Prevalence of and secular trends in diagnosed diabetes in Italy: 1980-2013.

BACKGROUND AND AIMS: The aim of this research was to examine the prevalence of diabetes in Italy over a 34-year period. METHODS AND RESULTS: Self-reported diabetes was assessed in eight health interview surveys of representative samples of Italian population aged 20 years and over. Crude and standardised prevalence were calculated by age, sex, educational level and area of residence. Logistic models were fitted to calculate the contribution of age and BMI to the trend in prevalence. In 2013 nearly 3.4 million Italians had a diagnosis of diabetes, more than twice as many as in 1980. The crude prevalence of diabetes in men rose from 3.3% in 1980 to 7.1% in 2013 (+115%), and from 4.7% to 6.8% in women (+45%). The prevalence was almost stable during the eighties, and started to rise from the beginning of the nineties. One third of the increase in men and two thirds in women is due to the ageing of the population, since the age-standardised prevalence increased by 79% in men and 14% in women. The prevalence of overweight and obesity increased less steeply than diabetes, and their contribution to the trend in diabetes is less relevant than age. Prevalence rose more in the elderly, in low-educated men, and in high-educated women. CONCLUSION: Given that the ageing population plays a considerable role in explaining the trend, and that the number of people in the oldest age groups will continue to grow, the rise in the number of individuals with diabetes will represent a severe challenge for the national health system.

Solvent-tunable morphology and emission of pyrene-dipeptide organogels.

Two pyrene based organogelators in which the pyrene moiety has been linked to the diphenylalanine dipeptide have been synthesized. We show how the solvent can tune both the morphology and the optical properties of the organogels: spherical aggregates with quenched emission were obtained in acetonitrile, whereas an entangled fibrillar network with enhanced emission was formed in o-dichlorobenzene. Fourier transform infrared spectroscopy, circular dichroism and nuclear magnetic resonance spectroscopy experiments suggest that both π-π stacking and hydrogen bonding contribute to the formation of the supramolecular networks. Ultraviolet-visible and steady state emission studies demonstrated the formation of I-aggregates in acetonitrile. In contrast, in o-dichlorobenzene, the formation of J-type aggregates leads to assemblies with enhanced emission. These results give some insight into the important role of the gelling solvent in the morphology of the supramolecular gels and may help in the design of new soft-materials.

Recursive neural networks for processing graphs with labelled edges: theory and applications.

In this paper, we introduce a new recursive neural network model able to process directed acyclic graphs with labelled edges. The model uses a state transition function which considers the edge labels and is independent both from the number and the order of the children of each node. The computational capabilities of the new recursive architecture are assessed. Moreover, in order to test the proposed architecture on a practical challenging application, the problem of object detection in images is also addressed. In fact, the localization of target objects is a preliminary step in any recognition system. The proposed technique is general and can be applied in different detection systems, since it does not exploit any a priori knowledge on the particular problem. Some experiments on face detection, carried out on scenes acquired by an indoor camera, are reported, showing very promising results.

A bioactive fullerene peptide.

The highly hydrophobic C60 (buckminsterfullerene) was water solubilized by covalently linking the synthon 1,2-dihydro-1,2-methanofullerene [60]-61-carboxylic acid to the alpha-amino group of the hydrophilic 4-8 sequence of peptide T, known to display potent human monocyte chemotaxis. The resulting compound, characterized by a variety of analytical techniques, including a UV spectrum in aqueous solution, exhibits remarkable chemotactic potency, comparable to that of the parent pentapeptide. Furthermore, this fullerene-peptide conjugate inhibits, albeit weakly, HIV-1 protease.

Epidemiological use of drug prescriptions as markers of disease frequency: an Italian experience.

All Italian citizens are covered by the National Health Service (NHS) and medical records of individual drug prescriptions are routinely collected and processed. A procedure entitled EPIFAR has been developed which, on the basis of a computer routine, makes it possible to trace back the prescription history of each individual included in the NHS. The validity of information gathered through the EPIFAR procedure to provide estimates of tuberculosis (TB) prevalence has been evaluated. A comparison with routine surveillance data has been made. The EPIFAR procedure identified a total figure of TB patients seven times higher than that from official notifications. A sample survey was conducted among the prescribing physicians in order to quantify the proportion of TB cases among subjects receiving prescriptions of anti-TB drugs. According to general practitioner recall 66.4% of the patients were treated because of TB diagnosis, TB prophylaxis and TB relapse.

Gangliosides and Guillain-Barré syndrome.

Cases of Guillain-Barré syndrome (GBS) associated with parenteral use of gangliosides have been reported in several European countries. To evaluate the hypothesis of association between ganglioside exposure and occurrence of GBS, a case-control study was conducted. GBS cases discharged during 1989 from public and private hospitals in three Italian provinces were identified: 42 GBS cases and 420 controls matched on age and gender were enrolled. Data of onset of symptoms of GBS was taken from clinical records. Exposure status of subjects was ascertained through the regional computerized drug prescription monitoring system. The odds ratio of association between ganglioside use, in the 30 days prior to onset of symptoms, and GBS was 9.1 (95% confidence interval 2.8-29.4). Although there are formidable difficulties in distinguishing prodromal therapy of GBS from drug causation, the association with ganglioside therapy is strong and supportive of the hypothesis of a role of ganglioside preparations in the occurrence of GBS.

Malignant melanoma in Rome, Italy, 1970-9.

