ED) with a diagnosis of hemodynamic shock, defined as hypotension (systolic blood pressure < 90 mmHg, or medial arterial pressure < 65 mmHg), and/or elevated lactate level (> 2 mmol/L), with one or more signs of cerebral or systemic hypoperfusion. For all the patients we dosed PCT at the time of admission, and we collected them into three different groups - septic, hemorrhagic and mixed shock - based on clinical presentation and laboratory and instrumental examination. First results did not show a significant increase of PCT in patients with hemorrhagic shock alone (average 0.12 ± 0.07 ng/mL), while PCT levels were similarly high in those with septic and mixed shock (17.63 ± 32.16 and 24.62 ± 33.02 respectively). PCT is not a marker of bleeding shock and does not help in distinguishing if bleeding or sepsis have the major impact on hemodynamics in those with mixed shock. However, patients with sepsis usually access the ED a few days after the initial infectious and inflammatory process has begun, while those with a major bleeding ask for intervention at the very first beginning. Thus, it may be helpful to see is PCT levels rise after some time from the bleeding start, or to investigate a different biomarker that rises earlier in course of systemic disfunction, such as presepsin. Finally, we also aimed at investigating if PCT levels would show any correlation with age of patients, regardless of the type of shock: results provided an higher PCT in individuals ≥ 80 years old, than in those < 80 years old.
This paper supports the 'Hydrogeological map of the Sabatini Volcanic District'. The map provides an overview of the hydrogeological setting of the Sabatini Volcanic District, using experimental ...water level data integrated with former volcanological and hydrogeological studies. The 1:50,000 scale map was produced in order to provide support to local authorities and professionals working on groundwater management. Fifteen hydrogeological complexes were defined based on volcanological properties and hydrogeological conditions.
Few studies report that Mediterranean dietary (MD) pattern has a beneficial role in the progression of non-alcoholic fatty liver disease (NAFLD). Evidence on its potential effect on the onset of ...disease are, however, scanty. With our study, we evaluated whether MD affects the risk of NAFLD with a large case-control study performed in Italy.
Three hundred and seventy-one cases of NAFLD and 444 controls were questioned on the demographic data and their dietary habits before diagnosis. Additionally, information about lifestyles and other related diseases, such as hypertension and diabetes mellitus were collected. The MD adherence was assessed using a pre-defined Mediterranean Diet Score (MDS). Odds ratios (OR) and 95% confidence intervals (CI) were obtained using a multiple logistic regression model.
A high adherence to the MD is significantly associated with decreased risk of NAFLD (OR: 0.83 95% CI: 0.71-0.98). When the different MD components were examined separately, higher legumes consumption (OR: 0.62 95% CI: 0.38-0.99) and high fish consumption (OR 0.38 95% CI: 0.17-0.85) were reported to be protective against NAFLD.
Our study shows that a high adherence to the MD decreases the risk of NAFLD.
Objectives
To evaluate the influence of cerebral venous drainage on the pathogenesis of idiopathic sudden sensorineural hearing loss (ISSHL) and Ménière syndrome (MD).
Design
Observational, ...prospective, cohort study.
Setting
ENT and Cardiology Departments (University of Bari, Policlinico Hospital, Bari, Italy).
Participants
We enrolled 59 consecutive patients (32 males, mean age 53.05 + 15.37 years): 40 ISSHL and 19 MD.
Main outcome measure
All patients underwent physical examination, biochemical evaluation (glycemic and lipid profile, viral serology, C reactive protein, etc), audiometric (tonal, vocal, vestibular evoked myogenic potentials and auditory brainstem response test) and impedentiometric examination. The pure tone average (PTA) was calculated for the following frequencies: 250, 500, 1000, 2000, 3000, 4000, 8000. An echo‐color Doppler evaluation of the venous cerebral veins, internal jugular (IJV) and vertebral veins (VV) at supine and 90° position was performed.
Results
No morphological alterations were found both in patients and controls. There were no signs of stenosis, blocked flow, membranes, etc. We found lower minimum, mean and maximum velocities in distal IJVs (P = .019; P = .013; P = .022; respectively) and left VVs (P = .027; P = .008; P = .001; respectively) in supine (0°) position in both MD and ISSHL patients as compared to controls. The same was for orthostatic position (90°). We found negative correlations between the velocities in extracranial veins and PTA values: therefore, the worst the audiometric performance of the subjects, the lower the velocities in the venous cerebral drainage.
Conclusions
Idiopathic sudden sensorineural hearing loss and Ménière syndrome patients showed altered venous flow in IJVs and VVs as compared to controls, independently from posture. This different behavior of venous tone control can influence the ear performance and may have a role in the pathogenesis of both diseases.
