Gate-Bias Induced RON Instability in p-GaN Power HEMTs

In this letter, we investigate the on-resistance ( RON ) instability in p-GaN power HEMTs induced by a positive or negative gate bias ( VGB ), following the application of a quasi-static initialization voltage ( VGP ) of opposite sign. The transient behavior of this instability was characterized at different temperatures in the 90–135 °C range. By monitoring the resulting drain current transients, the activation energy as well as time constants of the processes are characterized. Not trivially, both RON increase/decrease were found to be thermally activated and with same activation energy. We attribute the thermal activation of both RON increase/decrease to the charging/discharging of hole traps present in the AlGaN barrier in the region below the gate

Patient-reported outcomes in elderly patients with type 2 diabetes mellitus treated with dual oral therapy: a multicenter, observational study from Italy

Objective: To assess patient-reported outcomes after two years of use of dual oral anti-diabetes drug (OAD) therapy in elderly people (≥65 years) with type 2 diabetes mellitus (T2DM) from Italy under real-life settings. Methods: 3-AGE was a prospective, non-interventional study in elderly people with T2DM inadequately controlled on metformin monotherapy (defined as glycated hemoglobin [HbA1c] 7.0–9.0%), in whom a second OAD was prescribed. Primary endpoint was to assess the physical and psychological symptoms associated with T2DM from baseline to 24 months using the Diabetes Symptom Check List revised (DSC-R) questionnaire. Patient's quality of life and health status, treatment satisfaction, consumption of healthcare resources, and physician satisfaction with treatment were also assessed (secondary endpoints) using validated questionnaires. Additionally, safety and clinical characteristics were also evaluated. Results: The mean age of the study population (N = 860) was 71.5 ± 5.2 years. Addition of a second OAD significantly (p p p Conclusion: Addition of a second OAD improved physical and psychological symptoms associated with T2DM and was well tolerated in elderly people under real-life settings

Combined Inclusion of Former Foodstuff and Distiller Grains in Dairy Cows Ration: Effect on Milk Production, Rumen Environment, and Fiber Digestibility

Simple Summary One-third of the global food produced for human consumption is wasted every year. This leads to the wasting of economic, environmental, and social resources. The reallocation of some unconventional agro-industrial by-products, such as former foods or distiller grains, into the animal feed chain, can contribute to increasing the sustainability of livestock production, reducing the need for natural resources such as arable soil, water, fertilisers, and fuels, and consequentially reduce the impact of animal requirements. Many agro-food industrial by-products are already used in animal feeding, but the potential of these feed ingredients has not yet been fully investigated, especially in ruminant nutrition. The aim of the present study was to investigate the effect of the substitution, in dairy cow rations, of traditional protein and starch sources with more sustainable "circular" feeds to increase the sustainability of dairy production. For this purpose, eight multiparous mid-lactating cows were blocked and assigned to one of four treatments and were used in a replicated 4 x 4 Latin squares design with 21-days periods (14 days of adaptation and 7 of data collection). Two different circular feedstuffs were tested: a bakery's former foodstuff (FF) and a wheat distiller's grain with solubles (WDGS). These ingredients were used, alone and in combination, in three experimental diets (FF, WDGS; FF + WDGS) and compared to a standard ration (CTR). Dry matter intake and rumination time were not influenced by these diets. Conversely, dietary treatments partially influenced the milk yield, rumen pH, Volatile Fatty Acids (VFA) production, and fibre digestibility. In particular, the combined inclusion of FF and WDGS increased milk production (37.39 vs. 36.92, 35.48, 35.71 kg/day, for FF, WDGS and CTR diets, respectively) and reduced milk urea content (13.14 vs. 16.19, 15.58, 16.95 mg/dL for FF, WDGS, and CTR diets, respectively). No effects of this association were found in the milk composition, acetic and propionic production, and fibre digestibility. These results suggest that the association of former foodstuff and wheat distillers' grains could be safely included in dairy cow rations to increase the sustainability of cow nutrition and improve milk production without impairing animal health, dry matter intake, and fibre digestibility

Universal proposal strategies of anti-HPV vaccination for adolescents: comparative analysis between school-based and clinic immunization programs.

