Use of Metformin in the Treatment of Polycystic Ovary Syndrome

Metformin is quite an old drug, but it is optimal for the control of glycemia in Type 2 diabetes. It was reported, 15 years ago, that insulin resistance was abnormally high in most polycystic ovary syndrome (PCOS) patients. Starting from that moment, increasing numbers of studies were performed to demonstrate the efficacy of metformin in controlling and/or modulating several aspects of PCOS, which is the most common cause of menstrual irregularity, inesthetisms and infertility. Metformin induces higher glucose uptake, thus inducing a lower synthesis/secretion of insulin. Such an effect permits the possible restoration of the normal biological functions that are severely affected by the compensatory hyperinsulinemia reactive to the increased peripheral insulin resistance. These are the basis of the many positive effects of this drug, such as the restoration of menstrual cyclicity, ovulatory cycles and fertility, because abnormal insulin levels affect the hypothalamus–pituitary–ovarian function, as well as ..

Intertwined eco-morphodynamic evolution of salt marshes and tidal channels cutting through them

The formation and development of tidal channels and salt marshes are controlled by complex interactions between hydrodynamics, sediment transport, and vegetation dynamics. Tidal channels affect and, at the same time, are affected by the growth of salt marshes fringing them. The coupled evolution of these morphological units is thus a key ingredient for simulating the typical behaviour of tidal environments. We developed a mathematical model accounting for vegetation-induced flow resistance and wetting-drying processes typical of tidal environments, to investigate the eco-morphodynamic evolution of intertidal areas fringing a main channel and of the tidal creeks cutting through them. Model results indicate that vegetation promotes the development of channel networks, leading to more complex channel structures and higher drainage efficiency. Vegetation encroachment influences sediment deposition patterns by trapping sediment in the seaward and middle intertidal areas, while reducing the amount of sediment delivered to landward areas. In the presence of sea level rise, this deficit of sediment enhances the landward-decreasing trend of the intertidal platform and leads to more isolated vegetation patches. Overall, sea level rise restricts the extension of salt marshes and consequently reduces the effect of vegetation on channel development

Intertwined eco-morphodynamic evolution of salt marshes and tidal channels cutting through them

The formation and development of tidal channels and salt marshes are controlled by complex interactions between hydrodynamics, sediment transport, and vegetation dynamics. Tidal channels affect and, at the same time, are affected by the growth of salt marshes fringing them. The coupled evolution of these morphological units is thus a key ingredient for simulating the typical behaviour of tidal environments. We developed a mathematical model accounting for vegetation-induced flow resistance and wetting-drying processes typical of tidal environments, to investigate the eco-morphodynamic evolution of intertidal areas fringing a main channel and of the tidal creeks cutting through them. Model results indicate that vegetation promotes the development of channel networks, leading to more complex channel structures and higher drainage efficiency. Vegetation encroachment influences sediment deposition patterns by trapping sediment in the seaward and middle intertidal areas, while reducing the amount of sediment delivered to landward areas. In the presence of sea level rise, this deficit of sediment enhances the landward-decreasing trend of the intertidal platform and leads to more isolated vegetation patches. Overall, sea level rise restricts the extension of salt marshes and consequently reduces the effect of vegetation on channel development

Intertwined Eco‐Morphodynamic Evolution of Salt Marshes and Emerging Tidal Channel Networks

The formation and development of tidal channels and salt marshes are controlled by complex interactions between hydrodynamics, sediment transport, and vegetation dynamics. Tidal channels affect and, at the same time, are affected by the growth of salt marshes fringing them. The coupled evolution of these morphological units, mediated by vegetation growth, is thus a key ingredient for simulating the behavior of tidal environments. Considering these two factors, we developed a mathematical model to investigate the eco-morphodynamic evolution of intertidal areas fringing a main channel and of the tidal creeks cutting through them. Model results indicate that vegetation promotes the development of channel networks, leading to more complex channel structures and higher drainage efficiency. Vegetation encroachment influences sediment deposition patterns by trapping sediment in the seaward and middle intertidal areas, while reducing the amount of sediment delivered to landward areas. In the presence of sea level rise, this deficit of sediment enhances the landward-decreasing trend of the intertidal platform and leads to more isolated vegetation patches. Overall, sea level rise restricts the extension of salt marshes and consequently reduces the effect of vegetation on channel network form and function

Notational Analysis of Wheelchair Paralympic Table Tennis Matches

Paralympic table tennis is the third largest paralympic sport for the number of players. Performance analysis was conducted for the rally duration and interval and impact of serve, whilst none investigated the shots distribution among classes of physical impairment. Therefore, the purpose of this study was to conduct a notational analysis of international competitions in relation to the wheelchair classes. Five matches for each wheelchair class (C1-to-C5) were evaluated from 20 elite male right-handed players. Both players for each match were analyzed for the following performance indicators: strokes type, the area of ball bouncing, and the shots outcome. Backhand shots were the most used technique for all classes. The most used strokes for C1 players were backhand and forehand drive and backhand lob, while for C5 players they were backhand and forehand push and backhand topspin. Similar shots distribution was registered for C2-to-C5 players. The central and far-from-the-net zone was mainly reached by the serve for all classes. Errors shots were similar in all classes, whilst winning shots were more frequent in C1. The current notational analysis provided a meaningful performance modelling of indicators for coaches and athletes that can be used to design training programs for each class

Oxidative responsiveness to multiple stressors in the key Antarctic species, Adamussium colbecki: interactions between temperature, acidification and cadmium exposure.

