Economic microbiology: exploring microbes as agents in economic systems.

Microbial communities exhibit striking parallels with economic markets, resembling intricate ecosystems where microorganisms engage in resource exchange akin to human market transactions. This dynamic network of resource swapping mirrors economic trade in human markets, with microbes specializing in metabolic functions much like businesses specializing in goods and services. Cooperation and competition are central dynamics in microbial communities, with alliances forming for mutual benefit and species vying for dominance, similar to businesses seeking market share. The human microbiome, comprising trillions of microorganisms within and on our bodies, is not only a marker of socioeconomic status but also a critical factor contributing to persistent health inequalities. Social and economic factors shape the composition of the gut microbiota, impacting healthcare access and quality of life. Moreover, these microbes exert indirect influence over human decisions by affecting neurotransmitter production, influencing mood, behavior, and choices related to diet and emotions. Human activities significantly impact microbial communities, from dietary choices and antibiotic use to environmental changes, disrupting these ecosystems. Beyond their natural roles, humans harness microbial communities for various applications, manipulating their interactions and resource exchanges to achieve specific goals in fields like medicine, agriculture, and environmental science. In conclusion, the concept of microbial communities as biological markets offers valuable insights into their intricate functioning and adaptability. It underscores the profound interplay between microbial ecosystems and human health and behavior, with far-reaching implications for multiple disciplines. To paraphrase Alfred Marshall, "the Mecca of the economist lies in economic microbiology."

Probing the genomic landscape of human sexuality: a critical systematic review of the literature.

Whether human sexuality is the result of nature or nurture (or their complex interplay) represents a hot, often ideologically driven, and highly polarized debate with political and social ramifications, and with varying, conflicting findings reported in the literature. A number of heritability and behavioral genetics studies, including pedigree-based investigations, have hypothesized inheritance patterns of human sexual behaviors. On the other hand, in most twin, adoption, and nuclear family studies, it was not possible to disentangle between underlying genetic and shared environmental sources. Furthermore, these studies were not able to estimate the precise extent of genetic loading and to shed light both on the number and nature of the putative inherited factors, which remained largely unknown. Molecular genetic studies offer an unprecedented opportunity to overcome these drawbacks, by dissecting the molecular basis of human sexuality and allowing a better understanding of its biological roots if any. However, there exists no systematic review of the molecular genetics of human sexuality. Therefore, we undertook this critical systematic review and appraisal of the literature, with the ambitious aims of filling in these gaps of knowledge, especially from the methodological standpoint, and providing guidance to future studies. Sixteen studies were finally retained and overviewed in the present systematic review study. Seven studies were linkage studies, four studies utilized the candidate gene approach, and five studies were GWAS investigations. Limitations of these studies and implications for further research are discussed.

Artificial neural networks can be effectively used to model changes of intracranial pressure (ICP) during spinal surgery using different noninvasive ICP surrogate estimators.

BACKGROUND: Artificial intelligence (AI) techniques play a major role in anesthesiology, even though their importance is often overlooked. In the extant literature, AI approaches, such as artificial neural networks (ANNs), have been underutilized, being used mainly to model patient's consciousness state, to predict the precise number of anesthetic gases, the level of analgesia, or the need of anesthesiological blocks, among others. In the field of neurosurgery, ANNs have been effectively applied to the diagnosis and prognosis of cerebral tumors, seizures, low back pain, and also to the monitoring of intracranial pressure (ICP). METHODS: A multilayer perceptron (MLP), which is a feedforward ANN, with hyperbolic tangent as activation function in the input/hidden layers, softmax as activation function in the output layer, and cross-entropy as error function, was used to model the impact of prone versus supine position and the use of positive end expiratory pressure (PEEP) on ICP in a sample of 30 patients undergoing spinal surgery. Different noninvasive surrogate estimations of ICP have been used and compared: namely, mean optic nerve sheath diameter (ONSD), noninvasive estimated cerebral perfusion pressure (NCPP), Pulsatility Index (PI), ICP derived from PI (ICP-PI), and flow velocity diastolic formula (FVDICP). RESULTS: ONSD proved to be a more robust surrogate estimation of ICP, with a predictive power of 75%, whilst the power of NCPP, ICP-PI, PI, and FVDICP were 60.5%, 54.8%, 53.1%, and 47.7%, respectively. CONCLUSIONS: Our MLP analysis confirmed our findings previously obtained with regression, correlation, multivariate receiving operator curve (multi-ROC) analyses. ANNs can be successfully used to predict the effects of prone versus supine position and PEEP on ICP in patients undergoing spinal surgery using different noninvasive surrogate estimators of ICP.

