Roe deer summer habitat selection at multiple spatio-temporal scales in an alpine environment

Habitat selection is a hierarchical process that may involve different patterns depending on the spatial and temporal scales of investigation. We studied habitat selection by European roe deer (Capreolus capreolus) in a very diverse environment in the Italian eastern Alps, during summer. We sampled both coarse-grained habitat variables (topographic variables, habitat types and cover) and fine-grained habitat variables (forage components of habitat) in used and available locations along the movement trajectories of 14 adult roe deer equipped with GPS telemetry collars. We used conventional logistic regression to assess roe deer habitat selection at the seasonal home range scale, and conditional logistic regression to take into account the temporal aspect of habitat selection on a weekly basis. Our results indicate that topographic variables were not significant predictors for summer roe deer habitat selection. Roe deer strongly selected dense canopy cover, probably to avoid heat stress during warm summer days. In accordance with previous observations, roe deer preferred young forest stands dominated by pioneer species such as ash (Fraxinus spp.) and hazel (Corylus avellana) over climax environments. Roe deer positively selected shrubs (in particular Fraxinus spp., Erica herbacea, Rhododendron spp. and Vaccinium spp.) throughout the study period, whereas selection for grasses and sedges emerged only at the weekly scale. Habitat selection was clearly related to vegetation phenology, since roe deer selected plants in the most nutritive phenological stages, i.e., shrubs with buds, new leaves and fruits, and newly emergent grasses and sedges. Finally, we found stronger and more significant regression coefficients for forage components of habitat and habitat types at the weekly scale, indicating that matching spatial and temporal scales may improve our understanding of ecological patterns driving habitat selection. Conversely, selection patterns for canopy cover did not change across scales, indicating that this variable likely drives habitat selection in a similar way throughout the entire season

Roe deer summer habitat selection at multiple spatio-temporal scales in an Alpine environment

Habitat selection is a hierarchical process that may involve different patterns depending on the spatial and temporal scales of investigation. We studied habitat selection by European roe deer (Capreolus capreolus) in a very diverse environment in the Italian eastern Alps, during summer. We sampled both coarse-grained habitat variables (topographic variables, habitat types and cover) and fine-grained habitat variables (forage components of habitat) in used and available locations along the movement trajectories of 14 adult roe deer equipped with GPS telemetry collars. We used conventional logistic regression to assess roe deer habitat selection at the seasonal home range scale, and conditional logistic regression to take into account the temporal aspect of habitat selection on a weekly basis. Our results indicate that topographic variables were not significant predictors for summer roe deer habitat selection. Roe deer strongly selected dense canopy cover, probably to avoid heat stress during warm summer days. In accordance with previous observations, roe deer preferred young forest stands dominated by pioneer species such as ash (Fraxinus spp.) and hazel (Corylus avellana) over climax environments. Roe deer positively selected shrubs (in particular Fraxinus spp., Erica herbacea, Rhododendron spp. and Vaccinium spp.) throughout the study period, whereas selection for grasses and sedges emerged only at the weekly scale. Habitat selection was clearly related to vegetation phenology, since roe deer selected plants in the most nutritive phenological stages, i.e., shrubs with buds, new leaves and fruits, and newly emergent grasses and sedges. Finally, we found stronger and more significant regression coefficients for forage components of habitat and habitat types at the weekly scale, indicating that matching spatial and temporal scales may improve our understanding of ecological patterns driving habitat selection. Conversely, selection patterns for canopy cover did not change across scales, indicating that this variable likely drives habitat selection in a similar way throughout the entire season

Thoracic ultrasound evaluation and B-type natriuretic peptide value in elective cesarean section under spinal anesthesia

Pregnancy-induced changes in cardiovascular status make women more susceptible to pulmonary edema. During cesarean section, to counterbalance the effect of hypotension caused by spinal anesthesia, anesthesiologists must choose between two fundamental approaches to maintain the hemodynamic state-intravenous fluids or vasopressors-and this choice will depend upon their particular opinions and experience. We aim to assess for any correlations between thoracic ultrasound A- and B-line artifacts, brain natriuretic peptide (BNP) levels, and the amount of intraoperative fluids administered

Spazio a una pena perpetua anche in Spagna? Ambiguità e contraddizioni della prisión permanente revisable.

