Efficacy and safety of GLP-1 receptor agonists as add-on to SGLT2 inhibitors in type 2 diabetes mellitus: A meta-analysis

GLP-1 receptor agonists (GLP-1RA) and SGLT2 inhibitors (SGLT2i) have been associated with improved glycemic control, body weight loss and favorable changes in cardiovascular risk factors and outcomes. We conducted a systematic review and meta-analysis to evaluate the effects of the addition of GLP-1RA to SGLT2i in patients with type 2 diabetes mellitus and inadequate glycemic control. Six databases were searched until March 2019. Randomized controlled trials (RCT) with a follow-up of at least 24 weeks reporting on HbA1c, body weight, systolic blood pressure, lipids, achievement of HbA1c < 7%, requirement of rescue therapy due to hyperglycemia and hypoglycemic events were selected. Four RCTs were included. Compared to SGLT2i, the GLP-1RA/SGLT2i combination was associated with greater reduction in HbA1c (−0.74%), body weight (−1.61 kg), and systolic blood pressure (−3.32 mmHg). A higher number of patients achieved HbA1c < 7% (RR = 2.15), with a lower requirement of rescue therapy (RR = 0.37) and similar incidence of hypoglycemia. Reductions in total and LDL cholesterol were found. The present review supports treatment intensification with GLP-1RA in uncontrolled type 2 diabetes on SGLT2i. This drug regimen could provide improved HbA1c control, together with enhanced weight loss and blood pressure and lipids control

Unilateral inferior turbinate hypoplasia caused by a longstanding (approximately 35 yr) nasal foreign body.

We report the unusual case of a 44-year-old man who presented with a plastic foreign body that had been lodged in his right nasal cavity for approximately 35 years. Initial attempts to remove the object were unsuccessful; only after it was broken into several parts was removal achieved. Rigid nasal endoscopy and computed tomography revealed hypoplasia of the ipsilateral inferior turbinate

Spatially Resolved Event-Driven 24 × 24 Pixels SPAD Imager with 100% Duty Cycle for Low Optical Power Quantum Entanglement Detection

Quantum microscopy requires efficient detectors able to identify temporal correlations among photons. Photon coincidences are usually detected by postprocessing their timestamps measured by means of time-To-digital converters (TDCs), through a time and power-consuming procedure, which impairs the overall system performance. In this article, we propose an innovative single-photon sensitive imager based on single-photon avalanche diodes (SPADs), able to signal coincident photon pairs along with their position through a TDC-free, event-driven architecture. The result is a highly efficient detector (25.8%) with a 100% duty cycle and minimized data throughput. The modular architecture and the 330 ns readout time, independent of pixel number, pave the way to large format imagers based on the same paradigm. The detector enabled quantum imaging at extremely low, microwatt-level optical pump powers, four orders of magnitude lower than previous experiments with similar optical setups

DAMEWARE - Data Mining & Exploration Web Application Resource

Astronomy is undergoing through a methodological revolution triggered by an unprecedented wealth of complex and accurate data. DAMEWARE (DAta Mining & Exploration Web Application and REsource) is a general purpose, Web-based, Virtual Observatory compliant, distributed data mining framework specialized in massive data sets exploration with machine learning methods. We present the DAMEWARE (DAta Mining & Exploration Web Application REsource) which allows the scientific community to perform data mining and exploratory experiments on massive data sets, by using a simple web browser. DAMEWARE offers several tools which can be seen as working environments where to choose data analysis functionalities such as clustering, classification, regression, feature extraction etc., together with models and algorithms

Cardiovascular profile improvement during Natalizumab treatment

Cardiovascular comorbidities are associated with the risk of MS progression. Thus, we aim to measure variations of cardiovascular risk factors during Natalizumab treatment and their possible clinical associations. Seventy-one relapsing-remitting MS patients treated with Natalizumab were followed-up during a 12.9 ± 6.2 months. Cardiovascular risk factors were recorded on first and last study visits: systolic blood pressure, uric acid, total cholesterol, LDL, HDL, and triglycerides. EDSS progression and relapse occurrence were recorded. At multilevel mixed-effects linear regression models, the population presented with a significant reduction of total cholesterol (Coeff = -7.340; 95%CI = -13.152--1.527; p = 0.013), and of HDL cholesterol (Coeff = -3.473; 95%CI = -6.333--0.613; p = 0.017), and a non-significant reduction of LDL cholesterol (Coeff = -1.872; 95%CI = -8.481-0.736; p = 0.053), and of triglycerides (Coeff = -8.815; 95%CI = -34.011-5.380; p = 0.094). Uric acid levels increased during the study period (Coeff = 0.159; 95%CI = 0.212-0.340; p = 0.038). No significant associations were found with clinical outcomes. Serum lipids decreased and anti-oxidant uric acid increased during Natalizumab treatment. These biomarkers need to be further explored in relation to clinical outcomes on larger cohorts with longer follow-ups

Italian Health Care System: Methodology Suggestion for the Financial Equilibrium and Essential Level of Care

Italian Regions are the accountable entities for healthcare policies: their activity is not limited to policymaking but includes also management and financing of the Healthcare Public Utilities and services. A first step will be the creation of a dataset of revenues and expenditures of the Healthcare sector. Second, the cofinancing policy will be analyzed using comparative grids of in/out-flows of each Region. Third, it will be taken into account the regional fiscal coverage of the balance deficit. The sample is composed by the Italian Regions. Last the analysis between our theoretical approach based on law and the real economic balance. Furthermore it will be analyzed the National and Regional Healthcare System financing (in)-stability, highlighting current cash flows, sources and investments using the \u201cseparation\u201d of the Healthcare accounting items in the Balance Sheet. Through chi-square test analysis and method of OLS the group of study look a possible relation be-tween balance and respect of lea without finding a relationship. Latter, it will be represented an analysis of the National Health Fund allocation to the Regions. It will be also conducted a critical analysis of the current allocation formula and it will be proposed a simplified criterion of allocation

Low temperature synthesis of photocatalytic mesoporous tio2 nanomaterials

We report the synthesis of mesoporous TiO2 nanostructures based on the decomposition of TiOSO4 in aqueous alkaline solution at room temperature, followed by mild thermal treatment (110◦C) in an oven and suitable to yield up to 40 g of product per batch. The duration of the thermal treatment was found to be crucial to control crystalline phase composition, specific surface area, surface chemistry and, accordingly, the photocatalytic properties of the obtained TiO2 nanocrystals. The thorough investigation of the prepared samples allowed us to explain the relationship between the structure of the obtained nanoparticles and their photocatalytic behavior, that was tested in a model reaction. In addition, the advantage of the mild treatment against a harsher calcination at 450◦C was illustrated. The proposed approach represents a facile and sustainable route to promptly access an effective photocatalyst, thus holding a significant promise for the development of solutions suitable to real technological application in environmental depollution