Campania and cancer mortality: An inseparable pair? The role of environmental quality and socio-economic deprivation

The region of Campania in Southern Italy features high levels of socio-economic deprivation and low levels of environmental quality. A vast strand of the scientific literature has tried to verify whether poor environmental quality and widespread socio-economic deprivation might explain the high cancer mortality rates (CMRs) observed, especially in the municipalities – infamously labelled as the ‘Land of Fires’ – that were hit most severely by the crisis. While some studies managed to identify links between these two confounding factors and cancer mortality, the evidence is overall mixed. Interesting information may be drawn from the observation of municipal data: in spite of previous claims, some municipalities featuring high environmental quality and low socio-economic deprivation also display high CMRs, while other Campanian municipalities facing disastrous environmental and socio-economic conditions are characterised by low CMRs. These figures, in contrast to common sentiment and previous studies, need to be investigated thoroughly in order to assess the exact role of the confounding factors. In this work, we aim to identify the municipalities where confounding factors act as driving forces in the determination of high CMRs through an original multi-step analysis based on frequentist and Bayesian analysis. Pinpointing these municipalities could allow policymakers to design targeted and effective policy measures aimed at reducing cancer mortality

A Regional Perspective on Social Exclusion in European Regions: Context, Trends and Policy Implications

Social exclusion has become a popular topic in the policy agendas of European governments, especially after the global financial crisis of 2007–2009 hit the continent as hard as it could. The existing literature highlights the presence of spatial patterns in social exclusion, although previous contributions consist of local or national level studies, lacking a broader continental perspective. This work resorts to regional data covering 20 EU countries and aims to characterise the nature of spatial patterns, distinguishing between spatial heterogeneity and pure spatial autocorrelation. Using the Spatial Markov Chain Matrix, we find that the strong clusterisation process unfolded by previous studies tends to become less intense if the role of socio-economic covariates is taken into account. Socio-economic factors represent in other words a containment cage that reduces the extent of neighbour influence. Net of the covariates, we identify clusters of regions in Southern Europe where high levels of social exclusion constitute a structural problem, calling for long-term public intervention. The policy implications of our findings are then outlined

A Regional Perspective on Social Exclusion in European Regions: Context, Trends and Policy Implications

Social exclusion has become a popular topic in the policy agendas of European governments, especially after the global financial crisis of 2007–2009 hit the continent as hard as it could. The existing literature highlights the presence of spatial patterns in social exclusion, although previous contributions consist of local or national level studies, lacking a broader continental perspective. This work resorts to regional data covering 20 EU countries and aims to characterise the nature of spatial patterns, distinguishing between spatial heterogeneity and pure spatial autocorrelation. Using the Spatial Markov Chain Matrix, we find that the strong clusterisation process unfolded by previous studies tends to become less intense if the role of socio-economic covariates is taken into account. Socio-economic factors represent in other words a containment cage that reduces the extent of neighbour influence. Net of the covariates, we identify clusters of regions in Southern Europe where high levels of social exclusion constitute a structural problem, calling for long-term public intervention. The policy implications of our findings are then outlined

Corporate governance and sustainability in water utilities. The effects of decorporatisation in the city of Naples, Italy

The recent economic literature has largely investigated sustainability in the provision of public utilities, highlighting the role of governance models in the determination of economic results. Little attention however has been devoted to the social and environmental dimensions of sustainability. In Italy, a long‐lasting debate on governance structures in the water sector has been fuelled by scholars and policymakers for more than 30 years, whereas the first (and unique) experiment involving the return of full public management in water provision is taking place in the city of Naples. The present work analyses this peculiar case study, aiming to assess the effects of a major governance shift that occurred in the early 2010s—that is, decorporatisation—in terms of economic, social and environmental sustainability. We resort to a bundle of qualitative and quantitative techniques to address the research question and our exploratory results suggest that decorporatisation was overall beneficial: Although little changed in terms of economic sustainability, the social and environmental dimensions benefitted from the shift in governance

Language as a proxy for cultural change. A contrastive analysis for French and Italian lexicon on male homosexuality

