Implementazione di processi funzionali ad uno studio LCA applicato ad un servizio di pulizia in ottica di etichettatura ecologica

La metodologia LCA rappresenta lo strumento chiave delle politiche europee per la valutazione degli impatti ambientali di prodotti e servizi durante il loro intero ciclo di vita. Essa è ampiamente impiegata, tra l’altro, per la valutazione dei servizi professionali di pulizia per questo motivo sono state elaborate delle linee guida (Product Category Rules, PCR) specifiche. Il principale obiettivo della tesi è l’elaborazione di un modello analitico per la valutazione del ciclo di vita del servizio di pulizia professionale svolto presso il Politecnico di Torino. Il modello è stato realizzato per valutare e confrontare gli impatti derivanti da tre possibili scenari di miglioramento del servizio elaborati in ottica Ecolabel. Il secondo obiettivo della tesi è testare l’adeguatezza del modello tramite sua implementazione nel software GaBi con i dati relativi al servizio in esame. La struttura del modello è basata sulla letteratura di riferimento (PCR di settore e EPD di servizi di pulizia) ma viene adattata alle esigenze dello studio a supporto del processo di sostituzione della fornitura secondo i protocolli Ecolabel. Il servizio è diviso in tre fasi: processi di upstream, core e downstream, rispettivamente riguardanti la produzione e il trasporto degli articoli di pulizia, l’erogazione del servizio e il fine vita dei prodotti impiegati. I processi inclusi nel modello sono stati selezionati perché influenzati da una variazione del protocollo di pulizia. I risultati ottenuti dallo studio sono relativi alla categoria d’impatto "Riscaldamento globale con orizzonte temporale di 100 anni (GWP100)" e risultano coerenti con la letteratura: la fase di maggior impatto è quella di core, seguita da upstream e poi downstream. Il modello risulta dunque idoneo all’obiettivo dello studio. Le fasi successive del progetto, escluse dall’elaborato, prevedono l’impiego del modello come base per lo svolgimento della LCA degli scenari Ecolabel, garantendo un solido confronto tra risultati

Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation

Objective. To investigate intrathecal immune activation parameters and HIV-RNA in HIV-associated neurocognitive disorders (HAND) of advanced naïve HIV-infected patients and to evaluate their dynamics before and after initiation of antiretroviral therapy (ART). Methods. Cross-sectional and longitudinal analysis of HIV RNA, proinflammatory cytokines (IL-6, IL-10, INF-γ, TNF-α, TGF-β1, and TGF-β2) and chemokines (MIP-1α, MIP-1β, and MCP-1) in plasma and cerebrospinal fluid (CSF) of HIV-infected patients with CD4 <200/μL. Results. HAND was diagnosed at baseline in 6/12 patients. Baseline CSF HIV-RNA was comparable in patients with or without HAND, whereas CSF concentration of IL-6 and MIP-1β, proinflammatory cytokines, was increased in HAND patients. CSF evaluation at 12 weeks was available in 10/12 cases. ART greatly reduced HIV-RNA in all patients. Nevertheless, IL-6 and MIP-1β remained elevated after 12 weeks of therapy in HAND patients, in whom CSF HIV RNA decay was slower than the plasmatic one as well. Conclusion. Immune activation, as indicated by inflammatory cytokines, but not higher levels of HIV-RNA is observed in advanced naïve HIV-infected patients with HAND. In HAND patients, ART introduction resulted in a less rapid clearance of CSF viremia compared to plasma and no modifications of intratechal immune activation

O055. Headache and psychopathological aspects in Gilles de la Tourette Sindrome:a comparison between paediatric and adult patients

Only few studies have analyzed the occurrence of headache in patients with Gilles de la Tourette syndrome (GTS) [1–3]. The aim of this study was to compare the prevalence and characteristics of headache in paediatric and adult patients with GTS and the relationship of headache with tic severity, psychiatric comorbidities and quality of life

Progression of echocardiographic parameters and prognosis in transthyretin cardiac amyloidosis

