Severe asthma: One disease and multiple definitions

Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans – anteaters, sloths, and armadillos – have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with 24 domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, ten anteaters, and six sloths. Our dataset includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data-paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the south of the USA, Mexico, and Caribbean countries at the northern portion of the Neotropics, to its austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n=5,941), and Cyclopes sp. has the fewest (n=240). The armadillo species with the most data is Dasypus novemcinctus (n=11,588), and the least recorded for Calyptophractus retusus (n=33). With regards to sloth species, Bradypus variegatus has the most records (n=962), and Bradypus pygmaeus has the fewest (n=12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other datasets of Neotropical Series which will become available very soon (i.e. Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans dataset

An Indication of Anisotropy in Arrival Directions of Ultra-high-energy Cosmic Rays through Comparison to the Flux Pattern of Extragalactic Gamma-Ray Sources

A new analysis of the data set from the Pierre Auger Observatory provides evidence for anisotropy in the arrival directions of ultra-high-energy cosmic rays on an intermediate angular scale, which is indicative of excess arrivals from strong, nearby sources. The data consist of 5514 events above 20 EeV with zenith angles up to 80 degrees. recorded before 2017 April 30. Sky models have been created for two distinct populations of extragalactic gamma-ray emitters: active galactic nuclei from the second catalog of hard Fermi-LAT sources (2FHL) and starburst galaxies from a sample that was examined with Fermi-LAT. Flux-limited samples, which include all types of galaxies from the Swift-BAT and 2MASS surveys, have been investigated for comparison. The sky model of cosmic-ray density constructed using each catalog has two free parameters, the fraction of events correlating with astrophysical objects, and an angular scale characterizing the clustering of cosmic rays around extragalactic sources. A maximum-likelihood ratio test is used to evaluate the best values of these parameters and to quantify the strength of each model by contrast with isotropy. It is found that the starburst model fits the data better than the hypothesis of isotropy with a statistical significance of 4.0 sigma, the highest value of the test statistic being for energies above 39 EeV. The three alternative models are favored against isotropy with 2.7 sigma-3.2 sigma significance. The origin of the indicated deviation from isotropy is examined and prospects for more sensitive future studies are discussed

Cardiorespiratory and metabolic determinants during moderate and high resistance exercise intensities until exhaustion using dynamic leg press: comparison with critical load

The objective of this study was to assess cardiovascular, respiratory, and metabolic responses during a commonly used dynamic leg press resistance exercise until exhaustion (TEx) at different intensities and compare with critical load (CL). This was a prospective, cross-sectional, controlled, and crossover study. Twelve healthy young men (23±2.5 years old) participated. The subjects carried out three bouts of resistance exercise in different percentages of 1 repetition maximum (60, 75, and 90% 1RM) until TEx. CL was obtained by means of hyperbolic model and linearization of the load-duration function. During all bout intensities, oxygen uptake (VO2), carbon dioxide production (VCO2), ventilation (VE), and respiratory exchange ratio (RER) were obtained. Variations (peak-rest=Δ) were corrected by TEx. In addition, systolic and diastolic blood pressure (SBP and DBP), blood lactate concentration [La-] and Borg scores were obtained at the peak and corrected to TEx. CL induced greater TEx as well as number of repetitions when compared to all intensities (P<0.001). During CL, Borg/TEx, ΔSBP/TEx, ΔDBP/TEx, and [La-] were significantly lower compared with 90% load (P<0.0001). In addition, VO2, VCO2, VE, and RER were higher during CL when compared to 90 or 75%. TEx was significantly correlated with VO2 on CL (r=0.73, P<0.05). These findings support the theory that CL constitutes the intensity that can be maintained for a very long time, provoking greater metabolic and ventilatory demand and lower cardiovascular and fatigue symptoms during resistance exercise

