Population Change and International and Internal Migration in Italy, 2002-2017: Ravenstein Revisited

In 1885, Ravenstein formulated his "laws" of migration, based on the experience of the British Isles. In a further 1889 paper, he extended his analysis as a tour d’horizon of migration and population changes in other nations, including Italy. Even if social and economic processes including globalisation and rising mobility have changed the world since then, Ravenstein's "laws" remain a point of reference today. Harnessing theoretical and methodological advances made since the 19th century, this paper describes and seeks to explain the role of international and internal migration in regional population change in Italy from 2002-2017. This paper provides the first geographically detailed migration analysis for the country's 611 Local Labour Market Areas (LLMAs), using register-based migration and population data. Our contribution focuses on several of Ravenstein's "laws" relating to gender (differences between men and women), natives and non-natives (differences between the Italian and the foreign population), distance migrated from origin to destination, and the role of the economy in shaping push and pull factors of migration. The results show that international migration is more prominent among men than women. In the case of internal moves, the rates of migration among men and women are similar, and internal migration is more prominent among the foreign than the native Italian population. Overall, international migration gains contribute substantially more to population change than internal migration gains and losses do. In Italy, the effects of persistent economic imbalances and of distance on migration patterns are not in line with Ravenstein's hypotheses: not all areas with high unemployment show an effect of dispersion, nor does distance always act as a deterrent to migration. The geographically detailed analysis presented here illustrates the temporal and spatial coexistence of diverse international and internal migration processes depending on local characteristics, as well as the importance of the economic or administrative centres as the driving force behind national patterns. Our results show that, even 130 years after their formulation, Ravenstein’s migration "laws" (more accurately called "hypotheses" today) are still a valuable starting point in assessing and understanding migration processes and their role in regional population change

Clinical care pathway program versus open-access system: a study on appropriateness, quality, and efficiency in the delivery of colonoscopy in the colorectal cancer

Open-access colonoscopy (OAC), whereby the colonoscopy is performed without a prior office visit with a gastroenterologist, is affected by inappropriateness which leads to overprescription and reduced availability of the procedure in case of alarming symptoms. The clinical care pathway (CCP) is a healthcare management tool promoted by national health systems to organize work-up of various morbidities. Recently, we started a CCP dedicated to colorectal cancer (CRC), including a colonoscopy session for CRC diagnosis and prevention. We aimed to evaluate the appropriateness, the quality, and the efficiency in the delivery of colonoscopy with the open-access system and a CCP program in the CRC. Quality indicators for colonoscopy in subjects in the CCP were compared to referrals by general practitioners (OAC) or by non-gastroenterologist physicians (non-gastroenterologist physician colonoscopy, NGPC). Attendance rate to colonoscopy was greater in the CCP group and NGPC group than in the OAC group (99%, 99%, and 86%, respectively). Waiting time in the CCP group was shorter than in the OAC group (3.88 ± 2.27 vs. 32 ± 22.31 weeks, respectively). Appropriateness of colonoscopy prescription was better in the CCP group than in the OAC group (92 vs. 50%, respectively). OAC is affected by the lack of timeliness and low appropriateness of prescription. A CCP reduces the number of inappropriate colonoscopies, especially for post-polypectomy surveillance, and improves the delivery of colonoscopy in patients requiring a fast-track examination. The high rate of inappropriate OAC suggests that this modality of healthcare should be widely reviewed

Optical Excitations and Field Enhancement in Short Graphene Nanoribbons

The optical excitations of elongated graphene nanoflakes of finite length are investigated theoretically through quantum chemistry semi-empirical approaches. The spectra and the resulting dipole fields are analyzed, accounting in full atomistic details for quantum confinement effects, which are crucial in the nanoscale regime. We find that the optical spectra of these nanostructures are dominated at low energy by excitations with strong intensity, comprised of characteristic coherent combinations of a few single-particle transitions with comparable weight. They give rise to stationary collective oscillations of the photoexcited carrier density extending throughout the flake, and to a strong dipole and field enhancement. This behavior is robust with respect to width and length variations, thus ensuring tunability in a large frequency range. The implications for nanoantennas and other nanoplasmonic applications are discussed for realistic geometries

Adherence issues related to sublingual immunotherapy as perceived by allergists

Objectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence. Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10. Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists. Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers. © 2010 Scurati et al, publisher and licensee Dove Medical Press Ltd

Nuclear MET requires ARF and is inhibited by carbon nanodots through binding to phospho-tyrosine in prostate cancer

Nuclear receptor tyrosine kinases (nRTKs) are aberrantly upregulated in many types of cancers, but the regulation of nRTK remains unclear. We previously showed androgen deprivation therapy (ADT) induces nMET in castration-resistant prostate cancer (CRPC) specimens. Through gene expression microarray profiles reanalysis, we identified that nMET signaling requires ARF for CRPC growth in Pten/Trp53 conditional knockout mouse model. Accordingly, aberrant MET/nMET elevation correlates with ARF in human prostate cancer (PCa) specimens. Mechanistically, ARF elevates nMET through binding to MET cytoplasmic domain to stabilize MET. Furthermore, carbon nanodots resensitize cancer cells to MET inhibitors through DNA damage response. The inhibition of phosphorylation by carbon nanodots was identified through binding to phosphate group of phospho-tyrosine via computational calculation and experimental assay. Thus, nMET is essential to precision therapy of MET inhibitor. Our findings reveal for the first time that targeting nMET axis by carbon nanodots can be a novel avenue for overcoming drug resistance in cancers especially prostate cancer

General strategy for computing nonlinear optical properties of large neutral and cationic organic chromophores in solution

Tuning of nonlinear optical (NLO) properties of organic chromophores (OCs) by stereo-electronic and environmental effects has been widely documented by different experimental techniques and theoretical studies. Disentanglement and analysis of the different contributions requires, however, the availability of effective yet accurate quantum mechanical approaches for medium to large size systems in their natural environment. As a first step, we have shortly reviewed the phenomenological models still used by experimentalists to interpret their results and shown that a quantum mechanical approach based on the density functional theory (DFT) and the polarizable continuum model (PCM) should be able to overcome most theoretical limitations allowing, at the same time, the study of large systems with reasonable computational resources and the analysis of the results in terms of well-defined physical-chemical effects. After validation of the most suitable density functional/basis set in conjunction with the PCM description of bulk solvent effects, we have performed a systematic study of representative OCs, especially cationic ones, with special reference to their first order hyperpolarizability. The internal consistency of the results and their good agreement with experiment paves the route toward integrated experimental/computational studies of NLO properties taking together physical soundness, feasibility, reliability, and ease of interpretation