This umbrella review provides a comprehensive synthesis of the available evidence on the relationship between digital device use and adolescent sleep. It summarizes results from systematic reviews and meta-analyses, presenting the magnitude and direction of observed associations. A total of seven systematic reviews, including five qualitative reviews and two meta-analyses, were included, comprising 127 primary studies with a combined sample of 867,003 participants. The findings suggest a negative impact of digital device use on various sleep parameters, including sleep duration, bedtime procrastination, and sleep quality. Devices such as smartphones and computers were found to have a greater adverse effect, while television use showed a weaker association. The most significant disruptions were observed in relation to social media and internet use, with problematic usage leading to delayed bedtimes, shorter sleep duration, and increased sleep onset latency. The review also highlights the role of timing and duration of device use, with late-night use particularly contributing to sleep disturbances. Biological, psychological, and social mechanisms are proposed as potential pathways underlying these effects. Despite moderate evidence supporting the negative impact of digital media on sleep, there is considerable heterogeneity across studies, and many relied on self-reported data, which may limit the generalizability of the findings. Future research should aim to standardize exposure and outcome measures, incorporate objective data collection methods, and explore causal relationships through longitudinal studies. This umbrella review underscores the importance of developing targeted public health strategies, parental guidance, and clinical awareness to mitigate the potential adverse effects of digital device use on adolescent sleep and mental health.

Graves’ disease (GD) is an autoimmune disease considered the most common cause of hyperthyroidism. Some studies have investigated its relationship with the risk and prognosis of developing thyroid cancer. Considering that there is no consensus on the relationship between GD and thyroid cancer risk, this umbrella review aimed to summarize the epidemiologic evidence and evaluate its strength and validity on the associations of GD with thyroid cancer risk and its prognosis. This umbrella review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched PubMed and Scopus from January 2012 to December 2022. The strength of the epidemiological evidence was graded as high, moderate, or weak by the Measurement Tool to Assess Systematic Reviews (AMSTAR-2). “Strong” evidence was found for the risk of thyroid cancer in GD patients with thyroid nodular disease (OR: 5.30; 95% CI 2.43–12) and for the risk of mortality from thyroid cancer in these patients (OR 2.93, 95% CI 1.17–7.37, p = 0.02), particularly in Europe (OR 4.89; 95% CI 1.52–16). The results of this umbrella review should be interpreted with caution; as the evidence comes mostly from retrospective studies, potential concerns are selection and recall bias, and whether the empirically observed association reflects a causal relationship remains an open question.

Breast cancer (BC) is a major global health challenge, responsible for one in four cancer diagnoses and one in six cancer-related deaths worldwide. It is the most frequently diagnosed cancer among women and the primary cause of cancer-related deaths in most countries. Recent studies have suggested a potential link between exposure to ambient air pollutants—such as nitrogen dioxide (NO₂) and particulate matter (PM₁₀ and PM_2.5)—and an increased risk of breast cancer. However, the existing evidence remains inconclusive. This umbrella review, conducted according to PRISMA guidelines, aimed to evaluate the strength and reliability of epidemiological evidence concerning this association. All seven meta-analyses included in this review reported a relative risk greater than 1 for exposure to the three pollutants, though findings varied in terms of heterogeneity and publication bias. Notably, the overall analysis indicates that exposure to both NO₂ and PM_2.5 may be associated with an increased risk of breast cancer incidence, while the evidence linking PM_2.5 exposure to breast cancer mortality appears to be weaker. The most vulnerable groups were identified as premenopausal European women exposed to NO₂ and PM₁₀, as well as individuals in developed countries exposed to PM_2.5. Further research is necessary to examine PM composition and refine exposure assessment methodology. Given the widespread impact of breast cancer as the most common invasive malignancy, incorporating this outcome into environmental health research on air pollution is essential. A clearer understanding of these associations could support more targeted environmental interventions. Importantly, the available evidence suggests that breast cancer prevention can be addressed not only through personal lifestyle changes but also through broad public health policies focused on reducing NO₂, PM₁₀ and PM_2.5 levels.

