The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Towards Economic Land Evaluation at the Farm Scale Based on Soil Physical-Hydrological Features and Ecosystem Services

The economic evaluation of a land parcel is mainly based on the local economy, as well as on the topography, distance to the main streets, distance to the river, and presence of irrigation. Spatial variability of soil features and functionalities are often left behind during economic land evaluation, probably due to a scarce awareness of soil function’s economic value. The paper shows an approach for economic land evaluation of irrigated croplands in the Po River plain (Northern Italy), based on spatial variability of soil functions, namely biomass production and carbon sequestration, as well as taking into account the river flood risk. The soil spatial variability was mapped using proximal sensing technology and few calibration points (one every 5 hectares). Biomass production of the main crops of the area, namely maize, soybean, and sorghum, was monitored and mapped for three years (2016, 2017, and 2018) using precision agriculture technologies. The results showed that the available water capacity (AWC) reached the highest correlation with biomass production, additionally, soil texture and cation exchange capacity were significantly correlated. Economic evaluation of the land parcels was computed considering the mean land market value of the area, the site-specific deviations due to the spatial variability of the biomass production by capitalization rate, and carbon sequestration soil functions, applying a natural capital approach by the mean annual value of the carbon market. This site-specific methodology could be applied to many other arable lands

Effect of defatted oilseed meals applied as organic fertilizers on vegetable crop production and environmental impact.

Defatted oilseed meals from sunflower (Helianthus annuus L.), and some Brassica species have a wellknown economic value as feed for animals, whilst their value as organic nitrogen fertilizers has been notfully explored so far. Compared to sunflower, the seed meals of Brassica species are reported to have apotentially higher capacity of nutrient supply, due to their lower content of indigestible fiber. The highcontent of glucosinolates may conversely reduce the availability of nitrogen, because of their inhibitoryeffect on nitrification processes.In this lysimetric study we compared the effect of the application of three seed meals: partially defattedmeals of sunflower and of Ethiopian mustard (Brassica carinata A. Braun), and completed defatted meal ofsunflower on the yield and N utilization of three vegetable crops (lettuce, chard and spinach), comparedto an unfertilized control and one fertilized with ammonium nitrate. Furthermore, we also investigatedthe residual effect of fertility of oilseed meal application on winter barley and fallow. Both sunflowermeals revealed a fertilization effect comparable to that of the mineral fertilizer, whilst B. carinata mealreduced the yields of chard and spinach, due to low N availability as shown by the lower N use efficiencyindex. We argue that this lower efficacy of B. carinata meal was due to the technique of the application ofthe meal, that might have produced a high concentration of glucosinolates in the soil layer explored byroots, concurrently determining a significant impact on soil biota and direct phytotoxicity phenomena.A relevant part of the N applied with fertilizers was not absorbed by the three vegetables and henceaccumulated in the soil. Despite the high values of unabsorbed soil N in the plots fertilized with oilseedmeals, nitrate leaching was lower than with ammonium nitrate. The impact on global warming potentialof fertilization with defatted oilseed meals was assessed and shown to be lower than or comparable tothe impact of the synthetic fertilizer. In particular, defatted sunflower meals caused a lower impact perhectare and total biomass, and a similar impact per fresh marketable product.Overall, our findings confirmed the high value of oilseed meals as a sustainable alternative to mineralfertilizers. However, their efficacy strongly depends on the technique of application to the soil

Camelina (Camelina sativa L. Crantz) under low-input management systems in northern Italy: Yields, chemical characterization and environmental sustainability

Camelina can be considered a valuable crop for bio-based products and biofuels, but, to date, there are still many uninvestigated aspects concerning the optimization of its agricultural management and its environmental impact. Consequently, a low-input camelina cultivation has been realized, in northern Italy environment, through a 4-year camelina-wheat rotation in open field. In these conditions, camelina was grown as winter crop. Camelina reached, over the years, a variable (CV=28%) mean seed yield of 0.82 Mg ha–1. This notwithstanding, the oil content - 39.17%. (CV=3%) - and its related quality were rather stable, reaching an oil yield of 320 kg ha–1 particularly rich in omega-3 fatty acids. The low input cultivation system here adopted implied an energy ratio (output energy/input energy) of 4 and a 30% decrease in Global Warming Potential per hectare, compared to the standard value reported by the European Renewable Energy Directive for sunflower, reducing, at the same time, other relevant environmental burdens. However, due to its relatively low oil production, the full use of all camelina co-products should be considered in order to fulfil the sustainability requirements for European jet fuel production. In fact, stability of yields and quality of oil, oilcake and straws makes low-input camelina eligible for many other novel green chemistry applications

Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study

Postural instability (PI) in Parkinson’s disease (PD) exposes patients to an increased risk of falls (RF). While dopaminergic therapy and deep brain stimulation (DBS) improve motor performance in advanced PD patients, their effects on PI and RF remain elusive. PI and RF were assessed using a stabilometric platform in six advanced PD patients. Patients were evaluated in OFF and ON dopaminergic medication and under four DBS settings: with DBS off, DBS bilateral, and unilateral DBS of the more- or less-affected side. Our findings indicate that dopaminergic medication by itself exacerbated PI and RF, and DBS alone led to a decline in RF. No combination of medication and DBS yielded a superior improvement in postural control compared to the baseline combination of OFF medication and the DBS-off condition. Yet, for ON medication, DBS significantly improved both PI and RF. Among DBS conditions, DBS bilateral provided the most favorable outcomes, improving PI and RF in the ON medication state and presenting the smallest setbacks in the OFF state. Conversely, the more-affected side DBS was less beneficial. These preliminary results could inform therapeutic strategies for advanced PD patients experiencing postural disorders

Two Arabidopsis thaliana genes encode functional pectin methylesterase inhibitors

We have identified, expressed and characterized two genes from Arabidopsis thaliana (AtPMEI-1 and AtPMEI-2) encoding functional inhibitors of pectin methylesterases. AtPMEI- 1 and AtPMEI-2 are cell wall proteins sharing many features with the only pectin methylesterase inhibitor (PMEI) characterized so far from kiwi fruit. Both Arabidopsis proteins interact with and inhibit plant-derived pectin methylesterases (PMEs) but not microbial enzymes. The occurrence of functional PMEIs in Arabidopsis indicates that a mechanism of controlling pectin esterification by inhibition of endogenous PMEs is present in di\ua1erent plant species