The Evaluation of the Balance Test and MuscleLab Test for the Early Detection of Femoroacetabular Impingement.

Femoroacetabular impingement (FAI) is a common source of hip pain affecting a wide range of subjects. In this work, we assessed two tests, namely the balance test and the MuscleLab test, in comparison with the flexion-abduction-external rotation (FABER) and flexion-adduction-internal rotation (FADIR) tests, in order to evaluate the functionality of the neural-musculoskeletal system of the subjects affected by FAI based on the measurement of biomechanical parameters. Our goal was to investigate the early detection of an altered hip joint and to monitor pathology progression over time. A total of 52 subjects, 29 females and 23 males, with an average age of 42 ± 13 years presenting hip impingement diagnosed using X-ray, were enrolled. Twenty-eight patients without signs of hip impingements were used as the control group. The balance test, which evaluates the capacity of a person to keep the orthostatic position against terrestrial gravity, and the MuscleLab test, which measures the force and power generated by active muscles during a movement, as well as FABER and FADIR tests, were performed in each subject. The balance and MuscleLab tests presented 100% sensitivity and higher sensitivity in FAI diagnosis, with 72.9% and 70.4%, respectively, in comparison with those obtained using FABER and FADIR tests, with 59.6% and 67.3%, respectively. The evaluation of the neural-musculoskeletal system using the balance and MuscleLab tests can help in the early detection of the severity of hip impingements and the assessment of non-operative treatments used over time.

Volunteering in an emergency project in response to the COVID-19 pandemic crisis: the experience of Italian midwives.

OBJECTIVES: During the first wave of the COVID-19 pandemic, the Region of Lombardy in Italy and its Regional Emergency Service (Azienda Regionale Emergenza Urgenza [AREU]) created a dedicated 24/7 free phone service to help the Lombard population. After an invitation from their professional order, local midwives collaborated on the AREU project as volunteers to address the needs of women from antenatal to postnatal periods. The aim of this article was to explore the experiences of midwives who volunteered in the AREU project. STUDY DESIGN: This was a qualitative study using an interpretative phenomenological approach (IPA). METHODS: The experiences of midwives volunteering in AREU (N = 59) were explored using audio diaries. Written diaries were also offered as an alternative. Data collection took place between March and April 2020. Midwives were provided with semistructured guidance that indicated the main areas of interest of the study. The diaries were thematically analysed following a temporal criterion; a final conceptual framework was created from emerging themes and subthemes. RESULTS: The following five themes were identified: (1) choosing to join the volunteer project, (2) the day-to-day difficulties, (3) strategies to cope with the unexpected, (4) professional relationships and (5) reflecting on the personal experience. CONCLUSIONS: This is the first study to investigate the experiences of Italian midwives who volunteered in a public health project during a pandemic/epidemic. According to participants, taking part in the volunteer activities was informed by and impacted on both their professional and personal lives. Overall, the experiences of midwives who volunteered in AREU were positive and of humanitarian value. Providing midwifery services within a multidisciplinary team for the benefit of public health represented both a challenge and personal/professional enrichment.

Antonio Scarpa (1752-1832): His Contribution to the History of Surgery.

BACKGROUND: Antonio Scarpa (1752-1832) is generally remembered for his discoveries in the field of anatomy, but he also provided some important contributions to the history of surgery. METHODS: We analyzed main treatises written by Scarpa, highlighting how he contributed to the development of modern surgery. RESULTS: Scarpa made great innovations in three branches of surgery: abdominal surgery (hernia), orthopedics (clubfoot) and vascular surgery (aneurism). Furthermore, he contributed to the birth of modern ophthalmology.

Animal magnetism in Italy during the nineteenth century: the conflicting relationship with the Catholic Church.

This article explores the relationship between the Catholic Church and animal magnetism. At the beginning of the nineteenth century, the Catholic Church had first tried to stem the rise of animal magnetism in a vague manner, but after a few decades, it eventually put a genuine veto in place. This measure was founded upon the dangers to morality and faith arising from the progressive polarization of the original doctrine in forms related to esotericism. Among the causes of the condemnation by the Congregation of the Holy Office, the primary ones were the naturalist interpretation of the miracles described in the Gospels and in the New Testament, and the possibility of falling under the control of a demonic spirit.