Con la LOGP 1/2015 viene introdotta nell'ordinamento spagnolo la prisión permanente revisable; una pena le cui contraddizioni sono già insite nella nomenclatura: una pena permanente ma allo stesso revocabile. È proprio la sua nomenclatura che le permette di esistere, infatti, a livello europeo non sono ammesse delle pene che non garantiscano un orizzonte di libertà, il c.d. "diritto alla speranza" più volte affermato dalla Corte Europea dei Diritti dell'Uomo

Treatment of chronic hepatitis C by pegylated interferon plus ribavirin combination therapy in aged patients : why not ?

Background & Aims: Pegylated interferon (PEG-IFN) plus ribavirin combination therapy has significantly improved the successful rate in virus eradication in patients affected by chronic hepatitis C. However, only few data are available with respect to antiviral effect and safety in aged patients. This study aimed at investigating the efficacy and tolerability of pegylated interferon (Peg-IFN) plus ribavirin therapy in aged patients with chronic hepatitis C (CH-C). Methods: A total of 473 patients [319 (67.4%) naive, 195 (41,2% female) with CH-C (genotype 1, n = 266; genotype 2, n = 112, genotype 3 = 72, genotype 4=23), of whom 68 (14.4%) over 65 years old (y.o.) (mean age 69±2 years) , were treated with Peg-IFN (alfa-2a or alfa-2b) plus ribavirin according to international guidelines. These patients were assessed for sustained viral response (SVR) rate and for all known main predictors of SVR in CH-C. Results: The overall SVR rate resulted similar in both age groups (270/405 (66.6%) in subjects <65 y.o vs. 41/68 (60.3%) in subjects ≥ 65 y.o, respectively, p=0.334). No significant difference in therapy discontinuance rate was observed between patients over and under 65 y.o. (4.4% vs. 4.9%, respectively), the most common reason being anemia in both groups. The table resumes the distribution of main known SVR predictors in the two considered groups < 65 years (n=405) ≥ 65 years (n=68) p Genotype (1-4/2-3) 252/153 37/31 0.229 High viral load (cut off 500.000 UI/ml) (yes/no) 154/251 16/52 0.028 PegIFN alfa 2a / PegIFN alfa 2b use 244/161 59/9 <.001 Rapid Viral Response (RVR) (yes/no)* 106/107 28/28 1.000 Early Viral Response (EVR) (yes/no) 308/97 50/18 0.76 Naive (yes/no) 275/130 44/24 0.675 Sex (male/female) 248/157 30/38 0.011 Grading (Ishak score) 4.89±2.13 5.77±1.88 0.022 Staging (Ishak score) 2.08±1.49 2.73±1.51 0.029 Liver cirrhosis (yes/no) 42/363 13/55 0.043 Therapy reduction (yes/no) 123/282 20/48 0.888 Ribavirin reduction (yes/no) 87/318 18/50 0.430 Use of erythropoietic fatctors (yes/no) 43/362 26/42 <.001 *data not available for all patients For patients over 65 y.o., at multivariate analysis, genotype 2/3 (OR, 2.56,95% CI 1.89-5.65 p = 0.026) and EVR (OR, 45.5,95% CI 26.2-125.3 p <0.001) were significant predictors of SVR. Factors related to EVR at multivariate analysis were naive status (OR 2.58, 95%CI 1.26-3.69, p=.001), therapy with PEGIFNalfa 2a (OR 3.56, 95% CI 1.68-5.65, p=.014) and ribavirin reduction (OR 0.789, 95% CI 0.568-0.895, p=.015). Conclusions: Aged patients can be candidates for Peg-IFN plus ribavirin therapy.The appropriate use of erythropietic factors in these patients may be useful to achieve a significant reduction in the rate of therapy discontinuation due to hematological side-effects. The response-guided therapy may be applied in predicting therapy efficay in these patients

Occurrence of smooth endoplasmic reticulum aggregates in metaphase II oocytes: relationship with stimulation protocols and outcome of ICSI and IVF cycles

