Prácticas de innovación social para personas mayores: experiencias de Kollektivhus suecos que habilitan el capital humano de las personas mayores

Numerosos estudios empíricos han examinado los resultados de los recursos materiales y el bienestar subjetivo de las experiencias de co-vivienda. Se sabe poco acerca de cómo el co-alojamiento podría afectar el bienestar de las personas mayores en términos del “escenario de vida potencial y factible”. Siguiendo el modelo ecológico y la gerontología ambiental, el presente estudio agrega la perspectiva del enfoque de capacidades de Nussbaum al entorno del hogar definido como el espacio de interacción entre la libertad personal y las facilidades o limitaciones externas. El diseño de análisis y métodos mistos se completó posteriormente con un diseño longitudinal (2017-2022), pre y pospandémico. El cuestionario centrado en las capacidades más relacionadas con el entorno de la vivienda (Integridad corporal; Sentido, imaginación y pensamiento; Emociones; Afiliación), se aplicó a una muestra no probabilística (N = 154) de siete kollektivhus suecos. Los datos recopilados en Suecia demuestran que la forma de vida de kollektivhus proporciona un entorno seguro y protegido, donde los habitantes de la tercera edad pueden expresarse y experimentar las relaciones humanas en un entorno conectado e inclusivo

How good Neural Networks interpretation methods really are? A quantitative benchmark

Saliency Maps (SMs) have been extensively used to interpret deep learning models decision by highlighting the features deemed relevant by the model. They are used on highly nonlinear problems, where linear feature selection (FS) methods fail at highlighting relevant explanatory variables. However, the reliability of gradient-based feature attribution methods such as SM has mostly been only qualitatively (visually) assessed, and quantitative benchmarks are currently missing, partially due to the lack of a definite ground truth on image data. Concerned about the apophenic biases introduced by visual assessment of these methods, in this paper we propose a synthetic quantitative benchmark for Neural Networks (NNs) interpretation methods. For this purpose, we built synthetic datasets with nonlinearly separable classes and increasing number of decoy (random) features, illustrating the challenge of FS in high-dimensional settings. We also compare these methods to conventional approaches such as mRMR or Random Forests. Our results show that our simple synthetic datasets are sufficient to challenge most of the benchmarked methods. TreeShap, mRMR and LassoNet are the best performing FS methods. We also show that, when quantifying the relevance of a few non linearly-entangled predictive features diluted in a large number of irrelevant noisy variables, neural network-based FS and interpretation methods are still far from being reliable

Development and validation of a case-finding algorithm for the identification of non-small cell lung cancers in a region-wide Italian pathology registry

PurposeTo develop and validate a case-finding algorithm for the identification of Non-Small Cell Lung Cancer (NSCLC) cases in a region-wide Italian pathology registry (PR).Materials and methodsData collected between 2009 and 2017 in the PR and the Pharmacy Database of the University Hospital of Siena and the PR of Tuscany region were used. A NSCLC-identification algorithm based on free-text keywords and SNOMED morphology and topography codes was designed and tested on data from Siena: indication for drug use (i.e. NSCLC) was the reference standard for sensitivity (SE); positive predictive value (PPV) was estimated through manual review. Algorithm modifications were then tested to improve algorithm performance: PPV was calculated against validated dataset from PR of Siena; a range of SE [min-max] was estimated in PR of Tuscany using analytical formulae that assumed NSCLC incidence equal either to 80% or 90% of overall lung cancer incidence recorded in Tuscany. The algorithm modification with the best performance was chosen as the final version of the algorithm. A random sample of 200 cases was extracted from the PR of Tuscany for manual review.ResultsThe first version of the algorithm showed a PPV of 74.7% and SE of 79% in PR of Siena. The final version of the algorithm had a SE in PR of Tuscany that grew with calendar time (2009 = [24.7%-28%]; 2017 = [57.9%-65.1%]) and a PPV of 93%.ConclusionsThe final NSCLC-finding algorithm showed with very high PPV. SE was in line with the expected contribution of PR to overall cases captured in the regional Cancer Registry, with a trend of increase over calendar time. Given the promising algorithm validity and the wide use of SNOMED terminology in electronic pathology records, the proposed algorithm is expected to be easily adapted to other electronic databases for (pharmaco)epidemiology purposes

First-Line Pharmacotherapies and Survival among Patients Diagnosed with Non-Resectable NSCLC: A Real-Life Setting Study with Gender Prospective

(1) Purpose: To describe first-line pharmacotherapy and overall survival in non-resectable non-small cell lung cancer (nrNSCLC) patients by gender. (2) Methods: Incident cases of nrNSCLC recorded between 2009 and 2019 (cohort entry) in the pathology registry of the regional administrative healthcare database of Tuscany were identified. Records of antineoplastic therapies delivered up to 4 months following cohort entry were classified as chemotherapy, target therapies, immunotherapies, and undefined monoclonal antibodies. First-line treatment and survival of patients receiving drug treatment was described. Analyses were stratified according to histology, gender, and cohort entry year. (3) Results: 4393 incident cases of nrNSCLC were included. Women with non-squamous-NSCLC received target-therapy more frequently than men (14.9% vs. 6.5%). Immunotherapy incidence of use varied between 3.8% (2017) and 9.1% (2019). The 2-year survival rate increased over time: for non-squamous-NSCLC, it was 22.3% (2009-2011) and 30.6% (2018-2019), while for squamous-NSCLC, it was 13.5% and 22.5%, respectively. After multivariate analysis, a low reduction in mortality risk in 2018-2019 vs. 2009-2011 was found (non-squamous: HR: 0.95 CI95%: 0.92-0.98; squamous: HR: 0.94 CI95%: 0.90-0.98). Among non-squamous NSCLC, median survival was longer in women than in men (389 vs. 276 days). (4) Conclusion: In light of sex-related biomolecular differences, among non-squamous NSCLC, women received target-therapy more frequently than men. Survival seemed to slightly improve over the study period for both histologies, despite a poor reduction in mortality risk was still observed