(1) Background: Healthcare providers have a crucial role in contrasting vaccine hesitancy (VH). We aimed to investigate opinions, knowledge, and attitudes toward vaccines in healthcare students (HS) at the University of Catania (Italy). (2) Methods: A survey was conducted from 1 October 2019 to 31 January 2020. Data on the opinions, knowledge, and attitudes of HS toward vaccinations were collected using an anonymous self-administered questionnaire. The opinion answers were added to calculate the VH index (23 = high). Data were summarized by the VH index, degree, year of study, and sex differences, using descriptive statistics. (3) Results: A total of 1275 students (53.7% females) participated in the study, with a median (IQR) age of 21 (19–22) years. The median level of VH was 20 (17–23), with slightly higher values in males. We found an inverse trend between VH and opinions, knowledge, and attitudes toward vaccines. The same trend was confirmed in all study courses. Furthermore, the comparison between sexes revealed a higher level of knowledge in women. (4) Conclusions: The results highlight a lack of knowledge about vaccines, as well as contrasting opinions and attitudes among future health professionals. Therefore, future interventions on these topics in the preparation of future healthcare providers are needed.

Air emissions from livestock farming, particularly ammonia (NH₃) and particulate matter (PM_2.5 and PM₁₀), constitute a major environmental and occupational health concern. The aim of this work was to assess the compliance with the Verification of Environmental Technologies for Agricultural Production (VERA) protocol in livestock emission monitoring studies and to propose the Adherence VERA Index (AVI) as a novel quantitative tool for standardizing methodological evaluation. A literature search was conducted in PubMed and Scopus, identifying 26 eligible studies published between January 2012 and June 2025. Data were extracted on farm characteristics, analytical methods, environmental variables, and emission outcomes, and evaluated across the five VERA protocol domains. The review revealed substantial methodological heterogeneity and overall suboptimal compliance with the VERA protocol, with frequent deficiencies in the reporting of key parameters such as ventilation rate, sampling strategy, and emission estimation methods. In this context, the AVI, by condensing core VERA requirements into a concise and operational metric, may facilitate protocol uptake and improve reporting compliance compared with the full VERA framework. Notably, several studies reported NH₃, PM_2.5 and PM₁₀ concentrations exceeding occupational and environmental exposure thresholds, particularly in swine and poultry farms, highlighting critical risks to workers’ health. These findings underscore the need for enhanced standardization, integration of occupational health metrics, and improved air quality monitoring to ensure reliable exposure assessment and to safeguard both environmental and worker health in the livestock sector.

Cigarette butt waste is a widespread form of tobacco-related litter and an increasingly recognized source of environmental contamination. This systematic review synthesized evidence on the environmental impacts of cigarette butts and other tobacco and nicotine product waste, including contaminant release, plastic-derived particle generation, affected environmental matrices, ecotoxicological effects, dose–effect relationships, and ecological and human health risk assessment within a One Health framework. Following PRISMA guidelines and PROSPERO registration, PubMed, Scopus, and Web of Science were systematically searched. Forty-seven studies were included. Cigarette butts and related waste were found to release diverse contaminants, including metals, nicotine, PAHs, VOCs, BTEX, pesticides, phenolic compounds, aromatic amines, and cellulose-acetate-derived micro- and nanoplastics. Nicotine emerged as a prominent contaminant, with rapid release and high modelled ecological risk reported in some studies. Freshwater and marine environments were most frequently investigated, while soils, urban environments, stormwater systems, landfills, and waste-management pathways were also represented. Experimental studies reported mortality, growth inhibition, oxidative stress, reproductive and developmental impairment, genotoxicity, metabolic and behavioral alterations, and community-level effects. Evidence on emerging nicotine product waste remained limited and was constrained by differences in product design, terminology, characterization, and experimental scenarios. Overall, these wastes represent hybrid chemical–particulate environmental stressors, although their substantial heterogeneity limits broader generalization.