The impact of mean body mass index on reported mortality from COVID-19 across 181 countries

Accountability for global health issues such as a pandemic and its devastating consequences are usually ascribed to a virus, but a comprehensive view should also take into account the state of the host. Data suggests that excessive nutrition is to blame for a yet unknown but not negligible portion of deaths attributed to severe acute respiratory syndrome coronavirus 2. We analyzed the correlation between mean body mass index (BMI) and 2-year coronavirus disease 2019 (COVID-19) mortality rates reported by 181 countries worldwide. Almost two thirds of the countries included had a mean BMI greater or equal to 25, with death rates ranging from 3 to 6,280 per million. Death rates in countries with a mean BMI below 25 ranged from 3 to 1,533. When the analysis was restricted to countries where the extent of testing was deemed more representative of actual mortality, only 20.1% had a mean BMI <25 but the mortality difference persisted. A second analysis looking at pre-vaccination mortality obtained from a different source led to similar conclusions. Due to the nature of the variables, reverse causation can be excluded while common causation can not. A mean BMI <25 for a country seems to spare its citizens from the highest COVID-19 mortality rates. The impact of excess weight on global COVID-19 mortality is suspected to have been much higher than what currently perceived, here estimated at no less than a fourfold increase in mortality. Countries with normal mean BMI constitute precious test beds for the quantification of the effects of overeating on COVID-19 mortality

A closer look at declarative interpretations

AbstractThree semantics have been proposed as the most promising candidates for a declarative interpretation for logic programs and pure Prolog programs: the least Herbrand model, the least term model, i.e., the C-semantics, and the I-semantics. Previous results show that a strictly increasing information ordering between these semantics exists for the class of all programs. In particular, the I-semantics allows us to model the computed answer substitutions, which is not the case for the other two.We study here the relationship between these three semantics for specific classes of programs. We show that for a large class of programs (which is Turing complete), these three semantics are isomorphic. As a consequence, given a query, we can extract from the least Herbrand model of a program in this class all computed answer substitutions. However, for specific programs the least Herbrand model is tedious to construct and reason about because it contains “ill-typed” facts. Therefore, we propose a fourth semantics that associates with a “correctly typed” program the “well-typed” subset of its least Herbrand model. This semantics is used to reason about partial correctness and absence of failures of correctly typed programs. The results are extended to programs with arithmetic

Levelized Cost of Heat for Linear Fresnel Concentrated Solar Systems

In this paper, a deep investigation upon levelized cost of heat (LCOH) produced by small-scale solar linear concentrating Fresnel collectors (CSLFC) is proposed. Solar industrial process heat applications have temperature requirements from about 60 °C to 260 °C. CSLFCs can effectively integrate conventional fossil fuel thermal systems. The study is addressed to assess technology cost projection needed to achieve competitive LCOH. So, on the basis of a framework specifically developed for these economic assessments, the best investment scenarios, in terms of industrial application, geographical location and technical design solutions, where to effectively apply the technology of CSLFC, are highlighted. The analysis has been focused on specific cost of several existing CSLFCs associated with declared performances at different operating temperatures. Two main classes of CSLFC with different total efficiency (optical and thermal) corresponding to various design solutions and specific cost were selected. The expected performances in the whole application temperature range have been evaluated through Glayx Tech proprietary simulation code, including optical and thermal unsteady analysis. A huge database coming from full CSLFC simulation varying latitude, yearly DNI, operating fluid, outlet temperature, thermal storage options, has been collected. CLSFC design and performance requirements are the key-choice to achieve competitive LCOH: the use of high efficiency – high cost components is not always rewarding in terms of final LCOH and must be attentively decided basing on site, irradiation, heat quality and LCOH target. In this perspective, CLSFCs are the most promising for industrial small scale heat applications since they show the greatest potential to reduce manufacturing costs

Validation of a small scale woody biomass downdraft gasification plant coupled with gas engine

