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This study investigates the impact of dermatological diseases on work activity, with a particular focus on potential gender differences. The primary objectives are to evaluate the severity of these conditions and their implications for job performance, productivity, and non-work-related daily activities. A cross-sectional analysis was conducted on employed patients with dermatological conditions between September 2021 and November 2023. Participants completed a new self-reported survey, including the Dermatological Diseases Work Impact Questionnaire (2DWIQ), along with two validated tools: the Work Ability Score (WAS) and the Work Productivity and Activity Impairment questionnaire. Participants were stratified by occupational category (blue- and white-collar workers). Statistical analyses were adjusted for factors influencing questionnaire outcomes, and the internal reliability of the 2DWIQ was assessed using Cronbach’s α. The study included 417 participants (231 men and 186 women) affected by a dermatological disease primarily atopic dermatitis, psoriasis, and hidradenitis suppurativa. Women reported significantly higher levels of absenteeism, overall work impairment, and activity impairment compared to men. Additionally, they had lower WAS scores, indicating poorer work ability. Dermatological diseases have a greater impact on women, affecting both their work performance and daily lives. Gender-specific interventions are crucial to reducing the physical and psychological burden of these conditions and improving occupational health management.

Emotional dysregulation (ED) reflects a heightened reactivity to stimuli, characterized by excessive negative affect and impulsive behaviors. This study aimed to evaluate ED in workers seeking care for occupational stress and to examine its associations with sociodemographic characteristics, occupational stress, and the severity of anxiety and depressive symptoms. Eighty-seven workers referred for work-related stress were assessed using the Psychological Stress Measure (PSM) and the Job Content Questionnaire (JCQ) for stress, the Beck Depression Inventory-II (BDI-II) and the Self-Rating Anxiety Scale (SAS) for psychopathology, and the RIPoSt-40 for ED. Group comparisons and correlation analyses were conducted using parametric or non-parametric tests, as appropriate. Forty-six percent of participants met criteria for Adjustment Disorders and 54% for Major Depressive Disorder. No significant differences between diagnostic groups emerged for ED or symptom severity. Women reported higher perceived stress and anxiety than men. Negative ED domains—affective instability, negative emotionality, and emotional impulsivity—showed moderate-to-strong positive correlations with stress, anxiety, and depressive symptoms. Affective instability was also related to job stress dimensions, correlating negatively with decision latitude and positively with job demands. Negative emotional dysregulation appears to be a transdiagnostic vulnerability factor for stress-related psychopathology. Screening for ED may support early detection and targeted preventive interventions in occupational settings.

Malignant pleural mesothelioma (MPM) is an aggressive human cancer and miRNAs can play a key role for this disease. In order to broaden the knowledge in this field, the miRNA expression was investigated in a large series of MPM to discover new pathways helpful in diagnosis, prognosis and therapy. We employed nanoString nCounter system for miRNA profiling on 105 MPM samples and 10 healthy pleura. The analysis was followed by the validation of the most significantly deregulated miRNAs by RT-qPCR in an independent sample set. We identified 63 miRNAs deregulated in a statistically significant way. MiR-185, miR-197, and miR-299 were confirmed differentially expressed, after validation study. In addition, the results of the microarray analysis corroborated previous findings concerning miR-15b-5p, miR-126-3p, and miR-145-5p. Kaplan-Meier curves were used to explore the association between miRNA expression and overall survival (OS) and identified a 2-miRNA prognostic signature (Let-7c-5p and miR-151a-5p) related to hypoxia and energy metabolism respectively. In silico analyses with DIANA-microT-CDS highlighted 5 putative targets in common between two miRNAs. With the present work we showed that the pattern of miRNAs expression is highly deregulated in MPM and that a 2-miRNA signature can be a new useful tool for prognosis in MPM.

