Some Remarks on Group Bundles and C*-dynamical systems

We introduce the notion of fibred action of a group bundle on a C(X)-algebra. By using such a notion, a characterization in terms of induced C*-bundles is given for C*-dynamical systems such that the relative commutant of the fixed-point algebra is minimal (i.e., it is generated by the centre of the given C*-algebra and the centre of the fixed-point algebra). A class of examples in the setting of the Cuntz algebra is given, and connections with superselection structures with nontrivial centre are discussed.Comment: 22 pages; to appear on Comm. Math. Phy

Health profile of the PASSI surveillance system according to the second self-audit data

Background. The surveillance system PASSI (Progresses in ASSessing adult population health in Italy) is centrally coordinated by the Istituto Superiore di Sanita (ISS) and carried on by Local Health Units (LHU) from all the 21 Italian Regional Health Authorities since 2008. PASSI monitors the main behavioural health-related risk factors among the adult population in order to better orient and further elaborate interventions for the prevention of major chronic diseases.Study design. Basing on outcomes from the first pilot study in 2011, we conducted a second self-audit to investigate and map levels of conformity with recognized implementation standards by the protocol for PASSI local management in the 21 Italian Regional Health Authorities.Methods. We designed an online questionnaire supported by an open source application (Google) and sent to the local PASSI coordinators. Data were collected from April to September 2013. 113 out of 148 LHUs from all the 21 Italian Regional Health Authorities participated, with a response rate of 76%.Results. Overall, in the respondent LHUs 1,036 professionals result to differently engage in surveillance activities. Although PASSI is locally-based, where data collection and computerisation are arranged, central support is highly appreciated in terms of quality monitoring, analysis, output processing, professional training, delivery of dissemination material. PASSI data are more used for communication (60%) and planning (80%) than to scientific ends.Conclusions. After a ten-year activity, PASSI as complex public health program requires periodical self-audit rounds in order to assess to what extent relevant performance indicators match the levels indicated in its own operational protocol. The second self-audit showed to be reliable concerning both sustainability and data collection. It then represents an experience that can be renewed and repeated

Superselection Sectors and General Covariance.I

This paper is devoted to the analysis of charged superselection sectors in the framework of the locally covariant quantum field theories. We shall analize sharply localizable charges, and use net-cohomology of J.E. Roberts as a main tool. We show that to any 4-dimensional globally hyperbolic spacetime it is attached a unique, up to equivalence, symmetric tensor \Crm^*-category with conjugates (in case of finite statistics); to any embedding between different spacetimes, the corresponding categories can be embedded, contravariantly, in such a way that all the charged quantum numbers of sectors are preserved. This entails that to any spacetime is associated a unique gauge group, up to isomorphisms, and that to any embedding between two spacetimes there corresponds a group morphism between the related gauge groups. This form of covariance between sectors also brings to light the issue whether local and global sectors are the same. We conjecture this holds that at least on simply connected spacetimes. It is argued that the possible failure might be related to the presence of topological charges. Our analysis seems to describe theories which have a well defined short-distance asymptotic behaviour.Comment: 66 page

Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national Irish smoking ban: Interrupted time-series analysis

Copyright @ 2013 Stallings-Smith et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Background: Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. Methods: A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results: Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76-0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63-0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54-0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46-0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35-64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32-0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305-4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. Conclusions: The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular causes, and is the first to demonstrate reductions in cerebrovascular and respiratory causes

Effects of Italian Smoking Regulation on Rates of Hospital Admission for Acute Coronary Events: A Country-Wide Study

BACKGROUND: Several studies have reported a reduction in acute coronary events (ACEs) in the general population after the enforcement of smoking regulations, although there is uncertainty concerning the magnitude of the effect of such interventions. We conducted a country-wide evaluation of the health effects of the introduction of a smoking ban in public places, using data on hospital admissions for ACEs from the Italian population after the implementation of a national smoking regulation in January 2005. METHODS AND FINDINGS: Rates of admission for ACEs in the 20 Italian regions from January 2002 to November 2006 were analysed using mixed-effect regression models that allowed for long-term trends and seasonality. Standard methods for interrupted time-series were adopted to assess the immediate and gradual effects of the smoking ban. Effect modification by age was investigated, with the assumption that exposure to passive smoking in public places would be greater among young people. In total, 936,519 hospital admissions for ACEs occurred in the Italian population during the study period. A 4% reduction in hospital admissions for ACEs among persons aged less than 70 years was evident after the introduction of the ban (Rate Ratio [RR], 0.96; 95% Confidence Interval [CI], 0.95-0.98). No effect was found among persons aged at least 70 years (RR 1.00; 95% CI 0.99-1.02). Effect modification by age was further suggested by analyses using narrower age categories. CONCLUSIONS: Smoke-free policies can constitute a simple and inexpensive intervention for the prevention of cardiovascular diseases and thus should be included in prevention programmes

Thrombocytopenia and Mortality Risk in Patients With Atrial Fibrillation: An Analysis From the START Registry

Background: Thrombocytopenia is associated with increased mortality in the general population, but few data exist in patients with atrial fibrillation (AF) taking oral anticoagulants. We investigated factor determinants of thrombocytopenia in a large cohort of patients affected by AF and its association with total mortality. Methods and Results: Multicenter prospective cohort study, including 5215 patients with AF from the START (Survey on Anticoagulated Patients Register) registry, 3877 (74.3%) and 1338 (25.7%) on vitamin K or non\u2013vitamin K antagonist oral anticoagulants, respectively. Thrombocytopenia was defined by a platelet count <150 7109/L. Determinants of thrombocytopenia were investigated, and all-cause mortality was the primary survival end point of the study. Thrombocytopenia was present in 592 patients (11.4%). At multivariable logistic regression analysis, chronic kidney disease (odds ratio [OR], 1.257; P=0.030), active cancer (OR, 2.065; P=0.001), liver cirrhosis (OR, 7.635; P<0.001), and the use of diuretics (OR, 1.234; P=0.046) were positively associated with thrombocytopenia, whereas female sex (OR, 0.387; P<0.001) and the use of calcium channel blockers (OR, 0.787; P=0.032) were negatively associated. During a median follow-up of 19.2 months (9942 patient-years), 391 deaths occurred (rate, 3.93%/year). Mortality rate increased from 3.8%/year to 9.9%/year in patients with normal platelet count and in those with moderate-severe thrombocytopenia, respectively (log-rank test, P=0.009). The association between moderate-severe thrombocytopenia and mortality persisted after adjustment for CHA2DS2 VASc score (hazard ratio, 2.431; 95% CI, 1.254\u20134.713; P=0.009), but not in the fully adjusted multivariable Cox regression analysis model. Conclusions: Thrombocytopenia is common in patients with AF. Despite an increased incidence of mortality, thrombocytopenia was not associated with mortality at multivariable analysis. Thrombocytopenia may reflect the presence of comorbidities associated with poor survival in AF