Surface ruptures database related to the 26 December 2018, MW 4.9 Mt. Etna earthquake, southern Italy.

We provide a database of the surface ruptures produced by the 26 December 2018 Mw 4.9 earthquake that struck the eastern flank of Mt. Etna volcano in Sicily (southern Italy). Despite its relatively small magnitude, this shallow earthquake caused about 8 km of surface faulting, along the trace of the NNW-trending active Fiandaca Fault. Detailed field surveys have been performed in the epicentral area to map the ruptures and to characterize their kinematics. The surface ruptures show a dominant right-oblique sense of displacement with an average slip of about 0.09 m and a maximum value of 0.35 m. We have parsed and organized all observations in a concise database, with 932 homogeneous georeferenced records. The Fiandaca Fault is part of the complex active Timpe faults system affecting the eastern flank of Etna, and its seismic history indicates a prominent surface-faulting potential. Therefore, this database is essential for unravelling the seismotectonics of shallow earthquakes in volcanic areas, and contributes updating empirical scaling regressions that relate magnitude and extent of surface faulting.

High progesterone levels during the luteal phase related to the use of an aromatase inhibitor in breast cancer patients.

OBJECTIVE: To evaluate the hormonal profile in three breast cancer patients who underwent controlled ovarian stimulation in the presence of the aromatase inhibitor letrozole. PATIENTS AND METHODS: In IVF University referral center, a case series of three breast cancer patients who underwent controlled ovarian stimulation (COS) with recombinant FSH and letrozole were investigated. Ovulation was induced with hCG (case No. 1) or with GnRH agonist (case No. 2-3). The primary outcome of our study was the detection of progesterone levels in the luteal phase. RESULTS: Very high progesterone values (mean 186.6 ± 43.6 ng/mL) during the luteal phase were recorded in all three cases. CONCLUSIONS: High progesterone levels can be related to the use of letrozole independently of the most commonly used trigger regimen. Although progesterone has long been considered a protective factor against breast cancer, several studies have demonstrated that progesterone could expand a transformation-sensitive stem cell population in the mammary glands. The estrogen negative feedback effect on the hypothalamus-pituitary axis and the disruption of steroid biosynthesis and could represent an intriguing reason behind this phenomenon. Our results highlight the need to evaluate further the increase in progesterone levels in the luteal phase in women with breast cancer undergoing COS with letrozole.

The treatment of acute psychosis without neuroleptics: six-week psychopathology outcome data from The Soteria Project.

BACKGROUND: Today's treatment of acute psychosis usually includes short-term hospitalization and anti-psychotic drug treatment. The Soteria project compared this form of treatment (control) with that of a small, home-like social environment, usually without neuroleptics (experimental). METHOD: Newly diagnosed, young, unmarried persons with DSM-II schizophrenia were randomly assigned to treatment in two experimental and two control settings. Subjects and families were assessed at admission on 29 independent variables. Treatment environments were studied by means of Moos', COPES or WAS scales. Three dependent six week psychopathology outcome measures were collected. RESULTS: The groups were comparable on 25 of 29 admission variables. The environments of the two experimental and two control settings were different from each other. The milieus were similar to each other within each condition. At six weeks, psychopathology in both groups had improved significantly, and similarly, and overall change was the same. CONCLUSION: Specially designed, replicable milieus were able to reduce acute psychotic symptomatology within six weeks, usually without antipsychotic drugs, as effectively as usual hospital ward treatment that included routine neuroleptic drug use.

Durable power of attorney for health care. Are we ready for it?

Health care professionals need to be well informed about advance directives for medical care in the event a patient becomes incapacitated. The Patient Self-Determination Act requires that all patients be advised of their options at the time of hospital admission. Hospitals and health care professionals will need to work together to plan for implementing this law. We surveyed 215 physicians, nurses, and social workers at a Veterans Affairs Medical Center about the California advance directive, the Durable Power of Attorney for Health Care. Attitudes were generally positive. All of the social workers had heard of the durable power of attorney directive, but 36% of physicians and nurses had never heard of it and an additional 20% had no experience with one. For respondents who had heard of the directive, the mean knowledge score was 6.35 of a possible 10 (5 predicted by chance). Respondents brought up the issue of durable power of attorney with patients before a crisis only 19% of the time and determined whether one had been signed for only 16% of older patients in hospital. The most commonly cited reasons for failure to discuss this with patients were lack of proper forms, pamphlets, or a place to refer a patient. Of those who had ever seen such a document in use, 42% were aware of a problem with it at some time. Whereas attitudes toward advance directives are positive, many physicians and nurses had little knowledge of the Durable Power of Attorney for Health Care and were poorly equipped to discuss it with patients. We encourage educating hospital staff to prepare for the enactment of the Patient Self-Determination Act. We also recommend that the concerns raised by professionals about the use of a durable power of attorney be addressed.

Screening for frailty: criteria and predictors of outcomes.

