Association between obstructive apnea syndrome during sleep and damages to anterior labyrinth: Our experience

The obstructive sleep apnea syndrome is a chronic condition characterized by frequent episodes of collapse of the upper airways during sleep. It can be considered a multisystem disease. Among the districts involved, even the auditory system was seen to be concerned. It was enrolled a population of 20 patients after polysomnographic diagnosis of OSAS (Apnea Hypopnea Index > 10) and a control group of 28 healthy persons (Apnea Hypopnea Index < 5). Each patient has been subjected to Pure Tone Audiometry, Tympanometry, study of Acoustic Reflex, Otoacoustic Emissions and Auditory Brainstem Response. Moreover they were submitted to endoscopy of upper airway with Muller Maneuver and Epworth Sleepiness Scale (ESS). The values of ESS was 13.5 in OSAS group and 5.4 in control group. The tone audiometry is worse in all frequencies analyzed in OSAS patients, but within the normal range for both groups analyzed by 250 to 1000 Hertz. Otoacoustic emissions show a reduced reproducibility and a lower signal/ noise ratio in OSAS group (P <0.01)

The whip and the Bible: Punishment versus internalization

A variety of experimental and empirical research indicate that prosocial behavior is important for economic success. There are two sources of prosocial behavior: incentives and preferences. The latter, the willingness of individuals to “do their bit” for the group, we refer to as internalization, because we view it as something that a group can influence by appropriate investment. This implies that there is a trade-off between using incentives and internalization to encourage prosocial behavior. By examining this trade-off we shed light on the connection between social norms observed inside the laboratory and those observed outside in the field. For example, we show that a higher value of cooperation outside the laboratory may lower the use of incentives inside the laboratory even as it increases their usage outside. As an application we show that the model calibrated to experimental data makes reasonable out-of-sample quantitative forecasts

A logic for reasoning about knowledge of unawareness

In the most popular logics combining knowledge and awareness, it is not possible to express statements about knowledge of unawareness such as “Ann knows that Bill is aware of something Ann is not aware of” – without using a stronger statement such as “Ann knows that Bill is aware of p and Ann is not aware of p”, for some particular p. In Halpern and Rêgo (2006, 2009b) (revisited in Halpern and Rêgo (2009a, 2013)) Halpern and Rêgo introduced a logic in which such statements about knowledge of unawareness can be expressed. The logic extends the traditional framework with quantification over formulae, and is thus very expressive. As a consequence, it is not decidable. In this paper we introduce a decidable logic which can be used to reason about certain types of unawareness. Our logic extends the traditional framework with an operator expressing full awareness, i.e., the fact that an agent is aware of everything, and another operator expressing relative awareness, the fact that one agent is aware of everything another agent is aware of. The logic is less expressive than Halpern’s and Rêgo’s logic. It is, however, expressive enough to express all of the motivating examples in Halpern and Rêgo (2006, 2009b). In addition to proving that the logic is decidable and that its satisfiability problem is PSPACE-complete, we present an axiomatisation which we show is sound and complete

Application, validation and comparison in different geographical contexts of an integrated model for the design of ecological networks

The issue of the fragmentation of natural habitats is increasingly at the core of the scientific debate, yet it is not taken into account in planning tools, with particular reference to the dynamism and complexity of landscapes. As it has been recognised at a European level, in order to enable different species to remain in good functional status, a network of green infrastructures is required. The concept of “ecological island” is no longer sufficient to adequately protect the fauna and the ecosystem it lives in. As a consequence, ecological islands must turn into ecological networks. The Ecological connectivity refers to the way habitats are physically connected to each other and how easy it is for species to move in. Good ecological connectivity is fundamental to the effective conservation of biodiversity considering that most species and ecological functions provided by ecosystems (ecosystem services) require a much wider space than that available within the boundaries of a single protected area. The main objective of this paper is to critically compare the application of a model for the design of ecological networks to two very different environmental contexts. This model was first tested in a Mediterranean area (the Province of Reggio Calabria) in 2008; the goal was to integrate the traditional (physiographic and functional) approaches into the design of ecological networks by taking into account biological and orographic elements as well as the anthropic structure of the territory. In 2011, within the ECONNECT European project, the model was applied to the pilot region of South-Western Alps (including the French region of Provence-Alpes - Côte d’Azur and the Italian regions Piedmont and Liguria), which is one of the richest transnational districts in Europe in terms of biodiversity. In such a region, the issue of multidisciplinary ecological connectivity was tackled in order to provide a series of proposals aiming at the development of the ecological potential of the area. The two applications allowed to further investigate the strengths and weaknesses of the implemented model by integrating its validation with information on faunal presence, which obviated one of the major limitations occurred in the first application