Background/Objectives: Workplace conflict and aggression pose significant psychosocial risks across diverse professional sectors. This protocol outlines a novel, university-based educational intervention. Developed by a multidisciplinary team from the University Hospital of Pisa, Italy, including occupational physicians and a psychiatrist specializing in work and organizational psychology, its primary purpose is to enhance conflict prevention and crisis management skills. While initially developed and tested within the veterinary sector due to its identified vulnerabilities, the intervention is inherently generalizable to any high-stress professional environment characterized by intense client, customer, or public interactions. Methods: The intervention integrates didactic instruction with active, immersive learning through tailored role-playing scenarios simulating real-world challenging encounters. This study protocol details the structured methodology for evaluating the immediate effectiveness of this training. We are using a specifically developed efficacy scale to assess outcomes. Results: The results demonstrate a significant improvement in all assessed skills from the pre-training to the post-training evaluation. For every item on the scale, the median scores increased, indicating a positive shift in overall group performance. The p-value for each item was <0.001, confirming that the observed improvements were statistically significant. These results demonstrate enhanced conflict resolution skills, improved communication, and an increased sense of self-efficacy among participants. Conclusions: This protocol offers a comprehensive and generalizable approach to addressing workplace psychosocial risks through an innovative educational intervention. A key future goal involves advancing this training methodology by integrating virtual reality (VR) environments with AI-driven avatars for role-playing, aiming to achieve a more realistic and impactful learning experience and sustained behavioral change.

(1) Background: vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs, ensure patient’s safety and to maintain essential health care services during influenza epidemics. With the present study we aimed to evaluate the efficacy of incremental bundles of measures implemented during the last three flu campaigns and to assess the attitudes towards influenza vaccination and a potential vaccine against COVID-19 among HCWs, in a large university hospital in Pisa, Italy. (2) Methods: We described measures implemented during 2018/2019, 2019/2020 and 2020/2021 and assessed their impact on flu vaccine coverage (VC) among employees and residents in Pisa university hospital. We considered sex, profession and ward to investigate differences in uptake. In addition, in 2020 a survey was developed and distributed to all employees to evaluate flu and COVID-19 vaccines attitudes. (3) Results: during the 2018/19 and 2019/20 flu campaigns the overall VC rate among HCWs was, respectively, 10.2% and 11.9%. In 2020/21 the overall VC rate jumped to 39.3% (+ 230.6%). Results from the survey indicated a more positive attitude towards flu vaccine as compared to COVID-19 vaccines among the 10.6% of the staff members who responded to the survey. In addition, 70.97% of HCWs totally agreed that being vaccinated against influenza would be more important than the previous years because of COVID-19 emergency. (4) Conclusions: a significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years. The COVID-19 pandemic positively influenced flu vaccination uptake during the 2020/21 season.

The objective of this study is to evaluate ChatGPT’s accuracy and reliability in answering complex medical questions related to occupational health and explore the implications and limitations of AI in occupational health medicine. The study also provides recommendations for future research in this area and informs decision-makers about AI’s impact on healthcare. A group of physicians was enlisted to create a dataset of questions and answers on Italian occupational medicine legislation. The physicians were divided into two teams, and each team member was assigned a different subject area. ChatGPT was used to generate answers for each question, with/without legislative context. The two teams then evaluated human and AI-generated answers blind, with each group reviewing the other group’s work. Occupational physicians outperformed ChatGPT in generating accurate questions on a 5-point Likert score, while the answers provided by ChatGPT with access to legislative texts were comparable to those of professional doctors. Still, we found that users tend to prefer answers generated by humans, indicating that while ChatGPT is useful, users still value the opinions of occupational medicine professionals.

Introduction Malignant pleural mesothelioma (MPM) is a relatively rare tumor, with the epithelioid type occurring more frequently. Several biomarkers have been suggested for screening and early diagnosis of MPM. Currently, high levels of soluble mesothelin-related peptides (SMRP), plasma osteopontin (pOPN) and vimentin have been reported in patients with MPM as promising markers for diagnosis, but their clinical use in monitoring is still discussed. The aim of our study was to evaluate the usefulness of these substances as markers of the clinical response to treatment in patients suffering from epithelioid mesothelioma. Methods 219 serum samples from 56 patients were collected during follow-up and the clinical response to therapy was recorded. Percentage differences between 2 consecutive measurements of SMRP, osteopontin and vimentin (Δ markers) by means of commercially available kits were correlated with changes in the clinical course. Results Δ SMRP, Δ pOPN and Δ vimentin showed statistically significant differences between the disease categories stable disease, partial response and disease progression (p = 0.0001, p = 0.035 and p = 0.0025 for SMRP, pOPN and vimentin, respectively). Moreover, contingency table analysis showed statistically significant differences between clinical response and Δ of each marker clustered into 3 groups (<-20%, between -20% and +20%, >+20%). Conclusions The time course of Δ SMRP and Δ vimentin was strongly associated with disease status, and so was the time course of pOPN, albeit to a lesser extent. These markers appear to be particularly effective in cases of partial response and disease progression, while their possible use in stable disease should be better investigated.

