The paradigm of norgestimate: a third-generation testosterone-derivative progestin with a peripheral anti-androgenic activity and the lowest risk of venous thromboembolism

Introduction: Norgestimate (NGM) is a testosterone derivative with peculiar receptor activities. Areas covered: This is a narrative review of the available data on the pharmacotherapy of NGM in combined hormonal contraceptives (CHCs) in terms of contraceptive efficacy, venous thromboembolism (VTE) risk, safety, tolerability and bleeding patterns. A comprehensive literature review was conducted in August 2020 using PubMed with the keyword ‘norgestimate’. Expert Opinion: NGM shows a mild estrogenic activity associated with anti-mineralocorticoid and anti-androgenic properties, largely responsible for the cardiovascular safety profile. The anti-androgenic property depends on the androgen receptor (AR) nuclear translocation (AR trafficking and its subnuclear distribution), the inhibition of 5α-reductase activity (it possesses higher activity compared to other available progestins), and the increase on sexual hormone binding globulin (SHBG) levels if combined with an estrogenic counterpart. NGM is one of the molecules that best modulates the power of ethinyl-estradiol on the thromboembolic risk, being associated with the lowest VTE risk between different CHCs. NGM has the advantage of retaining peripheral anti-androgenic activity, demonstrated by the impact on lipid and glucose metabolism, and it should be preferred if compared with other similar progestins of the same class of risk which are much more androgenic, such as levonorgestrel

A lower bound for interval routing in general networks

Includes bibliographical references (p. 11).At head of title: Computer science publication.Cover title.published_or_final_versio

Robust optical frequency dissemination with a dual-polarization coherent receiver

Frequency dissemination over optical fiber links relies on measuring the phase of fiber-delivered lasers. Phase is extracted from optical beatnotes and the detection fails in case of beatnotes fading due to polarization changes, which strongly limit the reliability and robustness of the dissemination chain. We propose a new method that overcomes this issue, based on a dual-polarization coherent receiver and a dedicated signal processing that we developed on a field programmable gated array. Our method allowed analysis of polarization-induced phase noise from a theoretical and experimental point of view and endless tracking of the optical phase. This removes a major obstacle in the use of optical links for those physics experiments where long measurement times and high reliability are required

The impact of COVID-19 lockdown on admission to gynecological emergency departments: Results from a multicenter Italian study

Objective: To evaluate the impact of the COVID-19 lockdown on admissions to gynecological emergency departments (ED) of three Italian university hospitals with different rates of COVID-19 incidence. Methods: A retrospective study was conducted in the gynecological EDs of Modena (Emilia-Romagna), Sassari and Cagliari (Sardinia) regarding all admissions to gynecological EDs during November 1 to 30, 2019, and March 11 to April 9, 2020 (lockdown period). Results: A total of 691 women (mean age 38.3 \ub1 14.3 years) who were admitted to the gynecological EDs were included. The relative decrease in women evaluated from March 11 to April 9, 2020, was 1256.6% (95% confidence interval [CI] 52.2\u201361.1). Time spent in the ED was also significantly shorter during this period (P=0.02) in comparison to November 1 to 30, 2019. The most evident decrease was observed for pelvic pain ( 1268.9% [95% CI 60.3\u201376.7]; 1291 cases). The management of women suggests a more effective use of the ED, with higher rates of hospitalization (P=0.001) and recourse to emergent surgeries (P=0.005) and lower rates of discharge to home (P=0.03). Conclusion: The COVID-19 lockdown greatly reduced the rate of admission to gynecological EDs, but the real emergencies were filtered from the more deferrable ones

The role of the surfaces in the photon absorption in Ge nanoclusters embedded in silica

