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Abstract Sore throat represents one of the main causes of antibiotic overprescription in children. Its management is still a matter of debate, with countries considering streptococcal pharyngotonsillitis a benign and self-limiting condition and others advocating for its antibiotic treatment to prevent suppurative complications and acute rheumatic fever. Italian paediatricians frequently prescribe antibiotics on a clinical basis regardless of microbiological results. Moreover, broad-spectrum antibiotics are inappropriately prescribed for this condition. In this regard, an intersociety consensus conference was issued to promote the judicious use of antibiotic therapy in paediatric outpatient settings. A systematic review of the literature was performed, and updated recommendations were developed according to the GRADE methodology. Antibiotic treatment with amoxicillin (50 mg/kg/day) for 10 days is recommended in all children with proven streptococcal pharyngitis. Benzathine-penicillin could be prescribed in children with impaired intestinal absorption or inability to tolerate enteral intake and in those at high risk of suppurative complications with low compliance to oral therapy. In children with suspected amoxicillin allergy, third-generation cefalosporins for five days are recommended in low-risk patients, and macrolides are recommended in high-risk ones. Candidates for tonsillectomy due to recurrent pharyngitis could be treated with amoxicillin-clavulanic acid, clindamycin, or combined therapy with amoxicillin plus rifampicin for four days, in an attempt to avoid surgery.

Background: Staffing shortages across the healthcare sector pose a threat to the continuity of the Canadian healthcare system in the post-COVID-19 pandemic era. We sought to understand factors associated with turnover intention as well as Canadian healthcare providers’ (HCPs) perspectives and experiences with turnover intention as related to both organizational and professional turnover. Method: A convergent questionnaire mixed-methods design was employed. Descriptive statistics and ordinal logistic regressions were used to analyze quantitative data and ascertain factors associated with turnover intention. Thematic analysis was used to analyze qualitative open-field textbox data and understand HCPs’ perspectives and experiences with turnover intention. Results: Quantitative analyses revealed that 78.6% of HCPs surveyed (N = 398) reported at least a 25% turnover likelihood regarding their organization, with 67.5% reporting at least a 25% turnover likelihood regarding their profession. Whereas regression models revealed the significant impact of years worked, burnout, and organizational support on turnover likelihood for organizations, age, sex, burnout, and organizational support contributed to the likelihood of leaving a profession. Patterns of meaning drawn from participants’ qualitative responses were organized according to the following four themes: (1) Content to stay, (2) Drowning and no one cares, (3) Moral stressors, and (4) Wrestling with the costs and benefits. Conclusions: Many HCPs described weighing the costs and benefits of leaving their organization or profession during the COVID-19 pandemic. Although challenging working conditions, moral stressors, and burnout may play a significant role in HCPs’ experiences of turnover intention, there is ample room to intervene with organizational support.

Land use and land cover (LULC) in Ghana has undergone a lot of changes over the past years emanating from natural and anthropogenic activities. This study is a comprehensive analysis of LULC changes in parts of the Guinea-Savannah through an integrated approach of geospatial procedures. Multi-temporal satellite imagery data sets of four different years, 1990 (Landsat TM), 2000 (Landsat ETM+), 2010 (Landsat ETM+) and 2020 (Landsat ETM+) were analyzed. Built-up area, Agricultural land, Closed savannah vegetation, Open savannah vegetation and Water bodies were LULC categories delineated for Jirapa municipality. The Cellular Automata-Markov (CA-Markov) model was applied to predict the likely changes in LULC in 2030. The study revealed that the most dominant land cover type in the municipality is the Open savannah vegetation as it occupied averagely 45% of the total surface area. Built-up area increased in area coverage by 93% between 1990 and 2020. Agricultural activities, bushfires, deforestation, infrastructural development, and population growth are the main drivers of changes in Agricultural land, Open savannah vegetation, Closed savannah vegetation and Water bodies. The LULC prediction for 2030 showed that the Built-up areas would increase significantly in 2030 leading to a 6% reduction in Agricultural land in 2030.

ABSTRACTBackground: Healthcare workers (HCWs) across the globe have reported symptoms of Post-Traumatic Stress Disorder (PTSD) during the COVID-19 pandemic. Moral Injury (MI) has been associated with PTSD in military populations, but is not well studied in healthcare contexts. Moral Distress (MD), a related concept, may enhance understandings of MI and its relation to PTSD among HCWs. This study examined the independent and combined impact of MI and MD on PTSD symptoms in Canadian HCWs during the pandemic.Methods: HCWs participated in an online survey between February and December 2021, with questions regarding sociodemographics, mental health and trauma history (e.g. MI, MD, PTSD, dissociation, depression, anxiety, stress, childhood adversity). Structural equation modelling was used to analyze the independent and combined impact of MI and MD on PTSD symptoms (including dissociation) among the sample when controlling for sex, age, depression, anxiety, stress, and childhood adversity.Results: A structural equation model independently regressing both MI and MD onto PTSD accounted for 74.4% of the variance in PTSD symptoms. Here, MI was strongly and significantly associated with PTSD symptoms (β = .412, p

IntroductionDisease modifying therapies (DMTs) used to treat multiple sclerosis (MS) can be associated to the occurrence of hematological disorders. This systematic review aims to provide an overview of these events occurring in real-life conditions, by describing case reports and series published in the literature.MethodsA literature search of all publications up to January 5th 2024 on the Medline and Embase databases was carried out. The results were presented both in the text and in tables.ResultsSixty-seven case reports/series were included in this review, of which more than half related to alemtuzumab, natalizumab and ocrelizumab. The publication date of included studies ranged from 2006 to 2024. The majority of case reports and series described the occurrence of late-onset hematological disorders (events that occurred more than 30 days after the first DMT administration), mainly represented by case of neutropenia, autoimmune hemolytic anemia and immune thrombocytopenia. All cases reported a favorable outcome, apart one case report that described a fatal case. Among included cases, 4 articles, all related to natalizumab, described the occurrence of myeloid disorders in 13 newborns from mother receiving the DMT.DiscussionConsidering the limitations identified in the majority of included studies, further ad hoc studies are strongly needed to better evaluate the hematological disorders of DMTs. Meantime, the strict monitoring of treated patients for the occurrence of these toxicities should be highly recommended.

Treatment for pregnant women with psoriasis is limited by the lack of information typically related to clinical trials. While anti-tumor necrosis factor (TNF) drugs offer therapeutic benefits, their safety during pregnancy is a concern. Notably, certolizumab is comparatively safer than adalimumab, etanercept, infliximab, and golimumab according to the current recommendations. Thus, this study aimed to conduct a pharmacovigilance comparative analysis of maternal and neonatal outcomes associated with certolizumab versus other anti-TNF drugs by using data from EudraVigilance. A descriptive analysis was performed of Individual Case Safety Reports (ICSRs) associated with an anti-TNF drug and related to the pregnant patients with psoriasis from 2009 and 2023, focusing our analysis on the specific pregnancy outcomes and fetal/neonatal disorders. The most common pregnancy-related adverse event was spontaneous abortion, predominantly related to adalimumab and certolizumab. Certolizumab was also reported in cases of caesarean section, gestational diabetes, abortion, fetal death, fetal distress syndrome, pre-eclampsia, and premature separation of placenta. Generally, the findings from our study depicted a safety profile that overlapped for each anti-TNF drug, both in maternal/neonatal outcomes and other adverse events, suggesting no substantial differences between treatments. We advocate for further investigations before making concrete recommendations.

