AN INTEGRATED MODEL FOR THE ASSESSMENT OF STRESS-RELATED RISK FACTORS IN HEALTH CARE PROFESSIONALS

5Abstract To assess the risk from exposure to occupational stress and burnout in health care workers (HCW), a cross-sectional study was planned to compare objective data that can represent potential job stressors in hospital wards and subjective symptoms reported by the workers. Medical doctors, nurses and ancillary workers of the Internal Medicine Wards of a large public hospital in Northern Italy participated in the study. Three subjective questionnaires were administered: the Job Content Questionnaire (JCQ), the State-Trait Anxiety Inventory (STAI), the Maslach Burnout Inventory (MBI). In addition, seven objective parameters were collected as average during the 3 months period prior to the study: a) working understaffed; b) ratio number of patients/HCW on service; c) ratio number of HCW on sick leave/ HCW on service; d) number of skipped days off after night shifts; e) days of sick leave; f) number of deceased patients; g) number of accidents at work. A total group of 230 HCW were examined, employed in six different sub-units of the Medical wards. The female workers were 67.8% and the male workers 32.2%, the mean age was 37.4 years (SD 9.3) in the total group of HCW, 35.1 years (SD 7.9) in females and 42.3 years (SD 10.3) in males. The average scores of subjective and objective parameters resulted significantly higher in the same sub-units. The correlation analysis showed that the subjective questionnaires were highly inter-related. The multivariate analysis showed that the days of sick leave were significantly related to the subjective questionnaires, and the subjective subscales of emotional exhaustion (from MBI), job demand and decision latitude (from JCQ) and STAIt were significantly related to some of the objective parameters. These results support the integrated use of multiple subjective and objective assessment as the most appropriate approach for the evaluation of occupational stress.openopenAlbini, Elisa; Zoni, Silvia; Parrinello, Giovanni; Benedetti, Laura; Lucchini, RobertoAlbini, Elisa; Zoni, Silvia; Parrinello, Giovanni; Benedetti, Laura; Lucchini, Robert

BIM e beni architettonici. Verso una metodologia operativa per la conoscenza e la gestione del patrimonio culturale

Lo studio intende rispondere alla crescente ne- cessità di organizzare in maniera virtuosa gli ap- parati informativi relativi al Patrimonio Culturale, attraverso una metodologia che integri processi multidisciplinari di interazione con l’informazio- ne, finalizzati al rilievo, documentazione, gestio- ne, conoscenza e valorizzazione del Bene. È necessario ripercorrere, attualizzandolo, il pro- cesso di acquisizione strumentale dell’informa- zione, di normalizzazione e di strutturazione dei dati acquisti in un modello semantico tridimen- sionale e la successiva rappresentabilità e la frui- bilità del modello e della banca dati associata. Se nel campo della progettazione l’utilizzo del Buil- ding Information Modeling ha visto negli ultimi anni un consolidamento nelle procedure e l’indi- viduazione di metodologie standard, nell’ambito dei Beni Culturali, la sfida volta all’individuazione di metodologie operative è ancora aperta.The study aims to answer the growing need for virtuously organize informational apparatuses related to Cultural Heritage. We propose a me- thodology that integrates multidisciplinary pro- cesses of interaction with information aimed at survey, documentation, management, knowled- ge and enhancement of historic artifacts. It is needed to review and update the procedu- re of instrumental data acquisition, standardi- zation and structuring of the acquired data in a three-dimensional semantic model as well as the subsequent representability and accessibility of the model and the related database. If the use of Building Information Modeling has in recent years seen a consolidation in the procedures and the identification of standard methods in design process, nevertheless in the field of architectural heritage, the challenge to identify operational methodologies for the conservation, manage- ment and process enhancement is still open

883 An anti-carcinoma monoclonal antibody (mAb) NEO-201 can also target human acute myeloid leukemia (AML) cell lines in vitro

