Predictors of hospital readmission rate in geriatric patients.

BACKGROUND: Hospital readmissions among older adults are associated with progressive functional worsening, increased institutionalization and mortality. AIM: Identify the main predictors of readmission in older adults. METHODS: We examined readmission predictors in 777 hospitalized subjects (mean age 84.40 ± 6.77 years) assessed with Comprehensive Geriatric Assessment (CGA), clinical, anthropometric and biochemical evaluations. Comorbidity burden was estimated by Charlson Comorbidity Index (CCI). Median follow-up was 365 days. RESULTS: 358 patients (46.1%) had a second admission within 365 days of discharge. Estimated probability of having a second admission was 0.119 (95%C.I. 0.095-0.141), 0.158 (95%C.I. 0.131-0.183), and 0.496 (95%C.I. 0.458-0.532) at 21, 30 and 356 days, respectively. Main predictors of readmission at 1 year were length of stay (LOS) > 14 days (p < 0.001), albumin level < 30 g/l (p 0.018), values of glomerular filtration rate (eGFR) < 40 ml/min (p < 0.001), systolic blood pressure < 115 mmHg (p < 0.001), CCI ≥ 6 (p < 0.001), and cardiovascular diagnoses. When the joint effects of selected prognostic variables were accounted for, LOS > 14 days, worse renal function, systolic blood pressure < 115 mmHg, higher comorbidity burden remained independently associated with higher readmission risk. DISCUSSION: Selected predictors are associated with higher readmission risk, and the relationship evolves with time. CONCLUSIONS: This study highlights the importance of performing an accurate CGA, since defined domains and variables contained in the CGA (i.e., LOS, lower albumin and systolic blood pressure, poor renal function, and greater comorbidity burden), when combined altogether, may offer a valid tool to identify the most fragile patients with clinical and functional impairment enhancing their risk of unplanned early and late readmission.

Cardio-Ankle Vascular Index and Aging: Differences between CAVI and CAVI0.

BACKGROUND: Cardio-ankle vascular index (CAVI) and CAVI0 (a mathematical expression derived from CAVI, supposed to be less dependent on blood pressure), can describe arterial stiffness, considering a wide proportion of the arterial tree. The aim of this study was to examine the relationship between CAVI, CAVI0 and aging, looking at the differences between the two arterial stiffness indexes. METHODS: A total of 191 patients (68 male, mean age 68.3 ± 14.4 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included and underwent a comprehensive clinical evaluation. CAVI and CAVI0 were obtained for each. RESULTS: CAVI0 steeply rises in the elderly age strata, widening the gap between CAVI and CAVI0. An inverse relationship is evident between CAVI0 and DBP in older patients, and CAVI0 is shown to be dependent on age, DBP and age-DBP interaction (R2 = 0.508). Age modifies the effect of DBP on CAVI0, but not on CAVI. CONCLUSIONS: The real new findings of our study are that the association between CAVI0 and diastolic blood pressure (DBP) is modified by age, whereas the association between CAVI and DBP is not modified by age. From a clinical point of view, these are very important findings, as DBP decreases with aging, affecting in elderly populations the reliability of CAVI0, which strictly depends on DBP in the formula to calculate it. To monitor the effect of CV therapies, progression of CV diseases and to evaluate clinical outcomes in elderly populations, we suggest using CAVI and not CAVI0.

The Correlation of Arterial Stiffness Parameters with Aging and Comorbidity Burden.

