VOCs Measurements in Residential Buildings: Quantification via Thermal Desorption and Assessment of Indoor Concentrations in a Case-Study

Volatile organic compounds (VOCs) represent one of the most important categories of pollutants, influencing the air quality and human health and well-being in indoor environments. In the present study, 12 selected VOCs were sampled using Tenax TA tubes and analyzed by thermal desorption combined with gas chromatography and a flame ionization detector (TD-GC-FID). The TD-GC-FID method was optimized to obtain the separation of all the analytical peaks (including m- and p-xylene) and a satisfactory sensitivity, with low detection (between 0.14 and 0.31 ng) and quantification (between 0.47 and 1.02 ng) limits. The whole procedure was firstly assessed with the analysis of four co-located tubes exposed at an outdoor monitoring site, with results that revealed a very low inter-tubes variability (relative standard deviations of parallel measurements <5%). Then, the measurement protocol was used to quantify the indoor concentrations of the target VOCs in nine different homes during the dishwasher washing cycle. The most abundant detected VOC in all dwellings was d-limonene (mean: 231 µg/m3; maximum: 611 µg/m3). All the other compounds were monitored at concentration levels one or two orders of magnitude lower than d-limonene, and were generally comparable with those found in the scientific literature. In terms of health concerns, the measured concentrations were always well below the safe levels established for the protection of the general population in living environments

Functional reconstitution of HBV-specific CD8 T cells by in vitro polyphenol treatment in chronic hepatitis B.

Background & aims In chronic HBV infection, mitochondrial functions and proteostasis are dysregulated in exhausted HBV-specific CD8 T cells. To better characterise the potential involvement of deregulated protein degradation mechanisms in T cell exhaustion, we analysed lysosome-mediated autophagy in HBV-specific CD8 T cells. Bioactive compounds able to simultaneously target both mitochondrial functions and proteostasis were tested to identify optimal combination strategies to reconstitute efficient antiviral CD8 T cell responses in patients with chronic HBV infection. Methods Lysosome-mediated degradation pathways were analysed by flow cytometry in virus-specific CD8 T cells from patients with chronic HBV infection. Mitochondrial function, intracellular proteostasis, and cytokine production were evaluated in HBV-peptide-stimulated T cell cultures, in the presence or absence of the polyphenols resveratrol (RSV) and oleuropein (OLE) and their metabolites, either alone or in combination with other bioactive compounds. Results HBV-specific CD8 T cells from patients with CHB showed impaired autophagic flux. RSV and OLE elicited a significant improvement in mitochondrial, proteostasis and antiviral functions in CD8 T cells. Cytokine production was also enhanced by synthetic metabolites, which correspond to those generated by RSV and OLE metabolism in vivo, suggesting that these polyphenols may also display an effect after transformation in vivo. Moreover, polyphenolic compounds improved the T cell revitalising effect of mitochondria-targeted antioxidants and of programmed cell death protein 1/programmed cell death ligand 1 blockade. Conclusions Simultaneously targeting multiple altered intracellular pathways with the combination of mitochondria-targeted antioxidants and natural polyphenols may represent a promising immune reconstitution strategy for the treatment of chronic HBV infection. Lay summary In chronic hepatitis B, antiviral T lymphocytes are deeply impaired, with many altered intracellular functions. In vitro exposure to polyphenols, such as resveratrol and oleuropein, can correct some of the deregulated intracellular pathways and improve antiviral T cell function. This effect can be further strengthened by the association of polyphenols with antioxidant compounds in a significant proportion of patients. Thus, the combination of antioxidants and natural polyphenols represents a promising strategy for chronic hepatitis B therapy

Interleukin-17/Interleukin-21 and Interferon-g producing T cells specific for β2 Glycoprotein I in atherosclerosis inflammation of systemic lupus erythematosus patients with antiphospholipid syndrome

Systemic lupus erythematosus is frequently associated with antiphospholipid syndrome. Patients with lupus-antiphospholipid syndrome are characterized by recurrent arterial/venous thrombosis, miscarriages, and persistent presence of autoantibodies against phospholipid-binding proteins, such as β2-Glycoprotein I. We investigated the cytokine production induced by β2-Glycoprotein I in activated T cells that infiltrate in vivo atherosclerotic lesions of lupus-antiphospholipid syndrome patients. We examined the helper function of β2-Glycoprotein I-specific T cells for the tissue factor production, as well as their cytolytic potential and their helper function for antibody production. Lupus-antiphospholipid syndrome patients harbor in vivo activated CD4+ T cells that recognize β2-Glycoprotein I in atherosclerotic lesions. β2-Glycoprotein I induces T cell proliferation and expression of both Interleukin-17/Interleukin-21 and Interferon-γ in plaque-derived T cell clones. β2-Glycoprotein I-specific T cells display strong help for monocyte tissue factor production, and promote antibody production in autologous B cells. Moreover, plaque-derived β2-Glycoprotein I-specific CD4+ T lymphocytes express both perforin-mediated and Fas/FasLigand-mediated-cytotoxicity. Altogether, our results indicate that β2-Glycoprotein I is able to elicit a local Interleukin-17/Interleukin-21 and Interferon-γ inflammation in lupus-antiphospholipid syndrome patients that might lead, if unabated, to plaque instability and subsequent arterial thrombosis, suggesting that the T helper 17/T helper 1 pathway may represent a novel target for the prevention and treatment of the disease

Lipoprotein(a) Genotype Influences the Clinical Diagnosis of Familial Hypercholesterolemia