INTRODUCTION – A promising approach in order to increase adolescents’ adhesion to anti-HPV immunization is the administration of the vaccines within educational institutes. Taranto Local Health Unit experimented two different strategies of universal proposal for the vaccination of 12 year olds: the first is in the traditional call from the clinic while the second involves schools within the territory. The objective of the study is to evaluate the results of these strategies on different genders and different urban contests in order to identify an effective process that can lead to optimal coverage.METHODS – In order to estimate the number of anti-HPV doses administrated to the adolescents of the 2003 cohort, data from the Puglia region’s computerized vaccine registry have been used. Coverages of the anti-HPV vaccinations have been analyzed, dividing these by gender, proposal strategy and district size. Analyses were performed by using STATA SE 14.RESULTS – The multiple logistic regression underlines that female sex (OR = 3.2; p < 0.01), living in a small community  (OR = 1.3; p < 0.01) and school vaccination program (OR = 2; p < 0.01) increase the probability of completing the anti-HPV vaccination cycle in adolescents. The comparative evaluation of the anti-HPV coverage based on proposal strategies, shows that the school vaccination leads to significantly better results compared to the clinic vaccination, for all the groups taken into account (overall 72.3% vs 55.6%)CONCLUSIONS – The involvement of educational institutes can define a winning organization model in order to obtain a bigger adhesion of adolescents to immunization programs, especially for the male sex and in bigger communities

The effects of the exposure to neurotoxic elements on Italian schoolchildren behavior

Neurodevelopmental disorders are constantly increasing on a global scale. Some elements like heavy metals are known to be neurotoxic. In this cross-sectional study we assessed the neurobehavioral effect of the exposure to trace elements including lead, mercury, cadmium, manganese, arsenic and selenium and their interactions among 299 schoolchildren residing in the heavily polluted Taranto area in Italy. Whole blood, urine and hair were collected for metal analyses, while the Child Behavior Checklist and the Social Responsiveness Scale, administered to the main teacher and the mothers were considered to identify behavioral problems in children. Blood lead mainly influenced social problems, aggressive behavior, externalizing and total problems. Urinary arsenic showed an impact on anxiety and depression, somatic problems, attention problems and rule breaking behavior. A significant interaction between lead and arsenic was observed, with a synergistic effect of the two metals increasing the risk of attention problems, aggressive behavior, externalizing problems and total problems. Overall, we were able to test that higher blood lead, urinary arsenic concentrations and their interaction increase the risk of neurobehavioral problems. This is in line with the U.S. Environmental Protection Agency’s priority list of hazardous substances where arsenic and lead are ranked as first and second respectively

Increased carotid IMT in overweight and obese women affected by Hashimoto's thyroiditis: an adiposity and autoimmune linkage?

<p>Abstract</p> <p>Background</p> <p>Hashimoto's thyroiditis is the most important cause of hypothyroidism. It is a systemic disease that can even affect the cardiovascular system, by accelerating the atherosclerotic process. Aim of this study was to examine whether autoimmune thyroiditis has an effect on the intima-media thickness of the common carotid artery (IMT-CCT), independently of the thyroid function and well-known cardiovascular risk factors. Hashimoto's thyroiditis is a systemic disease. The aim is to examine whether autoimmune thyroiditis and adiposity can effect carotid IMT independently of thyroid hormones and cardiovascular risk factors.</p> <p>Methods</p> <p>A total of 104 obese women (BMI ≥ 25.0 kg/m^-2), with FT3 and FT4 serum levels in the normal range and TSH levels < 4.5 μU/ml, were investigated. None of these patients was taking any kind of drug influencing thyroid function. Measurements were made of the IMT-CCT, BMI, waist circumference, blood pressure levels, as well as fasting TSH, FT3, FT4, anti-thyroid antibodies, insulin, fasting glycemia, triglycerides, total and HDL-cholesterol serum concentrations.</p> <p>Results</p> <p>Of the 104 women, 30 (28.8%) were affected by autoimmune thyroiditis. Significantly higher values of IMT-CCT (p < 0.05), TSH (p < 0.05), and triglycerides (p < 0.05) were obtained, and significantly lower values of FT4 (p < 0.05), in patients with Hashimoto's thyroiditis as compared to those with a normal thyroid function. When examining the whole group together, at multiple regression analysis Hashimoto's thyroiditis maintained a positive association with the IMT (p < 0.001), independently of age, hypertension, BMI, and the fasting serum levels of TSH, FT3, FT4, insulin, fasting glycemia, triglycerides, total and HDL-cholesterol levels.</p> <p>Conclusions</p> <p>The present study shows that Hashimoto's thyroiditis is associated to an increased IMT only in overweight and obese, independently of the thyroid function, BMI and cardiovascular risk factors. These results suggest that Hashimoto's thyroiditis is a marker of evolution of the atherosclerosis if combined to adiposity.</p

