obesity is one of the most prevalent diseases all over the world. Because of its high social impact, the broadest possible approach on several levels – and not limited only to clinical aspect – is needed to better understand and face the challenges obesity poses to public health.

to analyse, through the main evidence, the social impact of weight excess in the general population and the actions aimed at mitigating its negative effects.

narrative review.

data obtained from the sources included in the study were gathered and analyzed in five macroareas Health Inequality, Society, Work, Impact on Social Medicine (focused on the Italian model), and Social Costs.

each category showed a bilateral relationship with obesity having a significant impact for the community.

for each field, various actions should be taken at institutional level. Many recommendations and actions have already been taken worldwide, but they alone seem to be not enough. This work points out that, in order to combat obesity and bring about a slowdown of this pandemic, the entire scientific community and institutions must work together to identify and design programmes that are truly effective.

for each field, various actions should be taken at institutional level. Many recommendations and actions have already been taken worldwide, but they alone seem to be not enough. This work points out that, in order to combat obesity and bring about a slowdown of this pandemic, the entire scientific community and institutions must work together to identify and design programmes that are truly effective.

assessment of the health effects on the resident population around the incinerator for municipal solid waste in Valmadrera (Lombardy Region, Northern Italy) in relation to the exposure level to the pollutants produced by the plant.

historical cohort study, based on the resident population from 2003 to 2016 in the study area. With a dispersion model, based on PM10 emitted by the plant, three areas of exposure (high, medium, low) were defined and, on the basis of the residence of the cohort, different exposure levels were attributed to the subjects. The association between level of exposure and health effects were estimated by comparing the high and medium exposure levels with the low exposure level, using a Cox model, adjusted for age and socioeconomic deprivation index.

mortality rates, hospitalization rates, cancer incidence rates, and perinatal outcomes were analysed for the main causes potentially associated with exposure to incineration plants.

the subjects enrolled in the cohort were 106,056 (1,0do not have aetiological plausibility with exposure to pollutants from waste incineration. In particular, for liver/liver and biliary cancer, the association with infectious causes rather than exposure to environmental pollutants is more plausible.

leukaemia is the most prevalent form of childhood cancer, an overall rare condition in childhood. Even few cases occurring in a small community can cause considerable apprehension among the population. From 2014 to 2017, 4 cases of childhood cancer occurred in Valle di Ledro, a municipality of 5,300 inhabitants in Province of Trento (Northern Italy), and a group of concerned citizens asked provincial health authorities for an investigation.

to address the community’s health needs by verifying the hypothesis of a cluster of childhood cancer and through effective risk communication activities.

retrospective cohort analysis based on data from the Cancer registry of the Autonomous Province of Trento and data collected from hospital discharge records. The communication activities were carried out according to the recommendations published by Epidemiologia&Prevenzione in 2016 in a Supplement „Childhood cancers, risk factors and investigation models for the evaluation of spatio-temporal clusters”.

Valle tion of the results of the statistical analyses was effective in reassuring the population.

Supplemental perioperative oxygen is a low-cost intervention theorized to reduce the risk of surgical site infections, but its effect among patients undergoing surgery for a tibial plateau, tibial pilon, or calcaneal fracture is unknown. We aimed to determine the effectiveness of a high fraction of inspired oxygen (FiO 2 , 80%) versus low FiO 2 (30%) in reducing surgical site infections in these patients.

A randomized controlled trial was conducted at 29 U.S. trauma centers. We enrolled 1,231 patients who were 18 to 80 years of age and had a tibial plateau, tibial pilon, or calcaneal fracture and were thought to be at elevated risk for infection based on their injury characteristics. Patients were randomized to receive 80% FiO 2 (treatment group) or 30% FiO 2 (control group) in the operating room and for up to 2 hours in the recovery room. The primary outcome was a composite of either deep surgical site infection (treated with surgery) or superficial surgical site infection (treated with antibiotics alonealthough the benefit appears to mostly be in reduction of superficial infections.

Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

Acquired erythrocytosis can be classified into polycythemia vera (PV) and non-neoplastic erythrocytosis (NNE). The vast majority of PV patients harbor JAK2 mutations, but differentiating JAK2 mutation-negative PV from NNE is challenging due to a lack of definitive molecular markers.

We studied the clinical features of 121 patients with erythrocytosis of which 47 (38.8%) were JAK2 mutation-positive and also fulfilled the diagnostic criteria for PV, and 67 (55.4%) JAK2 mutation-negative erythrocytosis patients who were diagnosed as NNE. Diagnosis was strictly based on driver mutation analysis and central pathology review.

