Short-Term Variations in Neutrophil-to-Lymphocyte and Urea-to-Creatinine Ratios Anticipate Intensive Care Unit Admission of COVID-19 Patients in the Emergency Department

Background: Timely assessment of COVID-19 severity is crucial for the rapid provision of appropriate treatments. Definitive criteria for the early identification of severe COVID-19 cases that require intensive care unit admission are lacking. Methods: This was a single-center, retrospective case-control study of 95 consecutive adults admitted to the intensive care unit (cases) or a medical ward (controls) for laboratory-confirmed COVID-19. Clinical data were collected and changes in laboratory test results were calculated between presentation at the emergency department and admission. Univariate and multivariable logistic regression was performed to calculate odds ratios for intensive care unit admission according to changes in laboratory variables. Results: Of the 95 adults with COVID-19, 25 were admitted to intensive care and 70 to a medical ward after a median 6 h stay in the emergency department. During this interval, neutrophil counts increased in cases and decreased in controls (median, 934 vs. −295 × 106/L; P = 0.006), while lymphocyte counts decreased in cases and increased in controls (median, −184 vs. 109 × 106/L; P < 0.001). In cases, the neutrophil-to-lymphocyte ratio increased 6-fold and the urea-to-creatinine ratio increased 20-fold during the emergency department stay, but these ratios did not change in controls (P < 0.001 for both comparisons). By multivariable logistic regression, short-term increases in the neutrophil-to-lymphocyte ratio (OR = 1.43; 95% CI, 1.16–1.76) and urea-to-creatinine ratio (OR = 1.72; 95% CI, 1.20–2.66) were independent predictors of intensive care unit admission. Conclusion: Short-time changes in neutrophil-to-lymphocyte ratio and urea-to-creatinine ratio emerged as stand-alone parameters able to identify patients with aggressive disease at an early stage

Diagnosis of prostate cancer with magnetic resonance imaging in men treated with 5-alpha-reductase inhibitors

Purpose The primary aim of this study was to evaluate if exposure to 5-alpha-reductase inhibitors (5-ARIs) modifies the effect of MRI for the diagnosis of clinically significant Prostate Cancer (csPCa) (ISUP Gleason grade >= 2).Methods This study is a multicenter cohort study including patients undergoing prostate biopsy and MRI at 24 institutions between 2013 and 2022. Multivariable analysis predicting csPCa with an interaction term between 5-ARIs and PIRADS score was performed. Sensitivity, specificity, and negative (NPV) and positive (PPV) predictive values of MRI were compared in treated and untreated patients.Results 705 patients (9%) were treated with 5-ARIs [median age 69 years, Interquartile range (IQR): 65, 73; median PSA 6.3 ng/ml, IQR 4.0, 9.0; median prostate volume 53 ml, IQR 40, 72] and 6913 were 5-ARIs naive (age 66 years, IQR 60, 71; PSA 6.5 ng/ml, IQR 4.8, 9.0; prostate volume 50 ml, IQR 37, 65). MRI showed PIRADS 1-2, 3, 4, and 5 lesions in 141 (20%), 158 (22%), 258 (37%), and 148 (21%) patients treated with 5-ARIs, and 878 (13%), 1764 (25%), 2948 (43%), and 1323 (19%) of untreated patients (p < 0.0001). No difference was found in csPCa detection rates, but diagnosis of high-grade PCa (ISUP GG >= 3) was higher in treated patients (23% vs 19%, p = 0.013). We did not find any evidence of interaction between PIRADS score and 5-ARIs exposure in predicting csPCa. Sensitivity, specificity, PPV, and NPV of PIRADS >= 3 were 94%, 29%, 46%, and 88% in treated patients and 96%, 18%, 43%, and 88% in untreated patients, respectively.Conclusions Exposure to 5-ARIs does not affect the association of PIRADS score with csPCa. Higher rates of high-grade PCa were detected in treated patients, but most were clearly visible on MRI as PIRADS 4 and 5 lesions.Trial registration The present study was registered at ClinicalTrials.gov number: NCT05078359

