Cost analysis of planned out-of-hospital births in Italy

Background and aim: In Italy, the main birthplace is a hospital, and only a few women choose an out-of-hospital setting. This study assessed the costs related to delivery in different birthplaces in Italy. Methods: The cost analysis considered direct and amortizable costs associated with mother-child care in physiological conditions. An analysis of the hospital births considered the Diagnoses-Related Groups 373 and 391. To estimate the cost of the births assisted privately by freelance midwives, an evaluation based on an experts’ opinion was carried out. Results: Childbirth hospital care in Italy amounts to € 1832.00, and birth in an out-of-hospital setting accredited with the National Health System has a full cost of € 1345.19 in the ‘maternity home’ and € 909.60 at home. The average cost of the birth in ‘private maternity homes’ amounted to € 3260.00, while at-home births amounted to € 2910.00. Conclusions: Any accreditation of out-of-hospital settings by the NHS would considerably reduce the waste of economic resources compared to hospital childbirth. (www.actabiomedica.it

Cold streams of ionospheric oxygen in the plasma sheet during the CDAW-6 event of March 22, 1979

During magnetospheric substorm events, the plasma and ion composition experiments in the ISEE-1 and 2 satellites detected cold ionospheric O+ streams, moving tailwards in the near Earth magnetotail. Flow is parallel to the magnetic field lines, with drift velocity in agreement with the electric field topology obtained by mapping the model ionospheric field along the magnetic field lines. Fluctuations of the flow velocity of the streams can be related to magnetotail movements. Oscillations of the flow direction and speed with periods ranging from 5 to 10 min that suggest the presence of waves are observed. The streams are observed at all distances between 15 and 6 Re from the Earth. When averaged over 360 deg, the streams show up as a low energy peak, superimposed on the distribution of isotropic plasma sheet ions. This double-peak structure of the energy spectrum seems typical of the disturbed plasma sheet

FDA-Approved Fluorinated Heterocyclic Drugs from 2016 to 2022

The inclusion of fluorine atoms or heterocyclic moiety into drug structures represents a recurrent motif in medicinal chemistry. The combination of these two features is constantly appearing in new molecular entities with various biological activities. This is demonstrated by the increasing number of newly synthesized fluorinated heterocyclic compounds among the Food and Drug Administration FDA-approved drugs. In this review, the biological activity, as well as the synthetic aspects, of 33 recently FDA-approved fluorinated heterocyclic drugs from 2016 to 2022 are highlighted

Synthesis and Antibacterial Activity of Mono- and Bi-Cationic Pyridinium 1,2,4-Oxadiazoles and Triazoles

One of the main causes of mortality in humans continues to be infectious diseases. Scientists are searching for new alternatives due to the fast increase in resistance of some harmful bacteria to the frontline antibiotics. To effectively treat pathogenic infections, it is crucial to design antibiotics that can prevent the development of pathogenic resistance. For this purpose, a set of 39 quaternary pyridinium and bis-pyridinium salts with different lengths of side alkyl or fluorinated chains, heterocyclic spacers, and counter ions were tested on diverse reference bacterial ATCC (American Type Culture Collection) strains, such as S. aureus and E. coli. Subsequently, 6 out of the 39 pyridinium salts showing relevant MIC (Minimum Inhibitory Concentration) values were tested on clinically isolated, resistant strains of S. aureus, S. epidermids, S. haemolyticus, K. pneumoniae, A. baumannii, and P. aeruginosa. Additional tests have been performed to assess if the minimum concentration detected through MIC assay may limit the growth of biofilms

Experimental study of nonlinear interaction of plasma flow with charged thin current sheets: 1. Boundary structure and motion

