Vulnerability assessment to trihalomethane exposure in water distribution system.

Chlorination is an effective and cheap disinfectant for preventing waterborne diseases-causing microorganisms, but its compounds tend to react with the natural organic matter (NOM), forming potentially harmful and unwanted disinfection by-products (DBPs) such as trihalomethanes (THMs), haloacetic acids (HAAs), and others. The present paper proposes a methodology for estimating the vulnerability with respect to users' exposure to DPBs in water distribution systems (WDSs). The presented application considers total THMs (TTHMs) concentration, but the methodology can be used also for other types of DPBs. Five vulnerability indexes are adopted that furnish different kinds of information about the exposure. The methodology is applied to five case studies, and the results suggest that the introduced indexes identify different critical areas in respect to elevated concentrations of TTHMs. In this way, the use of the proposed methodology allows identifying the higher risk nodes with respect to the different kinds of exposure, whether it is a short period of exposure to high TTHMs values, or chronic exposure to low concentrations. The application of the methodology furnishes useful information for an optimal WDS management, for planning system modifications and district sectorization taking into account water quality

Potential Approaches Versus Approved or Developing Chronic Myeloid Leukemia Therapy.

Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of patients with chronic myeloid leukemia (CML). However, continued use of these inhibitors has contributed to the increase in clinical resistance and the persistence of resistant leukemic stem cells (LSCs). So, there is an urgent need to introduce additional targeted and selective therapies to eradicate quiescent LSCs, and to avoid the relapse and disease progression. Here, we focused on emerging BCR-ABL targeted and non-BCR-ABL targeted drugs employed in clinical trials and on alternative CML treatments, including antioxidants, oncolytic virus, engineered exosomes, and natural products obtained from marine organisms that could pave the way for new therapeutic approaches for CML patients

Tuning an Earthworm phase picker: some considerations on the pick_ew parameters

Although the Earthworm project started with the initial mission of replacing the old real time picker by Rex Allen, as developed by Jim Ellis [Allen, 1978; Allen, 1982; USGS et al., 2010], that picker is still in use in many networks. The name of the procedure that implements the Allen’s algorithm is pick_ew. Despite its long-lived use, configuring this picker still seems not so immediate and easy. We discuss here a few simple rules to define some of the numerous (18) parameters of pick_ew, interpreting their physical meaning

Drinking water temperature around the globe: Understanding, policies, challenges and opportunities

Water temperature is often monitored at water sources and treatment works; however, there is limited monitoring of the water temperature in the drinking water distribution system (DWDS), despite a known impact on physical, chemical and microbial reactions which impact water quality. A key parameter influencing drinking water temperature is soil temperature, which is influenced by the urban heat island effects. This paper provides critique and comprehensive summary of the current knowledge, policies and challenges regarding drinking water temperature research and presents the findings from a survey of international stakeholders. Knowledge gaps as well as challenges and opportunities for monitoring and research are identified. The conclusion of the study is that temperature in the DWDS is an emerging concern in various countries regardless of the water source and treatment, climate conditions, or network characteristics such as topology, pipe material or diameter. More research is needed, especially to determine (i) the effect of higher temperatures, (ii) a legislative limit on temperature and (iii) measures to comply with this limit

Drinking water temperature around the globe : understanding, policies, challenges and opportunities

Water temperature is often monitored at water sources and treatment works; however, there is limited monitoring of the water temperature in the drinking water distribution system (DWDS), despite a known impact on physical, chemical and microbial reactions which impact water quality. A key parameter influencing drinking water temperature is soil temperature, which is influenced by the urban heat island effects. This paper provides critique and comprehensive summary of the current knowledge, policies and challenges regarding drinking water temperature research and presents the findings from a survey of international stakeholders. Knowledge gaps as well as challenges and opportunities for monitoring and research are identified. The conclusion of the study is that temperature in the DWDS is an emerging concern in various countries regardless of the water source and treatment, climate conditions, or network characteristics such as topology, pipe material or diameter. More research is needed, especially to determine (i) the effect of higher temperatures, (ii) a legislative limit on temperature and (iii) measures to comply with this limit

Fighting autoinflammation in FIRES: The role of interleukins and early immunomodulation

Febrile infection-related epilepsy syndrome (FIRES) is a challenging condition with unfavorable outcome in most cases. Preliminary evidence suggests that some interleukins, in particular IL-1 Receptor Antagonist (IL-1RA), could be elevated due to a functional deficiency of anti-inflammatory pathways. Therefore, treatment strategies acting on innate immunity could represent a targeted treatment. We describe the case of an 11-year-old child with super-refractory status epilepticus (SE), lasting more than two months. After being treated aggressively with antiseizure medications, anesthetics and empiric treatment for autoimmune encephalitis without success, she responded to anakinra and ketogenic diet. Escalation of the therapy was supported by the finding of a very high serum level of IL-1RA. This immunomodulatory approach allowed to discharge the child from intensive care 48 days after the SE onset. After more than one year follow-up the patient has moderate intellectual disability but with good language skills; she is seizure free and without motor deficits. This case suggests that serum IL-1RA serum levels may help to support treatment escalation. Moreover, anakinra and ketogenic diet represent encouraging immunomodulatory strategies which deserve further studies and could potentially have a synergistic effect. Finally, structured neuropsychological testing is an important outcome measure that will help to define the effectiveness of different treatment strategies

