Explore the vast range of titles available.

Background Field epidemiologists play a crucial role in addressing the complex challenges posed by emerging infectious diseases, transboundary animal diseases, and antimicrobial resistance. Despite the interdisciplinary nature of these issues, traditional field epidemiology training programs are often narrowly focused on specific sectors. To effectively confront these evolving challenges, it is imperative to equip field epidemiologists with the skills to adopt the One Health approach. However, there are neither globally accepted One Health competencies for guiding field epidemiology training programs nor standardized curricular guidance for program managers. Recognizing this gap, three international organizations joined forces to develop the Competencies for One Health Field Epidemiology framework. Methods A desktop review was conducted of the existing frontline, intermediate, and advanced field epidemiology training program curricula. Knowledge, skills, and competency (KSC) statements for frontline, intermediate and advanced levels were then defined and grouped into domains and subdomains by thematic area. An international Technical Advisory Group of 59 experts from the animal, environment, and human health sectors was convened to review the proposed statements. The framework was revised based on their feedback. KSC statements were classified into core and optional, and a prioritization tool was developed to assist countries in selecting optional KSC statements based on their specific requirements. Results The competency framework was developed and comprises KSC statements needed for field epidemiologists to successfully apply the One Health approach across the human, animal, and environment health sectors. These KSC statements are stratified by frontline, intermediate, and advanced training levels and are further categorized as core and optional; sector-specific KSC statements are also identified. Conclusions This innovative framework emerged from a multisectoral, collaborative, inclusive, and iterative process involving international animal, human, and environment health and field epidemiology training experts. Countries and regions can also use the framework to establish new, comprehensive One Health field epidemiology training programs or upgrade existing programs to incorporate the One Health approach. This framework is anticipated to pave the way for a more holistic approach to training the global community of field epidemiologists in all health sectors to meet the demands of our evolving health landscape.

BackgroundThe devastating effects of global health threats at the human-animal-environment interface have highlighted the continued need to improve collaboration between the human, animal, and environment health sectors. The National Bridging Workshop (NBW) Program contributes to this effort, gathering representatives from relevant sectors to assess their collaborative capacities and to develop a joint Roadmap to strengthen them.MethodsWe conducted NBWs in 58 countries and 51 Roadmaps are publicly available. A document analysis of these Roadmaps was conducted using a hybrid inductive-deductive coding approach. Roadmap activities were coded, categorized, and quantified for descriptive analysis. Hierarchical clustering (HCA) and principal component analysis (PCA) were applied to examine co-occurrence and variability across countries and activities. Jaccard index was used to assess inter-country alignment and regional trends were evaluated.ResultsThe analysis identified 60 distinct activity types (codes), grouped into six key themes, describing 2028 activities, providing unique and meaningful insight into how countries plan to improve their One Health capacity. Of these 60 activity types, 37 were present in a third of Roadmaps or more. The HCAs revealed an absence of clustering between activities or countries and the PCA confirmed a high degree of variability. The highest Jaccard similarity score between two countries was 0.64, and intra-regional (0.34) and inter-regional (0.32) average similarity scores were almost identical.ConclusionsThe activity needs, and their frequency, can help streamline international efforts to support countries in building their multisectoral collaborative capacities. With no dominant patterns of activity inclusion identified across countries or regions, our results offer concrete evidence for the need to tailor the One Health approach to countries’ national contexts. The findings support the growing body of literature that emphasizes the absence of a “one-size-fits-all” approach. They also demonstrate that the NBW method supports this needed flexibility.This study is the first to investigate One Health needs from such a broad range of countries, based on a common, standardized tool. Our findings offer critical insights into national and, by extension, global priorities for One Health collaboration, that can guide the development of tools and strategies that align with the specific needs articulated by countries.

In the Adriatic Sea, the European Union supported a cross-border cooperation research program, during which digital spatial data on shellfish production and relaying areas, regulated conditions on fishing activities, protected areas and restocking structures, administrative boundaries and sea bottom characteristics, were collated from digital repositories in various institutions and paper documents. A web-based geographical information system was developed to share data of the sea facing the Abruzzi region and to explore the spatial distribution of marine resources and maritime activities, thus focussing and facilitating fisheries management and providing a potential support to the regional planning of resource exploitation.

