Knowledge, attitudes, and practices of influenza and pneumococcal vaccines among agricultural workers: Results of an Italian a cross-sectional study

Background: Working age is increasing across Europe. Seasonal influenza (SID) and pneumococcal disease (PND) immunization programmes might be successfully implemented at the workplace. We conducted a cross-sectional survey among to assess SID and PND vaccine status, as well as knowledge, attitudes and practices (KAP) in a representative sample of agricultural workers (AWs) aged ≥55 years in North-Eastern Italy. Methods: A structured questionnaire was administered in person by trained personnel. Bivariate and multivariate logistic regression analyses were carried out to identify behavioral and work-related factors associated with SID and PND vaccine uptake. Results: Among 707 participants, 238 were aged 55 years or more (33.7% of total). Of them, 39.1% had an up-to-date immunization status towards influenza, and 17.6% towards pneumococcus. Factors associated with inadequate immunization were doubts about influenza vaccine safety (40.0%) and the confidence in natural immunity towards pneumococcus (30.8%). Attitude towards vaccinations was somehow favorable in 44.5% of participants for SID, and 37.8% for PND. Overall, 37.4% and 21.8% workers were aware of national recommendations on SID and PND immunization, respectively. This factor was characterized as a significant predictor for SID vaccination (multivariated Odds Ratio, OR 32.688 95%CI 12.015-88.930), as well as the perception of SID as a severe disease (OR 7.539 95%CI 3.312-17.164), and the perceived value of preventing new infections (OR 3.215 95%CI 1.205-8.578). A somehow favorable attitude towards vaccinations was the main predictor (OR 39.214 95%CI 10.179-151.1) for PND vaccination. Conclusions: Our study indicates that older workers lack appropriate knowledge of national recommendations and correct risk perception of SID and PND infections, but also vaccines’ side effects. As the latter has been recognized as predictive factor for SID vaccination, our results stress the importance for tailored informative interventions in the workplaces aimed to increase risk perception and vaccine acceptance. (www.actabiomedica.it)

The sources of committee Influence in the European Parliament

The European Parliament (EP) has evolved into a powerful legislative actor over the past 40 years. In order to exercise its hard won legislative competencies in an efficient and effective manner the EP has developed an extensive and influential committee system. The Treaty of Lisbon (ToL) recognised its equal status as co-legislator with the Council of the EU and introduced the Ordinary Legislative Procedure (OLP) as the default EU legislative procedure. Despite the fact that after the introduction of the OLP all EP committees formally operate under the same legal procedure, disparities remain in the levels of influence that each committee commands. This state of affairs demonstrates that if we are to understand what drives committee influence we need to explore the informal sources of influence that committees draw on in addition to the formal rules. This project addresses the lack of understanding of how the committees establish legislative influence by identifying and testing the different resources which committees may be utilising to establish their influence. The thesis puts forward four hypotheses concerning the factors that can account for how committees establish influence. These are developed and tested within three case studies. The case studies comprise the highly influential committees on, firstly, the Environment, Public Health and Food Safety Committee, secondly, the Budget Committee and, thirdly, the International Trade Committee. The research project adopts a qualitative approach to complement and create a different perspective from the quantitative studies which dominate the field. It draws on extensive primary material from thirty semi-structured interviews held with MEPs, advisers, EP staff and party officials active in the 7th legislative term (2009-2014). A number of the current conventions concerning the way in which expertise, partisan dynamics, and policy outputs affect how committees establish legislative influence are challenged and new insights regarding their relative importance are offered. Overall, these original findings, contained within this dissertation, have highly significant implications, not only with regard to the committee system of the EP but, also, for the wider field of legislative politics

Epidemiology of leprosy in Italy (1920-2019): A comprehensive review on existing data

