Prediction of Peptide Reactivity with Human IVIg through a Knowledge-Based Approach

The prediction of antibody-protein (antigen) interactions is very difficult due to the huge variability that characterizes the structure of the antibodies. The region of the antigen bound to the antibodies is called epitope. Experimental data indicate that many antibodies react with a panel of distinct epitopes (positive reaction). The Challenge 1 of DREAM5 aims at understanding whether there exists rules for predicting the reactivity of a peptide/epitope, i.e., its capability to bind to human antibodies. DREAM 5 provided a training set of peptides with experimentally identified high and low reactivities to human antibodies. On the basis of this training set, the participants to the challenge were asked to develop a predictive model of reactivity. A test set was then provided to evaluate the performance of the model implemented so far

Ultrasound evaluation of the first finger’s sesamoid bones: diagnostic value of sesamoid and subsesamoid indices

Purpose: Our analysis focuses explicitly on applying two sonographic and morphological indexes (sesamoid index and subsesamoid index) to better evaluate post-traumatic consequences to the sesamoids of the first finger. Methods: In 2 years, we enrolled 75 patients, divided into two groups: 60 without any history of trauma and 15 reporting hyperextension trauma of the first finger. We performed clinical and instrumental examinations (sonography and X-ray) on patients with one or more symptoms compatible with sesamoiditis, while an MRI scan was performed only on patients with an acute onset and severe symptomatology. We measured both the short and long-axis diameter (in mm) for each sesamoid as well as the relation between the two parameters (sesamoid index, SI and subsesamoid index, SubI). Results: All 15 patients showed sonographic alterations of the SI above the reference range, while the alterations of SubI varied according to the acuteness and gravity of trauma. In all cases, the X-ray did not show any relevant alterations. MRI scans in patients with acute symptoms confirmed the sonographic findings. Conclusion: Sonography enabled diagnosis of micro-injuries which were invisible to X-Ray and allowed to detect possible damages to the sesamoid complex, providing a qualitative and quantitative evaluations of the post-traumatic alteration of the metacarpophalangeal joint of the 1st finger and is therefore valid, combined with clinical examination and hand X-ray, in the evaluation of sesamoiditis without the need to perform further examinations

Morphometric evaluation of sesamoid bones of the first metacarpophalangeal joint with ultrasound

The purpose of our study is to demonstrate the role of ultrasound as a first-line technique in the evaluation of sesamoid bones of the first metacarpophalangeal joint

Masseter-facial neurorrhaphy for facial palsy reanimation: What happens after masseter denervation? Histomorphometric and stomatognathic functional analysis

The aim of the present study was to analyse the consequences of masseter muscle denervation. In facial palsy surgical treatment, the masseteric nerve constitutes an important nerve source for facial reanimation due to its anatomical position and large amount of available axons. Computed tomography and/or magnetic resonance imaging were performed in 30 control subjects, and three radiologists separately measured the longitudinal diameter (LD), anteroposterior diameter (APD), transverse diameter (TD), and skeletal muscle area (SMA) of the masseter muscles as reference values. Regarding the facial palsy group, from 2009 to 2018, 11 patients (4 men and 7 women) were selected on the following inclusion criteria: diagnosis of unilateral facial paralysis, minimum follow-up of 14 months, absence of temporomandibular dysfunction, presence of complete dentition (to minimise bias of stomatognathic evaluation), complete clinical and radiological records. The mean LD, APD, TD, and SMA values of the healthy and denervated masseter muscles were obtained and compared. Stomatognathic function was clinically examined through mean mouth opening (MMO) and Maximum Bite Force (MBF). Furthermore, facial symmetry analysis (FSA) was carried out using EMOTRICS Software. Reference values obtained were as follows: mean LD = 69 ± 5.9 mm (range: 59–85 mm); mean APD = 40.2 ± 3.3 mm (range: 34–48 mm); mean TD = 15.5 ± 3.1 mm (range: 11–26 mm); and mean SMA = 43.8 ± 13.5 mm3 (range: 26–85.8 mm3). No statistically significant difference was observed between the healthy facial palsy groups's masseter muscles and reference values. As the latter, in denervated masseter muscles, no statistically significant difference was observed for APD value in contrast to LD, TD and SMA that showed statistically significant difference in comparison with control population (p < 0.05, CI 95%). Moreover fibro-adipose degeneration was consistently observed, with its degree being directly proportional to the denervation time. MMO and MBF mean values were, respectively, 54.75 mm in men, 44.4 mm in women and 705N. None of the latter showed a statistically significant difference with respect to the control population and the parameters present in the literature, indicating that masseter-facial neurorrhaphy is a safe and effective procedure for facial reanimation with good functional and aesthetic outcomes

