The future outlook on allergen immunotherapy in children: 2018 and beyond.

Allergen immunotherapy (AIT) is the only currently available immune-modifying and aetiological treatment for patients suffering from IgE-mediated diseases. In childhood, it represents a suitable therapeutic option to intervene during the early phases of respiratory allergic diseases such as rhino-conjunctivitis and asthma, which is when their progression may be more easily influenced. A growing body of evidence shows that oral immunotherapy represents a promising treatment option in children with persistent IgE- mediated food allergy. The efficacy of AIT is under investigation also in patients with extrinsic atopic dermatitis, currently with controversial results. Furthermore, AIT might be a strategy to prevent the development of a new sensitization or of a (new) allergic disease. However, there are still some methodological criticisms, such as: a) the regimen of administration and the amount of the maintenance dose are both largely variable; b) the protocols of administration are not standardized; c) the description and classification of side effects is variable among studies and needs to be standardized; d) quality of life and evaluation of health economics are overall missing. All these aspects make difficult to compare each study with another. In addition, the content of major allergen(s) remains largely variable among manufacturers and the availability of AIT products differences among countries. The interest and the attention to AIT treatment are currently fervent and increasing. Well-designed studies are awaited in the near future in order to overcome the current gaps in the evidence and furtherly promote implementation strategies

Mandatory vaccinations in European countries, undocumented information, false news and the impact on vaccination uptake: the position of the Italian pediatric society.

BACKGROUND: High rates of vaccination coverage are important in preventing infectious diseases. Enforcing mandatory vaccinations is one of the strategies that some Countries adopted to protect the community when vaccination coverage is not satisfactory. In Italy, in 2017 vaccination against diphtheria, tetanus, pertussis, hepatitis B, poliovirus, Haemophilus influenzae type b, measles, mumps, rubella and varicella became compulsory in childhood. In order to contrast vaccination policies, anti-vaccination campaigns contribute to the spread of fake news. Among them, there is the false information that Italy is the only one country with mandatory vaccination policy. Aim of our study is confronting vaccination policies in children under 18 months against among different European countries for the following vaccines: diphtheria, tetanus, pertussis, hepatitis B, poliovirus, Haemophilus influenzae type b, measles, mumps, rubella and varicella. METHODS: Information on policies of mandatory or recommended vaccinations of the European Countries were gathered by ECDC and compared to the Italian one. RESULTS: European Countries recommend or contemplate compulsory vaccines. Among them, eleven Countries (35.4%) have mandatory vaccinations for at least one out of diphtheria, tetanus, pertussis, hepatitis B, poliovirus, Haemophilus influenzae type b, measles, mumps, rubella and varicella vaccine. CONCLUSION: Not only in Italy, vaccination against diphtheria, tetanus, pertussis, hepatitis B, poliovirus, Haemophilus influenzae type b, measles, mumps, rubella and varicella is mandatory in children under 18 months. Other European countries adopted compulsory policies in order to prevent the spread of infectious diseases and to protect the community

Il contributo degli Enti Locali alla riduzione dei gas serra

Le città occupano solo il 2% della superficie del pianeta, ma sono responsabili di circa tre quarti delle emissioni globali di anidride carbonica di origine antropica. Si comprende dunque come sia fondamentale un ruolo attivo degli enti locali e dei cittadini in una efficace strategia di riduzione delle emissioni. Da un lato una politica intelligente e coraggiosa può portare in diverse aree (pensiamo innanzitutto alla mobilità urbana) alla definizione di incisivi interventi di riduzione delle emissioni. In secondo luogo un’azione di sensibilizzazione dei cittadini può orientare le scelte individuali verso comportamenti ambientalmente corretti. Come si è visto nelle esperienze sviluppatesi finora, non si tratta di inventarsi niente di nuovo, ma di inserire azioni che generalmente hanno una valenza positiva sull’ambiente e sulla qualità della vita a livello locale nel contesto più ampio della lotta al riscaldamento del pianeta

Les routes dans les parcs naturels en Italie comme cas européennes et en Colombie comme un cas pour l'Amérique latine

