What neonatal complications should the pediatrician be aware of in case of maternal gestational diabetes?

In the epidemiologic context of maternal obesity and type 2 diabetes (T2D), the incidence of gestational diabetes has significantly increased in the last decades. Infants of diabetic mothers are prone to various neonatal adverse outcomes, including metabolic and hematologic disorders, respiratory distress, cardiac disorders and neurologic impairment due to perinatal asphyxia and birth traumas, among others. Macrosomia is the most constant consequence of diabetes and its severity is mainly influenced by maternal blood glucose level. Neonatal hypoglycemia is the main metabolic disorder that should be prevented as soon as possible after birth. The severity of macrosomia and the maternal health condition have a strong impact on the frequency and the severity of adverse neonatal outcomes. Pregestational T2D and maternal obesity significantly increase the risk of perinatal death and birth defects. The high incidence of maternal hyperglycemia in developing countries, associated with the scarcity of maternal and neonatal care, seriously increase the burden of neonatal complications in these countries

Decarbonizing the cold chain: Long-haul refrigerated deliveries with on-board photovoltaic energy integration

Decarbonizing the cold chain is a priority for sustainability due to the increasing demand for chilled/frozen food and pharmaceutics. Refrigerated transport requires additional fuel for refrigeration other than for traction. Photovoltaic panels on the vehicle rooftop, a battery bank, and a power conversion system can replace the diesel engine driving the transport refrigerated unit. In long-haul deliveries, vehicles cross zones with different climate conditions, which affect both refrigeration requirements and photovoltaic energy conversion. Mandatory driver\u2019s breaks and rest also affect delivery timing and energy consumption. A multiperiod, multizone optimization model is developed to size the onboard photovoltaic system, based on features of the delivery tour. The model is applied to a palletized chilled food delivery from North-Eastern Italy, showing a payback time of around four years, which can drop under two years for expected reduction of component costs. Economic and environmental performances can be increased by also allowing refrigerated products on-board during the return journey, leading to more fuel savings. Photovoltaic-integrated long-haul delivery for frozen products is not convenient at current market costs. Different climate conditions are tested, showing the model ability to act as a decision support tool to foster renewable energy penetration into the cold chain

Screening for cardiovascular disease risk factors beginning in childhood

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Individual detection and intervention on CVD risk factors and behaviors throughout childhood and adolescence has been advocated as a strategy to reduce CVD risk in adulthood. The U.S. National Heart, Lung, and Blood Institute (NHLBI) has recently recommended universal screening of several risk factors in children and adolescents, at odds with several recommendations of the U.S. Services Task Force and of the U.K. National Screening committee. In the current review, we discuss the goals of screening for CVD risk factors (elevated blood pressure, abnormal blood lipids, diabetes) and behaviors (smoking) in children and appraise critically various screening recommendations. Our review suggests that there is no compelling evidence to recommend universal screening for elevated blood pressure, abnormal blood lipids, abnormal blood glucose, or smoking in children and adolescents. Targeted screening of these risk factors could be useful but specific screening strategies have to be evaluated. Research is needed to identify target populations, screening frequency, intervention, and follow-up. Meanwhile, efforts should rather focus on the primordial prevention of CVD risk factors and at maintaining a lifelong ideal cardiovascular health through environmental, policy, and educational approaches

Screening for cardiovascular disease risk factors beginning in childhood

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Individual detection and intervention on CVD risk factors and behaviors throughout childhood and adolescence has been advocated as a strategy to reduce CVD risk in adulthood. The U.S. National Heart, Lung, and Blood Institute (NHLBI) has recently recommended universal screening of several risk factors in children and adolescents, at odds with several recommendations of the U.S. Services Task Force and of the U.K. National Screening committee. In the current review, we discuss the goals of screening for CVD risk factors (elevated blood pressure, abnormal blood lipids, diabetes) and behaviors (smoking) in children and appraise critically various screening recommendations. Our review suggests that there is no compelling evidence to recommend universal screening for elevated blood pressure, abnormal blood lipids, abnormal blood glucose, or smoking in children and adolescents. Targeted screening of these risk factors could be useful but specific screening strategies have to be evaluated. Research is needed to identify target populations, screening frequency, intervention, and follow-up. Meanwhile, efforts should rather focus on the primordial prevention of CVD risk factors and at maintaining a lifelong ideal cardiovascular health through environmental, policy, and educational approaches

The magnitude of nephron number reduction mediates intrauterine growth-restriction-induced long term chronic renal disease in the rat. A comparative study in two experimental models.

