Serotonin Trasporter Tracks Similarities Between Sids And Idiopathic Alte

Polymorphisms in the serotonin transporter (5HTT) (SLC6A4 encoding 5HTT) as a predisposing factor in infant death. Considering stric corrispondence between 5HTT and MAOA genotypic and allelic data inIALTE and SIDS, we hypothesize that the two syndromes are different expression of a common ethiopathogenesis

Quantification and characterization of water and wastewater in dairy farms. I. Water demand and effluent management

This study was carried out to quantify and characterize water demands in the different stages of the milking process and effluent management, in order to establish management criteria in dairy farms in Buenos Aires. Sixty-five dairy farms in three dairy areas were selected, and their farmers were surveyed. Water volumes used during the different milking routines were quantified in six of them, these will later become part of the total effluent. Surveys showed the several destinations of effluent generated during the milking process. Some, like effluent discharge into water bodies, may result in their contamination. Others, such as poorly designed effluent storages, could be responsible for the leaching of pollutants into groundwater. It was established that 74,47 to 91,29% of the total water volume was used by the plate-cooler operation (4,65?9,20 L.water/L.milk). Groundwater used by the plate-cooler can be reused, as its quality is not affected. This characterization allows to adequate and diminish water volumes used in dairy farms, giving priority to those practices that represent the largest water demands. The rational water use and effluent management will allow to minimize the potential environmental impact from one of the most important livestock productions in this region.Fil: Nosetti, L. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Buenos Aires, ArgentinaFil: Herrero, M.A. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Pol, M. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Maldonado May, V. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Iramain, M.S. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Flores, M. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Salud Pública. Buenos Aires, ArgentinaEl objetivo fue cuantificar la demanda de agua en las distintas operaciones realizadas durante el ordeño y caracterizar el manejo de los efluentes, para establecer criterios de manejo en tambos de Buenos Aires. Se seleccionaron y encuestaron 65 tambos en tres cuencas lecheras. Se caracterizaron 6 para cuantificar los caudales utilizados en las distintas rutinas durante el ordeño y que son generadoras del efluente final. Las encuestas mostraron varios destinos del efluente eliminado. Algunos, como el vertido a cuerpos de agua superficial resultan en un impacto en su posible contaminación, otros, como las lagunas de tratamiento mal diseñadas son un riesgo para la contaminación de aguas subterráneas. El mayor volumen de agua utilizada en el ordeño corresponde a la placa de refrescado (4,65 a 9,2 L.agua/L.leche producida) significando el 74,47% al 91,29% del consumo total. Esta fracción es la que posee mayores alternativas de reutilización, porque es agua subterránea que no altera su calidad durante el uso. Esta caracterización permite adecuar y disminuir el consumo de agua en los tambos, en función de las prácticas que mostraron mayores consumos. Un manejo racional del agua y de los efluentes permitirá disminuir el impacto ambiental de una de las producciones ganaderas más importantes de la región

Cluster Analysis of Home Polygraphic Recordings in Symptomatic Habitually-Snoring Children: A Precision Medicine Perspective

(1) Background: Sleep-disordered breathing (SDB) is a frequent problem in children. Cluster analyses offer the possibility of identifying homogeneous groups within a large clinical database. The application of cluster analysis to anthropometric and polysomnographic measures in snoring children would enable the detection of distinctive clinically-relevant phenotypes; (2) Methods: We retrospectively collected the results of nocturnal home-based cardiorespiratory polygraphic recordings and anthropometric measurements in 326 habitually-snoring otherwise healthy children. K-medoids clustering was applied to standardized respiratory and anthropometric measures, followed by Silhouette-based statistics. Respiratory Disturbance Index (RDI) and oxygen desaturation index (<= 3%) were included in determining the optimal number of clusters; (3) Results: Mean age of subjects was 8.1 +/- 4.1 years, and 57% were males. Cluster analyses uncovered an optimal number of three clusters. Cluster 1 comprised 59.5% of the cohort (mean age 8.69 +/- 4.14 years) with a mean RDI of 3.71 +/- 3.23 events/hour of estimated sleep (e/ehSleep). Cluster 2 included 28.5% of the children (mean age 6.92 +/- 3.43 years) with an RDI of 6.38 +/- 3.92 e/ehSleep. Cluster 3 included 12% of the cohort (mean age 7.58 +/- 4.73 years) with a mean RDI of 25.5 +/- 19.4 e/ehSleep. Weight z-score was significantly lower in cluster 3 [-0.14 +/- 1.65] than in cluster 2 [0.86 +/- 1.78; p = 0.015] and cluster 1 [1.04 +/- 1.78; p = 0.002]. Similar findings emerged for BMI z scores. However, the height z-score was not significantly different among the 3 clusters; (4) Conclusions: Cluster analysis of children who are symptomatic habitual snorers and are referred for clinical polygraphic evaluation identified three major clusters that differed in age, RDI, and anthropometric measures. An increased number of children in the cluster with the highest RDI had reduced body weight. We propose that the implementation of these approaches to a multicenter-derived database of home-based polygraphic recordings may enable the delineation of objective unbiased severity categories of pediatric SDB. Our findings could be useful for clinical implementation, formulation of therapeutic decision guidelines, clinical management, prevision of complications, and long-term follow-up

Application of latent class analysis in assessing the awareness, attitude, practice and satisfaction of paediatricians on sleep disorder management in children in Italy.

