11 research outputs found
Classical Mechanics with Mathematica
No full textThis textbook takes a broad yet thorough approach to mechanics, aimed at bridging the gap between classical analytic and modern differential geometric approaches to the subject. Developed by the authors from over 30 years of teaching experience, the presentation is designed to give students an overview of the many different models used through the history of the field—from Newton to Hamilton—while also painting a clear picture of the most modern developments. The text is organized into two parts. The first focuses on developing the mathematical framework of linear algebra and differential geometry necessary for the remainder of the book. Topics covered include tensor algebra, Euclidean and symplectic vector spaces, differential manifolds, and absolute differential calculus. The second part of the book applies these topics to kinematics, rigid body dynamics, Lagrangian and Hamiltonian dynamics, Hamilton–Jacobi theory, completely integrable systems, statistical mechanics of equilibrium, and impulsive dynamics, among others. This new edition has been completely revised and updated and now includes almost 200 exercises, as well as new chapters on celestial mechanics, one-dimensional continuous systems, and variational calculus with applications. Several Mathematica® notebooks are available to download that will further aid students in their understanding of some of the more difficult material. Unique in its scope of coverage and method of approach, Classical Mechanics with Mathematica® will be useful resource for graduate students and advanced undergraduates in applied mathematics and physics who hope to gain a deeper understanding of mechanics. Reviews of the First Edition: “The volume represents a real contribution to the field, being useful not only to students but to all readers who wish to have correct and well-written information.” – Petre P. Teodorescu, zbMATH, Vol. 1263, 2013 “By centering his presentation around the major aspects and omitting less important details, the author succeeds in providing a concise though lucid introduction into the mathematical areas. It enjoys many qualities that render this book a promising candidate for becoming a standard text in physics classrooms.” – H. Hogreve, Mathematical Reviews, October 2013
Teriparatide vs. alendronate as a treatment for osteoporosis: Changes in biochemical markers of bone turnover, BMD and quality of life
No full textThe risk of cerebral vein thrombosis associated with different types of combined hormonal contraceptives: a case-control study
No full textBackground: Cerebral vein thrombosis (CVT) is a rare manifestation of venous thrombosis predominantly affecting women due to female-specific risk factors, such as combined hormonal contraceptive (CHC) use. However, limited data exist on how different CHC types affect CVT risk. Objectives: This study aimed to evaluate CVT risk across CHC types and to investigate their combined effects with thrombophilia, family history of thrombosis, and body mass index. Methods: This case-control study included women with CVT (cases) and healthy women (controls) of childbearing age who were referred to our Center from 1992 to 2019 for a thrombophilia work-up. Women with pregnancy- and cancer-related CVT were excluded. Results: In total, 206 cases (157 CHC users, 49 nonusers) and 868 controls (196 CHC users, 672 nonusers) were included. CHC users had a 10-fold higher risk of CVT (odds ratio [OR]: 10.9; 95% CI: 7.7-15.7) than nonusers. Higher estrogen doses increased the risk in a dose-response manner. Variable estrogen dose CHC carried a 6-fold increased risk, similar to progestin-only pills. The risk increased with fourth-generation pills (OR: 28.3; 95% CI: 14.6-54.9). Thrombophilia abnormalities had a synergistic effect with CHC use (OR: 67.8; 95% CI: 34.6-133.0). For CHC users with a positive family history of thrombosis, the OR of the combined effect varied from 47.0 (95% CI: 24.4-90.7) to 254.1 (95% CI: 79.8-809.0), depending on the absence or presence of thrombophilia abnormalities. Conclusion: This study underscores the complex interaction between CHC type and other thrombotic risk factors in influencing CVT risk among women of childbearing age
The Maltese Labour Corps during World War I
No full textThe participation by Maltese troops abroad has been limited. During the
First World War Malta was not directly involved, yet during this time a significant
overseas deployment did take place. It did not take the form of front line troops; rather it
was some 5,600 locally enlisted men who volunteered for overseas service with the
Maltese Labour Corps. At least 120 men lost their lives on active service, very often from
disease. They are buried across various cemeteries mostly in Greece. It is a deployment
that has received little attention and is all but forgotten. This paper seeks to tell their
story and to remember the service these men provided.peer-reviewe
Lipids and Transaminase in Antiretroviral-Treatment-Experienced People Living with HIV, Switching to a Doravirine-Based vs. a Rilpivirine-Based Regimen: Data from a Real-Life Setting
No full text: Doravirine (DOR) is a newly approved non-nucleoside reverse transcriptase inhibitor (NNRTI). We aimed to investigate, in a real-life setting, how switching to a DOR-based regimen rather than a rilpivirine (RPV)-based regimen impacted metabolic and hepatic safety. The analysis included 551 antiretroviral treatment (ART)-experienced people living with HIV (PLWH), starting RPV-based or DOR-based regimens with viral load < 200 copies/mL, baseline (T0), and at least one control visit (6-month visit, T1). We enrolled 295 PLWH in the RPV and 256 in the DOR cohort. At T1, total cholesterol (TC), low-density lipoprotein-C (LDL-C), and triglycerides significantly decreased in both DOR and RPV cohorts, while high-density lipoprotein-C (HDL-C) only decreased in RPV-treated people. Consistently, the TC/HDL-C ratio declined more markedly in the DOR (-0.36, p < 0.0001) than in the RPV cohort (-0.08, p = 0.25) (comparison p = 0.39). Similar trends were observed when excluding the PLWH on lipid-lowering treatment from the analysis. People with normal alanine aminotransferase (ALT) levels showed a slight ALT increase in both cohorts, and those with baseline ALT > 40 IU/L experienced a significant decline (-14 IU/L, p = 0.008) only in the DOR cohort. Lipid profile improved in both cohorts, and there was a significant reduction in ALT in PLWH with higher-than-normal baseline levels on DOR-based ART