Spectrum of mutations in Italian patients with familial hypercholesterolemia: New results from the LIPIGEN study

Background Familial hypercholesterolemia (FH) is an autosomal dominant disease characterized by elevated plasma levels of LDL-cholesterol that confers an increased risk of premature atherosclerotic cardiovascular disease. Early identification and treatment of FH patients can improve prognosis and reduce the burden of cardiovascular mortality. Aim of this study was to perform the mutational analysis of FH patients identified through a collaboration of 20 Lipid Clinics in Italy (LIPIGEN Study). Methods We recruited 1592 individuals with a clinical diagnosis of definite or probable FH according to the Dutch Lipid Clinic Network criteria. We performed a parallel sequencing of the major candidate genes for monogenic hypercholesterolemia (LDLR, APOB, PCSK9, APOE, LDLRAP1, STAP1). Results A total of 213 variants were detected in 1076 subjects. About 90% of them had a pathogenic or likely pathogenic variants. More than 94% of patients carried pathogenic variants in LDLR gene, 27 of which were novel. Pathogenic variants in APOB and PCSK9 were exceedingly rare. We found 4 true homozygotes and 5 putative compound heterozygotes for pathogenic variants in LDLR gene, as well as 5 double heterozygotes for LDLR/APOB pathogenic variants. Two patients were homozygous for pathogenic variants in LDLRAP1 gene resulting in autosomal recessive hypercholesterolemia. One patient was found to be heterozygous for the ApoE variant p.(Leu167del), known to confer an FH phenotype. Conclusions This study shows the molecular characteristics of the FH patients identified in Italy over the last two years. Full phenotypic characterization of these patients and cascade screening of family members is now in progress

Familial hypercholesterolemia: The Italian Atherosclerosis Society Network (LIPIGEN)

BACKGROUND AND AIMS: Primary dyslipidemias are a heterogeneous group of disorders characterized by abnormal levels of circulating lipoproteins. Among them, familial hypercholesterolemia is the most common lipid disorder that predisposes for premature cardiovascular disease. We set up an Italian nationwide network aimed at facilitating the clinical and genetic diagnosis of genetic dyslipidemias named LIPIGEN (LIpid TransPort Disorders Italian GEnetic Network). METHODS: Observational, multicenter, retrospective and prospective study involving about 40 Italian clinical centers. Genetic testing of the appropriate candidate genes at one of six molecular diagnostic laboratories serving as nationwide DNA diagnostic centers. RESULTS AND CONCLUSIONS: From 2012 to October 2016, available biochemical and clinical information of 3480 subjects with familial hypercholesterolemia identified according to the Dutch Lipid Clinic Network (DLCN) score were included in the database and genetic analysis was performed in 97.8% of subjects, with a mutation detection rate of 92.0% in patients with DLCN score 656. The establishment of the LIPIGEN network will have important effects on clinical management and it will improve the overall identification and treatment of primary dyslipidemias in Italy

Phorbol esters and beta-adrenergic responsiveness of differentiated adipose precursor cells

Phorbol esters are a well defined group of tumor-promoting substances, which influence the proliferation, the differentiation and the hormonal responsiveness of a wide variety of cell types through the activation of protein-kinase C. Opposite effects have been described on the beta-adrenoceptors and the adenylate cyclase activity, depending on the cell type. Since there is no information about the influence of these substances on lipolysis in adipose precursor cells, the aim of the present study was to examine the effect of 7 days exposure to phorbol esters on the differentiation and the lipolytic responsiveness of rat preadipocytes, cultured in 10% charcoal-treated fetal calf serum. Our results demonstrate that prolonged exposure to these tumor promoters does not influence the differentiation, the beta-adrenoceptors number and the lipolytic response to adenylate cyclase or beta-adrenergic agonists in differentiated cells