La bonifica delle acque di falda tramite la tecnologia delle barriere permeabili reattive

A Permeable Reactive Barrier (PRB) represents a valid and sustainable in situ groundwater remediation technology. It consists of a diaphragm wall, filled with a reactive medium and placed across the flow path of the contaminated groundwater in order to intercept the contaminants.  A PRB does not require energy for, it requires the removal of modest volumes of soil, it does not present problems of visual impact and allows the use of the contaminated site during remediation. Monitoring performed on full-scale PRB, composed of zero valent iron (ZVI) as reactive medium, showed that, despite the considerable reactivity, ZVI is not able to maintain its hydraulic conductivity over a long period of time. The objective of the present work was to improve the hydraulic behaviour of the ZVI, by mixing this material with lapillus, a reactive medium of volcanic origin, sustainable for the environment and readily available. Experimental studies, conducted through batch and column tests, have shown that lapillus is reactive towards the tested contaminants, i.e. nickel and zinc, whose presence seriously  threatens the quality of aquifers. La bonifica delle acque di falda tramite la tecnologia delle Barriere Permeabili ReattiveUna barriera permeabile reattiva (BPR) rappresenta una tecnologia in situ per il risanamento delle acque di falda. Si tratta di un diaframma, costituito da un materiale permeabile e reattivo, installato nella stessa direzione del flusso di falda in maniera tale da intercettare gli inquinati contenuti in esso. Una BPR non necessita energia per il suo funzionamento, richiede la rimozione di modesti volumi di terreno, non presenta problemi di impatto visivo e consente di utilizzare il sito contaminato durante la bonifica. Monitoraggi eseguiti su BPR in vera grandezza, realizzate utilizzando ferro zero valente (Fe0) come materiale reattivo, hanno evidenziato come, nonostante la notevole reattività, esso non sia in grado di mantenere la propria conducibilità idraulica nel lungo periodo. Con l’obiettivo di migliorare le prestazioni idrauliche del Fe0, nel presente lavoro vengono presentati i risultati dei test di laboratorio effettuati per valutare la miscelazione di tale mezzo reattivo con il lapillo, un materiale di origine vulcanica, sostenibile per l’ambiente, e facilmente reperibile. Gli studi sperimentali condotti attraverso prove batch e prove di interazione in colonna, hanno dimostrato come il lapillo sia reattivo nei confronti degli inquinanti testati, ovvero nichel e zinco, la cui presenza minaccia profondamente la qualità delle falde acquifere.Una barriera permeabile reattiva (BPR) rappresenta una tecnologia in situ per il risanamento delle acque di falda. Si tratta di un diaframma, costituito da un materiale permeabile e reattivo, installato nella stessa direzione del flusso di falda in maniera tale da intercettare gli inquinati contenuti in esso. Una BPR non necessita energia per il suo funzionamento, richiede la rimozione di modesti volumi di terreno, non presenta problemi di impatto visivo e consente di utilizzare il sito contaminato durante la bonifica. Monitoraggi eseguiti su BPR in vera grandezza, realizzate utilizzando ferro zero valente (Fe0) come materiale reattivo, hanno evidenziato come, nonostante la notevole reattività, esso non sia in grado di mantenere la propria conducibilità idraulica nel lungo periodo. Con l’obiettivo di migliorare le prestazioni idrauliche del Fe0, nel presente lavoro vengono presentati i risultati dei test di laboratorio effettuati per valutare la miscelazione di tale mezzo reattivo con il lapillo, un materiale di origine vulcanica, sostenibile per l’ambiente, e facilmente reperibile. Gli studi sperimentali condotti attraverso prove batch e prove di interazione in colonna, hanno dimostrato come il lapillo sia reattivo nei confronti degli inquinanti testati, ovvero nichel e zinco, la cui presenza minaccia profondamente la qualità delle falde acquifere. Groundwater Remediation Using Permeable Reactive Barrier Technology A Permeable Reactive Barrier (PRB) represents a valid and sustainable in situ groundwater remediation technology. It consists of a diaphragm wall, filled with a reactive medium and placed across the flow path of the contaminated groundwater in order to intercept the contaminants.  A PRB does not require energy for, it requires the removal of modest volumes of soil, it does not present problems of visual impact and allows the use of the contaminated site during remediation. Monitoring performed on full-scale PRB, composed of zero valent iron (ZVI) as reactive medium, showed that, despite the considerable reactivity, ZVI is not able to maintain its hydraulic conductivity over a long period of time. The objective of the present work was to improve the hydraulic behaviour of the ZVI, by mixing this material with lapillus, a reactive medium of volcanic origin, sustainable for the environment and readily available. Experimental studies, conducted through batch and column tests, have shown that lapillus is reactive towards the tested contaminants, i.e. nickel and zinc, whose presence seriously  threatens the quality of aquifers