The aim of the study was to evaluate the relationships between carotid-femoral pulse wave velocity (PVW-cf), cardio-ankle vascular index (CAVI) and CAVI0 (which is a mathematical elaboration of CAVI, theoretically less dependent on blood pressure), age and comorbidity burden. Furthermore, 183 patients (119 female, mean age 67.5 ± 14.3 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included; demographic, clinical and blood analysis data were collected. Charlson Comorbidity Index (CCI), PVW-cf, CAVI and CAVI 0 were obtained. Significant correlations were found between CAVI, CAVI0, PVW-cf and both age (r = 0.698, r = 0.717, r = 0.410, respectively p < 0.001 for all) and CCI, (r = 0.654; r = 0.658; r = 0.448 respectively and p < 0.001 for all), still significant after adjustment for several variables. In a stepwise multiple regression model, considering several variables, CCI was the only predictor of PWV-cf, whereas age and CCI were significant predictors of both CAVI and CAVI 0. In conclusion, all arterial stiffness indexes are associated with CCI and aging; the latter correlation is more evident for CAVI and CAVI 0 than for PVW-cf. Arterial stiffness parameters can complement the characterization of patients affected by a remarkable comorbidity burden across aging; arterial stiffening might mirror the complexity of these individuals.

The polarizing impact of numeracy, economic literacy, and science literacy on the perception of immigration.

Immigrants might be perceived as a threat to a country's jobs, security, and cultural identity. In this study, we aimed to test whether individuals with higher numerical, scientific, and economic literacy were more polarized in their perception of immigration, depending on their cultural worldview orientation. We measured these variables in a representative sample of citizens in a medium-sized city in northern Italy. We found evidence that numerical, scientific, and economic literacy polarize concerns about immigration aligning them to people's worldview orientations. Individuals with higher numerical, economic, and scientific literacy were less concerned about immigration if they held an egalitarian-communitarian worldview, while they were more concerned about immigration if they held a hierarchical-individualistic worldview. On the contrary, individuals with less numerical, economic, and scientific literacy did not show a polarized perception of immigration. Results reveal that citizens with higher knowledge and ability presented a more polarized perception of immigration. Conclusions highlight the central role of cultural worldviews over information theories in shaping concerns about immigration.

New evidence of high association between carbohydrate deficient transferrin (CDT) and alcohol-related road traffic accidents. A retrospective study on 929 injured drivers.

BACKGROUND: It is well known that traffic injuries still represent one of the main causes of death and that high blood alcohol concentrations while driving significantly increase the occurrence of accidents. However, only limited literature on the correlation between chronic alcohol abuse and accident risk is available. The aim of the present study was to investigate the hypothesis of an association between elevated concentrations of carbohydrate deficient transferrin (CDT) and the occurrence of alcohol-related traffic accidents. METHODS: The analytical determinations of BAC and CDT were performed following certified methods in HS-GC-FID and HPLC, respectively. For BAC, 0.50 g/L was used as cut-off, whereas 2.0% was used for CDT, according to the standardisation proposed by IFCC. A total of 929 drivers, tested for BAC at the time of hospital admission after a traffic accident, were classified into two groups: InjDr 1 (BAC ≤ 0.50 g/L) and InjDr 2 (BAC>0.50 g/L); all drivers were also tested for CDT. RESULTS: InjDr 1 included 674 individuals, only 2.5% showing a CDT above the cutoff, whereas InjDr 2 group consisted of 255 subjects, 28.6% testing positive for CDT (Odds Ratio 15.5). When subdividing the InjDr group into increasing classes of CDT, a steady increase in the percentage of BAC-positive drivers was appreciated. Moreover, average BAC was found to parallel each class of CDT. CONCLUSIONS: The reported data strongly support the use of CDT as a biomarker of increased risk of alcohol-related traffic accidents in the procedures of re-granting of the driving license upon confiscation for "drink driving".

Multiple evanescent white dot syndrome: clinical course and factors influencing visual acuity recovery.

