A multilevel model with clustered management practices differentiating dairy herd environments in southeastern Sicily

Herd environments constitute productivity potentials, or aggregate opportunity outcomes, resulting from management actions taken with the available inputs. Management outcomes from cow nutrition, udder health and milking practices were quantified with the help of surveys of 254 dairy producers in southeastern Sicily. Objectives were to disentangle environmental opportunities by disaggregating herd effects into causal inputs. Average ME milk production was 8640 kg/lactation for the 183 Friesian herds containing 35 lactating cows and 10 dry cows. Seventy-one Brown Swiss herds averaged 6443 kg ME milk from 25 lactating and 10 dry cows. For Friesian (Brown Swiss) herds 10 (11) management practices affected milking performance and 9 (8) practices influenced somatic cell concentration (P<0.05). Multilevel analysis and herd clustering procedures differentiated low from high opportunity herd environments but altering relative weightings among management practices did not further discriminate them. This clustering methodology helps ensure unbiased estimation of management input effects and could help target priority management substitutions and technical support priorities in dairy extension programs.Partially funded by the CoRFiLaC (Ragusa, Italy) and Cornell University.www.elsevier.com/locate/livscihb201

How Contemporary Human Reproductive Behaviors Influence the Role of Fertility-Related Genes: The Example of the P53 Gene

Studies on human fertility genes have identified numerous risk/protective alleles involved in the occurrence of reproductive system diseases causing infertility or subfertility. Investigations we carried out in populations at natural fertility seem to suggest that the clinical relevance that some fertility genes are now acquiring depends on their interaction with contemporary reproductive behaviors (birth control, delayed childbearing, and spacing birth order, among others). In recent years, a new physiological role in human fertility regulation has emerged for the tumor- suppressor p53 gene (P53), and the P53 Arg72Pro polymorphism has been associated with recurrent implantation failure in humans. To lend support to our previous observations, we examined the impact of Arg72Pro polymorphism on fertility in two samples of Italian women not selected for impaired fertility but collected from populations with different (premodern and modern) reproductive behaviors. Among the women at near-natural fertility (n = 98), the P53 genotypes were not associated with different reproductive efficiency, whereas among those with modern reproductive behaviors (n = 68), the P53 genotypes were associated with different mean numbers of children [Pro/Pro = 0.75<Pro/Arg = 1.7<Arg/Arg = 2, (p = 0.056)] and a significant negative relationship between the number of children and P53 Pro allele frequencies (p = 0.028) was observed. These results are consistent with those of clinical studies reporting an association between the P53 Pro allele and recurrent implantation failure. By combining these findings with previous ones, we suggest here that some common variants of fertility genes may have become “detrimental” following exposure to modern reproductive patterns and might therefore be associated with reduced reproductive success. Set within an evolutionary framework, this change could lead to the selection of a set of gene variants fitter to current reproductive behaviors as the shift to later child-bearing age in developed countries

A new national survey of centers for cognitive disorders and dementias in Italy

IntroductionA new national survey has been carried out by the Italian Centers for Cognitive Disorders and Dementias (CCDDs). The aim of this new national survey is to provide a comprehensive description of the characteristics, organizational aspects of the CCDDs, and experiences during the COVID-19 pandemic.MethodsA list of all national CCDDs was requested from the delegates of each Italian region. The online questionnaire is divided in two main sections: a profile section, containing information on location and accessibility, and a data collection form covering organization, services, treatments, activities, and any service interruptions caused by the COVID-19 outbreak.ResultsIn total, 511 out of 534 (96%) facilities completed the profile section, while 450 out of 534 (84%) CCDDs also completed the data collection form. Almost half of the CCDDs (55.1%) operated for 3 or fewer days a week. About one-third of the facilities had at least two professional figures among neurologists, geriatricians and psychiatrists. In 2020, only a third of facilities were open all the time, but in 2021, two-thirds of the facilities were open.ConclusionThis paper provides an update on the current status of CCDDs in Italy, which still shows considerable heterogeneity. The survey revealed a modest improvement in the functioning of CCDDs, although substantial efforts are still required to ensure the diagnosis and care of patients with dementia

The Italian fund for Alzheimer's and other dementias: strategies and objectives to face the dementia challenge

The Italian Fund for Alzheimer's and other dementias was approved and signed in December 2021. The Fund is financed with 15 million euros in three years. The main goal is to provide new strategies in the field of dementia with a Public Health perspective. The Fund includes eight main activities that will be monitored and supervised by the Italian National Institute of Health: 1) development of a guideline for the assessment, management and support for people with dementia and their families/carers; 2) updating of the Dementia National Plan (DNP); 3) implementation of the documents of the DNP; 4) conducting surveys dedicated to the Italian Dementia Services; 5) promotion of dementia prevention strategies; 6) training strategies for healthcare professionals, families and caregivers; 7) creation of a National Electronic Record for Dementia; 8) evaluation and monitoring of activities promoted by Regions and Autonomous Provinces in the field of dementia, together with the dementia National Permanent Table. These activities are outlined in detail in the present paper

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR &lt; 60 mL/min/1.73 m2) or eGFR reduction &gt; 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR &lt; 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR &gt; 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Demenze e pseudodemenze.

Il capitolo illustra il tema del deterioramento cognitivo su base degenerativa e quello secondario ad altre patologie neurologiche. L'autore si sofferma in particolare sulla malattia di Alzheimer illustrando gli aspetti clinici, diagnostici e prognostici

La verit\ue0 sostenibile nelle malattie neurologiche degenerative

La comunicazione della diagnosi costituisce uno dei pi\uf9 importanti passi della presa in carico della persona affetta da demenza. In questo lavoro si passano in disamina i dilemmi etici che interessano la comunicazione della diagnosi nel rispetto del principio di autonomia del paziente versus il principio di non maleficienza. Infine vengono affrontati i problemi di natura giuridica, in particolare il consenso informato alla luce della consapevolezza che il paziente ha del proprio deficit cognitivo

Metodologia della valutazione delle "capacità": alcune osservazioni, tra prospettive e dilemmi

Nel saggio vengono discusse le linee guida della valutazione delle capacità nell'anzian

Invecchiamento della popolazione e passaggi generazionali: Questioni cliniche - Introduzione

Il volume raccoglie una serie di saggi di esperti nell'ambito dell'invecchiamento e del decadimento cognitivo, sui temi dei dilemmi in ambito clinico insiti nella valutazione delle capacità decisionali e di consapevolezza anche con particolare riferimento a momenti particolari delle fasi di invecchiament