Factors associated with work ability among employees of an Italian university hospital

Background: A growing body of evidence clearly documents the benefits of integrated systems approaches to protecting and promoting the safety, health and well-being of workers. The purpose of this study is to provide a holistic view of the work ability of employees of an Italian University Hospital measuring their resources in relation to job demands. In particular, it examines socio-demographics, family and organizational antecedents of health professionals' work ability. Methods: A survey was conducted to assess the work ability of healthcare professionals, including physicians, nurses and administrative staff, working at the University Hospital of Modena (Italy). The data collection allows us to get a sample of 443 workers, who correspond to 11% of the target population. The data were analyzed using preliminary statistics on the main characteristics of the sample in terms of work ability, socio-demographic variables, family and organizational characteristics. In addition, logit models of the likelihood of having high work ability were estimated using SPSS version 25. Results: Work ability decreases with increasing age, comorbidity, high body mass index, having at least one child under 5 and/or a dependent adult, having a poor work-life balance, and doing more than 20 h of housework. Specific job resources can significantly promote work ability, including relationship-oriented leadership, autonomy in decision making and individuals' skill match. The nursing profession is associated with a low work ability. Finally, a significant gender gap has been documented. Women find it more difficult to reconcile life and work, especially when they have children of preschool age and work in professions with greater responsibilities, as in the case of women doctors, who experience lower work capacity. Conclusions: Our results suggest that it is necessary to consider other factors, in addition to age, that are equally relevant in influencing work ability. Consequently, organisational interventions could be implemented to improve the work ability of all workers. In addition, we propose targeted interventions for groups at risk of reduced work capacity, in particular older workers (45 years and over), nurses, women with children of preschool age and in the position of physician

Defective Neurogenesis in Citron Kinase Knockout Mice by Altered Cytokinesis and Massive Apoptosis

AbstractCitron-kinase (Citron-K) has been proposed by in vitro studies as a crucial effector of Rho in regulation of cytokinesis. To further investigate in vivo its biologic functions, we have inactivated Citron-K gene in mice by homologous recombination. Citron-K−/− mice grow at slower rates, are severely ataxic, and die before adulthood as a consequence of fatal seizures. Their brains display defective neurogenesis, with depletion of specific neuronal populations. These abnormalities arise during development of the central nervous system due to altered cytokinesis and massive apoptosis. Our results indicate that Citron-K is essential for cytokinesis in vivo but only in specific neuronal precursors. Moreover, they suggest a novel molecular mechanism for a subset of human malformative syndromes of the CNS

90-yttrium-ibritumomab tiuxetan consolidation of fludarabine, mitoxantrone, rituximab in intermediate/high-risk follicular lymphoma: updated long-term results after a median follow-up of 7\ua0years

Radioimmunotherapy (RIT) after an induction phase with conventional chemoimmunotherapy became an attractive strategy of consolidation for patients with advanced follicular lymphoma: in particular, in many studies RIT was represented by yttrium-90-ibritumomab tiuxetan (90Y-IT). Independently by the different front-line treatment, updates on the long-term follow-up of these studies are needed because the disease course of follicular lymphoma is characterised by multiple relapses and progressively shorter durations of response. We report updated long-term efficacy and toxicity results of a multicenter phase II study on sequential treatment with four cycles of fludarabine, mitoxantrone, and rituximab followed by 90Y-IT as front-line therapy for untreated patients with intermediate/high-risk follicular lymphoma. With a median follow-up of 84 months, only 19/49 (38.8%) complete response patients relapsed, yielding an estimated long-term disease-free survival of 62.6%. The 7-year overall survival was 72.7%. Four (7.3%) second acute myeloid leukemia occurred, with a median time following RIT of 42 months. A relevant patients' responsiveness to subsequent therapies occurred: approximately 65% of relapsed patients obtained a good clinical response after the second-line treatment. These data represented the first evidence of a real role even in the long period of 90Y-IT after a fludarabine-containing regimen plus rituximab in the treatment of high-risk follicular lymphoma