OBJECTIVE: To report the demographics and the clinical course of patients with multiple evanescent white dot syndrome (MEWDS) and to investigate for those factors which influence visual acuity (VA) recovery. METHODS: This is a retrospective single-centre observational study. Electronic medical records and retinal imaging of patients with a diagnosis of MEWDS with a minimum follow-up of 3 months were reviewed. Patients were categorised into three groups according to the VA at presentation and at the last visit: group 1 >0.48 logarithm of the minimum angle of resolution (LogMAR), group 2 ≤0.48 and ≥0.18 LogMAR and group 3 <0.18 LogMAR. All patients had non-invasive multimodal imaging including optical coherence tomography, near-infrared reflectance imaging and blue fundus autofluorescence at presentation and during follow-up. RESULTS: A total of 51 eyes from 51 patients (41 women, mean age 29.8±7.8 years) were included. Significantly more patients presented in the autumn (X2=8.69, p=0.034). The percentage of eyes recovering vision to 0.0 LogMAR or better was 80.3% (41/51). Worse presenting vision and young age at presentation were independent significant predictive variables for poorer final VA (p=0.002 and p=0.02, respectively). No imaging features were significantly predictive of complete versus incomplete recovery, but disc hyperfluorescence on fluorescein angiography was more common in those with incomplete recovery. CONCLUSIONS: Although the majority of cases have a benign prognosis, the clinical spectrum of MEWDS includes incomplete visual recovery. In our series, poor presenting VA and young age were associated with poor VA outcome. Further study is warranted to confirm these findings.

The Perceptual Organisation of Visual Elements: Lines.

The aim of this study is to verify the conditions under which a series of visual stimuli (line segments) will be subjectively perceived as visual lines or surfaces employing four experiments. Two experiments were conducted with the method of subjective evaluation of the line segments, and the other two with the Osgood semantic differential. We analysed five variables (thickness, type, orientation, and colour) potentially responsible for the lines' categorisation. The four experiments gave similar results: higher importance of the variables thickness and type; general lower significance of the variable colour; and general insignificance of the variable orientation. Interestingly, for the variable type, straight lines are evaluated as surfaces more frequently than curved lines and perceived as geometrical, flat, hard, static, rough, sharp, bound, sour, frigid, masculine, cold and passive. Curved lines are prevalently evaluated as lines, and categorised as organic, rounded, soft, dynamic, fluffy, blunt, free, sweet, sensual, feminine, warm and active. These results highlight the specificity of perceptual characteristics for the considered variables and confirm the relevance of the characteristics of variables such as thickness and type.

CDT vs. GGT for the certification of the fitness to hold the driving license. A comparison based on the association of incremented values with the occurrence of alcohol-related road traffic accidents.

BACKGROUND: In the context of fitness certification to hold the driving license, GGT and CDT have been used, sometimes in combination (γ-CDT), to exclude chronic alcohol abuse. The present study was carried out with the aim of comparing the power of these biomarkers as tools for the objective screening of subjects at high risk of alcohol-associated traffic injuries. METHODS: 288 male drivers admitted to hospital after traffic accidents were examined by determination of GGT, CDT and BAC. The degree of association of GGT, CDT and γ-CDT with BAC was analysed using non-parametric statistics. RESULTS: Partitioning the cases using the cut-off concentrations of 0.5 g/L for BAC (the legal limit adopted in most European countries), 55 U/L for GGT and 1.9% for CDT, a highly significant difference was found between the frequency of elevated GGT or CDT in cases where BAC was within the legal limits and those with elevated BAC values (Fisher's exact test: p < 0.001). However, the calculation of the odds ratio showed a much higher increase for CDT (28 times) than for GGT (6 times) in those drivers with a BAC above the Italian legal limit in comparison with those showing a BAC within the cut-off; conversely, γ-CDT does not provide any significant advantage vs. CDT alone. CONCLUSIONS: Both GGT and CDT provide objective evidence of an association with the occurrence of alcohol-related severe traffic accidents, but CDT shows superior association with these events. Therefore, CDT, notwithstanding higher costs, should be preferred in a forensic/certification context.

Role of Body Weight in the Onset and the Progression of Idiopathic Premature Pubarche.

