Using statistical analyses for improving rating methods for groundwater vulnerability in contamination maps

With the aim of developing procedures coping with the disadvantages and emphasising the advantages of existing rating methods and the use of statistical methods for assessing groundwater vulnerability, we propose to combine the two approaches to perform a groundwater vulnerability assessment in a study area in Italy. In the case study, located in an area of northern Italy with both urban and agricultural sectors, keeping the structure of the DRASTIC rating method, we used a spatial statistical approach to calibrate weights and ratings of a series of variables, potentially affecting groundwater vulnerability. In order to verify the effectiveness of these procedures, the results were compared to a non-modified approach and to the map resulting from the ‘‘Time–Input’’ method, highlighting the advantages that can be obtained, and defining the general limit of these applications. The revised method shows a more realistic distribution of vulnerability classes in accordance with the distribution of wells impacted by high nitrate concentration, demonstrating the importance of taking into account the specific hydrogeological conditions of the area

Respiratory patterns and baroreflex function in heart failure

Little is known on the effects of respiratory patterns on baroreflex function in heart failure (HF). Patients with HF (n = 30, age 61.6 ± 10 years, mean ± SD) and healthy controls (CNT, n = 10, age 58.9 ± 5.6 years) having their R-R interval (RRI, EKG), systolic arterial blood pressure (SBP, Finapres) and respiratory signal (RSP, Respitrace) monitored, were subjected to three recording sessions: free-breathing, fast- (≥ 12 bpm) and slow- (6 bpm) paced breathing. Baroreflex sensitivity (BRS) and power spectra of RRI, SBP, and RSP signals were calculated. During free-breathing, compared to CNT, HF patients showed a significantly greater modulation of respiratory volumes in the very-low-frequency (< 0.04 Hz) range and their BRS was not significantly different from that of CNT. During fast-paced breathing, when very-low-frequency modulations of respiration were reduced, BRS of HF patients was significantly lower than that of CNT and lower than during free breathing. During slow-paced breathing, BRS became again significantly higher than during fast breathing. In conclusion: (1) in free-breathing HF patients is present a greater modulation of respiratory volumes in the very-low-frequency range; (2) in HF patients modulation of respiration in the very-low and low frequency (around 0.1 Hz) ranges contributes to preserve baroreflex-mediated control of heart rate

Accuracy of a CGM Sensor in Pediatric Subjects With Type 1 Diabetes. Comparison of Three Insertion Sites: Arm, Abdomen, and Gluteus

Patients with diabetes, especially pediatric ones, sometimes use continuous glucose monitoring (CGM) sensor in different positions from the approved ones. Here we compare the accuracy of Dexcom\uae G5 CGM sensor in three different sites: abdomen, gluteus (both approved) and arm (off-label)

Clusterization of co-morbidities and multi-morbidities among persons living with HIV: a cross-sectional study

Background: Among people living with HIV (PLWH), the prevalence of non-HIV related co-morbidities is increasing. Aim of the present study is to describe co-morbidity and multi-morbidity, their clustering mode and the potential disease-disease interactions in a cohort of Italian HIV patients. Methods: Cross-sectional analysis conducted by the Coordinamento Italiano per lo Studio di Allergia e Infezioni da HIV (CISAI) on adult subjects attending HIV-outpatient facilities. Non-HIV co-morbidities included: cardiovascular disease, diabetes mellitus, hypertension, oncologic diseases, osteoporosis, probable case of chronic obstructive pulmonary disease (COPD), hepatitis C virus (HCV) infection, psychiatric illness, kidney disease. Multi-morbidity was defined as the presence of two or more co-morbidities. Results: One thousand and eighty-seven patients were enrolled in the study (mean age 47.9 \ub1 10.8). One hundred-ninety patients (17.5%) had no co-morbidity, whereas 285 (26.2%) had one condition and 612 (56.3%) were multi-morbid. The most recurrent associations were: 1) dyslipidemia + hypertension (237, 21.8%); 2) dyslipidemia + COPD (188, 17.3%); 3) COPD + HCV-Ab+ (141, 12.9%). Multi-morbidity was associated with older age, higher body mass index, current and former smoking, CDC stage C and longer ART duration. Conclusions: More than 50% of PLHW were multi-morbid and about 30% had three or more concurrent comorbidities. The identification of common patterns of comorbidities address the combined risks of multiple drug and disease-disease interactions

Historia de la viña y el vino de Uruguay : el vino uruguayo y sus espacios, imagen y consumo (1870-1930). Tomo 3