The aim of the current work was to analyze, in the Sarda breed goat, genetic polymorphism within the casein genes and to assess their influence on milk traits. Genetic variants at the CSN1S1, CSN2, ...CSN1S2 and CSN3 gene loci were investigated using PCR‐based methods, cloning and sequencing. Strong alleles prevailed at the CSN1S1 gene locus and defective alleles also were revealed. Null alleles were evidenced at each calcium‐sensitive gene locus. At the CSN3 gene locus, we observed a prevalence of the CSN3 A and B alleles; the occurrence of rare alleles such as CSN3 B'', C, C', D, E and M; and the CSN3 S allele (GenBank KF644565) described here for the first time in Capra hircus. Statistical analysis showed that all genes, except CSN3, significantly influenced milk traits. The CSN1S1 BB and AB genotypes were associated with the highest percentages of protein (4.41 and 4.40 respectively) and fat (5.26 and 5.34 respectively) (P < 0.001). A relevant finding was that CSN2 and CSN1S2 genotypes affected milk protein content and yield. The polymorphism of the CSN2 gene affected milk protein percentage with the highest values recorded in the CSN2 AA goats (4.35, at P < 0.001). The CSN1S2 AC goats provided the highest fat (51.02 g/day) and protein (41.42 g/day) (P < 0.01) production. This information can be incorporated into selection schemes for the Sarda breed goat.
•We propose an analytical framework to quantify different social influence processes.•An accelerated reality experience captures the effects of social interactions on stated choices.•Hypothetical ...adoption rate of peers increases the bike sharing preference.•Benefits and drawbacks of bike sharing influence the propensity to change mode.•Diffusion and translation of information affect the bike sharing adoption.
The present study investigates how social influence and social interactions can affect the adoption of new technologies, using stated preference (SP) survey data combined with an “accelerated reality” experience of social interaction among the respondents. Specifically, the intention to use a pro-environmental transport mode (the bike sharing) during a public transport strike within a cohort of students has been analysed. Previous studies have modelled social influence effects using SP data by providing a hypothetical scenario with simulated interactions or information about social conformity processes (i.e. social adoption) during the survey. In our paper, in addition to the impact of assumed social norms, the effect of live/real social interactions is included in the survey. SP survey is developed to investigate the effect of Level-of-Service attributes on the hypothetical choices in the scenario of a public transport strike. Besides the pre-defined attributes characterising the alternatives in the SP design, the survey includes techniques to acquire information on conformity and social interactions. Specifically, the interviewees undertake a before and after stated preference experiment (SP1 and SP2), with a period of group discussion in between the two parts. This SP experiment involves different cognitive and interpersonal mechanisms, such as the functional information exchange on benefits and drawbacks of cycling and bike sharing. The aim is to establish whether hypothetical scenarios of social conformity are different from real/live social interactions and whether these social influence processes actually affect the individuals' mode choice. A joint SP1/SP2 mixed logit (ML) model has been estimated to explore the choice behaviour of individuals and allows us to incorporate the inertia/propensity to change behaviour between SP1 and SP2. Moreover, considering the “Reflexive Layers of Influence” (RLI) framework, the processes generated by social interactions (diffusion, translation and reflexivity) are measured and incorporated in the model. We finally show the effect of these social influence variables on the goodness-of-fit of the models and choice simulation for prediction. We also draw conclusions about the value of such enhanced choice models in understanding and predicting the impacts of social interactions on choice behaviour in the context of new transport technologies.
We present Monte Carlo simulations for studying the statistical mechanics of arbitrarily long single molecules under stretching. In many cases in which the thermodynamic limit is not satisfied, ...different statistical ensembles yield different macroscopic force-displacement curves. In this work we provide a description of the Monte Carlo simulations and discuss in details the assumptions adopted.
•We propose an analytical framework to account for correlated effects within a social network.•We quantify the correlated effects by combining individual’s peer attitudes and social proximity.•The ...social influence variable has been systematically tested in different hybrid choice model specifications in the context of EV purchase preferences.•An ‘open to innovation’ person is likely to be part of a social network in which peers are also ‘open to innovation’.•Social proximity and a larger number of ‘open to innovation’ peers can positively affect the preference for EVs.
While the importance of social influence on transport-related choices is commonly acknowledged within the transport and travel behaviour research community, there remain several challenges in modelling influence in practice. This paper proposes a new analytical approach to measure the effects of attitudes of peers on the decision making process of the individual. Indeed, while most of the previous literature focused its attention on capturing conformity to a certain real or hypothetical choice, we investigate the subtle effect of attitudes that underlies this choice. Specifically, the suggested measure enables us to model the correlated effect that might indirectly affect the individual’s choice within a social group. It combines detailed information on the attitudes in the individual’s social network and the social proximity of the individuals in the social network. To understand its behavioural implications on the individual’s choice, the individual’s peer attitude variable is tested in different components of a hybrid choice model. Our results show that the inclusion of this variable indirectly affects the decision making process of the individual as the peers’ attitudes are significantly related to the latent attitude of the individual. On the other hand, it does not seem to directly affect the utility of an alternative as a source of systematic heterogeneity nor does it work as a manifestation of the latent variable, i.e. as an indicator.
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