Factors predicting survival in patients with locally advanced pancreatic cancer undergoing pancreatectomy with arterial resection

Pancreatectomy with arterial resection is a treatment option in selected patients with locally advanced pancreatic cancer. This study aimed to identify factors predicting cancer-specific survival in this patient population. A single-Institution prospective database was used. Pre-operative prognostic factors were identified and used to develop a prognostic score. Matching with pathologic parameters was used for internal validation. In a patient population with a median Ca 19.9 level of 19.8 U/mL(IQR: 7.1–77), cancer-specific survival was predicted by: metabolic deterioration of diabetes (OR = 0.22, p = 0.0012), platelet count (OR = 1.00; p = 0.0013), serum level of Ca 15.3 (OR = 1.01, p = 0.0018) and Ca 125 (OR = 1.02, p = 0.00000137), neutrophils-to-lymphocytes ratio (OR = 1.16; p = 0.00015), lymphocytes-to-monocytes ratio (OR = 0.88; p = 0.00233), platelets-to-lymphocytes ratio (OR = 0.99; p = 0.00118), and FOLFIRINOX neoadjuvant chemotherapy (OR = 0.57; p = 0.00144). A prognostic score was developed and three risk groups were identified. Harrell’s C-Index was 0.74. Median cancer-specific survival was 16.0 months (IQR: 12.3–28.2) for the high-risk group, 24.7 months (IQR: 17.6–33.4) for the intermediate-risk group, and 39.0 months (IQR: 22.7–NA) for the low-risk group (p = 0.0003). Matching the three risk groups against pathology parameters, N2 rate was 61.9, 42.1, and 23.8% (p = 0.04), median value of lymph-node ratio was 0.07 (IQR: 0.05–0.14), 0.04 (IQR:0.02–0.07), and 0.03 (IQR: 0.01–0.04) (p = 0.008), and mean value of logarithm odds of positive nodes was − 1.07 ± 0.5, − 1.3 ± 0.4, and − 1.4 ± 0.4 (p = 0.03), in the high-risk, intermediate-risk, and low-risk groups, respectively. An online calculator is available at www.survivalcalculator-lapdac-arterialresection.org. The prognostic factors identified in this study predict cancer-specific survival in patients with locally advanced pancreatic cancer and low Ca 19.9 levels undergoing pancreatectomy with arterial resection

(Ri)conoscere le Mgf. Riflessioni sulle possibilità di quantificare un fenomeno elusivo”

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Migrating with Special Needs? Projections of Flows of Migrant Women with Female Genital Mutilation/Cutting Toward Europe 2016-2030

Female genital mutilation/cutting (FGM/C) is a rising issue in western societies as a consequence of international migration. Our paper presents demography-driven projections of female flows with FGM/C from each practicing country to each EU28 member state for the 3 sub-periods 20162020, 2021-2025, and 2026-2030, with the aim of supporting resource planning and policy making. According to our projections, the EU28 countries will receive a flow of around 400,000 female migrants between 2016 and 2020, and around 1.3 million female migrants between 2016 and 2030 from FGM/C practicing countries. About one-third of them, corresponding to an estimated 127,000 between 2016 and 2020, and more than 400,000 between 2016 and 2030 will have undergone FGM/C before migration. Among these female flows, slightly more than 20% is expected to be made up of girls aged 0-4. According to the expected age at arrival, 20% of these girls are expected to have already undergone FGM/C, while slightly less than 10% are to be considered potentially at risk of undergoing FGM/C after migration. As the number of women with FGM/C in Europe is expected to rise at quite a fast rate, it is important to act timely by designing targeted interventions and policies at the national and at the European level to assist cut women and protect children. Such measures are particularly compelling in France, Italy, Spain, UK, and Sweden that are expected to be the most affected countries by migration from FGM/C practicing countrie

Improving estimates of the prevalence of Female Genital Mutilation/Cutting among migrants in Western countries

Background: Female Genital Mutilation/Cutting (FGM/C) is an emerging topic in immigrant countries as a consequence of the increasing proportion of African women in overseas communities. Objective: While the prevalence of FGM/C is routinely measured in practicing countries, the prevalence of the phenomenon in western countries is substantially unknown, as no standardized methods exist yet for immigrant countries. The aim of this paper is to present an improved method of indirect estimation of the prevalence of FGM/C among first generation migrants based on a migrant selection hypothesis. A criterion to assess reliability of indirect estimates is also provided. Methods: The method is based on data from Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS). Migrants’ Selection Hypothesis is used to correct national prevalence estimates and obtain an improved estimation of prevalence among overseas communities. Results: The application of the selection hypothesis modifies national estimates, usually predicting a lower occurrence of FGM/C among immigrants than in their respective practicing countries. A comparison of direct and indirect estimations confirms that the method correctly predicts the direction of the variation in the expected prevalence and satisfactorily approximates direct estimates. Conclusions: Given its wide applicability, this method would be a useful instrument to estimate FGM/C occurrence among first generation immigrants and provide corresponding support for policies in countries where information from ad hoc surveys is unavailable

Estimating the number of foreign women with female genital mutilation/cutting in Italy

Background: Female genital mutilation/cutting (FGM/C), is an emerging topic in Europe as a consequence of the increasing proportion of women migrating from Africa. The prevalence of FGM/C is however unknown in Europe, as there are no country-representative surveys on this topic. The aim of this study is to provide an estimate for Italy for the year 2010. Methods: This study relies on the results of the First Survey on Women at Risk of FGM/C held in Italy in 2010. This cross-sectional survey involved 1000 migrants from the main FGM/C practicing countries aged 15–49 living in the Italian region of Lombardy. The estimate presented is based on a method combining direct estimates for the communities involved in the survey and indirect estimates for other communities. Indirect estimations were obtained using a refinement of the most general extrapolation-of-country-prevalence-data method. Results: It is estimated that some 57 000 foreign girls and women aged 15–49 with FGM/C were living in Italy in 2010. The Nigerian community is the most affected, with around 20 000 women with FGM/C (35.5% of the total number women affected in Italy), followed by the Egyptian community (around 18 600 women with FGM/C; 32.5%). Another 15% of the women affected are from the Horn of Africa, notably from Ethiopia (3200 women; 5.5%), Eritrea (2800 women; 4.9%) and Somalia (2300 women; 4%). Conclusions: This study offers an additional methodological advancement by proposing a combination of direct and indirect estimation of FGM/C. The results are crucial information to plan interventions and targeted policies

L'appartenenza religiosa degli stranieri immigrati in Italia

Dopo la presentazione delle stime, elaborate dalla fondazione ISMU, relative all'appartenenza religiosa dei diversi gruppi nazionali presenti in Italia nel 2022, viene presentata una panoramica della frammentata situazione religiosa che caratterizza i migranti provenienti dall'Ucraina

Osservatorio Economico Regionale dell'Artigianato. L'imprenditoria artigiana immigrata in Lombardia.

Il volume presenta i risultati di uno studio monografico, realizzato nell'ambito dell'Osservatorio, dedicato al fenomeno dell'imprenditoria immigrata straniera, che in pochi anni ha conosciuto una espansione considerevole, in seguito anche alle evoluzioni legislative, contribuendo al ricambio generazionale in diversi settori produttivi. L'indagine realizzata mette in luce alcune interessanti caratteristiche di questa componente dell'imprenditoria artigiana, facendo emergere come il "divenire imprenditore" rappresenti una strategia di mobilità professionale per coloro che sono nel nostro Paese da un certo numero di anni