STUDY QUESTION: Is there any association between the appearance of smooth endoplasmic reticulum aggregates (SERa) in oocytes and ovarian stimulation, embryological, clinical and neonatal outcomes of ICSI and IVF cycles?SUMMARY ANSWER: A suboptimal prolonged ovarian stimulation is detrimental to oocytes by inducing the occurrence of SERa, which reduces the reproductive potential of oocytes.WHAT IS KNOWN ALREADY: Controlled ovarian stimulation recruits oocytes of different qualities. Based on current evidence, it was agreed that non-homogeneous cytoplasm may represent the normal variability among oocytes rather than a dysmorphism with developmental significance. The only exception is the appearance of SERa within the ooplasm. Owing to the lack of univocal evidence in this literature about the safety of injecting oocytes with SERa and the mechanism responsible for the occurrence of SERa, this topic is still a matter of debate.STUDY DESIGN, SIZE, DURATION: A retrospective, longitudinal cohort study performed at a tertiary level public infertility center. We included 1662 cycles (180 SERa+ and 1482 SERa-) from 1129 women (age: 20-44years) who underwent IVF/ICSI treatments in 2012-2019. The SERa+ cycles had at least one SERa+ oocyte in the oocyte cohort. The SERa- cycles had morphologically unaffected oocytes.PARTICIPANTS/MATERIALS, SETTING, METHODS: We collected stimulation data and embryological, clinical, neonatal outcomes of SERa- and SERa+ cycles and oocytes.MAIN RESULTS AND THE ROLE OF CHANCE: Overall, 347 out of 12436 metaphase II oocytes (2.8%) were affected by SER. We performed only 12 transfers involving at least one SERa+ embryo. Stimulation length (P=0.002), serum progesterone (P=0.004) and follicle size (P=0.046) at trigger, number of retrieved (P=0.004) and metaphase II (P=0.0001) oocytes were significantly higher in SERa+ than SERa- cycles. Fertilization rate was significantly (P&lt;0.0001) reduced in SERa+ cycles and oocytes compared to SERa- counterparts. Embryos of SERa+ cycles had a lower blastocyst formation rate compared to embryos of SERa- cycles (P=0.059). Statistical analysis according to a generalized estimating equation model performed at patient level demonstrated that the duration of ovarian stimulation was predictive of SERa+ oocytes appearance. The clinical success of SERa+ cycles was lower than SERa- cycles, although no differences in neonatal birthweights or malformations were recorded in sibling unaffected oocytes of SERa+ cycles.LIMITATIONS, REASONS FOR CAUTION: Given that SERa+ oocytes were discarded in our center for years and transfers of embryos originating from affected oocytes were generally avoided, clinical outcomes of SERa+ cycles are largely attributable to the transfer of embryos derived from unaffected oocytes of SERa+ cycles and we did not have data about newborns from affected oocytes, since none of the transfers involving SERa+ embryos resulted in a progressive clinical pregnancy.WIDER IMPLICATIONS OF THE FINDINGS: For the first time, we speculate that the late-follicular phase elevated serum progesterone caused by a suboptimal prolonged ovarian stimulation may be detrimental to the oocytes by inducing the occurrence of SERa, resulting in negative effects on their reproductive potential. This raises the question of whether some stimulation regimens could be worse than others and a change in stimulation protocol would reduce the possibility of producing oocytes with suboptimal maturation. In particular, our data highlight the importance of correct timing of the trigger in order to maximize oocyte collection, not only in terms of numerosity but also their reproductive potential.STUDY FUNDING/COMPETING INTEREST(S): None.TRIAL REGISTRATION NUMBER: N/A

Efficacy and safety of combination therapy with pegylated interferon and ribavirin in aged patients with chronic hepatitis C

Background & Aims: Combination therapy with pegylated interferon (PEGIFN) and ribavirin has significantly improved virus eradication rate in patients affected by HCV-related chronic hepatitis (C-HC). However, only few data are available with respect to efficacy and safety of this therapy in aged patients. This study aimed at investigating efficacy and tolerability of combination therapy in aged patients with CH-C. Methods: 473 patients [319 (67.4%) naive, 195 (41,2% female) with CH-C (genotype 1, n=266; genotype 2, n=112, genotype 3, n=72, genotype 4, n=23), of whom 68 (14.4%) over 65 years old (mean age 69\ub12 years), were treated with Peg-IFN (alpha-2a or alpha-2b) plus ribavirin according to international guidelines from January 2007 to July 2011. These patients were assessed for sustained viral response (SVR) rate and for all known main predictors of SVR in CH-C. Results: The overall SVR rate resulted similar in both age groups [270/405 (66.6%) in subjects <65 years vs. 41/68 (60.3%) in subjects 6565 years, respectively, p=0.334)]. Overall, therapy discontinuance rate was low, with no significant difference between patients over or under age 65 (4.4% vs. 4.9%, respectively), the most common reason for discontinuance being anemia in both groups.For patients over 65, at multivariate analysis, non-na\uefve status, EVR and use of hematological growth factors were independent predictors of SVR. Factors independently related to EVR at multivariate analysis were non-naive, staging, genotype 2-3 vs. genotype1-4 and use of hematological growth factors Conclusions: Aged patients can be candidates for Peg-IFN plus ribavirin therapy. The appropriate use of hematological factors in these patients may be useful to achieve a significant reduction in the rate of therapy discontinuation due to hematological side-effects. The response-guided therapy may be applied in predicting therapy efficacy in this patient grou

