New Strategies in Quantitative Structure-Activity Relationships. Applications to Adenosine Receptor Ligands

Over the last years, an increasing number of applications of QSAR (Quantitative Structure-Activity Relationships) appeared in the literature, not only in lead finding and lead optimization, but also in other fields related to drug discovery, such as ADMET predictions. Neverthless, many questions are still open and they supplied the starting point of this research. Attention was focused on characteristics usually intended as “pitfalls” of QSAR itself. In this work, each step of the QSAR model development process was handled with a rational and rigorous approach, and the classic QSAR strategies were implemented with new protocol

Learning from Excellence to Improve Healthcare Services: The Experience of the Maternal and Child Care Pathway

The ability to deal with adversity and the resilience of people and groups are shown to depend positively on the tendency to nurture positivity. Therefore, the aim of this study is to evaluate whether Learning from Excellence (LfE) can be an effective method to manage systematic health systems, when transparent disclosure and benchmarking of data are adopted in performance evaluation. This study consists of a quantitative and a qualitative phase. In the former, maternal care is investigated at the regional level, starting from performance data and indicators of the maternity pathway referred to 98 healthcare providers in 10 Italian regions, that share the same evaluation system. The second phase investigates qualitatively the organizational determinants and the experience of professionals involved in the pathway, through the organization of on-site workshops. We identified the seven best practices among the 42 units of analysis. Communication, trust and shared goals among health professionals involved in the pathway emerged as core themes from the qualitative analysis. This study confirms that LfE under the conditions of benchmarking assessment and transparent disclosure of data can be implemented systematically in management practice, in order to boost health personnel’s resilience and, in general, the organizational climate in the working environment

Monitoring Appropriate Monoclonal Antibodies Prescribing via Administrative Data: An Application to Psoriasis

: The Italian Medicines Agency (AIFA) and the Italian Regional Health Systems have implemented measures together with data collection and analysis to improve medicines' appropriate prescription. Administrative databases represent rich Real-World Evidence (RWE) sources that may be leveraged for research purposes. Thus, such heritage may allow for appropriate prescription studies to be carried out on complex pharmaceutical molecules, as the appropriateness of prescriptions is essential both for patients' treatment and to ensure healthcare systems' sustainability. This study analyzed the appropriate monoclonal antibodies (mAbs) prescribed in psoriasis treatment across Tuscany, Italy. Data were extracted from several large administrative databases collected by the Tuscan Regional Healthcare System through record linkages. The analysis showed that over 30% of the 2020 cohort of psoriatic patients could be regarded as potentially inappropriate treated, signaling that mAbs are often prescribed as first-line treatment contrary to guidelines. Variation was observed in the appropriate prescription of mAbs, across different types of mAbs and areas. The study revealed potential inappropriate prescription, and its geographic variation should raise awareness among managers about the appropriate use of resources. Despite limitations, this could represent a pilot for future studies to evaluate the appropriate prescription of mAbs in other clinic conditions and across time

Healthcare costs of diabetic foot disease in Italy: estimates for event and state costs

Objective This study aimed to estimate healthcare costs of diabetic foot disease (DFD) in a large population-based cohort of people with type-2 diabetes (T2D) in the Tuscany region (Italy). Data sources/study setting Administrative healthcare data of Tuscany region, with 2018 as the base year. Study design Retrospective study assessing a longitudinal cohort of patients with T2D. Data collection/extraction methods Using administrative healthcare data, DFD were identifed using the International Classifcation of Diseases, Ninth Revision, Clinical Modifcation codes. Methods We examined the annual healthcare costs of these clinical problems in patients with T2D between 2015 and 2018; moreover, we used a generalized linear model to estimate the total healthcare costs. Principal fndings Between 2015 and 2018, patients with T2D experiencing DFD showed signifcantly higher average direct costs than patients with T2D without DFD (p<0.0001). Among patients with T2D experiencing DFD, those who experienced complications either in 2015–2017 and in 2018 incurred the highest incremental costs (incremental cost of € 16,702) followed by those with complications in 2018 only (incremental cost of € 9,536) and from 2015 to 2017 (incremental cost of € 800). Conclusions DFD signifcantly increase healthcare utilization and costs among patients with TD2. Healthcare costs of DFD among patients with T2D are associated with the timing and frequency of DFD. These fndings should increase awareness among policymakers regarding resource reallocation toward preventive strategies among patients with T2