BackgroundNEO-201 is an IgG1 mAb targeting variants of CEACAM5/6 and has demonstrated tumor sensitivity and specificity in epithelial cells. Functional analysis has revealed that NEO-201 can engage innate immune effector mechanisms including ADCC and CDC to directly kill tumor cells expressing its target. A recent Phase 1 clinical trial at the NCI has determined both safety and recommended Phase 2 dosing. We have also seen the expression of the NEO-201 target on hematologic cells, specifically Tregs and neutrophils. Due to epitope being expressed both on malignant epithelial cells as well as several hematologic cells, we designed this study to explore the reactivity of NEO-201 against hematological neoplastic cells in vitro.MethodsPhenotypic analysis was conducted by flow cytometry. Cell lines used were six AML (HL60, U937, MOLM13, AML2, IMS-M2 and OCL-AML3), two multiple myelomas (MM) (OPM2, MM1.S), two acute lymphoblastic leukemia (ALL) (SUP-B15, RPMI8402) and four mantle cell lymphoma (MCL) (Jeko-1, Z138, JVM2 and JVM13). Markers used for flow cytometry analysis were CD15, CD45, CD38, CD138, CD14, CD19 and NEO-201. Functional analysis was performed by evaluating the ability of NEO-201 to mediate ADCC activity against AML cell lines using human NK cells as effector cells.Results5 of 6 AML cell lines tested bind to NEO-201 and the% of positive cells were 47%, 99.5%,100%,100% and 97.8% for HL60, U937, MOLM13, AML3 and IMS-M2, respectively. The% of positive cells in the two MM cell line were 99% and 18% for OPM2 and MM1.S, respectively. NEO-201 binding was not detected in the two ALL and the four MCL cell lines tested. Functional analysis has demonstrated that NEO-201 can mediate ADCC activity against the AML cell line (HL60) tested.ConclusionsThis study demonstrates that NEO-201 mAb's target is expressed in most of the AML cell lines tested in vitro. In addition, we have shown it can mediate ADCC activity against HL60 cells (AML). Together, these findings provide a rationale for further investigation of the role of NEO-201 in AML as well as MM, further exploring patient PBMCs and bone marrow samples

BIM e beni architettonici: verso una metodologia operativa per la conoscenza e la gestione del patrimonio culturale - BIM and architectural heritage: towards an operational methodology for the knowledge and the management of Cultural Heritage

Lo studio intende rispondere alla crescente necessità di organizzare in maniera virtuosa gli apparati informativi relativi al Patrimonio Culturale, attraverso una metodologia che integri processi multidisciplinari di interazione con l’informazione, conoscenza e valorizzazione del Bene. È necessario ripercorrere, attualizzandolo, il processo di acquisizione strumentale dell’informazione, di normalizzazione e di strutturazione dei dati acquisti in un modello semantico tridimensionale e la successiva rappresentabilità e la fruibilità del modello e della banca dati associata. Se nel campo della progettazione l’utilizzo del Building Information Modeling ha visto negli ultimi anni un consolidamento nelle procedure e l’individuazione di metodologie standard, nell’ambito dei Beni Culturali, la sfida volta all’individuazione di metodologie operative è ancora aperta

Anaesthesiological implications of Kimura's disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Kimura's disease is a chronic inflammatory condition belonging to the angio-lymphatic proliferative group of disorders, usually affecting young men of Asian race, but is rare in Western countries. It is a benign but locally injurious disease, of unknown aetiology, whose classical clinical features are a tumour-like swelling, usually in the head and neck, with or without satellite lymphadenopathy, often accompanied by eosinophilia and elevated serum IgE.</p> <p>Case presentation</p> <p>We report the case of a 33-year-old Caucasian woman with an atypical localization of Kimura's disease, discussing the anaesthesiological implications and reviewing the current literature on Kimura's disease.</p> <p>Conclusions</p> <p>The diagnosis of Kimura's disease can be difficult and misleading, and anaesthesiological precautions could be ignored. Patients with this disease are often evaluated for other disorders: unnecessary diagnostic tests and investigations, or even surgery, may be avoided by just being aware of Kimura's disease.</p

A Central Role for the ERK-Signaling Pathway in Controlling Schwann Cell Plasticity and Peripheral Nerve Regeneration In Vivo