A Gamma-convergence argument for the blow-up of a non-local semilinear parabolic equation with Neumann boundary conditions

In this paper we study a simple non-local semilinear parabolic equation with Neumann boundary condition. We give local existence result and prove global existence for small initial data. A natural non increasing in time energy is associated to this equation. We prove that the solution blows up at finite time $T$ if and only if its energy is negative at some time before $T$. The proof of this result is based on a Gamma-convergence technique

No phenotypic differences for polycystic ovary syndrome (PCOS) between women with and without type 1 diabetes mellitus.

CONTEXT: Women with type 1 diabetes mellitus (DM1) have a higher prevalence of polycystic ovary syndrome (PCOS) than the general population. OBJECTIVE: The aim of this study was to clarify, in DM1 women with PCOS (PCOS-DM1), the influence of insulin therapy and glycemic control and evaluate the hormonal and phenotypic differences with age-matched and body mass index (BMI)-matched women with PCOS without diabetes. DESIGN, SETTING, AND PATIENTS: We evaluated 103 DM1 women with and without PCOS treated with intensive insulin therapy; 38 age-matched and BMI-matched women with PCOS without diabetes were compared in a cross-sectional study. OUTCOME MEASUREMENTS: Clinical, anthropometric, and metabolic parameters were evaluated. Hormonal evaluation and ovary ultrasound were performed during the follicular phase of the menstrual cycle. RESULTS: Applying the diagnostic criteria of the Androgen Excess Society, 38 (36.89%) women with DM1 showed PCOS. The 38 PCOS-DM1 women showed no differences in treatment and glycemic control compared with DM1 women without PCOS. The only difference was a higher visceral adiposity index in PCOS-DM1 (1.21±0.70 vs 0.90±0.32; P=.002). PCOS-DM1 showed no phenotypic differences with age-matched and BMI-matched PCOS without diabetes. The hormonal pattern was similar except that higher levels of Δ4androstenedione were found in PCOS-DM1 (12.89±3.49 vs 2.79±1.75 nmol/L; P=.010). CONCLUSIONS: The women with PCOS-DM1 do not exhibit particular phenotypic characteristics compared with nondiabetic women with PCOS. However, this pathological disorder must not be underestimated because it could be an additional cardiovascular risk factor in women with DM1

Frontal brain asymmetries as effective parameters to assess the quality of audiovisual stimuli perception in adult and young cochlear implant users

How is music perceived by cochlear implant (CI) users? This question arises as "the next step" given the impressive performance obtained by these patients in language perception. Furthermore, how can music perception be evaluated beyond self-report rating, in order to obtain measurable data? To address this question, estimation of the frontal electroencephalographic (EEG) alpha activity imbalance, acquired through a 19-channel EEG cap, appears to be a suitable instrument to measure the approach/withdrawal (AW index) reaction to external stimuli. Specifically, a greater value of AW indicates an increased propensity to stimulus approach, and vice versa a lower one a tendency to withdraw from the stimulus. Additionally, due to prelingually and postlingually deafened pathology acquisition, children and adults, respectively, would probably differ in music perception. The aim of the present study was to investigate children and adult CI users, in unilateral (UCI) and bilateral (BCI) implantation conditions, during three experimental situations of music exposure (normal, distorted and mute). Additionally, a study of functional connectivity patterns within cerebral networks was performed to investigate functioning patterns in different experimental populations. As a general result, congruency among patterns between BCI patients and control (CTRL) subjects was seen, characterised by lowest values for the distorted condition (vs. normal and mute conditions) in the AW index and in the connectivity analysis. Additionally, the normal and distorted conditions were significantly different in CI and CTRL adults, and in CTRL children, but not in CI children. These results suggest a higher capacity of discrimination and approach motivation towards normal music in CTRL and BCI subjects, but not for UCI patients. Therefore, for perception of music CTRL and BCI participants appear more similar than UCI subjects, as estimated by measurable and not self-reported parameters

