The thin line that made the difference: a case report on a Bosniak IIF renal cystic mass treated with cyst decortication

Abstract Background Among all benign kidney lesions, renal cysts are the most common type. In the proposed update of 2019, the Bosniak classification of cystic renal masses is used to classify renal masses according to their likelihood of malignancy, both on computed tomography (CT) and on magnetic resonance imaging (MRI). Case presentation A middle-aged Caucasian male presented to our department with chronic right flank pain. Imaging studies revealed a right renal Bosniak IIF cyst, later complicated by traumatic haemorrhage. The patient consequently underwent cyst decortication for symptom relief. Biopsy results from samples taken during the laparoscopic operation revealed ISUP grade 1 cystic clear cell carcinoma. Conclusion The treatment of Bosniak IIF cysts has long been a matter of debate. As a result of scarcity of data on the probability of malignancy in MRI using the new classification, such cysts should be carefully scrutinised and staged before choosing a treatment option. Retroperitoneal seeding should always be considered in interventions involving an incomplete resection margin or cyst drainage

Negative ozone anomalies at a high mountain site in northern Italy during 2020: a possible role of COVID-19 lockdowns?

Several studies investigated the possible impacts of the restriction measures related to the containment of the spread of the COrona VIrus Disease (COVID-19) to atmospheric ozone (O3) at global, regional, and local scales during 2020. O3 is a secondary pollutant with adverse effects on population health and ecosystems and with negative impacts on climate, acting as greenhouse gas. Most of these studies focused on spring 2020 (i.e. March–May) and on observations in the planetary boundary layer (PBL), mostly in the vicinity of urban agglomerates. Here, we analyzed the variability of O3 above the PBL of northern Italy in 2020 by using continuous observations carried out at a high mountain WMO/GAW global station in Italy (Mt. Cimone–CMN; 44°12' N, 10°42' E, 2165 m a.s.l.). Low O3 monthly anomalies were observed during spring (MAM) and summer (JJA), when periods of low O3 intertwined with periods with higher O3, within climatological ranges. A similar variability was observed for O3 precursors like NO2 and 15 anthropogenic non-methane volatile organic carbons, but the systematic O3 anomalies were not reflected in these variables. The analysis of meteorological variables and diel O3 cycles did not suggest major changes in the vertical transport related to the thermal circulation system in the mountain area. The analysis of five days back-trajectories suggested that the observed O3 anomalies cannot be explained by differences in the synoptic-scale circulation with respect to the previous years alone. On the other hand, the characterization of two transport patterns (i.e. air masses from the regional PBL or from the free troposphere) and the analysis of back-trajectories suggested an important contribution of transport from the continental PBL during the periods with the lowest O3 at CMN. When proxies of air mass transport from the regional PBL are considered, a lower NOx content was pointed out with respect to the previous years, suggesting a lower O3 production in a NOx-limited atmosphere. Our study suggested for the first time that, during MAM and JJA 2020, the reduced anthropogenic emissions related to the COVID-19 restrictions lowered the amount of this short-lived climate forcer/pollutant at remote locations above the PBL over northern Italy. This work suggests the importance of limiting anthropogenic precursor emissions for decreasing the O3 amount at remote locations and in upper atmospheric layers

Analysis of multi-year near-surface ozone observations at the WMO/GAW "Concordia" station (75°06′S, 123°20′E, 3280 m a.s.l. – Antarctica)

Abstract This work focuses on the near-surface O3 variability over the eastern Antarctic Plateau. In particular, eight years (2006–2013) of continuous observations at the WMO/GAW contributing station "Concordia" (Dome C–DMC: 75°06′S, 123°20′E, 3280 m) are presented, in the framework of the Italian Antarctic Research Programme (PNRA). First, the characterization of seasonal and diurnal O3 variability at DMC is provided. Then, for the period of highest data coverage (2008–2013), we investigated the role of specific atmospheric processes in affecting near-surface summer O3 variability, when O3 enhancement events (OEEs) are systematically observed at DMC (average monthly frequency peaking up to 60% in December). As deduced by a statistical selection methodology, these OEEs are affected by a significant interannual variability, both in their average O3 values and in their frequency. To explain part of this variability, we analyzed OEEs as a function of specific atmospheric variables and processes: (i) total column of O3 (TCO) and UV-A irradiance, (ii) long-range transport of air masses over the Antarctic Plateau (by Lagrangian back-trajectory analysis – LAGRANTO), (iii) occurrence of "deep" stratospheric intrusion events (by using the Lagrangian tool STLEFLUX). The overall near-surface O3 variability at DMC is controlled by a day-to-day pattern, which strongly points towards a dominating influence of processes occurring at "synoptic" scales rather than "local" processes. Even if previous studies suggested an inverse relationship between OEEs and TCO, we found a slight tendency for the annual frequency of OEEs to be higher when TCO values are higher over DMC. The annual occurrence of OEEs at DMC seems related to the total time spent by air masses over the Antarctic plateau before their arrival to DMC, suggesting the accumulation of photochemically-produced O3 during the transport, rather than a more efficient local production. Moreover, the identification of recent (i.e., 4-day old) stratospheric intrusion events by STEFLUX suggested only a minor influence (up to 3% of the period, in November) of "deep" events on the variability of near-surface summer O3 at DMC