Perspectives mondiales de la connectivité et solutions d'entretien des routes rurales: l'environnement des parcs naturels en Italie comme cas européennes et en Colombie comme un cas pour l'Amérique latine. - Après une relation internationale sur l'étendue et le type de routes rurales dans certains Pays européens (Italie, Espagne, France, Allemagne, Bulgarie), l'article décrit l'application de différentes solutions d'entretien par le biais de trois études de cas appliqués dans les routes rurales à faible volume de trafic dans l'environnement des parcs naturels en Italie et en Colombie. Ce document illustre les caractéristiques techniques, le mode de placement, examiner les coûts de chaque application et considère également que l'environnement estimé pour chaque aspect de rechange. Pour l'Italie on va parler de l'entretien des routes dans un parc en Toscane et un parc naturel dans la région de Vénétie. Le premier cas est la technique du confinement en trois dimensions à la stabilisation in situ de subrasantes ou une couche de soutien grâce à l'utilisation de cellules-géo. Le deuxiéme décrit la mise en place d'un produit chimique de stabilisateur qui est mélangé avec le matériel existant offrant la viabilité des services sur place comme un cours portant. Pour la Colombie discute de la solution d'entretien avec fraisage matériaux stabilisé avec émulsion comme couche pleine profondeur sur le réseau qui relie le parc naturel de la Páramo de Sumapaz de Bogota. La sélection des matériaux est d'une importance primordiale et nécessite de prendre en compte la contribution structurelle que doit avoir la piste, en particulier dans les cas où il est prévu aussi les transport lourds ---------------------------------- SPAGNOLO Panorama mundial de la conectividad de carreteras y alternativas de mantenimiento en caminos rurales: el entorno de parques naturales en Italia como caso Europeo y en Colombia como caso para Latinoamérica Después de una relación internacional sobre el alcance y el tipo de caminos rurales en algunos Países europeos (Italia, España, Francia, Alemania, Bulgaria), el artículo describe la aplicación de diferentes alternativas de mantenimiento mediante tres casos prácticos aplicados en vías rurales con bajo volumen de tránsito en el entorno de parques naturales en Italia y en Colombia. El documento ilustra las características técnicas, la modalidad de colocación, revisa los costos de cada aplicación y, además considera el aspecto ambiental estimando para cada alternativa. Para Italia se analiza el caso del mantenimiento vial en un parque Natural en Toscana y un Parque natural en la región del Véneto. El primer caso trata de la técnica de confinamiento tridimensional para la estabilización de subrasantes in-situ o bien una capa de soporte a través del uso de geo-celdas. En el segundo caso se describe la colocación de un estabilizante químico que se mezcla con el material existente in-situ ofreciendo serviciabilidad como capa de rodadura. Para Colombia se analiza la alternativa de mantenimiento con material fresado estabilizado con emulsión como capa full-depth sobre la red que conecta Bogotá con el Parque Natural del Páramo de Sumapaz. La selección de los materiales es de principal importancia y requiere tener en cuenta el aporte estructural que debe tener la rodadura, de manera particular en aquellos casos donde se tiene previsto también el tránsito vehículos pesado

Strategic R&D Investment under Information Revelation\u201d

R&D projects generally involve multiple phases with or without overlapping. Moreover, the investment is usually made in a phased manner, with the commencement of the subsequent phase being dependent on the successful completion of the preceding phase. The aim of this article is to analyze the equilibrium strategies of two firms competing for a two-stage sequential R&D investment, when a firm may infer a private signal from the strategy played by the other. Thus, firms must formulate their optimal strategies in a context of imperfect information. We evaluate the resulting compound option with information revelation as an American compound exchange option using Monte Carlo simulations. We then show that different equilibria may arise

Prototipi di auto idrogeno/elettriche del Politecnico di Milano

I due prototipi X-Team (Artemide e Apollo) rappresentano veicoli da corsa studiati appositamente per la Shell Eco-marathon (gara incentrata sulla mobilità sostenibile: protezione dell’ambiente, efficienza energetica e ricerca ) ma le innovazioni introdotte indicano linee di tendenza per tutta l’industria automobilistica. Sono trascorsi venti anni e al Politecnico si continuano a studiare e progettare veicoli innovativi. I prototipi che andiamo ad illustrare non sono utilizzabili sulla rete stradale ma rappresentano il futuro: si inizia sempre con soluzioni “speciali” e “tipizzate” per una specifica evenienza (in questo caso la partecipazione alla Eco Marathon) ma quasi tutte le innovazioni nascono così: pensate per uno specifico scopo e poi, con alcune piccole o grandi modificazioni, utilizzate in larga scala