Consistent effects of non-invasive vagus nerve stimulation (nVNS) for the acute treatment of migraine: Additional findings from the randomized, sham-controlled, double-blind PRESTO trial 11 Medical and Health Sciences 1103 Clinical Sciences
No full textBACKGROUND:
Non-invasive vagus nerve stimulation (nVNS) has been shown to be practical, safe, and well tolerated for treating primary headache disorders. The recent multicenter, randomized, double-blind, sham-controlled PRESTO trial provided Class I evidence that for patients with episodic migraine, nVNS significantly increases the probability of having mild pain or being pain-free 2 h post stimulation. We report additional pre-defined secondary and other end points from PRESTO that demonstrate the consistency and durability of nVNS efficacy across a broad range of outcomes.
METHODS:
After a 4-week observation period, 248 patients with episodic migraine with/without aura were randomly assigned to acute treatment of migraine attacks with nVNS (n = 122) or a sham device (n = 126) during a double-blind period lasting 4 weeks (or until the patient had treated 5 attacks). All patients received nVNS therapy during the subsequent 4-week/5-attack open-label period.
RESULTS:
The intent-to-treat population consisted of 243 patients. The nVNS group (n = 120) had a significantly greater percentage of attacks treated during the double-blind period that were pain-free at 60 (P = 0.005) and 120 min (P = 0.026) than the sham group (n = 123) did. Similar results were seen for attacks with pain relief at 60 (P = 0.025) and 120 min (P = 0.018). For the first attack and all attacks, the nVNS group had significantly greater decreases (vs sham) in pain score from baseline to 60 min (P = 0.029); the decrease was also significantly greater for nVNS at 120 min for the first attack (P = 0.011). Results during the open-label period were consistent with those of the nVNS group during the double-blind period. The incidence of adverse events (AEs) and adverse device effects was low across all study periods, and no serious AEs occurred.
CONCLUSIONS:
These results further demonstrate that nVNS is an effective and reliable acute treatment for multiple migraine attacks, which can be used safely while preserving the patient's option to use traditional acute medications as rescue therapy, possibly decreasing the risk of medication overuse. Together with its practicality and optimal tolerability profile, these findings suggest nVNS has value as a front-line option for acute treatment of migraine.
TRIAL REGISTRATION:
ClinicalTrials.gov identifier: NCT02686034
Practical and clinical utility of non-invasive vagus nerve stimulation (nVNS) for the acute treatment of migraine. A post hoc analysis of the randomized, sham-controlled, double-blind PRESTO trial
No full textBackground: The PRESTO study of non-invasive vagus nerve stimulation (nVNS; gammaCore®) featured key primary and secondary end points recommended by the International Headache Society to provide Class I evidence that for patients with an episodic migraine, nVNS significantly increases the probability of having mild pain or being pain-free 2 h post stimulation. Here, we examined additional data from PRESTO to provide further insights into the practical utility of nVNS by evaluating its ability to consistently deliver clinically meaningful improvements in pain intensity while reducing the need for rescue medication. Methods: Patients recorded pain intensity for treated migraine attacks on a 4-point scale. Data were examined to compare nVNS and sham with regard to the percentage of patients who benefited by at least 1 point in pain intensity. We also assessed the percentage of attacks that required rescue medication and pain-free rates stratified by pain intensity at treatment initiation. Results: A significantly higher percentage of patients who used acute nVNS treatment (n = 120) vs sham (n = 123) reported a ≥ 1-point decrease in pain intensity at 30 min (nVNS, 32.2%; sham, 18.5%; P = 0.020), 60 min (nVNS, 38.8%; sham, 24.0%; P = 0.017), and 120 min (nVNS, 46.8%; sham, 26.2%; P = 0.002) after the first attack. Similar significant results were seen when assessing the benefit in all attacks. The proportion of patients who did not require rescue medication was significantly higher with nVNS than with sham for the first attack (nVNS, 59.3%; sham, 41.9%; P = 0.013) and all attacks (nVNS, 52.3%; sham, 37.3%; P = 0.008). When initial pain intensity was mild, the percentage of patients with no pain after treatment was significantly higher with nVNS than with sham at 60 min (all attacks: nVNS, 37.0%; sham, 21.2%; P = 0.025) and 120 min (first attack: nVNS, 50.0%; sham, 25.0%; P = 0.018; all attacks: nVNS, 46.7%; sham, 30.1%; P = 0.037). Conclusions: This post hoc analysis demonstrated that acute nVNS treatment quickly and consistently reduced pain intensity while decreasing rescue medication use. These clinical benefits provide guidance in the optimal use of nVNS in everyday practice, which can potentially reduce use of acute pharmacologic medications and their associated adverse events. Trial registration: ClinicalTrials.gov identifier: NCT02686034
Update on the profile of the EUSTAR cohort: an analysis of the EULAR Scleroderma Trials and Research group database
No full textOBJECTIVES: Systemic sclerosis (SSc) is a rare disease requiring multicentre collaboration to reveal comprehensive details of disease-related causes for morbidity and mortality.