BACKGROUND: The term premature pubarche (PP) refers to the appearance of pubic hair before age 8 in girls and before age 9 in boys. Although idiopathic PP (often associated with premature adrenarche) is considered an extreme variation from the norm, it may be an initial sign of persistent hyperandrogenism. Factors contributing to PP onset and progression have not been identified to date. AIMS: The objectives of this study are to describe a group of Italian children with PP, to identify potential factors for its onset, and to define its clinical and biochemical progression. METHODS: We retrospectively enrolled all infants born between 2001 and 2014 with PP. Children with advanced bone age (BA) underwent functional tests to determine the cause of PP. Hormonal analysis and BA determination were performed annually during a 4-year follow-up period. RESULTS: A total of 334 children with PP were identified: idiopathic PP (92.5%, associated with premature adrenarche in some cases); related to precocious puberty (6.6%); late-onset 21-hydroxylase deficiency (0.9%). Low birth weight was associated with premature adrenal activation. Body mass index (BMI) was the only factor that influenced the progression of BA during follow-up. CONCLUSIONS: Low birth weight is a predisposing factor for premature adrenal activation. The increase in BMI in patients with idiopathic PP during the 4-years of follow-up was responsible for BA acceleration. We recommend prevention of excessive weight gain in children with PP and strict adherence to follow-up in order to prevent serious metabolic consequences.

Older People Living in Long-Term Care Facilities and Mortality Rates During the COVID-19 Pandemic in Italy: Preliminary Epidemiological Data and Lessons to Learn.

Background: Long-Term Care Facilities (LTCF) in Italy have been particularly affected by the COVID-19 pandemic, especially in terms of mortality rates of older residents. However, it is still unclear the actual extent of this situation. The aim of this manuscript is to assess the extent of mortality rates of older adults in LTCF during the pandemic across different regions of Italy, compared to the previous years and to older general population not resident in LTCF. Methods: We extracted and analyzed data collected by three Italian institutions (i.e., Italian Statistician Institute ISTAT, Italian N.I.H, Milan Health Unit) about the number of deaths among older people living in the community and among LTCF residents during the pandemic and the previous years. We also compared the observed mortality rate among LTCF residents in each Italian Region with the corresponding expected number of deaths of the general older adult population to obtain an observed/expected ratio (O/E ratio). Results: During the pandemic, about 8.5% (N = 6,797) of Italian older adults residents in LTCF died. Findings resulting from the O/E ratio suggest that LTCF residents (in particular in the Lombardy Region) show higher mortality rates when compared to expected values of mortality rates among the older general population living in the community. Furthermore, we found that the risk of death among LTCF residents increased about 4 times during the pandemic when compared to the previous years. Conclusions: Mortality rates in LTCF were high during the pandemic, especially in Lombardy. Possible causes of higher mortality rates in LTCF and suggestions for specific targeted interventions are discussed.

Cross-Modal Perceptual Organization in Works of Art.

This study investigates the existence of cross-modal correspondences between a series of paintings by Kandinsky and a series of selections from Schönberg music. The experiment was conducted in two phases. In the first phase, by means of the Osgood semantic differential, the participants evaluated the perceptual characteristics first of visual stimuli (some pictures of Kandinsky's paintings, with varying perceptual characteristics and contents) and then of auditory stimuli (musical excerpts taken from the repertoire of Schönberg's piano works) relative to 11 pairs of adjectives tested on a continuous bipolar scale. In the second phase, participants were required to associate pictures and musical excerpts. The results of the semantic differential test show that certain paintings and musical excerpts were evaluated as semantically more similar, while others were evaluated as semantically more different. The results of the direct association between musical excerpts and paintings showed both attractions and repulsions among the stimuli. The overall results provide significant insights into the relationship between concrete and abstract concepts and into the process of perceptual grouping in cross-modal phenomena.

Critical Evaluation of the Association Between Elevated Mean Corpuscular Volume and Alcohol-Related Traffic Accidents: A Retrospective Study on 6244 Car Crash Cases.