Workplace health promotion programs in different areas of Europe

Background Aging of the workforce challenges European countries. Keeping aged workers healthy and productive, through health promotion, is a key goal of European labour policy. The aim of the present study was to collect experiences of workplace health promotion for older workers (WHPOW) conducted in 10 representative countries of Central Europe, Eastern Europe and the Mediterranean. Methods A literature review of activities of WHPOW was conducted through a comprehensive search of major scientific databases and on the website of the major European Agencies on worker health promotion. The search was restricted to papers published in English from 2000 to 2015. Companies were asked for additional documentation about WHPOW programmes in a survey conducted with SurveyMonkey. Results A total of 756 initiatives regarding WHPOW were identified. 134 of these were guidelines, regulations, or review studies. The remaining 622 activities were intervention studies performed or promoted in the workplace and targeted at older workers or at the aging of the workforce. Most of the programs were carried out in Central Europe (295, 47.4%), less in East Europe (193, 31.0%) and in Mediterranean countries (134, 21.6%). Conclusion Our study shows that there are only a limited number of WHPOW actions throughout the 10 selected European Countries. While in Central Europe widespread interest in issues of aging workforce has resulted in national policies to encourage WHPO, not all the countries of Eastern Europe are equally well equipped. Lastly, in Southern Europe health promotion activities are largely inadequate compared to needs

Medium-evolved fragmentation functions

Medium-induced gluon radiation is usually identified as the dominant dynamical mechanism underling the {\it jet quenching} phenomenon observed in heavy-ion collisions. In its actual implementation, multiple medium-induced gluon emissions are assumed to be independent, leading, in the eikonal approximation, to a Poisson distribution. Here, we introduce a medium term in the splitting probabilities so that both medium and vacuum contributions are included on the same footing in a DGLAP approach. The improvements include energy-momentum conservation at each individual splitting, medium-modified virtuality evolution and a coherent implementation of vacuum and medium splitting probabilities. Noticeably, the usual formalism is recovered when the virtuality and the energy of the parton are very large. This leads to a similar description of the suppression observed in heavy-ion collisions with values of the transport coefficient of the same order as those obtained using the {\it quenching weights}.Comment: LaTeX, 18 pages, 13 figures included using epsfig, uses JHEP3; v2: enlarged discussions, one figure replaced, some references added, final versio

Jet Quenching via Jet Collimation

The ATLAS Collaboration recently reported strong modifications of dijet properties in heavy ion collisions. In this work, we discuss to what extent these first data constrain already the microscopic mechanism underlying jet quenching. Simple kinematic arguments lead us to identify a frequency collimation mechanism via which the medium efficiently trims away the soft components of the jet parton shower. Through this mechanism, the observed dijet asymmetry can be accomodated with values of $\hat{q}\, L$ that lie in the expected order of magnitude.Comment: 6 pages, 4 figure

Workplace health promotion for older workers: A systematic literature review

Background: Aging of the workforce is a growing problem. As workers age, their physical, physiological and psychosocial capabilities change. Keeping older workers healthy and productive is a key goal of European labor policy and health promotion is a key to achieve this result. Previous studies about workplace health promotion (WHP) programs are usually focused on the entire workforce or to a specific topic. Within the framework of the EU-CHAFEA ProHealth65+ project, this paper aims to systematically review the literature on WHP interventions specifically targeted to older workers (OWs). Methods: This systematic review was conducted by making a comprehensive search of MEDLINE, ISI Web of Science, SCOPUS, The Cochrane Library, CINAHL and PsychINFO databases. Search terms included ageing (and synonyms), worker (and synonyms), intervention (and synonyms), and health (and synonyms). The search was limited to papers in English or Italian published between January, 1st 2000 and May, 31st 2015. Relevant references in the selected articles were also analyzed. Results: Of the 299 articles initially identified as relating to the topic, 18 articles met the inclusion criteria. The type, methods and outcome of interventions in the WHP programs retrieved were heterogenous, as was the definition of the age at which a worker is considered to be 'older'. Most of the available studies had been conducted on small samples for a limited period of time. Conclusion: Our review shows that, although this issue is of great importance, studies addressing WHP actions for OWs are few and generally of poor quality. Current evidence fails to show that WHP programs improve the work ability, productivity or job retention of older workers. In addition, there is limited evidence that WHP programs are effective in improving lifestyles and concur to maintain the health and well-being of older workers. There is a need for future WHP programs to be well-designed so that the effectiveness and cost-benefit of workplace interventions can be properly investigated