Aerosol optical properties calculated from size distributions, filter samples and absorption photometer data at Dome C, Antarctica, and their relationships with seasonal cycles of sources

Optical properties of surface aerosols at Dome C, Antarctica, in 2007-2013 and their potential source areas are presented. Scattering coefficients (sigma(sp)) were calculated from measured particle number size distributions with a Mie code and from filter samples using mass scattering efficiencies. Absorption coefficients (sigma(ap)) were determined with a three-wavelength Particle Soot Absorption Photometer (PSAP) and corrected for scattering by using two different algorithms. The scattering coefficients were also compared with sigma(sp) measured with a nephelometer at the South Pole Station (SPO). The minimum sigma(ap) was observed in the austral autumn and the maximum in the austral spring, similar to other Antarctic sites. The darkest aerosol, i.e., the lowest single-scattering albedo omega(o) approximate to 0.91, was observed in September and October and the highest omega(o) approximate to 0.99 in February and March. The uncertainty of the absorption angstrom ngstrom exponent alpha(ap) is high. The lowest alpha(ap) monthly medians were observed in March and the highest in August-October. The equivalent black carbon (eBC) mass concentrations were compared with eBC measured at three other Antarctic sites: the SPO and two coastal sites, Neumayer and Syowa. The maximum monthly median eBC concentrations are almost the same (similar to 3 +/- 1 ng m(-3)) at all these sites in October-November. This suggests that there is no significant difference in eBC concentrations between the coastal and plateau sites. The seasonal cycle of the eBC mass fraction exhibits a minimum f (eBC) approximate to 0.1 % in February-March and a maximum similar to 4 %-5 % in August-October. Source areas were calculated using 50 d FLEXPART footprints. The highest eBC concentrations and the lowest omega(o) were associated with air masses coming from South America, Australia and Africa. Vertical simulations that take BC particle removal processes into account show that there would be essentially no BC particles arriving at Dome C from north of latitude 10 degrees S at altitudes < 1600 m. The main biomass-burning regions Africa, Australia and Brazil are more to the south, and their smoke plumes have been observed at higher altitudes than that, so they can get transported to Antarctica. The seasonal cycle of BC emissions from wildfires and agricultural burning and other fires in South America, Africa and Australia was calculated from data downloaded from the Global Fire Emissions Database (GFED). The maximum total emissions were in August-September, but the peak of monthly average eBC concentrations is observed 2-3 months later in November, not only at Dome C, but also at the SPO and the coastal stations. The air-mass residence-time-weighted BC emissions from South America are approximately an order of magnitude larger than from Africa and Oceania, suggesting that South American BC emissions are the largest contributors to eBC at Dome C. At Dome C the maximum and minimum scattering coefficients were observed in austral summer and winter, respectively. At the SPO sigma(sp) was similar to that observed at Dome C in the austral summer, but there was a large difference in winter, suggesting that in winter the SPO is more influenced by sea-spray emissions than Dome C. The seasonal cycles of sigma(sp) at Dome C and at the SPO were compared with the seasonal cycles of secondary and primary marine aerosol emissions. The sigma(sp) measured at the SPO correlated much better with the sea-spray aerosol emission fluxes in the Southern Ocean than sigma(sp) at Dome C. The seasonal cycles of biogenic secondary aerosols were estimated from monthly average phytoplankton biomass concentrations obtained from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) satellite sensor data. The analysis suggests that a large fraction of the biogenic scattering aerosol observed at Dome C has been formed in the polar zone, but it may take a month for the aerosol to be formed, be grown and get transported from the sea level to Dome C.Peer reviewe

