Agenzia Regionale Sanitaria della Puglia

The increased rate of mental illness conditions like depression, anxiety, insomnia, and stress has led to the pursuit of computational techniques for early intervention and detection. The work in this paper introduces a multi-label classification model with machine learning that estimates multiple mental health conditions at once based on lifestyle and emotional behavior. A first-hand data collection was done using a survey that was specially designed, where data on sleep habits, mood, diet, exercise, emotional support received, and stress coping mechanisms was gathered. Labels were constructed that denote the existence of certain mental illnesses from answers to behaviorally suggestive questions. Standard preprocessing including imputation, normalization, and one-hot encoding was done to the data. A Random Forest classifier, packaged in a One-vs-Rest environment, was trained to carry out multi-label classification. The model was assessed on accuracy, precision, recall, and F1-score for every mental health condition. The outcomes show that lifestyle and emotional markers can be strong predictors, and the model is capable of achieving good classification performance on all target conditions. This strategy points out the possibility of machine learning in enhancing mental health monitoring and screening, particularly in non-clinical environments.

Background: Tick-borne encephalitis (TBE) is a severe viral infection of the central nervous system transmitted by tick bites. Vaccination represents the only effective preventive measure, yet data on TBE vaccine effectiveness in Italy are lacking. This study aimed to evaluate TBE vaccine effectiveness and vaccination coverage in the province of Udine, an endemic area in the Friuli Venezia Giulia region of Northern Italy. Methods: We conducted a case-control study using linked anonymized health databases of the region, including vaccination, laboratory, and hospital admission records from 2017 to 2025. Cases were defined as residents hospitalized with a diagnosis of TBE (ICD-9-CM 063.x or 321.2) and a positive anti-TBE IgM result in serum or cerebrospinal fluid. Controls were residents tested for anti-TBE IgM during the same period but not hospitalized for TBE. Vaccination history was retrieved from the regional vaccination registry. Vaccine effectiveness was estimated through logistic regression models comparing vaccinated and unvaccinated individuals. Results: Between 2017 and 2025, 21 confirmed TBE hospitalizations were recorded (mean annual incidence: 0.45/100,000 inhabitants). The mean hospital stay was 13.8. Among 6065 individuals tested for anti-TBE IgM, 95.2% of cases and 81.8% of controls were unvaccinated. The estimated odds ratio of TBE hospitalization for individuals with ≥3 vaccine doses versus unvaccinated was 0.11 (95% CI: 0.02-0.88). Vaccination coverage in 2025 reached about 10% of the provincial population, with markedly higher coverage (up to 34%) in mountain districts compared with lowland areas (<5%). Conclusions: Although limited by small sample size, this study provides the first real-world evidence of TBE vaccine effectiveness in an Italian endemic area. Vaccination is an effective preventive measure. Given the regional epidemiology and expected increase in tick activity due to climate change, strengthening vaccination uptake and public awareness in endemic districts is strongly recommended.

Background and Objectives: The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O2) and the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H2) scales are designed to objectively monitor various overuse or acute injuries of professional and non-professional athletes in association with other physical problems that relate to health spheres. The aim of this study was to validate these questionnaires in a population of professional and amateur Italian athletes and to analyze their psychometric properties, in order to verify that both scales have equivalent properties in different linguistic and cultural contexts. Materials and Methods: The Italian versions of the OSTRC-O2 (OSTRC-O2-IT) and the OSTRC-H2 (OSTRC-H2-IT) were administered to 102 professional and non-professional athletes over a period of 3 months, once a week, for each rating scale. The inclusion criteria were: age over 18 years, practicing a sports activity for at least 1 year and having had at least one injury. The internal consistency and reliability of both scales and their correlations with pain and quality of life scales have been analyzed. Results: The psychometric properties of the scales turned out to be very high and statistically significant for both scales proposed to the athletes. A Cronbach's Alpha of 0.946 and an ICC between 0.705 and 0.746 confirmed the good reliability of the questionnaires. Conclusions: The Italian versions of the OSTRC-O2-IT and OSTRC-H2-IT assessment scales are reliable and valid tools for the monitoring of overload injuries. This study shows that they are easy to understand for the Italian sports population and may be of help to the scientific community to increase precautionary control and prevention measures for overuse injuries in professional and amateur athletes, favoring a safer return to the field.

Background/Objectives: Sex and gender minorities (SGMs) include individuals who do not comply with sexual binarism and heteronormative standards. They represent a high-risk population for Human Papillomavirus (HPV) infection and potential target of an HPV vaccine offer. This study investigates SGMs' knowledge, awareness and vaccination attitude regarding HPV. Methods: This is a cross-sectional, questionnaire-based study. The target population was represented by SGMs living in Italy and using social media platforms of SGM rights associations. The study questionnaire was based on the literature and disseminated via said associations' social media. It included items regarding knowledge and awareness, expressed as seven-point Likert scales, and questions about personal information, sexual anamnesis and vaccination attitude. Data collection started on 1 November 2023 and ended on 8 December 2023. Results: The questionnaire was answered by 177 people. Knowledge and awareness scores were generally high (45.98 ± 6.14 and 34.21 ± 4.62, respectively). Regarding attitude, 31.64% of participants reported being hesitant or refusing HPV vaccination, mainly due to prohibitive costs or low perception of the vaccine's utility. Higher education was associated with a higher knowledge score (coeff.: 2.25; 95%CI: 0.69-3.82); likewise, a history of HPV-related lesions positively influenced the score (coeff.: 2.47; 95%CI: 0.20-4.75). The awareness score was only increased by a greater number of sexual partners (coeff.: 0.06; 95%CI: 0.01-0.11). Older age was proven to significantly increase the odd of vaccine hesitancy (OR: 1.07; 95%CI: 1.02-1.12). Conclusions: Despite a good level of knowledge and awareness, the study population manifested significant barriers to vaccination. The main ones were related to the vaccine's cost and lack of medical information. Future efforts should focus on reinforcing vaccine offers to SGMs.

