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Background Secondhand smoke (SHS) exposure at home and fetal SHS exposure during pregnancy are a major cause of disease among children. The aim of this study is quantifying the burden of disease due to SHS exposure in children and in pregnancy in 2006-2017 for the 28 European Union (EU) countries. Methods Exposure to SHS was estimated using a multiple imputation procedure based on the Eurobarometer surveys, and SHS exposure burden was estimated with the comparative risk assessment method using meta-analytical relative risks. Data on deaths and disability-adjusted life years (DALYs) were collected from National statistics and from the Global Burden of Disease Study. Results Exposure to SHS and its attributable burden stalled in 2006-2017; in pregnant women, SHS exposure was 19.8% in 2006, 19.1% in 2010, and 21.0% in 2017; in children it was 10.1% in 2006, 9.6% in 2010, and 12.1% in 2017. In 2017, 35,633 DALYs among children were attributable to SHS exposure in the EU, mainly due to low birth weight. Conclusions Comprehensive smoking bans up to 2010 contributed to reduce SHS exposure and its burden in children immediately after their implementation; however, SHS exposure still occurs, and in 2017, its burden in children was still relevant. Impact Exposure to secondhand smoke at home and in pregnancy is a major cause of disease among children. Smoking legislation produced the adoption of voluntary smoking bans in homes; however, secondhand smoke exposure at home still occurs and its burden is substantial. In 2017, the number of deaths and disability-adjusted life years in children attributable to exposure to secondhand smoke in the European Union countries were, respectively, 335 and 35,633. Low birth weight caused by secondhand smoke exposure in pregnancy showed the largest burden. Eastern European Union countries showed the highest burden.

Introduction: Second-hand smoke exposure in the home is a serious cause of ill-health for children. Behaviour change interventions have been developed to encourage parents to keep homes smoke-free. This study evaluates a novel air quality feedback intervention using remote air quality monitoring with SMS and email messaging to promote smoke-free homes among families from deprived areas. Methods: This paper presents a pre-post study of this intervention. Using internet connected monitors developed with the Dylos DC1700, daily SMS and weekly email feedback provided for 16 days to participants recruited in four European countries. Participants were recruited based on their stage of change, in order to target those most able to achieve smoke-free homes. The primary outcome measure was median change in mean fine particulate matter (PM2.5) concentration between baseline and follow-up periods, while secondary outcome measures included change in time over the World Health Organisation (WHO) guideline limit for PM2.5 exposure over 24 h (25 mu g/m(3)) in those periods and the number of homes where PM2.5 concentrations reduced. Telephone interviews were conducted with participants in Scotland post-intervention to explore intervention experience and perceived effectiveness. Results: Of 86 homes that completed the intervention study, 57 (66%) experienced pre-post reductions in measured PM2.5. The median reduction experienced was 4.1 mu g/m(3) (a reduction of 19% from baseline, p = 0.008). Eight homes where concentrations were higher than the WHO guideline limit at baseline fell below that level at follow-up. In follow-up interviews, participants expressed positive views on the usefulness of air quality feedback. Discussion: Household air quality monitoring with SMS and email feedback can lead to behaviour change and consequent reductions in SHS in homes, but within the context of our study few homes became totally smoke-free.

Aim: The current study examined symptoms of irritation reported by non-smokers passively exposed to e-cigarette aerosols and their timing and association with the concentrations of volatile organic compounds (VOCs) produced. Methods: 40 healthy non-smoking adults were exposed to e-cigarette aerosols for 30 min in a 35 m3 room. Second-hand e-cigarette aerosol (SHA) was produced by an experienced e-cigarette user using a standardized topography and two resistance settings (exposure 0.5 Ohm and 1.5 Ohm), in addition to a control session (no emissions). PM2.5 and PM1.0 were continuously measured over the duration of exposure, while Volatile Organic Compounds (VOCs) were recorded at 0, 15 and 30 min (t0, t15 and t30) of exposure. Each participant completed an irritation questionnaire at t0, t15, t30 of exposure and t60 (30 min post-exposure) on ocular, nasal, throat-respiratory symptoms of irritation and general complaints. Kruskal-Wallis H test for PM comparisons, repeated measures ANOVA for VOCs and Generalized Estimating Equations for symptoms of irritation and association with VOCs were used for statistical analysis. Results: 20 males and 20 females, with a mean age of 24.6 years (SD = 4.3) and exhaled CO < 7 ppm participated. PM concentrations in both experimental sessions were higher than the Control (p < 0.001). The most commonly reported symptoms were burning, dryness, sore throat, cough, breathlessness and headache. During both experimental sessions, ocular, nasal, throat-respiratory symptoms and general complaints increased significantly (p < 0.05). Ocular and nasal symptoms returned to baseline by t60 (p > 0.05) while throat-respiratory symptoms were still significantly higher at t60 (p = 0.044). VOCs were significantly associated with reported nasal and throat-respiratory symptoms in both experimental sessions (p < 0.05). Conclusion: A 30-min exposure to SHA provoked symptoms of sensory irritation and general complaints that lasted up to 30 min after the exposure and were positively associated with the concentrations of the VOC mixture emitted. © 2019 Elsevier Inc.

