Patients' wishes, pregnancy and vascular access: When one size does not fit all

Pregnancy in dialysis patients is a rare but important event that challenges our knowledge and demands re-thinking many aspects of our practice, including vascular access. This editorial briefly discusses some open questions on vascular access in this situation that challenge the motto ‘fistula first’ and underline the need for personalised approaches. Information on vascular access in pregnant women is scant. Different approaches may be considered between women on dialysis already on a well-functioning tunnelled catheter and newly placed catheters: while a tunnelled catheter in a woman already stabilised on outpatient dialysis, who has shown being able to take correct care of it and who has freely chosen this option, is a reasonable choice, central venous catheters placed during pregnancy, especially in the hospital setting, may have a high risk of complications. Conversely, pregnancy may increase the risk of development of fistula aneurysms, but the frequency of this complication is still unknown. The problem of whether or not shifting pregnant patients on peritoneal dialysis to daily haemodialysis sessions is still open, as well as the role of patients’ preference for avoidance of an invasive procedure, or refuse of pain. In the wait for answers, reflecting on the problems encountered by pregnant women on dialysis should make us reflect on how to improve vascular access management for all our patients

Intake by Lactating Goats Browsing on Mediterranean Shrubland

In Mediterranean regions goat feeding systems are mainly based on shrubland that contain a wide variety of species. There are only a few equations for predicting feed intake of stall-fed goats (Luo et al., 2004). The objective of this study was to develop a model for predicting the intake of lactating goats browsing on Mediterranean shrubland

Radiopacity of Sodium Zirconium Cyclosilicate in Computed Tomography: a case of a patient with Hyperkalemia and kidney disease

Sodium Zirconium Cyclosilicate (SZC) is commonly used for treating hyperkalemia because it sequesters gastrointestinal potassium ions, thereby reducing serum potassium levels. However, a less-discussed aspect of SZC is its radiopacity on x-ray-based imaging techniques. The European Medicines Agency (EMA) has only vaguely addressed this issue. Radiopaque substances like SZC can interfere with diagnostic imaging, creating challenges for clinicians and radiologists. We present the case of a 34-year-old Italian male to illustrate these concerns

Modulation of the Sympatho-Vagal Balance during Sleep: Frequency Domain Study of Heart Rate Variability and Respiration

Sleep is a complex state characterized by important changes in the autonomic modulation of the cardiovascular activity. Heart rate variability (HRV) greatly changes during different sleep stages, showing a predominant parasympathetic drive to the heart during non-rapid eye movement (NREM) sleep and an increased sympathetic activity during rapid eye movement (REM) sleep. Respiration undergoes important modifications as well, becoming deeper and more regular with deep sleep and shallower and more frequent during REM sleep. The aim of the present study is to assess both autonomic cardiac regulation and cardiopulmonary coupling variations during different sleep stages in healthy subjects, using spectral and cross-spectral analysis of the HRV and respiration signals. Polysomnographic sleep recordings were performed in 11 healthy women and the HRV signal and the respiration signal were obtained. The spectral and cross-spectral parameters of the HRV signal and of the respiration signal were computed at low frequency and at breathing frequency (high frequency, HF) during different sleep stages. Results attested a sympatho-vagal balance shift toward parasympathetic modulation during NREM sleep and toward sympathetic modulation during REM sleep. Spectral analysis of the HRV signal and of the respiration signal indicated a higher respiration regularity during deep sleep, and a higher parasympathetic drive was also confirmed by an increase in the coherence between the HRV and the respiration signal in the HF band during NREM sleep. Our findings about sleep stage-dependent variations in the HRV signal and in the respiratory activity are in line with previous evidences and confirm spectral analysis of the HRV and the respiration signal to be a suitable tool for investigating cardiac autonomic modulation and cardio-respiratory coupling during sleep

Implementation of a multi-approach fake news detector and of a trust management model for news sources

Technological development combined with the evolution of the Internet has made it possible to reach an increasing number of people over the years and given them the opportunity to access information published on the network. The growth in the number of fake news generated daily, combined with the simplicity with which it is possible to share them, has created such a large phenomenon that it has become immediately uncontrollable. Furthermore, the quality with which malicious content is made is increasingly high so even professional experts, such as journalists, have difficulty recognizing which news is fake and which is real. This paper aims to implement an architecture that provides a service to final users that assures the reliability of news providers and the quality of news based on innovative tools. The proposed models take advantage of several Machine Learning approaches for fake news detection tasks and take into account well-known attacks on trust. Finally, the implemented architecture is tested with a well-known dataset and shows how the proposed models can effectively identify fake news and isolate malicious sources