Spatio-temporal analysis of the urban–rural gradient structure: an application in a Mediterranean mountainous landscape (Serra San Bruno, Italy)

Abstract. The most recent and significant transformations of European landscapes have occurred as a consequence of a series of diffused, varied and often connected phenomena: urban growth and sprawl, agricultural intensification in the most suitable areas and agricultural abandonment in marginal areas. These phenomena can affect dramatically ecosystems' structure and functioning, since certain modifications cause landscape fragmentation while others tend to increase homogeneity. Thus, a thorough comprehension of the evolution trends of landscapes, in particular those linked to urban-rural relations, is crucial for a sustainable landscape planning. In this framework, the main objectives of the present paper are: (a) to investigate Land Use/Land Cover (LULC) transformations and dynamics that occurred over the period 1955–2006 in the municipality of Serra San Bruno (Calabria, Italy), an area particularly representative of the Mediterranean mountainous landscape; (b) to compare the settlement growth with the urban planning tools in charge in the study area; (c) to examine the relationship between urban–rural gradient, landscape metrics, demographic and physical variables; (d) to investigate the evolution of urban–rural gradient composition and configuration along significant axes of landscape changes. Data with a high level of detail (minimum mapping unit 0.2 ha) were obtained through the digitisation of historical aerial photographs and digital orthophotos identifying LULC classes according to the Corine Land Cover legend. The investigated period was divided into four significant time intervals, which were specifically analysed to detect LULC changes. Differently from previous studies, in the present research the spatio-temporal analysis of urban–rural gradient was performed through three subsequent steps: (1) kernel density analysis of settlements; (2) analysis of landscape structure by means of metrics calculated using a moving window method; (3) analysis of composition and configuration of the urban–rural gradient within three landscape profiles located along significant axes of LULC change. The use of thematic overlays and transition matrices enabled a precise identification of the LULC changes that had taken place over the examined period. As a result, a detailed description and mapping of the landscape dynamics were obtained. Furthermore, landscape profiling technique, using continuous data, allowed an innovative and valuable approach for analysing and interpreting urban–rural gradient structure over space and time

Cardio-Metabolic Indices and Metabolic Syndrome as Predictors of Clinical Severity of Gastroenteropancreatic Neuroendocrine Tumors

Background: Obesity, mainly visceral obesity, and metabolic syndrome (MetS) are major risk factors for the development of type 2 diabetes, cardiovascular diseases, and cancer. Data analyzing the association of obesity and MetS with gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) are lacking. Fatty liver index (FLI) is a non-invasive tool for identifying individuals with non-alcoholic fatty liver disease (NAFLD). Visceral adiposity index (VAI) has been suggested as a gender-specific indicator of adipose dysfunction. Both indexes have been proposed as early predictors of MetS. This study aimed to investigate the association of FLI VAI as early predictors of MetS with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Methods: A cross-sectional, case–control, observational study was carried out at the ENETS Centers of Excellence Multidisciplinary Group for Neuroendocrine Tumors, University “Federico II”. VAI and FLI were calculated. Results: We enrolled 109 patients with histologically confirmed G1/G2 GEP-NET (53 M; 57.06 ± 15.96 years), as well as 109 healthy subjects, age, sex- and body mass index-matched. Forty-four GEP-NET patients were G2, of which 21 were with progressive disease, and 27 patients had metastases. GEP-NET patients had a higher value of VAI (p < 0.001) and FLI (p = 0.049) and higher MetS presence (p < 0.001) compared with controls. VAI and FLI values and MetS presence were higher in G2 than in G1 patients (p < 0.001), in patients with progressive disease, and in metastatic vs non-metastatic patients (p < 0.001). In addition, higher values of VAI and FLI and higher MetS presence were significantly correlated with the worst clinical severity of NENs. The cut-off values for the FLI and MetS to predict high grading of GEP-NETs and the presence of metastasis were also provided. Conclusions: This is the first study investigating an association between VAI and FLI as early predictors of MetS and GEP-NET. Our findings report that the worsening of clinicopathological characteristics in GEP-NET is associated with higher presence of MetS, NAFLD, evaluated by FLI, and visceral adiposity dysfunction, evaluated by VAI. Addressing the clinical evaluation of MetS presence, NAFLD, and visceral adiposity dysfunction might be of crucial relevance to establish targeted preventive and treatment interventions of NEN-related metabolic comorbidities