Il saggio analizza le novità apportate dalla cd. "legge Madia" in ordine all'utilizzazione delle figure contrattuale flessibili da parte delle pubbliche amministrazioni mettendo in evidenza come nonostante l'intento dichiarato nelle legge delega di limitare quanto più possibile l'utilizzo dei contratti di lavoro diversi da quelli a tempo indeterminato, il successivo decreto delegato continui a ritenere utilizzabili tutti i contratti flessibili esistenti nel settore privato

Our aim was to provide a systematic review of studies on the burden of disease due to second-hand smoke (SHS) exposure, reviewing methods, exposure assessment, diseases causally linked to SHS, health outcomes, and estimates available to date. A literature review of studies on the burden of disease from SHS exposure, available in PubMed and SCOPUS, published 2007-2018 in English language, was carried out following the PRISMA recommendations. Overall, 588 studies were first identified, and 94 were eligible. Seventy-two studies were included in the systematic review. Most of them were based on the comparative risk assessment approach, assessing SHS exposure using mainly surveys on exposure at home/workplaces. Diseases more frequently studied were: lung cancer, ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma and breast cancer in adults; lower respiratory tract infection, otitis media, asthma, sudden infant death syndrome and low birth weight in children. The SHS exposure assessment and the reported population attributable fractions (PAF) were largely heterogeneous. As an example, the PAF from lung cancer varied between 0.6% and 20.5%. Moreover, PAF were estimated applying relative risks and SHS exposures with no consistent definitions or with different age classes. The research gap on the SHS exposure burden is shrinking. However, estimates are not yet available for a number of countries, particularly the Middle Eastern and African countries, and not all diseases with the strongest evidence of causation, such as sudden infant death syndrome, have been explored. Moreover, in some cases the applied methodology revealed relatively low quality of data.

Il volume affronta in modo analitico e con un approccio critico le modifiche introdotte con la riforma Madia nell'ambito dei rapporti di lavoro alle dipendenze della P.A.

El estudio, desde la perspectiva de una reconstrucción general del trabajo económicamente dependiente en el ordenamiento italiano, examina las modificaciones que introdujo la Ley de reforma del mercado de trabajo de 2012 en el contrato por proyecto y en la regulación de otros tipos de trabajo por cuenta propia, como las –así llamadas– falsas partite IVA

The family of serine/threonine kinases B/Akt (hereafter Akt) represents a central node in signalling pathways downstream of growth factors, cytokines, and other cellular stimuli. In mammalian cells the Akt family comprises three highly homologous members -known as Akt1/PKBalpha, Akt2/PKBbeta, and Akt3/PKBgamma- that regulate several processes including cell proliferation and survival, growth and response to nutrient availability, migration, tissue invasion and angiogenesis. Aberrant activation of Akt is involved in a variety of human cancers including those arising in the thyroid gland. Here, we review the contribution of Akt-dependent pathway in the proliferation of normal thyrocytes, the different pathogenic mechanisms underlying aberrant Akt signalling in thyroid malignancies as well as the relative roles of Akt substrates that most likely contribute to the onset and/or progression of thyroid cancer. Finally, we discuss the current therapeutic strategies targeting the components of the PI3K/Akt pathway in the context of thyroid malignancy.

Simple Summary The main finding reported in this manuscript is that the gain-of-function mutation AKT1E17K is a bona fide oncogene for mammary epithelium, being able to efficiently initiate breast cancer in mice. On the basis of high-molecular-weight cytokeratins expressed by AKT1E17K-derived tumors supported by additional integrative gene expression analysis these tumors resulted similar to human basal-like cancer, phenotypically and molecularly. These results indicate that the AKTE17K strain may represent an appropriate model of human basal-like breast cancer for the identification of novel therapies specific for this type of tumor. The gain-of-function mutation in the pleckstrin homology domain of AKT1 (AKT1E17K) occurs in lung and breast cancer. Through the use of human cellular models and of a AKT1E17K transgenic Cre-inducible murine strain (R26-AKT1E17K mice), we have demonstrated that AKT1E17K is a bona fide oncogene for lung epithelial cells. However, the role of AKT1E17K in breast cancer remains to be determined. Here, we report the generation and the characterization of a MMTV-CRE; R26-AKT1E17K mouse strain that expresses the mutant AKT1E17K allele in the mammary epithelium. We observed that AKT1E17K stimulates the development of mammary tumors classified as ductal adenocarcinoma of medium-high grade and presented a variety of proliferative alterations classified as adenosis with low-to-high grade dysplasia in the mammary epithelium. A subsequent immunohistochemical characterization suggested they were PR-/HER2(-)/ER+, basal-like and CK8(-)/CK10(-)/CK5(+)/CK14(+). We also observed that, in parallel with an increased proliferation rate, tumors expressing mutant AKT1E17K presented an activation of the GSK3/cyclin D1 pathway in the mammary epithelium and cluster significantly with the human basal-like tumors. In conclusion, we demonstrate AKT1E17K is a bona fide oncogene that can initiate tumors at high efficiency in murine mammary epithelium in vivo.

