Higher in-hospital mortality during weekend admission for acute coronary syndrome: a large-scale cross-sectional Italian study

AIMS: An increased mortality risk during weekend hospital admission has been consistently observed. In the present study, we evaluated whether the current improvement in management of acute coronary syndromes (ACS) has reduced this phenomenon. METHODS AND RESULTS: We extracted data from the Italian National Healthcare System Databank of 80\u200a391 ACS admissions in the region of Lombardia between 2010 and 2014. ICD-9 codes were used to assess the diagnosis. We performed a multiple logistic regression analysis to compare the mortality rates between weekend and weekday admissions.Mean age of the study population was 67.6 years; 30.1% of patients were women. ST segment elevation myocardial infarction (STEMI) accounts for 42.2% of admissions. The total in-hospital mortality was 3.05% and was positively predicted by weekend admission [odds ratio (OR) 1.13, P\u200a=\u200a0.006], age and female sex. The weekend effect on mortality was only significant for STEMI (OR 1.11, P\u200a=\u200a0.04) in comparison to non-STEMI (NSTEMI) or unstable angina.The trend of the risk of death was found to be negatively correlated with age: the risk of death was significantly higher in all age clusters younger than 75 (OR 1.22, P\u200a<\u200a0.01) and even greater in the very young subgroup under 45 years of age (OR 2.09, P\u200a=\u200a0.03). CONCLUSION: Our data indicate that increased mortality risk is still present during weekend admissions. This phenomenon is particularly evident in younger patients and in individuals admitted for STEMI

Network Selection and Resource Allocation Games for Wireless Access Networks

Wireless access networks are often characterized by the interaction of different end users, communication technologies, and network operators. This paper analyzes the dynamics among these "actors" by focusing on the processes of wireless network selection, where end users may choose among multiple available access networks to get connectivity, and resource allocation, where network operators may set their radio resources to provide connectivity. The interaction among end users is modeled as a non-cooperative congestion game where players (end users) selfishly select the access network that minimizes their perceived selection cost. A method based on mathematical programming is proposed to find Nash equilibria and characterize their optimality under three cost functions, which are representative of different technological scenarios. System level simulations are then used to evaluate the actual throughput and fairness of the equilibrium points. The interaction among end users and network operators is then assessed through a two-stage multi-leader/multi-follower game, where network operators (leaders) play in the first stage by properly setting the radio resources to maximize their users, and end users (followers) play in the second stage the aforementioned network selection game. The existence of exact and approximated subgame perfect Nash equilibria of the two-stage game is thoroughly assessed and numerical results are provided on the "quality" of such equilibria

Stochastic characterization of the spectrum sharing game in ad-hoc networks

Abstract This work focuses on infrastructure-less ad hoc wireless networks where multiple transmitter/receiver pairs share the same radio resources (spectrum); transmitters have to choose how to split a total power budget across orthogonal spectrum bands with the goal to maximize their sum rate under cumulative interference from concurrent transmissions. We start off by introducing and characterizing the non-cooperative game among transmitter/receiver pairs when the network topology is deterministically given. The corresponding Nash equilibria are derived, highlighting their dependency on the topological parameters (distances between wireless nodes, propagation model, and background noise power). The analysis is then extended to the case of random network topologies drawn from a given spatial stochastic process. Tools of stochastic geometry are leveraged to derive a statistical characterization of the equilibria of the spectrum sharing game. Finally, a distributed algorithm is proposed to let the players of the spectrum sharing game converge to equilibria conditions. Numerical simulations show that the proposed algorithm drives the users to stable points that are close to the equilibria of the game requiring limited information exchange among nodes

Assessing Creative Expressiveness In Children's Written Stories Using The Consensual Assessment Technique

