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Background The burden of cardiovascular (CV) complications in patients hospitalised for community-acquired pneumonia (CAP) is still uncertain. Available studies used different designs and different criteria to define CV complications. We assessed the cumulative incidence of acute of CV complications during hospitalisation for CAP in Internal Medicine Units (IMUs). Methods This was a prospective study carried out in 26 IMUs, enrolling patients consecutively hospitalised for CAP. Defined CV complications were: newly diagnosed heart failure, acute coronary syndrome, new onset of supraventricular or ventricular arrhythmias, new onset hemorrhagic or ischemic stroke or transient ischemic attack. Outcome measures were: in-hospital and 30-day mortality, length of hospital stay and rate of 30-day re-hospitalisation. Results A total of 1266 patients were enrolled, of these 23.8% experienced at least a CV event, the majority (15.5%) represented by newly diagnosed decompensated heart failure, and 75% occurring within 3 days. Female gender, a history of CV disease, and more severe pneumonia were predictors of CV events. In-hospital (12.2% vs 4.7%, p p = 0.0001) mortality was higher in patients with CV events, as well as the re-hospitalisation rate (13.3% vs 9.3%, p = 0.002), and mean hospital stay was 11.4 ± 6.9 vs 9.5 ± 5.6 days (p p = 0.009). Conclusion Cardiovascular events are frequent in CAP, and their occurrence adversely affects outcome. A strict monitoring might be useful to intercept in-hospital CV complications for those patients with higher risk profile. Trial registration NCT03798457 Registered 10 January 2019 - Retrospectively registered

Introduction. The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions. Materials and Methods. In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients ( F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded. Results. At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) ( χ 2 10.4; p < 0.001 ), neutrophil-to-lymphocyte (NL) ratio ( χ 2 7.6; p = 0.006 ), and platelet count ( χ 2 5.39; p = 0.02 ), along with age ( χ 2 87.6; p < 0.001 ) and gender ( χ 2 17.3; p < 0.001 ), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a NL ratio > 4.68 was characterized by an odds ratio for in-hospital mortality OR = 3.40 (2.40-4.82), while the OR for a RDW > 13.7 % was 4.09 (2.87-5.83); a platelet count > 166,000 /μL was, conversely, protective (OR: 0.45 (0.32-0.63)). Conclusion. Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment.

In this paper we analyse the effect of constitutional structures over policy outcomes. In particular, we exploit the heterogeneity in parliamentary systems deriving from the presence and the use of the confidence vote to investigate whether stable and unstable parliamentary systems behave differently in terms of the policies they implement. This finer partition of parliamentary systems allows us to identify effects that are more robust than the ones previously discussed in the literature. We show that the difference between presidential and parliamentary systems documented in previous works is driven by a difference between presidential and stable parliamentary systems. We suggest that possible transmission channels are legislative cohesion and (the absence of) selection., SCOPUS: ar.j, info:eu-repo/semantics/published

Motivated by the need to understand voting behaviour under different electoral rules, Laslier etal. (Eur Union Polit, 16(4):601–615, 2015) have conducted an online experiment, the EuroVotePlus experiment, focusing on the effects of the different rules adopted to elect members of the European parliament on voters’ behaviour. The experiment took place in several European countries in the 3 weeks before the 2014 elections for the European Parliament. This paper focuses on the Italian data. Firstly, we show that the behaviour of Italian respondents is consistent with the empirical findings at the European level. Then, we exploit the change from open list to closed list elections implemented in Italy in 1993 to investigate whether and how preferences over institutions are affected by experience. We find that respondents who voted using the open list system in Italy are more likely to prefer closed list systems, and that the effect is stronger the higher the number of open list elections the respondents have faced.

Since it was founded in 1998, the University of Milano-Bicocca has worked to make its structures environmentally, socially, and economically sustainable, not only to reduce the costs and environmental impact of its management processes, but also to promote sustainable behaviour on the part of its employees, lecturers and students. This report focuses on the measures implemented by the university in order to make food consumption and lifestyles healthier and more sustainable. Inspired by nudge theory (according to which in order to achieve a change in behaviour it is necessary to act on indirect encouragement and enablement rather than on direct instruction, enforcement and punishment), these measures aimed to promote healthier and more appropriate styles of food consumption, in particular at university canteens. The interventions were oriented both towards offering healthier products and towards modifying the environment in order to encourage more balanced food choices. The programme of interventions was divided into three phases: firstly an investigation of eating behaviours and lifestyles; secondly planning the interventions; and finally evaluating the project and disseminating good practices

