Use of recommended medications after myocardial infarction in Austria

Guidelines recommend long-term use of beta-blockers (BB), statins, and angiotensin-converting-enzyme-inhibitors or angiotensin-receptor-blockers (ACEI/ARB) after myocardial infarction (MI), but data on their use after discharge are scarce. From Austrian sickness funds claims, we identified all acute MI patients who were discharged within 30 days and who survived ≥120 days after MI in 2004. We ascertained outpatient use of ACEI/ARBs, BBs, statins, and aspirin from all filled prescriptions between discharge and 120 days post MI. Comorbidities were ascertained from use of indicator drugs during the preceding year. Multivariate logistic regression was used to evaluate the independent determinants of study drug use. We evaluated 4,105 MI patients, whose mean age was 68.8 (±13.2) years; 59.5% were men. Within 120 days after MI, 67% filled prescriptions for ACE/ARBs, 74% for BBs, and 67% for statin. While 41% received all these classes and 34% two, 25% of patients received only one or none of these drugs. Older age and presence of severe mental illness were associated with lower use of all drug classes. Diabetics had greater ACEI/ARB use. Fewer BBs were used in patients with obstructive lung disease. Statin use was lower in patients using treatment for congestive heart failure (all P < 0.001). We conclude that recommended medications were underused in Austrian MI survivors. Quality indicators should be established and interventions be implemented to ensure maximum secondary prevention after MI

Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey

BACKGROUND: Nonadherence to immune-modifying therapy is a complex behaviour which, before the COVID-19 pandemic, was shown to be associated with mental health disorders in people with immune-mediated diseases. The COVID-19 pandemic has led to a rise in the global prevalence of anxiety and depression, and limited data exist on the association between mental health and nonadherence to immune-modifying therapy during the pandemic. OBJECTIVES: To assess the extent of and reasons underlying nonadherence to systemic immune-modifying therapy during the COVID-19 pandemic in individuals with psoriasis, and the association between mental health and nonadherence. METHODS: Online self-report surveys (PsoProtectMe), including validated screens for anxiety and depression, were completed globally during the first year of the pandemic. We assessed the association between anxiety or depression and nonadherence to systemic immune-modifying therapy using binomial logistic regression, adjusting for potential cofounders (age, sex, ethnicity, comorbidity) and country of residence. RESULTS: Of 3980 participants from 77 countries, 1611 (40.5%) were prescribed a systemic immune-modifying therapy. Of these, 408 (25.3%) reported nonadherence during the pandemic, most commonly due to concerns about their immunity. In the unadjusted model, a positive anxiety screen was associated with nonadherence to systemic immune-modifying therapy [odds ratio (OR) 1.37, 95% confidence interval (CI) 1.07-1.76]. Specifically, anxiety was associated with nonadherence to targeted therapy (OR 1.41, 95% CI 1.01-1.96) but not standard systemic therapy (OR 1.16, 95% CI 0.81-1.67). In the adjusted model, although the directions of the effects remained, anxiety was not significantly associated with nonadherence to overall systemic (OR 1.20, 95% CI 0.92-1.56) or targeted (OR 1.33, 95% CI 0.94-1.89) immune-modifying therapy. A positive depression screen was not strongly associated with nonadherence to systemic immune-modifying therapy in the unadjusted (OR 1.22, 95% CI 0.94-1.57) or adjusted models (OR 1.14, 95% CI 0.87-1.49). CONCLUSIONS: These data indicate substantial nonadherence to immune-modifying therapy in people with psoriasis during the pandemic, with attenuation of the association with mental health after adjusting for confounders. Future research in larger populations should further explore pandemic-specific drivers of treatment nonadherence. Clear communication of the reassuring findings from population-based research regarding immune-modifying therapy-associated adverse COVID-19 risks to people with psoriasis is essential, to optimize adherence and disease outcomes

CROISSANCE, DEVELOPPEMENT ET QUALITE DES FRUITS DU BANANIER (MUSA SPP GROUPE AAA CV GRANDE NAINE). MODELISATION DE LA REPARTITION DES ASSIMILATS ENTRE LES FRUITS DU REGIME

PARIS-AgroParisTech Centre Paris (751052302) / SudocSudocFranceF

L' heure verte

AIX-MARSEILLE2-BU Pharmacie (130552105) / SudocSudocFranceF

Floral bud damage compensation by branching and biomass allocation in genotypes of Brassica napus with different architecture and branching potential

