Meningococcal serogroup B vaccine in Italy: state-of-art, organizational aspects and perspectives

Neisseria meningitidis causes severe invasive meningococcal diseases (IMDs) in humans including meningitis and septicemia, responsible for serious clinical conditions and leading to life-long disabilities and death. Serogroup B dominates IMDs burden in Italy, accounting for over 60% of total cases. On January 2013 the European Medicine Agency (EMA) licensed the first serogroup B meningococcal (Men B) vaccine in Europe. A number of European countries and Regions have introduced the new Men B vaccine in their immunization schedule, including Italy. In this paper we present the state of art, related critical issues and future perspectives of Men B vaccine introduction in Italy, in the context of the most recent available epidemiological data. In particular, we systematically assess the ongoing processes in the 8 Italian regions and one autonomous province that have already introduced Men B vaccine. With the new National Vaccine Prevention Plan including active Men B vaccine offer about to be adopted, it is of fundamental importance to gather further evidence on Men B vaccine clinical effectiveness, duration of protection and cost-effectiveness. Italian regions are called to organize and manage Men B immunization programs. Careful consideration will need to be devoted on timing, doses, and co-administration with other vaccines but also to economic assessments and strengthened communication to the general public. Our data will help to plan, implement and evaluate Men B immunization programmes in other Italian and international settings

Not In My Back Yard (NIMBY), an endemic syndrome influencing Environmental Policies

Not In My Back Yard (NIMBY), an endemic syndrome influencing Environmental Policie

Comorbid bipolar disorder and obsessive-compulsive disorder: An old debate renewed

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Artificial intelligence-based tools to control healthcare associated infections: A systematic review of the literature

Background: Healthcare-associated infections (HAIs) are the most frequent adverse events in healthcare and a global public health concern. Surveillance is the foundation for effective HAIs prevention and control. Manual surveillance is labor intensive, costly and lacks standardization. Artificial Intelligence (AI) and machine learning (ML) might support the development of HAI surveillance algorithms aimed at understanding HAIs risk factors, improve patient risk stratification, identification of transmission pathways, timely or real-time detection. Scant evidence is available on AI and ML implementation in the field of HAIs and no clear patterns emerges on its impact. Methods: We conducted a systematic review following the PRISMA guidelines to systematically retrieve, quantitatively pool and critically appraise the available evidence on the development, implementation, performance and impact of ML-based HAIs detection models. Results: Of 3445 identified citations, 27 studies were included in the review, the majority published in the US (n = 15, 55.6%) and on surgical site infections (SSI, n = 8, 29.6%). Only 1 randomized controlled trial was included. Within included studies, 17 (63%) ML approaches were classified as predictive and 10 (37%) as retrospective. Most of the studies compared ML algorithms' performance with non-ML logistic regression statistical algorithms, 18.5% compared different ML models' performance, 11.1% assessed ML algorithms' performance in comparison with clinical diagnosis scores, 11.1% with standard or automated surveillance models. Overall, there is moderate evidence that ML-based models perform equal or better as compared to non-ML approaches and that they reach relatively high-performance standards. However, heterogeneity amongst the studies is very high and did not dissipate significantly in subgroup analyses, by type of infection or type of outcome. Discussion: Available evidence mainly focuses on the development and testing of HAIs detection and prediction models, while their adoption and impact for research, healthcare quality improvement, or national surveillance purposes is still far from being explored

Epidemiology of tuberculosis in a low-incidence Italian region with high immigration rates: differences between not Italy-born and Italy-born TB cases

<p>Abstract</p> <p>Background</p> <p>Emilia Romagna, a northern Italian region, has a population of 4.27 million, of which 9.7% are immigrants. The objective of this study was to investigate the epidemiology of tuberculosis (TB) during the period 1996-2006 in not Italy-born compared to Italy-born cases.</p> <p>Methods</p> <p>Data was obtained from the Regional TB surveillance system, from where personal data, clinical features and risk factors of all notified TB cases were extracted.</p> <p>Results</p> <p>5377 TB cases were reported. The proportion of immigrants with TB, over the total number of TB cases had progressively increased over the years, from 19.1% to 53.3%. In the not Italy-born population, TB incidence was higher than in Italians (in 2006: 100.7 cases per 100 000 registered not Italy-born subjects and 83.9/100 000 adding 20% of estimated irregular presences to the denominators. TB incidence among Italians was 6.5/100 000 Italians). A progressive rise in the not Italy-born incident cases was observed but associated with a decline in TB incidence. Not Italy-born cases were younger compared to the Italy-born cases, and more frequently classified as "new cases" (OR 2.0 95%CI 1.61-2.49 for age group 20-39); 60.7% had pulmonary TB, 31.6% extra pulmonary and 7.6% disseminated TB. Risk factors for TB in this population group were connected to lower income status (homeless: OR 149.9 95%CI 20.7-1083.3 for age group 40-59).</p> <p>Conclusions</p> <p>In low-incidence regions, prevention and control of TB among sub-groups at risk such as the foreign-born population is a matter of public health concern. In addition, increasing immigration rates may affect TB epidemiology. TB among immigrants is characterized by particular clinical features and risk factors, which should be analyzed in order to plan effective action.</p