Design of the WHIP-PD study: a phase II, twelve-month, dual-site, randomized controlled trial evaluating the effects of a cognitive-behavioral approach for promoting enhanced walking activity using mobile health technology in people with Parkinson-disease

BACKGROUND: Parkinson disease (PD) is a debilitating and chronic neurodegenerative disease resulting in ambulation difficulties. Natural walking activity often declines early in disease progression despite the relative stability of motor impairments. In this study, we propose a paradigm shift with a "connected behavioral approach" that targets real-world walking using cognitive-behavioral training and mobile health (mHealth) technology. METHODS/DESIGN: The Walking and mHealth to Increase Participation in Parkinson Disease (WHIP-PD) study is a twelve-month, dual site, two-arm, randomized controlled trial recruiting 148 participants with early to mid-stage PD. Participants will be randomly assigned to connected behavioral or active control conditions. Both conditions will include a customized program of goal-oriented walking, walking-enhancing strengthening exercises, and eight in-person visits with a physical therapist. Participants in the connected behavioral condition also will (1) receive cognitive-behavioral training to promote self-efficacy for routine walking behavior and (2) use a mHealth software application to manage their program and communicate remotely with their physical therapist. Active control participants will receive no cognitive-behavioral training and manage their program on paper. Evaluations will occur at baseline, three-, six-, and twelve-months and include walking assessments, self-efficacy questionnaires, and seven days of activity monitoring. Primary outcomes will include the change between baseline and twelve months in overall amount of walking activity (mean number of steps per day) and amount of moderate intensity walking activity (mean number of minutes per day in which > 100 steps were accumulated). Secondary outcomes will include change in walking capacity as measured by the six-minute walk test and ten-meter walk test. We also will examine if self-efficacy mediates change in amount of walking activity and if change in amount of walking activity mediates change in walking capacity. DISCUSSION: We expect this study to show the connected behavioral approach will be more effective than the active control condition in increasing the amount and intensity of real-world walking activity and improving walking capacity. Determining effective physical activity interventions for persons with PD is important for preserving mobility and essential for maintaining quality of life. Clinical trials registration NCT03517371, May 7, 2018. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03517371. Date of registration: May 7, 2018. Protocol version: Original.R01 HD092444 - NICHD NIH HHS; 1R01HD092444-01A1 - National Institute of Child Health and Human DevelopmentPublished versio

Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis

Purpose: The number of cancer survivors has risen substantially due to improvements in early diagnosis and treatment. Health behaviours such as physical activity (PA) and diet can reduce recurrence and mortality, and alleviate negative consequences of cancer and treatments. Digital behaviour change interventions (DBCIs) have the potential to reach large numbers of cancer survivors. Methods: We conducted a systematic review and meta-analyses of relevant studies identified by a search of Medline, EMBASE, PubMed and CINAHL. Studies which assessed a DBCI with measures of PA, diet and/or sedentary behaviour were included. Results: 15 studies were identified. Random effects meta-analyses showed significant improvements in moderate-vigorous PA (7 studies; mean difference (MD) = 41 minutes per week; 95% CI: 12, 71) and body mass index (BMI)/weight (standardised mean difference (SMD) = -0.23; 95% CI: -0.41, -0.05). There was a trend toward significance for reduced fatigue and no significant change in cancer-specific quality of life (QoL). Narrative synthesis revealed mixed evidence for effects on diet, generic QoL and self-efficacy and no evidence of an effect on mental health. Two studies suggested improved sleep quality. Conclusions: DBCIs may improve PA and BMI among cancer survivors and there is mixed evidence for diet. The number of included studies is small and risk of bias and heterogeneity was high. Future research should address these limitations with large, high-quality RCTs, with objective measures of PA and sedentary time. Implications for cancer survivors: Digital technologies offer a promising approach to encourage health behaviour change among cancer survivors

La sequenza sismica nel Montefeltro (Forlì - Cesena): l’intervento della rete sismica mobile

