Literature review on income inequality and the effects on social outcomes

In 2009, two epidemiologists, Wilkinson and Pickett, published a book entitled “The Spirit Level, Why More Equal Societies Almost Always Do Better” in which they claim that inequality and its acute perception by the average EU citizen is a toxic element of today’s European societies and one that seems to be associated with decreased levels of trust, civic engagement and participation, as well as to a host of other social challenges from poor health to crime, to underage pregnancies. Despite Wilkinson and Pickett’s intuitively convincing story of the link between higher income inequality and worse social outcomes, the empirical tests are based on simple bivariate correlations, implying that the authors fail to control for all the other numerous factors, which might have had an impact on both the social outcomes and income inequality. In doing so, the empirical associations reported in their book are likely to lead to misleading causal inferences. Nonetheless, Wilkinson and Pickett’s book attracted a lot of attention and called for a more careful analysis of the consequences of rising income inequality. The aim of this report is, hence, to look into sound empirical studies - based on multivariate analysis - which examine the effect of income inequality on important social outcomes related to (i) well-being, (ii) criminality, (iii) health, (iv) social capital, (v) education, (vi) political participation and (vii) female labor market participation. The upshot of this literature review is that higher criminality, reduced political agency and, to some extent, lower social capital formation and well-being appear to be tangible illustrations of the wastage produced by rising income inequality. In addition, there are a number of self-reinforcing loops linked to inequality. A clear illustration of this is the role of inequality in reducing the voting participation of the low income groups and the concomitant consequences in terms of redistributive policies and therefore on income disparities.JRC.G.3-Econometrics and applied statistic

Multivariate analysis of the effect of income inequality on health, social capital, and happiness

The last two decades have seen a growing concern about rising inequality. In a recent book (2012), Economics Nobel laureate Joseph Stiglitz argues that rising income inequality is one of the main factors underlying the economic and financial crisis in the United States. Wilkinson and Pickett (2009) similarly assert that higher inequality has harmful social consequences. This trend of growing inequality has furthermore been condemned in public arenas, where protests in the United States (the “Occupy Wall Street” movement) and in Spain (the “indignados”) show the extent of widespread public dissatisfaction with the present system which is denounced as being fundamentally flawed and unfair. The “We are the 99%” slogan and the associated web blog “We are the 99 percent” are direct references to this growing unequal distribution of wealth. A common rallying point of these movements is the argument that bankers who have benefited from large bonuses have been protected by bailout measures, while the victims of the crisis brought on by these very same bankers are faced with the reality of rising unemployment. This has also recently led the EU to agree on capping bonuses to bankers. Within this context, the European Commission decided last year to undertake a comprehensive study on the social and economic challenges associated with rising income inequality in Europe. This report constitutes the third deliverable of this global study. The first report includes a literature review on the relationship between income inequality and social outcome variables in the areas of happiness, criminality, health, social capital, education, voting behavior and female labor participation (d'Hombres, Weber, & Elia, 2012). The second report complements the literature review by examining the bivariate correlations on NUTS1 level between income inequality and the social outcomes mentioned above (Elia, d'Hombres, Weber, & Saltelli, 2013). However, since the analysis in the second report relied on bivariate correlations, none of the statistical associations could be regarded as evidence of a causal relationship. In this third report, we carry out a multivariate analysis on a selected number of social outcomes while controlling for a multitude of individual and country level specificities. The social outcomes are social capital, i.e. trust and participation in organizations, happiness and health. This study suggests that the adverse effect of income inequality on a plurality of societal development challenges as proposed by Wilkinson and Pickett (2009) cannot be confirmed by the data, except for the case of trust. In particular, our analysis cannot confirm the hypothesis of a strong and significant effect of income inequality on health, happiness and participation in associational activities. However, we show that income inequality has a potential damaging effect on trust in Europe. A negative association between income disparities and generalized trust is reported in all estimations presented in this report. Though these findings need to be considered with care given that they might be specific to the countries sampled or the time period covered, the implication of a significant effect of inequality on trust should not be discounted. According to a variety of scholars, trust is critical for the functioning of societies (Putnam, 2000). Social capital and trust are factors which are linked to cooperative behaviors and investment decisions as well as to the quality of institutions, which in turn are all key factors of economic performance (Knack and Keefer, 1996, and Guiso et al 2004).JRC.G.3-Econometrics and applied statistic

