Verso una moderna metodologia per la prevenzione, l'allenamento e la rieducazione della Lombalgia

Questa tesi nasce dall’esperienza di tirocinio formativo del corso di Laurea Specialistica, svolto in un noto centro Wellness all’avanguardia, in cui ho potuto conoscere, assistere e praticare il “Medical Fitness”, l’attività fisica nell’ottica di medicina preventiva e curativa. Descriverò un percorso posturale, con approccio Fitness Medicale, per il trattamento della Lombalgia, affezione dolorosa più comune nelle società occidentali ed una delle cause principali per la richiesta di visite mediche, in Italia. Durante la mia esperienza pratica ho seguito tre persone, per circa quattro mesi ciascuno, le quali hanno intrapreso un percorso mirato alla riduzione delle cause della Lombalgia e dei sintomi correlati. Le cause del “mal di schiena” erano diverse: una ascendente, quale il piede cavo; una discendente, quale il dorso curvo ed infine una centrale, quale l’ernia lombare dovuta a un’attività lavorativa che obbligava il soggetto a movimenti scorretti e ripetitivi. Essendo tre persone con caratteristiche diverse, tre casi differenti, riporterò tre percorsi personalizzati e individuali, combinati di più attività, offerte dal centro Fitness. Essendo un centro all’avanguardia, esso è dotato di un circuito di quattro sistemi tecnologici utili a valutare, allenare e mantenere una corretta postura. La “Postural Line”, frutto di approfonditi studi scientifici, integra l’iter valutativo e il training tradizionale posturale, con sistemi riguardanti la statica, la dinamica, il controllo propriocettivo del tronco e le catene muscolari. Ho voluto sottolineare l’aiuto che la tecnologia può dare in questo campo, sia come supporto tecnico all’operatore, in quanto offre una vasta gamma di dati oggettivi e quindi confrontabili, ma anche motivazionale per il cliente. Aiuto alla motivazione del soggetto, in quanto, oltre a contenere esercitazioni ludiche, offre la possibilità di vedere con i propri occhi un risultato comprensibile e immediato e quindi creare sul momento ogni minimo aggiustamento (feedforward). Nella stesura della tesi, ho introdotto la parte pratica attraverso quattro capitoli, trattando nei primi di postura e posturologia, descrivendo i sistemi “Postural Line” ed infine illustrando cause più comuni e sintomi della Lombalgia. Per concludere ho riportato, dopo i risultati dei trattamenti e i feedback dei clienti in questione, l’efficacia che ha “Postural Line” anche in soggetti non affetti da lombalgia o squilibri posturali che scatenano dolore o incapacità funzionale. Ho scelto questo argomento in quanto credo nelle potenzialità dell’esercizio fisico, nei suoi aspetti curativi, nella sua capacità di portare benessere, sia nella sfera psichica ed emotiva che a livello di salute fisica. Ritengo in prima persona che l’attività fisica sia un vero e proprio farmaco naturale, che deve essere alla portata di tutti

War and Food (In)security – A Lesson from the Russian-Ukrainian Conflict

The Russian invasion of Ukraine has implemented legitimate fears of a global crisis and further and inevitably aggravating existing food-security challenges. The international community is being called upon to take targeted action to address the rapidly-evolving, resultant scenarios, making it essential to go beyond immediate interim measures and to re-examine the agricultural and energy policies that underpin our global economy. This article, without any claim to exhaustiveness, examines the inevitable link between war and the dynamics related to food security. In the first instance, a theoretical-interpretative key of the logics of violent conflicts that generate a relevant impact on global food supplies and food (in)security is provided, within the broader framework of the dynamics related to the instability of international relations which hinder the supply of energy resources and determine the volatility of general price levels. In the concluding section, there is refl ection crossed reference to the ongoing Russia/Ukraine conflict as well as the devastating consequences on global food systems, already put under stress by the COVID-19 pandemic

Curiosity or aggressivity? Surface predatory behavior of the great white shark

The Great White Shark (Carcharodon carcharias) is an important top predator; however a little is known about its behaviour. During five study expeditions surface behaviour of Great White Sharks living in Dyer Island (South Africa) was observed. Aims of the research were to give more data in order to confirm the hypothesis that this area could be considered as a “training place”, where young sharks can learn new predator techniques, and to understand what is shark approach to a unnatural, floating and passive prey. By comparing behaviours performed by young and mature specimens, our data showed that latters exhibited more complex ethograms. Sharks showed also a curiosity approach to passive preys employed for this studies, with a strong predominance of the parading

Discrimination as a One-Day Performance Critically Reviewing an Anti-racism Day at School

Peer reviewe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

La Grange Comprehensive Plan 2018 - 2038

In the Fall of 2017, the City of La Grange and Texas Target Communities partnered to create a task force to represent the community. The task force was integral to the planning process, contributing the thoughts, desires, and opinions of community members—as well as their enthusiasm about La Grange’s future. This fifteen-month planning process ended in August 2018. The result of this collaboration is the La Grange Comprehensive Plan, which is the official policy guide for the community’s growth over the next twenty years.La Grange Comprehensive Plan 2018 - 2038 provides a guide for the future growth of the City. This document was developed by Texas Target Communities in partnership with the City of La Grange.Texas Target Communitie

Agnostic Pathway/Gene Set Analysis of Genome-Wide Association Data Identifies Associations for Pancreatic Cancer