Economic evaluation of screening programs for hepatitis C virus infection: evidence from literature

Silvia Coretti,1 Federica Romano,1 Valentina Orlando,2 Paola Codella,1 Sabrina Prete,1 Eugenio Di Brino,1 Matteo Ruggeri1 1Post-Graduate School of Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy; 2Center of Pharmacoeconomics (CIRFF), Department of Pharmacy, Federico II University, Naples, Italy Background: Hepatitis C is a liver infection caused by hepatitis C virus. Its main complications are cirrhosis and liver cancer. According to the World Health Organization (WHO), more than 185 million people worldwide are infected with hepatitis C virus and, of these, 350,000 die every year. Due to the high disease prevalence and the existence of effective (and expensive) medical treatments able to dramatically change the prognosis, early detection programs can potentially prevent the development of serious chronic conditions, improve health, and save resources. Objective: To summarize the available evidence on the cost-effectiveness of screening programs for hepatitis C. Methods: A literature search was performed on PubMed and Scopus search engines. Trip database was queried to identify reports produced by the major Health Technology Assessment (HTA) agencies. Three reviewers dealt with study selection and data extraction blindly. Results: Ten papers eventually met the inclusion criteria. In studies focusing on asymptomatic cohorts of individuals at general risk the cost/quality adjusted life year of screening programs ranged between US $4,200 and$50,000/quality adjusted life year gained, while in those focusing on specific risk factors the incremental cost-effectiveness ratio ranged between $848 and$128,424/quality adjusted life year gained. Age of the target population and disease prevalence were the main cost-effectiveness drivers. Conclusion: Our results suggest that, especially in the long run, screening programs represent a cost-effective strategy for the management of hepatitis C. Keywords: hepatitis C, screening, early detection, cost-effectivenes

Return on investment (ROI) and development of a workplace disability management program in a hospital\u2014a pilot evaluation study

The progressive ageing of the working population and the increase in related chronic diseases tend to affect working capacity. The aim of this study was to evaluate a Workplace Disability Management Program (WDMP) within a pediatric hospital. Absenteeism due to healthcare workers\u2019 (HCWs) pre-and post-WDMP and the related costs were used for the program evaluation. The Return on Investment (ROI), the Break-Even Analysis (BEA) and the value of the average annual productivity of HCWs who took advantage of the Disability Management (DM) interventions to assess the economic impact of the program, were also used. The HCWs enrolled in the program were 131 (approximately 4% of hospital staff), of which 89.7% females and with an average age of 50.4 years (SD \ub1 8.99). Sick leave days of the HCWs involved decreased by 66.6% in the year following the end of WDMP compared to the previous one (p < 0.001). The total estimated cost reduction of absenteeism is 427,896 \u20ac over a year. ROI was equal to 27.66 \u20ac. BEA indicated that the break-even point was reached by implementing the program on 3.27 HCWs. The program evaluation demonstrated the particular effectiveness of the implemented WDMP model, acting positively on the variables that affect productivity and the limitation to work

Dealing with COVID-19 epidemic in Italy: Responses from regional organizational models during the first phase of the epidemic

As the COVID-19 outbreak traveled through various Italian regions, all national and local administrations issued measures to counter the spread of the contagion and organize healthcare. The Italian healthcare system is, indeed, a decentralized system with 21 regional health systems (RHSs), with different models of healthcare service delivery and organization. This study investigates whether a different organization of RHSs would have led to different management of the COVID-19 epidemic, and evaluates the effect of different approaches in epidemic management on the COVID-19 epidemiological trend. A set of indicators is identified by conducting an online synchronous Focus Group, involving an experts panel. A Pearson's correlation test was performed on the values assumed by the historical series of indicators investigate correlations among the trends represented by the indicators or between them and external factors. The comparison between the experiences of the different Italian regions, regarding the management of the epidemic, has helped to confirm and emphasize the importance of a community-based approach in health care—integrated with the hospital’s functions for the care of complex conditions and the need for specialized assistance