Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Prerequisites for the concept of shop profit: Logic and memory

Several studies have shown that it is very difficult for children younger than 10 years old to understand the notion of shopkeepers' profits. In order to investigate the relationship between the development of this notion and the development of logico-arithmetical abilities and of STM span, 59 children (about 20 at each school grade from second through fourth) were administered the following tasks: (1) interview on buying and selling and shopkeepers' profits; (2) a task consisting of comparing expenses and income of a shopkeeper selling his goods at cost; (3) digit span forwards and backwards, and Case's (1985) counting span test. There was a strong association between the level of a child's conceptions of how shopkeepers make their living, and the procedures he or she adopted in comparing costs and income. Only low associations were found between the scores of children's performances on the memory tests and the levels they reached in the other two tasks

Acquiring Economic Notions: Profit

The study examines how an economic concept changes when children undergo different kinds of experiences simulated by means of tutorial and critical training. The final sample was composed of 68 third-grade Italian children, subdivided into a control group (given only a pre and post-test interview about buying and selling) and three experimental groups which were taught, by some different training procedures, that the shopkeeper can earn a profit by selling goods at a price higher than that which he paid for them. Results showed that experimental groups progressed, but not dramatically. An analysis of children's reactions during critical training pinpointed some difficulties that must be overcome in order to acquire the notion of profit

The development of economic notions: single sequence or separate acquisition?

The conceptions on shops and factories of a group pf 3rd grade children were assessed by means of the Piagetian clinical method. Factorial analysis showed that children's answewrs about the two economic institutions yielded two distinct factors. Children were then divided into three groups (one control and two experimental); children in the experimental group were taugh, by means of two different training procedures, how the shopkeeper can earn profit. A post test interview, one month later, showed that both experimental groups had progressed in the target notion; however, children did not generalize to the factory what they had learned about shops. According to these results, 3rd graders' thinking about economics consists of separate part systems, which will eventually become integrated as children grow older

Comparative effectiveness of disease-modifying-drugs in elderly patients after incident hospitalization for heart failure

Beta-blockers (BB), ACE inhibitors/angiotensin receptor blockers (ACEi/ARBs) and aldosterone antagonists (AA) do represent disease modifying drugs and have become the cornerstone of heart failure (HF) pharmacological therapy [1]. However, it is never safe to assume that treatments of proven efficacy in younger, healthier patients will provide equivalent benefit in older patients [2] but current guidelines rarely distinguish the use of these therapies on the basis of age [3]. To help clarify these issues a retrospective cohort study was undertaken by identifying all patients hospitalized for HF and never hospitalized for HF in the previous 10 years, discharged from 1 January 2009 to 31 December 2010 in the Emilia\u2013Romagna Region

[Indirect effects of the COVID-19 pandemic on cardiovascular mortality]

: The dramatic impact of the COVID-19 pandemic extends beyond the risk of deaths related to virus infection. Excess deaths from other causes, particularly cardiovascular deaths, have been reported worldwide. Our study based on administrative databases of the Emilia-Romagna region demonstrates a 17% excess of out-of-hospital cardiac deaths in the first 2020 semester with a peak of +62% on April. The excess of cardiac deaths may be explained by the indirect consequences of the response to the COVID-19 pandemic. These include a dramatic reduction of hospital admissions during the pandemic, particularly for acute coronary syndromes; an increase of out-of-hospital cardiac arrests; a reduction of outpatient clinic activities and cardiac procedures; long-term cardiovascular effects of COVID-19; and unfavorable cardiac effects of the lockdown imposed by the spread of COVID-19 infection. The knowledge of the indirect consequences of COVID-19 pandemic is important for planning cardiologic strategies