No JAK2 mutation-negative PV patients were found in our cohort. The NNE group showed significantly younger (p < 0.01) age with higher frequency of smoking (p < 0.001), alcohol consumption (p < 0.001), and diabetes mellitus (p < 0.05), whereas the PV group (n=47) showed significantly higher white blood cell count, platelet count, and lactate dehydrogenase (p < 0.001). Although serum erythropoietin (EPO) levels were significantly higher in NNE compared to PV (p < 0.001), approximately 40% of the NNE patients had EPO levels below the lower range of normal, fulfilling a minor diagnostic criterion of PV and raising the possibility of PV misdiagnosis.

Low EPO levels in JAK2 mutation-negative erythrocytosis may not be a reliable diagnostic criterion for distinguishing PV from NNE.

Low EPO levels in JAK2 mutation-negative erythrocytosis may not be a reliable diagnostic criterion for distinguishing PV from NNE.Studies of insecticide resistance provide insights into the capacity of populations to show rapid evolutionary responses to contemporary selection. Malaria control remains heavily dependent on pyrethroid insecticides, primarily in long lasting insecticidal nets (LLINs). Resistance in the major malaria vectors has increased in concert with the expansion of LLIN distributions. Identifying genetic mechanisms underlying high-level resistance is crucial for the development and deployment of resistance-breaking tools. Using the Anopheles gambiae 1000 genomes (Ag1000g) data we identified a very recent selective sweep in mosquitoes from Uganda which localized to a cluster of cytochrome P450 genes. Further interrogation revealed a haplotype involving a trio of mutations, a nonsynonymous point mutation in Cyp6p4 (I236M), an upstream insertion of a partial Zanzibar-like transposable element (TE) and a duplication of the Cyp6aa1 gene. The mutations appear to have originated recently in An. gambiae from the Kenya-Uganda border, with stepwise replacement of the double-mutant (Zanzibar-like TE and Cyp6p4-236 M) with the triple-mutant haplotype (including Cyp6aa1 duplication), which has spread into the Democratic Republic of Congo and Tanzania. The triple-mutant haplotype is strongly associated with increased expression of genes able to metabolize pyrethroids and is strongly predictive of resistance to pyrethroids most notably deltamethrin. Importantly, there was increased mortality in mosquitoes carrying the triple-mutation when exposed to nets cotreated with the synergist piperonyl butoxide (PBO). Frequencies of the triple-mutant haplotype remain spatially variable within countries, suggesting an effective marker system to guide deployment decisions for limited supplies of PBO-pyrethroid cotreated LLINs across African countries.Genetic and residual variances of traits are important input parameters for best linear unbiased prediction (BLUP) breeding value estimation. In honeybees, estimates of these variances are often associated with large standard errors, entailing a risk to perform genetic evaluations under wrong premises. The consequences hereof have not been sufficiently studied. In particular, there are no adequate investigations on this topic accounting for multi-trait selection or genetic peculiarities of the honeybee. We performed simulation studies and explored the consequences of selection for honeybee populations with a broad range of true and assumed genetic parameters. We found that in single-trait evaluations, the response to selection was barely compromised by assuming erroneous parameters, so that reductions in genetic progress after 20 years never exceeded 21%. Phenotypic selection appeared inferior to BLUP selection, particularly under low heritabilities. Parameter choices for genetic evaluation had great effects on inbreeding development. By wrongly assuming high heritabilities, inbreeding rates were reduced by up to 74%. When parallel selection was performed for two traits, the right choice of genetic parameters appeared considerably more crucial as several incorrect premises yielded inadvertent negative selection for one of the traits. This phenomenon occurred in multiple constellations in which the selection traits expressed a negative genetic correlation. It was not reflected in the estimated breeding values. Our results indicate that breeding efforts heavily rely on detailed knowledge on genetic parameters, particularly when multi-trait selection is performed. Thus, considerable effort should be invested into precise parameter estimations.

Women living with HIV (WLWH) experience higher rates of human papillomavirus (HPV) infection and cervical cancer than women without HIV. Changes in the vaginal microbiome have been implicated in HPV-related disease processes such as persistence of high-risk HPV infection but this has not been well defined in a population living with HIV.

Four hundred and 20 girls and WLWH, age ≥9, across 14 clinical sites in Canada were enrolled to receive three doses of quadrivalent HPV vaccine for assessment of vaccine immunogenicity. Blood, cervical cytology, and cervico-vaginal swabs were collected. Cervico-vaginal samples were tested for HPV DNA and underwent microbiota sequencing.

Principal component analysis (PCA) and hierarchical clustering generated community state types (CSTs). Relationships between taxa and CSTs with HPV infection were examined using mixed-effects logistic regressions, Poisson regressions, or generalized linear mixed-effects models, as appropriate. Three hundred and fifty-six cervico-vaginal microbiota samples from 172 women were sequenced.