Income Inequality and Social Outcomes: Bivariate Correlations at NUTS1 Level

The last two decades have been marked by a growing concern about rising inequality. In a recent book (2012), Joseph Stiglitz, a former Nobel prize winner in Economics argues that rising income inequality is one of the main factors underlying the economic and financial crisis in the United States. The Economist magazine has also recently devoted a special report on income inequality in the world (issue 13th‐19th October 2012). The social and economic challenges associated with rising income inequalities have gained prominence in the public debate, after the publication in 2009, of a widely cited book by Richard Wilkinson and Kate Pickett entitled “The Spirit Level, Why More Equal Societies Almost Always Do Better". Using cross‐national data, the authors show that income inequality correlates with lower levels of social capital as well as with a host of other social challenges from poor health, crime, to underage pregnancies. The current report takes part in this debate by examining the bivariate correlations at subnational level (NUTS 1 level) between income inequality and indicators of education, health, criminality, political participation, social capital and happiness at the EU level. Findings suggest a statistically significant negative relationship between income inequality and recorded voter turnout and participation in voluntary organizations, used as a proxy of social capital; while a significant positive correlation between inequality and crime rates as well as the percentage of early school leavers. On the contrary, rising income inequality seems not to be associated with health and wellbeing indicatorsJRC.G.3-Econometrics and applied statistic

Characteristics of Esophageal Cancer Cases in Tanzania.

PurposeAge-standardized incidence rates for esophageal cancer (EC) in East Africa have been reported as disproportionately high compared with the worldwide incidence of nine per 100,000 population. This study aimed to characterize EC cases seen at Muhimbili National Hospital and Ocean Road Cancer Institute in Dar es Salaam, Tanzania.MethodsDemographic, clinical, and treatment variables were abstracted from charts of patients who received care for a diagnosis of EC at one or both institutions between 2011 and 2013. Categorical data were summarized as frequency counts and percentages. Continuous data were presented as medians and ranges. To compare men and women, Pearson's χ2 and two-sample t tests were applied.ResultsSeven hundred thirty-eight unique cases of EC were identified, of whom 68% were men and the median age was 60 years (range, 19 to 95 years). Notably, 93 cases (13%) were ≤ 40 years old at diagnosis. Squamous cell carcinoma was the dominant histology, comprising 90% of cases with documented histopathology. However, 34% of cases with a diagnosis of EC were not pathologically confirmed. The stage was documented as locoregional in 4% of cases, locally advanced in 20% of cases, metastatic in 14% of cases, and unknown in 63% of cases. Of 430 patients who received treatment at Ocean Road Cancer Institute, 76% were treated with radiation, 44% were treated with chemotherapy, 3% underwent a cancer-related surgical procedure, and 10% of cases received no cancer-directed therapy. The median overall survival for all patients was 6.9 months (95% CI, 5.0 to 12.8), regardless of stage at presentation.ConclusionBetween 2011 and 2013, cases of EC represented a large clinical burden at both institutions

Opponent Coding of Sound Location (Azimuth) in Planum Temporale is Robust to Sound-Level Variations

Abstract Coding of sound location in auditory cortex (AC) is only partially understood. Recent electrophysiological research suggests that neurons in mammalian auditory cortex are characterized by broad spatial tuning and a preference for the contralateral hemifield, that is, a nonuniform sampling of sound azimuth. Additionally, spatial selectivity decreases with increasing sound intensity. To accommodate these findings, it has been proposed that sound location is encoded by the integrated activity of neuronal populations with opposite hemifield tuning ("opponent channel model"). In this study, we investigated the validity of such a model in human AC with functional magnetic resonance imaging (fMRI) and a phase-encoding paradigm employing binaural stimuli recorded individually for each participant. In all subjects, we observed preferential fMRI responses to contralateral azimuth positions. Additionally, in most AC locations, spatial tuning was broad and not level invariant. We derived an opponent channel model of the fMRI responses by subtracting the activity of contralaterally tuned regions in bilateral planum temporale. This resulted in accurate decoding of sound azimuth location, which was unaffected by changes in sound level. Our data thus support opponent channel coding as a neural mechanism for representing acoustic azimuth in human AC

Non-Natural Linker Configuration in 2,6-Dipeptidyl-Anthraquinones Enhances the Inhibition of TAR RNA Binding/Annealing Activities by HIV-1 NC and Tat Proteins

The HIV-1 nucleocapsid (NC) protein represents an excellent molecular target for the development of antiretrovirals by virtue of its well-characterized chaperone activities, which play pivotal roles in essential steps of the viral life cycle. Our ongoing search for candidates able to impair NC binding/annealing activities led to the identification of peptidylanthraquinones as a promising class of nucleic acid ligands. Seeking to elucidate the inhibition determinants and increase the potency of this class of compounds, we have now explored the effects of chirality in the linker connecting the planar nucleus to the basic side chains. We show here that the non-natural linker configuration imparted unexpected TAR RNA targeting properties to the 2,6-peptidyl-anthraquinones and significantly enhanced their potency. Even if the new compounds were able to interact directly with the NC protein, they manifested a consistently higher affinity for the TAR RNA substrate and their TARbinding properties mirrored their ability to interfere with NC-TAR interactions. Based on these findings, we propose that the viral Tat protein, sharing the same RNA substrate but acting in distinct phases of the viral life cycle, constitutes an additional druggable target for this class of peptidyl-anthraquinones. The inhibition of Tat-TAR interaction for the test compounds correlated again with their TAR-binding properties, while simultaneously failing to demonstrate any direct Tat-binding capabilities. These considerations highlighted the importance of TAR RNA in the elucidation of their inhibition mechanism, rather than direct protein inhibition. We have therefore identified anti-TAR compounds with dual in vitro inhibitory activity on different viral proteins, demonstrating that it is possible to develop multitarget compounds capable of interfering with processes mediated by the interactions of this essential RNA domain of HIV-1 genome with NC and Tat proteins