Dal segno al suono. Indagine sulla lettura musicale allo strumento

"From sign to sound" is a research project aimed to investigate some peculiar features of the musical reading with reference to instrumental performance. Its purpose is to extend the present knowledge about cognitive, musical, and pedagogical aspects of the subject, pointing out problematic issues and solutions significant for the young musicians' music performance education. The main study profile, which differentiates it from very few existing international studies on the subject, arises from the particular situation of the Latin countries (to which some other Latin American countries must be added) that adopted, starting from XIX century, the syllabic designation of notes, abandoning the alphabetic one. The aim of the research was to clarify a) the extent to which the outlined situation is widespread in Italian and European instrumental teaching, b) what are the prevailing opinions about it, and c) whether different perspectives can be found based on instrumental families or educational schools.Published"Dal segno al suono" è un progetto di ricerca che indaga alcuni aspetti peculiari della lettura musicale riferiti specificamente all'esecuzione strumentale. Il suo scopo è ampliare le attuali conoscenze sugli aspetti cognitivi, musicali e pedagogici in materia, evidenziando problematiche e soluzioni significative per l'educazione all'esecuzione musicale dei giovani musicisti. Il profilo peculiare di questo studio, che lo differenzia da pochissimi studi internazionali esistenti sull'argomento, nasce dalla particolare situazione dei paesi latini (a cui vanno aggiunti alcuni paesi latinoamericani) che adottarono, a partire dal XIX secolo, la nominazione sillabica delle note, abbandonando quella alfabetica. Lo scopo della ricerca è stato quello di chiarire a) in che misura questa situazione si trova nella didattica strumentale italiana ed europea, b) quali sono le opinioni prevalenti in merito, e c) se si possono rintracciare prospettive diverse sulla base di famiglie strumentali o scuole pedagogiche differenti

The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis

Objective: To quantify the impact of antiretroviral therapy (ART) on mortality in HIV-positive people during tuberculosis (TB) treatment. Design: We conducted a systematic literature review and meta-analysis. Studies published from 1996 through February 15, 2013, were identified by searching electronic resources (Pubmed and Embase) and conference books, manual searches of references, and expert consultation. Pooled estimates for the outcome of interest were acquired using random effects meta-analysis. Subjects The study population included individuals receiving ART before or during TB treatment. Main Outcome Measures: Main outcome measures were: (i) TB-case fatality ratio (CFR), defined as the proportion of individuals dying during TB treatment and, if mortality in HIV-positive people not on ART was also reported, (ii) the relative risk of death during TB treatment by ART status. Results: Twenty-one studies were included in the systematic review. Random effects pooled meta-analysis estimated the CFR between 8% and 14% (pooled estimate 11%). Among HIV-positive TB cases, those receiving ART had a reduction in mortality during TB treatment of between 44% and 71% (RR = 0.42, 95%CI: 0.29–0.56). Conclusion: Starting ART before or during TB therapy reduces the risk of death during TB treatment by around three-fifths in clinical settings. National programmes should continue to expand coverage of ART for HIV positive in order to control the dual epidemic

A Systematic Review of Clinical Practice Guidelines for Caries Prevention following the AGREE II Checklist.

Untreated oral diseases are detrimental to overall well-being and quality of life and are in close relationship with social and economic consequences. The presence of strong evidence for caries primary and secondary prevention is a compulsory tool for the development of clinical practice guidelines (CPGs). This paper was aimed to assess systematically the importance of clinical practice guidelines in caries prevention management considering both the adult and pediatric populations and evaluate them using the Appraisal of Guidelines for Research and Evaluation (AGREE II) Checklist. Records were extracted from EMBASE, SCOPUS, PubMed/Medline and seven other relevant guideline databases between 6 January and 14 February 2023. Two reviewers independently conducted the appraisal using the web-based platform My AGREE PLUS. Twenty-one guidelines/papers met the inclusion criteria and were reviewed. Eight CPGs included both primary and secondary prevention interventions, whereas thirteen presented a single preventive model. Overall, 12 guidelines were published in the USA. The mean AGREE II scores ranged from 35.4% to 84.3%. Of the total twenty-one included guidelines, twelve were classified as "Recommended", ranging from 56.3% to 84.3%, the others were described as "Recommended with modification", ranging from 35.4% to 68.9%. From the AGREE II analysis carried out, the CPGs included in this survey adopted a punctual methodological rigor but lacked applicative power. The present survey showed that the public, as the primary beneficiary, played a limited role in the development of the twenty-one CPGs. Hence, methodological improvement can better support high-quality CPG development in the future