Abstract Bevacizumab (Bev) plus chemotherapy is a standard first-line treatment in metastatic colorectal cancer (mCRC), however to date no predictive factors of response have been identified. Results of our previous analysis on patients enrolled in a randomized prospective phase III multicenter study (ITACa study) showed a predictive value of Vascular Endothelial Growth Factor (VEGF) polymorphism (VEGF + 936), a 27-nucleotide variable number tandem repeat (VNTR) of the endothelial nitric oxide synthase (eNOS) gene and eNOS + 894 polymorphism. mCRC patients, treated with Bev plus chemotherapy, were included in this prospective validation trial. eNOS + 894G > T was analyzed by Real time PCR, while the eNOS VNTR and VEGF + 936C > T were determined by standard PCR and direct sequencing analysis. These polymorphisms were assessed in relation to progression-free survival (PFS), overall survival (OS) and objective response rate (ORR). These three polymorphisms were not predictive of PFS (p 0.91, 0.59 and 0.09, respectively), and OS (p 0.95, 0.32 and 0.46, respectively). Moreover, the haplotype analyses did not confirm what was found in our previous study; patients bearing a specific haplotype of eNOS had not significantly improved outcomes. This prospective study failed to validate the predictive impact of eNOS and VEGF polymorphisms for response to Bev plus first-line chemotherapy in mCRC patients.

Background Palliative care is a comprehensive treatment approach that guarantees comfort for pediatric patients and their families from diagnosis to death. The techniques used for neurological patients in the field of palliative care can enhance the quality of care provided to patients with neurological disorders and support their families. Purpose This study aimed to analyze the palliative care protocols in use in our department, describe the palliative course in the clinical setting, and propose the implementation of hospital palliative care for long-term prognosis of patients with neurological diseases. Methods This retrospective observational study examined the application of palliative care from birth to early infancy in neurological patients. We studied 34 newborns with diseases affecting the nervous system impairing prognosis. The study was conducted from 2016 to 2020 at the Neonatology Intensive Care Unit and the Pediatric Unit of the San Marco University Hospital in Catania, Sicily, Italy. Results Despite current legislation in Italy, no palliative care network has been activated to meet the needs of the population. In our center, given the vast number of patients with neurological conditions requiring palliative care, we should activate a straightforward departmental unit for neurologic pediatric palliative care. Conclusion The establishment of specialized reference centers that manage significant neurological illnesses is due to neuroscience research progress in recent decades. Integration with specialized palliative care is sparse but now seems essential.

Background: Validated predictors of sensitivity or resistance to Bevacizumab (Bev) are not available, and Inflammatory Indexes (IIs) has been reported to be useful prognostic factors in various malignant solid tumours, including metastatic colorectal cancer (mCRC). Objectives: To explore the prognostic value of IIs in mCRC patients treated with first-line chemotherapy plus Bev. Design: One hundred and eighty-two patients diagnosed with mCRC and treated with first line chemotherapy plus Bev were considered for this prospective non-pharmacological study. Neutrophil, lymphocyte, platelet, aspartate transaminase (AST) and lactate dehydrogenase (LDH) tests were carried out at baseline and before each treatment cycle, according to clinical practice. Methods: Pre-treatment Systemic Immune-inflammation Index (SII), Colon Inflammatory Index (CII) and Aspartate aminotransferase-Lymphocyte Ratio Index (ALRI) were evaluated to assess a correlation with progression-free survival (PFS) and overall survival (OS). Results: In the overall population, PFS and OS were lower in patients with high SII (HR 1.64, p = 0.006 and HR 1.75, p = 0.004, respectively) and high ALRI (HR 2.13, p = 0.001 and HR 1.76, p = 0.02, respectively), but no difference was detected according to CII value. The multivariate analysis confirmed both SII and ALRI as independent prognostic factors for PFS (HR 1.64 and 2.82, respectively) and OS (HR 1.65 and 2.12, respectively). Conclusion: Our results demonstrate and confirm that IIs, and in particular SII and ALRI, are easy to measure prognostic markers for patient candidates to first line chemotherapy plus Bev for mCRC.

BackgroundAccording to Europe’s Beating Cancer Plan, the number of cancer survivors is growing every year and is now estimated at over 12 million in Europe. A main objective of the European Commission is to ensure that cancer survivors can enjoy a high quality of life, underlining the role of digital technology and eHealth apps and tools to achieve this. ObjectiveThe main objective of this study is the development of a user-centered artificial intelligence system to facilitate the input and integration of patient-related biopsychosocial data to improve posttreatment quality of life, well-being, and health outcomes and examine the feasibility of this digitally assisted workflow in a real-life setting in patients with colorectal cancer and acute myeloid leukemia. MethodsA total of 60 patients with colorectal cancer and 30 patients with acute myeloid leukemia will be recruited from 2 clinical centers: Universitätsmedizin der Johannes Gutenberg-Universität Mainz (Mainz, Germany) and IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori” (IRST, Italy). Psychosocial data (eg, emotional distress, fatigue, quality of life, subjective well-being, sleep problems, and appetite loss) will be collected by questionnaires via a smartphone app, and physiological data (eg, heart rate, skin temperature, and movement through step count) will be collected by a customizable smart wrist-worn sensor device. Each patient will be assessed every 2 weeks over their 3-month participation in the ONCORELIEF study. Inclusion criteria include patients with the diagnosis of acute myeloid leukemia or colorectal cancer, adult patients aged 18 years and older, life expectancy greater than 12 months, Eastern Cooperative Oncology Group performance status ≤2, and patients who have a smartphone and agree to use it for the purpose of the study. Exclusion criteria include patients with a reduced cognitive function (such as dementia) or technological illiteracy and other known active malignant neoplastic diseases (patients with a medical history of treated neoplastic disease are included). ResultsThe pilot study started on September 1, 2022. As of January 2023, we enrolled 33 patients with colorectal cancer and 7 patients with acute myeloid leukemia. As of January 2023, we have not yet started the data analysis. We expect to get all data in June 2023 and expect the results to be published in the second semester of 2023. ConclusionsWeb-based and mobile apps use methods from mathematical decision support and artificial intelligence through a closed-loop workflow that connects health professionals and patients. The ONCORELIEF system has the potential of continuously identifying, collecting, and processing data from diverse patient dimensions to offer health care recommendations, support patients with cancer to address their unmet needs, and optimize survivorship care. Trial RegistrationGerman Clinical Trials Register (DRKS) 00027808; https://drks.de/search/en/trial/DRKS00027808 International Registered Report Identifier (IRRID)DERR1-10.2196/45475

Abstract In these last 25 years, the Neonatal Emergency Transport (NET) service has been widely improved in Italy. To date, all National areas are covered by a NET service; 53 NET centers have been activated in all the Italian territory. Herein, the authors present an observational study to evaluate the rate of infantile mortality after introduction of NET in Sicily, and to study the efficiency of this service in reducing these rates of mortality in vulnerable neonates, transported from primary care birth centers to tertiary facilities to undergo to specialized NICU assistance. All neonates who required an emergency transport by NETS were included. No exclusions criteria were applied. Demographic and regional infantile mortality data, expressed as infant mortality rate, were selected by the official government database (ISTAT- National Statistic Institute— http://www.istat.it ). All data were respectively divided into three groups: data concerning transport, clinical condition, and mortality of the transported patients. We transported by NET 325 neonates. The analysis of the infant mortality rate (per 1.000 live births) in Catania from 2016 to 2018 was reduced compared to the same rate calculated before NETS activation (4.41 index before 2016 vs 4.17 index after 2016). These data showed an increase in other provinces (Enna, Caltanissetta, and Agrigento). 61% of neonates showed a respiratory disease. During the study period the proportion of neonates with a Mortality Index for Neonatal Transportation—MINT