SICOB-endorsed national Delphi consensus on obesity treatment optimization: focus on diagnosis, pre-operative management, and weight regain/insufficient weight loss approach

Purpose: Overweight and obesity affects 60% of adults causing more than 1.2 million deaths across world every year. Fight against involved different specialist figures and multiple are the approved weapons. Aim of the present survey endorsed by the Italian Society of Bariatric Surgery (SICOB) is to reach a national consensus on obesity treatment optimization through a Delphi process. Methods: Eleven key opinion leaders (KOLs) identified 22 statements with a major need of clarification and debate. The explored pathways were: (1) Management of patient candidate to bariatric/metabolic surgery (BMS); (2) Management of patient not eligible for BMS; (3) Management of patient with short-term (2&nbsp;years) weight regain (WR) or insufficient weight loss (IWL); (4) Management of the patient with medium-term (5&nbsp;years) WR; and (5) Association between drugs and BMS as WR prevention. The questionnaire was distributed to 65 national experts via an online platform with anonymized results. Results: 54 out of 65 invited panelists (83%) respond. Positive consensus was reached for 18/22 statements (82%); while, negative consensus (s20.4; s21.5) and no consensus (s11.5, s17) were reached for 2 statements, respectively (9%). Conclusion: The Delphi results underline the importance of first-line interdisciplinary management, with large pre-treatment examination, and establish a common opinion on how to properly manage post-operative IWL/WR. Level of evidence v: Report of expert committees

Five‐year analysis of background carbon dioxide and ozone variations during summer seasons at the Mario Zucchelli station (Antarctica)

The work focuses on the analysis of CO 2 and O 3 surface variations observed during five summer experimental campaigns carried out at the 'Icaro Camp' clean air facility (74.7°S, 164.1°E, 41 m a.s.l.) of the 'Mario Zucchelli' Italian coastal research station. This experimental activity allowed the definition of summer average background O 3 values that ranged from 18.3 ± 4.7 ppbv (summer 2005–2006) to 21.3 ± 4.0 ppbv (summer 2003–2004). Background CO 2 concentrations showed an average growth rate of 2.10 ppmv yr -1 , with the highest CO 2 increase between the summer campaigns 2002–2003 and 2001–2002 (+2.85 ppmv yr -1 ), probably reflecting the influence of the 2002/2003 ENSO event. A comparison with other Antarctic coastal sites suggested that the summer background CO 2 and O 3 at MZS-IC are well representative of the average conditions of the Ross Sea coastal regions. As shown by the analysis of local wind direction and by 3-D back-trajectory calculations, the highest CO 2 and O 3 values were recorded in correspondence to air masses flowing from the interior of the Antarctic continent. These results suggest that air mass transport from the interior of the continent exerts an important influence on air mass composition in Antarctic coastal areas. DOI: 10.1111/j.1600-0889.2011.00576.

Increasing the maturity of measurements of essential climate variables (ECVs) at Italian atmospheric WMO/GAW observatories by implementing automated data elaboration chains

In the framework of the National Project of Interest NextData, we developed automatic procedures for the flagging and formatting of trace gases, atmospheric aerosols and meteorological data to be submitted to the World Data Centers (WDCs) of the Global Atmosphere Watch program of the World Meteorological Organization (WMO/GAW). In particular, the atmospheric Essential Climate Variables (ECVs) covered in this work are observations of near-surface trace gas concentrations, aerosol properties and meteorological variables, which are under the umbrella of the World Data Center for Greenhouse Gases (WDCGG), the World Data Center for Reactive Gases, and the World Data Center for Aerosol (WDCRG and WDCA). We developed an overarching processing chain to create a number of data products (data files and reports) starting from the raw data, finally contributing to increase the maturity of these measurements. To this aim, we implemented specific routines for data filtering, flagging, format harmonization, and creation of data products, useful for detecting instrumental problems, particular atmospheric events and quick data dissemination towards stakeholders or citizens. Currently, the automatic data processing is active for a subset of ECVs at 5 measurement sites in Italy. The system represents a valuable tool to facilitate data originators towards a more efficient data production. Our effort is expected to accelerate the process of data submission to WMO/GAW or to other reference data centers or repositories. Moreover, the adoption of automatic procedures for data flagging and data correction allows to keep track of the process that led to the final validated data, and makes data evaluation and revisions more efficient by improving the traceability of the data production process