Background and aims: Incidence of leprosy in Italy has declined steadily over the last century, but available evidence remains fragmentary. Our review aims to summarize available data on the epidemiology of leprosy cases in Italy. Methods: The following keywords were used to explore PubMed and Embase: leprosy, Hansen’s disease, (Mycobacterium) leprae, Italy, without any chronological restriction. Results: We identified a total of 39 reports, including 7 national reports, 11 international reports, 20 case reports. Notified leprosy cases were: 839 between 1925 and 1948; 434 between 1955 and 1979; 76 cases for the decade 1980-1989; 112 between 1990 and 1999; 62 between 2000 and 2009, and a total of 25 cases since 2009. Since 2003, 53% of all cases occurred in illegal residents. Focusing on individual cases, latency between early signs/symptoms and a proper diagnosis ranged between 2 and 20 years in 52.1% of individual cases. Conclusion: Imported cases of leprosy are responsible for most leprosy incidence in Italy, and social stigma, the unfamiliarity of healthcare professionals with such disorders, and difficulties of some high-risk groups to be appropriately assessed hint to a possible under-diagnosis. Professionals should be made more aware of the potential for leprosy incidence among patients from countries where the disease is endemic. (www.actabiomedica.it)

Piloting a holistic information culture program: The experience of CETYS Universidad system of libraries

This article presents the staff, structure, methods and preliminary results from the pilot of a holistic information literacy program developed in the System of Libraries of CETYS Universidad in Mexico. ‘Information Culture Development’ (ICD) is driven by action research (AR) and the concept of information culture (IC), comprised of information literacy (IL), digital literacy (DL), and research competences. ICD aims at developing these competences and supporting reflection and improvement upon university practices related to curriculum, teaching, and research. ICD’s initiatives and products were divided into four axes: a) curriculum and learning support, b) information and digital literacies development, c) research and scientific communication support, and d) evaluation and communication of results. ICD’s pilot involved workshops and activities framed within an AR perspective and a mixed methods approach. Preliminary results determine the success of activities with academics and students regarding their strengths and weaknesses in IC-related competencies

Time Until Partial Response in Metastatic Adrenocortical Carcinoma Long-Term Survivors

A partial response (PR) has been proposed as a surrogate for overall survival in advanced adrenocortical carcinoma (ACC). The primary endpoint of the study was to characterize the time until a PR in patients with metastatic ACC treated with a standard therapy is achieved. Long-term survivors were selected to allow evaluation of delayed tumor response to mitotane. Records from patients with metastatic ACC that survived for > 24 months were retrieved. Tumor response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Time until a tumor response, after treatment initiation or therapeutic plasma mitotane level, was analyzed. Sixty-eight patients were analyzed. The first-line systemic therapy was mitotane as a monotherapy (M) (n = 57) or cytotoxic polychemotherapy plus/minus mitotane (PC ± M) (n = 11). The second-line therapy was M (n = 2) or PC ± M (n = 41). Thirty-two PRs occurred in 30/68 patients (44.1%): this was obtained for 13 (40.6%) during M and during PC ± M for 19/32 responders (59.4%). PRs were observed within 6 months of starting M or PC ± M in 76.9 and 94.7% of responses, respectively, within 6 months of therapeutic plasma mitotane being first observed in 88.9% of responses with M and in 53.3% of responses with PC ± M. All PRs (but one) occurred within 1 year after initiating treatment. To conclude, Most patients with metastatic ACC and long survival times had PRs within the first 6 months of standard systemic therapy, and almost all within the first year. The absence of response after that period could be considered as a treatment failure. Maintenance of mitotane therapy in non-responders after 1 year should be questioned in future randomized trials

p.Ala541Thr variant of MEN1 gene: A non deleterious polymorphism or a pathogenic mutation?