An epidemiological study was conducted in the city of Rome and the incidence of malignant melanoma was determined retrospectively for the years 1970-9. All patients had legal residence in Rome and a histological diagnosis of melanoma during that period; only cases of malignant melanoma of the skin (ICD 172, 8th revision) were considered. A total of 17 public and 82 private hospitals were involved in the study with 11 081 and 6127 hospital beds respectively. All the hospitals in the study had one of the following therapeutic and diagnostic facilities: internal medicine, dermatology, oncology, radiology, surgery, plastic surgery, histopathology. Analyses of incidence are based on 500 cases, 237 males and 263 females, collected in the period 1970-9. The data indicate a positive time trend in incidence; the average annual increase is 0.27 cases/year per 100 000. The data show that in a Mediterranean and Latin country such as Italy the incidence of melanoma presents the same ascending trend as that of other Caucasian countries, whether European or not, the slope of the curves is similar for both sexes. The distribution of the primary site for both sexes is closely parallel to that described for all Caucasian populations, the lower limbs being more affected in females and the trunk in males.

Optimal convergence of on-line backpropagation.

Many researchers are quite skeptical about the actual behavior of neural network learning algorithms like backpropagation. One of the major problems is with the lack of clear theoretical results on optimal convergence, particularly for pattern mode algorithms. In this paper, we prove the companion of Rosenblatt's PC (perceptron convergence) theorem for feedforward networks (1960), stating that pattern mode backpropagation converges to an optimal solution for linearly separable patterns.

On the problem of local minima in recurrent neural networks.

Many researchers have recently focused their efforts on devising efficient algorithms, mainly based on optimization schemes, for learning the weights of recurrent neural networks. As in the case of feedforward networks, however, these learning algorithms may get stuck in local minima during gradient descent, thus discovering sub-optimal solutions. This paper analyses the problem of optimal learning in recurrent networks by proposing conditions that guarantee local minima free error surfaces. An example is given that also shows the constructive role of the proposed theory in designing networks suitable for solving a given task. Moreover, a formal relationship between recurrent and static feedforward networks is established such that the examples of local minima for feedforward networks already known in the literature can be associated with analogous ones in recurrent networks.

Inductive inference from noisy examples using the hybrid finite state filter.

Recurrent neural networks processing symbolic strings can be regarded as adaptive neural parsers. Given a set of positive and negative examples, picked up from a given language, adaptive neural parsers can effectively be trained to infer the language grammar. In this paper we use adaptive neural parsers to face the problem of inferring grammars from examples that are corrupted by a kind of noise that simply changes their membership.We propose a training algorithm, referred to as hybrid finite state filter (HFF), which is based on a parsimony principle that penalizes the development of complex rules.We report very promising experimental results showing that the proposed inductive inference scheme is indeed capable of capturing rules, while removing noise.

[Relations between coronary risk factors and mortality for cancer in the Italian areas of Seven Countries Study (author's transl)]. / Relazioni tra fattori di rischio coronarico e mortalità per tumore nelle aree italiane del Seven Countries Study.

PIP: An analysis of cancer mortality over a 10-year period in Italy is presented. Data are from the Italian part of the Seven Countries Study, an international investigation into the epidemiology of coronary heart disease. The analysis confirms that coronary risk factors provide a useful guide to the prediction of cancer mortality, particularly in association with factors related to age, smoking habits, body weight, and diabetes. (summary in ENG)^ieng

Drug utilization studies within the VIDEOFAR project.

The epidemiological use of drug prescription data is getting increasing attention in Italy. All Italian citizens are included in the National Health Service (NHS) which reimburses almost every drug prescription. The potential information content of such systems have to be evaluated within a technological context which will allow, for medium term, drug prescription data collection for all of the individuals served by the NHS. The VIDEOFAR project did explore the possible use of drug prescription data for descriptive epidemiological studies, in the evaluation of General Practitioners activity and as a tool for Post-Marketing Drug Surveillance. Some examples are presented in this paper using data derived from Latium Region.

[Patterns of use of hormone replacement therapy in 2 Italian populations]. / Profilo d'uso della terapia ormonale sostitutiva in due popolazioni italiane.

We analysed the pattern of hormone replacement therapy (HRT) use, over the period 1990-92, in a random sample of 76,537 women (45-74 years old) resident in the province of Rome, and in 1994 among all women (45-74 years old) resident in the Umbria region; data were collected through the regional drug prescription monitoring systems. During the three-year period an estimated 3.8% of women were prescribed HRT, among these 42% received estrogen with concomitant progestin therapy. The prevalence of use increased from 1.5% in 1990 to 2.2% in 1992 mainly because of an increased use of skin patches. In the Umbria region, out of the 166,112 women, 2.1% received at least one estrogen prescription. The prevalence of use increased in younger age classes but is almost unchanged over the sixties.

Use of amoxicillin and amoxicillin-clavulanic acid and hospitalization for acute liver injury.

Increase of acute liver injury in patients taking amoxicillin-clavulanic acid (co-amoxiclav) as compared to those taking amoxicillin has been suggested. To further investigate the potential hepatotoxicity of the two drugs a historical cohort study was conducted in the Italian region of Friuli-Venezia Giulia. One hundred and eighteen potential cases of acute liver injury were identified through the regional hospital information system and medical records were reviewed for all of them. Overall, 12 cases of acute liver injury were identified: 3 cases occurred in the amoxicillin exposure category, 2 among co-amoxiclav group, and 7 in the non-use category. The adjusted estimate of the rate ratio was 5.7 (CI 95% 1.5-22.1) among users of amoxicillin alone and 6.2 (CI 95% 1.3-29.7) among users of co-amoxiclav.

Synthesis of luminescent 3D microstructures formed by carbon quantum dots and their self-assembly properties.

We report in this communication the synthesis of star-shaped carbon quantum dots-(poly-γ-benzyl-L-glutamate) conjugates that self-assemble into microstructures and retain the characteristic emission properties of the native dots. Dots were used either as an initiator to give a daisy-like peptide-polymer structure or as capping agents towards more elaborated hybrid nanostructures.