To investigate the prevalence of vascular, neurological and musculoskeletal disorders of the upper limb in a group of female workers performing either mechanical or hand sanding in the furniture industry (n=100) and in a control group of female office workers (n=100). A further aim was to study the possible adverse effects of exposure to a combination of vibration and ergonomic risk factors in female workers. All female workers underwent a medical interview and a complete physical investigation. The clinical diagnoses of Raynaud's phenomenon and carpal tunnel syndrome (CTS) were made according to international consensus criteria. Hand-transmitted vibration from orbital sanders was measured according to International Organization for Standardization (ISO) recommendations. Daily vibration exposure was assessed in terms of 8-h energy-equivalent frequency-weighted acceleration [A(8)] according to the European Directive on physical agents. Ergonomic load on the upper limbs was estimated by means of strain index methodology. There was no significant difference in the prevalence of Raynaud's phenomenon between the furniture workers (4%) and the controls (8%). The prevalence of CTS, peripheral sensorineural disturbances (after exclusion of CTS cases) and upper-limb musculoskeletal complaints was significantly greater in the furniture workers than in the controls. CTS was clinically diagnosed in 19% of the furniture workers and 8% of the controls. A log-binomial regression analysis showed that the occurrence of soft-tissue disorders of the upper limb increased significantly with the increase of both daily vibration exposure and the strain index score. It was estimated that the risk for CTS increased by a factor of 1.30 (95% CI 1.11-1.53) for each unit of increase in A(8) (ms(-2)), and by 1.09 (95% CI 1.02-1.15) for each unit of increase in the strain index score. Even though the cross-sectional design of this epidemiological study does not allow aetiological considerations, our findings suggest a significant association between occupational use of vibratory tools and soft-tissue disorders in the upper limbs of female workers. Quantitative estimation of vibration exposure and ergonomic stress showed that these physical risk factors seem to contribute in a multiplicative way to the occurrence of chronic nerve and musculoskeletal disorders in female workers operating hand-held vibrating tools in the furniture industry.

Background: Past workplace exposure to asbestos in combination with tobacco smoking has increased the risk of lung cancer for some residents in an area within the Friuli Venezia Giulia region, Northeast Italy. In light of studies showing that lung cancer screening (LCS) with low-dose computed tomography (LDCT) can reduce mortality, local stakeholders and decision-makers decided to assess the potential benefits, harms and cost-effectiveness of a single round of LCS with LDCT versus standard care among people aged 55 to 80 who were formerly exposed to asbestos and with at least 10 pack-years of smoking. Methods: An economic model was developed using a decision tree connected to a Markov cohort model. The primary outcome was the incremental cost per additional quality-adjusted life year (QALY). Other outcomes included the number of life years saved, the number of deaths averted and overdiagnosis. Results: Per 10,000 people screened, the intervention led to 395 additional QALYs (95% credible interval: 129 to 831) and incremental total costs of EUR 1,086,345 (95% credible interval: −852,607 to 2,155,826). The incremental cost per QALY gained was EUR 2750. There was a probability of cost-effectiveness of 99.5% relative to a threshold of EUR 25,000. Conclusions: The model estimated that the intervention was cost-effective. The model’s simplifications and limitations should be considered when interpreting the findings in relation to policy-making decisions. Further research could include the costs and benefits of incidental findings and could assess the cost-effectiveness of repeated rounds of screening for the same population.

The success of emergency intervention to control contagious animal diseases is dependent on the preparedness of veterinary services. In the framework of avian influenza preparedness, the Italian Ministry of Health, in cooperation with the National Reference Centers for Epidemiology and Avian Influenza, implemented an electronic learning course using new web-based information and communication technologies. The course was designed to train veterinary officers involved in disease outbreak management, laboratory diagnosis, and policy making. The “blended learning model” was applied, involving participants in tutor-supported self-learning, collaborative learning activities, and virtual classes. The course duration was 16 hr spread over a 4-wk period. Six editions were implemented for 705 participants. All participants completed the evaluation assignments, and the drop out rate was very low (only 4%). This project increased the number of professionals receiving high-quality training on AI in Italy, while reducing expenditure and maximizing return on effort.

To evaluate whether residential radon exposure explains the excess mortality for lung cancer in an Italian alpine valley with high natural radioactivity, the authors conducted a population-based case-control study on 138 deceased cases and 291 sex- and year-of-birth-matched controls. Year-long alpha-track measurements of radon were performed in the most recent residence, and information about occupational history and lifetime smoking habits was obtained. The authors adjusted for smoking, and radon was associated with lung cancer risk among men: compared with a radon level of < 40 becquerels (Bq) per cubic meter (m 3 ), the odds ratios for 40-76 Bq/m 3 , 77-139 Bq/m 3 , 140-199 Bq/m 3 , and 200+ Bq/m 3 were 2.1, 2.0, 2.7, and 1.4, respectively. The association between radon and lung cancer, as determined with a multiplicative model, was found only among male smokers.

