La salute degli anziani LGBT dalla prospettiva del minority stress. Rassegna della letteratura e raccomandazioni di ricerca

Lesbian, gay, bisexual, and transgender (LGBT) older adults have not received proper attention by the scientific literature and gerontology research, especially in Italy. This lack represents only an aspect of a more general condition of social invisibility that weighs on this population. The present contribution aims to provide researchers and clinicians with a review of scientific works which, especially in the USA, have casted light on experiences of stigmatization, discrimination, and victimization experienced and perceived by this population. The theoretical framework is represented by the minority stress perspective which provides an overview of risk and protective factors related to physical and mental health of minority groups. In the current review, authors considered studies conducted through quantitative, qualitative, and mixed methods, starting from 2000. Following the above described perspective, results are presented in two sections: the first one is focused on the different forms of stigma which weigh on LGBT older adults and the second one on the mental and physical health outcomes and on protective factors. The application of the minority stress perspective on LGBT older adults provides researchers and social and health care system providers with a psychosocial and clinical framework through which reading the phenomenon. Finally, main research recommendations are discussed

Substrate-based atom waveguide using guided two-color evanescent light fields

We propose a dipole-force linear waveguide which confines neutral atoms up to lambda/2 above a microfabricated single-mode dielectric optical guide. The optical guide carries far blue-detuned light in the horizontally-polarized TE mode and far red-detuned light in the vertically-polarized TM mode, with both modes close to optical cut-off. A trapping minimum in the transverse plane is formed above the optical guide due to the differing evanescent decay lengths of the two modes. This design allows manufacture of mechanically stable atom-optical elements on a substrate. We calculate the full vector bound modes for an arbitrary guide shape using two-dimensional non-uniform finite elements in the frequency-domain, allowing us to optimize atom waveguide properties. We find that a rectangular optical guide of 0.8um by 0.2um carrying 6mW of total laser power (detuning +-15nm about the D2 line) gives a trap depth of 200uK for cesium atoms (m_F = 0), transverse oscillation frequencies of f_x = 40kHz and f_y = 160kHz, collection area ~ 1um^2 and coherence time of 9ms. We discuss the effects of non-zero m_F, surface interactions, heating rate, the substrate refractive index, and the limits on waveguide bending radius.Comment: 12 pages, 4 figures, revtex, submitted to Phys. Rev. A Replaced: final version accepted by PRA v.61 Feb 2000. (2 paragraphs added

Deep Learning-Based Wave Digital Modeling of Rate-Dependent Hysteretic Nonlinearities for Virtual Analog Applications

Electromagnetic components greatly contribute to the peculiar timbre of analog audio gear. Indeed, distortion effects due to the nonlinear behavior of magnetic materials are known to play an important role in enriching the harmonic content of an audio signal. However, despite the abundant research that has been devoted to the characterization of nonlinearities in the context of virtual analog modeling over the years, the discrete-time simulation of circuits exhibiting rate-dependent hysteretic phenomena remains an open challenge. In this article, we present a novel data-driven approach for the wave digital modeling of rate-dependent hysteresis using recurrent neural networks (RNNs). Thanks to the modularity of wave digital filters, we are able to locally characterize the wave scattering relations of a hysteretic reluctance by encapsulating an RNN-based model into a single one-port wave digital block. Hence, we successfully apply the proposed methodology to the emulation of the output stage of a vacuum-tube guitar amplifier featuring a nonlinear transformer

A systematic comparison of protocols for recovery of high-quality rna from human islets extracted by laser capture microdissection

The isolation of high-quality RNA from endocrine pancreas sections represents a consider-able challenge largely due to the high ribonuclease levels. Laser capture microdissection (LCM) of mammalian islets, in association with RNA extraction protocols, has emerged as a feasible approach to characterizing their genetic and proteomic profiles. However, a validated protocol to obtain high-quality RNA from LCM-derived human pancreas specimens that is appropriate for next-generation sequencing analysis is still lacking. In this study, we applied four methods (Picopure extraction kit, Qiazol protocol, Qiazol + Clean-up kit, and RNeasy Microkit + Carrier) to extract RNA from human islets obtained from both non-diabetic individuals and patients with type 2 diabetes who had undergone partial pancreatectomy, as well as handpicked islets from both non-diabetic and diabetic organ donors. The yield and purity of total RNA were determined by 260/280 absorbance using Nanodrop 100 and the RNA integrity number with a bioanalyzer. The results indicated that among the four methods, the RNeasy MicroKit + Carrier (Qiagen) provides the highest yield and purity

Vitamin D deficiency: A new risk factor for type 2 diabetes?

