Low-dose aspirin for primary prevention of cardiovascular events in postmenopausal women with type-2 diabetes: The prescriptive approach in the real world

Background: The long-Term efficacy of low-dose aspirin for primary prevention of cardiovascular (CV) events in postmenopausal women with type-2 diabetes is controversial. Therefore, it is recommended only on an individual basis, recommendation of grade C. Methods: We enrolled 275 consecutive postmenopausal women with type-2 diabetes, without an increased bleeding risk and without preexisting CV disease as coronary artery disease, stroke, and peripheral vascular disease, but with a high risk assessed by score >10%, aged 60-69 years. All were receiving aspirin (75-100 mg daily), aspirin group (AG). 170 postmenopausal women with type-2 diabetes and without preexisting cardiovascular (CV) disease, but not on aspirin treatment, despite a high risk assessed by score >10%, were control group (CG). Mean age was 66 ± 4 years for AG and 65 ± 7 years for CG. Our goal was to identify the prevalence of low-dose aspirin prescriptions in these populations according to different clinical conditions. Results: Women with only high risk were 41/275 (15%) on AG and 72/170 (42.3%) on CG, Chi-squared 41, Odds ratio 0.2, c.i. 95%, P < 0.0001. Women affected by metabolic syndrome were 105/275 (38.1%) on AG and 47/170 (27.6%) on CG, Chi-squared 5.1, Odds ratio 1.6, c.i. 95%, P < 0.02. Women affected by metabolic cardiomyopathy were 111/275 (40.3%) on AG and 44/170 (25.9%) on CG, Chi-squared 8, Odds ratio 1.8, c.i. 95%, P < 0.004. Women affected by diabetic cardiomyopathy were 18/275 (6.6%) on AG and 7/170 (4.2%) on CG, Chi-squared 1.2, Odds ratio 16, c.i. 95%, P < 0.2 n.s. Conclusions: Low-dose aspirin in our population is prescribed preferentially in postmenopausal women with type-2 diabetes when affected by metabolic syndrome or metabolic cardiomyopathy, at the opposite women with only high risk have lower chance to receive aspirin

Switching on the deep brain stimulation: Effects on cardiovascular regulation and respiration.

BACKGROUND: Objective of this study was to evaluate the acute cardiovascular and respiratory effects of switching on the deep brain stimulation in the follow up of nine Parkinson's disease patients with subthalamic nucleus stimulation and six cluster headache patients with posterior hypothalamic area stimulation. METHODS: Systolic and diastolic blood pressure, heart rate, and respiratory rate were monitored continuously during supine rest in both groups. Each patient was assessed in two conditions: resting supine with stimulator off and with stimulator on. RESULTS: In supine resting condition switching on the DBS induced no significant changes (p>0.05) in systolic and diastolic blood pressure as well as in heart rate and respiratory rate, in both groups of patients, either taking 1 min or 10 heartbeats as a sample for analysis. CONCLUSIONS: Switching on the DBS does not modify heart rate, blood pressure nor respiratory rate in both Parkinson and cluster headache patients under resting conditions

Long-term data prove useful to keep track of non-indigenous seaweed fate

The Mar Piccolo of Taranto (southern Italy, Mediterranean Sea), a site of the European LTER network, is a transitional water system, where a century-old intensive mussel farming activity has been carried out, together with an intense import-export business of bivalve mollusks. Previous studies showed that this basinisthirdforNISseaweedintroductionintheMediterraneanSea,aftertheThau LagoonandtheVeniceLagoon.Thepresentpaperdealswiththeresultsof11-year monitoring activity on non-indigenous species (NIS) of seaweeds, which was performed in the Mar Piccolo. In the studied period (2011–2021), two different time frames (i.e., 2011–2015 and 2016–2021) were considered, since they were based on a different number of sampling sites. To investigate spatial and temporal differences in the seaweed assemblage, a multivariate analysis was performed considering the NIS and the most important native species in terms of temporal occurrence. Fourteen NIS were recorded in total in the Mar Piccolo of Taranto duringthisperiod,withvariableabundancesamongsitesandyears:ninespeciesin the firsttimeperiod,andthirteenspeciesinthesecondone.Caulerpacylindracea, recorded with negligible biomass in the first period, was absent in the secondperiod samplings. Molecular analyses confirmed the taxonomy of three species (i.e., Grateloupia minima, Neopyropia koreana, and Polysiphonia morrowii), previously identified only through morphological features. The most abundant specieswasHypneacorona,whichalmostdoubleditsbiomassinthesecondtime period compared to the first one. Three species (i.e., Caulacanthus okamurae, G. minima, and P. morrowii) increased their biomass by an order of magnitude in the second time period. No significant differences were found over years. Site 1 resulted in significant differences among the sites and different seasonal pattern occurred among the investigated sites. No significant long-term changes occurred in the seaweed assemblages, suggesting the absence of strong disturbances due to the settlement of NIS