Playing with the cultural pilgrimage to stimulate tourism: the xFORMAL project on cultural heritage and informal learning.

The focus on culture as an engine of sustainable development has favoured its gradual acquisition by institutions engaged in the protection and promotion of heritage as an enabling and systemic factor capable of connecting innovation, continue education, research, and citizen engagement in a single chain. Knowledge of the landscape that combines works of nature and humankind and its bio-cultural diversity makes it possible to identify innovative informal education and new tourist itineraries where the real experience is presented as a cultural pilgrimage. The European project of the Marie Sklodowska-Curie Programme RISE 'Informal and non-Formal E-Learning for Cultural Heritage - xFORMAL', currently halfway through its lifecycle, was born to create an informal way of accessing the cultural heritage of one's territory, revealing its past, history, and the civilisations that preceded us. After two years of closure due to the pandemic, this project reintroduced an authentic experience through gamification, a contact with landscapes, museums, and archaeological sites with physical, social, and cultural dimensions of their environments across space and over time. Building upon this foundation, the article delves into the intricate design and architectural principles that underpin the creation of the xFORMAL game, showcasing it as a paradigm of informal learning. This exploration includes a detailed analysis of the game's innovative design elements, educational strategies, and its role in facilitating an engaging and immersive learning experience outside traditional educational settings.

The 'Informal and non-Formal E-Learning for Cultural Heritage - xFORMAL' project aims to create a context where science and technology meet citizens of all ages in an informal intergenerational educational environment based on the interaction of a real-life experience of a cultural pilgrimage and virtual game dedicated to the common European cultural heritage. The main components of the project are the history of ancient Europe (partly taught in formal education), landscape (typically, a basis for non-formal learning), the heutagogical approach, gamification (widely recognised as a tool for informal learning) and the sharing of knowledge and experience between researchers from the social sciences and humanities and information and communication technologies in a stimulating cross-sectoral context. xFORMAL sets a new standard for interaction with cultural heritage, focusing on community involvement and sustainable tourism practises. This innovative project not only renews the approach to cultural tourism by making it more interactive and educational, but also paves the way for future initiatives that aim to combine cultural exploration, learning and social engagement into a harmonious and enriching experience.

The teaching of the History of Medicine in Italy: a path in progress.

BACKGROUND: The increasing attention to the potential application of technology in medicine represents a dangerous warning in the direction of a reductionist approach. The academic system should therefore be strongly engaged to ensure even in medical practice the greatest enhancement of the human dimension. Targets: How much space is offered to the teaching of History of Medicine (HM) in Italian Universities? This work aims to answer this question through an in-depth analysis of the teaching plans of the degree courses in Medicine and Surgery (CLMC) activated in Italy. MATERIALS AND METHODS: The survey was carried out through the consultation of information, relating to the year 2019-2020, contained in the UniversItaly portal of the Italian Ministry of Education, University and Research, created to accompany students in their studies, as well as through the information published in the web portals of the various universities. RESULTS AND DISCUSSION: In Italy in 43 out of 97 Universities there is the Degree Course in Medicine and Surgery for a total of 66 degree courses; some Universities have activated more degree courses depending on the number of learners or on issues of territorial distribution. The teaching of HM is present in the curricula of 54 CLMC (82%) and in these is mandatory. In 93% of the cases, it is included in integrated courses (CI) and for only 4 CLMC it results as autonomous teaching. For the most part (86%) it is included in the first year's educational plan. The typology of the different CIs is extremely varied, both in terms of denomination, year and content, as well as in the overall CFUs assigned. The current teaching staff is divided as follows: 6 full professors; 12 associate professors; 13 Researchers (RU/RD); 20 contract professors. 19 are the researchers/professors engaged in the scientific field of the HM (MED/02). CONCLUSION: Those findings indicate that the HM subject in the Italian medical education programs is not yet universally recognized as able to stimulate medical students to a holistic view of the person and illness and therefore not sufficiently valued.

An infodemiological investigation of the so-called "Fluad effect" during the 2014/2015 influenza vaccination campaign in Italy: Ethical and historical implications.

