Observations of Rogue Seas in the Southern Ocean.

We report direct observations of surface waves from a stereo camera system along with concurrent measurements of wind speed during an expedition across the Southern Ocean in the austral winter aboard the South African icebreaker S.A. Agulhas II. Records include water surface elevation across a range of wave conditions spanning from early stages of wave growth to full development. We give experimental evidence of rogue seas, i.e., sea states characterized by heavy tails of the probability density function well beyond the expectation based on bound mode theory. These conditions emerge during wave growth, where strong wind forcing and high nonlinearity drive wave dynamics. Quasiresonance wave-wave interactions, which are known to sustain the generation of large amplitude rogue waves, capture this behavior. Wave statistics return to normality as the wind forcing ceases and waves switch to a full developed condition.

Sea-ice algal phenology in a warmer Arctic.

The Arctic sea-ice decline is among the most emblematic manifestations of climate change and is occurring before we understand its ecological consequences. We investigated future changes in algal productivity combining a biogeochemical model for sympagic algae with sea-ice drivers from an ensemble of 18 CMIP5 climate models. Model projections indicate quasi-linear physical changes along latitudes but markedly nonlinear response of sympagic algae, with distinct latitudinal patterns. While snow cover thinning explains the advancement of algal blooms below 66°N, narrowing of the biological time windows yields small changes in the 66°N to 74°N band, and shifting of the ice seasons toward more favorable photoperiods drives the increase in algal production above 74°N. These diverse latitudinal responses indicate that the impact of declining sea ice on Arctic sympagic production is both large and complex, with consequent trophic and phenological cascades expected in the rest of the food web.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

BACKGROUND: The prevalence of impacted maxillary canine is reported to be between 1% and 3%. The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors. An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography. MATERIAL AND METHODS: 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements. RESULTS: Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If ß angle <18° and Lindauer = I, the probability of resorption is 0.06. CONCLUSIONS: Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of the evaluation criteria for prescribing second level examination (CT and CTCB) and for detecting root resorption of impacted maxillary canine adjacent teeth.

Suicide prevention among youths. Systematic review of available evidence-based interventions and implications for Italy.

Suicide completion is a leading cause of death for children, adolescents, and young adults. There is evidence that the suicide rate for those aged 15 to 24 years has tripled since 1950, and suicide is now the second or third leading cause of death in this age group. Recent studies indicate that the incidence of suicide attempts among adolescents may exceed 10% annually. The role of caregivers and schools (as well as colleges and universities) is important in the assessment, management, and prevention of suicidal behaviour in children and youth. Recognition of risk factors for suicide is of paramount importance for prevention. Furthermore, a number of educational programs have demonstrated possible key roles in implementing suicide prevention strategies. As suicide is a problem of concern among Italian youths, this paper overviews current official statistical evidence of the phenomenon and suggests a national suicide prevention strategy based on a number of tools already involved in this field, especially in the USA.

[Breastfeeding and health promotion of child: survey results in Molise region]. / Allattamento al seno e promozione della salute del bambino: risultati di un'indagine in Molise.

AIM: The aim of this study is to compare initiation and duration rates of breastfeeding in Molise region (Italy) to those targeted from World Health Organization (WHO), and to examine factors associated with infant health. METHODS: Trained caregivers administered interviews to 430 mothers whose infants were receiving the 2nd dose of compulsory immunisation in 4 primary health care centers (ASL) of Molise region, during October-December 2001. Type of breastfeeding was classified as predominant or partial, according to the WHO definitions. RESULTS: The rate of breastfeeding initiation was 92%, dropping to 30% when infants were 6 months of age. We found strong differences among the 4 health care centers involved in the study. Lacking of support after discharge, non-breastfed previous child, receiving infant formulas, breastfeeding on schedule, rooming-in not effected at hospital, both maternal and familiar smoking, were significantly associated with early breastfeeding cessation. The rate of iodine supplemented salt consuming was 40%; the rate of mothers who knew the importance of using folic acid in preconceptional age was 19%; only 1/3 of infants (34%) was placed back to sleep. CONCLUSIONS: Although we meet WHO goals regarding breastfeeding initiation, we don't about breastfeeding duration, yet. Moreover, the leading factors negatively linked to infant health, are not widely recognized. It is therefore necessary to promote the whole infant health, either supporting predominantly breastfeeding, especially in some ASL, or providing better knowledge about risk factors.

Gender differentials in life expectancy in Italy.

