Valutazione delle lesioni nell\u2019impatto ciclista adolescente -veicolo con simulazione multibody

Le situazioni di impatto e la dinamica di ciclista e pedone sono le informazioni fondamentali per lo sviluppo di soluzioni efficaci per migliorare la protezione del pedone e del ciclista in caso di urto con autovetture. La casistica degli incidenti a Palermo, negli ultimi anni, avvenuti su strade urbane (84%) che coinvolgono adolescenti (6,4%), mostra che i ciclisti hanno in genere una posizione di impatto superiore rispetto al pedone, con una quota maggiore di lesioni per urti nella zona del parabrezza. In questo lavoro \ue8 eseguita la simulazione dinamica per lo studio delle lesioni alla testa e al torace dell\u2019adolescente, tra una bicicletta generica e un modello di auto che presenta caratteristiche vantaggiose per la sicurezza del pedone o del ciclista. Il software SimWise (Visual Nastran) \ue8 stato usato per la simulazione multibody dell\u2019impatto; il modello antropomorfo, l'auto e le biciclette sono quelli utilizzati in lavori precedenti. L'attenzione \ue8 su un ciclista adolescente, perch\ue9 i relativi dati di lesione si trovano in letteratura con difficolt\ue0. I dodici test d\u2019impatto completo (auto contro ciclista) hanno come parametri principali: velocit\ue0 del veicolo (20, 30, 40 e 50 km/h), con tre diverse posizioni del ciclista rispetto al veicolo: frontale, laterale e posteriore. La posizione di impatto della testa (sopra il cofano, nel parabrezza), determinato dalla prova di crash, mostra che la protezione del ciclista dovrebbe essere migliorata nella zona pi\uf9 alta del parabrezza, rispetto a quelle pedonali. La ferita alla testa viene analizzata utilizzando il parametro HIC e la ferita al torace \ue8 analizzata secondo il criterio dei 3 ms; viene calcolata la probabilit\ue0 AIS 4 +, concludendo che la lesione alla testa \ue8 pi\uf9 pericolosa in caso di pedone adolescente, mentre la ferita della cassa toracica \ue8 pi\uf9 pericolosa nel caso di ciclista adolescente. Inoltre il ciclista adolescente ha una maggiore possibilit\ue0 di sopravvivenza rispetto al ciclista adulto. Incidentologia e simulazioni mostrano che il parabrezza \ue8 una posizione di impatto frequente per testa e torace

Salvage treatment with ganciclovir in a splenectomized, polytransfused patient affected by systemic inflammatory response syndrome

A 23-year-old man was admitted to hospital with a 12-day history of daily fever. A clinical history revealed that 10 months previously, the patient had been splenectomized and polytransfused for a severe blunt trauma. On admission, laboratory data revealed significant leukocytosis (33,230/ul). The patient's general clinical conditions rapidly worsened into a severe systemic inflammatory response syndrome in four days. After 10 days of broad-spectrum antibiotic treatment, the temperature curve was unmodified and severe leukocytosis persisted (44,300 ul) with absolute lymphocytosis. Laboratory tests ruled out hematological diseases, pneumonia, abscesses and endocarditis. In the light of IgM positivity for CMV (unconfirmed by PCR) and with the support of a PubMed search, we commenced a salvage treatment with intravenous ganciclovir, suspecting a viral infection or reactivation. After two days of therapy, an immediate defervescence was observed with a remarkable clinical improvement. After 10 days, the clinical syndrome had been completely resolved and the patient was discharged in good, general clinical health

Smartphone and social network addiction in early adolescents: The role of self-regulatory self-efficacy in a pilot school-based intervention

Background: Youths' online problematic behaviors, such as smartphone or social network sites (SNS) addiction, gained increasing attention nowadays, due to their impact on concurrent and later adjustment, such as emotional and/or behavioral problems, academic impairments, or relational issues. Aims: This study aims to evaluate the effectiveness of a pilot school-based intervention to contrast online addictive behaviors while fostering adolescents' self-regulative abilities. Materials & Methods: The intervention started in January 2022 in an Italian junior high school located in Rome, and consisted of four meetings with students. A total sample of 462 15-year-old adolescents (Mage = 15.2; SD = 0.50; 41% females; Ncontrol = 214; Nintervention = 248) was considered. Within the latent difference score framework, we examined short-term changes from the pre-to-the-postintervention levels of SNS and smartphone addiction, and self-regulatory self-efficacy (SRSE) beliefs as a possible booster of the intervention's effectiveness. Results: Results showed a significant decrease in both online addictions (SNS and smartphone addiction), controlling for age, gender, sexual orientation, and socioeconomic status, because of the short-term efficacy of the project. The buffering effect of SRSE beliefs was further supported. Conclusion: These findings emphasized the usefulness of promoting youths' self-regulative beliefs to contrast problematic tendencies, according to a Positive Youth Development perspective which focused on resources rather than only on the prevention of negative outcomes for youths' adjustment

Association between anti-apolipoprotein A-1 antibodies and cardiovascular disease in the general population. Results from the CoLaus study.