Media devices in pre-school children: the recommendations of the Italian pediatric society

BACKGROUND: Young children are too often exposed to mobile devices (MD) and most of them had their own device. The adverse effects of a early and prolonged exposure to digital technology on pre-school children has been described by several studies. Aim of the study is to analyze the consequences of MD exposure in pre-school children. METHODS: We analyzed the documented effects of media exposure on children's mental and physical health. RESULTS: According to recent studies, MD may interfere with learning, children development, well being, sleep, sight, listening, caregiver-child relationship. DISCUSSION: Pediatricians should be aware of both the beneficial and side effects of MD and give advice to the families, according to children's age. CONCLUSION: In according to literature, the Italian Pediatric Society suggest that the media device exposure in childhood should be modulated by supervisors

Association between spondylolisthesis and L5 fracture in patients with osteogenesis imperfecta

To investigate if an association between spondylolisthesis and L5 fracture occurs in patients affected by Osteogenesis Imperfecta (O.I.). Methods Anteroposterior and lateral radiograms were performed on the sample (38 O.I. patients, of whom 19 presenting listhesis); on imaging studies spondylolisthesis was quantified according to the Meyerding classification. Genant’s semiquantitative classification was applied on lateral view to evaluate the L5 fractures; skeleton spinal morphometry (MXA) was carried out on the same images to collect quantitative data comparable and superimposable to Genant’s classification. The gathered information were analyzed through statistical tests (O.R., χ 2 test, Fisher’s test, Pearson’s correlation coefficient). Results The prevalence of L5 fractures is 73.7 % in O.I. patients with spondylolisthesis and their risk of experiencing such a fracture is twice than O.I. patients without listhesis (OR 2.04). Pearson’s χ 2 test demonstrates an association between L5 spondylolisthesis and L5 fracture, especially with moderate, posterior fractures (p = 0.017) and primarily in patients affected by type IV O.I. Conclusions Spondylolisthesis represents a risk factor for the development of more severe and biconcave/posterior type fractures of L5 in patients suffering from O.I., especially in type IV. This fits the hypothesis that the anterior sliding of the soma of L5 alters the dynamics of action of the load forces, localizing them on the central and posterior heights that become the focus of the stress due to movement of flexion–extension and twisting of the spine. As a result, there is greater probability of developing an important subsidence of the central and posterior walls of the soma

Relational reasoning via probabilistic coupling

Probabilistic coupling is a powerful tool for analyzing pairs of probabilistic processes. Roughly, coupling two processes requires finding an appropriate witness process that models both processes in the same probability space. Couplings are powerful tools proving properties about the relation between two processes, include reasoning about convergence of distributions and stochastic dominance---a probabilistic version of a monotonicity property. While the mathematical definition of coupling looks rather complex and cumbersome to manipulate, we show that the relational program logic pRHL---the logic underlying the EasyCrypt cryptographic proof assistant---already internalizes a generalization of probabilistic coupling. With this insight, constructing couplings is no harder than constructing logical proofs. We demonstrate how to express and verify classic examples of couplings in pRHL, and we mechanically verify several couplings in EasyCrypt

Soluzioni per strade in ambiti territoriali protetti

Dopo aver analizzato le principali caratteristiche delle strade extraurbane in alcuni Paesi europei (Italia, Spagna, Francia, Germania), questo articolo compara diverse alternative di manutenzione partendo dalle soluzioni adottate per strade a basso volume di traffico in Italia e in Colombia. Partendo dalle caratteristiche tecniche sono stati analizzati in particolare i costi dei singoli interventi includendo i costi ambientali connessi. Per l'Italia sono stati esaminati due casi di manutenzione stradale: in Toscana ed in Veneto. Per la Colombia si è analizzato il caso della strada di collegamento tra Bogotà ed il parco naturale del Páramo di Sumapaz