Cyberbulli o ingenui digitali? Una ricerca esplorativa nella Regione Marche

[An exploratory research in Marche Region. Cyberbullies or digital naive?] This article is focused on the growing phenomenon of cyberbullying. It is based on data collected through an exploratory research that initially planned analysis of the judgments of the Juvenile Court in comparison with the data collected by the Postal Police and then included eleven primary and secondary schools. The research reveals that in the face of a limited number of cases of cyberbullying, questions about the use of the web by children does not provide a formalization of shared rules, both as prevention of digital bullying that as promotion of capacity of children in the use of digital tools

La pianificazione finanziaria in presenza del fenomeno della stagionalità. Il caso delle aziende agricole

La pianificazione finanziaria è diventata un fattore chiave per la sopravvivenza delle imprese. La difficoltà di accesso al credito, aumentata con l'adozione delle nuove regole di Basilea, si è aggravata ulteriormente con la crisi economica, rendendo più difficile per le aziende disporre di liquidità. Ciò è particolarmente vero per le aziende soggette a stagionalità, come quelle agricole, il cui fabbisogno finanziario è caratterizzato dal fenomeno delle punte e delle stasi. Obiettivo del lavoro sarà proprio approfondire il settore delle aziende agricole, analizzando le ragioni per cui una corretta pianificazione finanziaria può costituire la chiave del successo dell'impresa a lungo termine

Le famiglie e i nuovi strumenti di protezione sociale: il welfare aziendale.

L’articolo si focalizza sull’introduzione in Italia del welfare aziendale nel quadro dei processi di mutamento del welfare che a partire dagli anni Novanta è chiamato a far fronte ai nuovi rischi sociali cui sono esposte le famiglie.Ricostruendo sinteticamente il quadro legislativo che ne ha promosso la diffusione, l’autore intende fare emergere le peculiarità del welfare aziendale in un sistema di piccole imprese e di aumento della contrattazione territoriale.Lo scopo è quello di far luce sia sulle opportunità offerte dal welfare aziendale che sui i rischi di accentuazione dei dualismi territoriale, settoriale, relativo alle dimensioni aziendali e alla rinuncia all’universalismo. The paper focuses on the introduction in Italy of corporate welfare in the context of the change of welfare system that since the nineties is called to cope with the new social risks to which families are exposed.By synthetically reconstructing the legislative framework that has promoted its diffusion, the author intends to bring out the peculiarities of corporate welfare in a system of small businesses and increase in territorial bargaining.The aim is to shed light both on the opportunities offered by the company welfare and on the risks of accentuating the territorial, sectorial dualism related to company size and the renunciation of universalism

Matching between regional coronary vasodilator capacity and corresponding circumferential strain in individuals with normal and increasing body weight

Background: To define the relationship between regional coronary vasodilator capacity and myocardial circumferential strain at rest in normal weight, overweight, and obese individuals with normal global left-ventricular function. Methods and Results: Myocardial blood flow at rest and during pharmacologic vasodilation was measured with 13N-ammonia PET/CT in mL/g/minute in normal weight control (CON, n=12), overweight (OW, n=10), and obese individuals (OB, n=10). In addition, resting myocardial function was evaluated as circumferential strain (Єc, %) by MRI. Global myocardial flow reserve (MFR) did not differ significantly between CON and OW (2.98±0.96 vs 2.70±0.66, P=.290), whereas it declined significantly in OB (1.98±1.04, P=.030). Further, global Єc (%) was comparable between CON, OW, and OB (−0.24±0.03, −0.23±0.02, and −0.23±0.04) but it was lowest in OB when normalized to the rate-pressure product (NЄc: −0.31±0.06, −0.32±0.05, and −0.26±0.08). When MFR of the three major coronary territories was correlated with corresponding Єc, a positive association was observed in CON (r=0.36, P=.030), in OW (r=0.54, P=.002), and also in OB when relating NЄc to coronary vascular resistance during pharmacologic vasodilation (r=−0.46, P=.010). Conclusions: Higher coronary vasodilator capacity is related to corresponding regional circumferential strain at rest in non-obese individuals, while this is also observed for reduced MFR in obesit

Structural epicardial disease and microvascular function are determinants of an abnormal longitudinal myocardial blood flow difference in cardiovascular risk individuals as determined with PET/CT

