Functional health literacy of asylum seekers and refugees. A pilot study in italy

Literature shows how some groups of populations, among which are people seeking international protection and refugees, find it difficult to access services in national health systems. Usually, asylum seekers have limited Health Literacy (HL), which makes understanding the appropriate health information difficult. The objective of this research is to consider the relationship between how people requesting international protection and refugees approach the Italian Health System to request health services and their level of Functional Health Literacy (FHL). These relationships are examined through mixed methods. Data were obtained using several tools: a self-administered questionnaire in which the subjects revealed social and demographic data and a face-to-face interview together with the S-FHL Scale fulfilment in order to identify the functional level of HL. Twenty-one subjects were interviewed in two Centers of Protection System for Asylum Seekers and Refugees (SPRAR). Results show a picture of the actual situation. Data report a problematic or insufficient FHL level. Some factors, such as gender, age and health perceptions, play a role in the FHL levels. Some racial prejudices were reported. Language barriers had the most impact on the communication gap. Nevertheless, none of the subjects were denied health services. In conclusion, although this study is a pilot, we have experienced difficulty in obtaining asylum seekers’ trust to be open about their experience. This explains the number of the sample that should be more indicated for a qualitative study. Our results are in accordance with literature for inadequate level of FHL and lack of knowledge of the Italian Health System. This study highlighted several other issues to be taken into consideration for future research on the subject

Stochastic Testing Simulator for Integrated Circuits and MEMS: Hierarchical and Sparse Techniques

Process variations are a major concern in today's chip design since they can significantly degrade chip performance. To predict such degradation, existing circuit and MEMS simulators rely on Monte Carlo algorithms, which are typically too slow. Therefore, novel fast stochastic simulators are highly desired. This paper first reviews our recently developed stochastic testing simulator that can achieve speedup factors of hundreds to thousands over Monte Carlo. Then, we develop a fast hierarchical stochastic spectral simulator to simulate a complex circuit or system consisting of several blocks. We further present a fast simulation approach based on anchored ANOVA (analysis of variance) for some design problems with many process variations. This approach can reduce the simulation cost and can identify which variation sources have strong impacts on the circuit's performance. The simulation results of some circuit and MEMS examples are reported to show the effectiveness of our simulatorComment: Accepted to IEEE Custom Integrated Circuits Conference in June 2014. arXiv admin note: text overlap with arXiv:1407.302

The Collaborative for the Research on Black Women and Girls

<p>Seven patients per group. **P<0.01 Mann-Whitney U test. Representative granule cell layer hippocampal sections from patients without granule cell pathology (B) or with type-2 GCP (C) exhibiting DAB-labeled ANTXR1-like immunoreactivity (LI). Omitting the primary antibody to estimate nonspecific signal yielded completely negative labeling (data not shown). Note a widespread increase in ANTXR1-LI in granule cells from patients with type-2 GCP (C).</p

Lice (Haematopinus tuberculatus) in water buffalo farms from central Italy

The aim of the present study was to obtain information about the presence and distribution of the suckling louse Haematopinus tuberculatus in water buffalo farms in central Italy. The survey was carried out on 127 farms (epidemiological units), selected using a grid approach within a Geographical Information System, followed by proportional allocation. In each farm 6 buffaloes were examined in order to detect the louse presence. Parasitological examinations were performed on each buffalo at predilection sites. A total of 762 water buffaloes were examined. H. tuberculatus was found in the 11.0% (14/127) of the farms and in the 4.5% (34/762) of the animals. The presence H. tuberculatus should be routinely considered because it is a cause of serious health, production and economic damages in intensive breeding buffaloes

miRNAs expression analysis in paired fresh/frozen and dissected formalin fixed and paraffin embedded glioblastoma using real-time pCR.

miRNAs are small molecules involved in gene regulation. Each tissue shows a characteristic miRNAs epression profile that could be altered during neoplastic transformation. Glioblastoma is the most aggressive brain tumour of the adult with a high rate of mortality. Recognizing a specific pattern of miRNAs for GBM could provide further boost for target therapy. The availability of fresh tissue for brain specimens is often limited and for this reason the possibility of starting from formalin fixed and paraffin embedded tissue (FFPE) could very helpful even in miRNAs expression analysis. We analysed a panel of 19 miRNAs in 30 paired samples starting both from FFPE and Fresh/Frozen material. Our data revealed that there is a good correlation in results obtained from FFPE in comparison with those obtained analysing miRNAs extracted from Fresh/Frozen specimen. In the few cases with a not good correlation value we noticed that the discrepancy could be due to dissection performed in FFPE samples. To the best of our knowledge this is the first paper demonstrating that the results obtained in miRNAs analysis using Real-Time PCR starting from FFPE specimens of glioblastoma are comparable with those obtained in Fresh/Frozen samples

Promoter methylation analysis of O6-methylguanine-DNA methyltransferase in glioblastoma: detection by locked nucleic acid based quantitative PCR using an imprinted gene (SNURF) as a reference

<p>Abstract</p> <p>Background</p> <p>Epigenetic silencing of the <it>MGMT </it>gene by promoter methylation is associated with loss of <it>MGMT </it>expression, diminished DNA-repair activity and longer overall survival in patients with glioblastoma who, in addition to radiotherapy, received alkylating chemotherapy with carmustine or temozolomide. We describe and validate a rapid methylation sensitive quantitative PCR assay (MS-qLNAPCR) using Locked Nucleic Acid (LNA) modified primers and an imprinted gene as a reference.</p> <p>Methods</p> <p>An analysis was made of a database of 159 GBM patients followed between April 2004 and October 2008. After bisulfite treatment, methylated and unmethylated CpGs were recognized by LNA primers and molecular beacon probes. The <it>SNURF </it>promoter of an imprinted gene mapped on 15q12, was used as a reference. This approach was used because imprinted genes have a balanced copy number of methylated and unmethylated alleles, and this feature allows an easy and a precise normalization.</p> <p>Results</p> <p>Concordance between already described nested MS-PCR and MS-qLNAPCR was found in 158 of 159 samples (99.4%). The MS-qLNAPCR assay showed a PCR efficiency of 102% and a sensitivity of 0.01% for LNA modified primers, while unmodified primers revealed lower efficiency (69%) and lower sensitivity (0.1%). <it>MGMT </it>promoter was found to be methylated using MS-qLNAPCR in 70 patients (44.02%), and completely unmethylated in 89 samples (55.97%). Median overall survival was of 24 months, being 20 months and 36 months, in patients with <it>MGMT </it>unmethylated and methylated, respectively. Considering <it>MGMT </it>methylation data provided by MS-qLNAPCR as a binary variable, overall survival was different between patients with GBM samples harboring <it>MGMT </it>promoter unmethylated and other patients with any percentage of <it>MGMT </it>methylation (p = 0.003). This difference was retained using other cut off values for <it>MGMT </it>methylation rate (i.e. 10% and 20% of methylated allele), while the difference was lost when 50% of <it>MGMT </it>methylated allele was used as cut-off.</p> <p>Conclusions</p> <p>We report and clinically validate an accurate, robust, and cost effective MS-qLNAPCR protocol for the detection and quantification of methylated <it>MGMT </it>alleles in GBM samples. Using MS-qLNAPCR we demonstrate that even low levels of <it>MGMT </it>promoter methylation have to be taken into account to predict response to temozolomide-chemotherapy.</p

Pattern of care and effectiveness of treatment for glioblastoma patients in the real world: Results from a prospective population-based registry. Could survival differ in a high-volume center?

BACKGROUND: As yet, no population-based prospective studies have been conducted to investigate the incidence and clinical outcome of glioblastoma (GBM) or the diffusion and impact of the current standard therapeutic approach in newly diagnosed patients younger than aged 70 years. METHODS: Data on all new cases of primary brain tumors observed from January 1, 2009, to December 31, 2010, in adults residing within the Emilia-Romagna region were recorded in a prospective registry in the Project of Emilia Romagna on Neuro-Oncology (PERNO). Based on the data from this registry, a prospective evaluation was made of the treatment efficacy and outcome in GBM patients. RESULTS: Two hundred sixty-seven GBM patients (median age, 64 y; range, 29-84 y) were enrolled. The median overall survival (OS) was 10.7 months (95% CI, 9.2-12.4). The 139 patients 64aged 70 years who were given standard temozolomide treatment concomitant with and adjuvant to radiotherapy had a median OS of 16.4 months (95% CI, 14.0-18.5). With multivariate analysis, OS correlated significantly with KPS (HR = 0.458; 95% CI, 0.248-0.847; P = .0127), MGMT methylation status (HR = 0.612; 95% CI, 0.388-0.966; P = .0350), and treatment received in a high versus low-volume center (HR = 0.56; 95% CI, 0.328-0.986; P = .0446). CONCLUSIONS: The median OS following standard temozolomide treatment concurrent with and adjuvant to radiotherapy given to (72.8% of) patients aged 6470 years is consistent with findings reported from randomized phase III trials. The volume and expertise of the treatment center should be further investigated as a prognostic factor

Analysis and Design of Low-Jitter Digital Bang-Bang Phase-Locked Loops

Digital phase-locked loops based on bang-bang phase detectors are attractive candidates for low-jitter clock-frequency multiplication. Unfortunately, the coarse quantization of phase error makes these systems prone to the generation of limit cycles appearing as unwanted spurs in the spectrum. The random noise contributed by building blocks and acting as dithering signal can eliminate those spurs. The quantitative analysis of those phenomena becomes more involved when a DCO with relaxed intrinsic resolution, such as a ΔΣ-DCO is employed, and when practical spectra of random noise sources are considered. In this work, the expression of jitter is calculated in closed-form taking into account the quantization, introduced by both phase detector and DCO, and the phase noise of DCO, with both 1/f^2 and 1/^3 components. Combining these results, a closed-form expression of the total output jitter as a function of loop parameters and noise sources is developed which suggests a minimum-jitter design strategy. The proposed analysis and optimization are validated both numerically and experimentally on a 320-MHz digital bang-bang PLL fabricated in a 65-nm CMOS process

An efficient method to compute phase-noise in injection-locked frequency dividers

This paper provides an original and very efficient computational method to evaluate phase-noise effects in injection-locked frequency dividers. The technique relies on a realistic phase-domain macromodel of the locked oscillator whose parameters are extracted by means of an RF circuit simulator

Minimum-jitter design of bang-bang PLLs in the presence of 1/f2 and 1/f3 DCO noise

Digital phase-locked loops based on bang-bang phase detectors are attractive candidates for frequency synthesizers and clock multipliers because of their simplicity and low power consumption. However, being nonlinear systems, they are proved difficult to analyze and prone to the generation of limit cycles. Under the presence of phase noise originating from the controlled oscillator with 1/f2 and 1/f3 spectral shapes, simple expressions of the output jitter as a function of the loop parameters are developed which allow us to avoid limit cycles and to optimize the design to minimize output jitter