A new therapeutic class of oral agents firstly used for the treatment of type 2 diabetes mellitus is represented by gliflozines or sodium-glucose co-transporter 2 (SGLT2) inhibitors. SGLT2 inhibitors might be effective alone or in combination with any other drugs. This therapeutic class currently includes five agents: canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and sotagliflozin. SGLT2 inhibitors prevent the renal reabsorption of filtered glucose and sodium by blocking the SGLT2 co-transporters in the proximal convoluted renal tubule, facilitating glucose excretion in the urine (glycosuria) and lowering blood glucose levels. SGLT2 inhibitors have also shown to have pleiotropic effects and determine cardiovascular and renal prevention, thus leading to an extension of their therapeutic indication to include the heart failure. Despite their clinical benefits, warnings about adverse events have been implemented by Regulatory Agencies in the product's information since their introduction to the market. In particular, SGLT2 inhibitors have shown a strong impact on a high number of risk factors. They can cause hypoglycaemia, hypotension, lower limb amputation, fractures, genito-urinary infections, and diabetic ketoacidosis with different frequencies of onset. Despite some of these events are rare, they can lead to serious and dangerous complications, highlighting the importance of a strict monitoring of patients. Overall, SLGT-2 inhibitors are effective antidiabetic drugs with favorable advantages in renal and cardiovascular protection, and with a generally well-tolerated safety profile. This review aims to summarize the safety profile of SGLT2 inhibitors available in the market.

BackgroundA platform designed to support the home management of oral anticancer treatments and provide a secure web-based patient–health care professional communication modality, ONCO-TreC, was tested in 3 cancer centers in Italy. ObjectiveThe overall aims of the trial are to customize the platform; assess the system’s ability to facilitate the shared management of oral anticancer therapies by patients and health professionals; and evaluate system usability and acceptability by patients, caregivers, and health care professionals. MethodsPatients aged ≥18 years who were candidates for oral anticancer treatment as monotherapy with an Eastern Cooperative Oncology Group performance status score of 0 to 1 and a sufficient level of familiarity with mobile devices were eligible. ONCO-TreC consisted of a mobile app for patients and a web-based dashboard for health care professionals. Adherence to treatment (pill count) and toxicities reported by patients through the app were compared with those reported by physicians in medical records. Usability and acceptability were evaluated using questionnaires. ResultsA total of 40 patients were enrolled, 38 (95%) of whom were evaluable for adherence to treatment. The ability of the system to measure adherence to treatment was high, with a concordance of 97.3% (95% CI 86.1%-99.9%) between the investigator and system pill count. Only 60% (3/5) of grade 3, 54% (13/24) of grade 2, and 19% (7/36) of grade 1 adverse events reported by physicians in the case report forms were also reported in the app directly by patients. In total, 94% (33/35) of patients had ≥1 app launch each week, and the median number of daily accesses per patient was 2. Approximately 71% (27/38) and 68% (26/38) of patients used the app for messages and vital sign entering, respectively, at least once during the study period. ConclusionsONCO-TreC is an important tool for measuring and monitoring adherence to oral anticancer drugs. System usability and acceptability were very high, whereas its reliability in registering toxicity could be improved. Trial RegistrationClinicalTrials.gov NCT02921724; https://www.clinicaltrials.gov/ct2/show/NCT02921724

The management of non-compressible torso hemorrhage in military austere/remote environments is a leading cause of potentially preventable death in the prehospital/battlefield environment that has not shown a decrease in mortality in 26 years. Numerous conceptual innovations to manage non-compressible torso hemorrhage have been developed without proven effectiveness in this setting. This scoping review aims to assess the current literature to define non-compressible torso hemorrhage in civilian and military austere/remote environments, assess current innovations and the effectiveness of these innovations, assess the current knowledge gaps and potential future innovations in the management of non-compressible torso hemorrhage in civilian and military austere/remote environments, and assess the translational health science perspective of the current literature and its potential effect on public health. The Joanna Briggs Institute for evidence synthesis will guide this scoping review to completion. A nine-step development process, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, will be used to enhance the methodological and reporting quality of this scoping review. The Participant, Concept, Context framework will broaden this scoping review’s reach in developing a comprehensive search strategy. Thirty years will be explored to assess all relevant literature to ensure a thorough search. Two researchers will explore all the discovered literature and develop consensus on the selected literature included in this scoping review. The article will undergo review and data extraction for data analysis. The knowledge to action framework will guide the knowledge synthesis and creation of this scoping review. A narrative synthesis will systematically review and synthesize the collected literature to produce and explain a broad conclusion of the selected literature. Lastly, a consultation exercise in the form of qualitative interviews will be conducted to assess the thematic analysis results and validate the result of this scoping review. This scoping review will require Institutional Review Board approval for the expert consultation in the form of qualitative interviews. Consultants’ identifying information will remain confidential. The collected and analyzed data from this scoping review will identify gaps in the literature to create an evidence-informed protocol for the management of non-compressible torso hemorrhage of the abdomen in civilian and military austere/remote environments. The results of this scoping review will be distributed in peer-reviewed journals and educational, medical presentations. Scoping Review Protocol, Level IV.

Objective: The purpose of this scoping review is to evaluate the extent of library or librarian involvement in informatics education in the health domain. Methods: We searched eight databases from their inception to 2019 for reports of informatics educational activities for health professionals or health professions students that involved library staff or resources. Two reviewers independently screened all titles/abstracts (n=2,247) and resolved inclusion decisions by consensus. From the full text of the 36 papers that met the inclusion criteria, we extracted data on 41 educational activities. Results: The most frequent coded purposes of activities were “teaching clinical tools” (n=19, 46.3%) and “technology” (n=17; 41.5%). Medical students were the most frequent primary audience (34.1%), though 41.5% of activities had multiple audiences. Evaluation was reported for 24 activities (58.5%), only a few of which assessed short or post-activity impact on attitudes, knowledge, or skills. The most common long-term outcome was applying skills in other courses or clinical experiences. Thematic analysis yielded three areas of outcomes and issues for the library and organizational partners: expanded opportunities, technology and resource issues, and value demonstration. Conclusions: Limited published examples of health informatics educational activities provide models for library roles in informatics education. More librarians should report on their informatics educational activities and provide sufficient details on the interventions and their evaluation. This would strengthen the evidence base about the potential impact of libraries within informatics education.

Niemann-Pick type C disease (NPCD) is a neurodegenerative disease associated with increases in cellular cholesterol and glycolipids and most commonly caused by defective NPC1, a late endosomal protein. Using ratiometric probes we find that NPCD cells show increased endolysosomal pH. In addition U18666A, an inhibitor of NPC1, was found to increase endolysosomal pH, and the number, size and heterogeneity of endolysosomal vesicles. NPCD fibroblasts and cells treated with U18666A also show disrupted targeting of fluorescent lipid BODIPY-LacCer to high pH vesicles. Inhibiting non-lysosomal glucocerebrosidase (GBA2) reversed increases in endolysosomal pH and restored disrupted BODIPY-LacCer trafficking in NPCD fibroblasts. GBA2 KO cells also show decreased endolysosomal pH. NPCD fibroblasts also show increased expression of a key subunit of the lysosomal proton pump vATPase on GBA2 inhibition. The results are consistent with a model where both endolysosomal pH and Golgi targeting of BODIPY-LacCer are dependent on adequate levels of cytosolic-facing GlcCer, which are reduced in NPC disease.

