Sequential biological and photocatalysis based treatments for shipboard slop purification: A pilot plant investigation

This study investigated the treatment of a shipboard slop containing commercial gasoline in a pilot plant scale consisting of a membrane biological reactor (MBR) and photocatalytic reactor (PCR) acting in series. The MBR contributed for approximately 70% to the overall slop purification. More precisely, the biological process was able to remove approximately 40%, on average, of the organic pollution in the slop. Nevertheless, the membrane was capable to retain a large amount of organic molecules within the system, amounting for a further 30% of the influent total organic content removal. However, this affected the membrane fouling, thus resulting in the increase of the pore blocking mechanism that accounted for approximately 20% to the total resistance to filtration (2.85∙10 13 m −1 ), even if a significant restoration of the original membrane permeability was obtained after chemical cleanings. On the other hand, the biological treatment produced a clear solution for the photocatalytic system, thereby optimizing the light penetration and generation of highly oxidizing active oxygen species that enabled the degradation of bio-recalcitrant compounds. Indeed, low total organic carbon (TOC) values (<10 mg L −1 ) were achieved in the output of the photocatalytic reactor by means of only 60 Einstein (E) of cumulative impinging energy after the addition of K 2 S 2 O 8 . Overall, coupling the two processes enabled very high TOC removal (ca. 95%)

Sexual dimorphism in the neural impact of stress and alcohol

Alcohol use disorder is a widespread mental illness characterized by periods of abstinence followed by recidivism, and stress is the primary trigger of relapse. Despite the higher prevalence of alcohol use disorder in males, the relationship between stress and behavioral features of relapse, such as craving, is stronger in females. Given the greater susceptibility of females to stress-related psychiatric disorders, understanding sexual dimorphism in the relationship between stress and alcohol use is essential to identifying better treatments for both male and female alcoholics. This review addresses sex differences in the impact of stressors on alcohol drinking and seeking in rodents and humans. As these behavioral differences in alcohol use and relapse originate from sexual dimorphism in neuronal function, the impact of stressors and alcohol, and their interaction, on molecular adaptations and neural activity in males and females will also be discussed. Together the data reviewed herein, arising from a symposium entitled “Sex matters in stress-alcohol interactions” presented at the Fourth Volterra Conference on Stress and Alcohol, will highlight the importance of identifying sex differences to improve treatments for comorbid stress and alcohol use disorder in both populations

El fútbol dentro del campo y fuera de él : desafíos en la transición a la élite

Una de las transiciones que ha recibido menos atención en la literatura científica es la transición de junior al deporte profesional, en concreto al fútbol de élite. Basados en el modelo de desarrollo deportivo de Wylleman y Lavallee (2004), el objetivo de este estudio es explorar de forma retrospectiva los desafíos que tuvieron que afrontar futbolistas junior al realizar la transición a la élite del fútbol. Además, se analizan las especificidades de los desafíos en función del género al realizar dicha transición. Se entrevistaron 8 chicos y 8 chicas sobre sus experiencias en la transición a la élite del fútbol. Los resultados se distribuyen en dos apartados principales: desafíos asociados al fútbol dentro del campo y desafíos asociados al fútbol fuera del campo (e.g., estructura, concepción social). El análisis de contenido muestra que los desafíos a los que tienen que hacer frente los futbolistas dentro del campo se asocian a los niveles deportivo y psicológico. Los desafíos fuera del campo además de asociarse con estos dos niveles, se asocian también a los niveles psicosocial y académico/laboral. Las diferencias respecto a los desafíos que se encuentran chicos y chicas se asocian únicamente a la categoría fútbol fuera del campo. Se discute la relevancia de afrontar con éxito estos desafíos y su importancia para una correcta adaptación a la élite del fútbol.One of the transitions that has received little attention in scientific literature is the transition from junior to professional sport, specifically in football. Based on the development model of Wylleman and Lavallee (2004), the aim of this study is to explore, retrospectively, the challenges that junior football players experienced in making the transition into elite football. In addition, this study analyses specific challenges of this transition according to gender. 8 males and 8 females were interviewed about their experience in the transition to elite football. The results are divided into two main sections: challenges associated with football on the field and challenges associated with football off the field (e.g., structure, social concept). The analysis shows the effect the challenges that football players must cope with on the field produces on the athletes and their psychological levels. Off the field challenges are also produced at those levels and, in addition, at psychosocial and academic/work-related levels. The relevance of facing these challenges successfully and their importance for proper adaptation to elite football is discussed.Uma das transições que tem recebido menos atenção na literatura científica é a transição de júnior para o desporto profissional, em concreto para o futebol de elite. Baseado no modelo de desenvolvimento desportivo de Wylleman e Lavallee (2004), o objectivo deste estudo foi explorar de forma retrospectiva os desafios que enfrentaram os futebolistas juniores ao realizar a transição para a elite do futebol. Adicionalmente, foram analisadas as especificidades dos desafios em função do género. Foram entrevistados 8 rapazes e 8 raparigas acerca das suas experiências na transição para a elite do futebol. Os resultados são distribuídos em duas secções principais: desafios associados ao futebol dentro de campo e desafios associados ao futebol fora do campo (e.g., estrutura, concepção social). A análise de conteúdo revela que os desafios que os futebolistas têm que enfrentar dentro de campo se associam aos níveis desportivo e psicológico. Os desafios fora do campo, para além de se associarem a estes dois níveis, também se associam aos níveis psicossocial e académico/laboral. As diferenças referentes aos desafios que se verificam nos rapazes e raparigas associam-se unicamente à categoria futebol fora do campo. É discutida a relevância de enfrentar com êxito estes desafios e a sua importância para uma correcta adaptação ao futebol de elite

Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use at the University Hospital ?Paolo Giaccone?, Palermo, Italy

Introduction. Healthcare-associated infections (HAIs) and antimicrobial resistance are well known major public health threats. The first goal of our study was to describe the prevalence of HAI, while the second goal was to describe the antibiotic consumption at our University Hospital, ?P. Giaccone? in Palermo, Italy. Methods. A standardized methodology for a combined Point Prevalence Survey (PPS) on healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospital developed by the European Centre for Disease Prevention and Control (ECDC) was piloted across Europe. The teaching Hospital ?P. Giaccone? in Palermo, Italy, participated in the study Results. Out of 328 surveyed patients, 12 (3.6%) had an HAI and 159 (48.5%) were receiving at least one antimicro- bial agent. Prevalence results were highest in intensive care units, with 17.6% patients with HAI. Bloodstream infections represented the most common type (50%) of HAI. Surgical prophylaxis was the indication for antimicrobial prescribing in 59 (37.1%) out of 159 patients and exceeded 24 hours in 54 (91.5%) cases. Discussion. The results suggest that in our hospital there was a frequent and inappropriate use of antimicrobials, especially in the setting of surgical prophylaxis

Epidemiology of intensive care unit-acquired sepsis in Italy: results of the SPIN-UTI network

BACKGROUND: Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. STUDY DESIGN: Prospective multicenter study. METHODS: The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. RESULTS: During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. CONCLUSION: Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patient

Lung recurrence of papillary thyroid cancer diagnosed with antithyroglobulin antibodies after 10 years from initial treatment.

Introduction: Papillary thyroid cancer (PTC) is the most common endocrine malignancy. More than 98% of patients achieve an excellent response with no evidence of clinical, biochemical, or structural disease after initial treatment. In these patients structural recurrence is rare, more frequently diagnosed in the first 5 years from initial treatment and almost invariably localized in neck lymph nodes. Patient: We report the case of a woman affected by PTC who presented with rapidly rising anti-thyroglobulin antibodies (TgAb) level after 10 years from clinical, morphological and biochemical remission. Diagnosis and Treatment: In 2003, a 56 year old patient was treated with total thyroidectomy and radioiodine remnant ablation (RRA) for a PTC (2 cm) with minimal extrathyroidal extension (T3N1aM0 according to the 6th AJCC TNM staging system) associated with diffuse lymphocytic thyroiditis. In 2004 the patient was free of disease defined as undetectable Tg after recombinant human TSH administration in the absence of TgAb and structural disease. Since February 2012 the appearance and progressive increase of TgAb titer was observed and in 2014 a18FDG-PET scan documented three hypermetabolic lesions suggestive of lung micrometastases. The lung lesions were cytologically confirmed as PTC metastases. Both the primary tissue and the lung metastasis were positive for BRAF V600E mutation. The patient was treated with 131-radioiodine that showed radioiodine avid lung lesions that lose the ability to take up iodine at the following treatment. The patient is still alive and the lung lesions are growing slowly. Conclusions: Structural recurrence in patients that demonstrated an excellent response after initial treatment for PTC is extremely rare, and distant metastases exceptional but possible. This case is peculiar because recurrence was early identified after 10 years from initial treatment for the presence of detectable TgAb in a patient that had an histological diagnosis of lymphocytic thyroiditis but with an atypical clinical presentation (normal thyroid at neck ultrasound and undetectable TgAb and anti-thyroid peroxidase antibodies). For this reason TgAb should be tested with Tg in patients with a history of lymphocytic thyroiditis, either histological or humoral, also when TgAb is in the normal range and not suggestive of autoimmune thyroiditis

Management of pandemic influenza A (H1N1) 2009 in the major University Hospital of Sicily

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Impact of Candida species colonization and azoles resistance in a neonatal intensive care unit

Background: Candida species are among the top 10 most frequently isolated nosocomial bloodstream pathogens in Europe. In particular, in neonatal intensive care units (NICUs) Candida infections are an emerging concern because of the increasing incidence, the related high morbidity and mortality rates reported. Moreover, the epidemiology of Candida infection rapidly changed in these years leading to the selection of less sensitive strains and species. Surveillance studies are mandatory to identify the local distribution of species, their antifungal susceptibility profiles and the emergence of resistance strains. Material/methods: From December 2012 we performed a cohort prospective surveillance study in our NICU, collecting weekly nasal and rectal swabs. Swabs were placed on Sabouraud agar. Candida growth on agar plates was confirmed by microscopic observation. Furthermore, Candida spp. was identified through Candida chromogenic agar (Candida chromogenic agar, Laboratorios Conda) and API\uae 20C AUX (Biom\ue9rieux). The first isolated non-C.albicans Candida (NCAC) species from colonized patients were tested with the main antifungal agents (YeastOne\uae Y010 Thermo Fisher Scientific) and the obtained MIC values were read according to CLSI. Results: From December 2012 to June 2016 we enrolled 874 neonates and analyzed respectively 2014 nasal and rectal swabs. 20/2014 (0,99%) of nasal swabs and 128/2014 (6,35%) of rectal swabs tested positive for Candida spp. The species distribution is showed in the Graph 1. 89/874 (10,18%) neonates tested positive at least in one swab. 59 isolates of NCAC species were tested with the main antifungal agents. All the tested strains were susceptible to echinocandins and amphotericin B. The susceptibility patterns for azoles are shown in the Table 1. Conclusions: Our study confirm the rule of surveillance in the prevention and control of Candida spp. healthcare related infections especially in an high risk ward such as NICU. In particular, in our NICU fluconazole prophylaxis is administered according to standard protocols from 2009.Antifungal susceptibility testes allowed to identify resistant and mutant strains whom acquired resistance so to obtain both clinical and epidemiological data promptly