Background Genome-wide association studies (GWAS) identify associations of individual single-nucleotide polymorphisms (SNPs) with cancer risk but usually only explain a fraction of the inherited variability. Pathway analysis of genetic variants is a powerful tool to identify networks of susceptibility genes. Methods We conducted a large agnostic pathway-based meta-analysis of GWAS data using the summary-based adaptive rank truncated product method to identify gene sets and pathways associated with pancreatic ductal adenocarcinoma (PDAC) in 9040 cases and 12 496 controls. We performed expression quantitative trait loci (eQTL) analysis and functional annotation of the top SNPs in genes contributing to the top associated pathways and gene sets. All statistical tests were two-sided. Results We identified 14 pathways and gene sets associated with PDAC at a false discovery rate of less than 0.05. After Bonferroni correction (P Conclusion Our agnostic pathway and gene set analysis integrated with functional annotation and eQTL analysis provides insight into genes and pathways that may be biologically relevant for risk of PDAC, including those not previously identified.Peer reviewe

Three new pancreatic cancer susceptibility signals identified on chromosomes 1q32.1, 5p15.33 and 8q24.21.

Genome-wide association studies (GWAS) have identified common pancreatic cancer susceptibility variants at 13 chromosomal loci in individuals of European descent. To identify new susceptibility variants, we performed imputation based on 1000 Genomes (1000G) Project data and association analysis using 5,107 case and 8,845 control subjects from 27 cohort and case-control studies that participated in the PanScan I-III GWAS. This analysis, in combination with a two-staged replication in an additional 6,076 case and 7,555 control subjects from the PANcreatic Disease ReseArch (PANDoRA) and Pancreatic Cancer Case-Control (PanC4) Consortia uncovered 3 new pancreatic cancer risk signals marked by single nucleotide polymorphisms (SNPs) rs2816938 at chromosome 1q32.1 (per allele odds ratio (OR) = 1.20, P = 4.88x10 -15), rs10094872 at 8q24.21 (OR = 1.15, P = 3.22x10 -9) and rs35226131 at 5p15.33 (OR = 0.71, P = 1.70x10 -8). These SNPs represent independent risk variants at previously identified pancreatic cancer risk loci on chr1q32.1 ( NR5A2), chr8q24.21 ( MYC) and chr5p15.33 ( CLPTM1L- TERT) as per analyses conditioned on previously reported susceptibility variants. We assessed expression of candidate genes at the three risk loci in histologically normal ( n = 10) and tumor ( n = 8) derived pancreatic tissue samples and observed a marked reduction of NR5A2 expression (chr1q32.1) in the tumors (fold change -7.6, P = 5.7x10 -8). This finding was validated in a second set of paired ( n = 20) histologically normal and tumor derived pancreatic tissue samples (average fold change for three NR5A2 isoforms -31.3 to -95.7, P = 7.5x10 -4-2.0x10 -3). Our study has identified new susceptibility variants independently conferring pancreatic cancer risk that merit functional follow-up to identify target genes and explain the underlying biology

Genome-wide association study identifies multiple susceptibility loci for pancreatic cancer

We performed a multistage genome-wide association study including 7,683 individuals with pancreatic cancer and 14,397 controls of European descent. Four new loci reached genome-wide significance: rs6971499 at 7q32.3 (LINC-PINT, per-allele odds ratio (OR) = 0.79, 95% confidence interval (CI) 0.74-0.84, P = 3.0 x 10(-12)), rs7190458 at 16q23.1 (BCAR1/CTRB1/CTRB2, OR = 1.46, 95% CI 1.30-1.65, P = 1.1 x 10(-10)), rs9581943 at 13q12.2 (PDX1, OR = 1.15, 95% CI 1.10-1.20, P = 2.4 x 10(-9)) and rs16986825 at 22q12.1 (ZNRF3, OR = 1.18, 95% CI 1.12-1.25, P = 1.2 x 10(-8)). We identified an independent signal in exon 2 of TERT at the established region 5p15.33 (rs2736098, OR = 0.80, 95% CI 0.76-0.85, P = 9.8 x 10(-14)). We also identified a locus at 8q24.21 (rs1561927, P = 1.3 x 10(-7)) that approached genome-wide significance located 455 kb telomeric of PVT1. Our study identified multiple new susceptibility alleles for pancreatic cancer that are worthy of follow-up studies

Genome-wide meta-analysis identifies five new susceptibility loci for pancreatic cancer.

In 2020, 146,063 deaths due to pancreatic cancer are estimated to occur in Europe and the United States combined. To identify common susceptibility alleles, we performed the largest pancreatic cancer GWAS to date, including 9040 patients and 12,496 controls of European ancestry from the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreatic Cancer Case-Control Consortium (PanC4). Here, we find significant evidence of a novel association at rs78417682 (7p12/TNS3, P = 4.35 × 10-8). Replication of 10 promising signals in up to 2737 patients and 4752 controls from the PANcreatic Disease ReseArch (PANDoRA) consortium yields new genome-wide significant loci: rs13303010 at 1p36.33 (NOC2L, P = 8.36 × 10-14), rs2941471 at 8q21.11 (HNF4G, P = 6.60 × 10-10), rs4795218 at 17q12 (HNF1B, P = 1.32 × 10-8), and rs1517037 at 18q21.32 (GRP, P = 3.28 × 10-8). rs78417682 is not statistically significantly associated with pancreatic cancer in PANDoRA. Expression quantitative trait locus analysis in three independent pancreatic data sets provides molecular support of NOC2L as a pancreatic cancer susceptibility gene