Immune checkpoint inhibition induced a great step forward in the treatment of non-small cell lung cancer patients. In cancer immune microenvironment many checkpoints were studied and their involvement could represent a mechanism of resistance to cancer immunotherapy. For this reason, the inhibition of multiple immune checkpoints is under development. However, myeloid-derived suppressor cells (MDSC) and exhausted immune cells could limit the efficacy of cancer immunotherapy. We analyzed the variation of circulating immune suppressive-like cell subsets and exhausted immune cells in three non-small cell lung cancer patients treated with the combination of anti-CTLA-4 plus anti-PD-1 plus anti-LAG-3 at T0 (baseline), T1 (after 2 months) and T2 (after 4 months). We also describe the clinical and radiological course of the disease during this treatment in all three patients. We observed both clinical differences and changes in the composition of immune suppressive-like cell subsets and exhausted immune cells between the patients receiving the same schedule of treatment with immune checkpoint inhibitors. The study on a wider patient population and experimental model design could help to clarify the kinetics of these cell subpopulations with the perspective to find new targets for treatment or new biomarkers for resistance to cancer immunotherapy.

The gastrointestinal tract is an uncommon site of metastasis in melanoma. However, when the primary melanoma cannot be found, the diagnosis of gastric melanoma by endoscopic biopsy is problematic mainly because some tumors are amelanotic and do not contain melanin granules detectable by microscopy. A 56-year-old Caucasian man with melanoma was referred to us following an initial histopathological diagnosis via gastroscopy of poorly differentiated primary gastric carcinoma. A computerized tomography (CT) scan showed metastatic disease and on the basis of this information we started palliative chemotherapy. However, the atypical presentation of the disease with subcutaneous metastases prompted us to make a more in-depth evaluation. Immunohistochemical evaluation modified the diagnosis to melanoma. After only one cycle of chemotherapy, treatment was changed to dabrafenib + trametinib, which was better tolerated and initially induced a partial response. The patient is currently in good clinical condition 20 months after diagnosis. Our case report highlights the difficulty in diagnosing melanoma of the gastrointestinal tract and indicates the need for pathologists and clinicians to consider such a possibility when they are faced with a diagnosis of poorly differentiated gastric cancer and unusual sites of metastasis.

Considering the clinical significance for myocarditis and pericarditis after immunization with mRNA COVID-19 vaccines, the present pharmacovigilance study aimed to describe these events reported with mRNA COVID-19 vaccines in the Vaccine Adverse Events Reporting System (VAERS). From 1990 to July 2021, the mRNA vaccines were the most common suspected vaccines related to suspected cases of myocarditis and/or pericarditis (myocarditis: N = 1,165; 64.0%; pericarditis: N = 743; 55.1%), followed by smallpox vaccines (myocarditis: N = 222; 12.2%; pericarditis: N = 200; 14.8%). We assessed all suspected cases through the case definition and classification of the Brighton Collaboration Group, and only definitive, probable, and possible cases were included in the analysis. Our findings suggested that myocarditis and pericarditis mostly involve young male, especially after the second dose with a brief time to onset. Nevertheless, this risk is lower (0.38/100,000 vaccinated people; 95% CI 0.36–0.40) than the risk of developing myocarditis after SARS-CoV-2 infection (1000–4000 per 100,000 people) and the risk of developing “common” viral myocarditis (1–10 per 100,000 people/year). Comparing with the smallpox vaccine, for which is already well known the association with myocarditis and pericarditis, our analysis showed a lower probability of reporting myocarditis (ROR 0.12, 95% CI 0.10–0.14) and pericarditis (ROR 0.06, 95% CI 0.05–0.08) following immunization with mRNA COVID-19 vaccines.

Background: Although aripiprazole and risperidone are used widespread in pediatrics, there are still limited pieces of evidence on their actual safety profile. By using the EudraVigilance database, we carried out an analysis to perform a comprehensive overview of reported adverse events among children and adolescents treated with aripiprazole and risperidone.Methods: Descriptive analysis was performed of all individual case safety reports (ISCRs) submitted to EudraVigilance associated with aripiprazole and risperidone and related to the pediatric population from 2016 to 2018.Results: A total of 855 and 2,242 ISCRs for aripiprazole and risperidone, respectively, were recorded for a total of 11,042 suspected adverse drug reactions (2,993 for aripiprazole and 8,049 for risperidone). Most ISCRs were related to male patients (65.0 and 86.3% for aripiprazole and risperidone, respectively) and were serious (81.0 and 94.1% for aripiprazole and risperidone, respectively). Schizophrenia spectrum and other psychotic disorders, such as disruptive, impulse-control, and conduct disorders, and autism spectrum disorder were the top three clinical indications for aripiprazole (19.0, 16.1, and 11.6%, respectively). For risperidone, attention-deficit/hyperactivity disorder (25.4%), disruptive, impulse-control, and conduct disorders (17.1%), and bipolar and related disorders (14.2%) were more commonly reported as clinical indications. Data also showed a high proportion of use for clinical conditions not authorized in children. Psychiatric disorders were the main related adverse events for aripiprazole (20.2%), and among these, suicidal behavior was one of the most reported (14.9%). Reproductive system and breast disorders were the main related adverse events for risperidone (19.8%), and gynecomastia was the most reported event; metabolism and nutrition disorders, mainly reported as weight gain disorders, were more reported in children (3–11 years) than in adolescents (12–17 years).Conclusions: Our results demonstrate that spontaneously reported adverse events associated with aripiprazole and risperidone reflect what is already known in terms of safety profile, although with about 90% of them being serious. This analysis stresses the need for further studies and effective training and information activities to better define the actual benefit/risk ratio of these drugs in pediatric patients.

Academic burnout is a persistent disorder characterized by fatigue that affects academic performance and student motivation. The objective was to analyze academic burnout in Peruvian university students, comparing the results with the socio-academic characteristics of the students, such as age, sex, area and year of study. The study was descriptive, quantitative, non-experimental – ex-post facto. 1241 university students participated and were selected intentionally, and the Maslach Burnout Student Survey Inventory (MBISS) Peruvian validation was applied. High scores were found regarding emotional exhaustion and depersonalization, and low scores on personal accomplishment, determined the presence of academic burnout in the students. It is concluded that academic burnout is associated with gender (women), age (under 18 years old) and area of study (social sciences), being these students those who develop greater exhaustion, depersonalization and personal fulfillment. [ABSTRACT FROM AUTHOR]

In locally advanced pancreatic cancer (LAPC), the combination of chemotherapy and radiotherapy is a widely used treatment option. We performed a pooled analysis, including an exploratory analysis for prognostic and predictive factors, of two phase 2 trials including 73 patients with LAPC, treated with gemcitabine and oxaliplatin (GEMOX) and hypofractionated tomotherapy. With a median follow-up of 36 months (range 1–65), median progression-free (PFS) and overall survival (OS) were 10.2 (95% confidence interval [CI] 7.8–13.2) and 14.3 (95% CI 12.0–18.1) months, respectively. The overall resectability rate was 23.3% (95% CI 13.6–33.0), and the R0 resection rate was 13.7% (95% CI 5.8–21.6). In the multivariate analysis, ECOG performance status (PS) 0 and low levels of CA 19–9 were associated with improved OS and PFS. Concerning OS, log(CA19–9) resulted in a hazard ratio (HR) of 1.20 (95% CI 1.02–1.42), p = 0.027. For ECOG PS 0, HR was 1.00; for PS 1, HR was 2.69 (95% CI 1.46–4.96); for PS 2, HR was 4.18 (95% CI 0.90–19.46); p = 0.003. Low CA19–9 levels were also predictive for resection, with an odds ratio of 0.71 (95% CI 0.52–0.97), p = 0.034. In conclusion, GEMOX and hypofractionated radiotherapy is a treatment option in LAPC. Further studies are needed to identify differences in tumor biology, which may help to predict resectability and prognosis.

