Duration and breaks in sedentary behaviour: Accelerometer data from 1566 community-dwelling older men (British Regional Heart Study)

Background: Sedentary behaviours are increasingly recognised as raising risk of CVD events, diabetes and mortality, independently of physical activity (PA) levels. However, little is known about patterns of sedentary behaviour in older adults. Methods: Cross sectional study of 1566/3137 (50% response) men aged 71-91 years from a UK population-based cohort study. Men wore a GT3x accelerometer over the hip for one week in 2010-11. Mean daily minutes of SB, % of day in sedentary behaviours, sedentary bouts and breaks were calculated and summarized by health and demographic characteristics. Results: 1403 ambulatory men aged 78.4 years (SD 4.6 years) with ≥600 minutes of accelerometer wear on ≥3 days had complete data on covariables. Men spent on average 618 minutes (SD=83), or 72% of their day in sedentary behaviours (<100 counts/minute). On average men accumulated 72 spells of sedentary behaviours per day, with 7 breaks in each sedentary hour. Men had on average 5.1 sedentary bouts of ≥30 minutes, which accounted for 43% of sedentary time, and 1.4 bouts of ≥60 minutes, which accounted for 19% of daily sedentary time. Men who were over 80 years old, obese, depressed and had multiple chronic conditions accumulated more sedentary time and spent more time in longer sedentary bouts. Conclusions: Older men spend nearly three quarters of their day in sedentary behaviours, mostly accumulated in short bouts, although bouts lasting ≥30 minutes accounted for nearly half of the sedentary time each day. Men with medical risk factors were more likely to also display sedentary behaviour

Sinergitas Aktivitas Antibakteri Dari Kelopak Bunga Rosella Dan Kitosan Terhadap Staphylococcus Aureus: Synergistic Antibacterial Activity of Roselle Calyx and Chitosan Against Staphylococcus Aureus

Currently, the antibacterial research is increasingly promoted primarily from natural materials, due to the increasing number of pathogenic bacteria that have been resistant to existing antibiotics. One of the pathogenic bacteria that has been much resistant to antibiotics is Staphylococcus aureus. Rosella calyx (Hibiscus sabdariffa &nbsp;L.) and chitosan are known to have antibacterial activity. The aim of this study to find out the antibacterial synergy of the&nbsp; roselle calyx extract and chitosan against. S.aureus ATCC 33592. Rosella calyx was extracted by maceration using 80 %&nbsp; ethanol, while chitosan is obtained from deasetilation chitin of shrimp husk. Test antibacterial synergism using checkboard assay method by calculating the minimum inhibitory concentration (MIC) &nbsp;using microdilution assay. The results showed minimum inhibitory concentration (MIC) value of roselle calyx extract and chitosan were 1250 ppm and 50 ppm, respectively. &nbsp;MIC value of rosella calyx extract in the presence of chitosan was 625 ppm, while the value of MIC chitosan in the presence of rosella calyx extract was &lt; 0.19 ppm. Fractional Inhibition Concentration Index (FICI) was &lt; 0.5 which concluded that the combination of roselle calyx extract with chitosan has a synergistic antibacterial effect on S.aureus ATCC 33592

Investigation and monitoring on support to the structural mitigation of large slow moving landslides: an example from Ca\u2019 Lita (Northern Apennines, Reggio Emilia, Italy)

The Ca' Lita landslide is a large and deep-seated mass movement located in the Secchia River Valley, in the sector of the Northern Apennines falling into Reggio Emilia Province. about 70 km west of Bologna (Northern Italy). It consists of a composite landslide system that affects Cretaceous to Eocene flysch rock masses and chaotic complexes. Many of the components making up the landslide system have resumed activity between 2002 and 2004, and are now threatening some hamlets and an important road serving the upper watershed area of River Secchia, where many villages and key industrial facilities are located. This paper presents the analysis and the quantification of displacement rates and depths of the mass movements, based on geological and geomorphological surveys, differential DEM analysis, interpretation of underground stratigraphic and monitoring data collected during the investigation campaign that has been undertaken in order to design cost-effective mitigation structures, and that has been conducted with the joint collaboration between public offices and research institutes

Investigation and monitoring in support of the structural mitigation of large slow moving landslides: an example from Ca' Lita (Northern Apennines, Reggio Emilia, Italy)

