Immunization against Hepatitis B Surface Antigen (HBsAg) in a Cohort of Nursing Students Two Decades after Vaccination: Surprising Feedback

Health-care students can be exposed to biological risks during university training. The persistence of long-term immunogenicity against hepatitis B virus (HBV) was analyzed in a cohort of nursing students two decades after primary vaccination. A total of 520 students were enrolled at the University of Palermo and were evaluated for levels of anti-HBsAg antibodies. ThestudentswereexaminedduringthefirstyearoftheirDegreeCourseandwerecheckedtwoyears later. All students with anti-HBsAg <10 mIU/mL during their first or third year were boosted within onemonth. Theproportionofstudentsthatwerevaccinatedduringadolescenceshowinganti-HBsAg ≥10 mIU/mL was higher than that observed in students who were vaccinated during infancy (69% versus31.7%;p-value<0.001). ReceivingHBVvaccinationatadolescencewassignificantlyassociated with a fourfold increased possibility of having anti-HBsAg titers≥10 mIU/mL (adj-OR = 4.21, 95% CI: 2.43–7.30). Among the students who were checked at the third year and boosted after the first year (n = 279), those who were vaccinated during infancy showed a higher percentage of antibody titers <10 mIU/mL (20.3% versus 8.7% among vaccinated during adolescence; p < 0.01). This study confirms that HBV vaccination at adolescence might determine a higher long-term persistence of anti-HBsAg titers≥10 mIU/mL and that anti-HBV booster could increase levels of anti-HBsAg over a relatively short period, especially in subjects who were vaccinated during infancy

Heroin-piracetam mixture: suggested mechanisms of action and risks of misinterpretation for drug users

Piracetam is a positive allosteric modulator of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor that has been frequently used in the treatment of cognitive disorders. Press and internet reports indicate that the use of piracetam, as a heroin adulterant, has spread rapidly in some countries, especially in Asia and Europe. Its use, as adulterant, is believed to produce more profound desirable effects, while decreasing hangover. Recent surveys demonstrated that piracetam protects neurons from heroin-induced apoptosis. The protective role of this adulterating substance may be related to restoration of beta-endorphin levels and to its neuroprotective effects. The aim of this paper is to review the relevant literature and suggest the main hypothetical mechanisms that justify its use as a heroin adulterant, try to understand if its use could help people who want to come off heroin by reducing withdrawal symptoms and, finally, give useful information that permit us to understand why drug trafficking organisations started to use piracetam as heroin adulterant

A naturally light dilaton

Goldstone's theorem does not apply straightforwardly to the case of spontaneously broken scale invariance. We elucidate under what conditions a light scalar degree of freedom, identifiable with the dilaton, can naturally arise. Our construction can be considered an explicit dynamical solution to the cosmological constant problem in the scalar version of gravity.Comment: v2: published versio

Alta Velocità Ferroviaria e concorrenza modale: il caso del trasporto regionale campano

In termini di mentalità, know-how e tecnologia, il sistema ferroviario italiano non è inferiore a nazioni prestigiose quali il Giappone o la Francia ma, in termini di realizzazione di nuove linee veloci, il nostro paese è piuttosto in ritardo rispetto al resto d’Europa. Basti pensare che la Francia, nonostante abbia inaugurato con 5 anni di ritardo rispetto all’Italia la prima linea ad alta velocità, è riuscita ad avere la nostra attuale estensione della rete AV con ben10 anni di anticipo! Con l’avvento del primo vettore passeggeri ad alta velocità in concorrenza a Trenitalia (2011), il processo di liberalizzazione verrà attuato in modo “quasi” sostanziale anche in questo comparto del trasporto ferroviario. Il percorso verso la liberalizzazione è stato tuttavia lungo e a tratti complesso. Tra le direttive CEE che hanno permesso questo processo, vanno ricordate la n. 440 del 29 luglio 1991, con la quale si voleva incidere sull’assetto organizzativo delle Imprese Ferroviarie (IF) degli Stati membri e si individuavano spazi adeguati per il lancio di un’effettiva liberalizzazione del trasporto ferroviario, riconoscendo alle associazioni internazionali di IF il diritto di accesso e di transito12 negli Stati membri di tali associazioni in relazione a tutte le tipologie di servizi: trasporto internazionale passeggeri e merci, sia tradizionale che combinato

Influenza vaccination in high-risk groups: a revision of existing guidelines and rationale for an evidence-based preventive strategy

Influenza, an infectious respiratory disease, is one of the main causes of excess winter deaths (EWDs) in Europe. Annual flu epidemics are associated with high morbidity and mortality rates, especially among the elderly, those with underlying health conditions and pregnant women. Health Care Workers (HCWs) are also considered at high risk of both contracting influenza and spreading the virus to vulnerable patients. During the 2014/2015 season, the excess winter mortality rates observed in countries of the northern hemisphere (EuroMOMO network) and in Italy (+13%) were strongly related to the intensity of influenza circulation. Influenza vaccination is the most important public health intervention to prevent seasonal influenza transmission and infection. However, to date, influenza vaccination coverage reported in Europe (including high-risk groups) is still largely unsatisfactory. This study analyzes some international and European guidelines on influenza vaccination and the rationale that underlies evidence- based public health intervention for the prevention of influenza among the principal high-risk groups: a) the elderly (subjects aged 65 years or older); b) subjects with underlying health conditions; c) pregnant women; d) healthcare workers. Only by achievement recommended influenza vaccination coverage among high-risk groups in all European countries can we reduce the burden of disease

Distributed Ordering and Optimization for Intersection Management with Connected and Automated Vehicles

Intelligent transport systems are preparing to welcome connected and automated vehicles (CAVs), although it is uncertain which algorithms should be employed for the effective and efficient management of CAV systems. Even though remarkable improvements in telecommunication technologies, such as vehicle-to-everything (V2X), enable communication and computation sharing among different agents, e.g. vehicles and infrastructures, within existing approaches, a significant part of the computation burden is still typically assigned to central units. Distributed algorithms, on the other hand, could alleviate traffic units from most, if not all, of the high dimensional calculation duties, while improving security and remaining effective. In this paper, we propose a formation-control-inspired distributed algorithm to rearrange vehicles’ passing time periods through an intersection and a novel formulation of the underlying trajectory optimization problem so that vehicles need to exchange and process only a limited amount of information. We include early simulation results to demonstrate the effectiveness of our approach

Evaluation of varicella vaccine effectiveness as public health tool for increasing scientific evidence and improving vaccination programs

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The relevance for Public Health of the mid-term and interim analyses of seasonal influenza vaccination effectiveness

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