Intrauterine growth restriction (IUGR) is a risk factor for hypertension (HT) and chronic renal disease (CRD). A reduction in the nephron number is proposed to be the underlying mechanism; however, the mechanism is debated. The aim of this study was to demonstrate that IUGR-induced HT and CRD are linked to the magnitude of nephron number reduction, independently on its cause. Systolic blood pressure (SBP), glomerular filtration rate (GFR), proteinuria, nephron number, and glomerular sclerosis were compared between IUGR offspring prenatally exposed to a maternal low-protein diet (9% casein; LPD offspring) or maternal administration of betamethasone (from E17 to E19; BET offspring) and offspring with a normal birth weight (NBW offspring). Both prenatal interventions led to IUGR and a similar reduction in birth weight. In comparison to NBW offspring, BET offspring had a severe nephron deficit (-50% in males and -40% in females, p < 0.01), an impaired GFR (-33%, p < 0.05), and HT (SBP+ 17 mmHg, p < 0.05). Glomerular sclerosis was more than twofold higher in BET offspring than in NBW offspring (p < 0.05). Long-term SBP, GFR, and glomerular sclerosis were unchanged in LPD offspring while the nephron number was moderately reduced only in males (-28% vs. NBW offspring, p < 0.05). In this study, the magnitude of nephron number reduction influences long term renal disease in IUGR offspring: a moderate nephron number is an insufficient factor. Extremely long-term follow-up of adults prenatally exposed to glucocorticoids are required

Lower urinary tract dysfunction in Parkinsonian syndromes

Purpose of review: The aim of this review is to outline the clinical presentation, pathophysiology and evaluation of lower urinary tract (LUT) dysfunction in Parkinson’s disease and other parkinsonian syndromes including multiple system atrophy, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal degeneration. // Recent findings: LUT dysfunction commonly occurs in neurological disorders, including patients with parkinsonian syndromes. The pattern of LUT dysfunction and its severity are variable, depending upon the site of lesion within the neural pathways. Parkinsonian syndromes are broadly divided into Parkinson’s disease (PD) and a typical parkinsonian syndromes such as multiple system atrophy (MSA), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Different parkinsonian syndromes have distinct clinical features (e.g. dysautonomia, early dementia, supranuclear gaze palsy, higher cortical signs), and the pattern of LUT dysfunction and its severity can differ. // Conclusions: LUT dysfunction is a common feature in patients with parkinsonian syndromes. Recognising the pattern of LUT dysfunction during the assessment of these patients can help management and possibly facilitate an earlier diagnosis

Active veterinary and entomological surveillance to assess emerging vector-borne disease risk in the Autonomous Province of Bolzano (Italy)

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Three-points interfacial quadrature for geometrical source terms on nonuniform grids

International audienceThis paper deals with numerical (finite volume) approximations, on nonuniform meshes, for ordinary differential equations with parameter-dependent fields. Appropriate discretizations are constructed over the space of parameters, in order to guarantee the consistency in presence of variable cells' size, for which $L^p$-error estimates, $1\le p < +\infty$, are proven. Besides, a suitable notion of (weak) regularity for nonuniform meshes is introduced in the most general case, to compensate possibly reduced consistency conditions, and the optimality of the convergence rates with respect to the regularity assumptions on the problem's data is precisely discussed. This analysis attempts to provide a basic theoretical framework for the numerical simulation on unstructured grids (also generated by adaptive algorithms) of a wide class of mathematical models for real systems (geophysical flows, biological and chemical processes, population dynamics)

Multiple aspect trajectories: A case study on fishing vessels in the northern adriatic sea

In this paper we build, implement and analyze a spatio-temporal database describing the fishing activities in the Northern Adriatic Sea over four years. The database results from the fusion of two complementary data sources: trajectories from fishing vessels (obtained from terrestrial Automatic Identification System, or AIS, data feed) and the corresponding fish catch reports (i.e., the quantity and type of fish caught). We present all the phases of the dataset creation, starting from the raw data and proceeding through data exploration, data cleaning, trajectory reconstruction and semantic enrichment. Moreover, we formalise and compare different techniques to distribute the fish caught by the fishing vessels along their trajectories. We implement the database with MobilityDB, an open source geospatial trajectory data management and analysis platform. Subsequently, guided by our ecological experts, we perform some analyses on the resulting spatio-temporal database, with the goal of mapping the fishing activities on some key species, highlighting all the interesting information and inferring new knowledge that will be useful for fishery management

UAVS TO ASSESS THE EVOLUTION OF EMBRYO DUNES

The balance of a coastal environment is particularly complex: the continuous formation of dunes, their destruction as a result of violent storms, the growth of vegetation and the consequent growth of the dunes themselves are phenomena that significantly affect this balance. This work presents an approach to the long-term monitoring of a complex dune system by means of Unmanned Aerial Vehicles (UAVs). Four different surveys were carried out between November 2015 and November 2016. Aerial photogrammetric data were acquired during flights by a DJI Phantom 2 and a DJI Phantom 3 with cameras in a nadiral arrangement. GNSS receivers in Network Real Time Kinematic (NRTK) mode were used to frame models in the European Terrestrial Reference System. Processing of the captured images consisted in reconstruction of a three-dimensional model using the principles of Structure from Motion (SfM). Particular care was necessary due to the vegetation: filtering of the dense cloud, mainly based on slope detection, was performed to minimize this issue. Final products of the SfM approach were represented by Digital Elevation Models (DEMs) of the sandy coastal environment. Each model was validated by comparison through specially surveyed points. Other analyses were also performed, such as cross sections and computing elevation variations over time. The use of digital photogrammetry by UAVs is particularly reliable: fast acquisition of the images, reconstruction of high-density point clouds, high resolution of final elevation models, as well as flexibility, low cost and accuracy comparable with other available techniques