The usage of semiconductor nanostructures is highly promising for boosting the energy conversion efficiency in photovoltaics technology, but still some of the underlying mechanisms are not well understood at the nanoscale length. Ge quantum dots (QDs) should have a larger absorption and a more efficient quantum confinement effect than Si ones, thus they are good candidate for third-generation solar cells. In this work, Ge QDs embedded in silica matrix have been synthesized through magnetron sputtering deposition and annealing up to 800°C. The thermal evolution of the QD size (2 to 10 nm) has been followed by transmission electron microscopy and X-ray diffraction techniques, evidencing an Ostwald ripening mechanism with a concomitant amorphous-crystalline transition. The optical absorption of Ge nanoclusters has been measured by spectrophotometry analyses, evidencing an optical bandgap of 1.6 eV, unexpectedly independent of the QDs size or of the solid phase (amorphous or crystalline). A simple modeling, based on the Tauc law, shows that the photon absorption has a much larger extent in smaller Ge QDs, being related to the surface extent rather than to the volume. These data are presented and discussed also considering the outcomes for application of Ge nanostructures in photovoltaics

Análisis geoquímico de la calidad de agua en el Valle de Chaschuil-Catamarca

El agua es uno de los recursos más significativos de consumo en todo el planeta y especialmente en zonas áridas, como las localidades del departamento Tinogasta, donde las áreas de cultivos presentan una actividad alternativa para el desarrollo de la región. Dado que la cantidad y calidad de agua disponible para diferentes usos es variable, la calidad de agua del acuífero fue evaluado para el uso en cultivos. Por ello, se realizó un estudio para analizar la distribución espacial del acuífero de acuerdo a los parámetros de calidad y para identificar lugares con la mejor calidad basado en el análisis fisicoquímico de las muestras. Los resultados fueron comparados con los valores recomendados por la Organización Mundial de la Salud para el consumo y salud público. Del análisis realizado se puede clasificar las muestras como Aceptable para el riego con moderada restricción de uso, teniendo en cuenta la concentración de carbonatos/bicarbonatos encontrada.Water is one of the most significant consumption resources in the whole planet, especially in arid areas, such as the localities from Tinogasta Department, where crop areas represent an alternative activity for regional development. Since the quantity and quality of water available for different uses is variable, water quality of the aquifer was evaluated for use in crops. Therefore, a study was carried out to analyze the spatial distribution of the aquifer according to quality parameters and to identify places with the best quality based on the physicochemical analysis of the samples. Results were compared with the values recommended by the World Health Organization for public health and consumption. From the analysis carried out, the samples could be classified as acceptable for irrigation with moderate restriction of use, taking into account the carbonate / bicarbonate concentration found.Fil: Ortiz, Erlinda del Valle. Universidad Nacional de Catamarca. Facultad de Tecnología y Ciencias Aplicadas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Niz, Adriana Edith. Universidad Nacional de Catamarca. Facultad de Tecnología y Ciencias Aplicadas; ArgentinaFil: Savio, M. E.. Universidad Nacional de Catamarca. Facultad de Tecnología y Ciencias Aplicadas; ArgentinaFil: Lamas, C. A.. Universidad Nacional de Catamarca. Facultad de Tecnología y Ciencias Aplicadas; ArgentinaFil: Barbieri, N. R.. Universidad Nacional de Catamarca. Facultad de Tecnología y Ciencias Aplicadas; ArgentinaFil: Duchowicz, Pablo Román. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; Argentin

Generation of three iPSC lines from fibroblasts of a patient with Aicardi Goutières Syndrome mutated in TREX1

Fibroblasts from a patient with Aicardi Gouti\ue8res Syndrome (AGS) carrying a compound heterozygous mutation in TREX1, were reprogrammed into induced pluripotent stem cells (iPSCs) to establish isogenic clonal stem cell lines: UNIBSi006-A, UNIBSi006-B, and UNIBSi006-C. Cells were transduced using the episomal Sendai viral vectors, containing human OCT4, SOX2, c-MYC and KLF4 transcription factors. The transgene-free iPSC lines showed normal karyotype, expressed pluripotent markers and displayed in vitro differentiation potential toward cells of the three embryonic germ layers