A Mobile App Leveraging Citizenship Engagement to Perform Anonymized Longitudinal Studies in the Context of COVID-19 Adverse Drug Reaction Monitoring: Development and Usability Study.

BACKGROUND: Over the past few years, studies have increasingly focused on the development of mobile apps as complementary tools to existing traditional pharmacovigilance surveillance systems for improving and facilitating adverse drug reaction (ADR) reporting. OBJECTIVE: In this research, we evaluated the potentiality of a new mobile app (vaxEffect@UniMiB) to perform longitudinal studies, while preserving the anonymity of the respondents. We applied the app to monitor the ADRs during the COVID-19 vaccination campaign in a sample of the Italian population. METHODS: We administered vaxEffect@UniMiB to a convenience sample of academic subjects vaccinated at the Milano-Bicocca University hub for COVID-19 during the Italian national vaccination campaign. vaxEffect@UniMiB was developed for both Android and iOS devices. The mobile app asks users to send their medical history and, upon every vaccine administration, their vaccination data and the ADRs that occurred within 7 days postvaccination, making it possible to follow the ADR dynamics for each respondent. The app sends data over the web to an application server. The server, along with receiving all user data, saves the data in a SQL database server and reminds patients to submit vaccine and ADR data by push notifications sent to the mobile app through Firebase Cloud Messaging (FCM). On initial startup of the app, a unique user identifier (UUID) was generated for each respondent, so its anonymity was completely ensured, while enabling longitudinal studies. RESULTS: A total of 3712 people were vaccinated during the first vaccination wave. A total of 2733 (73.6%) respondents between the ages of 19 and 80 years, coming from the University of Milano-Bicocca (UniMiB) and the Politecnico of Milan (PoliMi), participated in the survey. Overall, we collected information about vaccination and ADRs to the first vaccine dose for 2226 subjects (60.0% of the first dose vaccinated), to the second dose for 1610 subjects (43.4% of the second dose vaccinated), and, in a nonsponsored fashion, to the third dose for 169 individuals (4.6%). CONCLUSIONS: vaxEffect@UniMiB was revealed to be the first attempt in performing longitudinal studies to monitor the same subject over time in terms of the reported ADRs after each vaccine administration, while guaranteeing complete anonymity of the subject. A series of aspects contributed to the positive involvement from people in using this app to report their ADRs to vaccination: ease of use, availability from multiple platforms, anonymity of all survey participants and protection of the submitted data, and the health care workers' support.

The birth of experimental physiology.

The year 2023 marks the 300th anniversary of the death of Antonio Maria Valsalva (1666-1723). Valsalva was a leading physician across the 17th and 18th centuries, specifically for his focus on experimental physiology, the science dealing with the normal functioning of bodily organs as a basis for a better understanding of diseases, symptoms, and care. He used a top-down systematic approach typical of the Enlightenment, rather than a heuristic one ("trial-and-error"), which became feasible after the long-lasting ban on dissecting human corpses was lifted. Valsalva's main interest was exploring the complex structure of the human ear, to which he dedicated a specific treatise, De Aure Humana. He understood the issues inherent in the imbalance in pressure between the outer and inner ear and found ways to exploit it to get rid of purulent fluid by deliberately raising the inside pressure with his maneuver. Time was however not yet ripe to see the broader importance that the Valsalva maneuver would achieve, not just in otorhinolaryngology, but also in cardiology and other fields of medicine. Although Valsalva's name is usually associated with his maneuver, his contributions to the history of medicine were broader: he discovered several anatomical parts (i.e., the sinuses of Valsalva), built the basis for the development of pathological anatomy, introduced advances in surgery, and promoted compassionate care of patients affected by mental diseases.NEW & NOTEWORTHY Antonio Maria Valsalva (1666-1723) was a pioneer in experimental physiology between the 17th and 18th centuries. The Valsalva maneuver is still a popular academic topic and has broad applications not only in physiology research, but also in the diagnosis and therapy of various diseases. The celebration of 300 years from his death could be a timely occasion to commemorate the scientific works of this illustrious scientist.

Sleep disorders and night-shift work in nursing students: a cross-sectional study.