In recent years, small scale cogeneration systems (< 500 kWe) distributed in different geographical locations using biomass has received special attention as economically competitive and environmentally friendly ways of producing energy. These systems can be integrated to industrial and agricultural activities where biomass residues are generated and can be converted into electricity and thermal energy by combustion or gasification. The legislations of many European countries such as Italy concerning renewable energy and energy efficiency along the taxation schemes have raised the incentives for small scale cogeneration plants. Consequently, there is a clear economic interest of the companies in this sector and there is also a scientific interest towards demonstration of their energetic efficiency, environmental performance and reliability. Among the suggested technologies for the biomass conversion into energy, downdraft gasification (using air as gasification agent), coupled with internal combustion engines, has the advantage of high electric efficiency (~ 25%) and low tar generation, making easier the gas cleaning process necessary for its use into engines. In the present work, the results of a measurement campaign performed on a commercial scale 350 kWth downdraft woodchips gasification plant, coupled with an SI internal combustion engine (ICE), are presented and discussed. The main goals of this first experimental campaign have been to verify the stability of gasifier and engine operation, operability of the plant and to determine its energy efficiency. The campaign verified a stable operation of the gasifier and the plant produced a syngas with a composition suitable for a gas engine. The energy balance resulted in a potential overall wood fuel to electricity efficiency of about 23 %

Geographical Analysis of Agro-Environmental Measures for Reduction of Chemical Inputs in Tuscany

The agro-environmental policies included in rural development plans are getting increasing importance in European Community strategies. These policies represent the meeting point between demand and supply of positive externalities. The difficulty of assessing real envi- ronmental efficiency is one of the elements characterizing agro-environmental measures. This difficulty is related to the identification of suitable parameters for evaluating farms according to their impact on the territory. This impact is mainly related both to chemical inputs and to the territorial characteristics of the farm. Different types of fertilizers, pesti- cides and herbicides are currently used in production processes; however, the analysis has focused only on nitrates, as they represent the most critical types of chemicals related to soil pollution. A case study is provided by analysis of agro-environmental measures in Tuscany for the reduction of nitrates in organic and integrated farms. Using spatial multicriteria analysis, integrated and organic farms were classified according to their geographical loca- tions and their release of nitrates into the soil. This classification permits the highlighting of farms that make the greatest economic efforts to reduce pollution and therefore it could determine environmental benefits. Considering that the trend of policy strategies is toward a reduction of monetary resources, the classification could help decision makers choose the right allocation of future resources

Diagnosis and treatment of acute pancreatitis: The position statement of the Italian Association for the study of the pancreas

BACKGROUND AND AIM: Till now, no Italian studies providing information on acute pancreatitis have been published. The aim of this study was to evaluate the epidemiological and clinical characteristics of acute pancreatitis in Italy. MATERIALS AND METHODS: The study involved 37 Italian centres distributed homogeneously throughout the entire national territory and prospectively collected epidemiological, anamnestic, laboratory, radiological, therapeutic (pharmacological, endoscopic and surgical) data, relevant to each individual case of acute pancreatitis consecutively observed during the period from September 1996 to June 2000. RESULTS: One thousand two hundred and six case report forms were collected, but 201 patients (16.6%) were subsequently eliminated from the final analysis. We therefore studied 1005 patients, 533 (53%) males and 472 (47%) females, mean age 59.6 +/- 20 years. On the basis of the Atlanta classification of acute pancreatitis, 753 patients of the 1005 cases analysed (75%) were mild and 252 patients (25%) severe. The aetiology was biliary in 60% of the patients, related to alcohol abuse in 8.5%, while in 21% of the cases it could not be identified. Over 80% of the patients (83%) were admitted to hospital within 24 h from the onset of clinical symptoms, while only 6% were admitted after 48 h. In particular, 65% of the patients were admitted to hospital within the first 12 h. Antibiotics were used in 85% of the severe and 75% of mild forms. Endoscopic therapy was carried out in 65% of the severe cases, but only in 40% it was carried out prior to 72 h. Eighty-five patients (8.5% of the total, 34% of the severe forms) underwent surgical intervention: 20% on the first day, 38.5% within the fourth day, and the remaining (41.5% of the cases) later on for infected necrosis. The mean duration of hospitalisation for patients with mild pancreatitis was 13 +/- 8 days, while for the severe disease it was of 30 +/- 14 days. The overall mortality rate was 5%, 17% in severe and 1.5% in mild pancreatitis. CONCLUSIONS: Acute pancreatitis in Italy is more commonly a mild disease with a biliary aetiology. The treatment of the disease is not optimal and, on the basis of these data, needs to be standardised. Despite this, the overall mortality rate is low (5%BACKGROUND AND AIM: Till now, no Italian studies providing information on acute pancreatitis have been published. The aim of this study was to evaluate the epidemiological and clinical characteristics of acute pancreatitis in Italy. MATERIALS AND METHODS: The study involved 37 Italian centres distributed homogeneously throughout the entire national territory and prospectively collected epidemiological, anamnestic, laboratory, radiological, therapeutic (pharmacological, endoscopic and surgical) data, relevant to each individual case of acute pancreatitis consecutively observed during the period from September 1996 to June 2000. RESULTS: One thousand two hundred and six case report forms were collected, but 201 patients (16.6%) were subsequently eliminated from the final analysis. We therefore studied 1005 patients, 533 (53%) males and 472 (47%) females, mean age 59.6 +/- 20 years. On the basis of the Atlanta classification of acute pancreatitis, 753 patients of the 10

