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Background: Incidence-based multistate models of population health are commonly applied to calculate state expectancies, such as a healthy life expectancy (HLE), or unhealthy life expectancy (UHE). These models also allow the computation of other summary indices, such as the distributions of healthy or unhealthy lifespans., Objective: We aim to show how a multistate health model implies a multistate death distribution, giving joint information on years lived in good and poor health. We also propose three aggregate indices of joint health and mortality inequality., Methods: We propose a double-accounting approach to increment-decrement life table methods to intuitively derive a multistate health distribution over age and cumulative duration spent in each state. We then define a variety of summary lifespan inequality indices based on different distance metrics, namely Euclidean, Chebyshev, and Manhattan distances., Results: We apply the method to multistate transition probabilities between health states based on the activities of daily living index for Italian women from the Survey of Health, Ageing and Retirement in Europe in 2015-2017. We demonstrate the added value of accounting for joint years lived in health states in multistate models for our understanding of the period health and mortality conditions from the perspective of health-specific lifespans of individuals., Conclusions: Multivariate state distributions and summary indices derived from them give a holistic representation of population health inequality. We offer selected summary indices of the multivariate distribution with different demographic interpretations from the measures derived from univariate distributions. Although more theoretical and methodological work is required to motivate a single comprehensive population health inequality index, this direction is a promising path for a better understanding of population health dynamics and relationships between univariate statistics., Competing Interests: Declarations. Ethics approval and consent to participate: This paper is based on data from the Survey on Health and Retirement (SHARE), which is anonymized microdata. Thus, ethics approval is not necessary. Consent for publication: Not applicable Competing interest: The authors declare that they have no Conflict of interest., (© 2024. The Author(s).)

Despite extensive global research into genetic predisposition for severe COVID-19, knowledge on the role of rare host genetic variants and their relation to other risk factors remains limited. Here, 52 genes with prior etiological evidence were sequenced in 1,772 severe COVID-19 cases and 5,347 population-based controls from Spain/Italy. Rare deleterious TLR7 variants were present in 2.4% of young (<60 years) cases with no reported clinical risk factors (n = 378), compared to 0.24% of controls (odds ratio [OR] = 12.3, p = 1.27 × 10 -10 ). Incorporation of the results of either functional assays or protein modeling led to a pronounced increase in effect size (OR max  = 46.5, p = 1.74 × 10 -15 ). Association signals for the X-chromosomal gene TLR7 were also detected in the female-only subgroup, suggesting the existence of additional mechanisms beyond X-linked recessive inheritance in males. Additionally, supporting evidence was generated for a contribution to severe COVID-19 of the previously implicated genes IFNAR2, IFIH1, and TBK1. Our results refine the genetic contribution of rare TLR7 variants to severe COVID-19 and strengthen evidence for the etiological relevance of genes in the interferon signaling pathway., Competing Interests: Declaration of interests K.U.L. is a co-founder of LAMPseq Diagnostics GmbH., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Picture naming tasks are currently the gold standard for identifying and preserving language-related areas during awake brain surgery. With multilingual populations increasing worldwide, patients frequently need to be tested in more than one language. There is still no reliable testing instrument, as the available batteries have been developed for specific languages. Heterogeneity in the selection criteria for stimuli leads to differences, for example, in the size, color, image quality, and even names associated with pictures, making direct cross-linguistic comparisons difficult. Here we present MULTIMAP, a new multilingual picture naming test for mapping eloquent areas during awake brain surgery. Recognizing that the distinction between nouns and verbs is necessary for detailed and precise language mapping, MULTIMAP consists of a database of 218 standardized color pictures representing both objects and actions. These images have been tested for name agreement with speakers of Spanish, Basque, Catalan, Italian, French, English, German, Mandarin Chinese, and Arabic, and have been controlled for relevant linguistic features in cross-language combinations. The MULTIMAP test for objects and verbs represents an alternative to the Oral Denomination 80 (DO 80) monolingual pictorial set currently used in language mapping, providing an open-source, standardized set of up-to-date pictures, where relevant linguistic variables across several languages have been taken into account in picture creation and selection.

