Public Health Genomics: moving towards the implementation of dedicated policies in Europe

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The preparation of the Shutdown Dose Rate experiment for the next JET Deuterium-Tritium campaign

The assessment of the Shutdown Dose Rate (SDR) due to neutron activation is a major safety issue for fusion devices and in the last decade several benchmark experiments have been conducted at JET during Deuterium-Deuterium experiments for the validation of the numerical tools used in ITER nuclear analyses. The future Deuterium-Tritium campaign at JET (DTE2) will provide a unique opportunity to validate the codes under ITER-relevant conditions through the comparison between numerical predictions and measured quantities (C/E). For this purpose, a novel SDR experiment, described in the present work, is in preparation in the frame of the WPJET3-NEXP subproject within EUROfusion Consortium. The experimental setup has been accurately designed to reduce measurement uncertainties; spherical air-vented ionization chambers (ICs) will be used for on-line ex-vessel decay gamma dose measurements during JET shutdown following DT operations and activation foils have been selected for measuring the neutron fluence near ICs during operations. Active dosimeters (based on ICs) have been calibrated over a broad energy range (from about 30 keV to 1.3 MeV) with X and gamma reference beam qualities. Neutron irradiation tests confirmed the capability of active dosimeters of performing on-line decay gamma dose rate measurements, to follow gamma dose decay at the end of neutron irradiation as well as insignificant activation of the ICs

Long-term efficacy and tolerability of intranasal fentanyl in the treatment of breakthrough cancer pain

Purpose: The aim of the present study was to assess the long-term tolerability and efficacy of intranasal fentanyl (INFS) in opioid-tolerant patients with breakthrough cancer pain (BTP).Patients and methods: A 6 months, observational, prospective, cohort study design was employed to follow advanced cancer patients with BTP receiving INFS under routine clinical practice. Eligible adult cancer patients suffering from BTP had been prescribed INFS at effective doses. Data were collected at T0 and at month intervals for six months. The principal outcomes were the evaluation of possible serious adverse effects with prolonged use of INFS, the efficacy of BTP treatment with INFS, the quality of sleep, the rate of INFS discontinuation, and reasons for that.Results: Seventy-five patients were surveyed. Thirty-four patients (45.3 %) had a follow-up at 3 months, and twelve patients (16 %) were followed up at 6 months. The mean opioid doses, expressed as oral morphine equivalents, ranged 111\u2013180 mg/day, while the mean INFS doses were 87\u2013119 \u3bcg. Adverse effects were reported in a minority of patients and were considered to be associated with opioid therapy used for background pain. The quality of sleep significantly improved during the first 3\u20134 months. Finally, efficacy based on a general impression regarding the efficacy of INFS was good-excellent in most patients and statistically improved in time up to the third month.Conclusion: The long-term use of INFS in advanced cancer patients is effective and safe. No serious adverse effects were found up to six months of assessment. The level of quality of sleep and patients\u2019 satisfaction was relatively good, considering the advanced stage of disease

Towards elimination of measles and rubella in Italy. Progress and challenges

Introduction In the WHO European Region, endemic transmission of measles and rubella had been interrupted by 37 and 42 of the 53 member states (MSs), respectively, by 2018. Sixteen MSs are still endemic for measles, 11 for rubella and nine for both diseases, the latter including Italy. Elimination is documented by each country’s National Verification Committee (NVC) through an annual status update (ASU). Objective By analysing data used to produce the ASUs, we aimed to describe the advances made by Italy towards elimination of measles and rubella. Moreover, we propose a set of major interventions that could facilitate the elimination process. Methods A total of 28 indicators were identified within the six core sections of the ASU form and these were evaluated for the period 2013–2018. These indicators relate to the incidence of measles/rubella; epidemiological investigation of cases; investigation of outbreaks; performance of the surveillance system; population immunity levels; and implementation of supplemental immunization activities (SIAs). Results From 2013 to 2018, epidemiological and laboratory analyses of measles cases in Italy improved substantially, allowing timely investigation in 2017 and 2018 of most outbreak and sporadic cases and identification of the majority of genotypic variants. Moreover, since 2017, vaccination coverage has increased significantly. Despite these improvements, several areas of concern emerged, prompting the following recommendations: i) improve outbreak monitoring; ii) strengthen the MoRoNet network; iii) increase the number of SIAs; iv) reinforce vaccination services; v) maintain regional monitoring; vi) design effective communication strategies; vii) foster the role of general practitioners and family paediatricians. Conclusions The review of national ASUs is a crucial step to provide the NVC with useful insights into the elimination process and to guide the development of targeted interventions. Against this background, the seven recommendations proposed by the NVC have been shared with the Italian Ministry of Health and the Technical Advisory Group on measles and rubella elimination and have been incorporated into the new Italian Elimination Plan 2019–2023 as a technical aid to facilitate the achievement of disease elimination goals

The Coulomb phase shift revisited

We investigate the Coulomb phase shift, and derive and analyze new and more precise analytical formulae. We consider next to leading order terms to the Stirling approximation, and show that they are important at small values of the angular momentum $l$ and other regimes. We employ the uniform approximation. The use of our expressions in low energy scattering of charged particles is discussed and some comparisons are made with other approximation methods.Comment: 13 pages, 5 figures, 1 tabl