Aims: Transthyretin amyloid cardiomyopathy (ATTR-CM) is an increasingly diagnosed disease. Echocardiography is widely utilized, but studies to confirm the value of echocardiography for tracking changes over time are not available. We sought to describe (i) changes in multiple echocardiographic parameters; (ii) differences in rate of progression of three predominant genotypes; and (iii) the ability of changes in echocardiographic parameters to predict prognosis. Methods and results: We prospectively studied 877 ATTR-CM patients attending our centre between 2000 and 2020. Serial echocardiography findings at baseline, 12 months and 24 months were compared with survival. Overall, 565 patients had wild-type ATTR-CM and 312 hereditary ATTR-CM (201 with V122I; 90 with T60A). There was progressive worsening of structural and functional parameters over time, patients with V122I ATTR-CM showing more rapid worsening of left and right ventricular structural and functional parameters compared to both wild-type and T60A ATTR-CM. Among a wide range of echocardiographic analyses, including deformation-based parameters, only worsening in the degree of mitral (MR) and tricuspid regurgitation (TR) at 12- and 24-month assessments was associated with worse prognosis (change at 12 months: MR, hazard ratio 1.43 [95% confidence interval 1.14–1.80], p = 0.002; TR, hazard ratio 1.38 [95% confidence interval 1.10–1.75], p = 0.006). Worsening in MR remained independently associated with poor prognosis after adjusting for known predictors. Conclusion: In ATTR-CM, echocardiographic parameters progressively worsen over time. Patients with V122I ATTR-CM demonstrate the most rapid deterioration. Worsening of MR and TR were the only parameters associated with mortality, MR remaining independent after adjusting for known predictors

Cross-ancestry GWAS meta-analysis identifies six breast cancer loci in African and European ancestry women.

Our study describes breast cancer risk loci using a cross-ancestry GWAS approach. We first identify variants that are associated with breast cancer at P < 0.05 from African ancestry GWAS meta-analysis (9241 cases and 10193 controls), then meta-analyze with European ancestry GWAS data (122977 cases and 105974 controls) from the Breast Cancer Association Consortium. The approach identifies four loci for overall breast cancer risk [1p13.3, 5q31.1, 15q24 (two independent signals), and 15q26.3] and two loci for estrogen receptor-negative disease (1q41 and 7q11.23) at genome-wide significance. Four of the index single nucleotide polymorphisms (SNPs) lie within introns of genes (KCNK2, C5orf56, SCAMP2, and SIN3A) and the other index SNPs are located close to GSTM4, AMPD2, CASTOR2, and RP11-168G16.2. Here we present risk loci with consistent direction of associations in African and European descendants. The study suggests that replication across multiple ancestry populations can help improve the understanding of breast cancer genetics and identify causal variants

An Evaluation of Hospital Cleaning Regimes&mdash;Microbiological Evaluation and LCA Analysis after Traditional and Sustainable/Green Procedures

The development of sustainable processes has a significant role in balancing social productivity demands, environmental protection, and natural resources. The control of microbial contamination has so far been concentrated on the use of chemical-based sanitation procedures, which may have various limitations, as testified by the persistence of contamination itself, by the growing antimicrobial resistance (AMR) of hospital microbes, and by chemical-related pollution. This communication aims to present a comparative analysis between the use of traditional and green sanitation products and processes in hospital environments. The sampling campaign was conducted in a day hospital ward of a general hospital (Imola, Santa Maria della Scaletta Hospital). Each sample comes from a specific surface, furniture or sanitary, and was taken using RODAC contact plates and swabs with a neutralizing agent in order to standardize the result of the microbiological evaluation. Sampling occurred before and after traditional and green cleaning procedures. The green experimental protocol using 100% natural and biodegradable products in sanitization procedures of hospital areas at a medium-high health risk was found to be a technique of relevant interest. From CAM requirements, the green protocol must give equal or better results than the traditional protocol. It can be concluded that the green experimental system meets this criterion and has shown better antimicrobial activity performance than the traditional system; all findings are in an acceptable state of sanitation, with no evidence of pathogenic micro-organisms specified in the guideline