Prospective life cycle assessment for the full valorization of anchovy fillet leftovers: The LimoFish process

Prospective life cycle assessment models were developed and applied at the laboratory and industrial scale with the aim to evaluate the environmental burdens associated with the LimoFish process used to produce the fish oil “AnchoiOil”, the new organic fertilizer “AnchoisFert” or biogas (by means of anaerobic digestion) after treatment of anchovy fillet leftovers (AnLeft) with agro-solvent d-limonene. Potential impacts for climate change and freshwater eutrophication were estimated at 29.1 kg CO2 eq/kg AnLeft and 1.7E−07 kg PO4 eq/kg AnLeft at laboratory scale, and at 1.5 kg CO2 eq/kg AnLeft and 2.2E−07 kg PO4 eq/kg AnLeft at industrial scale. Electricity consumption is the main contributor to the environmental impact of the process and plays a significant role in the production of d-limonene, for which cold pressing extraction would reduce the related impacts by ∼ 70 %. The use of the solid by-product as organic fertilizer or input to anaerobic digestion would provide additional environmental benefits to the process. The LimoFish process is a successful example of a low impacting strategy to reduce the demand for natural resources and maximize the application of the circular economy principles in the fishing industry

Pathophysiological mechanisms and clinical evidence of relationship between Nonalcoholic fatty liver disease (NAFLD) and cardiovascular disease

Evidence suggests a close connection between Nonalcoholic Fatty Liver Disease (NAFLD) and increased cardiovascular (CV) risk. Several cross-sectional studies report that NAFLD is related to preclinical atherosclerotic damage, and to coronary, cerebral and peripheral vascular events. Similar results have been showed by prospective studies and also by meta-analyzes on observational studies. The pathophysiological mechanisms of NAFLD are related to insulin resistance, which causes a dysfunction in adipokine production, especially adiponectin, from adipose tissue. A proinflammatory state and an increase in oxidative stress, due to increased reacting oxygen species (ROS) formation with consequent oxidation of free fatty acids and increased de novo lipogenesis with accumulation of triglycerides, are observed. These mechanisms may have an impact on atherosclerotic plaque formation and progression, and they can lead to increased cardiovascular risk in subjects with NAFLD. This review extensively discusses and comments current and developing NAFLD therapies and their possible impact on cardiovascular outcome

Exploratory pilot study of circulating biomarkers in metastatic renal cell carcinoma

With the introduction of immune checkpoint inhibitors (ICIs) and next-generation vascular endothelial growth factor receptor–tyrosine kinase inhibitors (VEGFR–TKIs), the survival of patients with advanced renal cell carcinoma (RCC) has improved remarkably. However, not all patients have benefited from treatments, and to date, there are still no validated biomarkers that can be included in the therapeutic algorithm. Thus, the identification of predictive biomarkers is necessary to increase the number of responsive patients and to understand the underlying immunity. The clinical outcome of RCC patients is, in fact, associated with immune response. In this exploratory pilot study, we assessed the immune effect of TKI therapy in order to evaluate the immune status of metastatic renal cell carcinoma (mRCC) patients so that we could define a combination of immunological biomarkers relevant to improving patient outcomes. We profiled the circulating levels in 20 mRCC patients of exhausted/activated/regulatory T cell subsets through flow cytometry and of 14 immune checkpoint-related proteins and 20 inflammation cytokines/chemokines using multiplex Luminex assay, both at baseline and during TKI therapy. We identified the CD3+CD8+CD137+ and CD3+CD137+PD1+ T cell populations, as well as seven soluble immune molecules (i.e., IFNγ, sPDL2, sHVEM, sPD1, sGITR, sPDL1, and sCTLA4) associated with the clinical responses of mRCC patients, either modulated by TKI therapy or not. These results suggest an immunological profile of mRCC patients, which will help to improve clinical decision-making for RCC patients in terms of the best combination of strategies, as well as the optimal timing and therapeutic sequence