International audienceThe Ca' Lita landslide is a large and deep-seated mass movement located in the Secchia River Valley, in the sector of the Northern Apennines falling into Reggio Emilia Province, about 70 km west of Bologna (Northern Italy). It consists of a composite landslide system that affects Cretaceous to Eocene flysch rock masses and chaotic complexes. Many of the components making up the landslide system have resumed activity between 2002 and 2004, and are now threatening some hamlets and an important road serving the upper watershed area of River Secchia, where many villages and key industrial facilities are located. This paper presents the analysis and the quantification of displacement rates and depths of the mass movements, based on geological and geomorphological surveys, differential DEM analysis, interpretation of underground stratigraphic and monitoring data collected during the investigation campaign that has been undertaken in order to design cost-effective mitigation structures, and that has been conducted with the joint collaboration between public offices and research institutes

Bullous central serous chorioretinopathy: A rare and atypical form of central serous chorioretinopathy. a systematic review

Bullous central serous chorioretinopathy (bCSCR) is a rare variant of the central serous chorioretinopathy, complicated by an exudative retinal detachment with shifting fluid. This systematic review aims to present the epidemiology, the pathogenesis, the clinical presentation, the imaging, the differential diagnosis, and the latest treatments of this disease. A total of 60 studies were identified following a literature search adhering to PRISMA guidelines. After full-text evaluation, 34 studies about bCSCR were included. bCSCR usually affects middle-aged men, and the principal risk factor is corticosteroid medications. Pathogenesis is related to an increased choroidal vessel and choriocapillaris permeability, with subsequent subretinal fluid accumulation, rich in fibrin, which may provoke the exudative retinal detachment. Clinical presentation and imaging are fundamental to distinguish bCSCR from other pathologies, avoiding unappropriated treatment. Corticosteroid withdraws (if assumed) and laser photocoagulation of leakage sites seen at angiography may speed up retinal reattachment. Verteporfin photodynamic therapy, transpupillary thermal therapy, oral eplerenone and scleral thinning surgery are other therapeutic options. An early diagnosis might prevent disease progression due to harmful medications as well as unnecessary surgery

What is the impact of intraoperative microscope-integrated oct in ophthalmic surgery? Relevant applications and outcomes. a systematic review

Background: Optical coherence tomography (OCT) has recently been introduced in the operating theatre. The aim of this review is to present the actual role of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology. Method: A total of 314 studies were identified, following a literature search adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. After full-text evaluation, 81 studies discussing MI-OCT applications in ophthalmology were included. Results: At present, three microscope-integrated optical coherence tomography systems are commercially available. MI-OCT can help anterior and posterior segment surgeons in the decision-making process, providing direct visualization of anatomic planes before and after surgical manoeuvres, assisting in complex cases, and detecting or confirming intraoperative complications. Applications range from corneal transplant to macular surgery, including cataract surgery, glaucoma surgery, paediatric examination, proliferative diabetic retinopathy surgery, and retinal detachment surgery. Conclusion: The use of MI-OCT in ophthalmic surgery is becoming increasingly prevalent and has been applied in almost all procedures. However, there are still limitations to be overcome and the technology involved remains difficult to access and use

The transformed-stationary approach: A generic and simplified methodology for non-stationary extreme value analysis

Statistical approaches to study extreme events require, by definition, long time series of data. In many scientific disciplines, these series are often subject to variations at different temporal scales that affect the frequency and intensity of their extremes. Therefore, the assumption of stationarity is violated and alternative methods to conventional stationary extreme value analysis (EVA) must be adopted. Using the example of environmental variables subject to climate change, in this study we introduce the transformed-stationary (TS) methodology for non-stationary EVA. This approach consists of (i) transforming a non-stationary time series into a stationary one, to which the stationary EVA theory can be applied, and (ii) reverse transforming the result into a non-stationary extreme value distribution. As a transformation, we propose and discuss a simple time-varying normalization of the signal and show that it enables a comprehensive formulation of non-stationary generalized extreme value (GEV) and generalized Pareto distribution (GPD) models with a constant shape parameter. A validation of the methodology is carried out on time series of significant wave height, residual water level, and river discharge, which show varying degrees of long-term and seasonal variability. The results from the proposed approach are comparable with the results from (a) a stationary EVA on quasi-stationary slices of non-stationary series and (b) the established method for non-stationary EVA. However, the proposed technique comes with advantages in both cases. For example, in contrast to (a), the proposed technique uses the whole time horizon of the series for the estimation of the extremes, allowing for a more accurate estimation of large return levels. Furthermore, with respect to (b), it decouples the detection of non-stationary patterns from the fitting of the extreme value distribution. As a result, the steps of the analysis are simplified and intermediate diagnostics are possible. In particular, the transformation can be carried out by means of simple statistical techniques such as low-pass filters based on the running mean and the standard deviation, and the fitting procedure is a stationary one with a few degrees of freedom and is easy to implement and control. An open-source MATLAB toolbox has been developed to cover this methodology, which is available at https://github.com/menta78/tsEva/ (Mentaschi et al., 2016)

