Austerity, measles and mandatory vaccination: cross-regional analysis of vaccination in Italy 2000-14.

Background: Italy has experienced a resurgence in measles since 2015. Although much emphasis has been placed on the role of individuals opting out of vaccination, here we test the hypothesis that large budget reductions in public health spending were also a contributing factor. Methods: Multi-variate statistical models were used to assess the relationship between measles, mumps and rubella (MMR) coverage and real public health expenditure per-capita across Italy's 20 regions covering the period 2000-14. Results: Between 2010 and 2014 Italy's public health expenditure fell by over 2%, although varying among regions. Fixed effects models estimate that each 1% reduction in per-capita public health expenditure was associated with a decrease of 0.5 percentage points (95% CI: 0.36-0.65 percentage points) in MMR coverage, after adjusting for time and regional-specific time trends. The consequences can be illustrated by comparing two regions, Lazio, where public health spending fell by 5% and MMR coverage by over 3 percentage points, and Sardinia, a historically deprived region, where public health spending partly rose and MMR rates remained approximately steady. Conclusion: Adoption of austerity policies in the Italian health system was found to be significantly associated with declining vaccination rates for MMR. However, the recent introduction of mandatory vaccination for Italian children may help counteract this trend

A Comprehensive assessment of preconception health needs and interventions regarding women in childbearing age: a systematic review

Background This systematic review summarizes the preconception health needs of women in childbearing age, necessary to be addressed to have an eventual safe and healthy pregnancy. Methods Web of Science, PubMed and Scopus were searched. We excluded studies involving women with reproductive system pathologies and referring to interconceptive or pregnancy period and non-empirical or only abstract studies. Two researchers independently performed the blind screening based on titles/abstracts and full-text and the quality assessment. Results Four major domains resulted from the thematical analysis: knowledge, behaviours and attitudes, health status and access to healthcare services. The most examined topics were knowledge and awareness on preconception health, folic acid assumption, tobacco and alcohol consumption, physical activity and healthy diet. Conclusions This review could assist healthcare professionals (physicians, nurses, midwives) in guiding tailored counselling to women to provide the adequate level of preconception care and act as a reference to policymakers

Perceived Quality as Assessment Tool for the Test Case Amore e Psiche Domus in Ostia Antica

Recent years have seen the development of many new ways for cultural heritage visualization; with the growing use of “Information and Communications Technology” (ICT) many 3D reconstructions, virtual tours and “Augmented Reality/Virtual Reality” (AR/VR) application has been developed to enrich the contents of museums, archeological sites and historical places. However, today only few cultural assets have an accurate 3D model with a detailed informative content. In fact, the costs due to the creation of virtual content are still high and they can be addressed only for the most iconic or important monuments. Inside this frame the project RECIPE (REsilience in art CIties: Planning for Emergencies) founded by ESA/ESTEC1 use a crowdsourcing approach, involving tourists and interested people, to acquire cheaply the photos necessary to create photogrammetric models. Such a models to be correctly used inside different level of recording and monitoring tasks, require developing procedure to evaluate their quality. This work discusses, with reference to a study case, only how to validate models by proposing a methodology based on dimensional and color error calculation together with structural indices, such as SSIM and PIQE. Besides to avoid influence generate by different cameras, focus and positioning in photos taken by tourists, the used photo data base has been produced with a professional device following the state of art rules in SfM. At least, it is also discussed the possibility to implement the 3D models in a virtual reality environment to increase their diffusion on new multimedia and interactive plat-forms

Comparing the prognostic value of stress myocardial perfusion imaging by conventional and cadmium-zinc telluride single-photon emission computed tomography through a machine learning approach