BACKGROUND: Erythrocyte mean corpuscular volume (MCV) has been used for decades as a biomarker of chronic alcohol abuse and in the treatment of alcohol dependence. More recently, it has also been adopted to investigate the fitness of subjects to hold the driving license to prevent traffic accidents. So far, however, the studies on the association of MCV with an increased risk of alcohol-associated car accidents are extremely scarce, if not totally absent. To the best of our knowledge, the present work is the first specifically aimed at studying a plausible association between elevated MCV and crash accidents correlated with alcohol abuse. METHODS: A total of 6,244 drivers involved in traffic accidents underwent mandatory laboratory analyses including blood alcohol concentration (BAC) determination and MCV analysis. BAC and MCV determinations were performed by headspace gas chromatography and complete blood count, respectively. RESULTS: The chi-square test evaluating the proportions of subjects with elevated MCVs (>95 fl) yielded a highly significant result (χ2  = 68.0; p < 0.001) in the blood samples where the BAC was above the legal limit (i.e., >0.5 g/l). However, when considering only drivers showing BACs in the range of 0.51 to 1.5 g/l, the frequencies of elevated MCV values are fairly comparable (χ2  = 0.062, p = 0.80). In contrast, limiting the evaluation to BACs > 1.5 g/l, the frequency of elevated MCVs raised to 19.1% (χ2  = 58.9, p value < 0.001 vs. the group with BAC within the legal limits). CONCLUSIONS: The present observations show that MCV increases are typically associated with drivers involved in accidents only if driving under severe alcohol intoxication, leading to a preliminary conclusion that, in the context of the certification of the fitness to the driving license, MCV fails to reveal individuals at risk who tend to drive in a condition of low-to-moderate alcohol intoxication.

Long-Term Anatomic and Visual Outcome Following Vitrectomy for Stage 4B and 5 Retinopathy of Prematurity.

BACKGROUND AND OBJECTIVES: Surgical indications in stages 4B and 5 retinopathy of prematurity (ROP) are not universally accepted. The authors' purpose is to evaluate the long-term anatomic and visual outcomes of vitrectomy for retinal detachment (RD) associated with stages 4B and 5 ROP. PATIENTS AND METHODS: Data of patients who consecutively underwent vitrectomy for stages 4B and 5 ROP from 1999 to 2013 were retrospectively reviewed and included grade of retinal attachment and visual acuity (VA) at the last follow-up. RESULTS: Seventy eyes of 38 infants were included: 23 with stage 4B and 47 with stage 5 ROP. Lens-sparing vitrectomy was performed in 11 eyes, combined lensectomy / vitrectomy in 59 eyes. Mean follow-up was 8.5 years. Anatomic success was maintained in 41 eyes (58.5%), and among them, VA greater than 5/200 was achieved in 17 eyes (41.4%). CONCLUSION: The long-term visual and anatomic success rates were encouraging for the surgical correction of RD associated with late stages ROP. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:208-214.].

Sensual Light? Subjective Dimensions of Ambient Illumination.

This work concerns the subjective impression of perceived illumination. The purpose of the study is to test attributes expressing qualitative experiences referring to ambient lighting that can be applied as descriptors. Seventy participants viewed an actual model room, with the fourth wall removed (viewing booth). Walls, floor, and ceiling were achromatic. Two achromatic cubes were placed inside the room: One was a reflectance increment to the walls, the other a decrement. The room was illuminated by two different light sources, Artificial Daylight (D65) or Tungsten Filament (F), the order of which was randomized across participants. The participants' task was to evaluate ambient illumination for each light source. A semantic differential method was employed with 27 pairs of adjectives on 1 to 7 rating scales, categorized in three groups: characteristics of atmosphere, time, and cross-modal. Only the ratings of nine pairs of adjectives were not influenced by the type of illumination. The most differentiated couples under different illuminants were hot/cold and modern/old, but large differences also appeared with the following couples: hard/soft, technological/primitive, summery/wintry, warm/cool, sensual/frigid, natural/artificial, and hospitable/inhospitable. The hypothesis that there would be consistency among the subjects in evaluations of the characteristics tested and that these would be differently perceived under different illuminants was confirmed. The results show that it is possible to identify subjective perceived illumination as a phenomenon endowed with specific filling-in qualities and that as a perceptual experience it can be categorized, with implications for application in architecture and design.