L'arco cefalico: non tutte le stenosi delle fistole sono uguali

La stenosi dell'arco cefalico rappresenta un'entità unica nel capitolo delle stenosi delle FAV arterovenose in campo dialitico. L'arco cefalico, cioè l'ultimo tratto di vena cefalica prima della sua confluenza nella vena ascellare è sede frequente di stenosi, quasi sempre riscontrabile con fistole prossimali. La presenza di numerose valvole che rispondono con un processo di ipertrofia all'aumento del flusso ematico, la riduzione dello shear stress per l'alterata emodinamica legata alla geometria dell'arco e la rigidità delle strutture che circondano il vaso, rappresentano le principali cause favorenti lo sviluppo della stenosi. La diagnosi è relativamente agevole attraverso un attento esame obiettivo e l'ultrasonografia, ma il trattamento si rivela spesso impegnativo per l'elevata resistenza della lesione alla dilatazione e la tendenza della stenosi alla recidiva. Langioplastica rappresenta la prima opzione terapeutica, ma richiede un'attenta valutazione tecnica nella scelta e nell'utilizzo di palloni ad alta pressione. L'utilizzo di stent o stent-graft costituisce una ulteriore strategia nei casi di recidiva stenotica precoce. La chirurgia può essere considerata una soluzione alternativa ma più ragionevolmente costituisce un approccio successivo e si avvale di interventi di trasposizione della vena o di posizionamento di ponte protesico. La riduzione chirurgica del flusso della FAV può essere razionale nei casi di accesso vascolare ad alta portata. In tutti i casi l'elevata frequenza di recidive impone una stretta sorveglianza della FAV per garantirne la pervietà a distanza

Resultados do monitoramento integrado da colheita da soja na safra 2019/2020 no Paraná

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Efficacy of ginger as antiemetic in children with acute gastroenteritis: a randomised controlled trial

Background: Ginger is a spice with a long history of use as a traditional remedy for nausea and vomiting. No data on the efficacy of ginger are presently available for children with vomiting associated with acute gastroenteritis (AGE). Aim: To test whether ginger can reduce vomiting in children with AGE. Methods: Double-blind, randomised placebo-controlled trial in outpatients aged 1 to 10 years with AGE-associated vomiting randomised to ginger or placebo. The primary outcome was the occurrence of ≥1 episode of vomiting after the first dose of treatment. Severity of vomiting and safety were also assessed. Results: Seventy-five children were randomised to the ginger arm and 75 to the placebo arm. Five children in the ginger arm and 4 in the placebo arm refused to participate in the study shortly after randomisation, leaving 70 children in the ginger arm and 71 in the placebo arm (N = 141). At intention-to-treat analysis (N = 150), assuming that all children lost to follow-up had reached the primary outcome, the incidence of the main outcome was 67% (95% CI 56 to 77) in the ginger group and 87% (95% CI 79 to 94) in the placebo group, corresponding to the absolute risk reduction for the ginger versus the placebo group of −20% (95% CI −33% to −7%, P = 0.003), with a number needed to treat of 5 (95% CI 3 to 15). Conclusion: Oral administration of ginger is effective and safe at improving vomiting in children with AGE. Trial registration: The trial was registered on https://clinicaltrials.gov/ with the identifier NCT02701491

Pessimistic Rescaling and Distribution Shift of Boosting Models for Impression-Aware Online Advertising Recommendation

In this paper, we provide an overview of the approach we used as team Gabibboost for the ACM RecSys Challenge 2023, organized by ShareChat and Moj. The challenge focused on predicting user activity in the online advertising setting based on impression data, in particular, predicting whether a user would install an advertised application using a high-dimensional anonymized feature vector. Our proposed solution is based on an ensemble model that combines the strengths of several machine learning sub-models, including CatBoost, LightGBM, HistGradientBoosting, and two hybrid models. Our proposal is able to harness the strengths of our models through a distribution shift postprocessing and fine-Tune the final prediction via a custom build pessimistic rescaling function. The final ensemble model allowed us to rank 1st on the academic leaderboard and 9th overall

Factors Affecting Infestation by Triatoma infestans in a Rural Area of the Humid Chaco in Argentina: A Multi-Model Inference Approach

Vector-borne transmission of Chagas disease remains a major public health problem in parts of Latin America. Triatoma infestans is the main vector in the countries located in the South American Cone, particularly in the Gran Chaco ecoregion where residual insecticide control has achieved only a moderate, irregular impact. To contribute to improved control strategies, we analyzed the factors associated with the presence and abundance of T. infestans in 327 inhabited houses in a well-defined rural area with no recent vector control interventions in the humid Argentine Chaco. Bugs were found mainly in domiciles, kitchens, storerooms, and chicken coops and nests, particularly where adequate refuge and animal hosts (humans, dogs, cats or poultry) were available. Domiciles constructed from mud were the most often infested, but brick-and-cement domiciles, even in good conditions, were also found infested. Availability of refuge and hosts for T. infestans are key targets for vector control. Ten-fold variations in domestic infestation observed across neighboring villages, and differences in the relevant factors for T. infestans presence with respect to other areas of the Gran Chaco region suggest that host management, building techniques and insecticide use need to be tailored to the local environment, socio-economic characteristics, and climatic conditions

Colorimetric point-of-care detection of Clostridium tyrobutyricum spores in milk samples

Clostridium tyrobutyricum represents the main spoiling agent responsible for late blowing defects (LBD) in hard and semi-hard cheeses. Its spores are resistant to manufacturing procedures and can germinate during the long ripening process, causing the burst of the cheese paste with a consequent undesirable taste. The lower quality of blown cheeses leads to considerable financial losses for the producers. The early identification of spore contaminations in raw milk samples thus assumes a pivotal role in industrial quality control. Herein, we developed a point of care (POC) testing method for the sensitive detection of C. tyrobutyricum in milk samples, combining fast DNA extraction (with no purification steps) with a robust colorimetric loop-mediated isothermal amplification (LAMP) technique. Our approach allows for the sensitive and specific detection of C. tyrobutyricum spores (limit of detection, LoD: ~2 spores/mL), with the advantage of a clear naked-eye visualization of the results and a potential semi-quantitative discrimination of the contamination level. In addition, we demonstrated the feasibility of this strategy using a portable battery-operated device that allowed both DNA extraction and amplification steps, proving its potential for on-site quality control applications without the requirement of sophisticated instrumentation and trained personnel