Il 24 maggio 2011, alle 12.40 UTC, la Rete Sismica Nazionale (RSN) dell’Istituto Nazionale di Geofisica e Vulcanologia (INGV) ha registrato un evento sismico di magnitudo (ML) 3.1 nel distretto sismico1 [Selvaggi et al., 1996] del Montefeltro (in provincia di Forlì-Cesena). Nelle successive due settimane sono stati localizzati dalla Sala di Sorveglianza Sismica della sede romana dell’INGV oltre 600 eventi di cui 13 di ML ≥ 3.0. Otto di questi eventi più energetici sono accaduti entro le prime 16 ore dalla prima scossa. L’evento di maggiore energia si è verificato la notte tra il 24 e il 25 maggio (ore 22.03 UTC del 24 maggio) con una magnitudo pari a ML 3.7 (Tabella 1). Considerando la peculiare evoluzione della sequenza nelle prime 24 ore dal primo evento, la prossimità dell'area epicentrale all’Alta Val Tiberina (AVT nel seguito) dove è attualmente in corso un esperimento sismico passivo [Progetto NOVAT2; Cattaneo et al., 2011; D’Alema et al., 2011] e l’apprensione che stava diffondendosi tra la popolazione, è stato ritenuto opportuno attivare le procedure di risposta ad una emergenza sismica e predisporre un intervento volto a migliorare la copertura strumentale dell'area. Il 25 maggio, in accordo con i colleghi INGV della Sezione di Pisa, dell’Osservatorio di Arezzo [Braun, 2006], della sede di Ancona e della Fondazione Prato Ricerche3, si è proceduto con l'istallazione di una rete sismica temporanea ad integrazione delle stazioni permanenti già presenti in zona. Nella giornata del 27 maggio, due delle stazioni temporanee sono state predisposte per la trasmissione in tempo reale alla Sala di Sorveglianza Sismica di Roma dei dati acquisiti, per migliorare la precisione delle localizzazioni prodotte. Nel contempo, sono stati curati dei comunicati informativi divulgati attraverso il sito web4 dell’Ente, parzialmente inclusi in questo lavoro, per dare una risposta alla popolazione interessata dalla sequenza e fortemente preoccupata dall’intensificarsi della sismicità. Il presente lavoro, la cui redazione è stata completata mentre la sequenza è ancora in corso, vuole essenzialmente descrivere le procedure che vengono attivate all’INGV in risposta ad una emergenza sismica e fornire uno strumento tecnico di supporto alla successiva elaborazione della base dati raccolta nel corso dell'esperimento. Viene quindi presentata una breve introduzione sulle conoscenze sismologiche dell’area interessata dalla sequenza, vengono descritti i comunicati emessi dall’INGV per informare i cittadini e viene descritto l’intervento della rete sismica temporanea, ovvero la tempistica dell'istallazione, la strumentazione utilizzata, e i siti occupati.Published1-171.1. TTC - Monitoraggio sismico del territorio nazionaleN/A or not JCRope

L’esercitazione nazionale di protezione civile sul rischio sismico “Nord-Est 2013” (13-15 settembre 2013) e la partecipazione dell’INGV. Report finale

Nell’ambito delle commemorazioni per i 50 anni dalla frana del Vajont, il Dipartimento della Protezione Civile (DPC), la Regione Veneto e la Regione Autonoma Friuli Venezia Giulia con il coinvolgimento delle Province Autonome di Trento e Bolzano, hanno organizzato un’esercitazione sul rischio sismico denominata “Nord-Est 2013” svoltasi dal 13 al 15 settembre 2013. Obiettivo primario dell’iniziativa era verificare la capacità di risposta in situazioni di emergenza di tutte le componenti e le strutture operative della Protezione Civile, a livello centrale e periferico, e della rete di collaborazioni ad essa collegate. L’esercitazione prevedeva la simulazione di un terremoto di magnitudo Richter (ML) 5.8 alle ore 7.30 locali con epicentro nel Comune di Tambre, in Provincia di Belluno, i cui effetti, in termini di popolazione coinvolta in crolli, avrebbero interessato anche le Province di Treviso e Pordenone. Come terremoto di riferimento per l’iniziativa, è stato scelto l’evento sismico di Bosco Cansiglio avvenuto il 18 ottobre 1936 alle 3:10 UTC (MW 5.8) (Figura 1 [Barbano et al., 1986]). L’emergenza simulata era, ai fini dell’attività di protezione civile1, di tipo C ovvero di rilievo nazionale (il tipo A si riferisce alle emergenze locali, gestibili su scala comunale; quelle di tipo B alle emergenze che richiedono una risposta e risorse su scala provinciale o regionale). L’Istituto Nazionale di Geofisica e Vulcanologia (INGV) ha partecipato attivamente all’esercitazione “Nord-Est 2013” nella giornata di sabato 14 settembre (dalle 7.30 alle 17.30, ora locale), attivando le procedure che sono disposte in caso di evento sismico come previsto dall’Allegato A2 dell’Accordo Quadro 2012-2021 della Convenzione esistente fra l’INGV e il Dipartimento della Protezione Civile (DPC). Nel presente report sono descritte brevemente le azioni approntate dall’INGV sia nella fase di pianificazione che durante l’esercitazione stessa; sebbene il risultato conseguito si possa ritenere più che positivo, in questo lavoro si vogliono mettere in evidenza alcune criticità osservate per le quali sarà opportuno trovare delle soluzioni da adottare nella prossima emergenza.Published1-881.1. TTC - Monitoraggio sismico del territorio nazionaleN/A or not JCRope