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HPV vaccination has been introduced in clinical practice in recent years and represents the most effective strategy of primary prevention of cervical carcinoma and of female genital preneoplastic conditions. One of the major issues of the subject is represented by vaccination coverage of the target population. Since its introduction, HPV vaccine efficacy has been progressively demonstrated also towards extragenital HPV-correlated conditions and in males too. Moreover, even subjects of older age groups or subjects who already had HPV infections have been demonstrated to received benefits from vaccination, due to improvements of their immunological response. Recently, vaccine efficacy has also been investigated in terms of adjuvant administration after treatments of preneoplastic or benign conditions of the female lower genital tract caused by HPVs; preliminary results indicate an interesting and promising field of application. On this basis, in this article an analysis of the state of the art has been performed, with specific regard to the Italian scenario and with the focus of future perspectives of implementation of the HPV vaccination policy. From the available evidences, the Italian HPV Study Group recommends the extension of systematic HPV vaccination to males too, to adult subjects and also after conservative treatment of genital HPV correlated conditions.

Supplemental material, Supp_Table_1 for Prognostic relevance of DNA damage and repair biomarkers in elderly patients with hormone-receptor-positive breast cancer treated with neoadjuvant hormone therapy: evidence from the real-world setting by Anna Di Benedetto, Cristiana Ercolani, Laura Pizzuti, Domenico Angelucci, Domenico Sergi, Camilla Marinelli, Laura Iezzi, Francesca Sperati, Irene Terrenato, Marco Mazzotta, Luciano Mariani, Enrico Vizza, Giancarlo Paoletti, Silverio Tomao, Marcello Maugeri-Saccà, Maddalena Barba, Nicola Tinari, Clara Natoli, Gennaro Ciliberto, Antonino Grassadonia and Patrizia Vici in Therapeutic Advances in Medical Oncology

HPV vaccines currently marketed in Italy (bivalent and quadrivalent against HPV 16-18 and HPV and 6,11,16,18 respectively) are an extraordinary tool for the primary prevention of HPV related diseases, particularly of the cervical cancer. Although the implementation of the organized vaccination programs has already translated (for some endpoint) in confirmation of clinical efficacy, remains excluded a significant proportion of the diseases linked to non-vaccine HPV types. The new nonavalent vaccine (HPV9), of impending commercialization, represents an evolution of the quadrivalent, the composition of which are added five high-risk HPV types (HPV 31,33,45,52,58). The high clinical-immunological efficacy in experimental trials against the new genotypes (96% for CIN2 +), and the equivalence immunogenic to the four already present in the previous vaccine, will render the use of HPV9 a tool able to control in an even more effective HPV disease. The potential of the new vaccine is linked to the reduction of the HPV cancer burden by 2-20% according to anatomical site, with major benefits for cervical cancer, vulvo-vaginal, penile and more limited benefits for anal tumours. Moreover, the potential benefits could be also linked to the reduction of incidence of pre-neoplastic lesions arising in the lower-genital tract, especially in the cervix (CIN2-3), so often cause lengthy and expensive diagnostic and therapeutic procedures. In the face of this broad provision of benefit from HPV9 vaccine, we have also to consider all the variables related to its introduction in the vaccination calendars: the market price, the schedule of administration (currently in three doses) and data regarding the cost-effectiveness. The authors recognize the new vaccine (currently registered only in the US) a lot of potential in the prevention of HPV-related diseases.

Preclinical, early phase clinical trials and epidemiological evidence support the potential role of insulin-sensitizers in cancer prevention and treatment. Insulin-sensitizers improve the metabolic and hormonal profile in PCOS patients and may also act as anticancer agents, especially in cancers associated with hyperinsulinemia and oestrogen dependent cancers. Several lines of evidence support the protection against cancer exerted by dietary inositol, in particular inositol hexaphosphate. Metformin, thiazolidinediones, and myoinositol postreceptor signaling may exhibit direct inhibitory effects on cancer cell growth. AMPK, the main molecular target of metformin, is emerging as a target for cancer prevention and treatment. PCOS may be correlated to an increased risk for developing ovarian and endometrial cancer (up to threefold). Several studies have demonstrated an increase in mortality rate from ovarian cancer among overweight/obese PCOS women compared with normal weight women. Long-term use of metformin has been associated with lower rates of ovarian cancer. Considering the evidence supporting a higher risk of gynaecological cancer in PCOS women, we discuss the potential use of insulin-sensitizers as a potential tool for chemoprevention, hypothesizing a possible rationale through which insulin-sensitizers may inhibit tumourigenesis.

