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The management of trans-sphincteric anal fistula (TAF) includes several surgical options; however, during the COVID-19 pandemic, the access to the operating rooms was severely limited, leaving only the choice of minimally invasive procedures. This study aimed to evaluate the safety and effectiveness of the slow cutting seton technique for TAF performed in an outpatient setting during the COVID-19 pandemic. Patients treated for TAF between January 2020 and July 2022 and followed-up for at least 12 months were retrospectively evaluated. A vascular silicone tie used as seton was positioned in the fistula tract using a Lockhart–Mummery fistula probe. The seton was maintained in moderate tension until the sphincter muscle was passed. Percentage and time for healing, recurrence, SF-36, VAS and Vaizey's Score were recorded. Fifty-eight patients [36 male/22 female, median age 56.5 years (IQR 41.25–65.75) [with TAF were included. After a median time of 4 months, complete healing occurred in 53 cases (91.5%), the anal pain VAS decreased from 6 to 0, the anal incontinence scores did not change significantly and the QoL improved significantly in all the SF36 domains. No complications were recorded, but the fistula recurred in five cases (8.5%). Two of them had additional seton treatment, and three underwent other surgical procedures after the COVID-19 emergency. The slow cutting seton technique is a safe and effective treatment for outpatient procedure with minimal patient discomfort. This treatment option in healthcare delivery for TAF should be reconsidered, even outside the limited in-hospital access during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

High-performance thermoplastic polymers, such as Poly(aryl ether ketone)s (PAEK)s, can be used in various space applications due to their high mechanical properties, low density, and low outgassing properties. Polyether ether ketone (PEEK) is a thermoplastic semi-crystalline polymer belonging to the PAEKs family, which, together with its composites, has been proved to be processable via Additive Manufacturing, in particular via Fused Filament Fabrication (FFF), enabling the production of parts both on-ground and possibly even for out-of-earth. In the past years, extensive efforts have been spent on the improvement of 3D-printed polymeric structures, extending the applications of high-performance polymers from purely mechanical to functional ones. It is possible to confer new properties to polymers by mixing and blending tailored fillers and different additives (e.g., clays, NdFeB powders, magnetite, and carbon fillers). Composite and nanocomposite polymers present customized functional properties such as electrical conductivity, thermal conductivity, soft and hard magnetic properties absent or utterly different from the ones of pure polymer. In this paper, we report the state of the art on 3D-printed PEEK composites, their mechanical properties, and functionalities in view of the production of parts made of PEEK composites and nanocomposites, and their possible space applications (e.g., electromagnetic devices, magnetic shielding, thermal protection system and sensors). [ABSTRACT FROM AUTHOR]

Quadratic scale-invariant gravity non minimally coupled to a scalar field provides a competitive model for inflation, characterized by the transition from an unstable to a stable fixed point, both characterized by constant scalar field configurations. We provide a complementary analysis of the same model in the static, spherically symmetric setting, obtaining two Schwarzschild-de Sitter solutions, which corresponds to the two fixed points existing in the cosmological scenario. The stability of such solutions is thoroughly investigated from two different perspectives. First, we study the system at the classical level by the analysis of linear perturbations. In particular, we provide both analytical and numerical results for the late-time behavior of the perturbations, proving the stable and unstable character of the two solutions. Then we perform a semi-classical, non-linear analysis based on the Euclidean path integral formulation. By studying the difference between the Euclidean on-shell actions evaluated on both solutions, we prove that the unstable one has a meta-stable character and is spontaneously decaying into the stable fixed point which is always favoured. [ABSTRACT FROM AUTHOR]

