Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: the prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study

Background: Adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial. Methods: AdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock. Results: Circulating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p < 0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM > 70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM > 70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8). Conclusions: AdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial. Trial registration: ClinicalTrials.gov, NCT02393781. Registered on March 19, 2015

The role of emotions on consumers’ satisfaction within the fitness context

Previous studies have suggested that consumption-related emotions are important to understand post-purchase reactions. This study examines the relationship between fitness consumers’ emotions and overall satisfaction. After an initial step of free-thought listing and content validity, followed by a pre-test, a survey was conducted among consumers of five different fitness centers (n=786). The questionnaire included measures to assess positive and negative emotions, as well as overall satisfaction with the fitness center. The results gathered through a structural equation model provide evidence that negative emotion experienced by consumers impacts negatively overall satisfaction, while positive emotion have a positive effect on overall satisfaction. These findings suggest managerial implications, such as the need to collect consumers’ perceptions of both tangible and intangible aspects of the services, listen costumers’ opinions in a regular basis, and provide regular training to staff members, in order to identify the triggers of positive emotions and contribute to increased levels of overall satisfaction. Guidelines for future research within the fitness context are also suggested.Estudos precedentes sugerem que as emoções relacionadas com o consumo são importantes para compreender as reações dos consumidores após a compra. Este estudo analisa a relação entre as emoções dos consumidores de fitness e satisfação global. Depois de uma etapa inicial de listagem de pensamento-livre e validade de conteúdo, seguido de um pré-teste, foi realizada uma pesquisa entre os consumidores de cinco centros de fitness diferentes (n = 786). O questionário incluiu medidas para avaliar as emoções positivas e negativas, bem como a satisfação global com o centro de fitness. Os resultados obtidos através de um modelo de equações estruturais forneceram evidências de que as emoções negativas vivenciadas pelos consumidores impactam negativamente a satisfação global, enquanto as emoções positivas têm um efeito positivo sobre a satisfação global. Estes resultados sugerem implicações para os gestores, tais como a necessidade de recolher informação sobre a perceção dos consumidores dos aspetos tangíveis e intangíveis dos serviços, ouvir regularmente as opiniões dos consumidores e facultar formação regular aos colaboradores. Isto permitirá identificar os aspetos que desencadeiam emoções positivas e contribuir para o aumento dos níveis de satisfação global. Orientações para futuras pesquisas no contexto de fitness também são sugeridas.Sin financiación0.185 SJR (2015) Q3, 1090/1779 Medicine (miscellaneous); Q4, 177/229 Health (social science), 112/128 Sports scienceUE

2D characterization of near-surface V P/V S: surface-wave dispersion inversion versus refraction tomography

International audienceThe joint study of pressure (P-) and shear (S-) wave velocities (Vp and Vs ), as well as their ratio (Vp /Vs), has been used for many years at large scales but remains marginal in near-surface applications. For these applications, and are generally retrieved with seismic refraction tomography combining P and SH (shear-horizontal) waves, thus requiring two separate acquisitions. Surface-wave prospecting methods are proposed here as an alternative to SH-wave tomography in order to retrieve pseudo-2D Vs sections from typical P-wave shot gathers and assess the applicability of combined P-wave refraction tomography and surface-wave dispersion analysis to estimate Vp/Vs ratio. We carried out a simultaneous P- and surface-wave survey on a well-characterized granite-micaschists contact at Ploemeur hydrological observatory (France), supplemented with an SH-wave acquisition along the same line in order to compare Vs results obtained from SH-wave refraction tomography and surface-wave profiling. Travel-time tomography was performed with P- and SH- wave first arrivals observed along the line to retrieve Vtomo p and Vtomo s models. Windowing and stacking techniques were then used to extract evenly spaced dispersion data from P-wave shot gathers along the line. Successive 1D Monte Carlo inversions of these dispersion data were performed using fixed Vp values extracted from Vtomo p the model and no lateral constraints between two adjacent 1D inversions. The resulting 1D Vsw s models were then assembled to create a pseudo-2D Vsw s section, which appears to be correctly matching the general features observed on the section. If the pseudo-section is characterized by strong velocity incertainties in the deepest layers, it provides a more detailed description of the lateral variations in the shallow layers. Theoretical dispersion curves were also computed along the line with both and models. While the dispersion curves computed from models provide results consistent with the coherent maxima observed on dispersion images, dispersion curves computed from models are generally not fitting the observed propagation modes at low frequency. Surface-wave analysis could therefore improve models both in terms of reliability and ability to describe lateral variations. Finally, we were able to compute / sections from both and models. The two sections present similar features, but the section obtained from shows a higher lateral resolution and is consistent with the features observed on electrical resistivity tomography, thus validating our approach for retrieving Vp/Vs ratio from combined P-wave tomography and surface-wave profiling