SummaryFollowing damage to peripheral nerves, a remarkable process of clearance and regeneration takes place. Axons downstream of the injury degenerate, while the nerve is remodeled to direct axonal regrowth. Schwann cells are important for this regenerative process. “Sensing” damaged axons, they dedifferentiate to a progenitor-like state, in which they aid nerve regeneration. Here, we demonstrate that activation of an inducible Raf-kinase transgene in myelinated Schwann cells is sufficient to control this plasticity by inducing severe demyelination in the absence of axonal damage, with the period of demyelination/ataxia determined by the duration of Raf activation. Remarkably, activation of Raf-kinase also induces much of the inflammatory response important for nerve repair, including breakdown of the blood-nerve barrier and the influx of inflammatory cells. This reversible in vivo model identifies a central role for ERK signaling in Schwann cells in orchestrating nerve repair and is a powerful system for studying peripheral neuropathies and cancer

The prognostic value of the myeloid-mediated immunosuppression marker Arginase-1 in classic Hodgkin Lymphoma

Neutrophilia is hallmark of classic Hodgkin Lymphoma (cHL), but its precise characterization remains elusive. We aimed at investigating the immunosuppressive role of high-density neutrophils in HL

Macrophage-induced blood vessels guide Schwann cell-mediated regeneration of peripheral nerves

The peripheral nervous system has remarkable regenerative capacities in that it can repair a fully cut nerve. This requires Schwann cells to migrate collectively to guide regrowing axons across a 'bridge' of new tissue, which forms to reconnect a severed nerve. Here we show that blood vessels direct the migrating cords of Schwann cells. This multicellular process is initiated by hypoxia, selectively sensed by macrophages within the bridge, which via VEGF-A secretion induce a polarized vasculature that relieves the hypoxia. Schwann cells then use the blood vessels as "tracks" to cross the bridge taking regrowing axons with them. Importantly, disrupting the organization of the newly formed blood vessels in vivo, either by inhibiting the angiogenic signal or by re-orienting them, compromises Schwann cell directionality resulting in defective nerve repair. This study provides important insights into how the choreography of multiple cell-types is required for the regeneration of an adult tissue

In-vitro NET-osis induced by COVID-19 sera is associated to severe clinical course in not vaccinated patients and immune-dysregulation in breakthrough infection

: Since neutrophil extracellular traps formation (NET-osis) can be assessed indirectly by treating healthy neutrophils with blood-derived fluids from patients and then measuring the NETs response, we designed a pilot study to convey high-dimensional cytometry of peripheral blood immune cells and cytokines, combined with clinical features, to understand if NET-osis assessment could be included in the immune risk profiling to early prediction of clinical patterns, disease severity, and viral clearance at 28&nbsp;days in COVID-19 patients. Immune cells composition of peripheral blood, cytokines concentration and in-vitro NETosis were detected in peripheral blood of 41 consecutive COVID-19 inpatients, including 21 mild breakthrough infections compared to 20 healthy donors, matched for sex and age. Major immune dysregulation in peripheral blood in not-vaccinated COVID-19 patients compared to healthy subjects included: a significant reduction of percentage of unswitched memory B-cells and transitional B-cells; loss of naïve CD3+CD4+CD45RA+ and CD3+CD8+CD45RA+ cells, increase of IL-1β, IL-17A and IFN-γ. Myeloid compartment was affected as well, due to the increase of classical (CD14++CD16-) and intermediate (CD14++CD16+) monocytes, overexpressing the activation marker CD64, negatively associated to the absolute counts of CD8+ CD45R0+ cells, IFN-γ and IL-6, and expansion of monocytic-like myeloid derived suppressor cells. In not-vaccinated patients who achieved viral clearance by 28&nbsp;days we found at hospital admission lower absolute counts of effector cells, namely CD8+T cells, CD4+ T-cells and CD4+CD45RO+ T cells. Percentage of in-vitro NET-osis induced by patients' sera and NET-osis density were progressively higher in moderate and severe COVID-19 patients than in mild disease and controls. The percentage of in-vitro induced NET-osis was positively associated to circulating cytokines IL-1β, IFN-γ and IL-6. In breakthrough COVID-19 infections, characterized by mild clinical course, we observed increased percentage of in-vitro NET-osis, higher CD4+ CD45RO+ and CD8+ CD45RO+ T cells healthy or mild-COVID-19 not-vaccinated patients, reduced by 24&nbsp;h of treatment with ACE inhibitor ramipril. Taken together our data highlight the role of NETs in orchestrating the complex immune response to SARS-COV-2, that should be considered in a multi-target approach for COVID-19 treatment