We compared the prognostic value of myocardial perfusion imaging (MPI) by conventional- (C-) single-photon emission computed tomography (SPECT) and cadmium-zinc-telluride- (CZT-) SPECT in a cohort of patients with suspected or known coronary artery disease (CAD) using machine learning (ML) algorithms. A total of 453 consecutive patients underwent stress MPI by both C-SPECT and CZT-SPECT. The outcome was a composite end point of all-cause death, cardiac death, nonfatal myocardial infarction, or coronary revascularization procedures whichever occurred first. ML analysis performed through the implementation of random forest (RF) and k-nearest neighbors (KNN) algorithms proved that CZT-SPECT has greater accuracy than C-SPECT in detecting CAD. For both algorithms, the sensitivity of CZT-SPECT (96% for RF and 60% for KNN) was greater than that of C-SPECT (88% for RF and 53% for KNN). A preliminary univariate analysis was performed through Mann-Whitney tests separately on the features of each camera in order to understand which ones could distinguish patients who will experience an adverse event from those who will not. Then, a machine learning analysis was performed by using Matlab (v. 2019b). Tree, KNN, support vector machine (SVM), Naïve Bayes, and RF were implemented twice: first, the analysis was performed on the as-is dataset; then, since the dataset was imbalanced (patients experiencing an adverse event were lower than the others), the analysis was performed again after balancing the classes through the Synthetic Minority Oversampling Technique. According to KNN and SVM with and without balancing the classes, the accuracy (p value = 0.02 and p value = 0.01) and recall (p value = 0.001 and p value = 0.03) of the CZT-SPECT were greater than those obtained by C-SPECT in a statistically significant way. ML approach showed that although the prognostic value of stress MPI by C-SPECT and CZT-SPECT is comparable, CZT-SPECT seems to have higher accuracy and recall

Somatic mutations of thymic epithelial tumors with myasthenia gravis

BackgroundThymic epithelial tumors are rare malignant neoplasms that are frequently associated with paraneoplastic syndromes, especially myasthenia gravis. GTF2I is an oncogene mutated in a subgroup of thymomas that is reputed to drive their growth. However, for GTF2I wild-type tumors, the relevant mutations remain to be identified.MethodsWe performed a meta-analysis and identified 4,208 mutations in 339 patients. We defined a panel of 63 genes frequently mutated in thymic epithelial tumors, which we used to design a custom assay for next-generation sequencing. We sequenced tumor DNA from 67 thymomas of patients with myasthenia gravis who underwent resection in our institution.ResultsAmong the 67 thymomas, there were 238 mutations, 83 of which were in coding sequences. There were 14 GTF2I mutations in 6 A, 5 AB, 2 B2 thymomas, and one in a thymoma with unspecified histology. No other oncogenes showed recurrent mutations, while sixteen tumor suppressor genes were predicted to be inactivated. Even with a dedicated assay for the identification of specific somatic mutations in thymic epithelial tumors, only GTF2I mutations were found to be significantly recurrent.ConclusionOur evaluation provides insights into the mutational landscape of thymic epithelial tumors, identifies recurrent mutations in different histotypes, and describes the design and implementation of a custom panel for targeted resequencing. These findings contribute to a better understanding of the genetic basis of thymic epithelial tumors and may have implications for future research and treatment strategies

Macchine del Tempo/Time Machines Concept per la realizzazione di una grande mostra INAF nella città di Roma

