Prescription Appropriateness of Drugs for Peptic Ulcer and Gastro-Esophageal Reflux Disease: Baseline Assessment in the LAPTOP-PPI Cluster Randomized Trial

Background: Drugs for peptic ulcer and gastro-esophageal reflux disease (GERD) are among the most widely prescribed, frequently without appropriate indications. This represents an important issue, as it leads to risk of adverse events for patients and unnecessary costs for National Health Service. Aim: To assess the prescription appropriateness of drugs for GERD, in the frame of the "Evaluation of the effectiveness of a Low-cost informative intervention to improve the Appropriate PrescripTiOn of Proton PumP Inhibitors in older people in primary care: a cluster-randomized controlled study" (LAPTOP-PPI) (Clinicaltrial.gov: NCT04637750). Methods: The appropriateness of drug prescription was assessed on data collected in administrative databases, by integrating information on concomitant medications, outpatient medical and laboratory procedures and hospital discharge diagnoses, according to the reimbursement criteria provided by the Italian Medicine Agency. We analyzed data of community-dwelling people aged 65 years and over, living in the areas of Bergamo (Northern Italy) and Caserta (Southern Italy), from July 1 to 31 December 2019. Results: Among 380,218 patients, 175,342 (46.1%) received at least one prescription of drugs for GERD. All in all, we found that only 41.2% of patients received appropriate prescriptions. Conclusion: Given the potential risk of adverse drug reactions, especially in older people, educational interventions should be prompted for physicians, in order to improve the quality of prescription of drugs for GERD and, in turn, avoid unfavorable health outcomes and unnecessary costs

Leakage evaluation in longitudinally cracked pressurized pipes

This paper presents a model to estimate leak in axially cracked pressurized pipe. The pipe is modeled based on the theory of beams with elastic constraints. The effectiveness of the proposed model is assessed by comparing its predictions with those obtained with a 3D finite element analysis

Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition—Narrative Review

The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition

Geopolymeric Composites Containing Industrial Waste Reinforced with <i>Arundo donax</i> Fibers

Traditional Portland cement-based composites have a great environmental impact. Alkali-activated binders can offer an alternative, particularly if they can be obtained even partially from waste. Two residuals derived from the finishing steps of the traditional ceramic industry have been used as possible polymerizable sources mixed with metakaolin. Moreover, to contrast the low dimensional stability of alkali-activated materials and their mechanical brittleness, natural fibers derived from the Arundo donax plant have been added to the mortars. The use of renewable natural fibers instead of synthetic ones can contribute a further environmental advantage. The fresh (consistency) and cured (mechanical) properties of composite materials prepared with residuals and metakaolin were analyzed here. For comparison’s sake, a reference set of composite materials not loaded with fibers but with an identical binder/sand and liquid/binder ratio was cast. A room-temperature curing condition was selected that, although inadequate to promote the short-time reactivity of the wastes, has a minimal energy requirement and allows on-site applications. A small-scale decrease in the properties in the compression mode tests was observed in the waste-modified mortars, while the Arundo addition improved their flexural strength and dimensional stability

Energy characterisation of herbaceous biomasses irrigated with marginal waters

The paper reports the results of a research program aiming to evaluate the agronomic, and energy sustainability of the biomass production by perennial non-food herbaceous crops irrigated with different kinds of marginal waters. In fourdifferent sites (Bologna, Padova, Reggio Calabria, and Catania) the same four species (Arundo, Typha, Phragmites, and Lythrum), usually tested without irrigation, were planted and monitored during 2008-2010. The results show that a planting density of 10 m2 is necessary to obtain a maximum dry yield levels already from the second year of transplanting. The maximum productivity was obtained with Arundo (close to 100 Mg ha-1 y-1 in Bologna and 86 Mg ha-1 y-1 in Padova, 50-60 Mg ha1 y1 in the southern locations). Lythrum productivity ranged from 5.2 to 9.2 Mg ha-1 y-1 in all the RUs, with the exception of Reggio Calabria. Typha (around 10 Mg ha-1 y-1 at the third year) and Phragmites (5-8 Mg ha-1 y-1) gave significant production only in the northern locations. The HHVs were close to 15.5 MJ kg-1 for Phragmites (except for Catania and Reggio Calabria with 20.0 MJ kg-1) 18.0 MJ kg-1 for the Arundo (except for Catania with 20.0 MJ kg-1), 18.5 MJ kg-1 for the Typha and Lythrum (except for Catania with 20.0 MJ kg-1)

Statin use and risk of dementia or Alzheimer's disease: a systematic review and meta-analysis of observational studies

Aims: As the potential impact of statins on cognitive decline and dementia is still debated, we conducted a meta-analysis of observational studies to examine the effect of statin use on the risk of Alzheimer's disease (AD) and dementia. Methods and results: PubMed, Cochrane, and EMBASE were searched since inception to January 2021. Inclusion criteria were: (i) cohort or case-control studies; (ii) statin users compared to non-users; and (iii) AD and/or dementia risk as outcome. Estimates from original studies were pooled using restricted maximum-likelihood random-effect model. Measure of effects were reported as odds ratio (OR) and 95% confidence intervals (CIs). In the pooled analyses, statins were associated with a decreased risk of dementia [36 studies, OR 0.80 (CI 0.75-0.86)] and of AD [21 studies, OR 0.68 (CI 0.56-0.81)]. In the stratified analysis by sex, no difference was observed in the risk reduction of dementia between men [OR 0.86 (CI 0.81-0.92)] and women [OR 0.86 (CI 0.81-0.92)]. Similar risks were observed for lipophilic and hydrophilic statins for both dementia and AD, while high-potency statins showed a 20% reduction of dementia risk compared with a 16% risk reduction associated with low-potency statins, suggesting a greater efficacy of the former, although a borderline statistical significance (P = 0.05) for the heterogeneity between estimates. Conclusion: These results confirm the absence of a neurocognitive risk associated with statin treatment and suggest a potential favourable role of statins. Randomized clinical trials with an ad hoc design are needed to explore this potential neuroprotective effect