METHODS: The European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) group initiated a database to prospectively gather key data of patients with SSc using a minimal essential dataset that was reorganised in 2008 introducing new items. Baseline visit data of patients who were registered between 2004 and 2011 were analysed using descriptive statistics.
RESULTS: In June 2011, 7655 patients (2838 with diffuse cutaneous (dc) and 4481 with limited cutaneous (lc) SSc who fulfilled the American College of Rheumatology diagnostic criteria had been registered in 174 centres, mainly European. The most prominent hallmarks of disease were Raynaud's phenomenon (96.3%), antinuclear antibodies (93.4%) and a typical capillaroscopic pattern (90.9%). Scleroderma was more common on fingers and hands than on any other part of the skin. Proton pump inhibitors (65.2%), calcium channel blockers (52.7%), and corticosteroids (45.3%) were most often prescribed. Among the immunosuppressant agents, cyclophosphamide was used more often in dcSSc than in lcSSc.
CONCLUSIONS: The EUSTAR database provides an abundance of information on the true clinical face of SSc that will be helpful in improving the classification of SSc and its subsets and for developing more specific therapeutic recommendations
The balance of prevention, investigation and treatment in the management of child protection services
No full textPatients treated with amiodarone accumulate lysobisphosphatidic acid (LBPA), also known as bis(monoacylglycero)phosphate, in airway secretions and develop in different tissues vacuoles and inclusion bodies thought to originate from endosomes. To clarify the origin of these changes, we studied in vitro the effects of amiodarone on endosomal activities like transferrin recycling, Shiga toxin processing, ESCRT-dependent lentivirus budding, fluid phase endocytosis, proteolysis and exosome secretion. Furthermore, since the accumulation of LBPA might point to a broader disturbance in lipid homeostasis, we studied the effect of amiodarone on the distribution of LBPA, unesterified cholesterol, sphingomyelin and glycosphyngolipids. Amiodarone analogues were also studied, including the recently developed derivative dronedarone. We found that amiodarone does not affect early endosomal activities, like transferrin recycling, Shiga toxin processing and lentivirus budding. Amiodarone, instead, interferes with late compartments of the endocytic pathway, blocking the progression of fluid phase endocytosis and causing fusion of organelles, collapse of lumenal structures, accumulation of undegraded substrates and amassing of different types of lipids. Not all late endocytic compartments are affected, since exosome secretion is spared. These changes recall the Niemann-Pick type-C phenotype (NPC), but originate by a different mechanism, since, differently from NPC, they are not alleviated by cholesterol removal. Studies with analogues indicate that basic pKa and high water-solubility at acidic pH are crucial requirements for the interference with late endosomes/lysosomes and that, in this respect, dronedarone is at least as potent as amiodarone. These findings may have relevance in fields unrelated to rhythm control
Delirium in nursing home residents: is there a role of antidepressants? A cross sectional study.
No full textBackground: Delirium is strongly associated with poor health outcomes, yet it is frequently underdiagnosed. Limited research on delirium has been conducted in Nursing Homes (NHs). Our aim is to assess delirium prevalence and its associated factors, in particular pharmacological prescription, in this care setting.
Methods: Data from the Italian "Delirium Day" 2016 Edition, a national multicenter point-prevalence study on patients aged 65 and older were analyzed to examine the associations between the prevalence of delirium and its subtypes with demographics and information about medical history and pharmacological treatment. Delirium was assessed using the Assessment test for delirium and cognitive impairment (4AT). Motor subtype was evaluated using the Delirium Motor Subtype Scale (DMSS).
Results: 955 residents, from 32 Italian NHs with a mean age of 84.72 ± 7.78 years were included. According to the 4AT, delirium was present in 260 (27.2%) NHs residents, mainly hyperactive (35.4%) or mixed subtypes (20.7%). Antidepressant treatment with selective serotonin reuptake inhibitors (SSRIs) was associated with lower delirium prevalence in univariate and multivariate analyses.
Conclusions: The high prevalence of delirium in NHs highlights the need to systematically assess its occurrence in this care settings. The inverse association between SSRIs and delirium might imply a possible preventive role of this class of therapeutic agents against delirium in NHs, yet further studies are warranted to ascertain any causal relationship between SSRIs intake and reduced delirium incidence