The other side of malnutrition in inflammatory bowel disease (Ibd): Non-alcoholic fatty liver disease

Steatohepatitis and hepatobiliary manifestations constitute some of the most common extraintestinal manifestations of Inflammatory Bowel Disease (IBD). On the other hand, non-alcoholic fatty liver disease (NAFLD) affects around 25% of the world’s population and is attracting ever more attention in liver transplant programs. To outline the specific pathways linking these two conditions is a pressing task for 21st-century researchers. We are accustomed to expecting the occurrence of fatty liver disease in obese people, but current evidence suggests that there are several different pathways also occurring in underweight patients. Genetic factors, inflammatory signals and microbiota are key players that could help in understanding the entire pathogenesis of NAFLD, with the aim of defining the multiple expressions of malnutrition. In the current review, we summarize the most recent literature regarding the epidemiology, pathogenesis and future directions for the management of NAFLD in patients affected by IBD

A Clostridium difficile outbreak in an Italian hospital: The efficacy of the multi-disciplinary and multifaceted approach

Introduction. We described an outbreak of C. difficile that occurred in the Internal Medicine department of an Italian hospital and assessed the efficacy of the measures adopted to manage the outbreak. Methods. The outbreak involved 15 patients and was identified by means of continuous integrated microbiological surveillance, starting with laboratory data (alert organism surveillance). Diarrheal fecal samples from patients with suspected infection by C. difficile underwent rapid membrane immuno-enzymatic testing, which detects both the presence of the glutamate dehydrogenase antigen and the presence of the A and B toxins. Extensive microbiological sampling was carried out both before and after sanitation of the environment, in order to assess the efficacy of the sanitation procedure. Results. The outbreak lasted one and a half month, during which time the Committee for the Prevention of Hospital Infections ordered the implementation of multiple interventions, which enabled the outbreak to be controlled and the occurrence of new cases to be progressively prevented. The strategies adopted mainly involved patient isolation, reinforcement of proper hand hygiene techniques, antimicrobial stewardship and environmental decontamination by means of chlorine-based products. Moreover, the multifaceted management of the outbreak involved numerous sessions of instruction/training for nursing staff and socio-sanitary operatives during the outbreak. Sampling of environmental surfaces enabled two sites contaminated by C. difficile to be identified. Conclusions. Joint planning of multiple infection control practices, together with effective communication and collaboration between the Hospital Infections Committee and the ward involved proved to be successful in controlling the outbreak

Effects on health-related quality of life of interventions affecting survival in critically ill patients: a systematic review

Survival has been considered the cornerstone for clinical outcome evaluation in critically ill patients admitted to intensive care unit (ICU). There is evidence that ICU survivors commonly show impairments in long-term outcomes such as quality of life (QoL) considering them as the most relevant ones. In the last years, the concept of patient-important outcomes has been introduced and increasingly reported in peer-reviewed publications. In the present systematic review, we evaluated how many randomized controlled trials (RCTs) were conducted on critically ill patients and reporting a benefit on survival reported also data on QoL. All RCTs investigating nonsurgical interventions that significantly reduced mortality in critically ill patients were searched on MEDLINE/PubMed, Scopus and Embase from inception until August 2021. In a second stage, for all the included studies, the outcome QoL was investigated. The primary outcome was to evaluate how many RCTs analyzing interventions reducing mortality reported also data on QoL. The secondary endpoint was to investigate if QoL resulted improved, worsened or not modified. Data on QoL were reported as evaluated outcome in 7 of the 239 studies (2.9%). The tools to evaluate QoL and QoL time points were heterogeneous. Four interventions showed a significant impact on QoL: Two interventions improved survival and QoL (pravastatin in subarachnoid hemorrhage, dexmedetomidine in elderly patients after noncardiac surgery), while two interventions reduced mortality but negatively influenced QoL (caloric restriction in patients with refeeding syndrome and systematic ICU admission in elderly patients). In conclusion, only a minority of RCTs in which an intervention demonstrated to affect mortality in critically ill patients reported also data on QoL. Future research in critical care should include patient-important outcomes like QoL besides mortality. Data on this topic should be collected in conformity with PROs statement and core outcome sets to guarantee quality and comparability of results