L’insegnamento della speleologia agli “under 15”

Dopo una breve panoramica storica sull’affermarsi della speleologia quale disciplina autonoma pensata e realizzata da e per gli adulti viene presentato il piano predisposto dalla Società Alpina delle Giulie – sezione di Trieste del CAI, per l’avvicinamento dei giovani minori di 15 anni – età minima per frequentare le scuole di speleologia del CAI – al mondo delle grotte. Considerazioni sui materiali utilizzati, sul tipo di cavità da visitare e sui tempi di permanenza in grotta completano l’esposizione.After a brief historical overview of the establishment of speleology as an autonomous discipline designed for and realized by adults, the program organized by the Julian Alpine Society – Trieste section of the CAI – to introduce minors under the age of 15 (minimum age required to attend CAI Speleology Schools) to the world of caving. Considerations on the materials used, types of cavities visited and time spent in the cave conclude the presentation

Out-of-hours primary care services: Demands and patient referral patterns in a Veneto region (Italy) Local Health Authority

open7PURPOSE: The aim of this study was to describe the characteristics of patients admitted to an out-of-hours (OOH) service and to analyze the related outputs. SETTING: A retrospective population-based cohort study was conducted by analyzing an electronic database recording 23,980 OOH service contacts in 2011 at a Local Health Authority in the Veneto Region (North-East Italy). METHOD: A multinomial logistic regression was used to compare the characteristics of contacts handled by the OOH physicians with cases referred to other services. RESULTS: OOH service contact rates were higher for the oldest and youngest age groups and for females rather than males. More than half of the contacts concerned patients who were seen by a OOH physician. More than one in three contacts related problems managed over the phone; only ≈10% of the patients were referred to other services. Many factors, including demographic variables, process-logistic variables and clinical characteristics of the contact, were associated with the decision to visit the patient's home (rather than provide telephone advice alone), or to refer patients to an ED or to a specialist. Our study demonstrated, even after adjusting, certain OOH physicians were more likely than their colleagues to refer a patient to an ED. CONCLUSION: Our study shows that OOH services meet composite and variously expressed demands. The determining factors associated with cases referred to other health care services should be considered when designing clinical pathways in order to ensure a continuity of care. The unwarranted variability in OOH physicians' performance needs to be addressed.Purpose: The aim of this study was to describe the characteristics of patients admitted to an out-of-hours (OOH) service and to analyze the related outputs. Setting: A retrospective population-based cohort study was conducted by analyzing an electronic database recording 23,980 OOH service contacts in 2011 at a Local Health Authority in the Veneto Region (North-East Italy). Method: A multinomial logistic regression was used to compare the characteristics of contacts handled by the OOH physicians with cases referred to other services. Results: OOH service contact rates were higher for the oldest and youngest age groups and for females rather than males. More than half of the contacts concerned patients who were seen by a OOH physician. More than one in three contacts related problems managed over the phone; only ≈10% of the patients were referred to other services. Many factors, including demographic variables, process-logistic variables and clinical characteristics of the contact, were associated with the decision to visit the patient's home (rather than provide telephone advice alone), or to refer patients to an ED or to a specialist. Our study demonstrated, even after adjusting, certain OOH physicians were more likely than their colleagues to refer a patient to an ED. Conclusion: Our study shows that OOH services meet composite and variously expressed demands. The determining factors associated with cases referred to other health care services should be considered when designing clinical pathways in order to ensure a continuity of care. The unwarranted variability in OOH physicians' performance needs to be addressed.openBuja, Alessandra; Toffanin, R; Rigon, S; Sandona', Paolo; Carraro, D; Damiani, G; Baldo, VincenzoBuja, Alessandra; Toffanin, R; Rigon, S; Sandona', Paolo; Carraro, D; Damiani, G; Baldo, Vincenz

Milk Fatty Acids Predicted by Mid-infrared Spectroscopy in Mixed Dairy Herds

Over the last years, healthy food has gained interest among consumers, especially with regard to the fat content of livestock products which has been associated to the risk of cardiovascular diseases. Individual milk samples (n = 12,624) of 2,977 Holstein-Friesian (HF), Brown Swiss (BS) and Simmental (SI) cows from 39 multibreed herds were analyzed for fat content, protein content, casein content and somatic cell count using mid-infrared spectroscopy (MIRS). Daily milk yield was also recorded. Groups of fatty acids (FA), expressed as percentage of milk fat, were predicted by MIRS: they were saturated (SFA), unsaturated (UFA), monounsaturated (MUFA) and polyunsaturated (PUFA) FA. Data were analyzed with a linear mixed model including the fixed effects of month of sampling, parity, days in milk (DIM), herd, breed, and interactions between parity and breed, and DIM and breed. The random effects were cow nested within breed and residual. Milk of HF cows exhibited the lowest percentage of SFA (70.45%) and the highest of UFA (31.20%), and milk of SI cows was intermediate between that of HF and BS breeds for all groups of FA. The values of groups of FA across DIM were similar for the different breeds. Results from this study indicate that, under similar environmental and management conditions, milk of HF exhibits better FA profile than milk of BS and SI

