319 research outputs found
Ulcus Vulvae Acutum LipschĂŒtz-UVAL: case series at a Swiss university hospital emergency room.
Ulcus Vulvae Acutum LipschĂŒtz (UVAL) is a largely unknown disease with a broad and complex differential diagnosis.
To provide a description of the main characteristics of UVAL, determine the most appropriate diagnostic process and describe the current therapeutic approach.
We designed a retrospective, descriptive cohort study using the gynecological-ER database of our institution. Inclusion criteria: female patients aged between 10 and 20 years old with suspicion of a UVAL diagnosis at CHUV's gynecological ER. Data extraction: epidemiological characteristics, clinical presentation, laboratory tests, established diagnostics, treatment, and ulcer outcomes.
15 patients were included for the analysis; average age: 15 years old; 60% of patients were virgo at the time of ulcer onset; all patients had at least one flu-like symptom concomitant with the vulvar lesion; the most-performed serology was for EBV and acute disease was present in only one patient; for diagnostic purposes two biopsies were performed with both inconclusive histopathology analysis; the main prescribed treatments were: oral NSAIDs, Paracetamol, and Lidocaine gel; 93% of cases presented signs of regression; the average follow-up time was 10 days. The diagnostic algorithm of Sadoghi et al: 10 out of 15 cases were retrospectively diagnosed with UVAL by the algorithm; half were diagnosed with UVAL, and the other half received a diagnosis of "ulcers of unknown origin" at the time of the gynecological ER visit.
We highly recommend the diagnostic and therapeutic algorithms developed by Sadoghi et al. as valuable tools to guide clinical reasoning and, consequently, improve acute vulvar ulcers management
How well do protected area networks support taxonomic and functional diversity in non-target taxa? The case of Iberian freshwaters
A methodological approach to upscale toward an agroecology system in EU-LAFSs: The case of the parma bio-district
The increasing interest in bio-districts is part of the debate on the capacity to integrate agri-food systems and territory in order to improve the quality of life in rural communities. Considering the goals of developing and promoting an innovative territorial rural development approach, the bio-district can become a process toward a more sustainable model represented by the agroecological agriculture system. The paper presents a case study of the Parma bio-district through the approach of a Localized Agri Food System (LAFS) to verify whether bio-districts can be a tool for scaling up towards agroecology. Stakeholder classification and analysis are conducted using an influence-interest matrix. We identified four groups of stakeholders in relation to their interests and power to influence the process. In the case of the Parma bio-district the role of local institutions in dialogue with consumers and producers' associations is crucial for success. We conclude that bio-districts can be a tool for a scaling-up towards agroecology since they can facilitate a synergetic relation between organic and agroecological agriculture, spreading organic agriculture more widely around the local area. However, the involvement of a wide variety of different stakeholders means that governance is a key element in facilitating "cross fertilization" and preventing the process from becoming purely formulaic
Civil society participation in international governance : the UN and the WTO compared
Civil society participation has become a buzzword in the debate about the legitimacy and accountability of international governance. Many organizations, prominently among them the World Trade Organization (WTO), have come under considerable pressure to open up their policy-making process towards non-state actors. Although the WTO has become more transparent in recent years, direct stakeholder access to its policy making is still denied. This situation is often contrasted with that at the United Nations (UN), where there is (allegedly) much more formally regulated and more substantial participation of civil society. In this paper, we compare the patterns of participation in these two organizations and seek to identify some common dynamics. We present a general framework for analysis based on a model of the policy cycle that allows us to distinguish âpushâ and âpullâ factors that determine cooperation in different phases of policy making. In our empirical study, we find that in the WTO, there are few incentives for the organization itself to pull civil society actors into its policy-making process. Agendasetting is the task of governments; research and analysis is delivered by the Secretariat; compliance control is undertaken jointly by the organization and its members. To push the door to trade policy making open, civil society can only rely on public shaming, that is, threatening to undermine the organizationâs legitimacy as it violates widely accepted standards of good governance. In the UN system, there is in fact more cooperation, but it remains largely limited to the policy phases of agenda-setting, research and analysis and compliance control. Quite like the WTO, the UN protects an intergovernmental core of policy making in which cooperation with civil society remains at the discretion of state parties. Evidence for this are informal and ad hoc ways of collaboration and a lack of participatory rights for non-state actors in the Security Council and the General Assembly. We conclude that studying civil society participation in international public organizations through the lens of the policy cycle can give us a fine-grained picture of cooperative arrangements and enables us to identify potentials for cooperation as well as exclusion. Yet, we also observed two other factors at work that were not really grasped by the model of the policy cycle. First, the institutional culture of organizations can be more or less amenable to civil society. Second, organizations are susceptible to campaigns for âgood governanceâ that invoke standards of due process and may open the door to nonstate actors
A Methodological Approach to Upscale Toward an Agroecology System in EU-LAFSs: The Case of the Parma Bio-District
The increasing interest in bio-districts is part of the debate on the capacity to integrate
agri-food systems and territory in order to improve the quality of life in rural communities. Considering
the goals of developing and promoting an innovative territorial rural development approach, the
bio-district can become a process toward a more sustainable model represented by the agroecological
agriculture system. The paper presents a case study of the Parma bio-district through the approach of a
Localized Agri Food System (LAFS) to verify whether bio-districts can be a tool for scaling up towards
agroecology. Stakeholder classification and analysis are conducted using an influenceâinterest matrix.