AIM: To identify subgroups regarding paediatricians' awareness, attitude, practice and satisfaction about management of Sleep-Disordered Breathing (SDB) in Italy using Latent Class Analysis (LCA). METHODS: A cross-sectional study was conducted on a large sample of Italian paediatricians. Using a self-administered questionnaire, the study collected information on 420 Paediatric Hospital Paediatricians (PHPs) and 594 Family Care Paediatricians (FCPs). LCA was used to discover underlying response patterns, thus allowing identification of respondent groups with similar awareness, attitude, practice and satisfaction. A logistic regression model was used to investigate which independent variables influenced latent class membership. Analyses were performed using R 3.5.2 software. A p-value<0.05 was considered statistically significant. RESULTS: Two classes were identified: Class 1 (n = 368, 36.29%) "Untrained and poorly satisfied" and Class 2 (n = 646, 63.71%) "Trained and satisfied." Involving paediatric pneumologists or otorhinolaryngologists in clinical practice was associated with an increased probability of Class 2 membership (OR = 5.88, 95%CI [2.94-13.19]; OR = 15.95, 95% CI [10.92-23.81] respectively). Examining more than 20 children with SDB during the last month decreased the probability of Class 2 membership (OR = 0.29, 95% CI [0.14-0.61]). FCPs showed a higher probability of Class 2 membership than PHPs (OR = 4.64, 95% CI [3.31-6.55]). CONCLUSIONS: These findings suggest that the LCA approach can provide important information on how education and training could be tailored for different subgroups of paediatricians. In Italy standardized educational interventions improving paediatricians' screening of SDB are needed in order to guarantee efficient management of children with SDB and reduce the burden of disease

Growth hormone therapy and respiratory disorders: Long-term follow-up in PWS children

Context: Adenotonsillar tissue hypertrophy and obstructive sleep apnea have been reported during short-term GH treatment in children with Prader-Willi syndrome (PWS). Objective: We conducted an observational study to evaluate the effects of long-term GH therapy on sleep-disordered breathing and adenotonsillar hypertrophy in children with PWS. Design: This was a longitudinal observational study. PatientsandMethods:Weevaluated 75 children with genetically confirmedPWS,ofwhom50 fulfilled the criteria and were admitted to our study. The patients were evaluated before treatment (t0), after 6 weeks (t1), after 6 months (t2), after 12 months (t3), and yearly (t4-t6) thereafter, for up to 4 years of GH therapy. The central apnea index, obstructive apnea hypopnea index (OAHI), respiratory disturbance index, and minimal blood oxygen saturation were evaluated overnight using polysomnography. We evaluated the adenotonsillar size using a flexible fiberoptic endoscope. Results: The percentage of patients with an OAHI of 1 increased from 3 to 22, 36, and 38 at t1, t4, and t6, respectively (2 12.2; P .05). We observed a decrease in the respiratory disturbance indexfrom1.4 (t0) to 0.8 (t3) (P.05)andthe centralapneaindexfrom1.2 (t0) to 0.1 (t4) (P.0001). We had to temporarily suspend treatment for 3 patients at t1, t4, and t5 because of severe obstructive sleep apnea. The percentage of patients with severe adenotonsillar hypertrophy was significantly higher at t4 and t5 than at t0. The OAHI directly correlated with the adenoid size (adjusted for age) (P .01) but not with the tonsil size and IGF-1 levels. Conclusion: Long-termGHtreatment in patients withPWSis safe; however,werecommend annual polysomnography and adenotonsillar evaluation

Quantification and characterization of water and wastewater in dairy farms II. Effluent quality and treatment process efficiency