The Timing and Effort of Lexical Access in Natural and Degraded Speech

Understanding speech is effortless in ideal situations, and although adverse conditions, such as caused by hearing impairment, often render it an effortful task, they do not necessarily suspend speech comprehension. A prime example of this is speech perception by cochlear implant users, whose hearing prostheses transmit speech as a significantly degraded signal. It is yet unknown how mechanisms of speech processing deal with such degraded signals, and whether they are affected by effortful processing of speech. This paper compares the automatic process of lexical competition between natural and degraded speech, and combines gaze fixations, which capture the course of lexical disambiguation, with pupillometry, which quantifies the mental effort involved in processing speech. Listeners' ocular responses were recorded during disambiguation of lexical embeddings with matching and mismatching durational cues. Durational cues were selected due to their substantial role in listeners' quick limitation of the number of lexical candidates for lexical access in natural speech. Results showed that lexical competition increased mental effort in processing natural stimuli in particular in presence of mismatching cues. Signal degradation reduced listeners' ability to quickly integrate durational cues in lexical selection, and delayed and prolonged lexical competition. The effort of processing degraded speech was increased overall, and because it had its sources at the pre-lexical level this effect can be attributed to listening to degraded speech rather than to lexical disambiguation. In sum, the course of lexical competition was largely comparable for natural and degraded speech, but showed crucial shifts in timing, and different sources of increased mental effort. We argue that well-timed progress of information from sensory to pre-lexical and lexical stages of processing, which is the result of perceptual adaptation during speech development, is the reason why in ideal situations speech is perceived as an undemanding task. Degradation of the signal or the receiver channel can quickly bring this well-adjusted timing out of balance and lead to increase in mental effort. Incomplete and effortful processing at the early pre-lexical stages has its consequences on lexical processing as it adds uncertainty to the forming and revising of lexical hypotheses

Do Musicians and Non-musicians Differ in Speech-on-Speech Processing?

Earlier studies have shown that musically trained individuals may have a benefit in adverse listening situations when compared to non-musicians, especially in speech-on-speech perception. However, the literature provides mostly conflicting results. In the current study, by employing different measures of spoken language processing, we aimed to test whether we could capture potential differences between musicians and non-musicians in speech-on-speech processing. We used an offline measure of speech perception (sentence recall task), which reveals a post-task response, and online measures of real time spoken language processing: gaze-tracking and pupillometry. We used stimuli of comparable complexity across both paradigms and tested the same groups of participants. In the sentence recall task, musicians recalled more words correctly than non-musicians. In the eye-tracking experiment, both groups showed reduced fixations to the target and competitor words' images as the level of speech maskers increased. The time course of gaze fixations to the competitor did not differ between groups in the speech-in-quiet condition, while the time course dynamics did differ between groups as the two-talker masker was added to the target signal. As the level of two-talker masker increased, musicians showed reduced lexical competition as indicated by the gaze fixations to the competitor. The pupil dilation data showed differences mainly in one target-to-masker ratio. This does not allow to draw conclusions regarding potential differences in the use of cognitive resources between groups. Overall, the eye-tracking measure enabled us to observe that musicians may be using a different strategy than non-musicians to attain spoken word recognition as the noise level increased. However, further investigation with more fine-grained alignment between the processes captured by online and offline measures is necessary to establish whether musicians differ due to better cognitive control or sound processing

Cryptogenic ischemic stroke in cardiac transthyretin amyloidosis and sinus rhythm: a case report

Cardiac amyloidosis is a group of diseases characterized by the deposition of amyloid fibers in cardiac tissue. Two forms are mainly reported: light chain (AL) and transthyretin (ATTR) amyloidosis. Among the complications of transthyretin amyloidosis there are thrombotic events and, to a lesser extent, hemorrhagic events. The latter are likely caused by perivascular amyloid deposition resulting in capillary fragility, in addition to INR lability during anticoagulant therapy. The onset of thrombotic events may be caused by the high prevalence of atrial fibrillation (AF), mechanical cardiac dysfunction and atrial myopathy observed in patients with transthyretin amyloidosis. It remains unclear why thromboembolic events occur even in patients with sinus rhythm or adequate anticoagulation, though a hypercoagulable state or underlying inflammation may be involved. We report a case of cryptogenic ischemic stroke in an 86-year-old woman with transthyretin amyloidosis and sinus rhythm. Traditional coagulation tests, whole blood rotational thromboelastometry and impedance aggregometry did not show a hypercoagulable state. The thrombin generation assay did not reveal a prothrombotic state. However, the study of extracellular vesicles highlighted underlying immune-mediated endothelial damage likely responsible for the thrombotic diathesis. It could be hypothesized that inflammation plays a role in the hypercoagulability of patients with transthyretin amyloidosis. Larger prospective studies are needed to validate our hypothesis

Brain Economics: Housekeeping Routines in the Brain

When resources (e.g., attention or memory) are scarce the human cognitive system must solve the economic problem of resource allocation. We used electroencephalography to examine the time course of the allocation of resources in the brain in hopes of revealing the routines adopted by the human-processing system when managing its resources. We first focused on individual differences in resource management. In this regard we found that individuals of low- and high-IQ did not differ in the amount of available resources. Rather they differed in the timing with which they allocate them, with high-IQ individuals choosing the most beneficial moment. We then examined resource allocation policies in dual-task situations. Using frequency tagging, a method which can provide distinct physiological responses for tasks that are executed simultaneously, we found that the amplitude of each response reflected the amount of resources allocated to a task. Moreover, the evidence suggested different allocation policies when multiple stimuli were presented within one modality (resource-sharing) versus when they were presented in different modalities (resource-addition). Finally, we examined the processes of active control which are involved in resources allocation. An electrophysiological marker for attention disengagement was identified, which has the potential to serve as an important tool for studying attention control.