A Review of: Avery, J. M. (2018). The open access availability of articles from highly ranked religious studies journals: A study of ten journals. Theological Librarianship, 11(1), 12-17. Retrieved from https://theolib.atla.com/theolib/index Abstract Objective – To examine the current state of open access scholarship among the most highly rated religious studies journals. Design – Quantitative analysis. Setting – Research articles published in 2014, in the ten most highly rated religious studies journals. Subjects – 377 peer-reviewed articles. Methods – Using the SCImago Journal & Country Rank, the researcher identified the top ten most cited religious studies journals from mid-2015. Articles published in these journals during 2014 were evaluated. The researcher identified 377 research articles through online databases and journal websites. The researcher then used both Google and Google Scholar to search for these articles using titles and authors. If the article was not found, other search strategies were employed, such as the use of additional search terms, limits, and quotes, as well as other search engines. Main Results – Open access (OA) versions were found for 132 of the 377 articles (35%), and the percent of OA articles by journal ranged from 5% to 100%. The researcher found 70 OA articles in institutional repositories (53%), 70 in Academia.edu or ResearchGate.net (53%), 19 from organizational websites (14.4%), 13 on personal websites (9.8%), and 4 on other sites (3%). The researcher found 44 articles in more than one location (33.3%). Of the 132 OA articles found, 87 (65.9%) were found by both Google and Google Scholar, and 43 (32.6%) articles were found by either Google or Google Scholar, but not both. Conclusion – Overall, the research results reveal that finding OA content can be done via Google and Google Scholar. While articles in religious studies journals are not typically accessible through OA, authors who tend to publish in these journals who support OA may use institutional repositories or social networking sites to make their work available.

A Review of: McCaffrey, C. & Breen, M. (2016). Quiet in the library: An evidence-based approach to improving the student experience. portal: Libraries and the Academy, 16(4), 775-791. http://doi.org/10.1353/pla.2016.0052 Abstract Objective – To examine the interventions implemented by an academic library for noise management, and their impact on library users, over a seven-year period. Design – Retrospective data analysis. Setting – University library in Ireland. Subjects – LibQUAL data from 2007, 2009, 2012, and 2014. Methods – The researchers analyzed data from the 22 core LibQUAL questions and the three dimensions of library as place, information control, and effect of service. The study focused specifically on LibQUAL question LP2 in the library as place dimension: quiet space for individual work. Qualitative free text comments in the surveys related to noise or quiet issues were also analyzed. The adequacy mean was used to determine improvement in scores; this metric is calculated by subtracting the minimum mean score from the perceived mean score. Main Results – LibQUAL scores related to the quiet space question steadily improved over the seven-year period studied. The adequacy mean went from -1.2 to -0.13, representing a 1.07 degree of improvement. For all 22 questions, the adequacy mean increased from 0.02 to 0.38, showing overall improvement of 0.36. Researchers reviewed the data for all individual questions to measure the degree of change over the seven years; the quiet space question had the highest level of improvement of all of the questions. Considering user groups’ perceptions, there was a 2.03 degree of improvement for graduate students, while there was a 0.82 degree of improvement for undergraduates. The researchers wanted to know if the noise interventions had a specific impact on the quiet space question compared to a more general impact on the “library as place” dimension. None of the other “library as place” questions improved to the degree of the quiet space question. Of the “library as place” questions, question LP5, the group space question, was the only one where the adequacy mean dropped, with an adequacy mean difference of -0.23. External benchmarking conducted by the researchers put these results in an international context, using consortium data from ARL in North America and the Society of College, National and University Libraries (SCONUL) in the United Kingdom (U.K.). Conclusion – Based on the study findings, the long-term noise management program implemented from 2007 to 2014 at the University library had a measurable impact, and users’ perceptions of the quiet space in the library improved. Because perceptions improved most among graduate students, researchers concluded that future efforts for noise management strategies should consider focusing on this group.

A Review of: Kennedy, M.R., & Brancolini, K.R. (2018). Academic librarian research: An update to a survey of attitudes, involvement, and perceived capabilities. College and Research Libraries, 79(6), 822-851. https://doi.org/10.5860/crl.79.6.822 Abstract Objective – To examine academic librarians’ current attitudes and preparedness to conduct research in order to update the knowledge gained from the authors’ 2010 survey, and to determine if changes were needed in their Institute for Research Design in Librarianship continuing education curriculum. Design – Web based survey. Setting – Institutions that employ academic and/or research librarians. Subjects – 793 academic and research librarians. Methods – The researchers posted a call for participation in their 2015 Librarian Research survey on listservs where academic and research librarians are members. The survey expanded upon the authors’ 2010 survey by adding questions to more fully explore three areas: research self-efficacy; Master’s thesis and statistics courses, and; research mentoring and institutional support. 793 librarians responded to the survey, and 669 of these respondents completed it. All data from incomplete surveys was included in the analysis. Survey results were compared with the results from the 2010 survey as well as with the responses from a survey conducted in 2000 by Powel, Baker, and Mika, which addressed many of the same topics under investigation. Main Results – The authors analyzed the survey results based on four areas: the current research practice of responding academic librarians; a self-evaluation of their confidence in performing the steps in the research process; methods training courses in which they have participated, and; demographics and institutional data related to support of library research. Regarding current research practices, 84% of respondents said it is assumed that they will read research-based literature as part of their job as academic librarians; 80% are allowed time at work for this purpose; 6% did not know if it was assumed that they will read research-based literature as part of their job; and 9% were unsure if they were allowed to use work time to read the literature. 78% scan tables of contents for research-based journals, while 58% regularly read the full content of these articles (this is a significant drop from the 78% who reported that they regularly read full text articles in the 2010 survey). Time was the primary reason cited for not regularly reading research-based literature. 77% of respondents have conducted research since completing their Library Science degree (although 2% did not have a Master’s degree). Respondents rated their confidence on a scale of one to five, with one being “Not at all confident” and five being “Very confident.” Overall, there were 38 components related to the steps in the research process, which were grouped into 8 questions on the survey. For these questions, an average rating of 3.41 was calculated. From statistical analysis, the authors determined that there is a significant correlation between conducting research and librarian confidence in the process. The survey contained seven questions related to methods training. The authors were specifically interested in the correlation between librarians having conducted research since completing their degree and librarians’ belief that their degree adequately prepared them to do so. Statistical analysis revealed that the relationship between these factors was not significant; this result was consistent with the results from the authors’ 2010 survey as well as from the findings of Powell, Baker, and Mika. The authors were also curious as to whether librarians who had written a thesis as part of their Library Science degree were more likely to have conducted research since earning their degree. This relationship between these variables was not significant, however the relationship between writing a thesis for another graduate degree and conducting research was significant. Conclusion – The number of survey responses indicates that research is still a current, important issue for academic and research librarians. The authors will use the information from the surveys to revise their educational curriculum, specifically in the areas of current research practice, librarian confidence, and methods training.

Remdesivir was recommended for hospitalized patients with COVID-19. As already reported in the Summary of Product Characteristics, most of remdesivir’s safety concerns are hepatoxicity and nephrotoxicity related. However, some cases have raised concerns regarding the potential cardiac events associated with remdesivir; therefore, the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency requested to investigate all available data. Therefore, we analyzed all Individual Case Safety Reports (ICSRs) collected in the EudraVigilance database focusing on cardiac adverse events. From April to December 2020, 1375 ICSRs related to remdesivir were retrieved from EudraVigilance, of which 863 (62.8%) were related to male and (43.3%) adult patients. A total of 82.2% of all AEs (N = 2604) was serious and one third of the total ICSRs (N = 416, 30.3%) had a fatal outcome. The most frequently reported events referred to hepatic/hepatobiliary disorders (19.4%,), renal and urinary disorders (11.1%) and cardiac events (8.4%). Among 221 cardiac ICSRs, 69 reported fatal outcomes. Other drugs for cardiovascular disorders were reported as suspected/concomitant together with remdesivir in 166 ICSRs (75.1%), 62 of which were fatal. Moreover, the mean time to overall cardiac event was 3.3 days (±2.2). Finally, disproportionality analysis showed a two-fold increased risk of reporting a cardiac adverse event associated with remdesivir compared to both hydroxychloroquine and azithromycin. This study showed that remdesivir could be associated to risk of cardiac events, suggesting a potential safety signal which has not been completely evaluated yet. Further studies are needed to confirm these findings.

