Starting from December 2019 the world has faced an unprecedented health crisis caused by the new Coronavirus (COVID-19) due to the SARS-CoV-2 pathogen. Within this topic, the aim of the paper was to ...quantify the effect of mobility habits in the spread of the Coronavirus in Italy through a multiple linear regression model. Estimation results showed that mobility habits represent one of the variables that explains the number of COVID-19 infections jointly with the number of tests/day and some environmental variables (i.e. PM pollution and temperature). Nevertheless, a proximity variable to the first outbreak was also significant, meaning that the areas close to the outbreak had a higher risk of contagion, especially in the initial stage of infection (time-decay phenomena). Furthermore, the number of daily new cases was related to the trips performed three weeks before. This threshold of 21 days could be considered as a sort of positivity detection time, meaning that the mobility restrictions quarantine commonly set at 14 days, defined only according to incubation-based epidemiological considerations, is underestimated (possible delays between contagion and detection) as a containment policy and may not always contribute to effectively slowing down the spread of virus worldwide. This result is original and, if confirmed in other studies, will lay the groundwork for more effective containment of COVID-19 in countries that are still in the health emergency, as well as for possible future returns of the virus.
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•We quantify the effect of mobility habits in the spread of the Coronavirus in Italy.•Daily COVID-19 cases are directly related to the mobility habits performed 21 days before.•Population density, PM pollutant and number of tests per day have a direct relationship with the infection.•Temperature has an inverse relationship with the spread of the virus.•The areas close to the outbreak had a higher risk of contagion (time-decay phenomena).
The Covid-19 pandemic has caused an unprecedented global crisis and led to a huge number of deaths, economic hardship and the disruption of everyday life. Measures to restrict accessibility adopted ...by many countries were a swift yet effective response to contain the spread of the virus. Within this topic, this paper aims to support policies and decision makers in defining the most appropriate strategies to manage the Covid-19 crisis. Precisely the correlation between positive Covid-19 cases and transport accessibility of an area was investigated through a multiple linear regression model. Estimation results show that transport accessibility was the variable that better explained the number of Covid-19 infections (about 40% in weight), meaning that the greater is the accessibility of a certain geographical area, the easier the virus reaches its population. Furthermore, other context variables were also significant, i.e. socio-economic, territorial and pollutant variables. Estimated findings show that accessibility, which is often used to measure the wealth of an area, becomes its worst enemy during a pandemic, providing to be the main vehicle of contagion among its citizens. These original results allow the definition of possible policies and/or best practices to better manage mobility restrictions. The quantitative estimates performed show that a possible and probably more sustainable policy for containing social interactions could be to apply lockdowns in proportion to the transport accessibility of the areas concerned, in the sense that the higher the accessibility, the tighter should be the mobility restriction policies adopted.
The Civil Economy (CE) approach, as developed by Italian economists Luigino Bruni and Stefano Zamagni, aims at introducing reciprocity into the economy as a humanizing factor. Despite being presented ...as an innovative perspective, the CE approach shares many characteristics with the German model of Social Market Economy (SME). The present paper compares both approaches, showing that they in fact share a normative basis and similar aims but address them from diverse points of view; namely, CE addresses them from a virtue ethics perspective and SME from an institutional ethics one. This leads them to stress diiferent aspects and to focus on diverse problems. Therefore, CE would not constitute an alternative to SME but a complement. Thus, a combination of both approaches should allow each to take advantage of their respective strengths and lead to a better result in terms of the common good.
Ellagic acid (EA) is a naturally occurring polyphenolic compound endowed with strong antioxidant and anticancer properties that is present in high quantity in a variety of berries, pomegranates, and ...dried fruits. The antitumor activity of EA has been mostly attributed to direct antiproliferative and apoptotic effects. Moreover, EA can inhibit tumour cell migration, extra-cellular matrix invasion and angiogenesis, all processes that are crucial for tumour infiltrative behaviour and the metastatic process. In addition, EA may increase tumour sensitivity to chemotherapy and radiotherapy. The aim of this review is to summarize the in vitro and in vivo experimental evidence supporting the anticancer activity of pure EA, its metabolites, and EA-containing fruit juice or extracts in a variety of solid tumour models. The EA oral administration as supportive therapy to standard chemotherapy has been recently evaluated in small clinical studies with colorectal or prostate cancer patients. Novel formulations with improved solubility and bioavailability are expected to fully develop the therapeutic potential of EA derivatives in the near future.