Alcohol Septal Ablation in Patients with Hypertrophic Obstructive Cardiomyopathy: A Contemporary Perspective

Alcohol septal ablation is a minimally invasive procedure for the treatment of left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic obstructive cardiomyopathy (HOCM) who remain symptomatic despite optimal medical therapy. The procedure causes a controlled myocardial infarction of the basal portion of the interventricular septum by the injection of absolute alcohol with the aim of reducing LVOT obstruction and improving the patient's hemodynamics and symptoms. Numerous observations have demonstrated the efficacy and safety of the procedure, making it a valid alternative to surgical myectomy. In particular, the success of alcohol septal ablation depends on appropriate patient selection and the experience of the institution where the procedure is performed. In this review, we summarize the current evidence on alcohol septal ablation and highlight the importance of a multidisciplinary approach involving a team of clinical and interventional cardiologists and cardiac surgeons with high expertise in the management of HOCM patients-the Cardiomyopathy Team

Rationale and Design of the PARTHENOPE Trial: A Two-by-Two Factorial Comparison of Polymer-Free vs. Biodegradable-Polymer Drug-Eluting Stents and Personalized vs. Standard Duration of Dual Antiplatelet Therapy in All-Comers Undergoing PCI.

BACKGROUND Over the past few decades, percutaneous coronary intervention (PCI) has undergone significant advancements as a result of the combination of device-based and drug-based therapies. These iterations have led to the development of polymer-free drug-eluting stents. However, there is a scarcity of data regarding their clinical performance. Furthermore, while various risk scores have been proposed to determine the optimal duration of dual antiplatelet therapy (DAPT), none of them have undergone prospective validation within the context of randomized trials. DESIGN The PARTHENOPE trial is a phase IV, prospective, randomized, multicenter, investigator-initiated, assessor-blind study being conducted at 13 centers in Italy (NCT04135989). It includes 2,107 all-comers patients with minimal exclusion criteria, randomly assigned in a 2-by-2 design to receive either the Cre8 amphilimus-eluting stent or the SYNERGY everolimus-eluting stent, along with either a personalized or standard duration of DAPT. Personalized DAPT duration is determined by the DAPT score, which accounts for both bleeding and ischemic risks. Patients with a DAPT score <2 (indicating higher bleeding than ischemic risk) receive DAPT for 3 or 6 months for chronic or acute coronary syndrome, respectively, while patients with a DAPT score ≥2 (indicating higher ischemic than bleeding risk) receive DAPT for 24 months. Patients in the standard DAPT group receive DAPT for 12 months. The trial aims to establish the non-inferiority between stents with respect to a device-oriented composite endpoint of cardiovascular death, target-vessel myocardial infarction, or clinically-driven target-lesion revascularization at 12 months after PCI. Additionally, the trial aims to demonstrate the superiority of personalized DAPT compared to a standard approach with respect to a net clinical composite of all-cause death, any myocardial infarction, stroke, urgent target-vessel revascularization, or type 2 to 5 bleeding according to the Bleeding Academic Research Consortium criteria at 24-months after PCI. SUMMARY The PARTHENOPE trial is the largest randomized trial investigating the efficacy and safety of a polymer-free DES with a reservoir technology for drug-release and the first trial evaluating a personalized duration of DAPT based on the DAPT score. The study results will provide novel insights into the optimizing the use of drug-eluting stents and DAPT in patients undergoing PCI

Long-lasting improvements in episodic memory among subjects with mild cognitive impairment who received transcranial direct current stimulation combined with cognitive treatment and telerehabilitation: a multicentre, randomized, active-controlled study