The study investigated methodological issues relating to the use of the Consensual Assessment Technique (CAT) for measuring creativity in children’s written stories. The CAT is a commonly used measure to estimate creativity of a product, based on social recognition of creativity by independent judges. Across domains, the CAT has shown high inter-rater reliability. The present study utilised the CAT to assess creativity in children’s written stories. The stories were also evaluated for: Imagination, Novelty, Liking (how much the judges liked the story), Detail, Emotion, Vocabulary, Straightforwardness, Logic and Grammar. The sample consisted of 277 nine-year-olds. The results showed that to reach sufficient inter-rater reliability, 5 coders were needed. The results gave evidence of a 2-factor structure among the 10 dimensions, indexing ‘Creative Expressiveness’ and ‘Logic’ constructs related to individual differences in writing. Girls outperformed boys on both constructs. The story length was positively correlated with the constructs, explaining 63% of the variance in Creative Expressiveness, and 42% in Logic. Creative Expressiveness was positively correlated with verbal ability (r = .20) and with teacher rating of writing (r = .28). Similarly, Logic was also correlated with verbal ability (r = .34) and teacher rating of writing (r = .44). The findings inform future research employing the CAT to measure creativity in children’s storytelling

The genetics of specific cognitive abilities

Most research on individual differences in performance on tests of cognitive ability focuses on general cognitive ability (g), the highest level in the three-level Cattell-Horn-Carroll (CHC) hierarchical model of intelligence. About 50% of the variance of g is due to inherited DNA differences (heritability) which increases across development. Much less is known about the genetics of the middle level of the CHC model, which includes 16 broad factors such as fluid reasoning, processing speed, and quantitative knowledge. We provide a meta-analytic review of 863,041 monozygotic-dizygotic twin comparisons from 80 publications for these middle-level factors, which we refer to as specific cognitive abilities (SCA). Twin comparisons were available for 11 of the 16 CHC domains. The average heritability across all SCA is 55%, similar to the heritability of g. However, there is substantial differential heritability and the SCA do not show the dramatic developmental increase in heritability seen for g. We also investigated SCA independent of g (g-corrected SCA, which we refer to as SCA.g). A surprising finding is that SCA.g remain substantially heritable (53% on average), even though 25% of the variance of SCA that covaries with g has been removed. Our review frames expectations for genomic research that will use polygenic scores to predict SCA and SCA.g. Genome-wide association studies of SCA.g are needed to create polygenic scores that can predict SCA profiles of cognitive abilities and disabilities independent of g. These could be used to foster children’s cognitive strengths and minimise their weaknesses

Genetic factors underlie the association between anxiety, attitudes and performance in mathematics

Students struggling with mathematics anxiety (MA) tend to show lower levels of mathematics self-efficacy and interest as well as lower performance. The current study addresses: (1) how MA relates to different aspects of mathematics attitudes (self-efficacy and interest), ability (understanding numbers, problem solving ability, and approximate number sense) and achievement (exam scores); (2) to what extent these observed relations are explained by overlapping genetic and environmental factors; and (3) the role of general anxiety in accounting for these associations. The sample comprised 3,410 twin pairs aged 16-21 years, from the Twins Early Development Study. Negative associations of comparable strength emerged between MA and the two measures of mathematics attitudes, phenotypically (~ -.45) and genetically (~ -.70). Moderate negative phenotypic (~ -.35) and strong genetic (~ -.70) associations were observed between MA and measures of mathematics performance. The only exception was approximate number sense whose phenotypic (-.10) and genetic (-.31) relation with MA was weaker. Multivariate quantitative genetic analyses indicated that all mathematics related measures combined accounted for ~75% of the genetic variance in MA and ~20% of its environmental variance. Genetic effects were largely shared across all measures of mathematics anxiety, attitudes, abilities and achievement, with the exception of approximate number sense. This genetic overlap was not accounted for by general anxiety. These results have important implications for future genetic research concerned with identifying the genetic underpinnings of individual variation in mathematics-related traits, as well as for developmental research into how children select and modify their mathematics-related experiences partly based on their genetic predispositions

Autonomic dysregulation and self‐injurious thoughts and behaviours in children and young people: A systematic review and meta‐analysis