Il presente articolo descrive sinteticamente il contesto politico e sociale nel quale sono maturate le discussioni relative alle alternative alla detenzione in Francia. Successivamente, analizza le alternative previste attualmente evidenziandone la ratio giuridica e criminologica ed esprimendone una succinta valutazione. Infine, vengono riportate ulteriori informazioni circa le alternative alla detenzione previste per specifiche categorie di persone. Cet article décrit tout d’abord le contexte politique et social dans lequel il conviendrait d’échanger sur les alternatives à la détention en France. Il analyse ensuite les alternatives existantes en expliquant leur nature et leurs sources juridiques et criminologiques avant de donner une courte évaluation des solutions alternatives à la détention. L’article se termine par un supplément d’informations sur les alternatives à l’incarcération pour certaines catégories de personnes. This article first sketches the political and social context in which the discussions about alternatives to detention in France are to be situated. It then analyses the existing alternatives by explaining their legal and criminological rationale and sources, and goes on providing a short evaluation of the alternatives to detention. It concludes with more information about alternatives to detention for specific categories of persons.

A Review of: Jacoby, J., Ward, D., Avery, S., & Marcyk, E. (2016). The value of chat reference services: A pilot study. portal: Libraries and the Academy, 16(1), 109-129. https://doi.org/10.1353/pla.2016.0013 Objective – To investigate student, instructor, and librarian perspectives of chat reference service in the context of first-year undergraduate students conducting research for an introductory composition course. Design – Focus groups, individual interviews, and surveys. Setting – A large, public university in the United States of America. Subjects – 57 library reference providers, 36 instructors of an introductory composition course, and approximately 936 undergraduate students in certain sections of the introductory composition course who were assigned a specific research project. Methods – In spring of 2014, all participants were invited via email to respond to an anonymous chat transcript of a librarian interacting with a student working on his or her research project. Study participants could participate via a brief survey or by taking part in a focus group or individual interview. The invited instructors were asked to forward the invitation to the students in their sections, and reminder emails were sent two weeks after the initial email. Main Results – Nine instructors, 24 students, and 25 library reference providers participated in the study, representing a response rate of 25%, 3% (estimated), and 44%, respectively. The authors conducted a qualitative analysis of key themes that were derived from both the focus groups or individual interviews and the survey questions. The themes were: students as novice researchers, question negotiation, open and closed questions, instruction, speed and convenience, customer service, and referrals. The theme of “students as novice researchers” is based on student comments related to their frustrations of being inexperienced researchers, as well as librarian comments on strategies for helping these students. Opinions regarding the traditional reference interview, including specific techniques that made the interaction successful, were categorized as “question negotiation.” The “open and closed questions” theme focused on feedback on the types of questions used by librarians in the reference interview. Several components related to chat and instruction were encompassed within the “instruction” theme, including whether those participating in the study were conscious of librarians providing instructions via chat and whether it was deemed valuable; the impact of a library instruction session in which students participated; and identification of missed teachable moments during the chat. The “speed and convenience” theme represented thoughts regarding the balance of instruction and librarian support of news skills, with the student expectation of having their question answered quickly and efficiently. The “customer service” theme focused on the service quality of the reference transaction, while the “referrals” theme encompassed thoughts related to whether students were referred to subject specialists, writing specialists, instructors, or if there was a lack of a referral altogether. Conclusion – Based on the research results, the authors highlighted the importance of the interconnectedness of teaching that is done in the classroom, in library instruction sessions, and on the reference desk, as all three types of instruction should align. Furthermore, because students are open to instruction via the chat service when they are creating and revising their research question and delving into subject research, chat can be viewed as a key teaching and learning opportunity.

Tisagenlecleucel has revolutionized the pharmacological approach of relapsed or refractory B-cell acute lymphoblastic leukaemialeukaemia in paediatrics. The safety profile of tisagenlecleucel still needs to be better defined. The aim of this study was a post-marketing evaluation of the safety of tisagenlecleucel through the analysis of the Eudravigilance database with focus on the paediatric population. From 2017 to 2020, one third of Individual Case Safety Reports referring to tisagenlecleucel (117/364) have been collected in paediatrics, on average nine year-old boys. Overall, 92% of the638 adverse events were serious and caused or prolonged hospitalisation. A total of 55 adverse events presented a fatal outcome, mainly due to progression of malignant neoplasm (N = 10; 18.2%), recurrence of acute lymphocytic leukaemia (N = 6; 10.9%) or occurrence of acute lymphocytic leukaemia (N = 5; 9.1%). Cytokine release syndrome was commonly reported after tisagenlecleucel infusion (54/638), followed by pyrexia (45/638) and hypotension (27/638). Only 18/638 events referred to neurotoxicity, none of them resulted in death. More than one third of cases (41/117) were suggestive of therapeutic failure. This first post-marketing analysis confirms pre-approval evidence of the safety profile of tisagenlecleucel in paediatrics. Since only a few years of marketing is available, further followed-up studies need to be performed to investigate longer-term safety of tisagenlecleucel.

A Review of: Vinyard, M., Mullally, C., & Colvin, J.B. (2017). Why do students seek help in an age of DIY? Using a qualitative approach to look beyond statistics. Reference & User Services Quarterly, 56(4), 257-267. http://dx.doi.org/10.5860/rusq.56.4.257 Abstract Objective – To explore how undergraduate students look for information and the reasons these students seek assistance from a librarian. Design – Qualitative research. Setting – A university in Southern California. Subjects – 10 students were interviewed: 1 freshman, 1 sophomore, 5 juniors, and 3 seniors. Methods – Students who met with a librarian for longer than 20 minutes were invited to participate in the study, and interviews were conducted within six weeks of this interaction. Semi-structured interviews were scheduled for one hour blocks and were audio-recorded and transcribed afterward. Interview data was analyzed using applied thematic analysis. The researchers used NVivo to assist with the process of coding data. Main Results – Once all transcripts were coded, the researchers identified the following six themes related to how students look for information and the reasons they asked for assistance: how students research, personal perceptions of research skills, assumptions (students’ misperceptions about library services), motivation for asking for help, path to the librarian (how students contacted librarians and their reason for selecting a particular librarian), and experience working with a librarian. Conclusion – Overall, the research results demonstrate that students prefer to conduct research independently but will consult a librarian if they are not able to find what they need, if they find the research question especially challenging, or if they have spent an unreasonable amount of time conducting research. In-class library instruction, along with professor referrals are the most effective methods for encouraging students to seek out library assistance.