Ellagic acid (EA) is a polyphenolic compound that can be found as a naturally occurring hydrolysis product of ellagitannins in pomegranates, berries, grapes, green tea and nuts. Previous studies have ...reported the antitumor properties of EA mainly using in vitro models. No data are available about EA influence on bladder cancer cell invasion of the extracellular matrix triggered by vascular endothelial growth factor-A (VEGF-A), an angiogenic factor associated with disease progression and recurrence, and tumor growth in vivo. In this study, we have investigated EA activity against four different human bladder cancer cell lines (i.e., T24, UM-UC-3, 5637 and HT-1376) by in vitro proliferation tests (measuring metabolic and foci forming activity), invasion and chemotactic assays in response to VEGF-A and in vivo preclinical models in nude mice. Results indicate that EA exerts anti-proliferative effects as a single agent and enhances the antitumor activity of mitomycin C, which is commonly used for the treatment of bladder cancer. EA also inhibits tumor invasion and chemotaxis, specifically induced by VEGF-A, and reduces VEGFR-2 expression. Moreover, EA down-regulates the expression of programmed cell death ligand 1 (PD-L1), an immune checkpoint involved in immune escape. EA in vitro activity was confirmed by the results of in vivo studies showing a significant reduction of the growth rate, infiltrative behavior and tumor-associated angiogenesis of human bladder cancer xenografts. In conclusion, these results suggest that EA may have a potential role as an adjunct therapy for bladder cancer.
Aggregation-induced emission (AIE) has, since its discovery, become a valuable tool in the field of nanoscience. AIEgenic molecules, which display highly stable fluorescence in an assembled state, ...have applications in various biomedical fields-including photodynamic therapy. Engineering structure-inherent, AIEgenic nanomaterials with motile properties is, however, still an unexplored frontier in the evolution of this potent technology. Here, we present phototactic/phototherapeutic nanomotors where biodegradable block copolymers decorated with AIE motifs can transduce radiant energy into motion and enhance thermophoretic motility driven by an asymmetric Au nanoshell. The hybrid nanomotors can harness two photon near-infrared radiation, triggering autonomous propulsion and simultaneous phototherapeutic generation of reactive oxygen species. The potential of these nanomotors to be applied in photodynamic therapy is demonstrated in vitro, where near-infrared light directed motion and reactive oxygen species induction synergistically enhance efficacy with a high level of spatial control.
Introduction and hypothesis
Stress urinary incontinence (SUI) surgery has significantly evolved with the introduction of synthetic midurethral slings (MUS). However, following reports from the US ...Food and Drug Administration and European Commission, the use of vaginal meshes in urogynaecology has been largely scrutinised. We analysed trends in female SUI surgery in England from 2000 to 2017.
Methods
The Hospital Episode Statistics database was retrieved from the Health and Social Care Information Centre website. Specific four-character codes of the evolving OPCS-4 coding system were used to quantify SUI operations.
Results
We analysed 180,773 admissions from 2000 to 2017. A steep rise in MUS use was noted until 2008–2009, followed by a consistent drop, with a nadir of 6383 procedures in 2016–2017. Removal of MUS has become increasingly popular, with a peak of 591 in 2012–2013. Numbers for traditional continence operations remained low. Colposuspensions markedly decreased to 189 in 2012–2013, with a slight positive trend only in the last few years, while autologous sling use costantly dropped from 262 to 124 throughout the study period. Admissions for urethral bulking agents increased from 650 to 1324 in the last 2 years.
Conclusions
MUS represents the most commonly performed procedure for SUI, despite an obvious reduction in the last 8 years. Urethral bulking agents are becoming more popular, while the numbers of colposuspensions and autologous slings are still low. Training programmes should take into account current shifts in surgical practice.
Trends in prolapse surgery in England Zacche, Martino Maria; Mukhopadhyay, Sambit; Giarenis, Ilias
International Urogynecology Journal,
11/2018, Letnik:
29, Številka:
11
Journal Article
Recenzirano
Introduction and hypothesis
Women have a lifetime risk of undergoing pelvic organ prolapse (POP) surgery of 11–19%. Traditional native tissue repairs are associated with reoperation rates of ...approximately 11% after 20 years. Surgery with mesh augmentation was introduced to improve anatomic outcomes. However, the use of synthetic meshes in urogynaecological procedures has been scrutinised by the US Food and Drug Administration (FDA) and by the European Commission (SCENIHR). We aimed to review trends in pelvic organ prolapse (POP) surgery in England.
