Barriers and Drivers in the Adoption of Advanced Wastewater Treatment Technologies: a Comparative Analysis of Italian Utilities

The adoption of new environmentally-friendly technologies is becoming a key issue in both public debate and policy arenas. The paper focuses on innovation adoption by wastewater utilities, and investigates why stringent environmental regulations are not sufficient to foster it. The adoption of advanced wastewater treatment technologies is made complex by the sunk nature of highly specific infrastructures, and the consequent exposure of utilities to political and institutional influences. In addition, it requires the involvement of various actors (utilities, suppliers, contractors), and is influenced by various stakeholders (communities, business users, citizens’ associations) that generally have no aligned objectives. With reference to the aforementioned theoretical background, our paper develops and analyzes a conceptual framework that unfolds over two dimensions: (a) the role played by firm-specific characteristics, i.e. technological and organizational capabilities and managerial professionalism; (b) the influence of community-level factors, i.e. citizens’ voice and pressure exerted by local stakeholders. We investigate these issues through multiple descriptive case studies based on semi-structured interviews with the CEOs and top managers of 11 wastewater utilities operating in a region in North-Italy. The results suggest that firm-specific resources could spur wastewater utilities into adopting innovation, despite an adverse institutional environment. At the same time, on the community-level side, the analysis shows that residents and local businesses are able to mobilize resources and exert pressure to either drive or hinder the adoption of water innovations

Discontinuous finite element visualization

The proceedings of the conferences have been published on CD since the initiative taken by Prof. G. M. Carlomagno at the Sorrento meeting allowing authors to include in their papers color, video clips and animations.The aim of this work is the study and the implementation of appropriate visualization techniques for high-order discontinuous finite element data in two and three-dimensions. In particular, we are dealing with field discontinuity and deformed cells. Such data are produced for example by chemical simulations, by fluid dynamics simulations, or, in general, anywhere high accuracy on boundary domain description is required

Glucocorticoids and Antivirals for HBV Reactivation in Onco-Hematologic Patients.

Patients with inactive or occult hepatitis B virus infection and onco-hematological malignancies are at risk of hepatitis flare, hepatic failure and death due to chemotherapy-mediated reactivation. Nucleot(s)ide analogues can reduce reactivation risks and/or hepatitis. However, immuno-mediated phenomena combine to determine liver damage and clinical outcome. We describe in this report two patients with onco-hematological malignancies and hepatitis B reactivation after chemotherapy in whom glucocorticoids were added to nucleot(s)ide. Antiviral therapy was effective on replication, while glucocorticoids managed hyperergic response. One patient without underlying liver disease survived, while the second died and the autopsy demonstrated cirrhosis undetected before death. This clinical trial suggests that in patients with onco-hematological malignancies and altered liver function tests in spite of effective antiviral response, glucocorticoids could control the effects of immune response. However prognosis and survival are related to the underlying liver status

Biosensing circulating MicroRNAs in autoinflammatory skin diseases: Focus on Hidradenitis suppurativa

MicroRNAs (miRNAs) play a crucial role in the early diagnosis of autoinflammatory diseases, with Hidradenitis Suppurativa (HS) being a notable example. HS, an autoinflammatory skin disease affecting the pilosebaceous unit, profoundly impacts patients’ quality of life. Its hidden nature, with insidious initial symptoms and patient reluctance to seek medical consultation, often leads to a diagnostic delay of up to 7 years. Recognizing the urgency for early diagnostic tools, recent research identified significant differences in circulating miRNA expression, including miR-24-1-5p, miR-146a-5p, miR26a-5p, miR-206, miR338-3p, and miR-338-5p, between HS patients and healthy controls. These miRNAs serve as potential biomarkers for earlier disease detection. Traditional molecular biology techniques, like reverse transcription quantitative-polymerase chain reaction (RT-qPCR), are employed for their detection using specific primers and probes. Alternatively, short peptides offer a versatile and effective means for capturing miRNAs, providing specificity, ease of synthesis, stability, and multiplexing potential. In this context, we present a computational simulation pipeline designed for crafting peptide sequences that can capture circulating miRNAs in the blood of patients with autoinflammatory skin diseases, including HS. This innovative approach aims to expedite early diagnosis and enhance therapeutic follow-up, addressing the critical need for timely intervention in HS and similar conditions

Unraveling the Epigenetic Tapestry: Decoding the Impact of Epigenetic Modifications in Hidradenitis Suppurativa Pathogenesis