BackgroundIn recent years, an increasing number of studies have examined the potential efficacy of cognitive training procedures in individuals with normal ageing and mild cognitive impairment (MCI).ObjectiveThe aims of this study were to (i) evaluate the efficacy of the cognitive Virtual Reality Rehabilitation System (VRRS) combined with anodal transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex compared to placebo tDCS stimulation combined with VRRS and (ii) to determine how to prolong the beneficial effects of the treatment. A total of 109 subjects with MCI were assigned to 1 of 5 study groups in a randomized controlled trial design: (a) face-to-face (FTF) VRRS during anodal tDCS followed by cognitive telerehabilitation (TR) (clinic-atDCS-VRRS+Tele@H-VRRS); (b) FTF VRRS during placebo tDCS followed by TR (clinic-ptDCS-VRRS+Tele@H-VRRS); (c) FTF VRRS followed by cognitive TR (clinic-VRRS+Tele@H-VRRS); (d) FTF VRRS followed by at-home unstructured cognitive stimulation (clinic-VRRS+@H-UCS); and (e) FTF cognitive treatment as usual (clinic-TAU).ResultsAn improvement in episodic memory was observed after the end of clinic-atDCS-VRRS (p &lt; 0.001). We found no enhancement in episodic memory after clinic-ptDCS-VRRS or after clinic-TAU.Moreover, the combined treatment led to prolonged beneficial effects (clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-ptDCS-VRRS+Tele@H-VRRS: p = 0.047; clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-VRRS+Tele@H-VRRS: p = 0.06).DiscussionThe present study provides preliminary evidence supporting the use of individualized VRRS combined with anodal tDCS and cognitive telerehabilitation for cognitive rehabilitation.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT03486704?term=NCT03486704&amp;rank=1, NCT03486704

Refinement of the diagnostic approach for the identification of children and adolescents affected by familial hypercholesterolemia: Evidence from the LIPIGEN study

Background and aims: We aimed to describe the limitations of familiar hypercholesterolemia (FH) diagnosis in childhood based on the presence of the typical features of FH, such as physical sings of cholesterol accumulation and personal or family history of premature cardiovascular disease or hypercholesterolemia, comparing their prevalence in the adult and paediatric FH population, and to illustrate how additional information can lead to a more effective diagnosis of FH at a younger age.Methods: From the Italian LIPIGEN cohort, we selected 1188 (&gt;= 18 years) and 708 (&lt;18 years) genetically-confirmed heterozygous FH, with no missing personal FH features. The prevalence of personal and familial FH features was compared between the two groups. For a sub-group of the paediatric cohort (N = 374), data about premature coronary heart disease (CHD) in second-degree family members were also included in the evaluation.Results: The lower prevalence of typical FH features in children/adolescents vs adults was confirmed: the prevalence of tendon xanthoma was 2.1% vs 13.1%, and arcus cornealis was present in 1.6% vs 11.2% of the cohorts, respectively. No children presented clinical history of premature CHD or cerebral/peripheral vascular disease compared to 8.8% and 5.6% of adults, respectively. The prevalence of premature CHD in first-degree relatives was significantly higher in adults compared to children/adolescents (38.9% vs 19.7%). In the sub-cohort analysis, a premature CHD event in parents was reported in 63 out of 374 subjects (16.8%), but the percentage increased to 54.0% extending the evaluation also to second-degree relatives.Conclusions: In children, the typical FH features are clearly less informative than in adults. A more thorough data collection, adding information about second-degree relatives, could improve the diagnosis of FH at younger age

A Qualitative Exploration of the Use of Contraband Cell Phones in Secured Facilities

Offenders accepting contraband cell phones in secured facilities violate state corrections law, and the possession of these cell phones is a form of risk taking behavior. When offenders continue this risky behavior, it affects their decision making in other domains where they are challenging authorities; and may impact the length of their incarceration. This qualitative phenomenological study examined the lived experience of ex-offenders who had contraband cell phones in secured correctional facilities in order to better understand their reasons for taking risks with contraband cell phones. The theoretical foundation for this study was Trimpop\u27s risk-homeostasis and risk-motivation theories that suggest an individual\u27s behaviors adapt to negotiate between perceived risk and desired risk in order to achieve satisfaction. The research question explored beliefs and perceptions of ex-offenders who chose to accept the risk of using contraband cell phones during their time in secured facilities. Data were collected anonymously through recorded telephone interviews with 8 male adult ex-offenders and analyzed using thematic content analysis. Findings indicated participants felt empowered by possession of cell phones in prison, and it was an acceptable risk to stay connected to family out of concern for loved ones. The study contributes to social change by providing those justice system administrators, and prison managers responsible for prison cell phone policies with more detailed information about the motivations and perspectives of offenders in respect to using contraband cell phones while imprisoned in secured facilities