21 research outputs found
Nanomaterial exposure, toxicity, and impact on human health
No full textThe use of engineered nanomaterials (ENM) has grown after the turn of the 21st century. Also, the production of ENM has globally grown, and exposure of workers especially via the lungs to ENM has increased. This review tackles with effects of ENM on workers' health because occupational environment is the main source of exposure to ENM. Assessment of exposure to ENM is demanding, and today there are no occupational exposure level (OEL) for ENM. This is partly due to challenges of such measurements, and in part to the unknown causality between ENM metrics and effects. There are also marked gaps in systematic knowledge on ENM hazards. Human health surveys of exposed workers, or human field studies have not identified specific effects of ENM linking them with a specific exposure. There is, however, a consensus that material characteristics such as size, and chemistry influence effects of ENM. Available data suggest that multiwalled carbon nanotubes (MWCNT) affect the immunological system and cause inflammation of the lungs, or signs of asthma whereas carbon nanofibers (CNF) may cause interstitial fibrosis. Metallic and metal oxide nanoparticles together with MWCNT induce genotoxicity, and a given type of MWCNT has been identified as a possible human carcinogen. Currently, lack of understanding of mechanisms of effects of ENM renders assessment of hazards and risks of ENM material-by-material a necessity. The so called "omics" approaches utilizing ENM-induced alterations in gene and protein expression may be useful in the development of a new paradigm for ENM hazard and risk assessment.This article is categorized under:Toxicology and Regulatory Issues in Nanomedicine > Toxicology of Nanomaterial
The impact of immunization programs on 10 vaccine preventable diseases in Italy: 1900–2015
No full textBackground: Vaccination has determined a dramatic decline in morbidity and mortality from infectious diseases over the last century. However, low perceived risk of the infectious threat and increased concern about vaccines’ safety led to a reduction in vaccine coverage, with increased risk of disease outbreaks. Methods: Annual surveillance data of nationally communicable infectious diseases in Italy between 1900 and 2015 were used to derive trends in morbidity and mortality rates before and after vaccine introduction, focusing particularly on the effect of vaccination programs. Autoregressive integrated moving average models were applied to ten vaccine-preventable diseases: diphtheria, tetanus, poliomyelitis, hepatitis B, pertussis, measles, mumps, rubella, chickenpox, and invasive meningococcal disease. Results of these models referring to data before the immunization programs were projected on the vaccination period to estimate expected cases. The difference between observed and projected cases provided estimates of cases avoided by vaccination. Results: The temporal trend for each disease started with high incidence rates, followed by a period of persisting reduction. After vaccine introduction, and particularly after the recommendation for universal use among children, the current rates were much lower than those forecasted without vaccination, both in the whole population and among the 0-to-4 year olds, which is, generally, the most susceptible age class. Assuming that the difference between incidence rates before and after vaccination programs was attributable only to vaccine, more than 4 million cases were prevented, and nearly 35% of them among children in the early years of life. Diphtheria was the disease with the highest number of prevented cases, followed by mumps, chickenpox and measles. Conclusions: Universal vaccination programs represent the most effective prevention tool against infectious diseases, having a major impact on human health. Health authorities should make any effort to strengthen public confidence in vaccines, highlighting scientific evidence of vaccination benefits
Towards defining a simplified procedure for COTS system-on-chip TID testing
No full textThe use of System-on-Chip (SoC) solutions in the design of on-board data handling systems is an important step towards further miniaturization in space. However, the Total Ionizing Dose (TID) and Single Event Effects (SEE) characterization of these complex devices present new challenges that are either not fully addressed by current testing guidelines or may result in expensive, cumbersome test configurations. In this paper we report the test setups, procedures and results for TID testing of a SoC microcontroller both using standard C60o and low-energy protons beams. This paper specifically points out the differences in the test methodology and in the challenges between TID testing with proton beam and with the conventional gamma ray irradiation. New test setup and procedures are proposed which are capable of emulating typical mission conditions (clock, bias, software, reprogramming, etc.) while keeping the test setup as simple as possible at the same time.Space Systems Egineerin
Can risk be predicted? An umbrella systematic review of current risk prediction models for cardiovascular diseases, diabetes and hypertension
No full textOBJECTIVE:
To provide an overview of the currently available risk prediction models (RPMs) for cardiovascular diseases (CVDs), diabetes and hypertension, and to compare their effectiveness in proper recognition of patients at risk of developing these diseases.
DESIGN:
Umbrella systematic review.
DATA SOURCES:
PubMed, Scopus, Cochrane Library.
ELIGIBILITY CRITERIA:
Systematic reviews or meta-analysis examining and comparing performances of RPMs for CVDs, hypertension or diabetes in healthy adult (18-65 years old) population, published in English language.