Development of an HPLC-MS/MS Method for the Determination of Silybin in Human Plasma, Urine and Breast Tissue

Silybin is a flavonolignan extracted from Silybum marianum with chemopreventive activity against various cancers, including breast. This study was designed to develop an HPLC-MS/MS method for the determination of silybin in human plasma, urine and breast tissue in early breast cancer patients undergoing Siliphos&reg; supplementation, an oral silybin-phosphatidylcholine complex. The determination of silybin was carried out by liquid&ndash;liquid extraction with methyl-tert-butyl ether (MTBE); total silybin concentration was determined by treating the samples with &beta;&ndash;glucuronidase, while for the determination of free silybin, the hydrolytic step was omitted. Naringenin and naproxen were selected as internal standards. The detection of the analyte was carried out by mass spectrometry and by chromatography. The HPLC-MS/MS method was evaluated in terms of selectivity, linearity, limit of quantification, precision and accuracy, and carryover. The method proved to be selective, linear, precise and accurate for the determination of silybin. To the best of our knowledge, this presents the first analytical method with the capacity to quantify the major bioactive components of milk thistle in three different biological matrices with a lower limit of quantification of 0.5 ng/mL for plasma. Silybin phosphatidylcholine, taken orally, can deliver high blood concentrations of silybin, which selectively accumulates in breast tumor tissue

Alternative dosing of exemestane in postmenopausal women with ER-positive breast cancer. Design and methods of a randomized presurgical trial.

IntroductionAromatase inhibitors are effective in lowering breast cancer incidence among postmenopausal women, but adverse events represent a barrier to their acceptability and adherence as a preventive treatment. This study aims to assess whether lowering exemestane schedule may retain biological activity while improving tolerability in breast cancer patients.Methods/designWe are conducting a, pre-surgical, non-inferiority phase IIb study in postmenopausal women with newly diagnosed estrogen receptor-positive breast cancer. Participants are randomized to receive either exemestane 25&nbsp;mg/day or 25&nbsp;mg/three times-week or once a week for 4 to 6&nbsp;weeks prior to surgery. The primary endpoint is the percentage change of serum estradiol concentration between baseline and surgery comparing the three arms. Sample size of 180 women was calculated assuming a 6% non-inferiority of the percent change of estradiol in the lower dose arms compared with the 80% decrease predicted in the full dose arm, with 80% power and using a one-sided 5% significance level and a two-sample t-test. Main secondary outcomes are: safety; change in Ki-67 in cancer and adjacent pre-cancer tissue, circulating sex hormones, adipokines, lipid profile, insulin and glucose changes, in correlation with drug and metabolites concentrations.Results and discussionThe present paper is focused on methodology and operational aspects of the study. A total of 180 participants have ben enrolled. The trial is still blinded, and the analyses are ongoing. Despite the short term duration, results may have relevant implications for clinical management of women at increased risk of developing a ER positive breast cancer

Alternative dosing of exemestane in postmenopausal women with ER-positive breast cancer. Design and methods of a randomized presurgical trial.

IntroductionAromatase inhibitors are effective in lowering breast cancer incidence among postmenopausal women, but adverse events represent a barrier to their acceptability and adherence as a preventive treatment. This study aims to assess whether lowering exemestane schedule may retain biological activity while improving tolerability in breast cancer patients.Methods/designWe are conducting a, pre-surgical, non-inferiority phase IIb study in postmenopausal women with newly diagnosed estrogen receptor-positive breast cancer. Participants are randomized to receive either exemestane 25&nbsp;mg/day or 25&nbsp;mg/three times-week or once a week for 4 to 6&nbsp;weeks prior to surgery. The primary endpoint is the percentage change of serum estradiol concentration between baseline and surgery comparing the three arms. Sample size of 180 women was calculated assuming a 6% non-inferiority of the percent change of estradiol in the lower dose arms compared with the 80% decrease predicted in the full dose arm, with 80% power and using a one-sided 5% significance level and a two-sample t-test. Main secondary outcomes are: safety; change in Ki-67 in cancer and adjacent pre-cancer tissue, circulating sex hormones, adipokines, lipid profile, insulin and glucose changes, in correlation with drug and metabolites concentrations.Results and discussionThe present paper is focused on methodology and operational aspects of the study. A total of 180 participants have ben enrolled. The trial is still blinded, and the analyses are ongoing. Despite the short term duration, results may have relevant implications for clinical management of women at increased risk of developing a ER positive breast cancer