Long-term prediction of adherence to continuous positive air pressure therapy for the treatment of moderate/severe obstructive sleep apnea syndrome

BACKGROUND: Continuous positive airway pressure (CPAP) therapy is a highly effective treatment for obstructive sleep apnea syndrome (OSAS). However, poor adherence is a limiting factor, and a significant proportion of patients are unable to tolerate CPAP. The aim of this study was to determine predictors of long-term non-compliance with CPAP. METHODS: CPAP treatment was prescribed to all consecutive patients with moderate or severe OSAS (AHI ≥15 events/h) (n = 295) who underwent a full-night CPAP titration study at home between February 1, 2002 and December 1, 2016. Adherence was defined as CPAP use for at least 4 h per night and five days per week. Subjects had periodical follow-up visits including clinical and biochemical evaluation and assessment of adherence to CPAP. RESULTS: Median follow-up observation was 74.8 (24.2/110.9) months. The percentage of OSAS patients adhering to CPAP was 41.4% (42.3% in males and 37.0% in females), and prevalence was significantly higher in severe OSAS than in moderate (51.8% vs. 22.1%; p < 0.001; respectively). At multivariate analysis, lower severity of OSAS (HR = 0.66; CI 95 0.46-0.94) p < 0.023), cigarette smoking (HR = 1.72; CI 95 1.13-2.61); p = 0.011), and previous cardiovascular events (HR = 1.95; CI 95 1.03-3.70; p = 0.04) were the only independent predictors of long-term non-adherence to CPAP after controlling for age, gender, and metabolic syndrome. CONCLUSIONS: In our cohort of patients with moderate/severe OSAS who were prescribed CPAP therapy, long-term compliance to treatment was present in less than half of the patients. Adherence was positively associated with OSAS severity and negatively associated with cigarette smoking and previous cardiovascular events at baseline

Prediction of milk, fat and protein yields in first lactation from serum ß-lactoglobulin concentrations during gestation in Italian Brown heifers

The Authors report the results of a study carried out on 23 pregnant Italian Brown heifers, with the aim to determine the relationships between blood serum ß-lactoglobulin (ß-LG) concentrations during first gestation and subsequent milk production and quality in first lactation, in order to obtain an improved selection method for replacement heifers. At weeks 20, 26 and 32 of gestation, ß-LG concentrations (±SE) were 706±78, 753±66 and 772±63 ng/ml, respectively (P>0.05). High and significant (P≤0.05) correlation coefficients were observed only between ß-LG content at week 32 and total milk and protein yields in first lactation. Prediction equations of milk, fat and protein production in first lactation from log10 ß-LG content at week 32 of gestation, from parent average genetic indexes and from both were calculated by means of multiple regression analysis. When the contribution of both ß-LG content and predicted genetic indexes were considered, the regression equations gave generally a better estimate of the production parameters in first lactation (higher R2, lower SE of estimate) than the above mentioned parameters alone. These results suggest that it is valuable to pre-estimate milk, fat and protein production in Italian Brown first lactating cows by means of the analysis of serum ß-LG content during gestation

Avaliação dos impactos econômico, social e ambiental do uso da alfafa em sistemas de produção de leite.

Foram avaliados os impactos econômico, social e ambiental do uso da alfafa na produção de leite. Compararam-se dois sistemas de produção: a) confinamento com fornecimento de silagem de milho (seca) e pastejo rotacionado de forrageira tropical (chuvas); b) pastejo rotacionado de alfafa e suplementação com silagem de milho (seca), e pastejo rotacionado de alfafa e de forrageira tropical (chuvas). Utilizou-se a metodologia do sistema Ambitec, composto por indicadores sociais e ambientais agrupados em planilhas eletrônicas. Na análise econômica calculou-se o custo operacional efetivo (COE), do custo operacional total (COT), do custo total de produção (CT) e do lucro operacional (LO). Utilizou-se a análise de probabilidade para avaliar o risco econômico da adoção da tecnologia, por meio de uma função de lucro operacional. Os coeficientes técnicos utilizados foram fornecidos por pesquisadores da Embrapa Pecuária Sudeste, com dados da unidade de demonstração da tecnologia, e por técnicos extensionistas e produtores rurais, com dados de propriedades dos Estados do PR e de SP. A tecnologia teve índice de 1,76 para o impacto social e índice de 0,43 para o impacto ambiental. O uso da alfafa reduziu em 40% o consumo de silagem de milho na estação seca e possibilitou a redução de 8% no teor de proteína bruta do concentrado, sem prejuízo da produção média das vacas em lactação (25 L/vaca.dia em ambos os sistemas). A introdução da alfafa na dieta (20% do consumo de matéria seca) reduziu em 9% e 7% o COE e o COT de produção de leite, respectivamente. Na análise de risco, o sistema sem alfafa teve LO de R$/L 0,26 (19,2$/L 0,26)