DATA EXTRACTION AND SYNTHESIS:
Data were extracted according to the following parameters: number of studies included, intervention (RPMs applied/assessed), comparison, performance, validation and outcomes. A narrative synthesis was performed. Data were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
STUDY SELECTION:
3612 studies were identified. After title/abstract screening and removal of duplicate articles, 37 studies met the eligibility criteria. After reading the full text, 13 were deemed relevant for inclusion. Three further papers from the reference lists of these articles were then added.
STUDY APPRAISAL:
The methodological quality of the included studies was assessed using the AMSTAR tool.
RISK OF BIAS IN INDIVIDUAL STUDIES:
Risk of Bias evaluation was carried out using the ROBIS tool.
RESULTS:
Sixteen studies met the inclusion criteria: six focused on diabetes, two on hypertension and eight on CVDs. Globally, prediction models for diabetes and hypertension showed no significant difference in effectiveness. Conversely, some promising differences among prediction tools were highlighted for CVDs. The Ankle-Brachial Index, in association with the Framingham tool, and QRISK scores provided some evidence of a certain superiority compared with Framingham alone.
LIMITATIONS:
Due to the significant heterogeneity of the studies, it was not possible to perform a meta-analysis. The electronic search was limited to studies in English and to three major international databases (MEDLINE/PubMed, Scopus and Cochrane Library), with additional works derived from the reference list of other studies; grey literature with unpublished documents was not included in the search. Furthermore, no assessment of potential adverse effects of RPMs was carried out.
CONCLUSIONS:
Consistent evidence is available only for CVD prediction: the Framingham score, alone or in combination with the Ankle-Brachial Index, and the QRISK score can be confirmed as the gold standard. Further efforts should not be concentrated on creating new scores, but rather on performing external validation of the existing ones, in particular on high-risk groups. Benefits could be further improved by supplementing existing models with information on lifestyle, personal habits, family and employment history, social network relationships, income and education
[What are the competencies that public health physician should have today? A proposal for a shared training program at three Hygiene and Preventive Medicine residency training schools in Rome (Italy)]
No full textTo acquire essential knowledge and skills for Public Health practice, residents in Hygiene and Preventive Medicine programs should be provided with excellent training. On behalf of the Roman Public Health Academy (ARSP), the authors, representing the three Hygiene and Preventive Medicine residency training programs in Rome (Italy) aimed to propose a training program to be shared by the above three schools. Firstly, they performed a scientific literature review to identify the core competencies that a public health specialist should have acquired at the end of training. Ten areas (macro-areas or domains) relevant to Public Health practice were defined. The authors then identified the main characteristics that the proposed training program should have, which include: enhancement of community healthcare services and optimization of local resources to create/strengthen exchange and cooperation networks; possibility to adapt the training proposal to an international setting; adoption of a training approach that can respond effectively to a changing health system; customization of training on the basis of residents' individual abilities and motivations, so that their individual strengths can be enhanced; achievement of educational excellence, in compliance with ethical requirements
A DNA-encoded chemical library based on chiral 4-amino-proline enables stereospecific isozyme-selective protein recognition
No full textDNA-encoded chemical libraries (DELs) consist of large chemical compound collections individually linked to DNA barcodes, facilitating pooled construction and screening. However, screening campaigns often fail if the molecular arrangement of the building blocks is not conducive to an efficient interaction with a protein target. Here we postulated that the use of rigid, compact and stereo-defined central scaffolds for DEL synthesis may facilitate the discovery of very specific ligands capable of discriminating between closely related protein targets. We synthesized a DEL comprising 3,735,936 members, featuring the four stereoisomers of 4-aminopyrrolidine-2-carboxylic acid as central scaffolds. The library was screened in comparative selections against pharmaceutically relevant targets and their closely related protein isoforms. Hit validation results revealed a strong impact of stereochemistry, with large affinity differences between stereoisomers. We identified potent isozyme-selective ligands against multiple protein targets. Some of these hits, specific to tumour-associated antigens, demonstrated tumour-selective targeting in vitro and in vivo. Collectively, constructing DELs with stereo-defined elements contributed to high library productivity and ligand selectivity
Frequent use of emergency departments by the elderly population when continuing care is not well established
No full textThe elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with "elderly frequent users"
A multivariate genetic analysis confirms rs5010528 in the human leucocyte antigen-C locus as a significant contributor to Stevens-Johnson syndrome/toxic epidermal necrolysis susceptibility in a Mozambique HIV population treated with nevirapine
No full textHematologic alterations and early mortality in a cohort of HIV positive African patients
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