A Review of: Zhang, L. (2015). Use of library services by engineering faculty at Mississippi State University, a large land grant institution. Science & Technology Libraries, 34(3), 272-286. http://dx.doi.org/10.1080/0194262X.2015.1090941 Objective – To investigate the engineering faculty’s information-seeking behaviour, experiences, awareness, and use of the university library. Design – Web-based survey questionnaire. Setting – The main campus of a state university in the United States of America. Subjects – 119 faculty members within 8 engineering departments. Methods – An email invitation to participate in a 16-item electronic survey questionnaire, with questions related to library use, was sent in the spring of 2015 to 119 engineering faculty members. Faculty were given 24 days to complete the survey, and a reminder email was sent 10 days after the original survey invitation. Main Results – Thirty-eight faculty members responded to the survey, representing a response rate of 32%. Overall, faculty had a high level of use and awareness of both online and physical library resources and services, although their awareness of certain scholarly communication services, such as data archiving and copyright advisory, was significantly lower. Faculty tend to turn to Google and Google Scholar when searching for information rather than turning to library databases. Faculty do not use social media to keep up with library news and updates. The library website, as well as liaison librarians, were cited as the primary sources for this type of information. Conclusions – The researcher concludes that librarians need to do a better job of marketing library resources, such as discipline-specific databases, as well as other library search tools. Because faculty use web search engines as a significant source of information, the author proposes further research on this behaviour, and suggests more action to educate faculty on different search tools, their limitations, and effective use. As faculty indicated a general lack of interest in integrating information literacy into their classes, the researcher notes that librarians need to find ways to persuade faculty that this type of integrated instruction is beneficial for students’ learning and research needs. Faculty were aware of the library liaison program, so this baseline relationship between faculty and librarian can serve as an opportunity to build upon current liaison services and responsibilities.

Objective – To investigate the citation performance of open access (OA) and toll access (TA) papers published in author-pays open access journals. Design – Longitudinal citation analysis. Setting – Publications in Springer and Elsevier’s author-pays open access journals. Subjects – 633 journals published using the author-pays model. This model encompasses both journals where the article processing charge (APC) is required and journals in which authors can request open access and voluntarily pay APCs for accepted manuscripts. Methods – The authors identified APC funded journals (journals funded by mandatory author processing charges as well as those where authors voluntarily paid a fee in order to have their articles openly accessible) from both Springer and Elsevier, and analyzed papers published in these journals from 2007 to 2011. The authors excluded journals that adopted the APC model later than 2007. To identify Springer titles, the authors created a search strategy to identify open access articles in SpringerLink. A total of 576 journals were identified and double checked in the Sherpa-Romeo database (a database of copyright and open access self-archiving policies of academic journals) to verify their open access policies. The authors then downloaded the journal content using SpringerLink, and using Springer Author-Mapper, separated out the open access articles from the toll access articles. In order to identify the Elsevier APC funded journals, the authors referred to “Open Access Journal Directory: A-Z,” which contained 35 OA journals (p. 584). Once the authors consulted “Sponsored articles” issued by Elsevier and verified titles in Sherpa-Romeo, they identified 57 journals that fit the “author-pays” model. The bibliographic information was downloaded and OA articles were separated from TA articles. The authors confirmed that all journals were indeed OA publications by downloading the full-text from off-campus locations; they also verified that the journals were using the APC model by visiting each journal’s website. Because of the large number of subject areas of the identified journals, the researchers decided to classify the journals into four broader categories: Health Sciences, Life Sciences, Natural Sciences, and Social Sciences and Humanities. To calculate the impact of OA papers, citation per paper (CPP) was calculated for each subject area. Impact values were calculated on an annual basis as well. The researchers calculated the citation advantage of OA articles as the “difference between the open access and toll access impacts in terms of a percentage of the latter” (p. 585). Main Results – The authors categorized their findings according to three themes: the growth of APC funded OA papers, the number of OA papers by discipline, and citation advantage of OA vs. TA in general and by subject area. Together, Springer and Elsevier published 18,654 OA papers in the APC journals; this number represents 4.7% of the 396,760 papers published between 2007 and 2011. While the number of OA and TA papers has been growing annually, the number of OA papers has been growing more rapidly compared to the TA papers. In terms of subject areas, Life Sciences had the largest number of OA and TA papers (184,315), followed by Health Sciences (149,341), Natural Sciences (121,274), and Social Sciences and Humanities (42,824). Natural Sciences had the most OA papers (5.7%) in terms of the number of papers in this subject area being OA papers, followed by Social Sciences and Humanities (5.2%), Health Sciences (4.6%) and Life Sciences (3.6%). Overall, the researchers found that the impact values of OA papers were larger than those of the TA papers for each year examined. In considering subject areas, in all disciplines except Life Sciences, the most highly cited paper in the field is an OA paper. In Life Sciences, the most highly cited TA paper had 2,215 citations, compared to the OA paper, which had 1,501 citations. Even though the TA paper had more citations, overall, the OA papers had a higher impact (citation advantage). In Health Sciences, the most highly cited OA paper received 1,501 citations, which is 1.2 times the most highly cited TA paper, with 1,252 citations. The citation advantage for the OA group is 33.29% higher than the TA group. In Natural Sciences, the number of citations from the highest cited OA paper is 1,736, or 2.52 times higher than the most highly cited TA paper. The OA papers in this discipline had a 35.95% citation advantage. In Social Sciences and Humanities, the most highly cited OA paper had 681 citations, compared to the TA paper, with 432 citations. For this subject area, the citation impact of the OA paper is 3.14% higher than the TA paper. Conclusions – In sum, the number of article processing charge funded open access papers has grown tremendously in recent years. Furthermore, open access papers have a citation advantage over toll access papers, both annually and across disciplines.

A Review of: Serrano, S. C. & Avilés, R. A. (2016). Academic librarians and project management: An international study. portal: Libraries and the Academy, 16(3), 465-475. http://dx.doi.org/10.1353/pla.2016.0038 Abstract Objective – To investigate academic librarians’ project management education and training, project management skills and experiences, and perceptions of project management courses within the library and information science (LIS) curriculum. Design – Online questionnaire. Setting – 70 universities worldwide with LIS programs and at least one project management course. Subjects – 4,979 academic librarians were invited to complete the online questionnaire; 649 librarians participated. Methods – From the identified institutions, the authors invited academic librarians to participate in a 17-question survey via e-mail. The survey was available in both English and Spanish and was validated via a pilot trial. A total of 649 individuals participated, for a response rate of 13%. The survey included questions related to geographic region and institution affiliation, university education and librarian training associated with project management, project participation and use of project management software or methods, and project management courses in LIS curriculums, and a final open-ended comment section. Main Results – Of the 649 librarians who participated in the survey, 372 were from North and South America (58%). The next highest number of responses came from Europe (38%), followed by low response rates from Africa, Asia, and Oceania. Respondents reported working in a variety of library departments and identified themselves as being one of a director or manager, assistant librarian, or library page. Of the 436 respondents who reported having a university degree, 215 attended an LIS Master’s level program, and 12 studied at the doctoral level. The majority of respondents indicated they have had training in project management, participating in formal coursework, conferences, webinars, or other self-directed learning methods. Of the 459 academic library staff responding to the question, 40% considered project management courses of “high importance in the university curriculum” and 26 % responded that project management courses were “extremely important in their field of expertise and working environment” (p. 472). The consensus among participants was that project management courses should be included in both undergraduate and graduate level LIS curricula. Conclusion – The high participation of librarians in project management, compared to the limited formal education received, suggests that courses in project management, including software and methodology, are needed in LIS university curricula. Additionally, less than 40% of academic librarian survey respondents were trained in LIS; other professions are working as librarians and therefore may have insufficient knowledge and skills to manage the projects they direct. The research results confirm the relationship between strategic planning and project management skills. The authors conclude that universities should revise their LIS curricula to include and require additional project management courses.