Il concetto di motivazione, in quanto costrutto multidimensionale, dinamico e socialmente costruito, è suscettibile di essere visto come una competenza che è possibile sviluppare lungo tutto il percorso formativo. Convinzioni e atteggiamenti possono costituire dei fattori particolarmente utili per esplorare i processi motivazionali, con riferimento ad aree complesse quali i rapporti tra motivazione, lingue e culture, tra motivazione e percezioni di sé e tra motivazione e compiti di apprendimento. Parallelamente, dal punto di vista operativo è utile considerare le strategie che insegnante e studente possono attivare, ciascuno nel proprio ruolo ma anche in una prospettiva di interdipendenza, per generare e mantenere la motivazione ad apprendere. L’illustrazione di alcuni fondamentali apporti teorici è accompagnata dalla citazione di affermazioni e di metafore di studenti, raccolte nel corso di alcuni sondaggi svolti sull’apprendimento delle lingue a scuola. MOTIVATION IN LANGUAGE LEARNING: THEORETICAL APPROACHES AND EDUCATIONAL IMPLICATIONS The concept of motivation as a multidimensional, dynamic and socially conditioned construct, can be seen as a competence which developed throughout the formative process. Beliefs and attitudes are particularly useful for exploring motivational processes, with special reference to complex areas such as the relationship between motivation, language and culture, motivation and the perception of the self, and motivation and learning tasks. In the same way, it is useful to consider the strategies that teachers and students can put into effect, maintaining their roles but also working interdependently, in order to generate and maintain the motivation to learn. Theoretical approaches to motivation are illustrated by statements and metaphors produced by students and collected during a series of surveys on the learning of languages in Italian school contexts., Italiano LinguaDue, Vol 4, No 1 (2012)

Le interazioni sociali, verbali e non verbali, sono sempre regolate da norme culturali, per lo più implicite, il cui rispetto costituisce un presupposto di una comunicazione efficace. La competenza pragmatica interculturale studia queste norme e come esse condizionano i comportamenti comunicativi. Il contributo, dopo aver esaminato il ruolo di questa competenza nell’ambito più generale della competenza comunicativa, illustra il rapporto tra forme linguistiche e norme culturali, in particolare nella realizzazione degli atti linguistici e delle loro sequenze. Vengono quindi prese in considerazione le implicazioni pedagogiche e le possibili applicazioni didattiche nel processo di apprendimento e di insegnamento di una lingua seconda o straniera, fornendo da ultimo alcuni esempi di attività e materiali. Between language and culture: intercultural pragmatic competence Social interactions, both verbal and non-verbal, are always governed by (usually implicit) cultural norms, which are a prerequisite of effective communication. Intercultural pragmatic competence studies such norms and how they impact on communicative behaviours. This paper first examines the role of this competence within the scope of communicative competence. The relationship between language forms and cultural norms is then explored, with particular reference to the realization of speech acts and their sequences. Finally, pedagogical implications and possible teaching applications are discussed in the context of second and foreign language learning and teaching, together with some examples of relevant activities and materials., Italiano LinguaDue, Vol 7, No 1 (2015)

Background Human papillomavirus (HPV) contribution in vulvar intraepithelial lesions (VIN) and invasive vulvar cancer (IVC) is not clearly established. This study provides novel data on HPV markers in a large series of VIN and IVC lesions. Methods Histologically confirmed VIN and IVC from 39 countries were assembled at the Catalan Institute of Oncology (ICO). HPV-DNA detection was done by polymerase chain reaction using SPF-10 broad-spectrum primers and genotyping by reverse hybridisation line probe assay (LiPA 25 ) (version 1). IVC cases were tested for p16 INK4a by immunohistochemistry (CINtec histology kit, ROCHE). An IVC was considered HPV driven if both HPV-DNA and p16 INK4a overexpression were observed simultaneously. Data analyses included algorithms allocating multiple infections to calculate type-specific contribution and logistic regression models to estimate adjusted prevalence (AP) and its 95% confidence intervals (CI). Results Of 2296 cases, 587 were VIN and 1709 IVC. HPV-DNA was detected in 86.7% and 28.6% of the cases respectively. Amongst IVC cases, 25.1% were both HPV-DNA and p16 INK4a positive. IVC cases were largely keratinising squamous cell carcinoma (KSCC) ( N = 1234). Overall prevalence of HPV related IVC cases was highest in younger women for any histological subtype. SCC with warty or basaloid features (SCC_WB) ( N = 326) were more likely to be HPV and p16 INK4a positive (AP = 69.5%, CI = 63.6–74.8) versus KSCC (AP = 11.5%, CI = 9.7–13.5). HPV 16 was the commonest type (72.5%) followed by HPV 33 (6.5%) and HPV 18 (4.6%). Enrichment from VIN to IVC was significantly high for HPV 45 (8.5-fold). Conclusion Combined data from HPV-DNA and p16 INK4a testing are likely to represent a closer estimate of the real fraction of IVC induced by HPV. Our results indicate that HPV contribution in invasive vulvar cancer has probably been overestimated. HPV 16 remains the major player worldwide.