Carbon forms: paths and processes in the Earth is a thematic set of six papers arising from the lectures presented at the Lake Como School, held at Villa del Grumello, Como, Italy (15–20 October 2017), and organized by the Graduate School of Milano Bicocca. This collection of lecture notes focusses on the structure of carbon allotropes, the geodynamics of deep Earth's carbon transport and fixation at mantle conditions, carbon degassing by ascending magmas, and the vast tectonic carbon degassing at the Earth's surface. New science is emerging for carbon, one of the fundamental elements for life, energy, and global climate change on our planet. Carbon is cycled between surface, atmosphere, and oceans. Most of the recyclable carbon is stored deep in the Earth. Ingassing from the atmo-hydrosphere into the mantle occurs by subduction; in the mantle carbon resides in solids such as diamonds and is transported by fluids and melts that migrate upward. Outgassing into the atmosphere is effected by volcanism and tectono-metamorphic soil emissions. The forms and processes of carbon ingassing and outgassing are still poorly constrained. There is as yet no consensus on how and when carbon transforms from solid to fluid …

We prove two results on the generic determinacy of Nash equilibrium in voting games. The first one is for negative plurality games. The second one is for approval games under the condition that the number of candidates is equal to three. These results are combined with the analogous one obtained in De Sinopoli (Games Econ Behav 34:270–286, 2001) for plurality rule to show that, for generic utilities, three of the most well-known scoring rules, plurality, negative plurality and approval, induce finite sets of equilibrium outcomes in their corresponding derived games—at least when the number of candidates is equal to three. This is a necessary requirement for the development of a systematic comparison amongst these three voting rules and a useful aid to compute the stable sets of equilibria Mertens (Math Oper Res 14:575–625, 1989) of the induced voting games. To conclude, we provide some examples of voting environments with three candidates where we carry out this comparison.

In this paper we experimentally investigate the consequences of electoral fraud on voter turnout. The experiment is based on a strategic binary voting model where voters decide whether to cast a costly vote in favour of their preferred candidate or to abstain. The electoral process is illicitly influenced by applying ballot-box stuffing. In the experiment we implement two different framings: we compare voter turnout in a neutral environment and with framed instructions to explicitly replicate elections. This approach enables us to both test the model's predictions and to estimate the framing effects of voting and fraud. Comparison of experimental results with theoretical predictions reveals over-voting, which is exacerbated when fraud occurs. Turnout increases as predicted with a moderate level of fraud while, with higher levels of electoral fraud, voters fail to recognize that the existence of a relatively larger number of “agents” voting with certainty considerably decreases the benefits of voting. Importantly, framing matters, as revealed by the higher turnout of those in the majority group, against which the fraud is applied.

Constitutional structures shape politicians’ behaviour and hence policy outcomes through the different incentives schemes that they generate. In this paper we analyse these mechanisms in parliamentary and presidential systems. The comparison is carried out by analysing how the two systems may select the efficient policy in the presence of asymmetric information. Presidential and parliamentary systems differ in that the policy proposed by the executive in the parliamentary system is confidence-dependent and observable. The main findings suggest that the parliament responds better to the incentive scheme in the presidential system due to the lower uncertainty faced by legislators over their term limit. However, the parliamentary system generates a more efficient behaviour of the executive due to selection and disciplining effects.

We consider a model where policy motivated citizens vote in two simultaneous elections, one for the President who is elected by majority rule, in a single national district, and one for the Congressmen, each of whom is elected by majority rule in a local district. The policy to be implemented depends not only on who is elected President but also on the composition of the Congress. We characterize the equilibria of the model using a conditional sincerity concept that takes into account the possibility that some voters may be simultaneously decisive in both elections. Such a concept emerges naturally in a model with trembles. A crucial feature of the solution is the moderation of Government. Our results are robust to several modifications of the model.

In this paper we show that in a simple spatial model where the government is chosen under strict proportional rule, if the outcome function is a linear combination of parties' positions, with coefficient equal to their shares of votes, essentially only a two-party equilibrium exists. The two parties taking a positive number of votes are the two extremist ones. Applications of this result include an extension of the well-known Alesina and Rosenthal model of divided government as well as a modified version of Besley and Coate's model of representative democracy. © Springer-Verlag 2007. In this paper we show that in a simple spatial model where the government is chosen under strict proportional rule, if the outcome function is a linear combination of parties' positions, with coefficient equal to their share of votes, essentially only a two-party equilibrium exists. The two parties taking a positive number of votes are the two extremist ones. Applications of this result include an extension of the well-known Alesina and Rosenthal model of divided government as well as a modified version of Besley and Coate's model of representative democracy.