Mowat-Wilson syndrome : growth charts

Background Mowat-Wilson syndrome (MWS; OMIM #235730) is a genetic condition caused by heterozygous mutations or deletions of theZEB2gene. It is characterized by moderate-severe intellectual disability, epilepsy, Hirschsprung disease and multiple organ malformations of which congenital heart defects and urogenital anomalies are the most frequent ones. To date, a clear description of the physical development of MWS patients does not exist. The aim of this study is to provide up-to-date growth charts specific for infants and children with MWS. Charts for males and females aged from 0 to 16 years were generated using a total of 2865 measurements from 99 MWS patients of different ancestries. All data were collected through extensive collaborations with the Italian MWS association (AIMW) and the MWS Foundation. The GAMLSS package for the R statistical computing software was used to model the growth charts. Height, weight, body mass index (BMI) and head circumference were compared to those from standard international growth charts for healthy children. Results In newborns, weight and length were distributed as in the general population, while head circumference was slightly smaller, with an average below the 30th centile. Up to the age of 7 years, weight and height distribution was shifted to slightly lower values than in the general population; after that, the difference increased further, with 50% of the affected children below the 5th centile of the general population. BMI distribution was similar to that of non-affected children until the age of 7 years, at which point values in MWS children increased with a less steep slope, particularly in males. Microcephaly was sometimes present at birth, but in most cases it developed gradually during infancy; many children had a small head circumference, between the 3rd and the 10th centile, rather than being truly microcephalic (at least 2 SD below the mean). Most patients were of slender build. Conclusions These charts contribute to the understanding of the natural history of MWS and should assist pediatricians and other caregivers in providing optimal care to MWS individuals who show problems related to physical growth. This is the first study on growth in patients with MWS.Peer reviewe

High efficacy of the MACOP-B regimen in the treatment of adult Langerhans cell histiocytosis, a 20 year experience

BACKGROUND: Adult Langerhans cell histiocytosis (LCH) is an orphan disease. Chemotherapy is usually reserved to patients presenting with single system multifocal (SS-m) or multisystem (MS) disease but due to the lack of randomized studies no standard first line therapy has been defined yet. Pediatric regimens based on the vinblastine/prednisone backbone are not well tolerated in adults and probably less effective. We previously demonstrated high efficacy of the dose dense polichemotherapy regimen MACOP-B in 7 adult patients with SS-m or MS-LCH, in terms of high response rate and durable responses. Here we report an update of these data with the purpose of evaluating the long term efficacy of MACOP-B in adult LCH. METHODS: Clinical data of all adult LCH patients (n = 17) diagnosed and treated at our Institution during the past 20-year period were retrospectively reviewed. RESULTS: A total of 11 patients (6 with SS-m and 5 with MS-LCH) were treated with MACOP-B from 1995 to 2014. The overall response rate was confirmed to be 100 %, with a complete response of 73 % and a partial response rate of 27 %. Overall progression free survival was 64 %, and disease free survival after achievement of initial CR was 87 %. Overall survival rate was 82 % after 6.7 years of median follow-up. CONCLUSIONS: These data confirm high activity of MACOP-B in adult LCH, indicating that a substantial fraction of patients achieve long lasting responses and can be cured with this therapeutic approach

Optimization of the extrusion process by means of a novel comprehensive approach

In light alloy extrusion process, different and conflicting objectives need to be achieved during die design stage in order to obtain an efficient and robust process. Among these, the production of extruded profiles within the required tolerances is of primary importance. A secondary aim, in case of profiles used for structural applications, is to guarantee adequate mechanical characteristics. In addition, the die has to resist without yielding under the selected process conditions. All these requirements are borne by the proper setting of process parameters and by die design. An extensive number of works are reported in literature for process and die design optimization. However, all these publications show the impact of a limited number of input parameters on a specific output that optimize the profile quality or, alternatively, the die life. Just one publication reports the multi-objective optimization of an extrusion process but the methodology is not clearly reported. Aim of this work is to extend this contribution to account for several input and output variables. To this aim, COMSOL Multiphyisics ® has been integrated with modeFRONTIER and the optimized solutions extracted from the Pareto frontier

Influence of Salinity on Copper Toxicity in <i>Paracentrotus lividus</i> and <i>Arbacia lixula</i> Embryos

The sea urchins Paracentrotus lividus and Arbacia lixula have a key role in benthic dynamics and they are often used to assess the toxicity of environmental contaminants. The aim of this research was to investigate the influence of salinity on copper toxicity on P. lividus and A. lixula embryos, evaluating the impact of future ocean salinity variations and estimating an optimum range for embryos. For this purpose, sea urchin embryos were exposed to different copper concentrations under varying salinity regimes, estimating the toxic effects with the percentage of abnormal embryos and the Integrative Toxicity Index (ITI). Results revealed acceptable levels of anomalies in a salinity range of 33–36‰ for A. lixula and 33–39‰ for P. lividus. The effect concentrations (EC50) of copper reveals increasing toxicity at increasing salinity for both sea urchin species, but between 33–36‰ (A. lixula) and 36–39‰ (P. lividus) the toxicity appear inversely related with salinity. This study illustrates the difficulty in relating a biological response to bioavailability, because the uptake and the sensitivity to copper across salinities is influenced by differences in osmoregulation, enhancing our knowledge about optimal salinity ranges and the potential impact of climate change on sea urchin embryo development

Comparison of different ecotoxicological batteries with WOE approach for the environmental quality evaluation of harbour sediments