Children with premature pubarche: is an alterated neonatal 17-Ohp screening test a predictive factor?

BACKGROUND: Neonatal screening for 21 hydroxylase deficiency is designed to detect classical form of congenital adrenal hyperplasia (CAH). It is still unclear whether newborns who result false positives at neonatal screening might later develop signs of androgen excess. The aim of this study is to verify whether a slightly elevated 17-OHP at newborn screening is a predictive factor for premature pubarche. METHODS: We evaluated all infants born between 2001 and 2014 with premature pubarche. In case of increased bone age, they were submitted to functional tests to find out the cause of their symptoms. Their 17-OHP values at newborn screening for CAH were reconsidered. RESULTS: We identified 330 patients (269 females, 61 males) with premature pubarche. All these children had a normal 17-OHP at newborn screening with the exception of a child, born preterm and not affected by CAH. CONCLUSIONS: An elevated 17-OHP at newborn screening is not a predictive factor for premature pubarche. A likely cause of increased 17-OHP level at screening is an immaturity of adrenal gland or a neonatal stress. Therefore a strict follow up of these neonates during childhood is not necessary.

The Role of Temporal Disparity on Audiovisual Integration in Low-Vision Individuals.

Recent findings have shown that sounds improve visual detection in low vision individuals when the audiovisual stimuli pairs of stimuli are presented simultaneously and from the same spatial position. The present study purports to investigate the temporal aspects of the audiovisual enhancement effect previously reported. Low vision participants were asked to detect the presence of a visual stimulus (yes/no task) presented either alone or together with an auditory stimulus at different stimulus onset asynchronies (SOAs). In the first experiment, the sound was presented either simultaneously or before the visual stimulus (i.e., SOAs 0, 100, 250, 400 ms). The results show that the presence of a task-irrelevant auditory stimulus produced a significant visual detection enhancement in all the conditions. In the second experiment, the sound was either synchronized with, or randomly preceded/lagged behind the visual stimulus (i.e., SOAs 0, ± 250, ± 400 ms). The visual detection enhancement was reduced in magnitude and limited only to the synchronous condition and to the condition in which the sound stimulus was presented 250 ms before the visual stimulus. Taken together, the evidence of the present study seems to suggest that audiovisual interaction in low vision individuals is highly modulated by top-down mechanisms.

Prognostic factors in ectopic Cushing's syndrome due to neuroendocrine tumors: a multicenter study.

OBJECTIVE: Evidence is limited regarding outcome of patients with ectopic Cushing's syndrome (ECS) due to neuroendocrine tumors (NETs). DESIGN: We assessed the prognostic factors affecting the survival of patients with NETs and ECS. METHODS: Retrospective analysis of clinicopathological features, severity of hormonal syndrome, treatments from a large cohort of patients with NETs and ECS collected from 17 Italian centers. RESULTS: Our series included 110 patients, 58.2% female, with mean (±s.d.) age at diagnosis of 49.5 ± 15.9 years. The main sources of ectopic ACTH were bronchial carcinoids (BC) (40.9%), occult tumors (22.7%) and pancreatic (p)NETs (15.5%). Curative surgery was performed in 56.7% (70.2% of BC, 11% of pNETs). Overall survival was significantly higher in BC compared with pNETs and occult tumors (P = 0.033) and in G1-NETs compared with G2 and G3 (P = 0.007). Negative predictive factors for survival were severity of hypercortisolism (P < 0.02), hypokalemia (P = 0.001), diabetes mellitus (P = 0.0146) and distant metastases (P < 0.001). Improved survival was observed in patients who underwent NET removal (P < 0.001). Adrenalectomy improved short-term survival. CONCLUSIONS: Multiple factors affect prognosis of ECS patients: type of NET, grading, distant metastases, severity of hypercortisolism, hypokalemia and diabetes mellitus. BCs have the highest curative surgical rate and better survival compared with occult tumors and pNETs. Hypercortisolism plays a primary role in affecting outcome and quality of life; therefore, prompt and vigorous treatment of hormonal excess by NET surgery and medical therapy should be a key therapeutic goal. In refractory cases, adrenalectomy should be considered as it affects outcome positively at least in the first 2 years.