Severe asthma: One disease and multiple definitions

123noopenIntroduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.restrictedopenBagnasco D.; Paggiaro P.; Latorre M.; Folli C.; Testino E.; Bassi A.; Milanese M.; Heffler E.; Manfredi A.; Riccio A.M.; De Ferrari L.; Blasi F.; Canevari R.F.; Canonica G.W.; Passalacqua G.; Guarnieri G.; Patella V.; Maria Pia F.B.; Carpagnano G.E.; Colle A.D.; Scioscia G.; Gerolamo P.; Puggioni F.; Racca F.; Favero E.; Iannacone S.; Savi E.; Montagni M.; Camiciottoli G.; Allegrini C.; Lombardi C.; Spadaro G.; Detoraki C.; Menzella F.; Galeone C.; Ruggiero P.; Yacoub M.R.; Berti A.; Scichilone N.; Durante C.; Costantino M.T.; Roncallo C.; Braschi M.; D'Adda A.; Ridolo E.; Triggiani M.; Parente R.; Maria D.A.; Verrillo M.V.; Rolla G.; Brussino L.; Frazzetto A.V.; Cristina Z.M.; Lilli M.; Crimi N.; Bonavia M.; Corsico A.G.; Grosso A.; Del Giacco S.; Deidda M.; Ricciardi L.; Isola S.; Cicero F.; Amato G.; Vita F.; Spanevello A.; Pignatti P.; Cherubino F.; Visca D.; Massimo Ricciardolo F.L.; Anna Carriero V.M.; Bertolini F.; Santus P.; Barlassina R.; Airoldi A.; Guida G.; Eleonora N.; Aruanno A.; Rizzi A.; Caruso C.; Colantuono S.; Senna G.; Caminati M.; Arcolaci A.; Vianello A.; Bianchi F.C.; Marchi M.R.; Centanni S.; Luraschi S.; Ruggeri S.; Rinaldo R.; Parazzini E.; Calabrese C.; Flora M.; Cosmi L.; Di Pietro L.; Maggi E.; Pini L.; Macchia L.; Di Bona D.; Richeldi L.; Condoluci C.; Fuso L.; Bonini M.; Farsi A.; Carli G.; Montuschi P.; Santini G.; Conte M.E.; Turchet E.; Barbetta C.; Mazza F.; D'Alo S.; Pucci S.; Caiaffa M.F.; Minenna E.; D'Elia L.; Pasculli C.; Viviano V.; Tarsia P.; Rolo J.; Di Proietto M.; Lo Cicero S.Bagnasco, D.; Paggiaro, P.; Latorre, M.; Folli, C.; Testino, E.; Bassi, A.; Milanese, M.; Heffler, E.; Manfredi, A.; Riccio, A. M.; De Ferrari, L.; Blasi, F.; Canevari, R. F.; Canonica, G. W.; Passalacqua, G.; Guarnieri, G.; Patella, V.; Maria Pia, F. B.; Carpagnano, G. E.; Colle, A. D.; Scioscia, G.; Gerolamo, P.; Puggioni, F.; Racca, F.; Favero, E.; Iannacone, S.; Savi, E.; Montagni, M.; Camiciottoli, G.; Allegrini, C.; Lombardi, C.; Spadaro, G.; Detoraki, C.; Menzella, F.; Galeone, C.; Ruggiero, P.; Yacoub, M. R.; Berti, A.; Scichilone, N.; Durante, C.; Costantino, M. T.; Roncallo, C.; Braschi, M.; D'Adda, A.; Ridolo, E.; Triggiani, M.; Parente, R.; Maria, D. A.; Verrillo, M. V.; Rolla, G.; Brussino, L.; Frazzetto, A. V.; Cristina, Z. M.; Lilli, M.; Crimi, N.; Bonavia, M.; Corsico, A. G.; Grosso, A.; Del Giacco, S.; Deidda, M.; Ricciardi, L.; Isola, S.; Cicero, F.; Amato, G.; Vita, F.; Spanevello, A.; Pignatti, P.; Cherubino, F.; Visca, D.; Massimo Ricciardolo, F. L.; Anna Carriero, V. M.; Bertolini, F.; Santus, P.; Barlassina, R.; Airoldi, A.; Guida, G.; Eleonora, N.; Aruanno, A.; Rizzi, A.; Caruso, C.; Colantuono, S.; Senna, G.; Caminati, M.; Arcolaci, A.; Vianello, A.; Bianchi, F. C.; Marchi, M. R.; Centanni, S.; Luraschi, S.; Ruggeri, S.; Rinaldo, R.; Parazzini, E.; Calabrese, C.; Flora, M.; Cosmi, L.; Di Pietro, L.; Maggi, E.; Pini, L.; Macchia, L.; Di Bona, D.; Richeldi, L.; Condoluci, C.; Fuso, L.; Bonini, M.; Farsi, A.; Carli, G.; Montuschi, P.; Santini, G.; Conte, M. E.; Turchet, E.; Barbetta, C.; Mazza, F.; D'Alo, S.; Pucci, S.; Caiaffa, M. F.; Minenna, E.; D'Elia, L.; Pasculli, C.; Viviano, V.; Tarsia, P.; Rolo, J.; Di Proietto, M.; Lo Cicero, S

Environmental Assessment of Admiralty Bay, King George Island, Antarctica

Monitoring has been developed by Antarctic Programmes such as Antarctic New Zealand (www.antarcticanz.govt.nz) and the US Antarctic Programme (USAP) (http://www.usap.gov) considering expansion of human activities and inevitable environmental.CNPq - 550345/02-7; 550347/02-0; 550348/02-6; 550349/02-2; 550350/02-0; 550351/02-7; 550354/02-6; 550356/02-9; 550357/02-5; 550359/02-8; 550365/02-8; 550368/02-7; 550371/02-8; 550373/02-

Efficacy and safety of pharmacotherapy in cancer-related psychiatric disorders across the trajectory of cancer care: a review

At least 25 – 30% of patients with cancer and an even higher percentage of patients in an advanced phase of illness meet the criteria for a psychiatric diagnosis, including depression, anxiety, stress-related syndromes, adjustment disorders, sleep disorders and delirium. A number of studies have accumulated over the last 35 years on the use of psychotropic drugs as a pillar in the treatment of psychiatric disorders. Major advances in psycho-oncology research have also shown the effi cacy of psychotropic drugs as adjuvant treatment of cancer-related symptoms, such as pain, hot fl ushes, pruritus, nausea and vomiting, fatigue, and cognitive impairment. The knowledge about pharmacokinetics and pharmacodynamics, clinical use, safety, side effects and effi cacy of psychotropic drugs in cancer care is essential for an integrated and multidimensional approach to patients treated in different settings, including community-based centres, oncology, and palliative care. A search of the major databases (MEDLINE, Embase, PsycLIT, PsycINFO, the Cochrane Library) was conducted in order to summarize relevant data concerning the effi cacy and safet