[Recommendations to develop Care Models for patients with Heart Failure (MAIC Project) from macromanagement]. / Recomendaciones para desarrollar Modelos Asistenciales de atención al paciente con Insuficiencia Cardiaca (Proyecto MAIC): Estudio Delphi.

BACKGROUND: The general objective of the study was to reflect on the key factors to advance in optimal models of care for Heart Failure (HF) and specifically, on the macromanagement elements most necessary for the development of comprehensive HF management models. MATERIAL AND METHODS: An Advisory Committee, composed of 15 experts and a multidisciplinary group of 31 additional experts, was appointed, together forming a Delphi panel of 46 experts. Based on a systematic bibliographic review and the analysis of the care course of the patient with HF, an initial battery of key factors for the development of HF care models was identified by the Advisory Committee. This proposal was adjusted and prioritized by the Delphi panel applying Delphi Rand/UCLA methodology. RESULTS: After two Delphi rounds, 75 key factors grouped into 7 challenges were defined. In the first of the challenges, related to the development of HF management models, 16 key factors were identified, 7 of which were valued as high priority and related to the establishment of common objectives, resources for the continuity of care and improving the measurement of health outcomes. CONCLUSIONS: The definition of management elements at the macro level was considered a priority to advance in the development of optimal models of assistance to HF.

Rurally rooted cross-border migrant workers from Myanmar, Covid-19, and agrarian movements.

This paper examines the situation of rurally rooted cross-border migrant workers from Myanmar during the Covid-19 pandemic. It looks at the circumstances of the migrants prior to the global health emergency, before exploring possibilities for a post-pandemic future for this stratum of the working people by raising critical questions addressed to agrarian movements. It does this by focusing on the nature and dynamics of the nexus of land and labour in the context of production and social reproduction, a view that in the context of rurally rooted cross-border migrant workers necessarily requires interrelated perspectives on labour, agrarian, and food justice struggles. This requires a rethinking of the role of land, not as a factor in either production or social reproduction, but as a central component in both spheres simultaneously. The question is not 'whether' it is necessary and desirable to forge multi-class coalitions and struggles against external capital, while not losing sight of the exploitative relations within rural communities and the household; rather, the question is 'how' to achieve this. It will require a messy recursive process, going back and forth between theoretical exploration and practical politics.

The global climate of land politics.

Land is a key input in economic production and production-waste sink. This links land to the causes of and responses to climate change. The dominant climate action ideas are based on the concept of 'land tenure security' which, in a global context marked by land-based inequities, means ratifying what already exists. This reinforces undemocratic social structures and institutions that themselves contribute to climate change. A restructuring of global land politics is called for, without which any analyses of and responses to climate change are at best superficial, and at worst, flawed and self-defeating. What is needed is to acknowledge the pervasive land-based social inequities in the world, and to end such inequities by pursuing a redistribution of a range of access to a range of land and resources in ways that categorically benefit the working people.

Detection of peri-implant inflammation by the use of a matrix metalloproteinase-8 chair-side test.

BACKGROUND: Active matrix metalloproteinase-8 (MMP-8) enzymes are associated with inflammation and the degradation of implant-supporting tissues. A high concentration of these enzymes in the peri-implant sulcular fluid (PISF) has been associated with a pathological condition. The aim of the present study was to evaluate the ability of a chair-side MMP-8 test to individuate pathological peri-implant site. The working hypothesis is that positive response to MMP-8 test corresponds to pathological values of periodontal indexes. A secondary working hypothesis is that PISF sampling method influences the test accuracy. METHODS: Fifty implants from 50 patients were evaluated during scheduled follow-up appointments in a clinical setting using the MMP-8 chair-side test and periodontal indices (probing depth, bleeding on probing, plaque index and peri-implant inflammation index). Two methods of PISF sampling were tested. RESULTS: The MMP-8 test demonstrated significant diagnostic capacity and good sensitivity and accuracy regarding indices of bleeding on probing, plaque index, and peri-implant inflammation index but fair agreement. CONCLUSIONS: Further studies should be performed to better define the interpretation of the MMP-8 chair-test results and their correlation to peri-implant indexes.

Autologous Periosteum-Derived Micrografts and PLGA/HA Enhance the Bone Formation in Sinus Lift Augmentation.

Sinus lift augmentation is a procedure required for the placement of a dental implant, whose success can be limited by the quantity or quality of available bone. To this purpose, the first aim of the current study was to evaluate the ability of autologous periosteum-derived micrografts and Poly(lactic-co-glycolic acid) (PLGA) supplemented with hydroxyl apatite (HA) to induce bone augmentation in the sinus lift procedure. Secondly, we compared the micrograft's behavior with respect to biomaterial alone, including Bio-Oss® and PLGA/HA, commercially named Alos. Sinus lift procedure was performed on 24 patients who required dental implants and who, according to the study design and procedure performed, were divided into three groups: group A (Alos + periosteum-derived micrografts); group B (Alos alone); and group C (Bio-Oss® alone). Briefly, in group A, a small piece of periosteum was collected from each patient and mechanically disaggregated by Rigenera® protocol using the Rigeneracons medical device. This protocol allowed for the obtainment of autologous micrografts, which in turn were used to soak the Alos scaffold. At 6 months after the sinus lift procedure and before the installation of dental implants, histological and radiographic evaluations in all three groups were performed. In group A, where sinus lift augmentation was performed using periosteum-derived micrografts and Alos, the bone regeneration was much faster than in the control groups where it was performed with Alos or Bio-Oss® alone (groups B and C, respectively). In addition, the radiographic evaluation in the patients of group A showed a radio-opacity after 4 months, while after 6 months, the prosthetic rehabilitation was improved and was maintained after 2 years post-surgery. In summary, we report on the efficacy of periosteum-derived micrografts and Alos to augment sinus lift in patients requiring dental implants. This efficacy is supported by an increased percentage of vital mineralized tisssue in the group treated with both periosteum-derived micrografts and Alos, with respect to the control group of Alos or Bio-Oss® alone, as confirmed by histological analysis and radiographic evaluations at 6 months from treatment.