Adaptive resistance to therapy is a hallmark of cancer progression. To date, it is not entirely clear how microenvironmental stimuli would mediate emergence of therapy-resistant cell subpopulations, although a rearrangement of the cancer cell secretome following therapy-induced stress can be pivotal for such a process. Here, by using the highly chemoresistant malignant pleural mesothelioma (MPM) as an experimental model, we unveiled a key contribution of the chaperone HSP90 at assisting a chemotherapy-instigated Senescence-Associated-Secretory-Phenotype (SASP). Thus, administration of a clinical trial grade, HSP90, inhibitor blunted the release of several cytokines by the chemotherapy-treated MPM cells, including interleukin (IL)-8. Reduction of IL-8 levels hampered the FAK-AKT signaling and inhibited 3D growth and migration. This correlated with downregulation of key EMT and chemoresistance genes and affected the survival of chemoresistant ALDH bright cell subpopulations. Altogether, inhibition of HSP90 provoked a switch from a pro-tumorigenic SASP to a pro-apoptotic senescence status, thus resulting in chemosensitizing effects. In mouse xenografts treated with first-line agents, inhibiting HSP90 blunted FAK activation and reduced the expression of ALDH1A3 and the levels of circulating human IL-8, these latter strongly correlating with the effect on tumor growth. We validated the above findings in primary mesothelioma cultures, a more clinically relevant model. We unveiled here a key contribution of the chaperone HSP90 at assisting the secretory stress in chemotherapy-treated cells, which may warrant further investigation in combinatorial therapeutic settings.

Background/objectives: Despite advancements in early diagnosis and clinical practices guided by standardized care protocols, Merkel cell carcinoma (MCC) is marked by an unfavorable prognosis with a 5-year relative survival rate of 65%, based primarily on data collected prior to the introduction of immunotherapy. Regional nodal metastases affect 40–50% of MCC patients, while approximately 33% experience distant dissemination. Among these, bone and bone marrow metastases are particularly notable, although the characteristics and clinical implications of this metastatic disease in MCC remain poorly understood. Methods: A comprehensive review was conducted using the Medline database (via PubMed) up to January 2025. The search strategy included the string “(Merkel cell carcinoma AND (bone OR marrow))”. Results: A total of 1133 (69.3% male and 30.7% female) patients diagnosed with advanced MCC were collected. The median (IQR) age at diagnosis was 67.5 (12.65) years old. Overall, 201 (20.8%) cases of bone and/or bone marrow metastases were identified and linked to a primary known MCC in 75.7% of cases. Bone metastases (BMs) appear as the third most common metastatic site, following the liver (second) and lymph nodes (first). They show mixed biological and radiological behavior, with a marked preference for the axial skeleton over the appendicular one. Addressing the characteristics of metastatic bone disease, neurological symptoms were the most documented, whereas bone marrow involvement and leukemic spread seemed to be primarily related to immunosuppression. Multimodal treatment strategies, including platinum-based chemotherapy and radiotherapy, were the primary approaches adopted, reflecting therapeutic practices from the pre-immunotherapy era. Conclusions: The pattern of metastatic spread in MCC differs among studies, with the bones resulting as the third most common site of distant spread. Excluding head and neck MCC, which seems to be more regularly associated with liver metastases, the relationship between the primary tumor site and the development of bone or bone marrow metastases appears inconsistent. Overall, BMs mostly correlated with advanced MCC stages and poorer survival outcomes, with a median overall survival (OS) of 8 months (range 12.75–4). The integration of international guidelines, evolving evidence from clinical trials, and the expanding role of immune checkpoint inhibitors (ICIs) will contribute to improving systemic disease control and enhance patient care.

Background Lung cancer represents the most frequent cause of death for cancer. In non-small cell lung cancer (NSCLC), which accounts for the vast majority of this disease, only early detection and treatment, when possible, may significantly affect patient's prognosis. An important role in NSCLC malignancy is attributed to the signal transduction pathways involving PI3Kinase, with consequent activation of the AKT family factors. The serum and glucocorticoid kinase (SGK) factors, which share high structural and functional homologies with the AKT factors, are a family of ubiquitously expressed serine/threonine kinases under the control of cellular stress and hormones. SGK1 is the most represented SGK member. Methods By means of immunohistochemistry and quantitative real-time PCR, we determined SGK1 protein and mRNA expression in a cohort of 66 formalin-fixed, paraffin-embedded NSCLC surgical samples. All samples belonged to patients with a well-documented clinical history. Results mRNA expression was significantly higher in squamous cell carcinomas, and correlated with several clinical prognostic indicators, being elevated in high-grade tumors and in tumors with bigger size and worse clinical stage. No correlation was found between SGK1 protein expression and these clinical parameters. Conclusions This explorative analysis of SGK1 expression in NSCLC samples highlights the potential role of this factor in NSCLC patients' prognosis. Moreover, the higher expression in the squamous cell carcinoma subtype opens new therapeutic possibilities in this NSCLC subtype by designing specific kinase inhibitors.