We aimed to determine the association between autoantibodies against apolipoprotein A-1 (anti-apoA-1 IgG) and prevalent cardiovascular (CV) disease (CVD) as well as markers of CV risk in the general population. Cross-sectional data were obtained from 6649 subjects (age 52.6 ± 10.7 years, 47.4 % male) of the population-based CoLaus study. CVD was defined as myocardial infarction, angina pectoris, percutaneous revascularisation or bypass grafting for ischaemic heart disease stroke or transient ischaemic attack, and was assessed according to standardised medical records. Anti-apoA-1 IgG and biological markers were measured by ELISA and conventional automated techniques, respectively. Prevalence of high anti-apoA-1 IgG levels in the general population was 19.9 %. Presence of anti-apoA-1 IgG was significantly associated with CVD [odds ratio 1.34, 95 % confidence interval (1.05-1.70), p=0.018], independently of established CV risk factors (CVRFs) including age, sex, hypertension, smoking, diabetes, low and high-density lipoprotein cholesterol levels. The n=455 (6.8 %) study participants with a history of CVD (secondary prevention subgroup) presented higher median anti-ApoA-1 IgG values compared with subjects without CVD (p=0.029). Among patients in the secondary prevention subgroup, those with positive anti-apoA-1 IgG levels had lower HDL (p=0.002) and magnesium (p=0.001) levels, but increased uric acid and high-sensitivity C-reactive protein levels (p=0.022, and p<0.001, respectively) compared to patients with negative anti-apoA-1 IgG levels. In conclusion, anti-apoA-1 IgG levels are independently associated with CVD in the general population and also related to CV biomarkers in secondary prevention. These findings indicate that anti-apoA-1 IgG may represent a novel CVRF and need further study in prospective cohorts

Impact of CD14 Polymorphisms on Anti-Apolipoprotein A-1 IgG-Related Coronary Artery Disease Prediction in the General Population.

We aimed to determine whether autoantibodies against apoA-1 (apolipoprotein A-1; anti-apoA-1 IgG) predict incident coronary artery disease (CAD), defined as adjudicated incident myocardial infarction, angina, percutaneous coronary revascularization, or bypass grafting, in the general population. We further investigated whether this association is modulated by a functional CD14 receptor single nucleotide polymorphism. In a prospectively studied, population-based cohort of 5220 subjects (mean age 52.6±10.7 years, 47.4% males), followed over a median period of 5.6 years, subjects positive versus negative for anti-apoA-1 IgG presented a total CAD rate of 3.9% versus 2.8% (P=0.077) and a nonfatal CAD rate of 3.6% versus 2.3% (P=0.018), respectively. After multivariate adjustment for established cardiovascular risk factors, the hazard ratios of anti-apoA-1 IgG for total and nonfatal CAD were: hazard ratio=1.36 (95% confidence interval, 0.94-1.97; P=0.105) and hazard ratio=1.53 (95% confidence interval, 1.03-2.26; P=0.034), respectively. In subjects with available genetic data for the C260T rs2569190 single nucleotide polymorphism in the CD14 receptor gene (n=4247), we observed a significant interaction between anti-apoA-1 IgG and rs2569190 allele status with regards to CAD risk, with anti-apoA-1 IgG conferring the highest risk for total and nonfatal CAD in non-TT carriers, whereas being associated with the lowest risk for total and nonfatal CAD in TT homozygotes (P for interaction =0.011 and P for interaction =0.033, respectively). Anti-apoA-1 IgG are independent predictors of nonfatal incident CAD in the general population. The strength of this association is dependent on a functional polymorphism of the CD14 receptor gene, a finding suggesting a gene-autoantibody interaction for the development of CAD

Prognostic and therapeutic considerations of antibodies against c-ter apolipoprotein A-1 in the general population.

Autoantibodies against apolipoprotein A1 (anti-apoA1 IgGs) and its C-terminal region (cter apoA1) have emerged as an independent biomarker for cardiovascular disease. Cter apoA1 mimetic peptides were shown to reverse the deleterious anti-apoA1 IgG effects in vitro. We evaluated the association of anti-cter apoA1 IgGs with overall mortality in the general population and tested the ability of a cter apoA1 mimetic peptide to reverse the anti-apoA1 IgG-induced inflammatory response and mortality in vitro and in vivo, respectively. Anti-cter apoA1 IgGs were measured in serum samples of 6386 participants of the CoLaus study of which 5220 were followed for a median duration of 5.6 years. The primary outcome was overall mortality. The peptide inhibitory concentration 50% (IC <sub>50</sub> ) was determined in vitro on HEK-Blue-4 and RAW cells. ApoE <sup>-/-</sup> mice were exposed to 16 weeks of anti-apoA1IgG passive immunisation with and without peptide co-incubation. Anti-cter apoA1 IgGs were associated with higher interleukin 6 levels and independently predicted overall mortality; an increase of one standard deviation of anti-cter apoA1 IgG level was associated with an 18% increase in mortality risk (hazard ratio: 1.18, 95% confidence interval: 1.04-1.33; P = 0.009). The cterApoA1 analogue reversed the antibody-mediated inflammatory response with an IC <sub>50</sub> of 1 µm in vitro but did not rescue the significant anti-apoA1 IgG-induced mortality rate in vivo (69% vs. 23%, LogRank P = 0.02). Anti-cter apoA1 IgG independently predicts overall mortality in the general population. Despite being effective in vitro, our cter apoA1 analogue did not reverse the anti-apoA1 IgG-induced mortality in mice. Our data suggest that these autoantibodies are not readily treatable through cognate peptide immunomodulation