Background: Surgical management of obstructed defecation syndrome (ODS) is challenging, with several surgical options showing inconsistent functional results over time. The aim of this study was to evaluate the trend in surgical management of ODS in a 10-year timeframe across Italian referral centers. Methods: Surgeons from referral centers for the management of pelvic floor disorders and affiliated to the Italian Society of Colorectal Surgery provided data on the yearly volume of procedures for ODS from 2010 to 2019. Six common clinical scenarios of ODS were captured, including details on patient's anal sphincter function and presence of rectocele and/or rectal intussusception. Perineal repair, ventral rectopexy (VRP), transanal repair (internal Delorme), stapled transanal rectal resection (STARR), Contour Transtar, and transvaginal repair were considered in each clinical scenario. Results: Twenty-five centers were included providing data on 2943 surgical patients. Procedure volumes ranged from 10–20 (54%) to 21–50 (46%) per year across centers. The most performed techniques in patients with good sphincter function were transanal repair for isolated rectocele (243/716 [34%]), transanal repair for isolated rectal intussusception (287/677 [42%]) and VRP for combined abnormalities (464/976 [48%]). When considering poor sphincter function, these were perineal repair (112/194 [57.8%]) for isolated rectocele, and VRP for the other two scenarios (60/120 [50%] and 97/260 [37%], respectively). The use of STARR and Contour Transtar decreased over time in patients with impaired sphincter function. Conclusions: The complexity of ODS treatment is confirmed by the variety of clinical scenarios that can occur and by the changing trend of surgical management over the last 10 years. [ABSTRACT FROM AUTHOR]

There is growing evidence for the benefits of peer support in mental health services. Less is known about the specific mechanisms whereby peer support brings about change. The aim of this study was to explore the experiences of adults using mental health services and peer workers to investigate whether the contents of an intentionally provided one-to-one peer support intervention can be adequately described using a standard taxonomy of behaviour change techniques (BCTs). This qualitative comparative case study involved semi-structured interviews with 11 peer workers and 10 people they supported, in 2017–2018. They participated in a randomised controlled trial of a peer support intervention. Data were coded using both an analytical framework, derived from Michie and colleague's taxonomy of BCTs, and inductive thematic analysis. The findings revealed that the intervention included BCTs from all 16 BCT groupings in the taxonomy, with the emphasis on the groupings of 'social support', 'comparison of behaviour', 'comparison of outcomes', 'regulation' 'shaping knowledge', 'identity' and 'covert learning'. Thematic analysis revealed a new group, 'relational aspects', consisting of five new BCTs: sharing of the peer worker's experiential knowledge; promoting reciprocity, autonomy, and confidentiality; and validation of a safe and trusting relationship. A standard taxonomy of BCTs was shown to be broadly applicable to describing the contents of an intentional one-to-one peer support intervention for adults using mental health services. The taxonomy may need to be extended to consider additional BCTs related to encouraging the therapeutic relationship. [ABSTRACT FROM AUTHOR]

Sacral nerve modulation (SNM) has represented a major advancement in the minimally invasive management of patients with fecal incontinence (FI). Although the success rate in the short–medium term has widely been demonstrated, the very long-term outcomes are poorly investigated. This study aims to assess the effectiveness of SNM in a cohort of patients with a follow-up longer than 10 years. Clinical records of patients submitted to SNM for FI in our tertiary referral colorectal Unit between 1998 and 2010 were retrospectively reviewed looking for status of the implantable pulse generator (IPG), follow-up duration, severity of FI by the St Marks' score and quality of life. 58 patients fulfilled the entry criteria and 36 (58%, median follow-up, 12 years) accepted to take part to the telephone interview, while 22 (38%) were lost to the follow-up. Nineteen patients had their IPG removed (Group A) while 17 (27%) had the SNM still active after a median follow-up of 13 years (Group B). In the group A, the median baseline St Marks' score was 13 and did not change after the IPG removal. In group B, the median baseline St Marks' score was 14, at last IPG substitution, it was of 7 and at the last follow-up dropped to 4. In the group A, the median SF-12 physical and mental scores did not change significantly while they improved significantly in group B. A progressive deterioration of the success rate of SNM with the time has been documented after a very long-term follow-up. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the safety and efficacy of short-term treatment for ocular surface disease (OSD) with topical low-dose (1,005 mg) preservative-free hydrocortisone in one hundred patients with and without glaucoma. Methods: This was an open label non-randomized clinical trial. Patients with OSD with and without primary open-angle glaucoma (POAG) received topical low-dose (1,005 mg) preservative-free hydrocortisone twice daily in each eye for 2 weeks. All patients underwent a complete ophthalmological examination at baseline (T0) and at 1 (T1) and 2 (T2) weeks post-treatment. At each visit, the intraocular pressure (IOP) and the ocular surface disease index (OSDI) questionnaire scores were recorded; the Schirmer test was performed only at T0 and T2. Results: The OSDI score significantly decreased in both the POAG and no-POAG groups (both p < 0.0001) after hydrocortisone treatment, with no difference between the two groups (p = 0.72). There were no significant differences in IOP and Schirmer test results between T0 and T2 in both treatment groups (p = 0.68 and p = 0.83, respectively). Conclusions: Topical low-dose (1,005 mg) preservative-free hydrocortisone is safe and effective for improving OSD symptoms both in patients with and without POAG. Trial registration: The trial was registered at clinicaltrials.gov under NCT04536129 on 01/09/2020 ("retrospectively registered"). [ABSTRACT FROM AUTHOR]