We introduce a model with strategic voting in a parliamentary election with proportional representation and uncertainty about the voter’s preferences. In any equilibrium of the model, most of the voters only vote for those parties whose positions are extreme. In the resulting parliament, a consensus government forms and the policy maximizing the sum of utilities of the members of the government is implemented.

We present a simple voting environment with three candidates where the Condorcet winner exists. Under plurality rule, the derived game has a stable set where such a candidate is elected with probability one. However, no stable set of the approval game elects the Condorcet winner with positive probability. We also analyze the robustness of such an example to changes in the number of voters and their preferences. To conclude, we present a generic four-candidate voting environment with the same properties. We present a simple voting environment with three candidates where the Condorcet winner exists. Under plurality rule, the derived game has a stable set where such a candidate is elected with probability one. However, no stable set of the approval game elects the Condorcet winner with positive probability. We also analyze the robustness of such an example to changes in the number of voters and their preferences. To conclude, we present a generic four-candidate voting environment with the same properties

In this paper we propose a model in which there are ideological and strate- gic voters who vote under poportional rule. We prove that the behavior of ideological voters matters for the determination of the outcome. We show that a subset of strategic voters partially counteracts the votes of the ideological voters.

We study the strategic behavior of voters in a spatial model of proportional representation, in which the policy space is multidimensional. Our main finding is that in large electorate, under some assumptions on voters’ preferences, voters essentially vote, in any equilibrium, only for the extreme parties.

We present a model where a society elects a parliament by voting for candidates belonging to two parties. The electoral rule determines the seats distribution between the two parties. We analyze two electoral rules, multidistrict majority and single-district proportional. In this framework, the policy outcome is simply a function of the number of seats parties take in the election. We prove that in both systems there is a unique pure strategy perfect equilibrium outcome. Finally, we compare the outcomes in the two systems.

Most of the voting models limit their analysis to the investigation of symmetric equilibria where "similar" voters make "similar" voting decisions. In this paper we examine the validity of this restriction in a model with costly plurality voting. We first show that in any pure strategy equilibrium every two individuals who have the same preferences and participate in elections, would vote for the same candidate. However, this result does not hold for mixed strategies equilibria. Most of the voting models limit their analysis to the investigation of symmetric equilibria where similar voters make similar voting decisions. In this paper we examine the validity of this restriction in a model with costly plurality voting. We first show that in any pure strategy equilibrium every two individuals who have the same preferences and participate in elections, would vote for the same candidate. However, this result does not hold for mixed strategies equilibria.

In this paper I describe an institutional structure in which there are two branches of the government: the executive one, elected by plurality rule, and the legislative one elected by proportional rule. The resulting policy outcome is described through a compromise between these two branches. Given the presidential result, legislative elections are characterized by essentially an unique Nash equilibrium such that any voter on the left of the corresponding policy outcome votes for the leftist party and any voter on the right votes for the rightist party. Moreover, this equilibrium can be obtained by a process of iterated elimination of dominated strategies. The whole game is then solved by backward induction and dominance arguments. In this paper I describe an institutional structure in which there are two branches of the government: the executive one, elected by plurality rule, and the legislative one elected by proportional rule. The resulting policy outcome is described through a compromise between these two branches. Given the presidential result, legislative elections are characterized by essentially an unique Nash equilibrium such that any voter on the left of the corresponding policy outcome votes for the leftist party and any voter on the right votes for the rightist party. Moreover, this equilibrium can be obtained by a process of iterated elimination of dominated strategies. The whole game is then solved by backward induction and dominance arguments.

This paper considers strategic voters who face an institutional structure in which there are two branches of the government: the executive, elected by plurality rule, and the legislature elected by proportional rule. Policy outcomes are described through a compromise between these two branches. I solve the game by relying only on purely non-cooperative behavior of individual voters. I prove the uniqueness of Nash equilibrium in the legislative subgame, where the election of the president is known. This equilibrium can be obtained by the process of iterated elimination of dominated strategies. I then solve the whole game by backward induction. The results suggest moderate behavior of voters, due to the desire to balance the plurality of a party in the presidential election by voting for the opposite party in the legislature. Similar results can be obtained in the case of reverse timing of the elections, as well as in the case where elections of the two branches of the government are simultaneous

We prove that for generic plurality games with positive cost of voting, the number of Nash equilibria is finite. Furthermore all the equilibria are regular, hence stable sets as singletons.