How the interpretation of drivers' behavior in virtual environment can become a road design tool: a case study

Driving is the result of a psychological process that translates data, signals and direct/indirect messages into behavior, which is continuously adapted to the exchange of varying stimuli between man, environment and vehicle. These stimuli are at times not perceived and at others perceived but not understood by the driver, even if they derive from tools (vertical signs, horizontal marking) specifically conceived for his safety. The result is unsafe behavior of vehicle drivers. For this reason, the road environment needs to be radically redesigned. The paper describes a research, based on real and virtual environment surveys, aimed to better understand drivers' action-reaction mechanisms inside different scenarios, in order to gain informations useful for a correct organization (design) of the road space. The driving simulator can help in developing, from road to laboratory, the study of new road design tools (geometrical, compositional, constructive ones, street furniture, etc.), because it can be used to evaluate solutions before their usefulness is proved on the road

Gas and Stellar Motions and Observational Signatures of Co-Rotating Spiral Arms

We have observed a snapshot of our N-body/Smoothed Particle Hydrodynamics simulation of a Milky Way-sized barred spiral galaxy in a similar way to how we can observe the Milky Way. The simulated galaxy shows a co-rotating spiral arm, i.e. the spiral arm rotates with the same speed as the circular speed. We observed the rotation and radial velocities of the gas and stars as a function of the distance from our assumed location of the observer at the three lines of sight on the disc plane, (l, b) = (90, 0), (120, 0) and (150,0) deg. We find that the stars tend to rotate slower (faster) behind (at the front of) the spiral arm and move outward (inward), because of the radial migration. However, because of their epicycle motion, we see a variation of rotation and radial velocities around the spiral arm. On the other hand, the cold gas component shows a clearer trend of rotating slower (faster) and moving outward (inward) behind (at the front of) the spiral arm, because of the radial migration. We have compared the results with the velocity of the maser sources from Reid et al. (2014), and find that the observational data show a similar trend in the rotation velocity around the expected position of the spiral arm at l = 120 deg. We also compared the distribution of the radial velocity from the local standard of the rest, V_LSR, with the APOGEE data at l = 90 deg as an example.Comment: 10 pages, 7 figures, accepted for publication in MNRA

The stellar kinematics of co-rotating spiral arms in Gaia mock observations

We have observed an N-body/Smoothed Particle Hydrodynamics simulation of a Milky Way like barred spiral galaxy. We present a simple method that samples N-body model particles into mock Gaia stellar observations and takes into account stellar populations, dust extinction and Gaia's science performance estimates. We examine the kinematics around a nearby spiral arm at a similar position to the Perseus arm at three lines of sight in the disc plane; (l,b)=(90,0), (120,0) and (150,0) degrees. We find that the structure of the peculiar kinematics around the co-rotating spiral arm, which is found in Kawata et al. (2014b), is still visible in the observational data expected to be produced by Gaia despite the dust extinction and expected observational errors of Gaia. These observable kinematic signatures will enable testing whether the Perseus arm of the Milky Way is similar to the co-rotating spiral arms commonly seen in N-body simulations.Comment: 9 pages 4 Figures, submitted to MNRAS 22nd Dec 201

Checklist for anesthesiological process: analysis of risks

Several methods are reported in the literature to analyze medically undesirable events during hospital care. Each method has several limitations, so no one has been defined as the standard tool to be able to detect failure during a medical process. The aim of this study was to compare an anesthesiological perioperative checklist with traditional Regional Incident Reporting (RIR) form in detecting and describing failures

Spatially explicit effective reproduction numbers from incidence and mobility data

Current methods for near real-time estimation of effective reproduction numbers from surveillance data overlook mobility fluxes of infectors and susceptible individuals within a spatially connected network (the metapopulation). Exchanges of infections among different communities may thus be misrepresented unless explicitly measured and accounted for in the renewal equations. Here, we first derive the equations that include spatially explicit effective reproduction numbers, ℛk(t), in an arbitrary community k. These equations embed a suitable connection matrix blending mobility among connected communities and mobility-related containment measures. Then, we propose a tool to estimate, in a Bayesian framework involving particle filtering, the values of ℛk(t) maximizing a suitable likelihood function reproducing observed patterns of infections in space and time. We validate our tools against synthetic data and apply them to real COVID-19 epidemiological records in a severely affected and carefully monitored Italian region. Differences arising between connected and disconnected reproduction numbers (the latter being calculated with existing methods, to which our formulation reduces by setting mobility to zero) suggest that current standards may be improved in their estimation of disease transmission over time

Role of interferon lambda 4 and ALT levels in optimising treatment of HCV for patients with low-stage fibrosis

