Immature platelet fraction as predictive index of sepsis

Introduction The incidence of sepsis is reported around 37% in European ICUs [1]. The mortality rate depends on the severity of organ failure, up to 65% if four or more organs are involved. Multiple organ failure (MOF) is due to microcirculatory dysfunction with microthrombosis resulting from coagulation disorders including platelets’ activation. An early diagnosis should identify the microcirculatory dysfunction before MOF became clinically evident. The diagnosis of sepsis is commonly based on clinical criteria, pathogen identifi cation and use of markers like procalcitonin (PCT) and C-reactive protein (PCR) associated with infection. The aim of our study is to evaluate whether the routine measurement of immature platelet fraction (IPF), considered a precocious marker of platelet production, is associated with sepsis and its severity and/or whether it could be used as a predicting marker of sepsis. Methods We enrolled 66 consecutive patients admitted to the ICU, dividing them into two groups: septic (n = 44) and no septic (n = 22). The severity of sepsis was evaluated. The exclusion criterion was a platelet count <150,000/mm3. Blood count, coagulation, PCR, PCT, and IPF were collected every day. Results The IPF values between septic (4.6 ± 3.1) and no septic patients (3.3 ± 1.5) did not diff er (P = 0.16). No correlation was found between IPF values and the severity of septic condition (no sepsis 11.7 ± 10.1; sepsis 14.3 ± 10.5; severe sepsis 10.5 ± 9.1; septic shock 19.5 ± 12.4; P = 0.3). When we considered only subjects who did not have sepsis at the ICU admission we found that patients who developed sepsis during the recovery had IPF values higher than patients who did not develop sepsis (Table 1). Conclusions From our results IPF cannot be considered a marker of sepsis. Conversely it could be used as predictive index of sepsis because it can identify patients who will develop sepsis. References 1. Vincent et al.: Sepsis in European intensive care units: results of the SOAP study. Intensive Care Med 2006, 34:344-353

Are the school prevention programmes - aimed at de-normalizing smoking among youths - beneficial in the long term? An example from the Smoke Free Class Competition in Italy

Tobacco smoking by young people is of great concern because it usually leads to regular smoking, nicotine addiction and quitting difficulties. Young people "hooked" by tobacco maintain the profits of the tobacco industry by replacing smokers who quit or die. If new generations could be tobacco-free, as supported by tobacco endgame strategies, the tobacco epidemic could end within decades. Smoking prevention programmes for teens are offered by schools with the aim to prevent or delay smoking onset. Among these, the Smoke Free Class Competition (SFC) was widely implemented in Europe. Its effectiveness yielded conflicting results, but it was only evaluated at short/medium term (6 - 18 months). The aim of this study is to evaluate its effectiveness after a longer follow-up (3 to 5 years) in order to allow enough time for the maturing of the students and the internalization of the experience and its contents. Fifteen classes were randomly sampled from two Italian high schools of Bologna province that regularly offered the SFC to first year students; 382 students (174 participating in the SFC and 208 controls) were retrospectively followed-up and provided their "smoking histories". At the end of their last year of school (after 5 years from the SFC), the percentage of students who stated that they were regular smokers was lower among the SFC students than in controls: 13.5% vs 32.9% (p=0.03). From the students' "smoking histories", statistically significant protective ORs were observed for SFC students at the end of 1st and 5th year: 0.42 (95% CI 0.19-0.93) and 0.32 (95% CI 0.11-0.91) respectively. Absence of smokers in the family was also a strongly statistically significant factor associated with being a non-smoker student. These results suggest that SFC may have a positive impact on lowering the prevalence of smoking in the long term (5 years)

A geobotanical survey on acidophilous grasslands in the Abruzzo, Lazio and Molise National Park (Central Italy)

The acidophilous grasslands of the south-eastern part of the Abruzzo, Lazio and Molise National Park was studied by the phytosociological method and analyzed from a synecological viewpoint with the help of soil analysis. Four clusters of relevés resulted from the numerical classification. Syntaxonomically they were ascribed to the following associations: Poo violaceae-Nardetum strictae, Potentillo rigoanae-Festucetum paniculatae, Nardo strictae-Brachypodietum genuensis and Potentillo rigoanae-Brachypodietum genuensis. Since the original proposal of all the syntaxa identified in the present study were affected by nomenclatural mistakes, they were corrected in accordance with the rules of ICPN. The occurrence of Anthoxanto-Brachypodietum in central Apennines, is excluded since this association falls in syntaxonomical synonymy with Potentillo-Brachypodietum. The synecological analysis proved that the distribution of the different communities identified within the study area to be correlated with topographic, geomorphological and soil factors. Among these latter, the ratio H+/basic cations, pH behave as the most influencing parameters in the distribution of the communities identified

On the inferential implications of decreasing weight structures in mixture models