: Background Evidence suggests that LPA risk genotypes are a possible contributor to the clinical diagnosis of familial hypercholesterolemia (FH). This study aimed at determining the prevalence of LPA risk variants in adult individuals with FH enrolled in the Italian LIPIGEN (Lipid Transport Disorders Italian Genetic Network) study, with (FH/M+) or without (FH/M-) a causative genetic variant. Methods and Results An lp(a) [lipoprotein(a)] genetic score was calculated by summing the number risk-increasing alleles inherited at rs3798220 and rs10455872 variants. Overall, in the 4.6% of 1695 patients with clinically diagnosed FH, the phenotype was not explained by a monogenic or polygenic cause but by genotype associated with high lp(a) levels. Among 765 subjects with FH/M- and 930 subjects with FH/M+, 133 (17.4%) and 95 (10.2%) were characterized by 1 copy of either rs10455872 or rs3798220 or 2 copies of either rs10455872 or rs3798220 (lp(a) score ≥1). Subjects with FH/M- also had lower mean levels of pretreatment low-density lipoprotein cholesterol than individuals with FH/M+ (t test for difference in means between FH/M- and FH/M+ groups &lt;0.0001); however, subjects with FH/M- and lp(a) score ≥1 had higher mean (SD) pretreatment low-density lipoprotein cholesterol levels (223.47 [50.40] mg/dL) compared with subjects with FH/M- and lp(a) score=0 (219.38 [54.54] mg/dL for), although not statistically significant. The adjustment of low-density lipoprotein cholesterol levels based on lp(a) concentration reduced from 68% to 42% the proportion of subjects with low-density lipoprotein cholesterol level ≥190 mg/dL (or from 68% to 50%, considering a more conservative formula). Conclusions Our study supports the importance of measuring lp(a) to perform the diagnosis of FH appropriately and to exclude that the observed phenotype is driven by elevated levels of lp(a) before performing the genetic test for FH

A novel organizational model to face the challenge of multimorbid elderly patients in an internal medicine setting: a case study from Parma Hospital, Italy

Continuous increase of elderly patients with multimorbidity and Emergency Department (ED) overcrowding are great challenges for modern medicine. Traditional hospital organizations are often too rigid to solve them without consistently rising healthcare costs. In this paper we present a new organizational model achieved at Internal Medicine and Critical Subacute Care Unit of Parma University Hospital, Italy, a 106-bed internal medicine area organized by intensity of care and specifically dedicated to such patients. The unit is partitioned into smaller wards, each with a specific intensity level of care, including a rapid-turnover ward (mean length of stay <4 days) admitting acutely ill patients from the ED, a subacute care ward for chronic critically ill subjects and a nurse-managed ward for stable patients who have socio-economic trouble preventing discharge. A very-rapid-turnover ("come'n'go") ward has also been instituted to manage sudden ED overflows. Continuity, effectiveness, safety and appropriateness of care are guaranteed by an innovative figure called "flow manager," with skilled clinical experience and managerial attitude, and by elaboration of an early personalized discharge plan anticipating every patient's needs according to lean methodology principles. In 2012-2014, this organizational model, compared with other peer units of the hospital and of other teaching hospitals of the region, showed a better performance, efficacy and effectiveness indexes calculated on Regional Hospital Discharge Records database system, allowing a capacity to face a massive (+22 %) rise in medical admissions from the ED. Further studies are needed to validate this model from a patient outcome point of view

Novel framework to improve water management adaptation under climate change scenarios

The impacts of projected climate change on freshwater resources are increasingly promoting the adoption of different approaches to water management, due to the likely occurrence of reduced water supplies and early-stage drought conditions in many river basins across Southern Europe. The traditional strategy to cope with water scarcity has largely relied on hard-path measures aimed at expanding the existing supply capacity by great investments in centralized, large-scale infrastructures such as dams and distribution systems. This approach is, however, becoming more and more unsustainable, giving way to effective soft-path solutions based on improved predictive capacities, optimal decision making and drought risk management. Given the need to ensure a more sustainable and efficient water management under current and projected scenarios, the study presents a novel decision-analytic framework to assist decision-makers in designing and assessing alternative soft-path measures in order to increase the adaptation of the system to a changing climate. The framework is being developed within the SO-WATCH project and it will be demonstrated on the Lake Como river basin (Italy) by implementing a four-stage procedure as follows: i) calibration and validation of a physical model comprising three sub-models simulating, respectively, the upstream catchment processes (TOPKAPI-ETH), the lake dynamics and water releases (DISTRILAKE) and the water balance in the irrigation system downstream the lake (IDRAGRA), ii) coupling of the hydrological model with a multi-agent systems model developed to reproduce human decisions and their effects on the system dynamics (e.g. dam operations and farmers practices), iii) definition and impact assessment of hydro-climatic and socio-technoeconomic scenarios supported by the calculation of drought indicators and iv) design and evaluation of soft-path measures to improve the efficiency of the water system. Preliminary results based on different climate change projections for the time period 2096-2100 (ensemble of different Global Climate Models, Regional Climate Models and Radiative Concentration Pathways as of the IPCC Fifth Assessment Report) reveal a general reduction of the lake inflows in spring and summer, with an increasing frequency of drought conditions under the business-as-usual scenario. In order to design the most effective soft-path measures, a newly developed index, the Transpiration Deficit Index (D-TDI), will be applied along with other commonly used indexes. D-TDI takes into account the transpiration deficit (i.e. difference between potential and actual transpiration) computed by the IDRAGRA model on a daily basis and cumulated over a selected time span and allows an effective identification of drought prone areas