Recent compelling evidence suggests a role of vitamin D deficiency in the pathogenesis of insulin resistance and insulin secretion derangements, with a consequent possible interference with type 2 diabetes mellitus. The mechanism of this link is incompletely understood. In fact, vitamin D deficiency is usually detected in obesity in which insulin resistance is also a common finding. The coexistence of insulin resistance and vitamin D deficiency has generated several hypotheses. Some cross-sectional and prospective studies have suggested that vitamin D deficiency may play a role in worsening insulin resistance; others have identified obesity as a risk factor predisposing individuals to exhibit both vitamin D deficiency and insulin resistance. The available data from intervention studies are largely confounded, and inadequate considerations of seasonal effects on 25(OH)D concentrations are also a common design flaw in many studies. On the contrary, there is strong evidence that obesity might cause both vitamin D deficiency and insulin resistance, leaving open the possibility that vitamin D and diabetes are not related at all. Although it might seem premature to draw firm conclusions on the role of vitamin D supplementation in reducing insulin resistance and preventing type 2 diabetes, this manuscript will review the circumstances leading to vitamin D deficiency and how such a deficiency can eventually independently affect insulin sensitivity. © 2012 S. Karger AG, Basel

Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases

Purpose: Degenerative spondylolisthesis (DS) is a debilitating condition that carries a high economic burden. As the global population ages, the number of patients over 80 years old demanding spinal fusion is constantly rising. Therefore, neurosurgeons often face the important decision as to whether to perform surgery or not in this age group, commonly perceived at high risk for complications. Methods: Six hundred seventy-eight elder patients, who underwent posterolateral lumbar fusion for DS (performed in three different centers) from 2012 to 2020, were screened for medical, early and late surgical complications and for the presence of potential preoperative risk factors. Patients were divided in three categories based on their age: (1) 60–69 years, (2) 70–79 years, (3) 80 and over. Multiple logistic regression was used to determine the predictive power of age and of other risk factors (i.e., ASA score; BMI; sex; presence or absence of insulin-dependent and -independent diabetes, use of anticoagulants, use of antiaggregants and osteoporosis) for the development of postoperative complications. Results: In univariate analysis, age was significantly and positively correlated with medical complications. However, when controls for other risk factors were added in the regressions, age never reached significance, with the only noticeable exception of cerebrovascular accidents. ASA score and BMI were the two risk factors that significantly correlated with the higher numbers of complication rates (especially medical). Conclusion: Patients of different age but with comparable preoperative risk factors share similar postoperative morbidity rates. When considering octogenarians for lumbar arthrodesis, the importance of biological age overrides that of chronological

Sotagliflozin, the first dual SGLT inhibitor. Current outlook and perspectives

Sotagliflozin is a dual sodium-glucose co-transporter-2 and 1 (SGLT2/1) inhibitor for the treatment of both type 1 (T1D) and type 2 diabetes (T2D). Sotagliflozin inhibits renal sodium-glucose co-transporter 2 (determining significant excretion of glucose in the urine, in the same way as other, already available SGLT-2 selective inhibitors) and intestinal SGLT-1, delaying glucose absorption and therefore reducing post prandial glucose. Well-designed clinical trials, have shown that sotagliflozin (as monotherapy or add-on therapy to other anti-hyperglycemic agents) improves glycated hemoglobin in adults with T2D, with beneficial effects on bodyweight and blood pressure. Similar results have been obtained in adults with T1D treated with either continuous subcutaneous insulin infusion or multiple daily insulin injections, even after insulin optimization. A still ongoing phase 3 study is currently evaluating the effect of sotagliflozin on cardiovascular outcomes (ClinicalTrials.gov NCT03315143). In this review we illustrate the advantages and disadvantages of dual SGLT 2/1 inhibition, in order to better characterize and investigate its mechanisms of action and potentialities

Antibiotic Utilization in Acute Pancreatitis: A Narrative Review

Acute pancreatitis is a complex inflammatory disease with significant morbidity and mortality. Despite advances in its management, the role of antibiotics in the prophylaxis and treatment of acute pancreatitis remains controversial. The aim of this comprehensive review is to analyze current evidence on the use of antibiotics in acute pancreatitis, focusing on prophylactic and therapeutic strategies. Prophylactic use aims to prevent local and systemic infections. However, recent studies have questioned the routine use of antibiotics for prophylaxis and highlighted the potential risks of antibiotic resistance and adverse effects. In selected high-risk cases, such as infected necrotizing pancreatitis, prophylactic antibiotic therapy may still be beneficial. As for therapeutic use, antibiotics are usually used to treat infected pancreatic necrosis and extrapancreatic infections. When selecting an antibiotic, the microbiologic profile and local resistance patterns should be considered. Combination therapy with broad-spectrum antibiotics is often recommended to cover both Gram-positive and Gram-negative pathogens. Recent research has highlighted the importance of individualized approaches to antibiotic use in acute pancreatitis and underscored the need for a tailored approach based on patient-specific factors. This review also highlights the potential role of new antimicrobial agents and alternative strategies, such as probiotics, in the management of acute pancreatitis

What do Italian medical students read? A call for a library of good books on physicians for physicians

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