Influenza vaccines represent a major tool to contain the clinical and epidemiological burden generated by influenza. However, in spite of their effectiveness, vaccines are victims of prejudices and false myths, which contribute to the increasing phenomenon of vaccine hesitancy and loss of confidence. Media and, mainly, new media, and information and communication technologies play a major role in disseminating health-related information. While, on the one hand, they can be extremely promising in promoting disease prevention, on the other hand, they can also have a negative impact on population's health attitudes and behaviors when delivering information not based on scientific evidences. The "Fluad-case" is an excellent example of the crucial role of an adequate information campaign. Following the cluster of deaths allegedly related to the administration of the adjuvanted influenza vaccine "Fluad" during the 2014-2015 influenza campaign, the Italian health authorities and regulatory bodies decided the withdrawal of two potentially contaminated Fluad batches. This fostered a huge media coverage, with resulted in negatively impacting on influenza vaccination coverage. Monitoring and tracking the Fluad-related web searches, we showed that Liguria resulted the Italian region with the highest number of Fluad-related website searches and that, interestingly, Fluad was searched also in Regions in which this vaccine was not distributed. A positive moderate correlation between accessing Fluad-related websites and overall influenza vaccination coverage was found (r = 0.66 ([95%CI 0.29-0.86], p = 0.0026). Considering subjects ≥65 years, who are the subjects for which the Fluad vaccination is recommended, the correlation resulted r = 0.49 ([95%CI 0.03-0.78], p = 0.0397). As such, health authorities and decision-makers should promote high-quality communication campaigns in order to raise awareness of vaccination practices.

Effects of acculturation, coping strategies, locus of control, and self-efficacy on chronic pain: study of Chinese immigrant women in Italy - insights from a thematic field analysis.

Chronic pain represents a common public health concern worldwide. It is a complex phenomenon, owing to the interaction of different factors, including biological, physiological, psychological, environmental, and social variables. Some groups, such as women and immigrants, are particularly vulnerable. However, little is known about how Chinese women in Italy live with and face chronic pain. The present study aimed at filling this knowledge gap by examining the burden of chronic pain in Chinese immigrants in Italy in terms of acculturation processes, perceived control over disease, social networks, and coping strategies. A qualitative approach was used, performing a thematic field analysis. We interviewed 82 Chinese women from different Italian towns (Genoa, Milan, Turin, Bologna, Florence, and Prato) in depth. The sense of belonging to the host culture was strong in our sample. However, this did not simply reflect or translate into a linear engagement with medical systems, as health care pathways were more complex and dual (both Chinese and Western). Chinese women who felt deeply rooted in the Italian environment did not discontinue the use of traditional Chinese medicine. Chronic pain extensively and adversely affected daily life, particularly interfering with work. Coping strategies were mainly adaptive behaviors, being problem focused or maladaptive, relying upon "cope and avoid" mechanisms. Chinese women preferred to use traditional Chinese remedies rather than conventional medicine, while using the Italian system in emergencies. Perceived control over chronic pain was usually external. Finally, Chinese women with chronic pain benefit from social networks and support, which were mainly composed of Chinese peers. In conclusion, our findings underline the tremendous burden of chronic pain affecting all aspects of Chinese women's lives. Health care workers and providers should be aware of the complexity of chronic pain Therefore, a holistic approach, involving different stakeholders, should be adopted when managing chronic pain and approaching immigrant patients.

Data of the Modified Somatic Perception Questionnaire (MSPQ) administered to a sample of immigrants in Genoa (Italy).

This article reports the data of the Modified Somatic Perception Questionnaire (MSPQ) administered to a sample of 143 immigrants accessing an outpatient clinic or the general practitioners offices in Genoa (Italy) compared with 186 Italian patients. For further details and for the interpretation of the data, the reader is referred to the original publication "Somatic perception, cultural differences and immigration: results from administration of the Modified Somatic Perception Questionnaire (MSPQ) to a sample of immigrants" by Bragazzi et al. (2014) [1].

Ethnopsychiatry fosters creativity and the adoption of critical and reflexive thinking in higher education students: insights from a qualitative analysis of a preliminary pilot experience at the Faculty of Medicine and Surgery, University of Genoa, Italy.