La vitivinicultura uruguaya es una de las actividades productivas en la que Uruguay ha conquistado un lugar destacado en mercados altamente exigentes y su «estrella» —el vino uruguayo— ha merecido numerosas premiaciones en los certámenes internacionales más importantes. Esta constatación interpela el perfil de su empresariado, tanto en su recorrido histórico como en sus desempeños actuales, sus capacidades para innovar y su voluntad de liderazgo. No deja de llamar la atención que el sector vitivinícola figure en los dos fines de siglo (XIX y XX) como una de las banderas de las «modernizaciones» que sus elites dirigentes se propusieron para el país. Por una parte, el desarrollo de la vitivinicultura se asocia con la diversificación productiva en el agro, la constitución de una fracción de agricultores con cierta capacidad de acumulación, la expansión del mercado interno y el Estado de bienestar. Por otra parte, el viñedo y el vino han incidido en modificar el paisaje ganadero, han propiciado instancias de innovación, y un cierto nivel de cualificación de sus trabajadores. Más recientemente, se ha reparado en su capacidad para acrecer los valores de «patrimonio», conformar espacios productivo-cultural-paisajísticos (terroir) y fomentar el turismo (enoturismo). No puede ignorarse su proyección sobre el diseño y la publicidad, así como en la generación de una cultura un tanto sofisticada que asocia el placer de los sentidos con el conocimiento y el consumo de vinos finos. A su vez, sustenta una red especializada de servicios (revistas para consumidores, catas, asociaciones de enófilos, cursos de degustación), proyectándose con fuerza sobre la gastronomía. Consiguientemente, el tema es relevante socialmente, a nivel de la producción, el intercambio y la culturaPresentación de la Colección Biblioteca Plural, Roberto Markarian. -- Prólogo / Jean-Marie Aurand. -- Prefacio / José María Lez Zecchi. -- Presentación / Alcides Beretta Curi. -- Capítulo 1. Buscando la uva para el vino uruguayo (1): La experiencia del catalán Francesc Vidiella / Alcides Beretta Curi. Anexo: Inventario de la biblioteca técnica de Francesc Vidiella. -- Capítulo 2. Buscando la uva para el vino uruguayo (2): La experiencia del vasco Pascual Harriague / Daniele Bonfanti. -- Capítulo 3. Las bodegas y su equipamiento, fines del siglo XIX y principios del XX (elementos involucrados en la industria derivada e inducida del vino) / Nicol de León. -- Capítulo 4. Los vinos del 900 / Estela de Frutos. -- Capítulo 5. Marco Jurídico / Yanel Gómez Recuero. Anexo: Ley 2.856. -- Capítulo 6. Entre el impulso, la protección y el desinterés un examen de la legislación vitivinícola (1870-1930) / Daniele Bonfanti. -- Capítulo 7. Cartografía de la ingesta de alcoholes / Daniela Bouret Vespa. -- Capítulo 8. El vino en la boca / Daniela Bouret Vespa. -- Capítulo 9. Apuntes para integrar el uso de las imágenes / Daniela Bouret, Fernando Miranda y Gonzalo Vicci. -- Capítulo 10. Paisaje y arquitectura en las primitivas bodegas del Uruguay a fines del siglo XIX / Carlos Altezor. -- Capítulo 11. Bebidas espirituosas de papel (Alcohol, gringos y criollos en la narrativa y la poesía rural, 1890-1950) / Pablo Rocca. -- Fuentes. -- Bibliografía

High frequency of Fredrickson's phenotypes IV and IIb in Brazilians infected by human immunodeficiency virus