Abstract: High-latitude marine ecosystems are ranked to be among the most sensitive regions to climate change since highly stenothermal and specially adapted organisms might be seriously affected by global warming and ocean acidification. The present investigation was aimed to provide new insights on the sensitivity to such environmental stressors in the key Antarctic species, Adamussium colbecki, focussing also on their synergistic effects with cadmium exposure, naturally abundant in this area for upwelling phenomena. Scallops were exposed for 2 weeks to various combinations of Cd (0 and 40 μgL-1), pH (8.05 and 7.60) and temperature (-1 and +1°C). Beside Cd bioaccumulation, a wide panel of early warning biomarkers were analysed in digestive glands and gills including levels of metallothioneins, individual antioxidants and total oxyradical scavenging capacity, onset of oxidative cell damage like lipid peroxidation, lysosomal stability, DNA integrity and peroxisomal proliferation. Results indicated reciprocal interactions between multiple stressors and their elaboration by a quantitative hazard model based on the relevance and magnitude of effects, highlighted a different sensitivity of analysed tissues. Due to cellular adaptations to high basal Cd content, digestive gland appeared more tolerant toward other prooxidant stressors, but sensitive to variations of the metal. On the other hand, gills were more affected by various combinations of stressors occurring at higher temperatur

Occupational Therapists and COVID-19 Pandemic: An Observational Survey in Europe

Background: The COVID-19 pandemic has resulted in a health care emergency in Europe since the first wave in 2020. Several challenges have arisen for occupational therapists, as well as all the health care professionals. The aim of this study was to determine what occupational therapists have changed to adapt their therapeutic processes for this catastrophic situation. Method: An online survey was developed and sent in conjunction with the Council of Occupational Therapy for European Countries (COTEC) to European national associations of occupational therapists. Results: The study was based on a sample of 65 occupational therapists who worked with people with COVID-19. More than half of the occupational therapists (54.8%) had changed departments. The main needs patients expressed (n = 136) during hospitalization were to have social contacts (30.9%), and the main clinical complaints (n = 144) were motor impairment and fatigue (35.4%) and depression (25.7%). The most frequently reported goal (n = 141) was recovery of physical performance and fatigue management (32.6%). Among the emotions mentioned by occupational therapists, negative emotions (76%) were the most common. Conclusion: European occupational therapists demonstrated flexibility and resilience to deal with clinical and organizational challenges during the COVID-19 emergency

Occupational Therapists and COVID-19 Pandemic: An Observational Survey in Europe

Background: The COVID-19 pandemic has resulted in a health care emergency in Europe since the first wave in 2020. Several challenges have arisen for occupational therapists, as well as all the health care professionals. The aim of this study was to determine what occupational therapists have changed to adapt their therapeutic processes for this catastrophic situation. Method: An online survey was developed and sent in conjunction with the Council of Occupational Therapy for European Countries (COTEC) to European national associations of occupational therapists. Results: The study was based on a sample of 65 occupational therapists who worked with people with COVID-19. More than half of the occupational therapists (54.8%) had changed departments. The main needs patients expressed (n = 136) during hospitalization were to have social contacts (30.9%), and the main clinical complaints (n = 144) were motor impairment and fatigue (35.4%) and depression (25.7%). The most frequently reported goal (n = 141) was recovery of physical performance and fatigue management (32.6%). Among the emotions mentioned by occupational therapists, negative emotions (76%) were the most common. Conclusion: European occupational therapists demonstrated flexibility and resilience to deal with clinical and organizational challenges during the COVID-19 emergenc

An interdisciplinary statement of scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT)

BACKGROUND: Delirium is a geriatric syndrome that presents in 1 out of 5 hospitalized older patients. It is also common in the community, in hospices, and in nursing homes. Delirium prevalence varies according to clinical setting, with rates of under 5% in minor elective surgery but up to 80% in intensive care unit patients. Delirium has severe adverse consequences, but despite this and its high prevalence, it remains undetected in the majority of cases. Optimal delirium care requires an interdisciplinary, multi-dimensional diagnostic and therapeutic approach involving doctors, nurses, physiotherapists, and occupational therapists. However, there are still important gaps in the knowledge and management of this syndrome. MAIN BODY: The objective of this paper is to promote the interdisciplinary approach in the prevention and management of delirium as endorsed by a delirium society (European Delirium Association, EDA), a geriatrics society (European Geriatric Medicine Society, EuGMS), a nursing society (European Academy of Nursing Science, EANS), an occupational therapy society (Council of Occupational Therapists for European Countries, COTEC), and a physiotherapy society (International Association of Physical Therapists working with Older People of the World Confederation for Physical Therapy, IPTOP/WCPT). SHORT CONCLUSION: In this paper we have strongly promoted and supported interdisciplinary collaboration underlying the necessity of increasing communication among scientific societies. We have also provided suggestions on how to fill the current gaps via improvements in undergraduate and postgraduate delirium education among European Countries.status: publishe

Left ventricular chamber dilation and filling pressure may help to categorise patients with type 2 diabetes

Type 2 diabetes may alter cardiac structure and function. Many patients with type 2 diabetes have diastolic dysfunction with preserved ejection fraction (EF). Recently, this latter measure was criticised. Thus, this research looked at the impact of left ventricular end-diastolic volume and E/e' ratio variations in patients with type 2 diabetes and preserved EF with the aim to recognise different clinical phenotypes