Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

The University Degree in Environment and workplace prevention techniques: a quasi unicum Course in the European panorama for non-medical professionals involved in prevention activities

The University Degree programme in Environment and workplace prevention techniques (Tecniche della Prevenzione nell'Ambiente e nei Luoghi di Lavoro) is a 3-year course established in Italy in 2000 by the Ministry of University to train healthcare professionals responsible for prevention activities such as environment and food controls, and workplaces prevention, operating both in the National Health Service and in private settings. Frontal teaching activities and training programmes include a background in bio-medical sciences, epidemiology, public health, social sciences and law, including the inspection and control tasks of health and safety in living and working environment, food hygiene, environmental controls and veterinary public health, which represent the field of specific competences of graduates. Currently, 38 courses have been activated in 30 Italian Universities, but relatively few similar courses are present in Europe (similar programmes were found in France, Spain, UK and Belgium) causing the lack of internalization and student exchange programmes. It is essential to identify similar training tasks in other European countries, in order to enhance cultural exchanges and the development of research activities in these strategic areas

On field vaccine effectiveness in three periods of 2018/2019 influenza season in Emilia-Romagna Region

Background and aim of the work: Epidemic influenza is associated with significant morbidity and mortality, particularly in people at risk. The vaccine reduces complications, hospitalization and mortality excess, as well as health care and social costs. Aim of the study was to estimate the influenza vaccine effectiveness (VE) in Emilia-Romagna Region during the 2018/2019 season. Methods: Within the context of virological surveillance conducted at the Regional Reference Laboratory of Parma, nasal/throat swabs were performed by sentinel practitioners and clinicians, on patients with ILI (Influenza-like illness). VE estimates, overall and against subtype A(H1N1)pdm09 and A(H3N2), were evaluated in three periods of the season, using a test-negative case-control design. Results: From November 2018 to April 2019, 2,230 specimens were analyzed: 1,674 (75.1%) performed by clinicians and 556 (24.9%) by sentinel practitioners of the regional network. The season was characterized by the predominant circulation of influenza type A viruses: 57.4% belonged to subtype A(H3N2), 41.2% to subtype A(H1N1)pdm09. 23.5% of patients was vaccinated against influenza with quadrivalent or adjuvate vaccine. The overall VE was -5% (95% CI -33% - 18%) with a decreasing trend during the season. The overall VE against subtype A(H1N1)pdm09 was 39% (95% CI 11% - 58%) and remained stable during the season. The overall VE against subtype A(H3N2) was -43% (95% CI -89% - -9%), and showed an important decreasing trend. Conclusions: The possibility to make accurate and continuous VE estimates during the season will help to better define the composition of the vaccine for the following season

“This Is Public Health in Italy”. An ASPPH-ASPHER campaign to raise awareness on health prevention and Health in All Policies

Introduction In many European countries, Public Health (PH) and Preventive Medicine are not perceived as important tools 1 2.The general population, especially those working in non-healthcare related fields, underestimates the crucial role of PH policies as food & veterinary safety, energy efficiency, transport regulation, healthcare design and city planning 3-8. The Health in All Policies (HiAP) approach is instrumental in tackling this information gap 9 10. Originally conceived in the EU, HiAP is now included in WHO’s Sustainable Development Goals. In the US, in 2018, the Association of Schools & Programs of Public Health (ASPPH) launched an international campaign called “This is Public Health” (TIPH), whose aim was “to brand public health and raise awareness of how [it] affects individuals, families, communities, and populations” 11. The Association of Schools of Public Health in the European Region (ASPHER) responded by creating a European campaign to reproduce the American one. An open challenge was set, in which PH Schools – students and staff – were requested to formulate country-specific proposals. The Accademia Lombarda di Sanità Pubblica, coordinating the Schools and Programs of PH of Vita-Salute “San Raffaele” University, Milan, University of Parma, University of Pavia and Politecnico of Milan set up a proposal to increase PH awareness both in the general population and in healthcare workers. Materials and methods The preliminary phase was dedicated to the Project setup and was conducted by the ten new Residents of the Vita-Salute “San Raffaele” University, with the coordination and supervision of the PI and the Schools’ Directors. The working group extensively discussed the need for an appropriate translation of the catchphrase and a new graphic rendering of the TIPH logo. An agreement was finally reached to adapt all the elements of the Campaign, re-elaborating them according to the Italian context. The word “health” has a double meaning in Italian (“salute” and “sanità”). Furthermore, people with limited English proficiency are a large part of the target population. Therefore, the Group opted for a non-literal translation (“Per la salute di tutti”). To further boost the Campaign online, the group created “TIPH – Italy” accounts and pages on the main social media (i.e. Facebook, Twitter, Instagram). Subsequently, the PI assigned tasks to each of the team’s members from the various PH Schools involved. The operational phase is currently underway, and a series of activities are already in schedule. All laws and resolutions enacted by local governments (Lombardy Region and, in a future phase, Emilia Romagna Region) are being thoroughly analysed, to assess their direct or indirect PH impact. Spreading the project will be a key for its success. In the next months, multiple promotional events will be organised, addressing both operators and the public at large. Surveys will be administered before and after the events, both to assess baseline knowledge and attitudes towards PH initiatives, and to verify the interventions’ effectiveness in raising awareness. Running a social media photo contest will be a useful option for targeting younger age groups, following in the steps of the US campaign. Side events will be organised, such as congress, meeting, press conferences, with the purpose of giving the latest updates about the Campaign. Conclusions Italy is a challenging country. A fairly strong National Health Service, with plenty of positive health indicators, coexist with impressive inequalities and contradictions, both in the North-South and in the rich-poor axis. In light of this scenario, stronger recognition of the role and the importance of PH is essential. PH awareness is ultimately directed at informing policymaking and improving community health 12. While the potential impact of TIPH in Italy is still to be fully explored, the basis for its potential success can only lie in the delivery of a culturally appropriate message. TIPH Italy is a wonderful opportunity of making PH accessible to the general population in an effective, yet entertaining way

The campaign "This Is Public Health" in Italy, set up by a team of Public Health Schools in Northern Italy

Despite the great effort to raise awareness among health promotion, nowadays Public Health policies are not often recognized as important tools. For this reason, the Health in All Policies (HiAP) approach is instrumental in tackling this information gap. In 2018, the US Association of Schools and Programs of Public Health (ASPPH) launched an international campaign called "This is Public Health" (TIPH), whose aim was "to brand public health and raise awareness of how it affects individuals, communities and populations". The Association of Schools of Public Health in the European Region (ASPHER), in coordination with ASPPH, decided to create a European campaign to support and to reproduce the American one, by opening a challenge among the European Public Health Schools. The Schools and Programs of PH of Vita-Salute "San Raffaele" University, Milan, University of Parma, University of Pavia and Politecnico of Milan won this bid. In this "briefing on" we present a report on the Italian project for raising awareness of Public Health among general population and health care personell