Les textes dialogués et de correspondance dans la poésie des troubadours

La thèse se propose comme objectif un examen approfondi du positionnement des textes dialogués dans la poésie des troubadours occitans. Comme mis en évidence par les études de Claudio Giunta autour des textes dialogués dans la poésie italienne des XIIème-XIIIème siècles (Versi a un destinatario. Saggio sui/a poesia italiana del Medioevo et Due saggi sui/a tenzone, 2002), les textes de correspondance forment un corpus qui a été à tort et sous plusieurs points de vue longtemps négligé. Toutefois, à plusieurs égards, il s'agit d'un ensemble qui présente un grand intérêt pour l'histoire littéraire et de la tradition des textes occitans ainsi que pour l'étude de l'évolution des genres poétiques médiévau x. La recherche se base sur un nouvel examen du corpus compris dans l'anthologie-édition basée sur les études préparatoires de John Marshall et menée à terme avec plusieurs collaborateurs par Ruth Harvey et Linda Paterson (The Troubadours Tensos and Partimens. A Critical Edition, 2010, 3 voll.). Le travail présente pour la première fois une étude monographique dédiée à l'ensemble des tensos et partimens en langue d'oc, mais confronte aussi à ce corpus un considérable nombre d'autres pièces impliquant, d'une manière ou de l'autre, un dialogue explicitement déclaré entre deux ou plusieurs auteurs ou voix comme les échanges de cab/as, les sirventès "de correspondance" ou encore les "tensons fictives". La thèse propose une analyse des textes dialogués et de correspondance des troubadours d'un point de vue historique, thématique et plus largement culturel, dans le but de restituer à ce corpus la considération qu'il mérite au sein des traditions poétiques occitane et romane

I TESTI DIALOGICI E DI CORRISPONDENZA NELLA POESIA DEI TROVATORI / Les textes dialogués et de correspondance dans la poésie des troubadours