Arthropod biodiversity associated to Europen sheep production systems

The rural territories linked to European sheep systems still cover wide areas and provide multiple ecosystems services although the current situation of the associated biodiversity is not fully understood. In this study the foliage arthropods (including pollinators), the vegetation cover and height, the number of flowers and plant species richness were evaluated in 9 sheep grazed lands from 5 EU countries with different livestock management strategies and dominant vegetation. The total abundance of arthropods, the abundance of Diptera and Heteroptera, sward height and plant species richness were higher in more extensive than in more intensively managed farms. The total abundance and the abundance of most of the orders were highest in mountain areas (MP) and lowest in improved pastures (IMP) whereas the total arthropod richness showed no differences and the richness of pollinators was lower in IMP than in MP (p < 0.01) and semi-natural pastures (SN, p < 0.01). The grass cover was higher in IMP than in the rest of the areas whereas forb cover was higher in SN than in IMP (p < 0.01). The plant species richness peaked in MP whereas the number of flowers showed no significant differences. Sward height correlated positively with forb cover, plant species richness, the richness of the whole arthropod community, the abundance of several orders like Araneae, Diptera or Homoptera, as well as with the richness of the pollinator community. The community composition of the total arthropod fauna (p < 0.01) and the pollinators in particular (p < 0.05) differed between management strategies and more diverse groups were linked to the areas under more extensive management. Both communities (total and pollinators) also differed in composition between the types of vegetation (p < 0.01) and less diverse assemblages with low abundant taxa were associated to IMP and SN whereas more diverse groups were linked to MP and grassland-forest (WP) in both cases. A better understanding of the flora-fauna dynamics in sheep grazed pasturelands is essential for the proper conservation of the biodiversity and other ecosystem services, as well as for the maintenance of sustainable sheep systems relying on the natural resources

Infrared, UV/VIS and Raman Spectroscopy of Comet Wild-2 Samples Returned by the Stardust Mission

Results from the preliminary examination of Stardust samples obtained using various spectroscopic methods will be presented

Opportunistic screening for type 2 diabetes in community pharmacies. Results from a region-wide experience in Italy

BACKGROUND AND AIMS:Given the paucity of symptoms in the early stages of type 2 diabetes, its diagnosis is often made when complications have already arisen. Although systematic population-based screening is not recommended, there is room to experience new strategies for improving early diagnosis of the disease in high risk subjects. We report the results of an opportunistic screening for diabetes, implemented in the setting of community pharmacies. METHODS AND RESULTS:To identify people at high risk to develop diabetes, pharmacists were trained to administer FINDRISC questionnaire to overweight, diabetes-free customers aged 45 or more. Each interviewee was followed for 365 days, searching in the administrative database whether he/she had a glycaemic or HbA1c test, or a diabetologists consultation, and to detect any new diagnosis of diabetes defined by either a prescription of any anti-hyperglycaemic drug, or the enrolment in the register of patients, or a hospital discharge with a diagnosis of diabetes. Out of 5977 interviewees, 53% were at risk of developing diabetes. An elevated FINDRISC score was associated with higher age, lower education, and living alone. Excluding the number of cases expected, based on the incidence rate of diabetes in the population, 51 new cases were identified, one every 117 interviews. FINDRISC score, being a male and living alone were significantly associated with the diagnosis. CONCLUSIONS:The implementation of a community pharmacy-based screening programme can contribute to reduce the burden of the disease, particularly focusing on people at higher risk, such as the elderly and the socially vulnerable

One Hundred Years of Observations of the Be Star HDE 245770 (the X-ray Binary A0535+26/V725 Tau): The End of an Active Phase

UBV observations of the X-ray binary system A0535+26/V725 Tau at the Crimean Station of the Sternberg Astronomical Institute in 1980-1998 are presented. Based on our and published data, we analyze the photometric history of the star from 1898.Comment: Translated from Pis'ma Astronomicheskii Zhurnal, Vol. 26, No. 1, 2000, pp. 13-2

Protective Effects of Pyridoxamine Supplementation in the Early Stages of Diet-Induced Kidney Dysfunction

Pyridoxamine, a structural analog of vitamin B6 that exerts antiglycative effects, has been proposed as supplementary approach in patients with initial diabetic nephropathy. However, the molecular mechanism(s) underlying its protective role has been so far slightly examined. C57Bl/6J mice were fed with a standard diet (SD) or a diet enriched in fat and fructose (HD) for 12 weeks. After 3 weeks, two subgroups of SD and HD mice started pyridoxamine supplementation (150 mg/kg/day) in the drinking water. HD fed mice showed increased body weight and impaired glucose tolerance, whereas pyridoxamine administration significantly improved insulin sensitivity, but not body weight, and reduced diet-induced increase in serum creatinine and urine albumin. Kidney morphology of HD fed mice showed strong vacuolar degeneration and loss of tubule brush border, associated with a drastic increase in both advanced glycation end products (AGEs) and AGEs receptor (RAGE). These effects were significantly counteracted by pyridoxamine, with consequent reduction of the diet-induced overactivation of NF-kB and Rho/ROCK pathways. Overall, the present study demonstrates for the first time that the administration of the antiglycative compound pyridoxamine can reduce the early stages of diet-dependent kidney injury and dysfunction by interfering at many levels with the profibrotic signaling and inflammatory cascades