Switch on the Big Brother! Investigating the educational gradients in acceptance of online and public areas surveillance among European citizens

In this study, we investigate whether, and why, individuals express different levels of acceptance of surveillance depending on their educational level, and whether this relationship varies with the level of digitalization and globalization expansion of their country. Additionally, we ask whether the type of surveillance (online surveillance vs cameras in public areas) conditions these differences. We build on two theoretical frameworks, one concerned with the resurgence of authoritarian values via the cultural backlash, and the other one explaining how different people analyse manufactured risks differently due to processes of reflexive modernization. In order to test the hypotheses, we employ data from the latest wave of the European Values Study (EVS) and implement multilevel multivariate regression models. Findings indicate that the lower educated individuals are more prone to accept online surveillance, due to their stronger authoritarianism and weaker reflexive mindset; however, there is no educational gradient in acceptance of video surveillance in public areas. Additionally, the countries' levels of digitalization and globalization expansion do not condition the educational gradient in acceptance of surveillance

Neo-adjuvant chemo/immunotherapy in the treatment of stage III (N2) non-small cell lung cancer: a phase I/II pilot study.

In a previous randomized study, we showed that adjuvant immunotherapy with tumor-infiltrating lymphocytes and recombinant interleukin-2 (rIL-2) significantly improved survival in resected N2-Non Small Cell Lung Cancer (NSCLC) patients. The present study assesses feasibility, safety and potential efficacy of combined neo-adjuvant chemotherapy and immunotherapy with peripheral blood mononuclear cells (PBMC) and rIL-2 in resectable N2-NSCLC patients. Eighty-two consecutive N2-NSCLC patients underwent neo-adjuvant chemotherapy with cisplatin and gemcitabine. Out of the 82 patients, 23 were also subjected to leukapheresis prior to neo-adjuvant chemotherapy while the remaining 59 did not. Collected PBMC were analyzed for viability and phenotype and then stored frozen in liquid nitrogen. Thawed PBMC were infused intravenously, 5 days before surgery. After the infusion, rIL-2 was administered subcutaneously until surgery. Only patients with a partial or complete response to neoadjuvant chemotherapy underwent surgery: 13 patients in the experimental immunotherapy group (A) and 32 in the reference group (B). The two groups were homogeneous for all major prognostic factors. Median leukapheresis yield was 10 billion PBMC, (range 3–24 billions). Two to six billion PBMC were infused. The phenotypic analysis showed that similar proportions of CD4 and CD8 cells were present in leukapheresis products, and thawed PBMC, as well as in T lymphocytes isolated from the removed tumours. No severe adverse effects were observed following immunotherapy. No significant differences in overall survival (OS) and event-free survival (EFS) were seen between the two groups. However, the 5-year OS in group A was almost twice as much compared to group B (59% vs 32%). After adjustment for major prognostic factors, a statistically significant 66% reduction in the hazard of death was seen in patients receiving immunotherapy. The OS benefit was more evident in patients with adenocarcinoma than in those with squamous cell carcinoma. This study supports the favorable toxicity profile and potential efficacy of combining neo-adjuvant chemotherapy and immunotherapy with PBMC and rIL-2 in the treatment of N2-NSCLC patients

The Nature of Optically Dull Active Galactic Nuclei in COSMOS

We present infrared, optical, and X-ray data of 48 X-ray bright, optically dull AGNs in the COSMOS field. These objects exhibit the X-ray luminosity of an active galactic nucleus (AGN) but lack broad and narrow emission lines in their optical spectrum. We show that despite the lack of optical emission lines, most of these optically dull AGNs are not well-described by a typical passive red galaxy spectrum: instead they exhibit weak but significant blue emission like an unobscured AGN. Photometric observations over several years additionally show significant variability in the blue emission of four optically dull AGNs. The nature of the blue and infrared emission suggest that the optically inactive appearance of these AGNs cannot be caused by obscuration intrinsic to the AGNs. Instead, up to ~70% of optically dull AGNs are diluted by their hosts, with bright or simply edge-on hosts lying preferentially within the spectroscopic aperture. The remaining ~30% of optically dull AGNs have anomalously high f_x/f_o ratios and are intrinsically weak, not obscured, in the optical. These optically dull AGNs are best described as a weakly accreting AGN with a truncated accretion disk from a radiatively inefficient accretion flow.Comment: 12 pages, 10 figures. Accepted for publication in the Ap

Are antifibrinolytic drugs equivalent in reducing blood loss and transfusion in cardiac surgery? A meta-analysis of randomized head-to-head trials