Hidradenitis suppurativa (HS) is a chronic autoinflammatory skin disorder, which typically occurs during puberty or early adulthood. The pathogenesis of HS is complex and multifactorial; a close interaction between hormonal, genetic, epigenetics factors, host-specific aspects, and environmental influences contributes to the susceptibility, onset, severity, and clinical course of this disease, although the exact molecular mechanisms are still being explored. Epigenetics is currently emerging as an interesting field of investigation that could potentially shed light on the molecular intricacies underlying HS, but there is much still to uncover on the subject. The aim of this work is to provide an overview of the epigenetic landscape involved in HS. Specifically, in this in-depth review we provide a comprehensive overview of DNA methylation/hydroxymethylation, histone modifications, and non-coding RNAs (such as microRNA—miRNA-132, miRNA-200c, miRNA-30a-3p, miRNA-100-5b, miRNA-155-5p, miRNA-338-5p) dysregulation in HS patients. An interesting element of epigenetic regulation in HS is that the persistent inflammatory milieu observed in HS lesional skin could be exacerbated by an altered methylation profile and histone acetylation pattern associated with key inflammatory genes. Deepening our knowledge on the subject could enable the development of targeted epigenetic therapies to potentially restore normal gene expression patterns, and subsequentially ameliorate, or even reverse, the progression of the disease. By deciphering the epigenetic code governing HS, we strive to usher in a new era of personalized and effective interventions for this enigmatic dermatological condition

Validation of satellite OPEMW precipitation product with ground-based weather radar and rain gauge networks

Abstract. The Precipitation Estimation at Microwave Frequencies (PEMW) algorithm was developed at the Institute of Methodologies for Environmental Analysis of the National Research Council of Italy (IMAA-CNR) for inferring surface rain intensity (sri) from satellite passive microwave observations in the range from 89 to 190 GHz. The operational version of PEMW (OPEMW) has been running continuously at IMAA-CNR for two years. The OPEMW sri estimates, together with other precipitation products, are used as input to an operational hydrological model for flood alert forecast. This paper presents the validation of OPEMW against simultaneous ground-based observations from a network of 20 weather radar systems and a network of more than 3000 rain gauges distributed over the Italian Peninsula and main islands. The validation effort uses a data set covering one year (July 2011–June 2012). The effort evaluates dichotomous and continuous scores for the assessment of rain detection and quantitative estimate, respectively, investigating both spatial and temporal features. The analysis demonstrates 98% accuracy in correctly identifying rainy and non-rainy areas; it also quantifies the increased ability (with respect to random chance) to detect rainy and non-rainy areas (0.42–0.45 Heidke skill score) or rainy areas only (0.27–0.29 equitable threat score). Performances are better than average during summer, fall, and spring, while worse than average in the winter season. The spatial–temporal analysis does not show seasonal dependence except over the Alps and northern Apennines during winter. A binned analysis in the 0–15 mm h−1 range suggests that OPEMW tends to slightly overestimate sri values below 6–7 mm h−1 and underestimate sri above those values. With respect to rain gauges (weather radars), the correlation coefficient is larger than 0.8 (0.9). The monthly mean difference and standard deviation remain within ±1 and 2 mm h−1 with respect to rain gauges (respectively −2–0 and 4 mm h−1 with respect to weather radars)

Circulating CD34+/CD38-/CD26+ Leukemia Stem Cells along Chronic Myeloid Leukemia progression: differences between Chronic, Accelerated and Blast Phase

In Chronic Myeloid Leukemia (CML) patients, CD34+/CD38-/CD26+ cell population represents a “CML specific” Leukemia Stem Cell (LSC) compartment. Indeed, preliminary studies showed that the expression of CD26 discriminates bone marrow CML Leukemic Stem Cells (LSCs) from nor-mal Hematopoietic Stem Cells (HSCs) or from LSCs of other myeloid neoplasms. We were first to demonstrate that at diagnosis CD34+/CD38-/CD26+ cells are easily measurable also in Peripheral Blood (PB) and that residual circulating CD26+LSCs persist, with a fluctuating trend, in most pa-tients in optimal response during treatment with Tyrosine Kinase Inhibitors (TKIs) and even after successful TKI discontinuation. These data corroborate and confirm the possibility of using flow-cytometry CD26+ evaluation as an important diagnostic tool that, combined with molecular biology and cytogenetic, could provide a rapid diagnosis of Chronic Phase (CP) CML starting from a simple PB sample. Yet, few data are available regarding the behavior of CD26+LSCs during Accelerated Phase (AP) or Blast Phase (BP) CML and the role, if any, this peculiar staminal cell compartment may play in disease progression. In the present study we compared the presence and phenotypic characteristics of circulating CD26+LSCs in CP CML patients at diagnosis, during AP and in cases of progression to lymphoid BP, inquiring a possible role of these cells during dis-ease evolution

Hidradenitis Suppurativa: A Perspective on Genetic Factors Involved in the Disease.

Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease of the pilosebaceous unit, clinically consisting of painful nodules, abscesses, and sinus tracts mostly in, but not limited to, intertriginous skin areas. HS can be defined as a complex skin disease with multifactorial etiologies, including-among others-genetic, immunologic, epigenetic, and environmental factors. Based on genetic heterogeneity and complexity, three different forms can be recognized and considered separately as sporadic, familial, and syndromic. To date, several genetic variants associated to disease susceptibility, disease-onset, and/or treatment response have been reported; some of these reside in genes encoding the gamma-secretase subunits whereas others involve autoinflammatory and/or keratinization genes. The aim of this perspective work is to provide an overview of the contribution of several genetic studies encompassing family linkage analyses, target candidate gene studies, and -omic studies in this field. In our viewpoint, we discuss the role of genetics in Hidradenitis suppurativa considering findings based on Sanger sequencing as well as the more recent Next Generation Sequencing (i.e., exome sequencing or RNA Sequencing) with the aim of better understanding the etio-pathogenesis of the disease as well as identifying novel therapeutic strategies.ThisworkwassupportedbyaBiomolecularAnalysesforTailoredMedicineinAcneiNversa (BATMAN)project, funded by ERA PerMed (JTC_2018) to A.V.M and S.C. and by a Starting Grant (SG-2019-12369421) funded by the Italian Ministry of Health to P.M.T

Competenze Infermieristiche Distintive in Area Ematologica: survey sulla loro diffusione

La natura specialistica dell’Ematologia richiede comprensione dei processi patologici, degli appropriati interventi terapeutici e dell’impatto che essi hanno sulla qualità di vita dei pazienti. Interventi infermieristici mirati in Ematologia richiamano il concetto di Competenze distintive. Questo studio si propone quindi di indagare la diffusione di queste tra gli Infermieri di Ematologia. È stato eseguito uno studio osservazionale multicentrico trasversale, con somministrazione di un questionario a risposta multipla ad un campione appartenente a 3 diverse Unità Operative di Ematologia Adulti delle province di Milano e Monza e Brianza. In base alla percentuale di risposte corrette alle domande del questionario, si può desumere che, tra i soggetti coinvolti nello studio, vi sia una buona diffusione delle Competenze distintive in Ematologia, ma questa appare strettamente legata all’esperienza professionale in questo ambito specifico. Si auspica che l’apprendimento di queste in futuro possa essere correlato anche ad una formazione specialistica post-base.Hematology's specialized nature requires understanding disease processes, appropriate therapeutic interventions, and their impact on a patient's quality of life. Targeted nursing interventions in Hematology invoke the concept of Distinctive Competencies. Therefore, this study aimed to investigate its prevalence among Hematology nurses. A multicenter cross-sectional observational study was performed, administering a multiple-choice questionnaire to a sample belonging to 3 different Adult Hematology Operating Units in Milan and Monza & Brianza. Based on the percentage of correct answers to the questions in the questionnaire, it can be inferred that, among those involved in the study, there is a good diffusion of Distinctive Competencies in Hematology, but this appears to be closely related to professional experience in this field. Hopefully, these learnings will also be related to specialized post-basic training in the future

Clinical and molecular characterization of hidradenitis suppurativa: a practical framework for novel therapeutic targets.

Background: The pathophysiological picture underlying hidradenitis suppurativa (HS) and its syndromic forms is still patchy, thus presenting a great challenge for dermatologists and researchers since just by better understanding the pathogenesis of disease we could identify novel therapeutic targets. Methods: We propose a practical framework to improve subcategorization of HS patients and support the genotype-phenotype correlation, useful for endotype-directed therapies development. Results: This framework includes (i) clinical work-up that involves the collection of demographic, lifestyle, and clinical data as well as the collection of different biological samples; (ii) genetic-molecular work-up, based on multi-omics analysis in combination with bioinformatics pipelines to unravel the complex etiology of HS and its syndromic forms; (iii) functional studies, – represented by skin fibroblast cell cultures, reconstructed epidermal models (both 2D and 3D) and organoids –, of candidate biomarkers and genetic findings necessary to validate novel potential molecular mechanisms possibly involved and druggable in HS; (iv) genotype-phenotype correlation and clinical translation in tailored targeted therapies. Conclusion: Omic findings should be merged and integrated with clinical data; moreover, the skin-omic profiles from each HS patient should be matched and integrated with the ones already reported in public repositories, supporting the efforts of the researchers and clinicians to discover novel biomarkers and molecular pathways with the ultimate goal of providing faster development of novel patient-tailored therapeutic approaches.This work was supported by a Biomolecular Analyses for Tailored Medicine in AcneiNversa (BATMAN) project, funded by ERAPerMed, by Starting Grant (SG-2019-12369421) funded by the Italian Ministry of Health, by Grant (RC16/2018) from the Institute for Maternal and Child Health IRCCS “Burlo Garofolo” funded by the Italian Ministry of Health, and by a grant from Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan (protocol No. 487_2020). This work was also partially supported by Italian Ministry of Health (Ricerca Corrente 2023)/Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan, Italy