Naturally Biased Associations Between Music and Poetry.

The study analyzes the existence of naturally biased associations in the general population between a series of musical selections and a series of quatrains. Differently from other studies in the field, the association is tested between complex stimuli involving literary texts, which increases the load of the semantic factors. The stimuli were eight quatrains taken from the same poem and eight musical clips taken from a classical musical version of the poem. The experiment was conducted in two phases. First, the participants were asked to rate 10 couples of opposite adjectives on a continuous bipolar scale when reading a quatrain or when listening to a musical clip; then they were asked to associate a given clip directly with the quatrains in decreasing order. The results showed the existence of significant associations between the semantics of the quatrains and the musical selections. They also confirmed the correspondences experienced by the composer when writing the musical version of the poem. Connotative dimensions such as rough or smooth, distressing or serene, turbid or clear, and gloomy or bright, characterizing both the semantic and the auditory stimuli, may have played a role in the associations. The results also shed light on the accomplishment of the two diverse methodologies adopted in the two different phases of the test. Finally, the role of specific musical components and their combinations is likely to have played an important role in the associations, an aspect that shall be addressed in further studies.

Renal shear wave velocity and estimated glomerular filtration rate in children with chronic kidney disease.

A shear wave velocity (SWV) value obtained by the acoustic radiation force impulse technique depends on tissue elasticity. We investigated the relationship between SWV values and the estimated glomerular filtration rate (eGFR) in children with chronic kidney disease. A total of 29 patients were enrolled in the study. There were 18 primary and 11 secondary cases of vesicoureteral reflux. eGFR was calculated using Schwartz's formulas (2012). Partial eGFR for each kidney was assessed by multiplying the eGFR by the percentage of renal function measured by means of renal (99m)Tc-dimercaptosuccinic acid scintigraphy. All ultrasound tests were done by a single qualified technician using a convex probe (frequency 4 MHz) on an S-2000 system. The mean SWV values of the two kidneys were significantly and negatively correlated with eGFR calculated with both univariate (cystatin C [Cys C] and multivariate (creatinine, Cys C, and nitrogen) equations. Of all the formulae, the strongest correlation was obtained with eGFR (Cys C). SWV of the renal cortex correlates with the eGFR of patients affected by malformative uropathies. Nevertheless, this technique needs standardization and validation.

The Tactile Dimensions of Abstract Paintings: A Cross-Modal Study.

In our research, we tested for the existence of cross-modal visual and tactile associations in the experience of abstract art. Specifically, we measured the association of 60 abstract paintings with four couples of antonyms related to texture, such as warm or cold, smooth or rough, lightweight or heavy, soft or hard, investigating if the different modality of presentation on a computer screen (color versions: natural colors, inverted colors, black and white) gave rise to different associations relative to the four couples of opponent qualities. Second, we tested whether there might be differences between the ratings of the paintings when they were presented as images on a computer screen versus in real life at the museum. The results confirmed that associations between visual and tactile experience with such complex stimuli exist. In the case of the couple warm or cold, a significant inversion of associated qualities occurs when the images are presented in inverted colors as opposed to natural colors; furthermore, when presented in black and white, warm evaluations are "cooled down," but cold evaluations remain the same. The degree of smoothness could be considered not associated with the color versions. When seen in black and white, both the mean softness and the mean lightweight-ness of the paintings were reduced; however, in the last case, this effect was more evident for the most lightweight pictures. There is only a slight difference between the two presentations of the paintings as images presented on a computer screen and seen in real life, relative to the warm or cold and soft or hard dimensions. Of the four opponent qualities, the three pairs warm or cold, lightweight or heavy, and soft or hard showed the most interesting results in relation to the cross-modal associations.