Introduction: Decreased plasma BDNF (pBDNF) levels have been proposed as a biomarker in the illness phases of mood disorders. This cross-sectional study aimed to evaluate the pBDNF and BDNF promoters’ DNA methylation levels in workers exposed to occupational stress and suffering from work-related stress disorders. Methods: the pBDNF and BDNF exon I and IV promoters’ methylation levels were measured by specific immunoassays and methylation-sensitive high-resolution melting (MS-HRM) in 62 patients with adjustment disorders (AD), 79 patients with major depressive disorder (MDD) and 44 healthy controls. Occupational stress was evaluated in the patients and controls using the Job Content Questionnaire (JCQ). Results: the pBDNF levels were significantly higher in the MDD (p < 0.001) and AD (p < 0.0001) patients than in the controls. The MDD patients showed significantly lower pBDNF levels than the AD ones (p = 0.01). The BDNF exon I and IV promoters’ methylation levels were significantly higher in the MDD patients than in the AD ones (exon I promoter: p = 0.0001, exon IV promoter: p < 0.0001) and controls (exon I promoter: p = 0.0001, exon IV promoter: p < 0.0001). In the patients, but not in the controls, the BDNF promoters’ methylation levels showed significant negative correlations with occupational stress. Conclusions: BDNF could play a key role in the pathophysiology of stress-related disorders and the peripheral elevation of it observed in patients exposed to occupational stress could suggest a protective mechanism for neurons from stress-mediated damage. The elevation of the pBDNF levels, even in MDD, may characterize a “reactive” subtype of depressive episode, while the significant elevation of the BDNF promoters’ methylation levels in depressed patients could indicate a predisposition to more severe illness under stress. Further research is needed, focusing on biomarkers for stress-related disorders as a potential tool for the diagnosis and prevention of occupational diseases.

Large language models, such as ChatGPT-4 and Google Bard, have demonstrated potential in healthcare. This study explores their utility in occupational medicine, a field where decisions rely on compliance with specific workplace health and safety regulations. A dataset of questions encompassing key occupational health topics derived from the Italian Legislative Decree 81/08, which governs workplace health and safety, was utilized. Responses from ChatGPT-4 with contextual information (ChatGPT-4+context) and Google Bard were evaluated for accuracy and completeness, with error categorization used to identify common issues. Subcategories of the topics of the regulations were analyzed as well. In total, 433 questions were included in our analysis. ChatGPT-4+context surpasses Bard in terms of accuracy and completeness in responses, with a lower error rate in the categories analyzed, except for the percentage of missed responses. In the subcategories analyzed, Bard is superior to ChatGPT-4+context only in the areas of the manual handling of loads and physical hazards. ChatGPT-4+context outperformed Bard in providing answers about Italian regulations on health and safety at work. This study highlights the potential and limitations of large language models as decision-support tools in occupational medicine and underscores the importance of regulatory context in enhancing their reliability.

(1) Background: In 2022, monkeypox (Mpox) was declared a public health emergency. The European Medicines Agency has authorized the use of Imvanex/Jynneos, a smallpox vaccine, for coverage against pox. Healthcare workers (HCWs) are all considered by the European Centre for Disease Prevention and Control to be at risk, but in Italy, vaccination was offered only to laboratory personnel. The present study aims to investigate smallpox vaccination coverage (VC) that provides protection against Mpox among HCWs in an Italian university hospital and to assess HCWs’ attitudes towards the possibility of getting vaccinated against Mpox. (2) Methods: We conducted a cross-sectional survey. 336 HCWs from selected wards were asked to fill out a self-declaration to collect their sex, profession, ward, vaccination status, and attitude toward Mpox vaccination. (3) Results: 60.71% of HCWs involved provided the requested data; 38.7% of them were previously vaccinated against smallpox, which corresponds to 23.5% of the total HCWs in the wards considered. Considering those born before 1979 as vaccinated, VC increases from 23.5% to 41.7%; the percentage of HCWs who adhered to vaccination is 23%; laboratory technicians showed a lower willingness to be vaccinated. The ward with the highest willingness to vaccinate is proctological surgery. (4) Conclusions: Based on our experience, a variability in smallpox VC and in willingness to vaccination has emerged both among different job titles and age categories and across the wards analyzed. Additionally, our survey reveals that vaccination attitudes are higher among HCWs from wards that currently do not have free access to such vaccinations.