Motivation to donate, job crafting, and organizational citizenship behavior in blood collection volunteers in non-profit organizations

This study assesses the levels of and relationships between the Motivation to donate, Job crafting propensity, and the Organizational citizenship behavior of blood collection volunteers in a non-profit association. An Italian sample of AVIS (the Italian Association of Voluntary Blood donors) blood donors (N = 1215) actively involved in organizing blood collection, were asked to complete the Italian version of the Volunteer Function Index, the Job crafting scale, and the Organizational citizenship behavior scale. The tools were verified by Confirmatory factor analysis and their relationships were explored using Structural equation modeling for hidden variables. The three constructs have overall high scores. Motivation to donate and Job crafting show a clear correlation, with the latter influencing volunteer Organizational citizenship behavior. The study highlights the need to take into consideration the Motivation to donate, Job crafting and Organizational citizenship behavior of volunteers, particularly in countries such as Italy, where blood collection is almost exclusively carried out thanks to spontaneous, altruistic, and disinterested commitment

The effect of parity number on the metabolism, inflammation, and oxidative status of dairy sheep during the transition period.

The objective of this study was to evaluate whether dairy sheep during the transition period are affected by their parity numbers with regard to (1) body weight (BW), body condition score (BCS), and production performance (milk yield and composition) and (2) metabolic, inflammation, and stress biomarkers. For this purpose, 30 Sarda dairy ewes [15 primiparous (PRP) and 15 multiparous (MUP) ewes] were recruited on d 90 of gestation. Each group was homogeneous according to age, BW, and BCS. Sampling was carried out at -60, -30, -7, 0, +30, and +60 d from lambing. The MUP ewes showed a higher BW (46.32 vs. 38.71 kg) and larger litter size (1.45 vs. 1.06 kg) but a lower BCS (2.47 vs. 2.70) than the PRP ewes. Furthermore, the MUP ewes had lower concentrations of glucose (3.49 vs. 4.27 mol/L), cholesterol (1.63 vs. 1.81 mmol/L), free fatty acids (0.47 vs. 0.62 mmol/L), and triglycerides (0.22 vs. 0.25 mmol/L) compared with PRP ewes. With regard to inflammation and oxidative stress parameters, the PRP group had higher haptoglobin (0.48 vs. 0.18 g/L) and paraoxonase (187.90 vs. 152.11 U/L) activity than the MUP group. Overall, the MUP ewes were characterized by greater milk production performance and greater feed intake, resulting in a better energy balance, than the PRP ewes. Interestingly, these findings highlighted a different metabolic and inflammatory response over the transition period between PRP and MUP ewes, with the latter displaying lower concentrations of inflammatory-related biomarkers

DISTRIBUTION OF SPAWNING AND NURSERY GROUNDS FOR DEEP–WATER RED SHRIMPS IN THE CENTRAL WESTERN MEDITERRANEAN SEA

The presence of spawning and nursery grounds of Aristeids in the central western Mediterranean Sea were investigated using fishery-independent data (trawl surveys, 1994–2012). Spatial distributions were generated for mature animals and recruits, for both spring/summer and autumn data, using an inverse distance weighted deterministic interpolation. The persistence index was used to identify stable spawning and nursery grounds in the Sardinian slope region for Aristaeomorpha foliacea and Aristeus antennatus. Areas of aggregation for recruits and mature females appear connected with important physical habitat features. The analysis also suggests a seasonal bathymetric distribution for nursery areas. The recruits of A. foliacea are located in the upper part of the continental slope (377-450 m) in spring-summer and reach greater depths (468-628 m) in autumn. For A. antennatus, for which nursery areas only emerge in autumn, there is presumably an opposite ontogenic migration, from deep sea to upper slope, during the summer (575-681 m). Results indicate also a partial overlap between the nursery and spawning grounds of both species. In this particular areas, local environmental conditions such as upwelling events or the presence of canyons and seamounts seem to play an important role in their distribution. This study generated also relevant information on the spatial and temporal distribution of seasonal or persistent aggregations of spawners and recruits, providing scientific elements to suggest the feasibility of protecting these important resources