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This study aims to provide real-world data about starting-dose of NOACs and dose-adjustment in patients with atrial fibrillation (AF). In fact, even if new oral anticoagulation agents (NOACs) have a predictable effect without need for regular monitoring, dose-adjustments should be performed according to the summary of product information and international guidelines. We employed the Italian Medicines Agency monitoring registries comprising data on a nationwide cohort of patients with AF treated with NOACs from 2013 to 2018. Logistic regression analysis was used to evaluate the determinants of dosage choice. During the reference period, treatment was commenced for 866,539 patients. Forty-five percent of the first prescriptions were dispensed at a reduced dose (dabigatran 60.3%, edoxaban 45.2%, apixaban 40.9%, rivaroxaban 37.4%). The prescription of reduced dose was associated with older age, renal disease, bleeding risk and the concomitant use of drugs predisposing to bleeding, but not with CHA2DS2-VASc and HAS-BLED. A relative reduction of the proportion of patients treated with low dosages was evident overtime for dabigatran and rivaroxaban; whereas prescription of low dose apixaban and edoxaban increased progressively among elderly patients. Evidence based on real-world data shows a high frequency of low dose prescriptions of NOACs in AF patients. Except for older age, renal disease, bleeding risk and the concomitant use of drugs predisposing to bleeding, other factors that may determine the choice of reduced dose could not be ascertained. There may be potential under-treatment of AF patients, but further evaluation is warranted. [ABSTRACT FROM AUTHOR]

Work related stress can highly negatively affect not only company's productivity but also other aspects causing increased costs for absenteeism, increased number of work accident and near miss, higher turnover, reduced quality of products and services, reduced capability of renewal, and so on. In agreement with the Italian legislative decree 81/08 we evaluated stress level of workers of three different sanitary structures located in the middle of Italy. 305 workers (physicians, nurses, technicians, auxiliary nurse, white collars) were submitted to a questionnaire designed by our team of work. The sector reporting higher stress level was represented by nurses, the sector with lower stress level was made of technicians. We proposed a set of measures aiming to reduce the load of stress based on the assumption that in this sector is fundamental to develop strategies of intervention both at organizational and individual level. [ABSTRACT FROM AUTHOR]

Abstract: In clayey and calcareous soils without a stable irrigation and fertilization system, the type of rootstock can particularly affect both the vegetative and productive properties of ‘Suncrest’ peach (Prunus persica L. Batsch) plants, and the qualitative and nutritional attributes of their fruit. The GF677 rootstock (P. persica × Prunus amygdalus) promoted the highest vegetative development, followed by Julior (Prunus insistitia). The ‘Suncrest’ on Ishtara [(Prunus cerasifera × P. persica)×(P. cerasifera × Prunus salicina)] and Barrier1 (P. persica × Prunus davidiana) had lower, but similar, plant vigour, but the latter rootstock differed in its higher production of pruned wood. The lowest adaptability to these cultivation conditions was observed for ‘Suncrest’ grafted onto Citation (P. persica × P. salicina), which showed the lowest plant development and production. For the plant yield, the ‘Suncrest’ grafted onto GF677, Julior, Ishtara, and Barrier1 were all similar. The fruit yield and both the canopy volume and pruned wood of ‘Suncrest’ grafted onto Ishtara showed a particular relationship, giving the best indices of yield efficiency and plant physiological equilibrium. Moreover, the same rootstock promoted the largest fruit size, while the smallest fruit were found on GF677 rootstock. The fruit from the Citation ‘Suncrest’ ripened 3 days early, while those from Barrier1 had a late fruit ripening. Firmness, soluble solids and the soluble solids to total acidity ratio were only affected slightly by the different rootstocks, while the total acidity of the fruit varied significantly according to rootstock; the fruit from ‘Suncrest’ grafted onto Barrier1, Julior, and Citation had the highest total acidities. The rootstock effects on the nutritional attributes of the fruit were relevant. The ‘Suncrest’ on Julior and GF677, followed by Ishtara, produced fruit with the greatest antioxidant activities and total phenolic contents. The ‘Suncrest’ on Citation and, especially, Barrier1 had reduced nutritional values of the fruit. The variations in antioxidant activities and total phenolic contents showed a positive correlation. [Copyright &y& Elsevier]

Il presente lavoro è stato effettuato allo scopo di elaborare delle linee guida comuni da seguire nella provincia di Ancona, per la tutela della salute della donna lavoratrice durante il periodo gravidico ed il puerperio. Analizzando i principali comparti produttivi presenti nella suddetta provincia, si è giunti alla realizzazione di un opuscolo informativo in lingua italiana ed un altro in lingua albanese, al fine di informare e formare le donne lavoratrici italiane e straniere quest'ultime spesso discriminate. [ABSTRACT FROM AUTHOR]