The politics of biofuels, land and agrarian change: editors' introduction.

This introduction frames key questions on biofuels, land and agrarian change within agrarian political economy, political sociology and political ecology. It identifies and explains big questions that provide the starting point for the contributions to this collection. We lay out some of the emerging themes which define the politics of biofuels, land and agrarian change revolving around global (re)configurations; agro-ecological visions; conflicts, resistances and diverse outcomes; state, capital and society relations; mobilising opposition, creating alternatives; and change and continuity. An engaged agrarian political economy combined with global political economy, international relations and social movement theory provides an important framework for analysis and critique of the conditions, dynamics, contradictions, impacts and possibilities of the emerging global biofuels complex. Our hope is that this collection demonstrates the significance of a political economy of biofuels in capturing the complexity of the "biofuels revolution" and at the same time opening up questions about its sustainability in social and environmental terms that provide pathways towards alternatives.

Effects of three low-dose oral contraceptive formulations on lipid metabolism.

Three oral contraceptive preparations were studied in 60 healthy women. This randomized, comparative, baseline controlled study was designed to investigate the effects of the preparations on plasma lipids and lipoproteins. The following formulations were studied: a monophasic preparation containing ethinylestradiol and desogestrel (M-DSG) and two triphasic formulations containing ethinylestradiol and gestodene or levonorgestrel respectively (T-GSD and T-LNG). These preparations were studied for six treatment cycles. Total cholesterol and apoprotein B did not change in any group. Low density lipoprotein (LDL) cholesterol was significantly decreased in the groups of women treated with M-DSG and T-GSD respectively. No changes were observed in the T-LNG group. With M-DSG, significant increases were observed in high-density lipoprotein (HDL) cholesterol and HDL3 cholesterol, whilst HDL2 cholesterol did not change. With both T-GSD and T-LNG, no changes were observed in HDL cholesterol, whilst a significant increase in HDL3 cholesterol together with a trend to decrease in HDL2 cholesterol were observed. Apolipoprotein AI increased with the following ranking M-DSG greater than T-GSD greater than T-LNG. The LDL/HDL cholesterol ratio significantly decreased with both M-DSG and T-GSD. In the T-LNG group there was no change in this ratio. Triglycerides increased to the same extent in all treatment groups. As far as concerns the risk of arterial diseases, these three oral contraceptive formulations mostly induced negligible and/or partly favorable changes in plasma lipids and lipoproteins; however, the lipoprotein pattern during M-DSG treatment resulted better than during T-GSD, and the latter turned out to be better than during T-LNG.

PIP: 3 oral contraceptive (OC) preparations were studied in 60 healthy women. This randomized, comparative, baseline controlled study was designed to investigate the effects of the preparations on plasma lipids and lipoproteins. The following formulations were studied: a monophasic preparation containing ethinyl estradiol and desogestrel (M-DSG) and 2 triphasic formulations containing ethinyl estradiol and gestodene or levonorgestrel respectively (T-GSD and T-LNG). These preparations were studied for 6 treatment cycles. Total cholesterol and apoprotein B did not change in any group. Low density lipoprotein (LDL) cholesterol was significantly decreased in the groups of women treated with M-DSG and T-GSD respectively. No changes were observed in the T-LNG group. With M-DSG, significant increases were observed in the high density lipoprotein (HDL) and HDL3 cholesterols, while HDL2 cholesterol did not change. With both T-GSD and T-LNG, no changes were observed in HDL3 cholesterol together with a trend to decrease in HDL2 cholesterol were observed. Apolipoprotein AI increased with the following ranking M-DSG T-GSD T-LNG. The LDL/HDL cholesterol ratio significantly decreased with both M-DSG and T-GSD. In the T-LNG group there was no change in this ratio. Triglycerides increased to the same extent in all treatment groups. As far as the risk of arterial diseases, these 3 OC formulations mostly induced negligible and/or partly favorable changes in plasma lipids and lipoproteins; however, the lipoprotein pattern during M-DSG treatment was better than during T-GSD, and the latter was better than during T-LNG.

Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children.

Following a brief outline of current knowledge concerning atherosclerosis and its treatment, the authors describe the results obtained by treating with pantethine (900-1200 mg daily for 3 to 6 months) a series of 7 children and 65 adults suffering from hypercholesterolemia alone or associated with hypertriglyceridemia (types IIa and IIb of Fredrickson's classification). Pantethine treatment produced significant reduction of the better known risk factors (total cholesterol, LDL-cholesterol, triglycerides, and apo-B) and a significant increase of HDL-cholesterol (signally HDL2) and apolipoprotein A-I. The authors conclude with a discussion of these results and of the possible role of pantethine in the treatment of hyperlipoproteinemia, in view of its perfect tolerability and demonstrated therapeutic effectiveness.