We study plasma transport at a thin magnetopause (MP), described hereafter as a thin current sheet (TCS), observed by Cluster at the southern cusp on 13 February 2001 around 20:01 UT. The Cluster observations generally agree with the predictions of the Gas Dynamic Convection Field (GDCF) model in the magnetosheath (MSH) up to the MSH boundary layer, where significant differences are seen. We find for the MP a normal roughly along the GSE x-axis, which implies a clear departure from the local average MP normal, a ~90 km thickness and an outward speed of 35 km/s. Two populations are identified in the MSH boundary layer: the first one roughly perpendicular to the MSH magnetic field, which we interpret as the &quot;incident&quot; MSH plasma, the second one mostly parallel to <b>B</b>. Just after the MP crossing a velocity jet is observed with a peak speed of 240 km/s, perpendicular to <b>B</b>, with <i>M_A</i>=3 and &beta;>10 (peak value 23). The magnetic field clock angle rotates by 70&deg; across the MP. <i>E_x</i> is the main electric field component on both sides of the MP, displaying a bipolar signature, positive on the MSH side and negative on the opposite side, corresponding to a ~300 V electric potential jump across the TCS. The <i>E</i>&times;<i>B</i> velocity generally coincides with the perpendicular velocity measured by CIS; however, in the speed jet a difference between the two is observed, which suggests the need for an extra flow source. We propose that the MP TCS can act locally as an obstacle for low-energy ions (&lt;350 eV), being transparent for ions with larger gyroradius. As a result, the penetration of plasma by finite gyroradius is considered as a possible source for the jet. The role of reconnection is briefly discussed. The electrodynamics of the TCS along with mass and momentum transfer across it are further discussed in the companion paper by Savin et al. (2006)

Super fast plasma streams as drivers of transient and anomalous magnetospheric dynamics

Abstract. We present multi spacecraft measurements in the magnetosheath (MSH) and in the solar wind (SW) by Interball, Cluster and Polar, demonstrating that coherent structures with magnetosonic Mach number up to 3 – Supermagnetosonic Plasma Streams (SPS) – generate transient and anomalous boundary dynamics, which may cause substantial displacements of the magnetospheric boundaries and the riddling of peripheral boundary layers. In this regard, for the first time, we describe a direct plasma penetration into the flank boundary layers, which is a candidate for being the dominant transport mechanism for disturbed MSH periods. Typically SPS's have a ram pressure exceeding by several times that of the SW and lead to long-range correlations between processes at the bow shock (BS) and at the magnetopause (MP) on one side and between MSH and MP boundary layers on the other side. We demonstrate that SPS's can be observed both near the BS and near the MP and argue that they are often triggered by hot flow anomalies (HFA), which represent local obstacles to the SW flow and can induce the SPS generation as a means for achieving a local flow balance. Finally, we also discuss other causes of SPS's, both SW-induced and intrinsic to the MSH. SPS's appear to be universal means for establishing a new equilibrium between flowing plasmas and may also prove to be important for astrophysical and fusion applications

In vitro and in silico analysis of imatinib analogues as anti-Trypanosoma cruzi drug candidates

Chagas disease (CD) is a neglected tropical disease caused by the intracellular protozoan Trypanosoma cruzi that remains a serious public health issue affecting more than 6 million people worldwide. The available treatment includes 2 nitro derivatives, benznidazole (BZ) and nifurtimox, that lack in efficacy in the later chronic phase and when administered against the several naturally resistant parasite strains and present several side-effects, demanding new therapeutic options. One strategy is based on repurposing by testing drugs already used for other illness that may share similar targets. In this context, our previous data on imatinib (IMB) and derivatives motivated the screening of 8 new IMB analogues. Our findings showed that all except 1 were active against bloodstream trypomastigotes reaching drug concentration capable of inducing a 50% of parasite lysis (EC50) values 60) towards the proliferative forms. Physicochemical parameters as well as the absorption, distribution, metabolism, excretion and toxicity properties were predicted to be acceptable and with good chance of a favourable oral bioavailability. The promising results motivate further studies such as in vivo and combinatory assays aiming to contribute for a novel safer and effective therapy for CD