Methods
Data were collected from the national hospital episode statistics database. Procedure and interventions-4 character tables were used to quantify POP operations. Annual reports from 2005 to 2016 were considered.
Results
The total number of POP procedures increased from 2005, reaching a peak in 2014 (
N
= 29,228). With regard to vaginal prolapse, native tissue repairs represented more than 90% of the procedures, whereas surgical meshes were considered in a few selected cases. The number of sacrospinous ligament fixations (SSLFs) grew more than 3 times over the years, whereas sacrocolpopexy remained stable. To treat vault prolapse, transvaginal surgical meshes have been progressively abandoned. We also noted a steady increase in uterine-sparing, and obliterative procedures.
Conclusions
Following FDA and SCENIHR warnings, a positive trend for meshes has only been seen in uterine-sparing surgery. Native tissue repairs constitute the vast majority of POP operations. SSLFs have been increasingly performed to achieve apical support. Urogynaecologists’ training should take into account shifts in surgical practice.
Cushing's syndrome is a serious endocrine disease caused by chronic, autonomous, and excessive secretion of cortisol. The syndrome is associated with increased mortality and impaired quality of life ...because of the occurrence of comorbidities. These clinical complications include metabolic syndrome, consisting of systemic arterial hypertension, visceral obesity, impairment of glucose metabolism, and dyslipidaemia; musculoskeletal disorders, such as myopathy, osteoporosis, and skeletal fractures; neuropsychiatric disorders, such as impairment of cognitive function, depression, or mania; impairment of reproductive and sexual function; and dermatological manifestations, mainly represented by acne, hirsutism, and alopecia. Hypertension in patients with Cushing's syndrome has a multifactorial pathogenesis and contributes to the increased risk for myocardial infarction, cardiac failure, or stroke, which are the most common causes of death; risks of these outcomes are exacerbated by a prothrombotic diathesis and hypokalaemia. Neuropsychiatric disorders can be responsible for suicide. Immune disorders are common; immunosuppression during active disease causes susceptibility to infections, possibly complicated by sepsis, an important cause of death, whereas immune rebound after disease remission can exacerbate underlying autoimmune diseases. Prompt treatment of cortisol excess and specific treatments of comorbidities are crucial to prevent serious clinical complications and reduce the mortality associated with Cushing's syndrome.
Aims
Obstetric anal sphincter injury (OASI) is associated with long‐term anal incontinence (AI). We aimed to address the following questions: (a) are women with major OASI (grade 3c and 4) at higher ...risk of developing AI when compared to women with minor OASI (grade 3a and 3b)? (b) is a fourth‐degree tear more likely to cause AI over a third‐degree tear?
Methods
A systematic literature search from inception until September 2022. We considered prospective and retrospective cohort studies, cross‐sectional and case‐control studies without language restrictions. The quality was assessed by the Newcastle‐Ottawa Scale and the Joanna Briggs Institute critical appraisal checklist. Risk ratios (RRs) were calculated to measure the effect of different grades of OASI.
Results
Out of 22 studies, 8 were prospective cohort, 8 were retrospective cohort, and 6 were cross‐sectional studies. Length of follow‐up ranged from 1 month to 23 years, with the majority of the reports (n = 16) analysing data within 12‐months postpartum. Third‐degree tears evaluated were 6454 versus 764 fourth‐degree tears. The risk of bias was low in 3, medium in 14 and high in 5 studies, respectively. Prospective studies showed that major tears are associated with a twofold risk of AI for major tears versus minor tears, while retrospective studies consistently showed a risk of fecal incontinence (FI) which was two‐ to fourfold higher. Prospective studies showed a trend toward worsening AI symptoms for fourth‐degree tears, but this failed to reach statistical significance. Cross‐sectional studies with long‐term (≥5 years) follow‐up showed that women with fourth‐degree tear were more likely to develop AI, with an RR ranging from 1.4 to 2.2. Out of 3, 2 retrospective studies showed similar findings, but the follow‐up was significantly shorter (≤1 year). Contrasting results were noted for FI rates, as only 5 out of 10 studies supported an association between fourth‐degree tear and FI.
Conclusions
Most studies investigate bowel symptoms within few months from delivery. Data heterogeneity hindered a meaningful synthesis. Prospective cohort studies with adequate power and long‐term follow‐up should be performed to evaluate the risk of AI for each OASI subtype.
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