OBJECTIVE: To determine the reliability of rapid screening by clinically derived geriatric criteria in predicting outcomes of elderly hospitalized patients. DESIGN: Prospective cohort study of 985 patients screened at the time of hospital admission and followed for 1 year with respect to the outcomes of mortality, hospital readmission, and nursing home utilization. SETTING: Palo Alto Veterans Affairs Medical Center, a tertiary care teaching hospital. SUBJECTS: Male patients 65 years of age and older admitted to the Medical and Surgical services during the period from October 1, 1985 through September 30, 1986. RESULTS: Patients were grouped by specific screening criteria into three groups of increasing frailty: Independent, Frail, and Severely Impaired. Each criterion focused on a geriatric condition and was designed to serve as a marker for frailty. Increasing frailty was significantly correlated with increasing length of hospital stay (P less than 0.0001), nursing home utilization (P less than 0.0001), and mortality (P less than 0.0001). Multivariate analyses revealed that the clinical groups were more predictive of mortality and nursing home utilization than were age or Diagnosis-Related Groups (DRGs). Rehospitalization was unrelated to age, clinical group, or DRG, suggesting that utilization may not be driven by the clinical factors measured in this study. CONCLUSIONS: Rapid clinical screening using specific geriatric criteria is effective in identifying frail older subjects at risk for mortality and nursing home utilization. Our findings suggest that geriatric syndromes are more predictive of adverse outcomes than diagnosis per se. This well operationalized screening process is inexpensive as well as effective and could easily be introduced into other hospital settings.

Overconfident prediction of future actions and outcomes by self and others.

In a follow-up study to Dunning, Griffin, Milojkovic, and L. Ross (1990), which had investigated the phenomenon of overconfidence in social prediction, two samples of first-year undergraduates were invited to make predictions about their own future responses (and, in the case of Sample 2, also those of their roommates) over the months ahead. These predictions were accompanied by confidence estimates and were evaluated in the light of actual responses reported later by the subjects in question. The primary finding was that self-predictions, like social predictions, proved to be consistently overconfident. As in Dunning et al., moreover, overconfidence could be traced to two sources. First, expressions of particularly high confidence rarely proved to be warranted; as confidence increased, the gap between accuracy and confidence widened. Second, predictions that went against relevant base rates yielded very low accuracy in the face of relatively unattenuated confidence levels. The implications of these results are discussed, and one potentially important underlying mechanism--the failure to make adequate inferential allowance for the uncertainties of situational construal--is proposed for further research.

The hostile media phenomenon: biased perception and perceptions of media bias in coverage of the Beirut massacre.

After viewing identical samples of major network television coverage of the Beirut massacre, both pro-Israeli and pro-Arab partisans rated these programs, and those responsible for them, as being biased against their side. This hostile media phenomenon appears to involve the operation of two separate mechanisms. First, partisans evaluated the fairness of the media's sample of facts and arguments differently: in light of their own divergent views about the objective merits of each side's case and their corresponding views about the nature of unbiased coverage. Second, partisans reported different perceptions and recollections about the program content itself; that is, each group reported more negative references to their side than positive ones, and each predicted that the coverage would sway nonpartisans in a hostile direction. Within both partisan groups, furthermore, greater knowledge of the crisis was associated with stronger perceptions of media bias. Charges of media bias, we concluded, may reflect more than self-serving attempts to secure preferential treatment. They may result from the operation of basic cognitive and perceptual mechanisms, mechanisms that should prove relevant to perceptions of fairness or objectivity in a wide range of mediation and negotiation contexts.

[Pneumomediastinum or mediastinal emphysema. Case contribution and classification]. / Pneumomediastino o enfisema mediastinico. Contributo casistico e classificativo.

Five cases of pneumomediastinum with different aetiology are reported. The pathogenetic problems are examined and a new classification with physiopathologic criteria proposed.

Acquired neutrophil myeloperoxidase deficiency: an indicator of subclinical activation of blood coagulation?

Using an automated cytochemical analyzer used for routine differential counts, we have been able to demonstrate acquired myeloperoxidase deficiency in 102 patients at our institution. Clinical and laboratory data on these patients showed a high incidence of diabetes mellitus (25.5%) and thrombotic diseases (24.5%), as well as a strikingly constant hyperfibrinogenemia (mean = 635 mg/100 ml; range = 360-1015 mg/100 ml). In 4 additional acute leukemia patients in complete remission, a close time correlation was noted between acquired MPO deficiency, diffuse intravascular coagulation and relapse. These findings indicate the importance of the relationships between neutrophil granulocytes and blood coagulation, and suggest that similar changes in neutrophil MPO activity may represent an early morphological indicator of subclinical activation of blood coagulation.

Antigeno HBs en el Uruguay. Estudio clinico epidemiologico en ninos y adultos. / HBs antigens in Uruguay. Clinical and epidemiological study in children and adults

Se realiza un estudio clinico epidemiologico en ninos y adultos para detectar el AgHBs y determinar su real importancia en la poblacion del Uruguay. Se observo un 6,4% de portadores de AgHBs en donantes de sangre, con un 15,5% de AcHBs; 16% de AgHBs en politransfundidos; 4% de AgHBs en ninos "sanos" y 12,6% en ninos internados con afecciones miscelaneas.En los casos clinicos se encontro el AgHBs en el 48,8% de las hepatitis agudas; en el 82,3% de las hepatitis prolongadas; en el 50% de las hepatitis cronicas persistentes y en el 77,7% de las hepatitis cronicas agresivas. En estos tres ultimos grupos el numero de pacientes estudiados es insuficiente para dar real valor a estas cifras. Se determino la importancia de la antigenuria asi como del estudio de la biopsia hepatica por inmunofluorescencia