THE BEHAVE APPLICATION: AN EVIDENCE-BASED TOOL TO MANAGE SOCIAL EMOTIONAL BEHAVIOURAL DIFFICULTIES

Social Emotional and Behavioural Difficulties (SEBD) are a persistent and multiple manifestation of maladaptive behaviours which interfere with the students’ learning, social functioning and development and/or that of their peers. They may become apparent through withdrawn, passive, aggressive or self-injurious tendencies. The prevalence of these disorders is 2-16% of the general population. Children with SEBD, diagnosed or not, are likely to live in social isolation, to receive a poor education, and they risk becoming deviant teenagers, or unemployed adults. A way to approach SEBD with consistent level of educational success is to equip teachers with proper training on practical and proven classroom management strategies, but also with evidence-based tools that can help them to effectively control difficult behaviours with confidence and competence. This contribution presents the web-based BEHAVE application aimed to ease the way for teachers to apply behavioural evidence-based interventions at school. The paper describes the main features of the BEHAVE application: the definition of the behaviour to be observed, the creation and selection of appropriate measures, the collection of behavioural data, and the statistical analysis to evaluate the direction and the power of the effect of the carried-out intervention

Interventions to promote cost-effectiveness in adult Intensive care units: consensus statement and considerations for best practice from a multidisciplinary and multinational eDelphi study

Background There is limited evidence to guide interventions that promote cost-effectiveness in adult intensive care units (ICU). The aim of this consensus statement is to identify globally applicable interventions for best ICU practice and provide guidance for judicious use of resources. Methods A three-round modified online Delphi process, using a web-based platform, sought consensus from 61 multidisciplinary ICU experts (physicians, nurses, allied health, administrators) from 21 countries. Round 1 was qualitative to ascertain opinions on cost-effectiveness criteria based on four key domains of high-value healthcare (foundational elements; infrastructure fundamentals; care delivery priorities; reliability and feedback). Round 2 was qualitative and quantitative, while round 3 was quantitative to reiterate and establish criteria. Both rounds 2 and 3 utilized a five-point Likert scale for voting. Consensus was considered when > 70% of the experts voted for a proposed intervention. Thereafter, the steering committee endorsed interventions that were identified as ‘critical’ by more than 50% of steering committee members. These interventions and experts’ comments were summarized as final considerations for best practice. Results At the conclusion of round 3, consensus was obtained on 50 best practice considerations for cost-effectiveness in adult ICU. Finally, the steering committee endorsed 9 ‘critical’ best practice considerations. This included adoption of a multidisciplinary ICU model of care, focus on staff training and competency assessment, ongoing quality audits, thus ensuring high quality of critical care services whether within or outside the four walls of ICUs, implementation of a dynamic staff roster, multidisciplinary approach to implementing end-of-life care, early mobilization and promoting international consensus efforts on the Green ICU concept. Conclusions This Delphi study with international experts resulted in 9 consensus statements and best practice considerations promoting cost-effectiveness in adult ICUs. Stakeholders (government bodies, professional societies) must lead the efforts to identify locally applicable specifics while working within these best practice considerations with the available resources

Accelerating legacy applications with spatial computing devices

Heterogeneous computing is the major driving factor in designing new energy-efficient high-performance computing systems. Despite the broad adoption of GPUs and other specialized architectures, the interest in spatial architectures like field-programmable gate arrays (FPGAs) has grown. While combining high performance, low power consumption and high adaptability constitute an advantage, these devices still suffer from a weak software ecosystem, which forces application developers to use tools requiring deep knowledge of the underlying system, often leaving legacy code (e.g., Fortran applications) unsupported. By realizing this, we describe a methodology for porting Fortran (legacy) code on modern FPGA architectures, with the target of preserving performance/power ratios. Aimed as an experience report, we considered an industrial computational fluid dynamics application to demonstrate that our methodology produces synthesizable OpenCL codes targeting Intel Arria10 and Stratix10 devices. Although performance gain is not far beyond that of the original CPU code (we obtained a relative speedup of x 0.59 and x 0.63, respectively, for a single optimized main kernel, while only on the Stratix10 we achieved x 2.56 by replicating the main optimized kernel 4 times), our results are quite encouraging to drawn the path for further investigations. This paper also reports some major criticalities in porting Fortran code on FPGA architectures