Impact of biliary stents on the diagnostic accuracy of EUS-guided fine-needle biopsy of solid pancreatic head lesions: A multicenter study

There is no clear evidence of a negative impact of biliary stents on the diagnostic yield of EUS-guided fine-needle biopsy (EUS-FNB) for diagnosing pancreatic head lesions. We aimed to evaluate the association between the presence of biliary stents and the diagnostic accuracy of EUS-FNB. Materials and Methods: A multicenter retrospective study including all jaundiced patients secondary to pancreatic head masses was performed. Patients were divided into two groups according to the presence of a biliary stent placed before EUS-FNB. Pathological results were classified according to the Papanicolaou classification and compared against the final diagnosis. Diagnostic measures in the two groups were compared. Multivariate logistic regression analyses including potential factors affecting EUS-FNB accuracy were performed. Results: Overall, 842 patients were included, 495 (58.8%) without and 347 (41.2%) with biliary stent. A plastic or a metal stent was placed in 217 (62.5%) and 130 (37.5%) cases, respectively. Diagnostic sensitivity and accuracy were significantly higher in patients without biliary stent than in those with stent (91.9% and 92.1% vs. 85.9% and 86.4%, P = 0.010 At multivariate analyses, lesion size (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.02-1.09, P = 0.01) and presence of biliary stent (OR: 0.51, 95% CI: 0.32-0.89, P = 0.01) were independently associated with diagnostic accuracy. In the subgroup of patients with biliary stent, the type of stent (plastic vs. metal) did not impact EUS-FNB yield, whereas the use of larger bore needles enhanced diagnostic accuracy (OR: 2.29, 95% CI: 1.28-4.12, P = 0.005). Conclusions: In this large retrospective study, an indwelling biliary stent negatively impacted the diagnostic accuracy of EUS-FNB. Preferably, EUS-FNB should precede endoscopic retrograde cholangiopancreatography, especially in the case of small tumors

Crop changes from the XVI century to the present in a hill/mountain area of eastern Liguria (Italy)

<p>Abstract</p> <p>Background</p> <p>Chronological information on the composition and structure of agrocenoses and detailed features of land cover referring to specific areas are uncommon in ethnobotanical studies, especially for periods before the XIX century. The aim of this study was to analyse the type of crop or the characteristics of soil cover from the XVI century to the present.</p> <p>Methods</p> <p>This diachronic analysis was accomplished through archival research on the inventories of the Parish of St. Mary and those of the Municipality of Pignone and from recent surveys conducted in an area of eastern Liguria (Italy).</p> <p>Results</p> <p>Archival data revealed that in study area the primary means of subsistence during the last five centuries, until the first half of the XX century, was chestnuts. In the XVIII and XIX centuries, crop diversification strongly increased in comparison with previous and subsequent periods. In more recent times, the abandonment of agricultural practices has favoured the re-colonisation of mixed woodland or cluster-pine woodland.</p> <p>Conclusion</p> <p>Ancient documents in the ecclesiastic or municipal inventories can be a very useful tool for enhancing the knowledge of agricultural practice, as well as of subsistence methods favoured by local populations during a particular time and for reconstructing land use change over time.</p