Creativity is an ability that plays a major role in the modern economy and society. It should represent an important component of the medical syllabus. However, it is often overlooked by the formal courses at universities. The current study aimed at evaluating whether the interactive educational models, recently adopted by the Faculty of Medicine and Surgery, at the University of Genoa, Italy, would favor the adoption of critical thinking, attitudes to changes, cultural diversity acceptance, and the adoption of relational soft skills versus traditional and frontal didactic teaching. Thirty students, who attended the last year of health care professional course at the Faculty of Medicine, volunteered to take part in the study and were randomly allocated to two groups: one group receiving an innovative, interactive excellence course and the other group receiving a more traditional approach. Ethnopsychiatry was chosen as the topic since it was hypothesized that it would have contributed to generation of a new approach toward diseases and patients. The first group of students, exposed to interactive lectures with the aim of promoting the adoption of critical thinking, were more satisfied than the second group. Participants who were involved in an active manner and had to work in small groups, actively finding their own solutions to solve the problems, perceived the utilized teaching method and experience more stimulating, involving, and effective. Implications for education policy makers are also envisaged.

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study.

Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014-2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one's own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources.

[Renaissance medicine and the discovery of the lesser circulation: the role of Michael Servetus (1511-1553)] / La medicina del rinascimento e la scoperta della circolazione minore: il ruolo di Michele Serveto (1511­1553)

Human urine is currently the subject of biomedical investigations as a potential therapeutic resource and it continues to be used in remedies in different cultures and societies, including the Spanish culture. In this study we gather etnomedical knowledge about urotherapy and determine their associated symbolisms in Spain. A literature overview and a case study were carried out to compile urine-based remedies and as a direct analysis of symbolic systems. Urotherapy is widespread in Spanish folk medicine. Among the 204 collected remedies, those related to treatment of diseases or skin conditions predominate (63%). Remedies have been reported for the treatment of skin diseases such as eczema, chloasma, alopecia, etc. to treat or alleviate burns, chilblains, wounds or skin chapping, and as a treatment of venomous bites. Most of the collected remedies have an associated naturalist symbolism, based on local traditions and the transmission of empirical initial knowledge. The use of urine in Spain is a result of the interaction of two types of practice: a local and traditional urotherapy, rural and with a utilitarian purpose, and a technical urotherapy, limited to an urban environment and a naturopathic medicine.

Infodemiological data of West-Nile virus disease in Italy in the study period 2004-2015.

Google Trends (GT) was mined from 2004 to 2015, searching for West-Nile virus disease (WNVD) in Italy. GT-generated data were modeled as a time series and were analyzed using classical time series analyses. In particular, correlation between GT-based Relative Search Volumes (RSVs) related to WNVD and "real-world" epidemiological cases in the same study period resulted r=0.76 (p<0.0001) on a monthly basis and r=0.80 (p<0.0001) on a yearly basis. The partial autocorrelation analysis and the spectral analysis confirmed that a 1-year regular pattern could be detected. Correlation between GT-based RSVs related to WNVD yielded a r=0.54 (p<0.05) on a regional basis. Summarizing, GT-generated data concerning WNVD well correlated with epidemiology and could be exploited for complementing traditional surveillance.

Infodemiological data of high-school drop-out related web searches in Canada correlating with real-world statistical data in the period 2004-2012.

The present data article describes high-school drop-out related web activities in Canada, from 2004 to 2012, obtained mining Google Trends (GT), using high-school drop-out as key-word. The searches volumes were processed, correlated and cross-correlated with statistical data obtained at national and province level and broken down for gender. Further, an autoregressive moving-average (ARMA) model was used to model the GT-generated data. From a qualitative point of view, GT-generated relative search volumes (RSVs) reflect the decrease in drop-out rate. The peak in the Internet-related activities occurs in 2004 (56.35%, normalized value), and gradually declines to 40.59% (normalized value) in 2007. After, it remains substantially stable until 2012 (40.32%, normalized value). From a quantitative standpoint, the correlations between Canadian high-school drop-out rate and GT-generated RSVs in the study period (2004-2012) were statistically significant both using the drop-out rate for academic year and the 3-years moving average. Examining the data broken down by gender, the correlations were higher and statistically significant in males than in females. GT-based data for drop-out resulted best modeled by an ARMA(1,0) model. Considering the cross correlation of Canadian regions, all of them resulted statistically significant at lag 0, apart from for New Brunswick, Newfoundland and Labrador and the Prince Edward island. A number or cross-correlations resulted statistically significant also at lag -1 (namely, Alberta, Manitoba, New Brunswick and Saskatchewan).