Context Multiple Endocrine Neoplasia Type 1 (MEN1) is an autosomal dominant inherited syndrome, related to mutations in the MEN1 gene. Controversial data suggest that the nonsynonymous p.Ala541Thr variant, usually considered as a non-pathogenic polymorphism, may be associated with an increased risk of MEN1-related lesions in carriers. Objective The aim of this study was to evaluate the pathogenic influence of the p.Ala541Thr variant on clinical and functional outcomes. Patients and methods We analysed a series of 55 index patients carrying the p.Ala541Thr variant. Their clinical profile was compared to that of 117 MEN1 patients. The biological impact of the p.Ala541Thr variant on cell growth was additionally investigated on menin-deficient Leydig cell tumour (LCT)10 cells generated from Men1+/Men1− heterozygous knock-out mice, and compared with wild type (WT). Results The mean age at first appearance of endocrine lesions was similar in both p.Ala541Thr carriers and MEN1 patients, but no p.Ala541Thr patient had more than one cardinal MEN1 lesion at initial diagnosis. A second MEN1 lesion was diagnosed in 13% of MEN1 patients and in 7% of p.Ala541Thr carriers in the year following preliminary diagnosis. Functional studies on LCT10 cells showed that overexpression of the p.Ala541Thr variant did not inhibit cell growth, which is in direct contrast to results obtained from investigation of WT menin protein. Conclusion Taken together, these data raise the question of a potential pathogenicity of the p.Ala541Thr missense variant of menin that commonly occurs within the general population. Additional studies are required to investigate whether it may be involved in a low-penetrance MEN1 phenotype

Shifted Symplectic Structures

This is the first of a series of papers about \emph{quantization} in the context of \emph{derived algebraic geometry}. In this first part, we introduce the notion of \emph{$n$-shifted symplectic structures}, a generalization of the notion of symplectic structures on smooth varieties and schemes, meaningful in the setting of derived Artin n-stacks. We prove that classifying stacks of reductive groups, as well as the derived stack of perfect complexes, carry canonical 2-shifted symplectic structures. Our main existence theorem states that for any derived Artin stack $F$ equipped with an $n$-shifted symplectic structure, the derived mapping stack $\textbf{Map}(X,F)$ is equipped with a canonical $(n-d)$-shifted symplectic structure as soon a $X$ satisfies a Calabi-Yau condition in dimension $d$. These two results imply the existence of many examples of derived moduli stacks equipped with $n$-shifted symplectic structures, such as the derived moduli of perfect complexes on Calabi-Yau varieties, or the derived moduli stack of perfect complexes of local systems on a compact and oriented topological manifold. We also show that Lagrangian intersections carry canonical (-1)-shifted symplectic structures.Comment: 52 pages. To appear in Publ. Math. IHE

Prognostic factors in stage III-IV adrenocortical carcinomas (ACC): an European Network for the Study of Adrenal Tumor (ENSAT) study.

BACKGROUND: The clinical course of advanced adrenocortical carcinoma (ACC) is heterogeneous. Our study aimed primarily to refine and make headway in the prognostic stratification of advanced ACC. PATIENTS AND METHODS: Patients with advanced ENSAT ACC (stage III or stage IV) at diagnosis registered between 2000 and 2009 in the ENSAT database were enrolled. The primary end point was overall survival (OS). Parameters of potential prognostic relevance were selected. Univariate and multivariate analyses were carried out: model 1 'before surgery'; model 2 'post-surgery'. RESULTS: Four hundred and forty-four patients with advanced ENSAT ACC (stage III: 210; stage IV: 234) were analyzed. After a median follow-up of 55.2 months, the median OS was 24 months. A modified ENSAT (mENSAT) classification was validated: stage III (invasion of surrounding tissues/organs or the vena renalis/cava) and stage IVa, IVb, IVc (2, 3 or >3 metastatic organs, including N, respectively). Two- or 5-year OS was 73%, 46%, 26% and 15% or 50%, 15%, 14% and 2% for stages III, IVa, IVb and IVc, respectively. In the multivariate analysis, mENSAT stages (stages IVa, IVb, or IVc, respectively) were significantly correlated with OS (P 6 and/or Ki67 ≥20%, P = 0.06) in model 2. CONCLUSION: The mENSAT classification and GRAS parameters (Grade, R status, Age and Symptoms) were found to best stratify the prognosis of patients with advanced ACC