BACKGROUND: Aprotinin has been shown to be effective in reducing peri-operative blood loss and the need for re-operation due to continued bleeding in cardiac surgery. The lysine analogues tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) are cheaper, but it is not known if they are as effective as aprotinin. METHODS: Studies were identified by searching electronic databases and bibliographies of published articles. Data from head-to-head trials were pooled using a conventional (Cochrane) meta-analytic approach and a Bayesian approach which estimated the posterior probability of TXA and EACA being equivalent to aprotinin; we used as a non-inferiority boundary a 20% increase in the rates of transfusion or re-operation because of bleeding. RESULTS: Peri-operative blood loss was significantly greater with TXA and EACA than with aprotinin: weighted mean differences were 106 mls (95% CI 37 to 227 mls) and 185 mls (95% CI 134 to 235 mls) respectively. The pooled relative risks (RR) of receiving an allogeneic red blood cell (RBC) transfusion with TXA and EACA, compared with aprotinin, were 1.08 (95% CI 0.88 to 1.32) and 1.14 (95% CI 0.84 to 1.55) respectively. The equivalent Bayesian posterior mean relative risks were 1.15 (95% Bayesian Credible Interval [BCI] 0.90 to 1.68) and 1.21 (95% BCI 0.79 to 1.82) respectively. For transfusion, using a 20% non-inferiority boundary, the posterior probabilities of TXA and EACA being non-inferior to aprotinin were 0.82 and 0.76 respectively. For re-operation the Cochrane RR for TXA vs. aprotinin was 0.98 (95% CI 0.51 to 1.88), compared with a posterior mean Bayesian RR of 0.63 (95% BCI 0.16 to 1.46). The posterior probability of TXA being non-inferior to aprotinin was 0.92, but this was sensitive to the inclusion of one small trial. CONCLUSION: The available data are conflicting regarding the equivalence of lysine analogues and aprotinin in reducing peri-operative bleeding, transfusion and the need for re-operation. Decisions are sensitive to the choice of clinical outcome and non-inferiority boundary. The data are an uncertain basis for replacing aprotinin with the cheaper lysine analogues in clinical practice. Progress has been hampered by small trials and failure to study clinically relevant outcomes

Switch on the Big Brother! Investigating the educational gradients in acceptance of online and public areas surveillance among European citizens

In this study, we investigate whether, and why, individuals express different levels of acceptance of surveillance depending on their educational level, and whether this relationship varies with the level of digitalization and globalization expansion of their country. Additionally, we ask whether the type of surveillance (online surveillance vs cameras in public areas) conditions these differences. We build on two theoretical frameworks, one concerned with the resurgence of authoritarian values via the cultural backlash, and the other one explaining how different people analyse manufactured risks differently due to processes of reflexive modernization. In order to test the hypotheses, we employ data from the latest wave of the European Values Study (EVS) and implement multilevel multivariate regression models. Findings indicate that the lower educated individuals are more prone to accept online surveillance, due to their stronger authoritarianism and weaker reflexive mindset; however, there is no educational gradient in acceptance of video surveillance in public areas. Additionally, the countries' levels of digitalization and globalization expansion do not condition the educational gradient in acceptance of surveillance

La necrosi pancreatica infetta in terapia intensiva

BACKGROUND: Infected necrotizing pancreatitis is the most fulminant variety of this disease. The reported mortality is up to 50%. The haemodynamic features of cardiovascular instability has many similarities to sepsis syndrome, septic shock and multiple organ dysfunction syndrome (MODS). The purpose of this study is to review personal experience in the ICU (hospital of Varese) to determine etiology, treatment and complications. METHODS: Twenty patients treated since 1988 with infected necrotizing pancreatitis required surgical treatment and mechanical ventilation. RESULTS: The mortality rate was 60% and ICU-stay was 26.5 +/- 12.3 days, the median age was 54 +/- 13. Ranson's criteria at admission to the ICU was 6.6 +/- 1.2, Glasgow point was 4.6 +/- 1.2 (5.5 +/- 0.87 died, 3.2 +/- 0.8 survived p < 0.01), Baltazar score 6.2 +/- 2.1 (7.4 +/- 2.1 died, 5.5 +/- 0.9 survived p < 0.05) and SAPS II score 43.4 +/- 12.1 (50.1 +/- 7.8 died, 34 +/- 5.5 survived p < 0.01). The etiology was: gallstones (45%), alcoholism (15%), ERCP (15%) and idiopathic in 25%. Serum pancreatic amylase was 342 +/- 113.9 U/l (550 +/- 100 died, 155 +/- 60 survived p < 0.01), lipase was 334 +/- 176 U/l and transaminases GOT was 123 +/- 46 u/l (156 +/- 90 died, 29 +/- 7 survived p < 0.05). High initial amylase and GOT levels were frequently found in non survived patients. MODS occurred in 17 cases (85%), ARDS in 2 patients (10%), abdominal bleeding in 6 (30%) and septic syndrome in 8 (40%). CONCLUSIONS: It is thus possible that a target-oriented approach including fluid replacement, rapid correction of intestinal underperfusion, inotropic and antibiotic therapy, supply of specific nutrients and other therapeutic strategies as open laparostomy must be employed to prevent MODS or septic syndrome in pancreatic infection after acute necrotizing pancreatitis