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".

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.

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.

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.

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.

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.

First objective association between elevated carbohydrate-deficient transferrin concentrations and alcohol-related traffic accidents.

BACKGROUND: Carbohydrate-deficient transferrin (CDT) is a well-recognized highly specific marker of chronic alcohol abuse. The association of CDT with alcohol-related traffic accidents was evaluated to objectively validate the use of this marker for certifying the physical fitness for driving license regranting after its confiscation for drunk driving. METHODS: The study was carried out on 468 injured drivers (InjDr), who underwent mandatory blood alcohol concentration (BAC) and drug analysis in biological fluids. The InjDr group was divided into 2 subgroups on the basis of BAC legal limit adopted in Italy (BAC ≤ 0.5 g/l: InjDr1 ; BAC >0.5 g/l: InjDr2 ). The control group (CntDr) included 236 subjects holding safety-sensitive job positions and undergoing mandatory toxicological analyses. The determination of BAC in blood and CDT in serum were performed using validated analytical methods based on head-space gas chromatography and high-performance liquid chromatography, respectively. RESULTS: The evaluation of CDT distribution in the 3 groups (CntDr, InjDr1 , InjDr2 ) showed that CDT distribution in the InjDr1 group was similar to that observed in the CntDr group (p = 0.159) and different from that observed in the InjDr2 group (p < 0.001). Partitioning the CDT data of each group into "CDT positives" and "CDT negatives" on the basis of the cut off (1.90%), it was possible to calculate the odds of the 3 groups and then the odds ratios. The odds ratio of InjDr1 versus CntDr was 4.56 (p = 0.158), whereas the odds ratio of InjDr2 versus CntDr was 132 (p < 0.001). Furthermore, a dose-response effect was found only when comparing InjDr2 with CntDr. CONCLUSIONS: The data of the present study strongly support the use of the CDT test to evaluate the risk of a subject to be involved in a road accident while driving under the influence of alcohol.

Cross-modal associations between materic painting and classical Spanish music.

The study analyses the existence of cross-modal associations in the general population between a series of paintings and a series of clips of classical (guitar) music. Because of the complexity of the stimuli, the study differs from previous analyses conducted on the association between visual and auditory stimuli, which predominantly analyzed single tones and colors by means of psychophysical methods and forced choice responses. More recently, the relation between music and shape has been analyzed in terms of music visualization, or relatively to the role played by emotion in the association, and free response paradigms have also been accepted. In our study, in order to investigate what attributes may be responsible for the phenomenon of the association between visual and auditory stimuli, the clip/painting association was tested in two experiments: the first used the semantic differential on a unidimensional rating scale of adjectives; the second employed a specific methodology based on subjective perceptual judgments in first person account. Because of the complexity of the stimuli, it was decided to have the maximum possible uniformity of style, composition and musical color. The results show that multisensory features expressed by adjectives such as "quick," "agitated," and "strong," and their antonyms "slow," "calm," and "weak" characterized both the visual and auditory stimuli, and that they may have had a role in the associations. The results also suggest that the main perceptual features responsible for the clip/painting associations were hue, lightness, timbre, and musical tempo. Contrary to what was expected, the musical mode usually related to feelings of happiness (major mode), or to feelings of sadness (minor mode), and spatial orientation (vertical and horizontal) did not play a significant role in the association. The consistency of the associations was shown when evaluated on the whole sample, and after considering the different backgrounds and expertise of the subjects. No substantial difference was found between expert and non-expert subjects. The methods used in the experiment (semantic differential and subjective judgements in first person account) corroborated the interpretation of the results as associations due to patterns of qualitative similarity present in stimuli of different sensory modalities and experienced as such by the subjects. The main result of the study consists in showing the existence of cross-modal associations between highly complex stimuli; furthermore, the second experiment employed a specific methodology based on subjective perceptual judgments.

The semantics of biological forms.

This study analyses how certain qualitative perceptual appearances of biological forms are correlated with expressions of natural language. Making use of the Osgood semantic differential, we presented the subjects with 32 drawings of biological forms and a list of 10 pairs of connotative adjectives to be put in correlations with them merely by subjective judgments. The principal components analysis made it possible to group the semantics of forms according to two distinct axes of variability: harmony and dynamicity. Specifically, the nonspiculed, nonholed, and flat forms were perceived as harmonic and static; the rounded ones were harmonic and dynamic. The elongated forms were somewhat disharmonious and somewhat static. The results suggest the existence in the general population of a correspondence between perceptual and semantic processes, and of a nonsymbolic relation between visual forms and their adjectival expressions in natural language.

The association between excess weight and comorbidity and self-rated health in the Italian population.

PURPOSE: To evaluate the association of obesity with comorbidity and with subjective health perception in a large sample representative of the Italian population and how the association differs by age and gender. METHODS: Cross-sectional data were obtained from nine waves of the "Multipurpose Household Survey," conducted by the Italian National Institute of Statistics. Self-reported height and weight, six weight-associated diseases and self-rated health (SRH) were evaluated on 352,020 subjects aged 20 to 89 years. Comorbidity was defined as the presence of two or more diseases. RESULTS: The prevalence of comorbidity was significantly different between obese and normal weight subjects in all age categories. SRH was worse in obese subjects than in those of normal weight; this difference persisted, at least in females, into older ages. CONCLUSIONS: Obesity is associated with comorbidity and self-rated health; this association varies across ages and genders. The results found for obese subjects of a given age category were similar to (or worse than) those found for older normal weight subjects of the next age class. For comorbidity, this was true both in males and in females of all the considered age categories; for SRH, this was true in particular for females and younger males.

