175 research outputs found
On Monami modes and scales of a flexible vegetation array in a laminar boundary layer
No full textFlexible aquatic vegetation exists widely in nature and serves multiple hydro-environmental functions mainly through fluid–structure interactions. The waving motion of vegetation arrays, known as Monami, is predominantly governed by Kelvin–Helmholtz (KH) instability, and its characteristic scales, such as wave height and wavelength, are still being explored. In this paper, the interactions between a large array of flexible vegetations and a laminar boundary-layer flow are investigated using direct numerical simulation. The parameters used are the Reynolds number Re = 400, mass ratio beta=1.0, bending rigidity gamma=0.04–0.22, and gap distance d=0.4–1.6. A low frequency in Monami is found to be related to the fluctuation frequency of the onset position of the KH instability, which leads to the identification of four different Monami modes: regular Monami, quasi-regular Monami A, quasi-regular Monami B, and irregular Monami. The influences of the bending rigidity and gap distance on the Monami modes, KH instability onset position, and Monami characteristic scales are discussed. It was found that the causes of spatial and temporal variations in the characteristic scales of Monami vary depending on the mode. In the regular Monami mode, these variations result from the evolution of the KH vortex. In the quasi-regular Monami A mode, they are strongly affected by the shifting of the onset position of the KH instability. In the other two modes, these variations are caused by a combination of the fluctuation in the KH instability onset position and the complex interaction between vortices.</p
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On Monami modes and scales of a flexible vegetation array in a laminar boundary layer
No full textFlexible aquatic vegetation exists widely in nature and serves multiple hydro-environmental functions mainly through fluid–structure interactions. The waving motion of vegetation arrays, known as Monami, is predominantly governed by Kelvin–Helmholtz (KH) instability, and its characteristic scales, such as wave height and wavelength, are still being explored. In this paper, the interactions between a large array of flexible vegetations and a laminar boundary-layer flow are investigated using direct numerical simulation. The parameters used are the Reynolds number Re = 400, mass ratio β = 1.0, bending rigidity γ = 0.04–0.22, and gap distance d = 0.4–1.6. A low frequency in Monami is found to be related to the fluctuation frequency of the onset position of the KH instability, which leads to the identification of four different Monami modes: regular Monami, quasi-regular Monami A, quasi-regular Monami B, and irregular Monami. The influences of the bending rigidity and gap distance on the Monami modes, KH instability onset position, and Monami characteristic scales are discussed. It was found that the causes of spatial and temporal variations in the characteristic scales of Monami vary depending on the mode. In the regular Monami mode, these variations result from the evolution of the KH vortex. In the quasi-regular Monami A mode, they are strongly affected by the shifting of the onset position of the KH instability. In the other two modes, these variations are caused by a combination of the fluctuation in the KH instability onset position and the complex interaction between vortices
Correction to: Autologous cell therapy for ischemic diabetic foot: a meta-analysis of randomized controlled trials for the development of the Italian guidelines for the treatment of diabetic foot syndrome (Acta Diabetologica, (2024), 10.1007/s00592-024-02393-z)
No full textIn the original version of this article, the author name ‘Matteo Monami’ at affiliation ‘Azienda Ospedaliero Universitaria Careggi and University of Florence, Florence, Italy' was missing from the author[consortium] list. The original article has been corrected
Innovative interfaces in MonAMI
No full textThis demo paper presents an early version of the Reminder, a prototype ECA developed in the European project MonAMI, which aims at "mainstreaming accessibility in consumer goods and services, using advanced technologies to ensure equal access, independent living and participation for all". The Reminder helps users to plan activities and to remember what to do. The prototypemerges mobile ECA technology with other, existing technologies:Google Calendar and a digital pen and paper. The solution allows users to continue using a paper calendar in the manner they are used to, whilst the ECA provides notifications on what has been written in the calendar. Users may ask questions such as "When was I supposed to meet Sara?" or "What's my schedule today"?</p
PCSK9 Inhibitor Therapy. A systematic review and meta-analysis of metabolic and cardiovascular outcomes in patients with diabetes