Plant branching is a key process in the yield elaboration of winter oilseed rape (WOSR). It is also involved in plant tolerance to flower damage because it allows the setting of new fertile inflorescences. Here we characterize the changes in the branching and distribution of the number of pods between primary and secondary inflorescences in response to floral bud clippings. Then we investigate the impacts of the modifications in branching on the biomass allocation and its consequence on the crop productivity (harvest index). These issues were addressed on plants with contrasted architecture and branching potential, using three genotypes (Exocet, Pollen, and Gamin) grown under two levels of nitrogen fertilization. Clipping treatments of increasing intensities were applied to either inflorescences or flower buds.We were able to show that restoration of the number of pods after clipping is the main lever for the compensation. Genotypes presented different behaviors in branching and biomass allocation as a function of clipping treatments. The number of fertile ramifications increased for the high intensities of clipping. In particular, the growth of secondary ramifications carried by branches developed before clipping has been observed. The proportions of yield and of number of pods carried by these secondary axes increased and became almost equivalent to the proportion carried by primary inflorescences. In terms of biomass allocation, variations have also been evidenced in the relationship between pod dry mass on a given axis and the number of pods set, while the shoot/root ratio was not modified. The harvest index presented different responses: it decreased after flower buds clipping, while it was maintained after the clipping of the whole inflorescences. The results are discussed relative to their implications regarding the identification of interesting traits to be target in breeding programs in order to improve WOSR tolerance

Agroecology: biodiversity in agroecosystems to regulate pests and diseases?

Agroecology: biodiversity in agroecosystems to regulate pests and diseases?Agriculture is currently facing yield stability and is causing a negative environmental impact. These two elements call into question the ever increasing use of synthetic inputs. In order to make agroecosystems resilient and autonomous with regard to synthetic inputs, one of the bets of agroecology is to mobilize biodiversity to promote biological regulation. In short, it aims to design agroecosystems capable of self-regulation while remaining sufficiently productive. We will begin by presenting the different meanings of agroecology and our own positioning. Then we will show how leveraging biodiversity is possible by illustrating it at different scales from organ to landscape. Thirdly, we will question the limits or unknowns of these effects and the compromises with respect to other services expected from agroecosystems. In conclusion, we will put these elements in a context of global change and in particular of climate change.Agroécologie : la biodiversité dans les agroécosystèmes pour réguler les bioagresseurs ?L’agriculture fait actuellement face à une stabilité des rendements et est source d’un impact environnemental négatif. Ces deux éléments remettent en cause l’usage toujours en augmentation des intrants de synthèse. Afin de rendre les agroécosystèmes résilients et autonomes vis-à-vis des intrants de synthèse, un des paris de l’agroécologie est de mobiliser la biodiversité pour favoriser les régulations biologiques. En somme elle vise à concevoir des agroécosystèmes capables de s’autoréguler tout en restant suffisamment productifs. Nous commencerons par présenter les différentes acceptions de l’agroécologie et notre propre positionnement. Puis nous montrerons comment l’utilisation du levier que représente la biodiversité est possible en l’illustrant à différentes échelles depuis l’organe jusqu’au paysage. Dans un troisième temps, nous questionnerons les limites voire les inconnus de ces effets et les compromis vis à vis des autres services attendus des agroécosystèmes. En conclusion nous replacerons ces éléments dans un contexte de changement global et en particulier de changement climatique

Pre-harvest growth and development, measured as accumulated degree days, determine the post-harvest green life of banana fruit

We aimed to define a more robust indicator for banana harvest date that ensures an optimal fruit green life (GL). Our hypothesis was that development rather than growth would account for GL more accurately. To this end, five indicators were compared: one related to fruit size (i.e., growth, expressed as the diameter of fruit); two related to fruit age [i.e., development, expressed as the age of fruit measured in the number of days or in degree days (°Cd) from inflorescence emergence]; and two related to metabolism during maturation (i.e., the concentrations of malate and citrate in the pulp). Different treatments (e.g., fruit removal, leaf shading, bunch bagging, defoliation, water deficit, and flooding) were applied to modify the fruit growth rate. On different dates between the emergence of the inflorescence and harvest, fruit GL and the five indicators were measured. The results showed that there was a decreasing exponential relationship between GL and accumulated °Cd from inflorescence emergence (r2 = 0.77). This was more reliable than the relationships between GL and fruit diameter (r2 = 0.39), or between GL and fruit age, expressed in days (r2 = 0.39). Relationships were also established between GL and malate or citrate concentrations, but they were not sufficiently reliable to estimate GL. The results illustrate that GL is related to fruit development, and that °Cd is a more reliable criterion for harvest date than the number of days, or fruit diameter, because it is less sensitive to different fruit growth rates. Banana growers in the French West Indies usually use fruit diameter and age in days to determine harvest date. However, they face problems of fruit ripening during transportation. The use of °Cd as an indicator may help to determine the optimum harvest date more accurately. (Résumé d'auteur