TNFA and IL10 Gene Polymorphisms are not Associated with Periodontitis in Brazilians

IL-10 and TNF-α are cytokines that have complex and opposing roles in the inflammatory responses. G/A polymorphisms at position –1082 of IL10 and –308 of TNFA genes have been reported to influence the expression of IL-10 and TNF-α, respectively. The aim of this study was to investigate the association between the IL10 (-1082) and TNFA (- 308) gene polymorphisms with different clinical forms or severity of periodontitis in a sample of Brazilian individuals. DNA was obtained from oral swabs of 165 Brazilian individuals, which were divided into three groups: individuals with chronic periodontitis, aggressive periodontitis and individuals without clinical evidence of periodontitis. Evaluation of IL10 and TNFA polymorphisms was performed by RFLP analysis. Statistical analysis of data was performed using the χ2 likelihood ratio and Fisher`s exact test. No significant differences in the genotype and allele distribution of either IL10 or TNFA were observed among individuals with different clinical forms or with different degrees of severity of periodontitis. Moreover, combined analysis of IL10 and TNFA polymorphisms did not show any association with periodontal status. As conclusion, the IL10 and TNFA gene promoter polymorphisms investigated are not associated with different clinical forms of periodontitis or with severity of the disease in the Brazilian population polymorphisms

Athlete brand construction: A perspective based on fans’ perceptions

Abstract The purpose of this study was to develop a framework for understanding the antecedents and components of athlete brand. Based on a set of 21 interviews conducted in three different countries, a detailed framework is proposed including five antecedents and two components of athlete brand. The antecedents are media (social media, mass media, video games and major sport events), oral communications (word of mouth, and rumors and narratives), impression management, social agents (parents, family members, friends and community), and teams and sport (sport interest, team interest and team geographical location). In turn, the components of athlete brand are related with on-field attributes (behavior, team, achievements, style of play and skills) and off-field attributes (physical attraction, lifestyle, personal appeal, ethnicity and entertainment). Complementarily, these components of athlete brand are proposed to have an impact on fans' loyalty towards the athlete. Implications of these findings for building and managing athlete brand are discussed, and directions for future studies are provided

Sports events and interaction among spectators: examining antecedents of spectators’ value creation

Research question: Spectating at sports events comprises on-pitch and off-pitch benefits. Value may also derive from spectator-to-spectator interaction, however, we do not know whether all types of interaction have similar effects on value creation and subsequent word-of-mouth (WOM) behaviours. We investigate two types of spectator-to-spectator interaction – between known/familiar others, and between unknown-others. We study their effects within a framework grounded in Customer Dominant Logic and sport value framework, integrating on-pitch sport performance, off-pitch service quality, overall satisfaction, team identification and WOM intention. Research methods: Hypotheses were tested using a survey of 1002 spectators of a British Premier League football club. Respondents were asked about the last game they attended. Data were analysed using Structural Equations Modelling and PROCESS analysis. Results and findings: Customer-to-customer interaction was antecedent to overall satisfaction and team identification. Satisfaction and team identification led to WOM intention, with team identification having greater effect. Evaluation of on-pitch performance (the football match) influenced overall satisfaction more than off-pitch service quality. The study contributes to knowledge in finding that customer-to-customer interaction with familiar accompaniers influenced satisfaction more than interaction with anonymous-other spectators. However, the latter contributed more to team identification and indirectly to WOM. Implications: The study highlights the importance to sports events organisers of facilitating customer-to-customer interaction. While promotion of many sports events focuses on game performance, this study highlights the importance of promoting the social benefits of attendance in increasing positive WOM. Suggestions are made, including provision of social media platforms within events to promote interaction among spectators

Cardiovascular disease and the role of oral bacteria

In terms of the pathogenesis of cardiovascular disease (CVD) the focus has traditionally been on dyslipidemia. Over the decades our understanding of the pathogenesis of CVD has increased, and infections, including those caused by oral bacteria, are more likely involved in CVD progression than previously thought. While many studies have now shown an association between periodontal disease and CVD, the mechanisms underpinning this relationship remain unclear. This review gives a brief overview of the host-bacterial interactions in periodontal disease and virulence factors of oral bacteria before discussing the proposed mechanisms by which oral bacterial may facilitate the progression of CVD