Infodemiological data of Ironman Triathlon in the study period 2004-2013.

This article reports data concerning the Internet-related activities and interest for Ironman Triathlon competition. Google Trends (GT) was used and mined from 2004 onwards. The interest for Ironman Triathlon was found to be cyclic over time. The Triathlon-related Internet activities negatively correlated with the number of finishers per year (Pearson׳s correlation r=-0.690, p-value<0.05), while an increasing participation of female athletes who were less likely to surf the Internet could be noticed (r=-0.811, p-value<0.05). Further, younger athletes, who were more likely to access the web, were underrepresented in the Ironman Triathlon event. Moreover, there was a correlation between the biking time and the Internet query volumes (r=0.590, p-value<0.05), and, in particular, for the male athletes (r=0.664, p-value<0.05). Finally, the countries which most contributed to the Internet query volumes were those with the highest number of medals.

Mind the gap between high school and university! A field qualitative survey at the National University of Caaguazú (Paraguay).

Paraguay has eight public universities and 45 private universities. The National University of Caaguazú (Universidad Nacional de Caaguazú or UNCA), with its main campus located in Coronel Oviedo, is one of the most recently founded public universities, being established in 2007. The UNCA has launched a project aiming at exploring the potentiality of its educational system, as well as its gaps. In particular, the UNCA wants to assess the effectiveness of preparatory courses for preparing students for admission to the degree course in medicine (Cursos Probatorios de Ingreso or CPI), in order to identify the main strong and weak points of the system, the popularity and usefulness of CPI as perceived by the students, the students' and teachers' opinions regarding the limits of school, and their suggestions. This paper is based on a field survey and highlights the care that must be taken in order to develop conditions respectful of the wellbeing of those participating in the educational context.

Applying artificial neural networks to predict communication risks in the emergency department.

AIMS: To describe the utility of artificial neural networks in predicting communication risks. BACKGROUND: In health care, effective communication reduces the risk of error. Therefore, it is important to identify the predictive factors of effective communication. Non-technical skills are needed to achieve effective communication. This study explores how artificial neural networks can be applied to predict the risk of communication failures in emergency departments. DESIGN: A multicentre observational study. METHODS: Data were collected between March-May 2011 by observing the communication interactions of 840 nurses with their patients during their routine activities in emergency departments. The tools used for our observation were a questionnaire to collect personal and descriptive data, level of training and experience and Guilbert's observation grid, applying the Situation-Background-Assessment-Recommendation technique to communication in emergency departments. RESULTS: A total of 840 observations were made on the nurses working in the emergency departments. Based on Guilbert's observation grid, the output variables is likely to influence the risk of communication failure were 'terminology'; 'listening'; 'attention' and 'clarity', whereas nurses' personal characteristics were used as input variables in the artificial neural network model. A model based on the multilayer perceptron topology was developed and trained. The receiver operator characteristic analysis confirmed that the artificial neural network model correctly predicted the performance of more than 80% of the communication failures. CONCLUSION: The application of the artificial neural network model could offer a valid tool to forecast and prevent harmful communication errors in the emergency department.

Academic climate, well-being and academic performance in a university degree course.

BACKGROUND: The psychological climate within organisations affects not only the behaviour and the attitude of group members, but also the performance of the group itself. According to the ecological model, this research examines how learning in different classroom contexts of the same nursing degree programme can affect academic performance, well-being, self-esteem and perceived climate. METHODS: Four scales were used to assess students' perceptions by collecting primary data while academic performance was measured by obtaining students' academic records. A questionnaire completed by 391 first-year nursing students was administered. RESULTS: Differences were observed in the perceptions of climate and academic performance in different classroom contexts with trends, which did not always overlap; however, strong correlations were observed among self-esteem, well-being and climate, and schoolmate relationships. CONCLUSIONS: Universities should not merely train competent professionals but also build learning communities that support the well-being of relationships and the development of well-being contexts. IMPLICATIONS FOR NURSING MANAGEMENT: The findings support the need for an educational intervention for improving the quality of life and well-being of the community and individual students. This type of intervention requires a 'compliant' organisational environment that puts studetns, teachers and professionals in the condition to practice their professional skills.