This study was carried out in three dairy production areas in Buenos Aires. Effluent quality, treatment process efficiency, water management strategies and environmental contamination risk by effluent discharge, was characterized in 9 dairy farms. Holding area feces were measured. Treatment lagoons were sampled. Physicochemical and microbiological qualities, and BOD and COD were determined, and used as environmental risk indicators. Plate-cooler water management strategies were established in order to divide the dairy farms in two groups (G1 and G2). Treatment lagoons were inefficient in regards to effluent treatment. BOD, COD, nitrogen (N), phosphorus (P) and enterococci found in the samples were not within acceptable values according to effluent discharge guidelines. NPK concentration would allow its potential use as a nutrient source. Variability found in the several parameters measured is related to the different lagoons? characteristics and water management strategies. Significant differences (p<0.05) were detected in N and P contents between G1 and G2. Proper environmental management in animal production systems requires an appropriate wastewater handling within each farm.Fil: Nosetti, L. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Buenos Aires, ArgentinaFil: Herrero, M.A. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Pol, M. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Maldonado May, V. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Korol, S. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Cátedra de Higiene y Sanidad. Buenos Aires, ArgentinaFil: Rossi, S. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Cátedra de Higiene y Sanidad. Buenos Aires, ArgentinaFil: Gemini, V. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Cátedra de Higiene y Sanidad. Buenos Aires, ArgentinaFil: Flores, M. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Salud Pública. Buenos Aires, ArgentinaEl estudio fue realizado en tres cuencas lecheras de Buenos Aires. Se caracterizaron en 9 establecimientos, la calidad de efluentes, la eficiencia de los sistemas de tratamiento, la estrategia del manejo del agua en el ordeño y el riesgo de contaminación ambiental por el vertido de efluentes. Fueron cuantificadas las heces en corrales de espera. Se tomaron muestras de las lagunas de tratamiento, analizando la calidad fisicoquímica y microbiológica. La DBO y DQO fueron utilizados como indicadores de riesgo ambiental. Los tambos fueron agrupados según la utilización del agua de la placa de refrescado (G1 y G2). Las lagunas no resultaron eficientes ya que no completaron el tratamiento de los efluentes, tampoco se obtuvieron valores aceptables de DQO, DBO, Nitrógeno (N), Fósforo (P) y enterococos, compatibles con normativas de vertido para evitar la contaminación de cursos de agua. La concentración de NPK permitiría su uso potencial como abono. La variabilidad de los parámetros analizados se relaciona a las diferentes características de las lagunas y a los sistemas de reutilización de agua. Se encontraron diferencias significativas (p<0.05), entre G1 y G2, para el contenido de nitrógeno y fósforo. Las necesidades de una gestión ambiental adecuada en los sistemas de producción animal, requiere de un manejo apropiado de estos residuos dentro del mismo establecimiento

Assessing Sleep Habits in Italian Community-Dwelling Adolescents: Psychometric Properties of the School Sleep Habits Survey Scales

Background. In the field of adolescent sleep research, different sleep surveys have been implemented; however, psychometric properties of these instruments have been investigated only minimally. Methods. In order to assess the psychometric properties of the Sleep-Wake Problems Behaviour Scale (SWP), the Sleepiness Scale (SLS), and the Morningness/Eveningness Questionnaire (ME), a moderately large sample of community-dwelling Italian adolescents (N = 778; 59.8% female; mean age = 15.77 years) was administered the Italian translation of the School Sleep Habits Survey. Results. Internal consistency estimates values were satisfactory for all measures; dimensionality analyses suggested a unidimensional structure for SWP, SLS and ME, respectively. Goodness-of-fit statistics for the one-factor model of the SLS, SWP, and ME scale items were adequate for all measures. Non -redundant taxometric analysis results consistently suggested a dimensional latent structure for the SLS, SWP, and ME, respectively. Conclusion. Our findings supported the use of the SLS, SWP, and ME total scores as measures of sleepiness, sleep-wake problem, and morningness/eveningness, at least among Italian community -dwelling adolescents, and encourage practitioners to rely on the conventional percentiles in order to interpret the SLS, SWP, and ME total scores

Risk of hospitalization for heart failure in patients with type 2 diabetes newly treated with DPP-4 inhibitors or other oral glucose-lowering medications: A retrospective registry study on 127,555 patients from the Nationwide OsMed Health-DB Database

Aims Oral glucose-lowering medications are associated with excess risk of heart failure (HF). Given the absence of comparative data among drug classes, we performed a retrospective study in 32 Health Services of 16 Italian regions accounting for a population of 18 million individuals, to assess the association between HF risk and use of sulphonylureas, DPP-4i, and glitazones. Methods and results We extracted data on patients with type 2 diabetes who initiated treatment with DPP-4i, thiazolidinediones, or sulphonylureas alone or in combination with metformin during an accrual time of 2 years. The endpoint was hospitalization for HF (HHF) occurring after the first 6 months of therapy, and the observation was extended for up to 4 years. A total of 127 555 patients were included, of whom 14.3% were on DPP-4i, 72.5% on sulphonylurea, 13.2% on thiazolidinediones, with average 70.7% being on metformin as combination therapy. Patients in the three groups differed significantly for baseline characteristics: age, sex, Charlson index, concurrent medications, and previous cardiovascular events. During an average 2.6-year follow-up, after adjusting for measured confounders, use of DPP-4i was associated with a reduced risk of HHF compared with sulphonylureas [hazard ratio (HR) 0.78; 95% confidence interval (CI) 0.62-0.97; P = 0.026]. After propensity matching, the analysis was restricted to 39 465 patients, and the use of DPP-4i was still associated with a lower risk of HHF (HR 0.70; 95% CI 0.52-0.94; P = 0.018). Conclusion In a very large observational study, the use of DPP-4i was associated with a reduced risk of HHF when compared with sulphonylureas