La Mostra “Macchine del Tempo/Time Machines” sarà inaugurata a fine 2023, si chiuderà a Primavera del 2024 e verrà ospitata nel secondo piano del Palazzo delle Esposizioni di Roma, in Via Nazionale, gestito dall’Azienda Speciale Palaexpo, una partecipata del Comune di Roma, con cui sarà siglata una specifica convenzione. Il progetto ha un duplice obiettivo, da un lato realizzare una mostra pop che parli a tutti e che metta al centro l’Istituto Nazionale di Astrofisica, le sue persone e le sue ricerche, dall’altro dar vita a qualcosa di unico, che faccia parlare di sé e che incentivi il pubblico a informarsi sulle tematiche affrontate per ampliare il proprio sapere e conoscere INAF e i suoi osservatori distribuiti sul territorio italiano. Un percorso che vuole giocare tra il vecchio e il nuovo, con uno stile anni ’80, ma con contenuti che parlano dell’oggi e del domani e che usa il gioco come meccanismo per suscitare interesse ed emozione positiva. Le “Macchine del Tempo” sono strumenti dell’ingegno italiano, frutto della ricerca condotta negli osservatori dell’Istituto Nazionale di Astrofisica dalle donne e dagli uomini che ogni giorno mettono impegno e passione per portare le conoscenze umane sempre più distanti. Questa mostra vuole diffondere la conoscenza attuale facendo però vedere chi c’è “dietro l’oculare”. Un’esperienza immersiva che comincia da noi stessi e subito passa a Galileo, l’italiano che - inventando il cannocchiale - posò l’occhio sulla nostra prima “macchina del tempo”. Sarà importante realizzare un catalogo della mostra e sono stati avviati contatti per rendere l’esposizione fruibile al pubblico in modo quanto più possibile inclusivo. Nel corso del periodo in cui sarà visitabile la mostra saranno organizzati incontri scientifici di alto livello, con nomi di primo piano della Ricerca astrofisica e spaziale mondiale, ma anche aperitivi scientifici più informali, durante i quali i cittadini potranno conversare direttamente con i ricercatori. Verranno proposti dei progetti di public engagement che utilizzano format nuovi come il Poetry Slam abbinato a uno stage scientifico o rassegne cinematografiche che propongono film nei quali sono presenti strutturei INAF. Si intende inoltre realizzare uno show per planetario, in collaborazione con il Planetario di Roma, sul tema “Macchine del Tempo”, da programmare in un periodo vicino a quello della della mostra e da diffondere in seguito, anche sotto forma di film per planetario, sia in italiano che in altre lingue, per la fruizione da parte di un pubblico internazionale. La mostra “Macchine del Tempo” ha per INAF molteplici aspetti di ritorno in campo sociale, comunicativo e relazionale. La mostra vuole stimolare le giovani generazioni allo studio di materie STEM, ma con “contaminazioni” anche di altre discipline non solo scientifiche. Questo determinerà in futuro per INAF anche la possibilità di avere giovani risorse da inserire nell’organico di ricerca. L’astrofisica italiana è un'eccellenza internazionalmente riconosciuta e deve essere maggiormente valorizzata anche in Italia, per potenziare l’immagine che INAF trasmette ai cittadini, alle istituzioni e agli stakeholders, attraverso i finanziamenti pubblici rivolti alla ricerca, incentivando ad esempio le collaborazioni, o anche le donazioni, con altre realtà pubbliche o private. Questa mostra vuole essere un mezzo per offrire alle scuole del territorio, e non solo, la possibilità di accedere a un patrimonio culturale che unisce scienza, tecnologia e storia. Un patrimonio davvero unico nel suo genere. L’ambizione è di riuscire a realizzare un contenitore di eventi e di dibattiti che ruotino attorno ai temi più attuali dell’astrofisica, ma che non temono e che anzi cercano forti legami con l’arte tutta, dal teatro alla pittura, dalla musica alla letteratura

Influenza vaccination coverage among medical residents: An Italian multicenter survey

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P < 0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P < 0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future. © 2014 Landes Bioscience

Cardiovascular risk factors in secondary progressive multiple sclerosis: A cross-sectional analysis from the MS-STAT2 randomized controlled trial

BACKGROUND AND PURPOSE: There is increasing evidence that cardiovascular risk (CVR) contributes to disability progression in multiple sclerosis (MS). CVR is particularly prevalent in secondary progressive MS (SPMS) and can be quantified through validated composite CVR scores. The aim was to examine the cross-sectional relationships between excess modifiable CVR, whole and regional brain atrophy on magnetic resonance imaging, and disability in patients with SPMS. METHODS: Participants had SPMS, and data were collected at enrolment into the MS-STAT2 trial. Composite CVR scores were calculated using the QRISK3 software. Prematurely achieved CVR due to modifiable risk factors was expressed as QRISK3 premature CVR, derived through reference to the normative QRISK3 dataset and expressed in years. Associations were determined with multiple linear regressions. RESULTS: For the 218 participants, mean age was 54 years and median Expanded Disability Status Scale was 6.0. Each additional year of prematurely achieved CVR was associated with a 2.7 mL (beta coefficient; 95% confidence interval 0.8-4.7; p = 0.006) smaller normalized whole brain volume. The strongest relationship was seen for the cortical grey matter (beta coefficient 1.6 mL per year; 95% confidence interval 0.5-2.7; p = 0.003), and associations were also found with poorer verbal working memory performance. Body mass index demonstrated the strongest relationships with normalized brain volumes, whilst serum lipid ratios demonstrated strong relationships with verbal and visuospatial working memory performance. CONCLUSIONS: Prematurely achieved CVR is associated with lower normalized brain volumes in SPMS. Future longitudinal analyses of this clinical trial dataset will be important to determine whether CVR predicts future disease worsening

The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

To compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019