OBJECTIVE: To analyze the gender differential in life expectancy in Italy from 1970 to 1997, to determine which ages and causes of death mostly influenced its trend. METHODS: Pollard method was used to explain which ages and which pathologies give the highest contribution to the gender differential. RESULTS: A slight reduction of the gender differential has been observed since 1980. The olds and very olds became the most relevant contributors to the differential. Cardiovascular diseases were the principal contributing causes of death until 1980 and Cancer replaced them afterwards. CONCLUSION: Relatively recent adoption of unhealthy life styles by women together with an opposite process run by young men towards healthier behaviour, seem to be at the basis of the slight reduction of the gender differential in life expectancy observed since 1980.

Tobacco smoking habits, attitudes and beliefs among nurse and medical students in Tuscany.

In this study we evaluated the smoking habits, beliefs and attitudes of nurse and medical students at the University of Siena and Florence, Italy. Students who entered the 1st year of school in 1998 were asked to complete a self-administered anonymous questionnaire. Two hundred medical students completed the questionnaire; they had a mean age (+/-SD) of 19.8+/-1.7 years and 68% were females. A total of 205 nurse respondents answered to the questionnaire; they had a mean age of 21.8+/-4.1 years and females were 83% of the total. The overall response rate among students always remained higher than 85%. Thirty per cent of medical students were current smokers, and 5% former-smokers. A total of 43% of nurse students were current smokers and 11.5% former-smokers. Nurse students were more likely to smoke than medical students (p = 0.001). Among current smokers, the number of daily cigarettes smoked and the degree of nicotine addiction did not differ between groups. The prevalence of maternal smoking were higher among nurse students. In spite of students' beliefs the knowledge about smoking remained generic in both groups. Nurse students were less aware than medical students of their special responsibility towards people about tobacco smoking. Such a difference remained significant also after adjustment for smoking status (p < 0.01). Students overestimated the prevalence of current smokers among health caregivers of the local hospitals, and Italian people and adolescents. Targeted and continuous training about smoking prevention should be mandatory in Italian medical and nurse schools.

Differential impact of combined antiretroviral therapy on the survival of italian patients with specific AIDS-defining illnesses.

BACKGROUND: A decrease in HIV-related mortality and morbidity has been observed since 1996 in most developed countries as a consequence of the extensive use of combined antiretroviral therapies. The purpose of this study was to investigate whether combined antiretroviral therapies had a differential impact on the survival of patients with different AIDS-defining illnesses (ADIs). METHODS: In total, 35,318 persons representing all the adults with AIDS (PWAs) diagnosed in Italy from January 1, 1990 to August 31, 1998 were studied. Actuarial life tables and the Kaplan-Meier method were used to estimate the cumulative probability of survival; the multivariate Cox proportional hazards model was used to estimate adjusted relative hazard of death (RH). RESULTS: Among PWAs diagnosed after 1995, the proportion of survivors 24 months after diagnosis was more than doubled (66%) compared with that of PWAs diagnosed before the end of 1995 (31%). Significantly decreased RHs for some ADIs were observed as early as 1996 (i.e., esophageal candidiasis, Pneumocystis carinii pneumonia, brain toxoplasmosis, HIV-wasting syndrome, and pulmonary tuberculosis). In the last period (1997-1998), the decrease was marked and significant for almost all the ADIs, ranging from 55% to 80% compared with the RHs of the reference year (1995). Conversely, primary lymphoma of the brain and Burkitt's lymphoma showed a low and not statistically significant decrease; these were the ADIs with the worst outcome. CONCLUSIONS: After 1995, there was a rather uniform increase in the survival of PWAs diagnosed with most specific ADIs but not for patients affected by primary brain lymphoma and Burkitt's lymphoma. The determinants of this differential effect need to be investigated.

The impact of the major causes of death on life expectancy in Italy.

BACKGROUND: This study aims to evaluate the contribution of the reduction in major cardiovascular diseases (CVD), malignant neoplasms (MN), accidents and AIDS mortality to the gains in life expectancy observed during the decade 1985-1994, as well as to calculate and compare the potential gains due to the partial or total elimination of these causes. METHODS: Mortality data from the Italian Mortality Data Base were analysed by the method of decomposition of changes in life expectancy and the partial multiple decrement life table technique. RESULTS: In Italy, considering the decade 1985-1994, the gain in life expectancy at birth was 2.27 years for men and 2.16 for women. The major contribution to this increase was the reduction in CVD mortality followed by fewer deaths from accidents and MN. Conversely, AIDS caused a loss in the length of life of adults. Major potential gains in life expectancy at birth could be obtained by the elimination or even partial reduction of CVD and MN mortality. When working life (15-64 years) is considered, the relative importance of the causes changes. The elimination of accidents and AIDS would result in increased life expectancy longer than that associated with a 50% reduction in CVD. CONCLUSIONS: The findings of this study provide useful information which could contribute to a more effective allocation of resources for research activity and public health programmes.