BACKGROUND: Human immunodeficiency virus (HIV) infection is very prevalent in Brazil. HIV therapy has been recently associated with coronary heart disease (CHD). Dyslipidemia is a major risk factor for CHD that is frequently described in HIV positive patients, but very few studies have been conducted in Brazilian patients evaluating their lipid profiles. METHODS: In the present work, we evaluated the frequency and severity of dyslipidemia in 257 Brazilian HIV positive patients. Two hundred and thirty-eight (93%) were submitted to antiretroviral therapy (224 treated with protease inhibitors plus nucleoside reverse transcriptase inhibitors, 14 treated only with the latter, 12 naive and 7 had no records of treatment). The average time on drug treatment with antiretroviral therapy was 20 months. None of the patients was under lipid lowering drugs. Cholesterol, triglyceride, phospholipid and free fatty acids were determined by enzymatic colorimetric methods. Lipoprotein profile was estimated by the Friedewald formula and Fredrickson's phenotyping was obtained by serum electrophoresis on agarose. Apolipoprotein B and AI and lipoprotein "a" were measured by nephelometry. RESULTS: The Fredrickson phenotypes were: type IIb (51%), IV (41%), IIa (7%). In addition one patient was type III and another type V. Thirty-three percent of all HIV+ patients presented serum cholesterol levels ≥ 200 mg/dL, 61% LDL-cholesterol ≥ 100 mg/dL, 65% HDL-cholesterol below 40 mg/dL, 46% triglycerides ≥ 150 mg/dL and 10% have all these parameters above the limits. Eighty-six percent of patients had cholesterol/HDL-cholesterol ratio ≥ 3.5, 22% increased lipoprotein "a", 79% increased free fatty acids and 9% increased phospholipids. The treatment with protease inhibitors plus nucleoside reverse transcriptase inhibitors increased the levels of cholesterol and triglycerides in these patients when compared with naïve patients. The HDL-cholesterol (p = 0.01) and apolipoprotein A1 (p = 0.02) levels were inversely correlated with the time of protease inhibitor therapy while total cholesterol levels had a trend to correlate with antiretroviral therapy (p = 0.09). CONCLUSION: The highly varied and prevalent types of dyslipidemia found in Brazilian HIV positive patients on antiretroviral therapies indicate the urgent need for their early diagnosis, the identification of the risk factors for CHD and, when needed, the prompt intervention on their lifestyle and/or with drug treatment

COVID-19 in rheumatic diseases in Italy: first results from the Italian registry of the Italian Society for Rheumatology (CONTROL-19)

OBJECTIVES: Italy was one of the first countries significantly affected by the coronavirus disease 2019 (COVID-19) epidemic. The Italian Society for Rheumatology promptly launched a retrospective and anonymised data collection to monitor COVID-19 in patients with rheumatic and musculoskeletal diseases (RMDs), the CONTROL-19 surveillance database, which is part of the COVID-19 Global Rheumatology Alliance. METHODS: CONTROL-19 includes patients with RMDs and proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) updated until May 3rd 2020. In this analysis, only molecular diagnoses were included. The data collection covered demographic data, medical history (general and RMD-related), treatments and COVID-19 related features, treatments, and outcome. In this paper, we report the first descriptive data from the CONTROL-19 registry. RESULTS: The population of the first 232 patients (36% males) consisted mainly of elderly patients (mean age 62.2 years), who used corticosteroids (51.7%), and suffered from multi-morbidity (median comorbidities 2). Rheumatoid arthritis was the most frequent disease (34.1%), followed by spondyloarthritis (26.3%), connective tissue disease (21.1%) and vasculitis (11.2%). Most cases had an active disease (69.4%). Clinical presentation of COVID-19 was typical, with systemic symptoms (fever and asthenia) and respiratory symptoms. The overall outcome was severe, with high frequencies of hospitalisation (69.8%), respiratory support oxygen (55.7%), non-invasive ventilation (20.9%) or mechanical ventilation (7.5%), and 19% of deaths. Male patients typically manifested a worse prognosis. Immunomodulatory treatments were not significantly associated with an increased risk of intensive care unit admission/mechanical ventilation/death. CONCLUSIONS: Although the report mainly includes the most severe cases, its temporal and spatial trend supports the validity of the national surveillance system. More complete data are being acquired in order to both test the hypothesis that RMD patients may have a different outcome from that of the general population and determine the safety of immunomodulatory treatments

La vitivinicultura uruguaya en la región (1870-2000) : una introducción a estudios y problemas

En 2000 y con apoyo de fondos de la Comisión Sectorial de Investigación Científica de la Universidad de la República, iniciamos un proyecto de investigación sobre la vitivinicultura en el Uruguay, e hicimos los primeros contactos con investigadores en la región. Desde entonces, hemos recorrido una década de trabajo con encuentros periódicos, confrontando resultados, cooperando en algunos emprendimientos conjuntos. Este libro nació en el calor de esos vínculos, académicos pero también humanos, fortalecidos por el entusiasmo que imponen en cada instancia, los investigadores más jóvenes. Paulatinamente se fueron dibujando algunas líneas de trabajo que, próximamente, plasmarán en estudios más ambiciosos e integradores

Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

Dysregulated systemic inflammation is the primary driver of mortality in severe COVID-19 pneumonia. Current guidelines favor a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg·day-1. A comparative RCT with a higher dose and a longer duration of intervention was lacking

Group IV Phospholipase A2α Controls the Formation of Inter-Cisternal Continuities Involved in Intra-Golgi Transport

The enzyme phospholipase A2 (cPLA2α) is involved in the formation of intercisternal tubules that mediate transport of proteins within the Golgi complex