Background/Objectives: The increasing incidence of cancer during pregnancy is a growing public health concern, driven by delayed parenthood and rising maternal age. Pregnancy-associated cancer (PAC) presents complex clinical challenges, necessitating a balance between maternal cancer treatment and fetal safety. Historically considered incompatible with favorable pregnancy outcomes, evidence now suggests that pregnancy can often proceed without affecting cancer prognosis. A 2022 study in Italy provided the first population-based PAC estimates by linking cancer registries (CRs) and hospital discharge records (HDRs). This study aimed to update PAC estimates to 2019, covering 30% of the Italian population and addressing prior data limitations. Methods: A retrospective longitudinal analysis was conducted on women aged 15-49 diagnosed with malignant cancers between 2003 and 2019. Data from 21 Italian CRs were linked with HDRs to identify PAC cases, defined as obstetric hospitalizations occurring for women diagnosed with cancer in our study cohort in the period spanning from one year before to two years after a cancer diagnosis. All malignant cancers, excluding non-melanoma skin cancers, were analyzed. PAC rates were calculated per 1000 pregnancies, and trends were assessed using log-linear and JoinPoint regression models. Results: Among 131,774 women diagnosed with cancer, 6329 PAC cases were identified, with a PAC rate of 1.43 per 1000 pregnancies, consistent with global estimates. Thyroid (24.4%) and breast cancer (23.2%) were the most common. Analyzing the PAC rate by pregnancy outcome, in the period 2015-2019, this increased for both childbirths and miscarriages but decreased for voluntary terminations. Most hospitalizations (54%) occurred pre-diagnosis, peaking at diagnosis, especially for breast cancer (69%). Conclusions: PAC incidence is rising, particularly for live births and miscarriages, underscoring the need for multidisciplinary care and robust epidemiological insights to guide clinical management.

Nationwide studies described a reduction in preterm birth (PTB) during the Coronavirus disease 19 (COVID-19) pandemic, but this was not confirmed in others. Very few data are available on the trend of PTBs over a longer period, including the post-pandemic period, and on potential risk factors, especially those associated with social disparities. To investigate the trend in PTB rates and the influence of maternal risk factors in Italy from January 2018 to December 2022, based on 12 Regional Birth Registries covering 86.1% of Italian births. PTB trend was investigated by an interrupted time series analysis. We assessed the associations of potential risk factors with PTB (Poisson regressions) and calculated their population impact fractions (PIFs). We studied 1,762,422 births; 7.25% were PTB. Before the pandemic, we observed a monthly decrease in PTB rate [-0.2% (95% CI: -0.3; -0.1)]; from July 2020 onwards, the average monthly level of PTBs was 5% lower than before (95% CI: -7.3; -2.7), with a flat trend until December 2022 [-0.02% (95% CI: -0.5; 0.5)]. Socio-economic maternal risk factors (low education, unemployment) and foreign nationality, whose risk ratios were 1.14 (95% CI: 1.04; 1.24), 1.08 (1.05; 1.12), and 1.17 (1.14; 1.21), respectively, showed a decreasing trend after pandemic; their impact on the decrease in PTBs was modest (PIFs between -2.4‱ and -4.2‱). The COVID-19 pandemic changed the pattern of PTB rates in Italy, lowering their average frequency and interrupting a previous decreasing trend. Changes in the trend of socio-economic maternal risk factors marginally explained this pattern.

OBJECTIVE To establish and implement a women-centred continuity of midwifery care service specifically focused on urogynecological conditions. DESIGN Observational study was conducted. SETTING R. Guzzardi Hospital – Vittoria (Italy) POPULATION 441 wom

Background: Given the relationship between reduced pulmonary and respiratory muscle function in neck pain, incorporating breathing exercises into neck pain management may be beneficial. Purpose: The purpose of this study was to investigate the benefits of breathing exercises for treating neck pain. Methods: We searched PubMed (MEDLINE), PEDro, CINAHL, Scopus, and EMBASE databases, up to the 28 of February 2024. Randomized controlled trials evaluating the impact of breathing exercises on reducing pain and disability in both persistent and recent neck pain were selected. A meta-analysis was conducted for each outcome of interest; however, if quantitative methods were not possible, a qualitative synthesis approach was used. The risk of bias was assessed using the Cochrane RoB 2.0 Tool (version 22 August 2019). We used the GRADE approach to judge the certainty of the evidence. Results: Five studies were included. Meta-analysis showed a statistically significant reduction in pain (standardized mean difference (SMD), -10.16; 95% CI: -14.82, -5.50) and disability (SMD, -0.80; 95% CI: -1.49, -0.11), in favor of breathing exercises. Qualitative synthesis for pulmonary functional parameters resulted in a statistically significant improvement for FVC, MIP, MEP, and MVV, in favor of breathing exercises. Conclusions: Breathing exercises showed significant short-term effects in reducing pain and disability for persistent neck pain. They also provided benefits for functional respiratory parameters. However, the evidence certainty is low.