Eruption anomalies of the maxillary permanent cuspids in children with cleft lip and/or palate.

Eruption anomalies of the maxillary permanent cuspid on the cleft side was analyzed in a sample of 77 children with mono- and bi-lateral cleft lip/palate. The main findings were: 1) The permanent cuspid showed an initial mesial position in relation to the root of its primary predecessor in a relatively high number of cases. Nearly all those cuspids that showed an anomalous position (mesial or distal) in relation to the corresponding primary teeth at the time of the first observation erupted in malposition (palatally in the cleft area, mesially or distally to the primary cuspids). 2) In most cases presenting a mesially positioned permanent cuspid at the time of first observation, the permanent later incisor was congenitally missing, microdontic or in a mesial position in relation to the cleft. 3) Distally positioned permanent cuspids were always associated with a supernumerary lateral incisor. 4) A congenitally missing lateral incisor could represent a predisposing factor to a mesial position of the permanent cuspid. An early radiographic evaluation of the position of the permanent cuspid was suggested especially in those children presenting a congenitally missing lateral incisor.

Abnormalities of the maxillary incisors in children with cleft lip and palate.

Dental anomalies of the maxillary anterior teeth were studied in seventy-seven children affected by unilateral and bilateral clefts of the lip and alveolar process, with or without involvement of the palate. As for the permanent lateral incisor in the cleft area, our results show that its congenital absence is the most frequent abnormality followed by anomalies in size and shape and supernumerary teeth. Enamel hypoplasia was found to affect the permanent central incisor on the cleft side more frequently. Early recognition of tooth abnormalities during the primary dentition phase for an interceptive treatment of potentially severe problems was emphasized.

Primary tooth ankylosis: report of case with histological analysis.

Two primary molars in infraclusion showing clinical and radiographic signs of ankylosis, were subject to histological examination by bright field and polarization microscopy. The roots revealed signs of ongoing resorptive and reparative processes and in some areas dentin with signs of resorption-or repair cementum-were fused with simple lamellar or osteonic bone. These results suggest that ankylosis of primary molars can result from a disturbance of root resorption, with repair processes prevailing over resorptive ones and leading to excessive deposition of bone besides cementum-as a consequence of bone-inductive properties of dentin.

Increased expression of tissue plasminogen activator and its inhibitor and reduced fibrinolytic potential of human endothelial cells cultured in elevated glucose.

In diabetic patients, elevated plasma levels of t-PA and PAI-1 accompany impaired fibrinolysis. To identify mechanisms for these abnormalities, we examined whether vascular endothelial cells exposed to high glucose upregulate t-PA and PAI-1 production and whether ambient PA activity is decreased concomitantly. In 17 cultures of human umbilical vein endothelial cells grown to confluency in 30 mM glucose, the t-PA antigen released to the medium in 24 h was (median) 52 ng/10(6) cells (range 10-384) and the PAI-1 antigen was 872 ng/10(6) cells (range 217-2074)--both greater (P less than 0.02) than the amounts released by paired control cultures grown in 5 mM glucose--29 ng/10(6) cells (range 7.5-216) and 461 ng/10(6) cells (range 230-3215), respectively. In the presence of high glucose, the steady-state levels of t-PA and PAI-1 mRNAs were increased correspondingly (median 142 and 183% of control, respectively, P less than 0.05); high glucose per se and hypertonicity contributed to the upregulation in additive fashion. The PA activity of conditioned medium from cultures exposed to high glucose was 0.4 IU/ml (range 0.2-0.6), which was significantly lower (P less than 0.02) than the PA activity of control medium (0.5 IU/ml, range 0.2-0.9). No difference was observed when comparing the PA activities of acidified conditioned media, expected to be depleted of inhibitors. Thus, high glucose coordinately upregulates endothelial t-PA and PAI-1 expression through effects exerted at the pretranslational level and enhanced by even mild degrees of hypertonicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Microscopical aspects of root resorption of human deciduous teeth.