Background: The aim of this study was to determine whether epicardial structural disease may affect the manifestation of a longitudinal decrease in myocardial blood flow (MBF) or MBF difference during hyperemia in cardiovascular risk individuals, and its dependency on the flow increase. Methods and Results: In 54 cardiovascular risk individuals (at risk) and in 26 healthy controls, MBF was measured with 13N-ammonia and PET/CT in mL/g/min at rest and during dipyridamole stimulation. Computed tomography coronary angiography (CTA) was performed using a 64-slice CT of a PET/CT system. Absolute MBFs during dipyridamole stimulation were mildly lower in the mid-distal than in the mid-LV myocardium in controls (2.20±.51 vs 2.29±.51, P<.0001), while it was more pronounced in at risk with normal and abnormal CTA (1.56±.42 vs 1.91±.46 and 1.18±.34 vs 1.51±.40mL/g/min, respectively, P<.0001), resulting in a longitudinal MBF difference that was highest in at risk with normal CTA, intermediate in at risk abnormal CTA, and lowest in controls (.35±.16 and .22±.09 vs .09±.04mL/g/min, respectively, P<.0001). On multivariate analysis, log-CCS and mid-LV hyperemic MBF increase, indicative of microvascular function, were independent predictors of the observed longitudinal MBF difference (P≤.004 by ANOVA). Conclusions: Epicardial structural disease and microvascular function are important determinants of an abnormal longitudinal MBF difference as determined with PET/C

Elevated endocannabinoid plasma levels are associated with coronary circulatory dysfunction in obesity

Aims Aim of this study was to evaluate a possible association between endocannabinoid (EC) plasma levels, such as anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and coronary circulatory function in obesity. Methods and results Myocardial blood flow (MBF) responses to cold pressor test (CPT) and during pharmacological vasodilation with dipyridamole were measured with 13N-ammonia PET/CT. Study participants (n = 77) were divided into three groups based on their body mass index (BMI, kg/m2): control group 20≤ BMI <25 (n = 21); overweight group, 25≤ BMI <30 (n = 26); and obese group, BMI ≥30 (n = 30). Anandamide plasma levels, but not 2-AG plasma levels, were significantly elevated in obesity as compared with controls, respectively [0.68 (0.53, 0.78) vs. 0.56 (0.47, 0.66) ng/mL, P = 0.020, and 2.2 (1.21, 4.59) vs. 2.0 (0.80, 5.90) ng/mL, P = 0.806)]. The endothelium-related change in MBF during CPT from rest (ΔMBF) progressively declined in overweight and obese when compared with control group [0.21 (0.10, 0.27) and 0.09 (−0.01, 0.15) vs. 0.26 (0.23, 0.39) mL/g/min; P = 0.010 and P = 0.0001, respectively). Compared with controls, hyperaemic MBFs were significantly lower in overweight and obese individuals [2.39 (1.97, 2.62) vs. 1.98 (1.69, 2.26) and 2.10 (1.76, 2.36); P = 0.007 and P = 0.042, respectively)]. In obese individuals, AEA and 2-AG plasma levels were inversely correlated with ΔMBF to CPT (r = −0.37, P = 0.046 and r = −0.48, P = 0.008) and hyperaemic MBFs (r = −0.38, P = 0.052 and r = −0.45, P = 0.017), respectively. Conclusions Increased EC plasma levels of AEA and 2-AG are associated with coronary circulatory dysfunction in obese individuals. This observation might suggest increases in EC plasma levels as a novel endogenous cardiovascular risk factor in obesity, but needing further investigation

Valutazione di Health Technology Assessment del sistema di sanificazione biologico a base di probiotici del genere Bacillus (PCHS)

Le infezioni correlate all’assistenza: priorità per la salute pubblica Epidemiologia delle infezioni correlate all’assistenza in Italia e loro impatto per la salute pubblica Sistemi di sanificazione attualmente disponibili in Italia Il Probiotic Cleaning Hygiene System (PCHS): caratteristiche della tecnologia, aspetti di efficacia e sicurezza Un sistema di sanificazione a base di probiotici per la riduzione delle infezioni correlate all’assistenza e la resistenza antimicrobica: analisi dell’impatto sul budget Impatto ambientale per la salute pubblica degli attuali sistemi di sanificazione di ambienti/superfici in setting assistenziale e comunitario e potenziali benefici dei nuovi sistemi innovativi Analisi delle principali raccomandazioni nazionali su sanificazione e disinfezione degli ambienti sanitari Valutazione etica dell’utilizzo del Probiotic Cleaning Hygiene System (PCHS) in Italia Elementi chiave per il processo decisional