An Evaluation of Hospital Cleaning Regimes—Microbiological Evaluation and LCA Analysis after Traditional and Sustainable/Green Procedures

The development of sustainable processes has a significant role in balancing social productivity demands, environmental protection, and natural resources. The control of microbial contamination has so far been concentrated on the use of chemical-based sanitation procedures, which may have various limitations, as testified by the persistence of contamination itself, by the growing antimicrobial resistance (AMR) of hospital microbes, and by chemical-related pollution. This communication aims to present a comparative analysis between the use of traditional and green sanitation products and processes in hospital environments. The sampling campaign was conducted in a day hospital ward of a general hospital (Imola, Santa Maria della Scaletta Hospital). Each sample comes from a specific surface, furniture or sanitary, and was taken using RODAC contact plates and swabs with a neutralizing agent in order to standardize the result of the microbiological evaluation. Sampling occurred before and after traditional and green cleaning procedures. The green experimental protocol using 100% natural and biodegradable products in sanitization procedures of hospital areas at a medium-high health risk was found to be a technique of relevant interest. From CAM requirements, the green protocol must give equal or better results than the traditional protocol. It can be concluded that the green experimental system meets this criterion and has shown better antimicrobial activity performance than the traditional system; all findings are in an acceptable state of sanitation, with no evidence of pathogenic micro-organisms specified in the guideline

Analysis of Civil Environments Cleaning Services&mdash;Microbiological and LCA Analysis after Traditional and Sustainable Procedures

The development of sustainable processes has an important role to play in balancing social productivity requirements, protecting the environment and natural resources. Up to date, efforts to combat microbial contamination have focused on the use of chemical-based sanitation procedures, which may have various limitations, as testified by the persistence of contamination itself, by the growing antimicrobial resistance of microbes and by the chemical related pollution. The purpose of this paper is to present a comparative analysis of the use of conventional and sustainable cleaning products and processes in civilian environments. The sampling campaign is conducted in a sports hall in Turin, Italy. Each sample comes from a specific environment, surface, furniture and sanitary and is taken using RODAC contact plates and swabs with a neutralizing agent in order to standardize the result of the microbiological evaluation. Sampling occurred before and after traditional and sustainable cleaning procedures. The sustainable experimental design using ecological products in the cleaning procedures of the analyzed areas proved to be a relevant technique. From CAM (minimal environmental criteria) requirements, the sustainable protocol must give equal or better results than the traditional protocol from both microbiological and environmental (LCA) point of view. It can be concluded that the ecological experimental system meets this criterion and has demonstrated better performance both in antimicrobial activity and in environmental impact than the conventional system: all findings are in an acceptable state of sanitation, with no evidence of pathogenic micro-organisms specified in the guideline

Preventing HIV mother-to-child transmission in a vertically infected pregnant woman with multiclass drug resistance, role of bis-in-die dolutegravir and neonatal AZT prophylaxis: A case report

A suppressive antiretroviral therapy (ART) is necessary to prevent mother-to-child transmission (MTCT) of HIV during pregnancy. During this period, it is recommended to continue an ongoing safe and suppressive regimen, but history of multiclass drug-resistance (MDR) might need tailored, uncommon approaches posing tolerability and toxicity issues. This is the case of a 33 years of age, vertically infected woman with MDR HIV infection suppressed on a darunavir/cobicistat + atazanavir regimen switched during pregnancy to lamivudine + darunavir/ritonavir + dolutegravir 50 mg bis-in-die, maintaining complete viral suppression and delivering via caesarian section and without zidovudine (AZT) intrapartum prophylaxis a healthy HIV-negative newborn who received AZT post-exposure prophylaxis and showed regular growth patterns up to 2 years. Our case shows how archived MDR might complicate the preservation of HIV RNA suppression and highlights the importance of a tailored, multidisciplinary approach for pregnant women with MDR HIV and their newborns