A Phase II Trial of Fixed-Dose Rate Gemcitabine plus Capecitabine in Metastatic/Advanced Biliary Tract Cancer Patients

Background: This phase II trial was conducted to determine the activity and safety of the combination of fixed-dose rate (FDR) gemcitabine and capecitabine in metastatic biliary tract cancer (BTC) patients. Methods: Patients with unresectable BTC who had pathologically confirmed adenocarcinoma, no prior chemotherapy, Eastern Cooperative Oncology Group (ECOG) performance status 641 and measurable disease were enrolled. Treatment consisted of FDR gemcitabine at 800 mg/m 2 on days 1 and 8 every 21 days with capecitabine administered orally b.i.d. in equal doses (650 mg/m 2 b.i.d.) for 14 days (28 doses). Results: Between May 2005 and February 2009, 30 patients were enrolled. The median age was 67 years (45-76) and there were 14 males. Thirty patients were evaluable for response and toxicity. A total of 221 cycles were administered (median 7, range 2-16). One patient achieved complete response and 7 patients achieved partial response, giving an overall response rate of 26.7% in the intention-to-treat population. Twelve patients (40.0%) had stable disease. The median progression-free survival was 6.33 months. The median overall survival was 10.8 months. Grade 3/4 neutropenia and thrombocytopenia were noted in 13 and 7% of the patients, respectively. Grade 2/3 nonhematologic toxicities were asthenia (54% of patients), diarrhea (17%), stomatitis (23%) and hand-foot syndrome (7%). There was no treatment-related death. The drugs taken were skipped at least once in 45% of the patients and the dose was reduced in 26% of them. Conclusions: The combination of FDR gemcitabine and capecitabine in this 3-week cycle is safe and seems to have a good activity in advanced biliary cancer

An online network tool for quality information to answer questions about occupational safety and health: usability and applicability

<p>Abstract</p> <p>Background</p> <p>Common information facilities do not always provide the quality information needed to answer questions on health or health-related issues, such as Occupational Safety and Health (OSH) matters. Barriers may be the accessibility, quantity and readability of information. Online Question & Answer (Q&A) network tools, which link questioners directly to experts can overcome some of these barriers. When designing and testing online tools, assessing the usability and applicability is essential. Therefore, the purpose of this study is to assess the usability and applicability of a new online Q&A network tool for answers on OSH questions.</p> <p>Methods</p> <p>We applied a cross-sectional usability test design. Eight occupational health experts and twelve potential questioners from the working population (workers) were purposively selected to include a variety of computer- and internet-experiences. During the test, participants were first observed while executing eight tasks that entailed important features of the tool. In addition, they were interviewed. Through task observations and interviews we assessed applicability, usability (effectiveness, efficiency and satisfaction) and facilitators and barriers in use.</p> <p>Results</p> <p>Most features were usable, though several could be improved. Most tasks were executed effectively. Some tasks, for example searching stored questions in categories, were not executed efficiently and participants were less satisfied with the corresponding features. Participants' recommendations led to improvements. The tool was found mostly applicable for additional information, to observe new OSH trends and to improve contact between OSH experts and workers. Hosting and support by a trustworthy professional organization, effective implementation campaigns, timely answering and anonymity were seen as important use requirements.</p> <p>Conclusions</p> <p>This network tool is a promising new strategy for offering company workers high quality information to answer OSH questions. Q&A network tools can be an addition to existing information facilities in the field of OSH, but also to other healthcare fields struggling with how to answer questions from people in practice with high quality information. In the near future, we will focus on the use of the tool and its effects on information and knowledge dissemination.</p

Measurements of Higgs boson production and couplings in diboson final states with the ATLAS detector at the LHC

Measurements are presented of production properties and couplings of the recently discovered Higgs boson using the decays into boson pairs, H →γ γ, H → Z Z∗ →4l and H →W W∗ →lνlν. The results are based on the complete pp collision data sample recorded by the ATLAS experiment at the CERN Large Hadron Collider at centre-of-mass energies of √s = 7 TeV and √s = 8 TeV, corresponding to an integrated luminosity of about 25 fb−1. Evidence for Higgs boson production through vector-boson fusion is reported. Results of combined fits probing Higgs boson couplings to fermions and bosons, as well as anomalous contributions to loop-induced production and decay modes, are presented. All measurements are consistent with expectations for the Standard Model Higgs boson