The use of new anti-HCV drugs is currently limited by high costs and dual therapy; pegylated interferon and ribavirin (peg-IFN+RBV) still represents the only affordable treatment in patients with low-stage fibrosis. We evaluated the role of Interferon lambda4 (IFNL4) polymorphisms and its combination with on-treatment alanine transaminase (ALT) modification in predicting sustained virological response (SVR) in HCV genotype 1 and 4 patients with low-stage fibrosis. We retrospectively analysed 124 patients with Metavir ≤F2, who received dual therapy at our centre. Genotyping for IFNL4 polymorphisms was assessed at baseline, as well as ALT levels (baseline and week 2, 4, 12 and 24 of therapy). Thirty patients (24%) were TT/TT, 74 (60%) TT/DG and 20 (16%) DG/DG. The SVR rate was significantly higher in TT/TT genotype compare to TT/DG and DG/DG (97% vs. 53% and 50%, respectively, p=0.001). Patients that achieved a 60% reduction of ALT baseline value after 4 weeks of therapy had a significantly higher SVR rate (94% vs. 52%, p<0.001). Factors significantly associated with SVR were TT/TT genotype (p=0.029), RVR (p=0.019) and 60% ALT reduction at 4 week of therapy (p=0.005). The absence of both TT/TT genotype and 60% ALT reduction were negative predictors of SVR (p<0.001). In conclusion, the combined use of IFNL4 polymorphisms and ALT reduction at 4 week of treatment is able to optimize candidates’ selection for peg-IFN+RBV, discriminating those that could still benefit from dual therapy from the ones that need the new regimen

Cancer incidence in Italian contaminated sites

Introduction. The incidence of cancer among residents in sites contaminated by pollutants with a possible health impact is not adequately studied. In Italy, SENTIERI Project  (Epidemiological study of residents in National Priority Contaminated Sites, NPCSs)  was implemented to study major health outcomes for residents in 44 NPCSs.Methods. The Italian Association of Cancer Registries (AIRTUM) records cancer incidence in 23 NPCSs. For each NPCSs, the incidence of all malignant cancers combined  and 35 cancer sites (coded according to ICD-10), was analysed (1996-2005). The observed cases were compared to the expected based on age (5-year period,18 classes),  gender, calendar period (1996-2000; 2001-2005), geographical area (North-Centre and  Centre-South) and cancer sites specific rates. Standardized Incidence Ratios (SIR) with  90% Confidence Intervals were computed.Results. In both genders an excess was observed for overall cancer incidence (9% in men  and 7% in women) as well as for specific cancer sites (colon and rectum, liver, gallbladder,  pancreas,  lung,  skin  melanoma,  bladder  and  Non  Hodgkin  lymphoma).  Deficits  were  observed  for  gastric  cancer  in  both  genders,  chronic  lymphoid  leukemia  (men),  malignant thyroid neoplasms, corpus uteri and connective and soft-tissue tumours and  sarcomas (women).Discussion. This report is, to our knowledge, the first one on cancer risk of residents in  NPCSs. The study, although not aiming to estimate the cancer burden attributable to  the environment as compared to occupation or life-style, supports the credibility of an  etiologic role of environmental exposures in contaminated sites. Ongoing analyses focus  on the interpretation of risk factors for excesses of specific cancer types overall and in  specific NPCSs in relation to the presence of carcinogenic pollutants.

Effect of RNS60 in amyotrophic lateral sclerosis: a phase II multicentre, randomized, double-blind, placebo-controlled trial

Background and purpose Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with limited treatment options. RNS60 is an immunomodulatory and neuroprotective investigational product that has shown efficacy in animal models of ALS and other neurodegenerative diseases. Its administration has been safe and well tolerated in ALS subjects in previous early phase trials. Methods This was a phase II, multicentre, randomized, double-blind, placebo-controlled, parallel-group trial. Participants diagnosed with definite, probable or probable laboratory-supported ALS were assigned to receive RNS60 or placebo administered for 24 weeks intravenously (375 ml) once a week and via nebulization (4 ml/day) on non-infusion days, followed by an additional 24 weeks off-treatment. The primary objective was to measure the effects of RNS60 treatment on selected biomarkers of inflammation and neurodegeneration in peripheral blood. Secondary objectives were to measure the effect of RNS60 on functional impairment (ALS Functional Rating Scale-Revised), a measure of self-sufficiency, respiratory function (forced vital capacity, FVC), quality of life (ALS Assessment Questionnaire-40, ALSAQ-40) and survival. Tolerability and safety were assessed. Results Seventy-four participants were assigned to RNS60 and 73 to placebo. Assessed biomarkers did not differ between arms. The mean rate of decline in FVC and the eating and drinking domain of ALSAQ-40 was slower in the RNS60 arm (FVC, difference 0.41 per week, standard error 0.16, p = 0.0101; ALSAQ-40, difference -0.19 per week, standard error 0.10, p = 0.0319). Adverse events were similar in the two arms. In a post hoc analysis, neurofilament light chain increased over time in bulbar onset placebo participants whilst remaining stable in those treated with RNS60. Conclusions The positive effects of RNS60 on selected measures of respiratory and bulbar function warrant further investigation

Economic consequences of investing in anti-HCV antiviral treatment from the Italian NHS perspective : a real-world-based analysis of PITER data

OBJECTIVE: We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy. METHODS: A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered. RESULTS: The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively. CONCLUSIONS: This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV