A proposal for an evidence-based model of the screening for the colorectal carcinoma in an Italian setting

Introduction. The aim of this paper is to improve the feasibility perception of policymakers, health care workers and target population about the cost-effectiveness of the implementation of colorectal screening as Public Health strategy. Methods. Retrospective study by application of a three-step model designed for a local setting in Sicily (Palermo and its Province) in order to distribute Fecal Occult Blood Tests (FOBTs), offer colonoscopy and surgery, by district allocation of pharmacies, public digestive endoscopic centres and oncologic and general surgery units. Mean adherence to consolidated colorectal screening programs in Italy was applied in order to evaluate the feasibility of an operative model in our area. Results. Applying the model to the target population (269,368 individuals of both sexes), it can be expected a mean percentage of 79% delivered invitation and a mean participation rate of 46.3% accounting for a total of 213,070 invited individuals and 98,651 participating in the first round of the program. Furthermore, considering the national mean of 6% positive FOBT, 82% of colonscopy adhesion and 7% CRC detection rate, it can be scheduled a burden for health care structures involved in the program accounting for 49,325 FOBTs, 2,338 colonscopies and 141 surgeries for each year. Discussion. This work demonstrates the feasibility of a colorectal screening project in our area, showing a sustainable impact for local health care involved structures. Furthermore, this program may be spread as an applicative model to other areas, adapting the project to the needs of the local setting in which the colorectal screening will be organized

Does access to care play a role in liver cancer survival? The ten-year (2006\u20132015) experience from a population-based cancer registry in Southern Italy

Background: Hepatocellular carcinoma (HCC) is the most frequent primary invasive cancer of the liver. During the last decade, the epidemiology of HCC has been continuously changing in developed countries, due to more effective primary prevention and to successful treatment of virus-related liver diseases. The study aims to examine survival by level of access to care in patients with HCC, for all patients combined and by age. Methods: We included 2018 adult patients (15\u201399 years) diagnosed with a primary liver tumour, registered in the Palermo Province Cancer Registry during 2006\u20132015, and followed-up to 30 October 2019. We obtained a proxy measure of access to care by linking each record to the Hospital Discharge Records and the Ambulatory Discharge Records. We estimated net survival up to 5 years after diagnosis by access to care (\u201ceasy access to care\u201d versus \u201cpoor access to care\u201d), using the Pohar-Perme estimator. Estimates were age-standardised using International Cancer Survival Standard (ICSS) weights. We also examined survival by access to care and age (15\u201364, 65\u201374 and 65 75 years). Results: Among the 2018 patients, 62.4% were morphologically verified and 37.6% clinically diagnosed. Morphologically verified tumours were more frequent in patients aged 65\u201374 years (41.6%), while tumours diagnosed clinically were more frequent in patients aged 75 years or over (50.2%). During 2006\u20132015, age-standardised net survival was higher among HCC patients with \u201ceasy access to care\u201d than in those with \u201cpoor access to care\u201d (68% vs. 48% at 1 year, 29% vs. 11% at 5 years; p < 0.0001). Net survival up to 5 years was higher for patients with \u201ceasy access to care\u201d in each age group (p < 0.0001). Moreover, survival increased slightly for patients with easier access to care, while it remained relatively stable for patients with poor access to care. Conclusions: During 2006\u20132015, 5-year survival was higher for HCC patients with easier access to care, probably reflecting progressive improvement in the effectiveness of health care services offered to these patients. Our linkage algorithm could provide valuable evidence to support healthcare decision-making in the context of the evolving epidemiology of hepatocellular carcinoma

Evaluating web-based static, animated and interactive maps for injury prevention

This is the final version of the article. Available from PAGEpress via the DOI in this record.Public health planning can benefit from visual exploration and analysis of geospatial data. Maps and geovisualization tools must be developed with the user-group in mind. User-needs assessment and usability testing are crucial elements in the iterative process of map design and implementation. This study presents the results of a usability test of static, animated and interactive maps of injury rates and socio-demographic determinants of injury by a sample of potential end-users in Toronto, Canada. The results of the user-testing suggest that different map types are useful for different purposes and for satisfying the varying skill level of the individual user. The static maps were deemed to be easy to use and versatile, while the animated maps could be made more useful if animation controls were provided. The split-screen concept of the interactive maps was highlighted as particularly effective for map comparison. Overall, interactive maps were identified as the preferred map type for comparing patterns of injury and related socio-demographic risk factors. Information collected from the user-tests is being used to expand and refine the injury web maps for Toronto, and could inform other public health-related geo-visualization projects.Partial funding for this project was provided by the Natural Sciences and Engineering Research Council of Canada and the Canadian Institutes of Health Research

Importance of meteorological variables for aeroplankton dispersal in an urban environment

Passive wind dispersal is one of the major mechanisms through which organisms disperse and colonize new areas. The detailed comprehension of which factors affect this process may help to preserve its efficiency for years to come. This is especially important in the current context of climate change, which may seriously alter weather regimes that drive dispersal, and is crucial in urban contexts, where biodiversity is dramatically threatened by pollution and fragmentation of natural patches. Despite its interest, the analysis of factors affecting aeroplankton dispersal in urban environments is rare in literature. We sampled aeroplankton community uninterruptedly every 4 hours from 17th May to 19th September 2011 in the urban garden of Parco d'Orléans, within the campus of the University of Palermo (Sicily). Sampling was performed using a Johnson-Taylor suction trap with automatized sample storing. Weather variables were recorded at a local meteorological station. Overall, 11,739 insects were caught during the present study, about 60% of these belonged to the order Hymenoptera, with particular presence of families Agaonidae and Formicidae. The suction trap also captured specimens of very small size, and in some cases, species caught were new records for Italy. Composition and abundance of aeroplankton community was influenced by alternation day/night, as well as by daily fluctuations of climatic variables, for example fluctuating temperature . The diversity of samples was also studied and resulted higher when wind blew from the nearby green area. Our findings confirm that passive transport of arthropods strictly depends on weather conditions, and that the presence of natural areas within the urban environment significantly contribute to raise aeroplankton diversity, eventually fuelling overall biodiversity at a local scale. We discuss how climate change may affect future dispersal of these organisms

Oleocanthal Exerts Antitumor Effects on Human Liver and Colon Cancer Cells Through ROS Generation

The beneficial health properties of the Mediterranean diet are well recognized. The principle source of fat in Mediterranean diet is extra-virgin olive oil (EVOO). Oleocanthal (OC) is a naturally occurring minor phenolic compound isolated from EVOO, which has shown a potent anti-inflammatory activity, by means of its ability to inhibit the cyclooxygenase (COX) enzymes COX-1 and COX-2. A large body of evidence indicates that phenols exhibit anticancer activities. The aim of the present study was to evaluate the potential anticancer effects of OC in hepatocellular carcinoma (HCC) and colorectal carcinoma (CRC) models. A panel of human HCC (HepG2, Huh7, Hep3B and PLC/PRF/5) and CRC (HT29, SW480) cell lines was used. Cells were treated with OC, and cell viability and apoptosis were evaluated. Compared with classical commercially available COX inhibitors (ibuprofen, indomethacin, nimesulide), OC was more effective in inducing cell growth inhibition in HCC and CRC cells. Moreover, OC inhibited colony for mation and i nduced ap optosis, as confirmed by PARP cleavage, activation of caspases 3/7 and chromatin condensation. OC treatment in a dose dependent-manner induced expression of \uce\ub3H2AX, a marker of DNA damage, increased intracellular ROS production and caused mitochondrial depolarization. Moreover, the effects of OC were suppressed by the ROS scavenger N-acetyl-L-cysteine. Finally, OC was not toxic in primary normal human hepatocytes. In conclusion, OC treatment was found to exert a potent anticancer activity against HCC and CRC cells. Taken together, our findings provide preclinical support of the chemotherapeutic potential of EVOO against cancer

Valutazione in vitro dell'affaticamento di strumenti rotanti in nichel-titanio

Riassunto Obiettivo L'obiettivo di questo lavoro e quello di valutare, in vitro, la fatica ciclica di ProFile, K3 e Twisted File, strumenti rotanti in nichel-titanio, in canali radicolari simulati aventi angoli di curvatura di 45°, 60° e 90°. Materiali e metodi Per effettuare questo studio sono stati utilizzati: 18 file 25/.06 ProFile; 18 file 25/.06 K3; 18 file 25/.06 Twisted File. La resistenza a fatica ciclica degli strumenti rotanti Ni-Ti e stata testata ad angolazioni di 45°, 60° e 90° mediante un modello sperimentale creato specificatamente. Risultati e conclusioni Dall'analisi dei dati e emersa una buona resistenza alla fatica ciclica per quanto concerne le sistematiche ProFile e Twisted File, di contro, la sistematica K3 e risultata essere inferiore alle altre per tutte le curvature prese in esame. I Twisted File all'angolazione di 90° hanno mostrato una resistenza a fatica ciclica nettamente superiore rispetto ai ProFile e ai K3

Novel Combination of Sorafenib and Celecoxib Provides Synergistic Anti-Proliferative and Pro-Apoptotic Effects in Human Liver Cancer Cells

Molecular targeted therapy has shown promise as a treatment for advanced hepatocellular carcinoma (HCC). Sorafenib, a multikinase inhibitor, recently received FDA approval for the treatment of advanced HCC. However, although sorafenib is well tolerated, concern for its safety has been expressed. Celecoxib (Celebrex®) is a selective cyclooxygenase-2 (COX-2) inhibitor which exhibits antitumor effects in human HCC cells. The present study examined the interaction between celecoxib and sorafenib in two human liver tumor cell lines HepG2 and Huh7. Our data showed that each inhibitor alone reduced cell growth and the combination of celecoxib with sorafenib synergistically inhibited cell growth and increased apoptosis. To better understand the molecular mechanisms underlying the synergistic antitumor activity of the combination, we investigated the expression profile of the combination-treated liver cancer cell lines using microarray analysis. Combination treatment significantly altered expression levels of 1,986 and 2,483 transcripts in HepG2 and Huh7 cells, respectively. Genes functionally involved in cell death, signal transduction and regulation of transcription were predominantly up-regulated, while genes implicated in metabolism, cell-cycle control and DNA replication and repair were mainly down-regulated upon treatment. However, combination-treated HCC cell lines displayed specificity in the expression and activity of crucial factors involved in hepatocarcinogenesis. The altered expression of some of these genes was confirmed by semi-quantitative and quantitative RT-PCR and by Western blotting. Many novel genes emerged from our transcriptomic analyses, and further functional analyses may determine whether these genes can serve as potential molecular targets for more effective anti-HCC strategies