Data-driven bicycle network planning for demand and safety

Developing safe infrastructure for cycling and micromobility is an efficient pathway towards climate-friendly, sustainable, and livable cities. However, urban cycling infrastructure is typically planned ad-hoc and at best informed by survey data. For a systematic, data-driven planning process here we develop an automated planning framework using data of the existing network and of empirical e-scooter trips and bicycle crashes as proxies for demand and safety, to generate a cohesive network optimizing public health benefits while minimizing investments. We introduce a parameter that tunes the focus between demand-based and safety-based development, and investigate systematically this tradeoff for the city of Turin. We find that a full focus on demand or safety generates different network extensions in the short term, with an optimal tradeoff in-between. In the long term our framework improves overall network quality independent of short-term focus. Thus, this data-driven process can provide urban planners with automated assistance for variable short-term scenario planning while maintaining the long-term goal of a sustainable, city-spanning micromobility network.Comment: Main text: 16 pages, 5 figures, SI: 8 pages, 6 figures, 3 table

Development of Amyotrophic Lateral Sclerosis and military service: a case report

Amyotrophic lateral sclerosis is a neurovegetative disease, and some studies point out a major risk of ALS in people who have served in the armed forces. In this case report we present an Italian case of ALS in a senior officer of the Italian Arm

Migrants’ Economic integration Cluster. Implement in cluster a new form of governance to empower social capital of local networks for Third Country’s Nationals’ Labour inclusion

The Labour Integration for Migrants' Employment (LIME) project, dedicated to young third-country nationals (aged 18-29), released a toolkit for designing cluster interventions. Networks have become a main tool for cooperation among various integration stakeholders. The current toolkit is based on the Migrants Economic Integration Cluster (MEIC) methodology: a participatory approach to creating networks - or clusters - among public and private stakeholders. Working in such clusters is seen as key to faster, multi-stakeholder approach to integration. Drawing on the experience of the seven LIME project partners based in France, Italy and Spain, the toolkit argues that the MEIC approach is transferable across Europe. The toolkit goes on to illustrates the MEIC methodology, suggesting concrete steps for engaging institutional and private stakeholders, creating and managing clusters to respond to specific integration needs, and ensuring the long-term sustainability of such networks. In addition to the toolkit, the project published the EU recommendation paper “Implement in cluster: a new form of governance to empower social capital of local networks for Third Country Nationals’ labour inclusion”. The paper promotes the involvement of beneficiaries in the co-design of labour inclusion programs at the local level, argues in favour of qualification recognition procedures for third-country nationals, and more. Both documents are available in English, Italian and Spanish

Humeral trochlear morphology does not influence coronoid fractures in elbow dislocation

Abstract Purpose Traumatic elbow dislocation is the second most frequent joint dislocation, even though the elbow is a congruent and stable joint. Individual variability in anatomical congruence of the elbow and how it relates to simple or complex instability has rarely been studied in the literature; we hypothesized that a greater articular coverage by the humeral trochlea would be more likely to result in complex dislocation. The aim of this study is to analyze trochlear morphology in simple (SED) and complex elbow dislocation (CED), to assess whether the degree of humeroulnar joint congruence influences the incidence of coronoid fractures in elbow dislocation. The secondary goal is to evaluate the association between trochlear morphology and coronoid fracture pattern. Methods All the elbow CT scans of the hospital server were retrospectively analyzed. 62 patients were enrolled and so divided in 2 groups: SED and CED with isolated coronoid fracture. Patients who were skeletally immature, presented with other concomitant elbow fractures, or who previously underwent elbow surgery were excluded. The CT scans were performed after closed reduction and prior to further treatment. Coronoid fracture pattern was classified on CT scan according to Regan‐Morrey and O’Driscoll classifications; “grade 0” was assigned to SED. Trochlear coverage was measured and expressed as three angles (anterior, posterior, and distal) and their width/depth ratios. Measurements were taken by four different readers and the assessment was repeated after 15 days. Results No statistically significant difference was found between humeral trochlear morphology of SED and CED patients. There was no association between morphometric measurements and coronoid fracture pattern. The results are strengthened by a good intra‐ and inter‐reader reproducibility of the CT analysis protocol. Conclusions Our study is the first to evaluate the impact of trochlear morphology on elbow instability. Considering the results, other variables may have a greater impact on coronoid bone damage, such as trauma energy or ligamentous hyperlaxity: in particular, we believe that the capsuloligamentous structures of the elbow might contribute in a preponderant way to articular stability. The CT analysis protocol gave excellent results: reproducible, accurate and easy to perform. Level of evidence III