This study was conducted under the Italian Ministerial Decree D.M. 173/2016 which regulates the assessment of the Sediment Class Quality in Italy using ecotoxicological bioassay and chemical analysis (Weight-Of-Evidence model). The aim of this work was to evaluate the real classification obtained by the theoretically equivalent responses of nine different combinations of batteries based on six different species: Aliivibrio fischeri (inhibition of bioluminescence), Phaeodactylum tricornutum, Skeletonema costatum, Dunaliella tertiolecta (inhibition of algal growth), Paracentrotus lividus and Crassostrea gigas (embryotoxicity). Bioassays, in many cases, showed a non-bioavailability effect of the pollutants; these one highly revealed by the chemical analyses. Algal species showed responses very similar from each other. Otherwise, species used for embryotoxicity produced wide responses, consequently modifying the quality class of sediments and the handling management (i.e. landfill confinement or beach nourishment) allowed by the Law. \ua9 202

Hepatogastric and splenomesenteric arterial trunks: anatomical variations report

According to 1756 Haller description, coeliac trunk presents usually his typical trifurcation in left gastric, splenic and common hepatic arteries [1]. In 1928 Adachi first classified anatomical variations of the coeliac trunk2. Then Adachi and Michels classified the coeliac trunk into six different types [2,3]. The types are: 1, normal branching; 2, hepatosplenic trunk and left gastric artery from aorta; 3, hepatosplenomesenteric trunk and left gastric artery from aorta; 4, hepatogastric trunk and splenic artery from superior mesenteric artery; 5, splenogastric type (splenic and left gastric from the coeliac trunk and common hepatic artery from superior mesenteric artery); 6, coeliacomesenteric trunk (splenic, left gastric, common hepatic and superior mesenteric arteries arise from a common trunk). It appears that only 87.6% of the coeliac trunk shows the classical trifurcation, while an incomplete coeliac trunk can be observed in 12.4% of cases [4]. In our Department, during a routine gross anatomy dissection of a 98-year-old Caucasian male cadaver for undergraduated, postgraduated students and residents, it was noted that the coeliac trunk divided just into two vessels (left gastric and common hepatic arteries). The length of this trunk was 3.0 cm and it had diameter of 0.6 cm. A second trunk, divided into two branches (superior mesenteric and splenic arteries), arose from abdominal aorta 0.7 cm below the coeliac trunk. This anatomical variation corresponds to type 4 according to Michels. In the reported variation, because of this low origin, splenic artery resulted very long and particularly tortuous, and was located below and anteriorly to both body and tail of the pancreas. This is highlighted by the fact that dorsal pancreatic artery originates from splenic artery inferiorly to pancreatic body, with an ascending course. The presence of variations of coeliac and superior mesenteric arteries is due to variable ways of fusion of right and left primitive yolk arteries when they localize in the dorsalis meso root. Probably the hepatogastric trunk originates from right yolk artery, and the splenomesenteric trunk from the left one. The small distance between the two origins (0.7 cm versus 2.5 cm, i.e. the common distance) supports this organogenetic explanation. It is worthwhile mentioning that the reported findings are interesting given that this variation is quite rare [5] and is not responsible for any hemodynamic problems, as reported by clinical history of the patient

Human induced pluripotent stem cells differentiate into insulin-producing cells able to engraft in vivo

AIMS: New sources of insulin-secreting cells are strongly required for the cure of diabetes. Recent successes in differentiating embryonic stem cells, in combination with the discovery that it is possible to derive human induced pluripotent stem cells (iPSCs) from somatic cells, have raised the possibility that patient-specific beta cells might be derived from patients through cell reprogramming and differentiation. In this study, we aimed to obtain insulin-producing cells from human iPSCs and test their ability to secrete insulin in vivo. METHODS: Human iPSCs, derived from both fetal and adult fibroblasts, were differentiated in vitro into pancreas-committed cells and then transplanted into immunodeficient mice at two different stages of differentiation (posterior foregut and endocrine cells). RESULTS: IPSCs were shown to differentiate in insulin-producing cells in vitro, following the stages of pancreatic organogenesis. At the end of the differentiation, the production of INSULIN mRNA was highly increased and 5 ± 2.9 % of the cell population became insulin-positive. Terminally differentiated cells also produced C-peptide in vitro in both basal and stimulated conditions. In vivo, mice transplanted with pancreatic cells secreted human C-peptide in response to glucose stimulus, but transplanted cells were observed to lose insulin secretion capacity during the time. At histological evaluation, the grafts resulted to be composed of a mixed population of cells containing mature pancreatic cells, but also pluripotent and some neuronal cells. CONCLUSION: These data overall suggest that human iPSCs have the potential to generate insulin-producing cells and that these differentiated cells can engraft and secrete insulin in vivo