Clinic blood pressure, ambulatory blood pressure and cardiac structural alterations in nonagenarians and in centenarians

Scant information is available on the alterations in cardiac structure and function characterizing very elderly people as well as on their relationships to clinic and ambulatory blood pressure (BP) values. In 106 subjects aged 95.3 ± 3.7 years (mean ± standard deviation, 89 nonagenarians and 17 centenarians) in good clinical conditions and living in the municipal house in Milan, we measured, along with standard clinical and laboratory variables, clinic BP, 24-h ambulatory BP and echocardiographic parameters. Forty-five of the recruited subjects were normotensive individuals, whereas 61 were treated hypertensive patients. Subjects with an age greater than 90 years showed clinic systolic (SBP) and diastolic BP (DBP) both within the normal range, with values that for clinic SBP were slightly lower than the corresponding 24-h SBP (120.8 ± 15.9 vs 128.0 ± 16.3 mmHg) and for DBP slightly higher (69.7 ± 8.8 vs 64.9 ± 8.0 mmHg). Daytime average mean BP was slightly lower than night-time average mean BP, indicating the attenuation of the BP reduction during night-time. Left ventricular mass index (LVMI) was increased and significantly related to both 24-h and clinic BP values (r = 0.24, p < 0.04 and r = 0.20, p < 0.05). Thus in nonagenarians and centenarians, abnormalities in left ventricular pattern are of frequent detection and may be related both to the ageing process and to BP load. © 2012 Scandinavian Foundation for Cardiovascular Research

Beyond Paradigms in Cultural Astronomy. Proceedings of the 27th SEAC conference held together with the EAA

Proceedings of the 27th SEAC conference held together with the EAA.-- Editors: A. César González-García, Roslyn M. Frank, Lionel D. Sims, Michael A. Rappenglück, Georg Zotti, Juan A. Belmonte, Ivan Šprajc.Cultural Astronomy is the endeavour to understand the role of the sky in past and present societies, and how these societies incorporated the sky into their culture. This broad ranging discipline is closely related to archaeology when investigating material remains of the past. Cultural Astronomy also explores the role of the heavens from the perspectives of the anthropological sciences. In recent decades the discipline has been concerned with methodological and theoretical issues. This volume offers chapters based on presentations at the 27th SEAC meeting held in Bern (2019). These chapters provide a vivid image of front-line research in diverse areas, from Roman light and shadow effects to highlight power, to Maya city organization, Etruscan temple orientation or the ontology of the sky.Peer reviewe

Evaluation of receptor and chemical transport models for PM10 source apportionment

In this study, the performance of two types of source apportionment models was evaluated by assessing the results provided by 40 different groups in the framework of an intercomparison organised by FAIRMODE WG3 (Forum for air quality modelling in Europe, Working Group 3). The evaluation was based on two performance indicators: z-scores and the root mean square error weighted by the reference uncertainty (RMSEu), with pre-established acceptability criteria. By involving models based on completely different and independent input data, such as receptor models (RMs) and chemical transport models (CTMs), the intercomparison provided a unique opportunity for their cross-validation. In addition, comparing the CTM chemical profiles with those measured directly at the source contributed to corroborate the consistency of the tested model results. The most commonly used RM was the US EPA- PMF version 5. RMs showed very good performance for the overall dataset (91% of z-scores accepted) while more difficulties were observed with the source contribution time series (72% of RMSEu accepted). Industrial activities proved to be the most difficult sources to be quantified by RMs, with high variability in the estimated contributions. In the CTMs, the sum of computed source contributions was lower than the measured gravimetric PM10 mass concentrations. The performance tests pointed out the differences between the two CTM approaches used for source apportionment in this study: brute force (or emission reduction impact) and tagged species methods. The sources meeting the z-score and RMSEu acceptability criteria tests were 50% and 86%, respectively. The CTM source contributions to PM10 were in the majority of cases lower than the RM averages for the corresponding source. The CTMs and RMs source contributions for the overall dataset were more comparable (83% of the z-scores accepted) than their time series (successful RMSEu in the range 25% - 34%). The comparability between CTMs and RMs varied depending on the source: traffic/exhaust and industry were the source categories with the best results in the RMSEu tests while the most critical ones were soil dust and road dust. The differences between RMs and CTMs source reconstructions confirmed the importance of cross validating the results of these two families of models

Results of the first European Source Apportionment intercomparison for Receptor and Chemical Transport Models

In this study, the performance of the source apportionment model applications were evaluated by comparing the model results provided by 44 participants adopting a methodology based on performance indicators: z-scores and RMSEu, with pre-established acceptability criteria. Involving models based on completely different and independent input data, such as receptor models (RMs) and chemical transport models (CTMs), provided a unique opportunity to cross-validate them. In addition, comparing the modelled source chemical profiles, with those measured directly at the source contributed to corroborate the chemical profile of the tested model results. The most used RM was EPA- PMF5. RMs showed very good performance for the overall dataset (91% of z-scores accepted) and more difficulties are observed with SCE time series (72% of RMSEu accepted). Industry resulted the most problematic source for RMs due to the high variability among participants. Also the results obtained with CTMs were quite comparable to their ensemble reference using all models for the overall average (>92% of successful z-scores) while the comparability of the time series is more problematic (between 58% and 77% of the candidates’ RMSEu are accepted). In the CTM models a gap was observed between the sum of source contributions and the gravimetric PM10 mass likely due to PM underestimation in the base case. Interestingly, when only the tagged species CTM results were used in the reference, the differences between the two CTM approaches (brute force and tagged species) were evident. In this case the percentage of candidates passing the z-score and RMSEu tests were only 50% and 86%, respectively. CTMs showed good comparability with RMs for the overall dataset (83% of the z-scores accepted), more differences were observed when dealing with the time series of the single source categories. In this case the share of successful RMSEu was in the range 25% - 34%.JRC.C.5-Air and Climat

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Medipix2: a 64-k Pixel readout Chip with 55-um Square Elements Working in Single Photon Counting Mode

The Medipix2 chip is a pixel-detector readout chip consisting of 256 /spl times/ 256 identical elements, each working in single photon counting mode for positive or negative input charge signals. Each pixel cell contains around 500 transistors and occupies a total surface area of 55 /spl mu/m /spl times/ 55 /spl mu/m. A 20-/spl mu/m wide octagonal opening connects the detector and the preamplifier input via bump bonding. The preamplifier feedback provides compensation for detector leakage current on a pixel by pixel basis. Two identical pulse height discriminators are used to create a pulse if the preamplifier output falls within a defined energy window. These digital pulses are then counted with a 13-b pseudorandom counter. The counter logic, based in a shift register, also behaves as the input-output register for the pixel. Each cell also has an 8-b configuration register which allows masking, test-enabling and 3-b individual threshold adjust for each discriminator. The chip can be configured in serial mode and readout either serially or in parallel. The chip is designed and manufactured in a 6-metal 0.25-/spl mu/m CMOS technology. First measurements show an electronic pixel noise of 140 e~ root mean square (rms) and an unadjusted threshold variation around 360 e~ rms