No full textAims: Pro-protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors bring about a wide reduction in low-density lipoprotein (LDL) cholesterol, greater than that of other lipid-lowering agents. The aim of this metanalysis was assessment of the effects of PCSK9 inhibitors on glucose metabolism, LDL cholesterol, cardiovascular morbidity and mortality in individuals with and without diabetes. Materials and methods: A Medline and Clinicaltrials.gov search for eligible studies published before 1 December 2017 was performed. All randomized trials comparing PCSK-9 inhibitors with placebo or active drugs were included. Primary endpoints included (a) incident diabetes, fasting glucose and HbA1c, (b) LDL cholesterol at endpoint in patients with diabetes and in the total sample, and (c) major cardiovascular events (MACE) and mortality in individuals with and without diabetes. Results: A total of 38 trials was identified. The risk of incident diabetes was not increased by PCSK-9 inhibitors, vs placebo or any comparator. The reduction in LDL cholesterol vs placebo in patients with diabetes was 52.6 [41.3;63.8] mg/dL; the corresponding figure for all patients was 66.9 [62.4;71.3] mg/dL. Meta-regression analysis showed an inverse correlation between proportion of patients with diabetes and drug effect on LDL cholesterol in trials vs ezetimibe, but not in those vs placebo. In studies reporting data on MACE and mortality separately for individuals with and without diabetes, the effect of PCSK-9 did not appear to be affected by diabetes. Conclusion: PCSK-9 inhibitors do not affect glucose metabolism. Their efficacy on LDL cholesterol and MACE in patients with diabetes does not seem to be very dissimilar to that observed in non-diabetic participants
Microvascular effects of glucagon-like peptide-1 receptor agonists in type 2 diabetes. a meta-analysis of randomized controlled trials
No full textAims: Results with GLP1-receptor agonists (GLP-1RA) on microvascular complications of diabetes are contrasting. In trials designed for cardiovascular outcomes, both liraglutide and semaglutide were associated with a relevant reduction in the incidence and progression of nephropathy. On the other hand, in the same trials, semaglutide was associated with an increased progression of retinopathy, and a similar trend was observed for liraglutide. This meta-analysis is aimed at assessing the effects of GLP-1RA on retinopathy and nephropathy. Methods: A Medline search for GLP-1 receptor agonists (exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, or semaglutide) was performed, collecting all randomized clinical trials with a duration >11 weeks, enrolling patients with type 2 diabetes, and comparing a GLP-1 receptor agonist with placebo or any other non-GLP-1 receptor agonist drug. Results: Of the 113 trials fulfilling the inclusion criteria, 78 and 62 did not report information on retinopathy and nephropathy, respectively. Treatment with GLP1-RA was not associated with a significant increase in the incidence of retinopathy (MH-OR [95% CI] 0.92 [0.74–1.16]. p = 0.49). In subgroup analyses, GLP1-RA were associated with a lower risk of retinopathy in comparison with sulfonylureas. Cases of macular edema were reported only in nine trials with no sign of increased risk. GLP1-RA reduced the incidence of nephropathy with respect to comparators (MH-OR [95% CI] 0.74 [0.60–0.92]. p = 0.005). This difference was significant versus placebo, but not versus any class of active comparators. Conclusions: GLP1-RA appear to reduce the incidence and/or progression of nephropathy and to have no specific effect on retinopathy—with the notable exception of semaglutide, which could have a negative impact on the retina
Major cardiovascular events, heart failure, and atrial fibrillation in patients treated with glucagon-like peptide-1 receptor agonists: an updated meta-analysis of randomized controlled trials
No full textBackground and aims: Glucagon-like Peptide 1 Receptor Agonists (GLP1-RA) has been associated with a reduction of major cardiovascular events (MACE) and mortality on the basis of the results of cardiovascular outcome trials (CVOT). Several meta-analyses on this issue have been recently published; however, they were all restricted to CVOT, with the exclusion of all studies designed for other endpoints; moreover, other cardiovascular endpoints, such as atrial fibrillation and heart failure have not been fully explored. Methods and results: A Medline search for GLP-1 receptor agonists (exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, or semaglutide) was performed, collecting all randomized clinical trials with a duration ≥52 weeks, enrolling patients with type 2 diabetes, and comparing a GLP-1 receptor agonist with placebo or any other non-GLP-1 receptor agonist drug. We included 43 trials, enrolling 63,134 patients. A significant reduction of MACE (MH-OR 0.87 [0.83, 0.92]), all-cause mortality (MH-OR 0.89 [0.83, 0.96]), and a nonstatistical trend toward reduction of heart failure (MH-OR 0.93 [0.85, 1.01]) was observed – GLP1-RA did not increase the risk of atrial fibrillation (MH-OR 0.94 [0.84, 1.04]). Conclusion: The present meta-analysis confirms the favorable effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events, cardiovascular and all-cause mortality, stroke, and possibly myocardial infarction. Conversely, the effects on heart failure remain uncertain. Available data on atrial fibrillation seems to exclude any major safety issues in this respect. Registration number (PROSPERO): CRD42018115577
Immune checkpoints inhibitors and hyperglycemia. A Meta-analysis of randomized controlled trials
