Background. Overuse of imaging results in cost increases, with little to no benefit to patients. The purpose of this study is to evaluate imaging tests and radiology equipment over a ten-year period in 16 Organisation for Economic Co-operation and Development (OECD) countries. Methods. Twelve countries were included in a time-trend analysis based on OECD indicators on diagnostic imaging (computer tomography [CT], magnetic resonance imaging [MRI], and positron emission tomography [PET]). These annual indicators included the number of exams per 1000 population, the number of devices per million population, and the number of exams per device. Average annual percent change was used to measure country-specific trends. Results. Most countries saw a rise in the exam-to-scanner ratio for CT, MRI, and PET, demonstrating a faster increase in exam volume than device volume. Italy exhibited an increase in CT, MRI, and PET equipment units during the same period, but not in exams, most likely due to a reduction in medical procedures during the pandemic. Only in Luxemburg, CT and PET examinations increased despite a reduction in scanners. Conclusions. Considering the expected increasing demand for diagnostics due to the evolving needs of the population, proper governance and resource allocation are necessary requirements for cost-efficient health systems.
The present study aims to analyze country-specific antidepressant consumption rates across 30 OECD countries, comparing them with the OECD average from 2010 to 2020. This analysis examines annual variations in consumption and identifies potential trends over time. Using a retrospective observational design, the study employs pooled secondary data from 30 OECD countries. A time trend analysis was conducted to assess overall and country-specific linear and quadratic trends, modeling the variation in Defined Daily Dose (DDD) per 1,000 inhabitants from 2010 to 2020. Findings reveal a significant increase in antidepressant consumption across most countries. The mean DDD value rose from 52.42 in 2010 to 69.5 in 2020. Three distinct trend patterns emerged: linear, concave, and convex. While 15 countries exhibited a significant linear increase, five showed a plateauing trend, and others experienced exponential growth with a convex trajectory. Denmark was the only country to show a decline in consumption, whereas Norway displayed no significant change over time. These results underscore a notable rise in antidepressant use across most OECD countries, alongside variations in consumption trajectories. By assessing and comparing national consumption rates, this study highlights the importance of international collaboration in addressing mental health challenges and optimizing healthcare accessibility and outcomes.
Knockout of the ubiquitously expressed miRNA-17∼92 cluster in mice produces a lethal developmental lung defect, skeletal abnormalities, and blocked B lymphopoiesis. A shared target of miR-17∼92 miRNAs is the pro-apoptotic protein BIM, central to life-death decisions in mammalian cells. To clarify the contribution of miR-17∼92:Bim interactions to the complex miR-17∼92 knockout phenotype, we used a system of conditional mutagenesis of the nine Bim 3′ UTR miR-17∼92 seed matches. Blocking miR-17∼92:Bim interactions early in development phenocopied the lethal lung phenotype of miR-17∼92 ablation and generated a skeletal kinky tail. In the hematopoietic system, instead of causing the predicted B cell developmental block, it produced a selective inability of B cells to resist cellular stress; and prevented B and T cell hyperplasia caused by Bim haploinsufficiency. Thus, the interaction of miR-17∼92 with a single target is essential for life, and BIM regulation by miRNAs serves as a rheostat controlling cell survival in specific physiological contexts.
Background: Vitamin D intake and synthesis are essential. Vitamin D deficiency is increasing across all age groups, raising concerns regarding public health. Serum 25(OH)D is measured to define vitamin D deficiency. However, its quantification in non-invasively collected biological matrices is still poorly studied. This study aimed to assess 25(OH)D levels in unconventional matrices using cost-effective analytical methods. Methods: Serum, urine, and saliva were collected from 62 healthy, non-smoking volunteers, 25–44 years of age. Biological samples were analysed using the Enzyme-Linked Immunosorbent Assay (ELISA). The serum was additionally analysed via the chemiluminescent microparticle immunoassay (CMIA), which was used as a benchmark. Results: We observed a linear correlation (Pearson r = 0.44; p = 0.05) between the benchmark and ELISA-measured 25(OH)D urinary levels. After stratification by sex, the correlation was stronger and significant only in females (Pearson r = 0.62; p = 0.04). Salivary 25(OH)D levels did not correlate with serum levels for both ELISA and CMIA measures. Subjects with a CMIA serum-based deficiency showed lower urinary 25(OH)D levels (p = 0.04). Conclusion: Our study opens up the possibility of using urinary 25(OH)D levels as a proxy measurement of vitamin D. Such an approach may allow future investigations on the association between environmental factors and vitamin D assessed in non-invasively collected biological matrices via cost-effective analytical methods.
Cyberaggression (CyA) embraces a broad spectrum of hostile behaviors through electronic means. This cross-sectional study aimed to evaluate features and outcomes of this phenomenon among Italian adults. A nationwide survey was distributed on social media platforms. Being victim and being perpetrator of CyA were the primary outcomes; positive scores for GAD-2 (generalized anxiety disorder) and PHQ-2 (depressive symptoms) scales were the secondary outcomes. In total, 446 surveys were collected. Considering the primary outcomes, 46.3% and 13.5% reported having been victims and perpetrators of CyA, respectively. Politics, ethnic minority, and sexual orientation were main subjects triggering CyA. A higher likelihood of being cyber-victims was observed for women and the LGBTQA+ group. Women were less likely to be CyA perpetrators. There was an association between being a CyA victim and a CyA perpetrator. A total of 22.4% and 34.0% respondents scored positive for PHQ-2 and GAD-2, respectively. The main mental health consequences after CyA exposure were anger and sadness, whereas sleep alterations and stomach ache were the most experienced psychosomatics symptoms. No significant relationships between PHQ-2/GAD-2 and CyA emerged. CyA also represents a crucial public health issue among Italian adults. Further investigations are needed to better define the phenomenon and to study the potential consequences on mental health.
The Electronic Personal Health Record (EPHR) provides an innovative service for citizens and professionals to manage health data, promoting patient-centred care. It enhances communication between patients and physicians and improves accessibility to documents for remote medical information management. The study aims to assess the prevalence of awareness and acceptance of the EPHR in northern Italy and define determinants and barriers to its implementation. In 2022, a region-wide cross-sectional study was carried out through a paper-based and online survey shared among adult citizens. Univariable and multivariable regression models analysed the association between the outcome variables (knowledge and attitudes toward the EPHR) and selected independent variables. Overall, 1634 people were surveyed, and two-thirds were aware of the EPHR. Among those unaware of the EPHR, a high prevalence of specific socio-demographic groups, such as foreign-born individuals and those with lower educational levels, was highlighted. Multivariable regression models showed a positive association between being aware of the EPHR and educational level, health literacy, and perceived poor health status, whereas age was negatively associated. A higher knowledge of the EPHR was associated with a higher attitude towards the EPHR. The current analysis confirms a lack of awareness regarding the existence of the EPHR, especially among certain disadvantaged demographic groups. This should serve as a driving force for a powerful campaign tailored to specific categories of citizens for enhancing knowledge and usage of the EPHR. Involving professionals in promoting this tool is crucial for helping patients and managing health data.