The hue of shapes.

This article presents an experimental study on the naturally biased association between shape and color. For each basic geometric shape studied, participants were asked to indicate the color perceived as most closely related to it, choosing from the Natural Color System Hue Circle. Results show that the choices of color for each shape were not random, that is, participants systematically established an association between shapes and colors when explicitly asked to choose the color that, in their view, without any presupposition, they saw as the most naturally related to a series of given shapes. The strongest relations were found between the triangle and yellows, and the circle and square with reds. By contrast, the parallelogram was connected particularly infrequently with yellows and the pyramid with reds. Correspondence analysis suggested that two main aspects determine these relationships, namely the "warmth" and degree of "natural lightness" of hues.

Re-assessment of the cut-off levels of Carbohydrate Deficient Transferrin (CDT) for automated immunoassay and multi-capillary electrophoresis for application in a forensic context.

BACKGROUND: The determination of Carbohydrate Deficient Transferrin (CDT) in a forensic context should be based on the use of a screening technique followed, for the "positive samples", by a confirmatory technique. The aim of this study was to compare the two most used automated screening methods for CDT analysis, immuno-nephelometric assay (INA) and multi-capillary electrophoresis (mCE), with a validated HPLC procedure, used as confirmation test, in order to re-evaluate the cut-off concentrations of the screening methods. METHODS: 195 serum samples underwent CDT analysis by using the N Latex CDT direct immuno-nephelometric assay, the multicapillary system Capillarys™ and an anion exchange HPLC method with UV-visible detection at 460nm developed and validated at our laboratories. Statistical analyses were performed by using Bland-Altman plots and ROC curves. RESULTS AND DISCUSSION: The 95% limits of agreement were ±0.94% when comparing INA and HPLC and ±0.60% when comparing mCE and HPLC. The ROC analysis of both INA and mCE, using HPLC as the reference method, showed that no false negative results were found when the cut-off was fixed to 1.2% for mCE and to 2.3% for INA. CONCLUSIONS: The study showed a good agreement among CDT determinations carried out either with mCE or INA or HPLC. However, the usual cut-offs of both mCE (1.3%) and INA (2.5%) should be lowered to minimize false negatives at the screening analysis.

The hue of concepts.

The study shows a systematic naturally biased association between percepts and concepts. Specifically, it shows that a series of terms pertaining to an abstract semantic field (related to the frame of ethics in social behaviour) has a nonrandom, highly significant, association with colours (hues). This is the first time that consistent associations between abstract terms and colours have been reported in the general population. The main hypothesis, ie that there appear to be 'hues of concepts', was borne out by the results: the abstract terms considered were coloured with blue/green (ie cool) colours as well as their synonyms, while their antonyms were coloured with red/yellow (ie warm) colours. The association provides information about the nature of abstract concepts and their relationship with perception. It also sheds light on the interrelations among words in semantic domains that, to date, have been studied from only a computational viewpoint.

Morphological patterns and their colour.

This study analyzed qualitative aspects in perception, particularly the relationship between morphological aspects of biological shapes and colour. The experiment reported by the study assessed the functional relation between shape and colour and, in particular, the relations among the patterns of shapes appearing in perceptual configurations, as well as certain characteristics of colour. Participants were shown 32 natural images and were asked to match them with a colour. The results indicated that some figures were more frequently associated (positively or negatively) with some colours instead of others. Type of shape, texture, and three-dimensionality were important elements in the participants' choices. Rounded figures and non-holed figures had positive matches with red; elongated figures were associated with colours between blue and green; and holed figures showed positive matches with colours between green and yellow. Type of shape and texture also exhibited a relationship with the warmth of the colour.

Prevalence of overweight and obesity in Italy (2001-2008): is there a rising obesity epidemic?

PURPOSE: To provide national, population-based estimates of the prevalence of overweight and obesity in the Italian population. METHODS: Prevalence estimates of overweight and obesity were calculated in seven waves (2001-2008) of the cross-sectional Multipurpose Household Survey organized by the Italian National Institute of Statistics, which are representative of the general adult Italian population. Sampling weights were used to estimate prevalence figures as well as their standard errors. Mean-difference plot was used to evaluate changes in the distribution of body mass index across sex and age categories. RESULTS: Almost half of Italian men and about 1 of 3 Italian women are overweight or obese. Between 2001 and 2008 the age-standardized prevalence of overweight (obesity) increased 1.4% (1.9%) in men and 0.4% (0.5%) in women. Mean-difference plots showed an upward shift for body mass index distribution with an increasing skewness. CONCLUSIONS: The obesity epidemic is one of the major issues in United States and other developed countries. However, if for "epidemic" we mean that in Italy obesity is steadily increasing, then our data give little support to this interpretation. In fact, trends observed between 1983 and 2008 suggest that the rates of changes in the prevalence of overweight and/or obesity are not increasing.