We identified four groups of stakeholders in relation to their interests and power to influence the
process. In the case of the Parma bio-district the role of local institutions in dialogue with consumers
and producersâ associations is crucial for success. We conclude that bio-districts can be a tool for a
scaling-up towards agroecology since they can facilitate a synergetic relation between organic and
agroecological agriculture, spreading organic agriculture more widely around the local area. However,
the involvement of a wide variety of dierent stakeholders means that governance is a key element in
facilitating âcross fertilizationâ and preventing the process from becoming purely formulaic
Taxonomic and functional responses of benthic macroinvertebrate communities to hydrological and water quality variations in a heavily regulated river
Aquatic macroinvertebrates are frequently used to evaluate river system conditions and restoration project performance. A better understanding of macroinvertebrate community responses to multiple stressors is a primary challenge for river science. In this paper, macroinvertebrate responses to hydrological and water quality variability were studied in the regulated Oglio River (northern Italy). We hypothesized that in regulated rivers the hydrological, rather than the physico-chemical conditions, would affect macroinvertebrate communities and biomonitoring tools (taxonomic metrics and functional indices). Repeated sampling (six times a year) was performed at four sites downstream of four dams in a 30 km river stretch during 2014 and 2015. Data were analysed using a linear mixed effect framework, to take into account random variation due to site and sampling date, and with multivariate analysis to track changes in community structure. A total of 69 families and 134,693 organisms were identified. The investigated metrics were mainly affected by the coefficient of variation of discharge, minimum discharge, ammonium, and temperature. The short-term dynamics of hydrological and physico-chemical variables were generally less important than the overall random effects as drivers of macroinvertebrate-based metrics. However, the relevance of a random effect (site, time, their interaction) differed depending on the biological metrics analysed. Understanding potential differences in response to short term and short stretch conditions would benefit biomonitoring and restoration procedures in both regulated and natural rivers
Strategies to control antibiotic resistance: Results from a survey in Italian children's hospitals
Desempenho de genótipos de soja nas condiçÔes edafoclimåticas da região Norte do estado do Rio de Janeiro.
Nintedanib targets KIT D816V neoplastic cells derived from induced pluripotent stem cells of systemic mastocytosis
The KIT D816V mutation is found in >80% of patients with systemic mastocytosis (SM) and is key to neoplastic mast cell (MC) expansion and accumulation in affected organs. Therefore, KIT D816V represents a prime therapeutic target for SM. Here, we generated a panel of patient-specific KIT D816V induced pluripotent stem cells (iPSCs) from patients with aggressive SM and mast cell leukemia to develop a patient-specific SM disease model for mechanistic and drug-discovery studies. KIT D816V iPSCs differentiated into neoplastic hematopoietic progenitor cells and MCs with patient-specific phenotypic features, thereby reflecting the heterogeneity of the disease. CRISPR/Cas9n-engineered KIT D816V human embryonic stem cells (ESCs), when differentiated into hematopoietic cells, recapitulated the phenotype observed for KIT D816V iPSC hematopoiesis. KIT D816V causes constitutive activation of the KIT tyrosine kinase receptor, and we exploited our iPSCs and ESCs to investigate new tyrosine kinase inhibitors targeting KIT D816V. Our study identified nintedanib, a US Food and Drug Administration-approved angiokinase inhibitor that targets vascular endothelial growth factor receptor, platelet-derived growth factor receptor, and fibroblast growth factor receptor, as a novel KIT D816V inhibitor. Nintedanib selectively reduced the viability of iPSC-derived KIT D816V hematopoietic progenitor cells and MCs in the nanomolar range. Nintedanib was also active on primary samples of KIT D816V SM patients. Molecular docking studies show that nintedanib binds to the adenosine triphosphate binding pocket of inactive KIT D816V. Our results suggest nintedanib as a new drug candidate for KIT D816V-targeted therapy of advanced SM.Peer reviewe
Impact on Prehospital Delay of a Stroke Preparedness Campaign: A SW-RCT (Stepped-Wedge Cluster Randomized Controlled Trial)
Background and PurposeâPublic campaigns to increase stroke preparedness have been tested in different contexts,
showing contradictory results. We evaluated the effectiveness of a stroke campaign, designed specifically for the Italian
population in reducing prehospital delay.
MethodsâAccording to an SW-RCT (Stepped-Wedge Cluster Randomized Controlled Trial) design, the campaign was
launched in 4 provinces in the northern part of the region Emilia Romagna at 3-month intervals in randomized sequence.
The units of analysis were the patients admitted to hospital, with stroke and transient ischemic attack, over a time period
of 15 months, beginning 3 months before the intervention was launched in the first province to allow for baseline data
collection. The proportion of early arrivals (within 2 hours of symptom onset) was the primary outcome. Thrombolysis
rate and some behavioral end points were the secondary outcomes. Data were analyzed using a fixed-effect model,
adjusting for cluster and time trends.
ResultsâWe enrolled 1622 patients, 912 exposed and 710 nonexposed to the campaign. The proportion of early access
was nonsignificantly lower in exposed patients (354 [38.8%] versus 315 [44.4%]; adjusted odds ratio, 0.81; 95%
confidence interval, 0.60â1.08; P=0.15). As for secondary end points, an increase was found for stroke recognition, which
approximated but did not reach statistical significance (P=0.07).
ConclusionsâOur campaign was not effective in reducing prehospital delay. Even if some limitations of the intervention,
mainly in terms of duration, are taken into account, our study demonstrates that new communication strategies should be
tested before large-scale implementation.
Clinical Trial RegistrationâURL: http://www.clinicaltrials.gov. Unique identifier: NCT01881152
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