Objectives: To investigate the occurrence of adverse events (AEs) in naïve patients receiving biotech drugs.Design: A prospective observational study.Setting: Onco-hematology, Hepato-gastroenterology, Rheumatology, Dermatology, and Neurology Units in Campania Region (Italy).Participants: 775 patients (53.81% female) with mean age 56.0 (SD 15.2). The mean follow-up/patient was 3.48 (95% confidence interval 3.13–3.84).Main outcome measures: We collected all AEs associated to biotech drugs, including serious infections and malignancies. Serious AEs were defined according to the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use, clinical safety data management: definitions and standards for expedited reporting E2A guideline.Results: The majority of the study population was enrolled in Onco-hematology and Rheumatology Units and the most common diagnosis were hematological malignancies, followed by rheumatoid arthritis, colorectal cancer, breast cancer, and psoriatic arthritis. The most commonly prescribed biotech drugs were rituximab, bevacizumab, infliximab, trastuzumab, adalimumab, and cetuximab. Out of 775 patients, 320 experienced at least one AE. Most of patients experienced AEs to cetuximab therapy, rituximab and trastuzumab. Comparing female and male population, our findings highlighted a statistically significant difference in terms of AEs for adalimumab (35.90% vs. 7.41%, p < 0.001) and etanercept (27.59% vs. 10.00%, p = 0.023). Considering all biotech drugs, we observed a peak for all AEs occurrence at follow-up 91–180 days category. Bevacizumab, brentuximab, rituximab, trastuzumab and cetuximab were more commonly associated to serious adverse events; most of these were possibly related to biotech drugs, according to causality assessment. Three cases of serious infections occurred.Conclusions: The results of our study demonstrated that the majority of AEs were not serious and expected. Few cases of serious infections occurred, while no case of malignancy did. Overall, the safety profile of biotech drugs used in our population was similar to those observed in pivotal trials. Notwithstanding the positive results of our study, some safety concerns still remain unresolved. In order to collect more effectiveness and safety data on biotech drugs, the collection and analysis of real world data should be endorsed as well as the management of post-authorization studies.

In the present article, we provide a review of current knowledge regarding the role played by physical activity (PA) in preventing age-related cognitive decline and reducing risk of dementia. The cognitive benefits of PA are highlighted by epidemiological, neuroimaging and behavioral studies. Epidemiological studies identified PA as an influential lifestyle factor in predicting rates of cognitive decline. Individuals physically active from midlife show a reduced later risk of cognitive impairment. Neuroimaging studies documented attenuation of age-related brain atrophy, and also increase of gray matter and white matter of brain areas, including frontal and temporal lobes. These structural changes are often associated with improved cognitive performance. Importantly, the brain regions that benefit from PA are also those regions that are often reported to be severely affected in dementia. Animal model studies provided significant information about biomechanisms that support exercise-enhanced neuroplasticity, such as angiogenesis and upregulation of growth factors. Among the growth factors, the brain-derived neurotrophic factor seems to play a significant role. Another putative factor that might contribute to beneficial effects of exercise is the neuropeptide orexin-A. The beneficial effects of PA may represent an important resource to hinder the cognitive decline associated with aging.

Background Allergic sensitization in children and allergic diseases arising therefrom are increasing for decades. Several interventions, functional foods, pro- and prebiotics, vitamins are proposed for the prevention of allergies and they can’t be uncritically adopted.Objective This Consensus document was developed by the Italian Society of Preventive and Social Paediatrics and the Italian Society of Paediatric Allergy and Immunology.The aim is to provide updated recommendations regarding allergy prevention in children.Methods The document has been issued by a multidisciplinary expert panel and it is intended to be mainly directed to primary care paediatricians.It includes 19 questions which have been preliminarily considered relevant by the panel. Relatively to each question, a literature search has been performed, according to the Italian National Guideline Program. Methodology, and a brief summary of the available literature data, has been provided.Many topics have been analyzed including the role of mother’s diet restriction, use of breast/formula/hydrolyzed milk; timing of introduction of complementary foods, role (if any) of probiotics, prebiotics, vitamins, exposure to dust mites, animals and to tobacco smoke.Results Some preventive interventions have a strong level of recommendation. (e.g., the dehumidifier to reduce exposure to mite allergens). With regard to other types of intervention, such as the use of partially and extensively hydrolyzed formulas, the document underlines the lack of evidence of effectiveness.No preventive effect of dietary supplementation with polyunsaturated fatty acids, vitamins or minerals has been demonstrated.There is no preventive effect of probiotics on asthma, rhinitis and allergic diseases. It has demonstrated a modest effect, but steady, in the prevention of atopic dermatitis.Conclusions The recommendations of the Consensus are based on a careful analysis of the evidence available.The lack of evidence of efficacy does not necessarily imply that some interventions may not be effective, but currently they can’t be recommended. Keywords: Allergy, Children, Prevention, Consensus

A Review of: Perkins, G.H. & Slowik, A.J.W. (2013). The value of research in academic libraries. College & Research Libraries, 74(2), 143-158. Retrieved from http://crl.acrl.org/content/74/2/143.full.pdf+html Abstract Objective – To explore academic library administrators’ perceived value of their librarians’ research, specifically the importance to the profession and the library community. Design – Qualitative, exploratory study using a survey questionnaire. Setting – Academic libraries in the United States of America. Subjects – 23 library administrators. Methods – During the summer of 2010, one of the authors conducted 20-30 minute telephone interviews with 23 academic library administrators. Interviews were recorded and transcribed for coding. Interview questions 1-3 and 8-19 were content-analyzed; the authors described common themes for each of these questions. Items 4-7 had Likert scale response formats, and a mean and standard deviation were computed for each of these items. Main Results – The benefits of librarians’ research included fulfilling tenure-track requirements, enriching relationships with teaching faculty, library faculty recognition, improved services and programs, collaboration with others, research result application to daily issues, development as librarians, and improved knowledge of the research field. The perceived current changes and future issues for university libraries included increased digitization of collections, scholarly communication, and expanded instructional engagement of faculty and students, as well as future economic downturn and budget cuts. Administrators noted several methods that influenced their thinking: professional meetings, reading professional journals, informal discussions with colleagues, and social media such as Facebook and Twitter. Academic library administrators used a variety of methods to support their librarians’ research. These included tenure-track requirements, research incentives, travel funds, grants, sabbaticals, release time, and shared communication about research. Additionally, there was a substantial perceived interrelationship between how librarians’ research benefited the librarian, the library, the university, and the profession. Recognition and new programs and services were thought to benefit all four areas, and monetary rewards were considered benefits for the first three areas. Conclusion – Based on the sample of 23 academic library administrators, the authors conclude that librarians’ research is perceived as valuable to both the academic and library communities.

Il Novecento non è stato solo un secolo di cambiamenti radicali sotto il profilo politico, economico e sociale. Le periodizzazioni più importanti sul piano storiografico si misurano con esso attraverso l’analisi di crisi di sistemi politici e di relazioni internazionali, crisi di modelli economici, rotture intervenute sul piano degli equilibri sociali, movimenti di globalizzazione che investono tutto il globo. Ma, ad un esame più profondo, il Novecento è soprattutto il secolo di rottura e declino delle categorie fondative dell’architettura statuale e sociale moderna, ed è però l’epoca di affermazione definitiva della Tecnica nella sua forma sistemica. Questo lavoro analizza i caratteri e gli orizzonti di questo inedito soggetto e i suoi riflessi sulle categorie tradizionali regolative dell’agire umano.

Nel Novecento l’esclusione si applica in maniera metodica e regolamentata all’interno dei confini statuali come procedura legata alla guerra. Essa diventa strumento di esercizio del momento bellico. L’”Altro” sarà, allora, il cittadino straniero di un paese nemico; il dissidente interno; l’ebreo perseguitato per motivi razziali; oppure tutte queste figure insieme, rappresentate nella categoria di nemico oggettivo. Questo studio analizza i momenti e le forme dell’internamento civile organizzato dal ministero dell’Interno in Abruzzo all’indomani del 10 giugno 1940, nei suoi caratteri di affinità e di specificità rispetto alla più generale esperienza nazionale.