Background: self-injurious thoughts and behaviours (SITBs) have been associated with dysfunction of the Autonomic Nervous System (ANS) in children and young people, suggesting that objective ANS measures may aid assessment of suicide risk, but a systematic synthesis of this literature is currently lacking.Methods: following a pre-registered protocol (PROSPERO CRD42022327605), we conducted a systematic search of PubMed, Medline, Embase, PsycINFO, and Web of Science, for empirical studies published until 10th May 2022 that compared indices of ANS functioning in individuals aged 0–25 years with versus without SITBs, or reported continuous associations between ANS measures and SITBs. Study quality was assessed with the Newcastle-Ottawa Scales. Pooled effect sizes (Hedge's g) were estimated with random-effects meta-analytic models.Results: twenty studies (1979 participants) were included in our systematic review, with 16 included in meta-analyses. Results suggested that SITBs were associated with altered cardiac indices of arousal (g = −0.328, p &lt; 0.001), which was driven by lower heart rate variability in individuals with SITBs (g = −0.375, p = 0.025). Overall results for electrodermal activity were not significant (g = 0.026, p = 0.857), but subgroup analyses showed increased activity in studies of individuals who engaged specifically in non-suicidal self-harm (g = 0.249, p = 0.014) but decreased activity in the remaining studies (g = −0.567, p = 0.004).Conclusions: our systematic review and meta-analysis found evidence of reduced parasympathetic regulation as well as more tentative evidence of altered electrodermal activity in children and young people displaying SITBs. Future longitudinal studies should test the clinical utility of these markers for detecting and monitoring suicide risk

Using DNA to predict behaviour problems from preschool to adulthood

Background: One goal of the DNA revolution is to predict problems in order to prevent them. We tested here if the prediction of behaviour problems from genome-wide polygenic scores (GPS) can be improved by creating composites across ages and across raters and by using a multi-GPS approach that includes GPS for adult psychiatric disorders as well as for childhood behaviour problems. Method: Our sample included 3,065 genotyped unrelated individuals from the Twins Early Development Study who were assessed longitudinally for hyperactivity, conduct, emotional problems, and peer problems as rated by parents, teachers, and children themselves. GPS created from 15 genome-wide association studies were used separately and jointly to test the prediction of behaviour problems composites (general behaviour problems, externalising, and internalising) across ages (from age 2 to 21) and across raters in penalised regression models. Based on the regression weights, we created multi-trait GPS reflecting the best prediction of behaviour problems. We compared GPS prediction to twin heritability using the same sample and measures. Results: Multi-GPS prediction of behaviour problems increased from <2% of the variance for observed traits to up to 6% for cross-age and cross-rater composites. Twin study estimates of heritability, although to a lesser extent, mirrored patterns of multi-GPS prediction as they increased from <40% to 83%. Conclusions: The ability of GPS to predict behaviour problems can be improved by using multiple GPS, cross-age composites and cross-rater composites, although the effect sizes remain modest, up to 6%. Our approach can be used in any genotyped sample to create multi-trait GPS predictors of behaviour problems that will be more predictive than polygenic scores based on a single age, rater, or GPS

Phenomenon of mathematical fluency.

This study explored the longitudinal relationship between motivation and acquisition of a second modern foreign language (MFL). Participants were 11 to 12 year-old pupils attending the first year of secondary school. They constituted a naïve population as formal MFL learning in the United Kingdom begins in secondary school. MFL achievement, assessed using national curriculum standards, and self-report measures of motivation were collected at four time points throughout the year. Previous motivation was found to be the only predictor of motivation at the end of the academic year. In the same way, previous achievement was the only predictor of final achievement. Results showed that the correlational relationship between motivation and achievement over time was stable, with modest effect size. Cross-lagged panel analysis was adopted in order to assess the causality of the observed relationship between motivation and achievement. However, no cross-lagged relationships were observed in this sample. Once accounting for the stability of the constructs and their cross-sectional (contemporaneous) relationship, no further variance was explained by cross-lagged relationships between motivation and achievement at different time points