In order to obtain detailed information on the tissue changes which occur during physiological root resorption, 52 human deciduous teeth at various stages of resorption were studied under light microscopy. The early stage of root resorption was defined as resorption of not more than one third of the root length; the late stage was defined as resorption of more than one third. A close topographical interrelationship was found among che sites of pressure of the permanent tooth, the extent of root resorption and the types of tissue changes. Linear resorption (which reflects suspension or marked slowing down of resorption) and redeposition of hard tissue were more pronounced at the early stage of resorption, while lacunar resorption was more pronounced at the late stage. There were pronounced haemorrhagic and inflammatory infiltrates within the pulp at the late stage of resorption and the subodontoblastic cells disappeared as the infiltrates took over the tooth. False denticles were found frequently, especially at the early stage of resorption. Unexpectedly, acellular cementum was found to be deposited against secondary dentine at the cuspidal tip of the pulp chamber of seven teeth, independently of any sign of resorption nearby. These data indicate that: 1) the pressure exerted by a permanent tooth is the most important factor in the differentiation of odontoclasts. 2) the extent of lacunar (i.e., active) resorption correlates directly with the resorption rate, which is higher at the late stage of root resorption. 3) inflammation is a consequence, rather than a cause, of resorption; it may lead to the loss of subodontoblastic cells and a consequent decrease in the ability of the pulp cells to replace damaged odontoblasts. 4) the pulp of the deciduous tooth might be cementogenic in some way, given that about 13% of the samples were found to be so.

[The transmigration of the permanent lower canine]. / Contributo clinico sulla trasmigrazione del canino inferiore permanente.

A rare dental anomaly--the transmigration--is analysed. This condition, which is sparsely recorded in the literature, typically affects the mandibular canine. Twelve cases in which an unerupted mandibular canine has crossed the midline, are described and discussed. Reference is made to considerations put forward in the past by other Authors on this subject, after which personal conclusions are drawn on the diagnosis, etiology and therapy of this rare but serious behaviour of the mandibular canine. The anomaly can be properly diagnosed only by an attentive radiographic evaluation which is primarily based on the orthopantomogram. A series of successive panoramic radiographs taken over years documents the progressive ectopic movement of an unerupted mandibular canine from its developmental site, through the symphysis of the mandible. Lateral, postero-anterior cephalometric films and periapical radiographs, provide additional important information. After having analysed the most frequent etiological factors of mandibular canine impaction, the authors present their considerations concerning the probable pathogenetic mechanism of transmigration. In addition to the proinclination of the lower incisors and the increasing axial inclination of the unerupted canine, already pointed out by other authors, an enlargement of the symphyseal cross-sectional area has been observed and documented. In conclusion it is important, also from a therapeutical point of view, to keep under control, by periodical panoramic radiographs, all those clinical situations considered at risk due to their possible evolution in transmigration and which are characterized by: 1) an unerupted canine which can be palpated in a mesial position in the labial sulcus; 2) an enlarged symphyseal cross-sectional area; 3) an obstacle to normal eruption (cysts, odontomas, ecc.); 4) a proinclination of the lower incisors. A progressive worsening of the position of the unerupted canine should induce to consider the possibility of an early interception of this anomalous condition, which, once established, results in the definitive impaction of the tooth.

[Cephalometric study of the results of orthodontic treatment of Class III malocclusion]. / Contributo cefalometrico sui risultati del trattamento ortognatodontico delle malocclusioni di III Classe.

It's carried out a research on 60 children, 32 boys and 28 girls, taken from 5-12 of age, affected by Class III malocclusion. All of cases was subdivided in four groups on the ground of the age of orthodontic treatment beginning. Two teleradiographs of each patient were examined, one at the beginning and one at the conclusion of the treatment. About the results reported on the boards, were expressed some considerations on the effects of Class III malocclusions treatment as they result at the cephalometric analysis, in comparison with the starting situation of lack of balance. In every case is pointed out the significance of interception and a more favourable behaviour of cephalometric data in the groups with a earlier beginning of treatment.

Two models for microsimulation of family life cycle and family structure.

PIP: 2 models are proposed for the microsimulation of the family and analysis of family structure and life cycle. These models were devised primarily for teaching purposes. The families are composed of 3 generations (parents, grandparents, children). Cohabitation is not considered. The 1st model is governed by a transition mechanism based on the rules of a Markov multidimensional, nonhonogeneous chain. The 2nd model is based on stochastic point processes. Input data comprise annual mortality probability according to 1) sex, 2) age, 3) civil status, 4) annual probability of 1st marriage, 5) age combinations between the spouses, and 6) the probability of having 1, 2, or 3 children at 6 months intervals from the previous event (marriage or birth of nth child). The applications of the 1st model are presented using 2 mortality and fertility hypotheses (high and low) and a nuptiality hypothesis (West European nature). The various features of family composition are analyzed according to the duration of a couple's marriage and the age of the individual, as well as the characteristic features of the individual and family life cycle given these 2 demographic conditions.^ieng