Discrimination against LGBT people represents a significant and long-standing societal problem that occurs in several forms, including lexical discrimination, which consists in frequent usage of discriminatory epithets. Lexical discrimination produces a vicious circle where speakers grow subconsciously accustomed to abusive language and marginalisation becomes institutionalised. A vast literature has tackled lexical discrimination, providing several country-level studies. The cases of France and Italy are described as very different: while the French experience is centred around grassroot mobilisation, Italy features a traditional strategy of silence. This work aims to verify such difference empirically. Using a rich and detailed dataset, we apply time series analysis on the frequencies of usage of the terms that characterise male homosexuality. Our results highlight some similarities and some differences between the French and the Italian case, stressing the importance of lexical resemantisation that occurred in France but not in Italy

Cross-cultural adaptation and validation of the Italian version of the Western Ontario Rotator Cuff (WORC) index

: The aim of the study was to accomplish translation, cross-cultural adaptation and validation of the Western Ontario Rotator Cuff (WORC) Index questionnaire for its use in Italy. The WORC original version was translated and cross-culturally adapted into Italian. Subsequently, it was administered to a population of 60 patients suffering from rotator cuff disease to evaluate the validity and reliability of the Italian version. The content validity evaluated the correlation between questions and total score of each domain through Pearson's correlation coefficient. The construct validity was similarly assessed through Pearson's correlation coefficient by testing the correlation between the Italian WORC and the Italian version of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Reliability was assessed using two methods: internal consistency by calculating the Cronbach's alpha coefficient for each domain; and test-retest by means of the intraclass correlation coefficient (ICC). The translation and cross-cultural adaptation of the Italian version did not reveal any major problems. No significant floor or ceiling effects were found. All the questions were linearly related to the concept expressed by the domain of belonging. Overall correlation with the DASH score was 0.75. Internal consistency was very high overall (α = 0.93) as well as reliability (overall ICC = 0.87). The Italian version of the WORC questionnaire is a valid and reproducible measuring instrument and can be considered a valid tool for the evaluation of the effectiveness of a treatment in terms of quality of life, in Italian patients affected by rotator cuff diseases.Level of evidence Diagnostic study, level II

Knotless PEEK and double-loaded biodegradable suture anchors ensure comparable clinical outcomes in the arthroscopic treatment of traumatic anterior shoulder instability: a prospective randomized study

Purpose: To compare the clinical outcome of arthroscopic capsulolabral repair for traumatic anterior shoulder instability with PEEK knotless and knotted biodegradable suture anchors. Methods: Arthroscopic stabilization was performed in 78 patients with recurrent traumatic anterior shoulder instability. They were divided into 2 groups of 39 patients each, according to suture anchors used: knotless PEEK anchors in group 1, and biodegradable anchors in group 2. Exclusion criteria were: instability without dislocation, posterior or multidirectional instability, glenoid bone loss > 20%, off-track lesions, concomitant rotator cuff tears and previous surgery. The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) self-administered questionnaire. Secondary outcomes were: Work-DASH, Sport-DASH, Rowe score, recurrent instability and subsequent surgery. The following independent variables were considered: age, gender, dominance, generalized ligamentous hyperlaxity, duration of symptoms, age at first dislocation, number of dislocations, type of work, type of sport, sports activity level, capsule-labral injury pattern, SLAP lesion and number of anchors. Differences between groups for numerical variables were analyzed by use of the Student’s t-test or Mann–Whitney U-test. Fisher’s exact test was used for analysis of categorical variables. Significance was set at p < 0.05. Results: Seven patients (9%) were lost at follow-up, 5 from group 1 and 2 from group 2. Follow-up ranged from 36 to 60 months (median: 44; IQR: 13). Comparison between groups did not show significant differences for each independent variable considered. No differences could be found either for DASH (n.s.) or Rowe (p = n.s.) scores between the two groups. Overall recurrence rate was 7%. Three re-dislocations were reported in group 1 and two in group 2 (n.s.). Only one patient in each group underwent re-operation. Conclusions: The study showed no significant differences in clinical outcomes after arthroscopic treatment of traumatic anterior shoulder instability using PEEK knotless or biodegradable knotted anchors at mid-term follow-up. Level of evidence: I