Bayesian estimation of nonparametric mixture models strongly relies on available representations of discrete random probability measures. In particular, the order of the mixing weights plays an important role for the identifiability of component-specific parameters which, in turn, affects the convergence properties of posterior samplers. The geometric process mixture model provides a simple alternative to models based on the Dirichlet process that effectively addresses these issues. However, the rate of decay of the mixing weights for this model may be too fast for modeling data with a large number of components. The need for different decay rates arises. Some variants of the geometric process featuring different decay behaviors, while preserving the decreasing structure, are presented and investigated. An asymptotic characterization of the number of distinct values in a sample from the corresponding mixing measure is also given, highlighting the inferential implications of different prior specifications. The analysis is completed by a simulation study in the context of density estimation. It shows that by controlling the decaying rate, the mixture model is able to capture data with a large number of components

High expression of beta-adrenergic receptor kinase in human peripheral blood leukocytes. Isoproterenol and platelet activating factor can induce kinase translocation.

Receptor phosphorylation is a key step in the process of desensitization of the beta-adrenergic and other related receptors. A selective kinase (called beta-adrenergic receptor kinase, beta ARK) has been identified which phosphorylates the agonist-occupied form of the receptor. Recently the bovine beta ARK cDNA has been cloned and the highest levels of specific mRNA were found in highly innervated tissues. It was proposed that beta ARK may be primarily active on synaptic receptors. In the present study, the cDNA of human beta ARK was cloned and sequenced. The sequence was very similar to that of the bovine beta ARK (the overall amino acid homology was 98%). Very high levels of beta ARK mRNA and kinase activity were found in peripheral blood leukocytes and in several myeloid and lymphoid leukemia cell lines. Since agonist-induced beta ARK translocation is considered the first step involved in beta ARK-mediated homologous desensitization, we screened a number of G-protein-coupled receptor agonists for their ability to induce beta ARK translocation. In human mononuclear leukocytes, beta-AR agonist isoproterenol and platelet-activating factor were able to induce translocation of beta ARK from cytosol to membrane. After 20 min of exposure to isoproterenol (10 microM), the cytosolic beta ARK activity decreased to 61% of control, while membrane-associated beta ARK activity increased to 170%. 20-min exposure to platelet-activating factor (1 microM) reduced the cytosolic beta ARK activity to 42% of control with concomitant increase in membrane beta ARK activity to 214% of control. The high levels of beta ARK expression in human peripheral blood leukocytes together with the ability of isoproterenol and platelet-activating factor to induce beta ARK translocation, suggest a role for beta ARK in modulating some receptor-mediated immune functions

Numerical propagation of high energy cosmic rays in the Galaxy I: technical issues

We present the results of a numerical simulation of propagation of cosmic rays with energy above $10^{15}$ eV in a complex magnetic field, made in general of a large scale component and a turbulent component. Several configurations are investigated that may represent specific aspects of a realistic magnetic field of the Galaxy, though the main purpose of this investigation is not to achieve a realistic description of the propagation in the Galaxy, but rather to assess the role of several effects that define the complex problem of propagation. Our simulations of Cosmic Rays in the Galaxy will be presented in Paper II. We identified several effects that are difficult to interpret in a purely diffusive approach and that play a crucial role in the propagation of cosmic rays in the complex magnetic field of the Galaxy. We discuss at length the problem of the extrapolation of our results to much lower energies where data are available on the confinement time of cosmic rays in the Galaxy. The confinement time and its dependence on particles' rigidity are crucial ingredients for 1) relating the source spectrum to the observed cosmic ray spectrum; 2) quantifying the production of light elements by spallation; 3) predicting the anisotropy as a function of energy.Comment: 29 pages, 12 figures, submitted to JCA

Modification of cluster radio halo appearance by the thermal Sunyaev-Zeldovich effect

We discuss the consequences of the spectral and morphological modification of galaxy cluster radio halos due to the Sunyaev-Zeldovich (SZ) effect for the interpretation of existing and upcoming high frequency radio observations. Likely these modifications have affected the interpretation of the existing Coma cluster radio data. The radio halo emission visible at low (< 5 GHz) frequencies is at higher (> 10 GHz) frequencies completely over-compensated by the thermal SZ decrement. Thus, the total radio emission of a galaxy cluster goes through zero (in comparison to the constant cosmic microwave background (CMB) emission) at a frequency of several GHz. Since the radio halo brightness has a narrow radial profile compared to the SZ decrement, a central emission region is surrounded by a decrement within the intermediate frequency range of several GHz. The size of this emission regions shrinks with increasing frequency until the decrement dominates everywhere in the cluster.Comment: accepted by A&A Letters, 4 pages, 3 figurs, typo correcte

The origin of ultra high energy cosmic rays

We briefly discuss some open problems and recent developments in the investigation of the origin and propagation of ultra high energy cosmic rays (UHECRs).Comment: Invited Review Talk at TAUP 2005 (Zaragoza - September 10-14, 2005). 7 page