A machine-learning based bio-psycho-social model for the prediction of non-obstructive and obstructive coronary artery disease

Background: Mechanisms of myocardial ischemia in obstructive and non-obstructive coronary artery disease (CAD), and the interplay between clinical, functional, biological and psycho-social features, are still far to be fully elucidated. Objectives: To develop a machine-learning (ML) model for the supervised prediction of obstructive versus non-obstructive CAD. Methods: From the EVA study, we analysed adults hospitalized for IHD undergoing conventional coronary angiography (CCA). Non-obstructive CAD was defined by a stenosis &lt; 50% in one or more vessels. Baseline clinical and psycho-socio-cultural characteristics were used for computing a Rockwood and Mitnitski frailty index, and a gender score according to GENESIS-PRAXY methodology. Serum concentration of inflammatory cytokines was measured with a multiplex flow cytometry assay. Through an XGBoost classifier combined with an explainable artificial intelligence tool (SHAP), we identified the most influential features in discriminating obstructive versus non-obstructive CAD. Results: Among the overall EVA cohort (n = 509), 311 individuals (mean age 67 ± 11&nbsp;years, 38% females; 67% obstructive CAD) with complete data were analysed. The ML-based model (83% accuracy and 87% precision) showed that while obstructive CAD was associated with higher frailty index, older age and a cytokine signature characterized by IL-1β, IL-12p70 and IL-33, non-obstructive CAD was associated with a higher gender score (i.e., social characteristics traditionally ascribed to women) and with a cytokine signature characterized by IL-18, IL-8, IL-23. Conclusions: Integrating clinical, biological, and psycho-social features, we have optimized a sex- and gender-unbiased model that discriminates obstructive and non-obstructive CAD. Further mechanistic studies will shed light on the biological plausibility of these associations. Clinical trial registration: NCT02737982

Carriers of ADAMTS13 Rare Variants Are at High Risk of Life-Threatening COVID-19

Thrombosis of small and large vessels is reported as a key player in COVID-19 severity. However, host genetic determinants of this susceptibility are still unclear. Congenital Thrombotic Thrombocytopenic Purpura is a severe autosomal recessive disorder characterized by uncleaved ultra-large vWF and thrombotic microangiopathy, frequently triggered by infections. Carriers are reported to be asymptomatic. Exome analysis of about 3000 SARS-CoV-2 infected subjects of different severities, belonging to the GEN-COVID cohort, revealed the specific role of vWF cleaving enzyme ADAMTS13 (A disintegrin-like and metalloprotease with thrombospondin type 1 motif, 13). We report here that ultra-rare variants in a heterozygous state lead to a rare form of COVID-19 characterized by hyper-inflammation signs, which segregates in families as an autosomal dominant disorder conditioned by SARS-CoV-2 infection, sex, and age. This has clinical relevance due to the availability of drugs such as Caplacizumab, which inhibits vWF-platelet interaction, and Crizanlizumab, which, by inhibiting P-selectin binding to its ligands, prevents leukocyte recruitment and platelet aggregation at the site of vascular damage

An explainable model of host genetic interactions linked to COVID-19 severity

We employed a multifaceted computational strategy to identify the genetic factors contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing (WES) dataset of a cohort of 2000 Italian patients. We coupled a stratified k-fold screening, to rank variants more associated with severity, with the training of multiple supervised classifiers, to predict severity based on screened features. Feature importance analysis from tree-based models allowed us to identify 16 variants with the highest support which, together with age and gender covariates, were found to be most predictive of COVID-19 severity. When tested on a follow-up cohort, our ensemble of models predicted severity with high accuracy (ACC = 81.88%; AUCROC = 96%; MCC = 61.55%). Our model recapitulated a vast literature of emerging molecular mechanisms and genetic factors linked to COVID-19 response and extends previous landmark Genome-Wide Association Studies (GWAS). It revealed a network of interplaying genetic signatures converging on established immune system and inflammatory processes linked to viral infection response. It also identified additional processes cross-talking with immune pathways, such as GPCR signaling, which might offer additional opportunities for therapeutic intervention and patient stratification. Publicly available PheWAS datasets revealed that several variants were significantly associated with phenotypic traits such as "Respiratory or thoracic disease", supporting their link with COVID-19 severity outcome.A multifaceted computational strategy identifies 16 genetic variants contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing dataset of a cohort of Italian patients