Marine sedimentary record of Meltwater Pulse 1a along the NW Barents Sea continental margin

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Climate and landscape composition explain agronomic practices, pesticide use and grape yield in vineyards across Italy

Context Worldwide, organic farming is being promoted as one of the main alternatives to intensive conventional farming. However, the benefits of organic agriculture are still controversial and need to be tested across wide environmental gradients. Objective Here, we carried out an observational study to test how agronomic practices, pest management, environmental impact and yield of conventional and organic vineyards changed along wide climatic and landscape gradients across Italy. Methods We used a block design with 38 pairs of conventional and organic vineyards across Italy. Results and conclusions Most agronomic practices did not differ between conventional and organic vineyards. By contrast, landscape composition and climate were strong predictors of management in both systems. First, increasing semi-natural areas around the vineyards reduced pesticide pressure and related environmental impacts, but was also associated with lower yield. Second, irrespective of the farming system, a warm and dry climate was associated with reduced fungicide pressure. Conventional farming had a yield gain of 40% in cold and wet climate compared to organic but the yield gap disappeared in the warmest regions. Significance In both farming systems, we observed a large variability in management practices that was mainly explained by climate and landscape composition. This large variability should be considered when evaluating the benefits and drawbacks of different farming systems under contrasting environmental contexts

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Agénésie congénitale des incisives latérales maxillaires : évaluation parodontale et fonctionnelle à long terme après fermeture orthodontique de l'espace avec ingression de la première prémolaire et égression de la canine

Introduction : Les objectifs de cette étude sont d'évaluer, sur une période de 10 ans, chez des sujets présentant les agénésies d'une ou de deux incisives latérales maxillaires, l'éventuelle association entre la fermeture de l'espace orthodontique (avec, pour des raisons esthétiques, ingression de la première prémolaire et égression de la canine) et une éventuelle atteinte parodontale et/ou l'apparition d'une symptomatologie articulaire (troubles temporomandibulaires : DTM). Méthodes : Il s'agit d'une étude de cohorte rétrospective concernant des patients traités par le même orthodontiste. Le groupe expérimental avec agénésie comporte 26 sujets adolescents et jeunes adultes (9 hommes, 17 femmes), traités consécutivement par fermeture d'espace. Le groupe contrôle est composé de 32 patients orthodontiques (12 hommes, 20 femmes) présentant une denture complète et pas d'indication d'extractions. Dans le groupe expérimental, les profondeurs de poche et les saignements au sondage sont enregistrés à six endroits pour chacune des 657 dents (3942 sites parodontaux). Des données comparatives sont recueillies pour le groupe témoin au niveau des premières molaires, des prémolaires, canines et incisives latérales maxillaires, soit un total de 264 dents (1584 sites parodontaux). Mobilité et récession gingivale sont également évaluées. Nous avons demandé aux patients des deux groupes de remplir des questionnaires concernant la symptomatologie articulaire. Résultats : L'évaluation de la cavité buccale dans sa globalité dans le groupe « agénésie » montre une bonne santé parodontale, avec des profondeurs de poche au sondage inférieures à 4 mm, de rares sites de saignement et une mobilité normale des premières prémolaires substituées aux canines. On note quelques petites récessions, principalement sur les molaires et les secondes prémolaires. Les comparaisons entre les deux groupes concernant l'augmentation de profondeur de poche (supérieure ou égale à 4 mm) ou l'accroissement de mobilité ne montrent pas de différences statistiquement significatives au niveau des dents maxillaires. On note moins de saignement au sondage au niveau des sites interproximaux dans le groupe expérimental que dans le groupe contrôle, et ce de façon statistiquement significative. Les dents antérieures du groupe expérimental ne présentent pas plus de récession gingivale que dans le groupe contrôle. En outre, nous n'avons observé aucune différence de symptomatologie articulaire entre les deux groupes. Cela pourrait être dû à la petitesse de l'échantillon et/ou aux inconvénients liés à un protocole basé sur des enquêtes. Ainsi, à long terme, la santé des tissus parodontaux et l'incidence des dysfonctionnements ou des signes de DTM sont similaires dans le groupe de fermeture d'espace d'agénésie et dans le groupe témoin des patients bénéficiant de traitement orthodontique sans extraction. Conclusions : La fermeture orthodontique d'espace d'agénésie d'incisive latérale avec ingression de la première prémolaire et égression de la canine ne génère pas de risque de détérioration du tissu parodontal ou de DTM sur le long terme

(Table 2) Radiocarbon dates of sediment cores obtained during Bio Hespérides cruise SVAIS and OGS Explora cruise EGLACOM between 2007-2008

A high-resolution paleomagnetic and rock magnetic study has been carried out on sediment cores collected in glaciomarine silty-clay sequences from the continental shelf and slope of the southern Storfjorden trough-mouth fan, on the northwestern Barents Sea continental margin. The Storfjorden sedimentary system was investigated during the SVAIS and EGLACOM cruises, when 10 gravity cores, with a variable length from 1.03 m to 6.41 m, were retrieved. Accelerator mass spectrometry (AMS) 14C analyses on 24 samples indicate that the cores span a time interval that includes the Holocene, the last deglaciation phase and in some cores the last glacial maximum. The sediments carry a well-defined characteristic remanent magnetization and have a valuable potential to reconstruct the paleosecular variation (PSV) of the geomagnetic field, including relative paleointensity (RPI) variations. The paleomagnetic data allow reconstruction of past dynamics and amplitude of the geomagnetic field variations at high northern latitudes (75°-76° N). At the same time, the rock magnetic and paleomagnetic data allow a high-resolution correlation of the sedimentary sequences and a refinement of their preliminary age models. The Holocene PSV and RPI records appear particularly sound, since they are consistent between cores and they can be correlated to the closest regional stacking curves (UK PSV, FENNOSTACK and FENNORPIS) and global geomagnetic model for the last 7 ka (CALS7k.2). The computed amplitude of secular variation is lower than that outlined by some geomagnetic field models, suggesting that it has been almost independent from latitude during the Holocene