La presente ricerca muove dall’obiettivo di fornire uno studio complessivo del corpus dialogico e di corrispondenza dei trovatori nell’intento di restituirne la dimensione di segmento fondamentale e altamente rappresentativo della prima tradizione poetica romanza. Le nozioni di “dialogicità” e “dialogo” hanno goduto in tempi recenti di una certa fortuna critica, ergendosi talvolta a paradigma ermeneutico utile per uno studio della poesia delle Origini condotto secondo prospettive originali, come nei saggi di Claudio Giunta (Versi a un destinatario e Due studi sulla tenzone, 2002). L'adozione di tali prospettive, volte a cogliere spinte comunicative e aperture al “realismo” in una poesia, come quella delle Origini, spesso tacciata di ripetitività e astrazione, ha permesso di valorizzare generi e testi a lungo trascurati e di problematizzare la categoria storiografica e critica di poésie formelle, che descriveva la poesia trobadorica come essenzialmente “lirica”, “monologica” e “monotematica”. La ricerca prende in esame il corpus dei testi dialogati e latamente responsivi occitani, comprendendo anche tipologie e componimenti esclusi dall'antologia-edizione critica delle tenzoni e partimens coordinata da Ruth Harvey et Linda Paterson (The Troubadours Tensos and Partimens. A Critical Edition, 2010). A seguito di questa importante iniziativa, che ha finalmente reso disponibile in un’unica sede un’ampia sezione del corpus dialogico occitano, e grazie al supporto fondamentale della Bibliografia Elettronica dei Trovatori, è stato possibile procedere, tramite uno studio a tutto campo, a un riesame complessivo delle tipologie testuali dialogiche e di corrispondenza. Un certo numero di testi di particolare interesse infatti, come scambi di sirventesi, coblas e altri testi “di corrispondenza” o le tenzoni con interlocutori immaginari o fittizi erano infatti stati esclusi per i criteri di definizione, di estensione o di destinazione adottati nell'edizione (per un totale di 165 testi a fronte delle 157 tensos e partimens). La riconsiderazione e l’ampiamento del corpus sono stati intrapresi in funzione di un nuovo tentativo di inquadramento storico-letterario, nell’intento di discuterne in un quadro organico anche i principali aspetti retorici, formali e contenutistici e, almeno per le fasi più antiche, illustrare tempi, momenti e protagonisti centrali nella produzione e circolazione delle tipologie testuali dialogiche e di corrispondenza. Il percorso intrapreso nella ricerca si situa quindi al crocevia tra diversi interrogativi e discipline nel tentativo di tener conto di problematiche afferenti sia alla Storia delle Idee e della Letteratura che alle questioni poste dall'ecdotica e dalla linguistica, dalla codicologia allo studio retorico e lessicale della poesia medievale. L’interesse principale è rivolto alla storia e all'”evoluzione” dei generi poetici, alla definizione dello spazio poetico del medioevo romanzo e al significato che possono assumere in questo quadro i testi definibili come testi dialogici e di corrispondenza. L’idea di fondo che ha guidato questo studio è stata quella di considerare i testi dialogici e di corrispondenza occitani come poesie à part entière, nella convinzione che questi componimenti, oltre ad essere in molti casi degni di considerazione in quanto tali, possano costituire fondamentali banchi di prova per indagare le concezione della poesia e dell’individualità poetica che prendono forma nella poesia dei trovatori.The aim of the research is to provide an overall study of the Troubadours dialogical corpus in order to highlight its dimension as a fundamental and highly representative section of the earliest Romance poetic tradition. The notions of "dialogicity" and "dialogue" have enjoyed a certain critical fortune in recent times, sometimes rising to a hermeneutic paradigm useful for a study of medieval poetry lead according to original perspectives, as in the essays by C. Giunta Versi a un destinatario and Due saggi sulla tenzone (2002). The adoption of these perspectives, aimed at capturing communicative and “realistic” tendencies in a poetic tradition, such as that of the Troubadours, often accused of repetitiveness and abstraction, has allowed us to value long neglected genres and texts and to problematize the historiographical category and critical labels such as poesié formelle, which saw Medieval Poetry as essentially "lyrical", "monological" and "monothematic". The research examines an extended corpus of Occitan dialogical texts, starting from the anthology-edition of the tensos and partimens edited by Ruth Harvey and Linda Paterson (The Troubadours Tensos and Partimens, A Critical Edition, 2010). Many pieces were not included (165 against the 157 of the edition), both for reasons of definition (from the distinction made in the Leys d'Amors between tenso and partimen), and of dimension or destination (they have decided to exclude the textual units "too short" or involving an addressee presumably or clearly fictitious). With the consequence that compositions of particular interest and which undoubtedly deserved to be the subject of more in-depth studies such as Sirventese exchanges, coblas and other pieces like the tensos with imaginary or fictitious interlocutors were omitted. Following the important initiative of Harvey and Paterson, who finally collected and made available an important number of otherwise dispersed textes, it was therefore possible to proceed to a whole reconsideration of the corpus, through a wide-ranging study, with the goal to provide an overall review of the textual dialogic pieces in function of an attempt of historical-literary framing of the same that could give an account of the main rhetorical, formal and content aspects and, at least for the most ancient phases, of the times, moments and main protagonists of the production and circulation of Troubadours dialogue poems. In addition to covering an immense interest from a historical-documentary and literary point of view (which is still largely unexplored) dialogic and correspondence texts may in fact constitute a privileged place of observation of that dynamical frame of ethical and poetic values which often constitutes the basis of Troubadours poetic discourse. This work is therefore located at the crossroads between different questions and disciplines in an attempt to take into account problems relating both to the History of Ideas and to Literature and to the questions posed by Ecdotics and Linguistics, by Codicology and by the rhetorical and lexical study of Medieval Poetry. The main interest is focused on the history and the "evolution" of poetic genres, the definition of the vernacular poetic space of the Middle Ages and on the meaning that dialogical pieces can assume inside this complex frame. The underlying idea that has guided this study was to consider Occitan dialogical texts as poems à part entière, in the belief that these pieces, as well as being in many cases worthy of consideration as such, can be crucial to investigate the conception of poetry and poetic subjectivity shaped by the Troubadours poetry