Objectives: With COVID-19 infections resulting in death according to a hierarchy of risks, with age and pre-existing health conditions enhancing disease severity, the objective of this study is to estimate the condition-specific case fatality ratio (CFR) for different subpopulations in Italy., Study Design: The design of the study was to estimate the 'pre-existing comorbidity'-conditional CFR to eventually explain the mortality risk variability reported around in different countries., Methods: We use the available information on pre-existing health conditions identified for deceased patients 'positive with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)' in Italy. We (i) estimated the total number of deaths for different pre-existing health conditions categories and (ii) calculated a conditional CFR based upon the number of comorbidities before SARS-CoV-2 infection., Results: Our results show a 0.6% conditional CFR for a population with zero pre-existing pathology, increasing to 13.9% for a population diagnosed with one and more pre-existing health conditions., Conclusions: Condition-specific mortality risks are important to be evaluated during the COVID-19 pandemic, with potential elements to explain the CFR variability around the globe. A careful postmortem examination of deceased cases to differentiate death 'caused by COVID-19' from death 'positive with SARS-CoV-2' is therefore urgently needed and will likely improve our understanding of the COVID-19 mortality risk and virus pathogenicity., (Copyright © 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Rationale: In Parkinson's disease (PD), spatial covariance analysis of 18 F-FDG PET data has consistently revealed a characteristic PD-related brain pattern (PDRP). By quantifying PDRP expression on a scan-by-scan basis, this technique allows objective assessment of disease activity in individual subjects. We provide a further validation of the PDRP by applying spatial covariance analysis to PD cohorts from the Netherlands (NL), Italy (IT), and Spain (SP)., Methods: The PDRP NL was previously identified (17 controls, 19 PD) and its expression was determined in 19 healthy controls and 20 PD patients from the Netherlands. The PDRP IT was identified in 20 controls and 20 "de-novo" PD patients from an Italian cohort. A further 24 controls and 18 "de-novo" Italian patients were used for validation. The PDRP SP was identified in 19 controls and 19 PD patients from a Spanish cohort with late-stage PD. Thirty Spanish PD patients were used for validation. Patterns of the three centers were visually compared and then cross-validated. Furthermore, PDRP expression was determined in 8 patients with multiple system atrophy., Results: A PDRP could be identified in each cohort. Each PDRP was characterized by relative hypermetabolism in the thalamus, putamen/pallidum, pons, cerebellum, and motor cortex. These changes co-varied with variable degrees of hypometabolism in posterior parietal, occipital, and frontal cortices. Frontal hypometabolism was less pronounced in "de-novo" PD subjects (Italian cohort). Occipital hypometabolism was more pronounced in late-stage PD subjects (Spanish cohort). PDRP IT , PDRP NL , and PDRP SP were significantly expressed in PD patients compared with controls in validation cohorts from the same center (P < 0.0001), and maintained significance on cross-validation (P < 0.005). PDRP expression was absent in MSA., Conclusion: The PDRP is a reproducible disease characteristic across PD populations and scanning platforms globally. Further study is needed to identify the topography of specific PD subtypes, and to identify and correct for center-specific effects.

The purpose of this study was to analyze the characteristics of individuals working in the field of neuropsychology in Italy, as part of a larger study examining the practice of neuropsychology across various countries. They were asked about their background, professional training, current work situation, types of assessment, preferred diagnostic procedures, as well as the rehabilitation techniques, their targeted populations, teaching responsibilities, and research activities. A total of 154 professionals completed an online survey from April 28, 2016 through June 30, 2016. The majority of participants were women, with a mean age of 42.6 years. Participants reported working for the National Health System, in private practice, or in private rehabilitation facilities. Overall, they reported being very satisfied with their work. Those who identified themselves as neuropsychologists primarily assessed individuals with dementia, stroke, movement disorders, and traumatic brain injury. While the majority of participants declared no problems with the instruments they used, others reported complaints, including but not limited to the financial cost of current neuropsychological tests and the lack of psychometric support. The main perceived obstacles were the lack of willingness to collaborate among professionals, the scarcity of academic training programs, and the lack of clinical training opportunities.

Previous research has shown that the transect walks (TW) method provide a practical and effective approach to welfare assessment in broiler and turkey farms. This method for turkey welfare assessment is reasonable in terms of time demands within minimal costs. Furthermore, TW approach resembles the routine checks used by farmers. The overall aim of this study was to verify the feasibility of the TW method as potential practical tool for on-farm welfare assessment in turkeys during the fattening period. A total of 14 commercial turkey farms (8 male and 6 female flocks) of the same genetic strain (British United Turkeys [B.U.T.] - Big 6) with similar management standard procedures were evaluated. Bird ages at evaluation ranged from 122 to 138 D and 90 to 103 D old, for males and females, respectively. Two independent assessors walked slowly on randomized longitudinal paths (transects) within each house, while recording the prevalence of birds showing any of the 12 welfare and health indicators considered: immobility, lameness, wounds, small size, featherless, dirtiness, sick, terminally ill, dead, and behavioral indicators, such as, aggression towards mate, interaction with humans and mating. The effect of assessor, gender, and interaction assessor by gender was evaluated by using ANOVA. Reliability of the method was noted by the effect of gender (P < 0.001) for immobility, lameness, wounds, and dirtiness indicators. Male flocks showed higher prevalence of immobility (0.035±0.004% vs. 0.004±0.001%), lameness (2.269±0.108% vs. 1.253±0.051%), wounds (0.288±0.014% vs. 0.127±0.009%), and dirtiness (0.050±0.004% vs. 0.022±0.004%) as compared to female flocks. Differences among assessors were relatively minor, with differences detected only for back and tail wounds, dirtiness, aggression towards mate, and interaction with humans. This study reports advantages and limitations of this method for welfare assessment on-commercial turkey flocks and it is the first description of the Italian welfare profile of turkey's commercial flocks., (© 2018 Poultry Science Association Inc.)