Functional Outcomes of Anterior-Based Muscle Sparing Approach Compared to Direct Lateral Approach for Total HIP Arthroplasty Following Acute Femoral Neck Fractures

Introduction: Total hip arthroplasty (THA) performed for femoral neck fractures (FNFs) is becoming a more frequent treatment in the active elderly population. Since there is limited research available presenting clinical outcomes after THA using the anterior-based muscle sparing (ABMS) approach, the aim of this study was to compare this surgical approach to the direct lateral (DL) approach in patients treated by THA for FNFs. Materials and Methods: We retrospectively reviewed the data prospectively collected as a part of our “Hip Fracture Unit” and included 163 patients who underwent THA from January 2016 to January 2019 for acute displaced FNFs. Results: A total of 132 patients who completed a minimum 2-years follow up (69 in the ABMS group and 63 in DL group) were included. The ABMS group demonstrated significantly shorter time to reach milestone for hospital discharge (1.5&nbsp;Days vs 2.1 days, P =.018), while no statistically significant differences were detected in peri-operative complications. At 3&nbsp;months, the timed up and go test, the Harris Hip Score (HHS) and the Oxford ip Score (OHS) were significantly better (P =.024,.032 and.034, respectively) in the ABMS group compared to the DL group. No differences were found in functional outcomes (HHS and OHS) nor in complication rate at 6, 12 and 24&nbsp;months. Discussion: This is one of the first studies to analyze functional results of THA performed for FNFs through an ABMS approach. Results are in line with those already present in the Literature. Conclusion: ABMS approach allows earlier mobilization and better early functional outcomes, compared to DL approach, in patients undergoing THA for acute displaced FNF. No differences are found after 6&nbsp;months in functional results and complications rate

SPADA: A project to study the effectiveness of shielding materials in space

The SPADA (SPAce Dosimetry for Astronauts) project is a part of an extensive teamwork that aims to optimize shielding solutions against space radiation. Shielding is indeed an irreplaceable tool to reduce exposure of crews of future Moon and Mars missions. We concentrated our studies on two flexible materials, Kevlar R� and Nextel R,� because of their ability to protect human space infrastructures from micrometeoroids. We measured radiation hardness of these shielding materials and compared to polyethylene, generally acknowledged as the most effective space radiation shield with practical applications in spacecraft. Both flight test (on the International Space Station and on the Russian FOTON M3 rocket), with passive dosimeters and accelerator-based experiments have been performed. Accelerator tests using high-energy Fe ions have demonstrated that Kevlar is almost as effective as polyethylene in shielding heavy ions, while Nextel is a poor shield against high-charge and -energy particles. Preliminary results from spaceflight, however, show that for the radiation environment in low-Earth orbit, dominated by trapped protons, thin shields of Kevlar and Nextel provide limited reduction

Cystatin B Involvement in Synapse Physiology of Rodent Brains and Human Cerebral Organoids

Cystatin B (CSTB) is a ubiquitous protein belonging to a superfamily of protease inhibitors. CSTB may play a critical role in brain physiology because its mutations cause progressive myoclonic epilepsy-1A (EPM1A), the most common form of progressive myoclonic epilepsy. However, the molecular mechanisms underlying the role of CSTB in the central nervous system (CNS) are largely unknown. To investigate the possible involvement of CSTB in the synaptic plasticity, we analyzed its expression in synaptosomes as a model system in studying the physiology of the synaptic regions of the CNS. We found that CSTB is not only present in the synaptosomes isolated from rat and mouse brain cortex, but also secreted into the medium in a depolarization-controlled manner. In addition, using biorthogonal noncanonical amino acid tagging (BONCAT) procedure, we demonstrated, for the first time, that CSTB is locally synthesized in the synaptosomes. The synaptic localization of CSTB was confirmed in a human 3D model of cortical development, namely cerebral organoids. Altogether, these results suggest that CSTB may play a role in the brain plasticity and open a new perspective in studying the involvement of CSTB deregulation in neurodegenerative and neuropsychiatric diseases