BACKGROUND: University students are known to have higher sleep disorders prevalence than the general population. Among them, nursing students are even more susceptible to sleep disorders. This study evaluates sleep disorders' risk factors among nursing students and their potential association with symptoms and assesses whether night shifts affect sleep quality by increasing the prevalence of sleep disorders. METHODS: A total of 202 nursing students were included; a self-administered questionnaire was used to collect data on sociodemographic and academic characteristics (i.e., gender, age, height, weight, and year of nursing program) and risk factors for sleep disorders (e.g., smoking, lack of physical activity, and coffee intake late in the evening). The survey included the General Health Questionnaire to assess perceived stress, the Sleep and Daytime Habits Questionnaire, and the Epworth Sleepiness Scale to assess sleep disorders symptoms. RESULTS: A high level of perceived stress is associated with sleep disorders symptoms and with poor sleep quality. Daytime symptoms are also associated with smoking. Students who drink coffee late in the evening report fewer nighttime symptoms. Night shifts and their increasing number are not associated with sleep disorders symptoms. The perception of an unsatisfying academic performance is associated with daytime symptoms and poor sleep quality. CONCLUSIONS: Although night shifts seem to not affect sleep quality among nursing students, sleep disorders represent a critical issue in this population since sleep disorders symptoms may result in errors, accidents, or low academic performance.

Medieval Interpretation of Phonation Through the Divine Comedy, by Dante Alighieri.

The anatomic and medical knowledge of people throughout history is unexpectedly evident in some of the poems and texts written by intellectuals of the time. This article attempts to understand the conception of laryngology in the Middle Ages by analyzing the Divine Comedy, written by the Italian poet Dante Alighieri (1265-1321) at the beginning of the 14th century. In the text, Dante mentions the throat several times. He recognizes that the larynx has the dual functions of allowing respiration (dead souls recognize that the poet is alive through movement of his throat when breathing) and speech (souls with their throat cut cannot speak). However, Dante does not seem to know of the existence of vocal cords, thinking that it is the tongue that allows for word formation. In general, Dante's poem indicates that the anatomy and function of the throat were known during the medieval period, although this knowledge was not precise.

Anti-SARS-CoV-2 IgG antibodies induced by the BNT162b2 mRNA vaccine is age-dependent and influenced by a previous natural SARS-CoV-2 infection.

BACKGROUND AND AIM: our study aimed to investigate the association between anti-SARS-CoV-2 IgG level after two doses of BNT162b2 vaccine and the previously infected/infection-naïve status, age, and gender in a population of health care workers (HCWs). METHODS: all the population of immunocompetent HCWs were vaccinated with two doses of BNT162b2 based on a technical data sheet. SARS-CoV-2 IgG assay was performed 25 to 32 days after the second dose. Anti-SARS-CoV-2 IgG level was used as a categorical variable, since 2080 BAU/ml was the median IgG value. The multivariate logistic regression model included the previously infected/infection-naïve status, age groups, and gender. RESULTS: All HCWs tested were seropositive. The odds ratio (OR) for anti-SARS-CoV-2 IgG> 2080 BAU / ml between previously infected and infection-naïve HCWs was 2.05 [95% CI 1.1-3.8].  Older age groups had lower percentage of HCWs with anti-SARS-CoV-2 IgG> 2080 BAU / mL than younger groups. Finally, no association between gender and IgG level was found. CONCLUSIONS: our study showed an excellent antibody response to vaccination with BNT162b2 after two doses. A significant difference was observed between anti-SARS-CoV-2 IgG level with age and previous SARS-CoV-2 infection status.

Lifestyle Profiles and Their Sociodemographic Correlate in an Academic Community Sample.

Promoting healthy behaviors throughout life is an essential prevention tool. Prior research showed that unhealthy behaviors tend to co-occur and interplay. However, which behaviors co-occur most frequently and which sociodemographic variables are associated with specific clusters of unhealthy behavior are still being determined. This study aimed to identify different lifestyle profiles and analyze their associations with sociodemographic factors in an Italian academic community to plan targeted initiatives to promote healthy lifestyles. A sample of 8715 adults from an Italian university (mean age = 26 years; range = 18-76; 30% male) participated in an online survey in 2019. Four health-related behaviors were evaluated: diet, physical activity, smoking, and alcohol consumption. Lifestyle profiles were identified through cluster analysis. Then, a multinomial logistic regression was performed to explore the association among lifestyle profiles, sociodemographic variables (age, gender, and academic role), and body mass index (BMI). Results showed that older age was associated with the probability of belonging to the profile characterized by smoke addiction and regular alcohol consumption but also with the healthiest diet. The younger the age, the greater the probability of belonging to the most physically active profile. Men were more likely than women to belong to the lifestyle profile with the most regular alcohol consumption and the highest physical activity. Lower BMI was associated with the most physically active profile. This study shed light on factors associated with different co-occurring health-related behaviors that should be considered in planning effective communication strategies and preventive health interventions within the academic community.