Industrial relations in Italy in the 21st century

Purpose (mandatory) To reflect on the developments which have characterized Italy’s industrial relations from post-war Fordism to neo-liberal hegemony and recent crisis, with a particular focus on the major changes occurred in 21st century, especially those concerning concertative (tripartite) policy making between the government, the employers’ organisations and the trade unions. Design/methodology/approach (mandatory) Conceptual paper with analysis of main development trends. Findings (Mandatory) Italy’s industrial relations in the 21st century are characterized by ambivalent features which are the heritage of the past. These are summarized as follows: ‘collective autonomy’ as a classical source of strength for trade unions and employers’ organization, on the one hand. On the other hand, low level of legislative regulation and weak institutionalization, accompanied by little engagement in a generalized 'participative-collaborative' model. Due to the instability in the socio-political setting in the 21st century, unions and employers encounter growing difficulties to affirm their common points of view and to build up stable institutions that could support cooperation between them. The result is a clear reversal of the assumptions that had formed the classical backdrop of the paradigm of Italy’s 'political exchange'. This paradigm has long influenced the way through which the relationships between the employers, the trade unions and the state were conceived, especially during 1990s and, to some extent during 2000s, that is the development of concertative (tripartite) policy making. However, since the end of 2000s, and particularly from 2010s onwards national governments have stated their will to act independently of the choices made by the unions (and partially the employers). The outcome is the eclipse of concertation. The paper explores how the relationships among the main institutional actors such as the trade unions (and among the unions themselves), the employers, the state and the politics have evolved, within a dynamic socio-political and economic context, as the essential factors to understand Italy’s industrial relations in the 21st century. Originality/value (mandatory) It shows that understanding the relationship among the main institutional actors such as the trade unions (and among the unions themselves), the employers and the state and their politics is essential to understand the change occurred in contemporary Italy’s industrial relations.status: publishe

Industrial relations in Italy in the 21st century

Purpose (mandatory) To reflect on the developments which have characterized Italy’s industrial relations from post-war Fordism to neo-liberal hegemony and recent crisis, with a particular focus on the major changes occurred in 21st century, especially those concerning concertative (tripartite) policy making between the government, the employers’ organisations and the trade unions. Design/methodology/approach (mandatory) Conceptual paper with analysis of main development trends. Findings (Mandatory) Italy’s industrial relations in the 21st century are characterized by ambivalent features which are the heritage of the past. These are summarized as follows: ‘collective autonomy’ as a classical source of strength for trade unions and employers’ organization, on the one hand. On the other hand, low level of legislative regulation and weak institutionalization, accompanied by little engagement in a generalized 'participative-collaborative' model. Due to the instability in the socio-political setting in the 21st century, unions and employers encounter growing difficulties to affirm their common points of view and to build up stable institutions that could support cooperation between them. The result is a clear reversal of the assumptions that had formed the classical backdrop of the paradigm of Italy’s 'political exchange'. This paradigm has long influenced the way through which the relationships between the employers, the trade unions and the state were conceived, especially during 1990s and, to some extent during 2000s, that is the development of concertative (tripartite) policy making. However, since the end of 2000s, and particularly from 2010s onwards national governments have stated their will to act independently of the choices made by the unions (and partially the employers). The outcome is the eclipse of concertation. The paper explores how the relationships among the main institutional actors such as the trade unions (and among the unions themselves), the employers, the state and the politics have evolved, within a dynamic socio-political and economic context, as the essential factors to understand Italy’s industrial relations in the 21st century. Originality/value (mandatory) It shows that understanding the relationship among the main institutional actors such as the trade unions (and among the unions themselves), the employers and the state and their politics is essential to understand the change occurred in contemporary Italy’s industrial relations.status: accepte

Modeling and experimental validation of mass transfer from carbonated beverages in polyethylene terephthalate bottles

Mass transfer and related shelf life assessment is an important issue in the beverage industry. Product change due to mass transfer is at stake and, with it, its consumer value and consideration. Carbonation loss takes place at the product/package interface, and to the environment through the package itself. In this paper a joint experimental/computational approach has been exploited: the CO2 loss through the polyethylene terephthalate barrier has been computed by means of a multidimensional finite element code, while actual measurements have been carried out to validate the computations. Residual carbonation histories are validated and presented for a variety of thermal regimes and for two different bottles carrying the same capacity. The paper highlights on the combination of bottle weight, initial carbonation and storage temperature, indicating the operational set for the longest shelf life within the explored cases. Lighter bottles can be used with no inference on shelf life, while the carbonic loss depends non-linearly on initial carbonation and temperature increment. The associated concentration maps help infer on the importance of polyethylene terephthalate thickness uniformity. It is then demonstrated that the model carries the flexibility of a general tool, applicable to any carbonated beverage at any storage condition