Mosquitoes represent a considerable nuisance and are actual/potential vectors of human diseases in Europe. Costly and labour-intensive entomological monitoring is needed to correct planning of interventions aimed at reducing nuisance and the risk of pathogen transmission. The widespread availability of mobile phones and of massive Internet connections opens the way to the contribution of citizen in complementing entomological monitoring. ZanzaMapp is the first mobile &ldquo, mosquito&rdquo, application for smartphones specifically designed to assess citizens&rsquo, perception of mosquito abundance and nuisance in Italy. Differently from other applications targeting mosquitoes, ZanzaMapp prioritizes the number of records over their scientific authentication by requesting users to answer four simple questions on perceived mosquito presence/abundance/nuisance and geo-localizing the records. The paper analyses 36,867 ZanzaMapp records sent by 13,669 devices from 2016 to 2018 and discusses the results with reference to either citizens&rsquo, exploitation and appreciation of the app and to the consistency of the results obtained with the known biology of main mosquito species in Italy. In addition, we provide a first small-scale validation of ZanzaMapp data as predictors of Aedes albopictus biting females and examples of spatial analyses and maps which could be exploited by public institutions and administrations involved in mosquito and mosquito-borne pathogen monitoring and control.

Background Case-finding tools, such as the Identify Chronic Migraine (ID-CM) questionnaire, can improve detection of CM and alleviate its significant societal burden. We aimed to develop and validate the Italian version of the ID-CM (ID-EC) in paper and as a smart app version in a headache clinic-based setting. Methods The study investigators translated and adapted to the Italian language the original ID-CM questionnaire (ID-EC) and further implemented it as a smart app. The ID-EC was tested in its paper and electronic version in consecutive patients referring to 9 Italian tertiary headache centers for their first in-person visit. The scoring algorithm of the ID-EC paper version was applied by the study investigators (case-finding) and by patients (self-diagnosis), while the smart app provided to patients automatically the diagnosis. Diagnostic accuracy of the ID-EC was assessed by matching the questionnaire results with the interview-based diagnoses performed by the headache specialists during the visit according to the criteria of International Classification of Headache Disorders, III edition, beta version. Results We enrolled 531 patients in the test of the paper version of ID-EC and 427 in the validation study of the smart app. According to the clinical diagnosis 209 patients had CM in the paper version study and 202 had CM in the smart app study. 79.5% of patients returned valid paper questionnaires, while 100% of patients returned valid and complete smart app questionnaires. The paper questionnaire had a 81.5% sensitivity and a 81.1% specificity for case-finding and a 30.7% sensitivity and 90.7% specificity for self-diagnosis, while the smart app had a 64.9% sensitivity and 90.2% specificity. Conclusions Our data suggest that the ID-EC, developed and validated in tertiary headache centers, is a valid case-finding tool for CM, with sensitivity and specificity values above 80% in paper form, while the ID-EC smart app is more useful to exclude CM diagnosis in case of a negative result. Further studies are warranted to assess the diagnostic accuracy of the ID-EC in general practice and population-based settings.

A rising global attention to the environmental impact of anthropogenic activities pushes towards a continuous reduction of such impact and a control, through monitoring techniques, of the main sources of pollution. The transport sector is involved, as all other field of anthropogenic activities in the efforts towards a drastic abatement of emissions. Shipping activities generate greenhouse effect gases (GHGs), affecting the environment on a global scale, and other pollutants harmful for human health and the ecosystem on a local scale. These latter aspects are particularly relevant in ports where berths are close to densely inhabited areas. Many efforts have been and will be spent to predict and quantify these emissions with the aim of controlling them but direct measurements aimed at the identification and quantification of particularly polluting substances are to be considered a key point to achieve an effective control of emissions. In the context of ports, as in any transportation infrastructure, an identification of polluting vehicles and a quantification in an objective way of their emissions is crucial to implement any control activity of the polluting emissions. The development of optical remote sensing techniques appears to be particularly promising. This work provides a state of the art of the main techniques based on optical sensors (LIDAR, LIDAR DIAL, DOAS, camera UV) possibly applied in the maritime sector, highlighting advantages and potentialities. Results of a preliminary measurement campaign are reported to show the first encouraging feedback for the feasibility of the application.

The essay makes a comment on the articles 54, 55 and 56 of the Act of the legislative provisions on the protection and support of maternity and paternity

L'A. esamina in modo critico le modifiche apportate al sistema della contrattazione collettiva e alla partecipazione sindacale dalla Riforma Madia, mettendo in evidenza i profili di discontinuità con la precedente riforma del 2009.