Adherence, Perception of, and Attitude toward Influenza and Flu Vaccination: A Cross-Sectional Study among a Population of Future Healthcare Workers.

Healthcare students (HCSs) represent a target category for seasonal flu vaccination. This study aimed to examine adherence to flu vaccination campaigns from 2016 to 2019 among HCSs and to investigate knowledge and perception of and attitude toward influenza and flu vaccination. This cross-sectional study was conducted among the HCSs of a northern Italian university. Data on adherence, knowledge, perception, and attitude were investigated through an anonymous online self-administered questionnaire. The questionnaire was filled out by 352 out of 392 third-year HCSs (response rate = 90%). The main reason for refusal was the perception of influenza as non-threatening (24.4%), while self-protection was the main reason for adherence (87.5%). A univariate logistic regression analysis revealed some statistically significant associations with the adherence to the 2018-2019 campaign: being a nursing/midwifery student (OR: 4.14; 95% CI: 1.77-9.71) and agreeing with (OR: 19.28; 95% CI: 2.47-146.85) or being undecided (OR: 10.81; 95% CI: 1.33-88.27) about the obligation of vaccination in health facilities. The associations were also evaluated with a multiple logistic regression model. Despite the low vaccine uptake, good knowledge of the risks for HCSs and patients related to flu has emerged. Improving promotion strategies will be necessary to increase the adhesion of future healthcare workers.

COVID-19 Vaccination and Asymptomatic Infection: Effect of BNT162b2 mRNA Vaccine on the Incidence of COVID-19 and Duration of Sick Leave Among Healthcare Workers.

OBJECTIVE: To determine the incidence of COVID-19 and the duration of sick leave among asymptomatic healthcare workers (HCWs) after vaccination with BNT162b2. METHODS: From October 2020 to March 2021, we determined the incidence of COVID-19 in a cohort of 671 asymptomatic HCWs before and after the vaccination. We also analyzed the days required to obtain a negative RT-PCR result after infection. RESULTS: Prior to vaccination 105 (15.6%) HCWs were positive. Positive cases were reduced to 42 (7.5%) after the vaccination period (P < 0.0001). A negative RT-PCR was observed at the first control in 80% of vaccinated HCWs and only in 37% before vaccination. CONCLUSIONS: Even in case of asymptomatic infection, vaccinated HCWs have a reduced incidence and a shorter period of sick leave than before vaccination, suggesting vaccination impacts on the sustainability of the health system and labor costs.

COVID-19 vaccine hesitancy and reasons for or against adherence among dentists.

BACKGROUND: COVID-19 has spread widely among health care workers. Oral health care workers have an increased risk of being infected owing to dental practice characteristics. New, effective vaccines against COVID-19 have been approved for use. The authors aim was to evaluate intentions to be vaccinated against COVID-19 in a population of dentists and identify factors associated with their intentions. METHODS: The authors conducted an anonymous online survey among 761 dentists enrolled at the Board of Physicians and Dentists of the District of Monza Brianza, Monza, Italy. The authors collected data on demographic characteristics, influenza vaccine uptake, COVID-19 history, vaccine attitudes, and specific reasons for their intentions to be vaccinated against COVID-19 or not. RESULTS: Overall, 421 dentists completed the survey. More than 82% of the participants declared their intention to be vaccinated against COVID-19. The multivariate logistic regression model reported a positive association with receiving the influenza vaccine in the 2020-2021 influenza season (odds ratio, 5.15; 95% CI, 2.14 to 12.39) and a negative association with receiving a diagnosis of COVID-19 previously (odds ratio, 0.32; 95% CI, 0.15 to 0.66). The participants' main reason for supporting vaccination was to protect their family and friends (87%) and their main reason for opposing vaccination was the lack of information (39%). CONCLUSIONS: It is fundamental to consider vaccine hesitancy in health care workers and address it properly because they must provide recommendations to patients and promote adherence to vaccination programs. PRACTICAL IMPLICATIONS: The vaccination of dental practitioners should be prioritized owing to the high risk related to dental practice.