Mulching in lowland hay meadows drives an adaptive convergence of above- and below-ground traits reducing plasticity and improving biomass: A possible tool for enhancing phytoremediation

We aimed to understand the effect of mulching (i.e., cutting and leaving the crushed biomass to decompose in situ) on above- and below-ground plant functional traits and whether this practice may be a potential tool for enhancing the phytoremediation of lowland hay meadows. To this aim, we evaluated at the community level seven years of mulching application in a PCBs and HMs soil-polluted Site of National Interest (SIN Brescia-Caffaro) through the analysis of the floristic composition and the above- and below-ground plant traits. We found that the abandonment of agricultural activities led to a marked increase in the soil organic carbon and pH, and the over-imposed mulching additionally induced a slight increase in soil nutrients. Mulching favored the establishment of a productive plant community characterized by a more conservative-resource strategy, a higher biomass development, and lower plasticity through an adaptative convergence between above- and below-ground organs. In particular, the analysis of the root depth distribution highlighted the key role of roots living in the upper soil layer (10 cm). Mulching did not show a significant effect on plant species known to be effective in terms of PCB phytoremediation. However, the mulching application appears to be a promising tool for enhancing the root web that functions as the backbone for the proliferation of microbes devoted to organic contaminants' degradation and selects a two-fold number of plant species known to be metal-tolerant. However, besides these potential positive effects of the mulching application, favoring species with a higher biomass development, in the long term, may lead to a biodiversity reduction and thus to potential consequences also on the diversity of native species important for the phytoremediation

Single-agent rituximab is an effective salvage therapy in pretreated patients with hairy cell leukemia

No abstract availabl

Colorectal neoplastic emergencies in immunocompromised patients: preliminary result from the Web-based International Register of Emergency Surgery and Trauma (WIRES-T trial)

Association of advanced age, neoplastic disease and immunocompromission (IC) may lead to surgical emergencies. Few data exist about this topic. Present study reports the preliminary data from the WIRES-T trial about patients managed for colorectal neoplastic emergencies in immunocompromised patients. The required data were taken from a prospective observational international register. The study was approved by the Ethical Committee with approval n. 17575; ClinicalTrials.gov Identifier: NCT03643718. 839 patients were collected; 753 (80.7%) with mild-moderate IC and 86 (10.3%) with severe. Median age was 71.9 years and 73 years, respectively, in the two groups. The causes of mild-moderate IC were reported such malignancy (753-100%), diabetes (103-13.7%), malnutrition (26-3.5%) and uremia (1-0.1%), while severe IC causes were steroids treatment (14-16.3%); neutropenia (7-8.1%), malignancy on chemotherapy (71-82.6%). Preoperative risk classification were reported as follow: mild-moderate: ASA 1-14 (1.9%); ASA 2-202 (26.8%); ASA 3-341 (45.3%); ASA 4-84 (11.2%); ASA 5-7 (0.9%); severe group: ASA 1-1 patient (1.2%); ASA 2-16 patients (18.6%); ASA 3-41 patients (47.7%); ASA 4-19 patients (22.1%); ASA 5-3 patients (3.5%); lastly, ASA score was unavailable for 105 cases (13.9%) in mild-moderate group and in 6 cases (6.9%) in severe group. All the patients enrolled underwent urgent/emergency surgery Damage control approach with open abdomen was adopted in 18 patients. Mortality was 5.1% and 12.8%, respectively, in mild-moderate and severe groups. Long-term survival data: in mild-moderate disease-free survival (median, IQR) is 28 (10-91) and in severe IC, it is 21 (10-94). Overall survival (median, IQR) is 44 (18-99) and 26 (20-90) in mild-moderate and severe, respectively; the same is for post-progression survival (median, IQR) 29 (16-81) and 28, respectively. Univariate and multivariate analyses showed as the only factor influencing mortality in mild-moderate and severe IC is the ASA score. Colorectal neoplastic emergencies in immunocompromised patients are more frequent in elderly. Sigmoid and right colon are the most involved. Emergency surgery is at higher risk of complication and mortality; however, management in dedicated emergency surgery units is necessary to reduce disease burden and to optimize results by combining oncological and acute care principles. This approach may improve outcomes to obtain clinical advantages for patients like those observed in elective scenario. Lastly, damage control approach seems feasible and safe in selected patients

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI