Expanding Economic Opportunity: Lessons From the East Baltimore Revitalization Initiative

This report reviews the economic inclusion efforts, achievements and challenges from the East Baltimore Revitalization Initiative. It examines the placement of local residents in construction jobs and the workforce pipeline that has trained and placed East Baltimore residents in jobs generated by the new development or elsewhere in the city, while also noting the complexity of creating project-related employment. It also reviews how East Baltimore Development, Inc. (EBDI) and its partners connected minority-owned businesses to the project and supported their growth. For context and comparison, this report cites examples of similar initiatives around the country. Finally, it offers various lessons learned over the course of the project to date. This report serves to inform and assist a range of people and institutions, including government leaders, businesses and nonprofits interested in economic inclusion

Current Cancer Epidemiology

In this brief report, we offer a concise overview on current cancer epidemiology garnered from the official databases of World Health Organization and American Cancer Society and provide recent information on frequency, mortality, and survival expectancy of the 15 leading types of cancers worldwide. Overall, cancer poses the highest clinical, social, and economic burden in terms of cause-specific Disability-Adjusted Life Years (DALYs) among all human diseases. The overall 0\u201374 years risk of developing cancer is 20.2% (22.4% in men and 18.2% in women, respectively). A total number of 18 million new cases have been diagnosed in 2018, the most frequent of which are lung (2.09 million cases), breast (2.09 million cases), and prostate (1.28 million cases) cancers. Beside sex-specific malignancies, the ratio of frequency between men and women is >1 for all cancers, except thyroid (i.e., 0.30). As concerns mortality, cancer is the second worldwide cause of death (8.97 million deaths) after ischemic heart disease, but will likely become the first in 2060 (~18.63 million deaths). Lung, liver, and stomach are the three most deadly cancers in the general population, while lung and breast cancers are the leading causes of cancer related-mortality in men and women, respectively. Prostate and thyroid cancers have the best prognosis, with 5-year survival ~100%, while esophagus, liver, and especially pancreas cancers have the worst prognosis, typically <20% at 5 years. We hope that this report will provide fertile ground for addressing health-care interventions aimed at preventing, diagnosing, and managing cancer around the world

Is digital epidemiology the future of clinical epidemiology?

[no abstract available

Seasonal variation in the frequency of myocardial infarction diagnosed in a large emergency department of a European country with a temperate climate

Previous studies at different latitudes showed that acute myocardial infarction (AMI) exhibits a seasonal variation, with higher frequency in spring and winter. We conducted a retrospective analysis to verify whether the frequency of AMI cases diagnosed in the emergency department (ED) may follow a seasonal pattern in a European country with a temperate climate. A retrospective analysis was performed in the hospital database of the University Hospital of Parma (northwestern Italy), to retrieve the total number of AMI cases diagnosed in the ED during the entire year 2010. The search for AMI cases was conducted using both ICD-9 codes and related diagnostic terms. The seasonality was defined according to the typical equinoxes and solstices at the latitude of the study. A total of 83,919 patients visited the ED of the University Hospital of Parma during the year 2010, 502 (0.6%) of whom with a final diagnosis of AMI (mean age, 73±14 years; 188 women and 314 men). The largest frequency of AMIs was observed in autumn (n=148; 29%), followed by winter (n=136, 27%), whereas the lowest frequencies were recorded in spring (n=110; 22%) and summer (n=108; 22%). The difference in frequency distribution of AMI cases across the four seasons of the year was found to be statistically significant (P<0.001), and this trend was independent from sex and age. Compared to the summer period (i.e., the season with the lowest frequency of AMI cases), the relative risk (RR) for AMI was significantly higher in autumn (1.37; 95% CI, 1.15-1.63; P<0.001) and winter (1.26; 95% CI, 1.05-1.51; P=0.013), but not in spring (1.02; 95% CI, 0.83-1.24; P=0.857). Compared to the spring period, the RR for AMI was found also to be significantly higher in autumn (1.34; 95% CI, 1.13-1.60; P<0.001) and winter (1.24; 95% CI, 1.03-1.48; P=0.021)

Overview on patient safety in healthcare and laboratory diagnostics

The healthcare context is characterized by a high degree of complexity. Despite eager efforts of the healthcare personnel, sometimes things go wrong and produce unintentional harm to the patients. As such, patient safety must be considered as one of leading healthcare challenges. Some foremost studies have highlighted that serious medical errors might occur rather frequently, jeopardizing patient\u27s health and costing a huge amount of money to the healthcare system. A medical error is traditionally defined as an unintended act, the failure of a planned action to be completed as intended, the use of a wrong plan to achieve an aim when the failure can not be attributed to chance. Medical errors can be classified according to several models, such as the clinical pathway (i.e., diagnostic, treatment, prevention and others), or the resulting harm to the patient (i.e., near misses, no harm or harmful incident). Medical errors can also be classified in skill-based slips and lapses (i.e., errors of action), or rule and knowledge-based mistakes (i.e., errors of intention). According to the source, most errors result from the combination of active failures and latent conditions. It is noteworthy, however, that diagnostic errors have been frequently underestimated in the clinical practice. A laboratory error is any defect occurring at any part of the laboratory cycle, from ordering tests to reporting, interpreting, and reacting to results. Although they have been traditionally identified with analytical problems and uncertainty of measurements, an extensive scientific literature now attests that the vast majority of these arise from the extra-analytical activities of the total testing process. Data from representative studies also show that preanalytical errors are the first cause of variability in laboratory testing. The aim of this article is to provide an overview on the current knowledge about patient safety in healthcare and laboratory diagnostics

Overview on patient safety in healthcare and laboratory diagnostics

The healthcare context is characterized by a high degree of complexity. Despite eager efforts of the healthcare personnel, sometimes things go wrong and produce unintentional harm to the patients. As such, patient safety must be considered as one of leading healthcare challenges. Some foremost studies have highlighted that serious medical errors might occur rather frequently, jeopardizing patient\u27s health and costing a huge amount of money to the healthcare system. A medical error is traditionally defined as an unintended act, the failure of a planned action to be completed as intended, the use of a wrong plan to achieve an aim when the failure can not be attributed to chance. Medical errors can be classified according to several models, such as the clinical pathway (i.e., diagnostic, treatment, prevention and others), or the resulting harm to the patient (i.e., near misses, no harm or harmful incident). Medical errors can also be classified in skill-based slips and lapses (i.e., errors of action), or rule and knowledge-based mistakes (i.e., errors of intention). According to the source, most errors result from the combination of active failures and latent conditions. It is noteworthy, however, that diagnostic errors have been frequently underestimated in the clinical practice. A laboratory error is any defect occurring at any part of the laboratory cycle, from ordering tests to reporting, interpreting, and reacting to results. Although they have been traditionally identified with analytical problems and uncertainty of measurements, an extensive scientific literature now attests that the vast majority of these arise from the extra-analytical activities of the total testing process. Data from representative studies also show that preanalytical errors are the first cause of variability in laboratory testing. The aim of this article is to provide an overview on the current knowledge about patient safety in healthcare and laboratory diagnostics

Interference of medical contrast media on laboratory testing

The use of contrast media such as organic iodine molecules and gadolinium contrast agents is commonplace in diagnostic imaging. Although there is widespread perception that side effects and drug interactions may be the leading problems caused by these compounds, various degrees of interference with some laboratory tests have been clearly demonstrated. Overall, the described interference for iodinate contrast media include inappropriate gel barrier formation in blood tubes, the appearance of abnormal peaks in capillary zone electrophoresis of serum proteins, and a positive bias in assessment of cardiac troponin I with one immunoassay. The interference for gadolinium contrast agents include negative bias in calcium assessment with ortho-cresolphthalein colorimetric assays and occasional positive bias using some Arsenazo reagents, negative bias in measurement of angiotensin converting enzyme (ACE) and zinc (colorimetric assay), as well as positive bias in creatinine (Jaffe reaction), total iron binding capacity (TIBC, ferrozine method), magnesium (calmagite reagent) and selenium (mass spectrometry) measurement. Interference has also been reported in assessment of serum indices, pulse oximetry and methaemoglobin in samples of patients receiving Patent Blue V. Under several circumstances the interference was absent from manufacturer-supplied information and limited to certain type of reagents and/or analytes, so that local verification may be advisable to establish whether or not the test in use may be biased. Since the elimination half-life of these compounds is typically lower than 2 h, blood collection after this period may be a safer alternative in patients who have received contrast media for diagnostic purposes

L'OGGETTO DEL PROCESSO AMMINISTRATIVO DI LEGITTIMITA'.

In this research work has been analysed the problem of the object of the administrative process. The main issues relating to the object of the process has been studied in depth by critical examination of some among the relevant theories of the civil ed administrative doctrine, without neglecting the analysis of the case law. The first and second chapter was addressed the issue of the specialty and the role of the Administration Court in the current istorical ed legal context, and the problem of the identification of the “res in judicium deducta”. In the third chapter it is passed to the examination of the two main doctrinal approaches on the object of the administrative process: that is to say, the formalistic concept, focused on the question of the legality of the administrative act, and the sostanzialistc concept, according to which the object of the judgment should be taken on the relationship between citizen and Administration. Continuing, the investigation was dedicated to the theme of the relationship between judicial determination and the reasons for the appeal, presenting a thesis that recognises the importance of the notions of coordination and substantial administrative act, stating the principle of unity of action. In the fifth chapter of the thesis, dedicated to the theme of the force of “res judicata” and its objective limits, the attention has focused in particular on the question of the judgement execution and of her possible classification such as un executive process

Current laboratory diagnostics of coronavirus disease 2019 (COVID-19)

Laboratory medicine provides an almost irreplaceable contribution to the diagnostic reasoning and managed care of most human pathologies. The novel coronavirus disease 2019 (COVID-19) is not an exception to this paradigm. Although the relatively recent emergence does not allow to draw definitive conclusions on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostics, some standpoints can be conveyed. First and foremost, it seems now clear that we will be living together with this virus for quite a long time, so that our vigilance and responsiveness against the emergence of new local outbreaks shall be maintained at the highest possible levels. The etiological diagnosis of COVID-19 is, and will remain for the foreseeable future, deeply based on direct identification of viral RNA by means of molecular biology techniques in biological materials, especially upper and lower respiratory tract specimens. Whether other materials, such as blood, urine, stools, saliva and throat washing, will become valid alternatives has not been unequivocally defined so far. As concerns serological testing, promising information can be garnered from preliminary investigations, showing that the vast majority of COVID-19 patients seem to develop a sustained immune response against the virus, characterized especially by emergence of anti-SARS-CoV-2 IgG and IgA, 1 to 2 weeks after the onset of fever and/or respiratory symptoms. Whether these antibodies will have persistent neutralizing activity against the virus is still to be elucidated on individual and general basis. The availability of rapid tests for detecting either viral antigens or anti-SARS-CoV-2 antibodies are a potentially viable opportunity for purposes of epidemiologic surveillance, though more information is needed on accuracy and reliability of these portable immunoassays

Glycogen phosphorylase isoenzyme BB in the diagnosis of acute myocardial infarction: a meta-analysis

Background: Early diagnosis is crucial for management of patients with suspected acute myocardial infarction (AMI). Among innovative and promising biomarkers, the recent interest raised on glycogen phosphorylase isoenzyme BB (GPBB) has prompted us to perform a meta-analysis of published studies. Materials and methods: A systematic electronic search was carried out on PubMed, Web of Science and Google Scholar, with no date restriction, to retrieve all articles that have investigated the early diagnostic performance of GPBB in patients with suspected AMI, and directly reported or allowed calculation of sensitivity and specificity. A meta-analysis of the reported sensitivity and specificity of each study and pooled area under the curve (AUC) was then performed by random effect approach. Heterogeneity was assessed by I-square statistics. Results: Eight studies were finally selected for analysis (941 subjects; 506 cases and 435 controls), with a high heterogeneity (I-squared, 86.3%). The resulting pooled estimates and 95% confidence interval were 0.854 (0.801-0.891) for sensitivity, 0.767 (0.713-0.815) for specificity, 0.826 (0.774-0.870) for negative predictive value, 0.802 (0.754-0.844) for positive predictive value, and 0.754 (0.602-0.907) for AUC. In those studies that have simultaneously assessed GPBB and a troponin immunoassay, the combination of these biomarkers did not significantly improve the performance of troponin alone. Conclusion: GPBB does not meet the current requirements for an efficient diagnosis of AMI when used as a stand-alone test, whereas its combination with troponin merits further investigation in larger trials