No full textBackground: Immune checkpoint inhibitors (ICI) exert their therapeutic effect by modulating the immune system and potentiating antitumor immunity. ICI have been associated with several immune-related adverse events, such as diabetes. However, no formal metaanalysis with this respect has been conducted so far. Aim of the present metaanalysis of randomized trials is to assess the effects of ICI on incident diabetes and hyperglycemia. Methods: A MEDLINE, Scopus, ISI-WOS, and Cochrane database search was performed to identify trials, enrolling patients with any form of cancer, up to April 23rd, 2019 in which ICI have been compared either with placebo or active comparators. Data were extracted from published reports or, if not available, from clinicaltrials.gov. The principal endpoints were the incidence of diabetes and cases of hyperglycemia, reported as adverse events. Mantel-Haenszel Odds Ratio with 95% Confidence Interval (MH-OR) was calculated for all outcomes. The study has been registered on PROSPERO website (CDR133927). Findings: Out of 42 trials retrieved, 40 reported information on incident diabetes or hyperglycemia. No association of ICI with incident diabetes (MH-OR 1.27 [0.66, 2.43], p = 0.47) was observed; whereas there was a trend toward an increased risk of hyperglycemia (MH-OR 1.45 [0.99, 2.13], p = 0.060), which reached statistical significance in sensitivity analyses and when analyzing separately placebo-controlled trials (MH-OR 1.95 [1.10, 3.49], p = 0.020). I2 statistics did not suggest any relevant heterogeneity for all the principal analyses performed. Interpretation: ICI treatment is associated with an increased risk of hyperglycemia, and an increase in the risk of diabetes cannot be excluded
COVID-19 Vaccine Hesitancy and Early Adverse Events Reported in a Cohort of 7,881 Italian Physicians
No full textBackground: The COVID-19 vaccination campaign began in Italy at the end of December 2020, with the primary aim of immunizing healthcare professionals, using the EMA approved mRNA vaccines (Comirnaty® by Pfizer/BioNTech; mRNA-1273 by Moderna) and recombinant adenoviral vaccine (Vaxzevria® by AstraZeneca). The study aimed at evaluating the prevalence and motivations underlying Vaccine Hesitancy, as well as the incidence and type of adverse events associated with COVID-19 vaccination. Methods: Cross-sectional study. Data were collected January 1st to 28th 2021 using a purposely created online self-administered questionnaire from a selected cohort of Italian physicians. Results: Overall, 7,881 questionnaires were analyzed: 6,612 physicians had received one dose, and 1,670 two doses of Comirnaty®; 30 had received one dose of mRNA-1273. Vaccine Hesitancy rate was 3.6%; it correlated with prior SARS-CoV-2 infection, diabetes, Adverse Eventss at previous vaccinations and refusal of 2020 flu vaccine, and was mainly motivated by concerns about vaccine Adverse Events. Typical Adverse Events were pain/itching/paresthesia at the inoculation site, followed by headache, fever, fatigue and myalgia/arthralgia occurring more frequently after the second dose (77.8 vs 66.9%; p<0.001), and in subjects with a prior SARS-CoV-2 infection. Conclusion: Adherence to COVID-19 vaccination is high among physicians. Adverse Events are typically mild and more frequent in people with a prior SARS-CoV-2 infection
Predictors of response to glucagon-like peptide-1 receptor agonists. a meta-analysis and systematic review of randomized controlled trials
No full textAims: The aim of the present meta-analysis is the identification of the characteristics of patients, which predict the efficacy on HbA1c of glucagon-like peptide-1 receptor agonists (GLP-1 RA). Methods: A Medline and Embase search for “exenatide” OR “liraglutide” OR “albiglutide” OR “dulaglutide” OR “lixisenatide” was performed, collecting randomized clinical trials (duration > 12 weeks) up to September 2016, comparing GLP-1 RA at the maximal approved dose with placebo or active drugs. Furthermore, unpublished studies were searched in the www.clinicaltrials.gov register. For meta-analyses, the outcome considered were 24- and 52-week HbA1c. Separate analyses were performed, whenever possible, for subgroups of trials based on several inclusion criteria. In addition, meta-regression analyses were performed for comparisons for which 10 or more trails were available. Results: A total of 92 trials fulfilling the inclusion criteria were identified. In placebo-controlled trials (n = 41), the 24-week mean reduction of HbA1c with GLP-1 RA was − 0.75 [− 0.87; − 0.63]%. Shorter-acting molecules appear to be more effective in patients with lower fasting glucose, whereas longer-acting agents in patients with higher fasting hyperglycaemia. Obesity and duration of diabetes do not seem to moderate the efficacy of GLP-1 RA, whereas in non-Caucasians and older patients liraglutide could be less effective. At 52 weeks, only 9 placebo-controlled trials were available for preventing any reliable analyses. Conclusions: Using a variety of approaches (meta-analyses of subgroup of trials, meta-regression, systematic review of subgroup analyses in individual trials, and meta-analyses of subgroups of patients), we identified some putative predictors of efficacy of GLP-1 RA, which deserve further investigation
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