This letter reports on the passive voltage amplification provided by X-cut Lithium Niobate (LN) ${S}_{{0}}$ mode resonators when implemented as Matching Networks (MN) in the front-end of ultra-low-power, Internet of Things (IoT) receivers. In the first section, a simple gain analytical model is described. In the second part, devices design rules and geometries are disclosed. In the third and last section, measurements methodology and results are presented. Measured gains of 38.9 dB and 32.5 dB are reported at 110 and 570 MHz, respectively, for a capacitive load of ~100 fF. These performance represent, to the knowledge of the authors, the largest passive voltage gains ever recorded at the given frequencies for MEMS-based matching networks. [ABSTRACT FROM AUTHOR]

Background: Anal fissure (AF) is a common, painful disease that strongly affects patients' quality of life, however, no scoring system to assess the severity of AF is available in the literature. The aim of this study was to set up and validate a reliable scoring system to quantify the severity of AF, to be used in prospective trials comparing the efficacy and the outcomes of surgical or medical treatments. Methods: The study was conducted on patients with acute or chronic AF and a control group in a tertiary centre for coloproctology in June 2020–September 2020. Two researchers independently carried out a structured interviewer-led questionnaire at two different time points (T1/T2). The questionnaire consisted of five items selected according to the most commonly reported symptoms for AF: the item pain, was scored from 0 to 10 using a visual analogue scale, and quality of life, duration of pain, use of painkillers, and bleeding were scored from 1 to 5 using Likert-scale questions. The scoRing systEm for AnaL fIsSurE (REALISE) score was the sum of the points. Patients with AF and a control group of patients with haemorrhoids, anal fistula, or obstructed defecation syndrome entered the study. Main outcome measures were reliability, inter-/intraobserver agreement, and repeatability. Results: One hundred and fifty well-matched patients (75 with AF and 75 controls) were enrolled. A significant difference was found between the mean REALISE score for patients with AF and controls (p < 0.001). The two REALISE scores were highly correlated (r = 0.99). The coefficient of repeatability was 1.45 in T1 and 1.18 in T2. Conclusions: The REALISE score may have an important role in the assessment and management of AF, in grading the severity of AF and comparing results of different treatments. [ABSTRACT FROM AUTHOR]

Background: The efficacy of sacral nerve stimulation (SNS) on patients with chronic refractory slow-transit constipation is controversial and its mechanism of action on gastrointestinal motility and transit is not fully understood. The aim of this study was to document the effects of temporary SNS on the gastrointestinal and biliary tract motility and on gastrointestinal transit in patients with refractory slow-transit constipation. Methods: This was a prospective interventional study. Patients with slow-transit chronic constipation, unresponsive to any conservative treatment, were enrolled between January 2013 and December 2018. Patients' quality of life [patient assessment of constipation quality of life (PAC-QOL) questionnaire], constipation scores (Cleveland Clinic Constipation Score) colonic transit time (CTT), orocecal transit time (OCTT), gastric and gallbladder kinetics, together with the assessment of the autonomic nerve function were evaluated before and during temporary SNS. Results: 14 patients (12 females, median age 38 years, range 24–42 years) had temporary SNS. The Cleveland Clinic Constipation Score did not change compared to baseline (23 ± 3 vs 21.4; p = 070). The PAC-QOL did not improve significantly during the stimulation period. Gallbladder/stomach motility (half-emptying time) did not change significantly before and after SNS. OCTT was delayed at baseline, as compared to standard internal normal values, and did not change during SNS. CTT did not improve significantly, although in two patients it decreased substantially from 97 to 53 h, and from 100 to 65 h. Conclusions: Temporary SNS did not have any effect on upper/lower gastrointestinal motility and transit in patients with severe constipation. [ABSTRACT FROM AUTHOR]

Background Mental health trusts in England were expected to become completely smoke-free and embed smoking cessation practices by 2018. Such policies are fraught with concerns and have received mixed support from mental health staff. Understanding staff attitudes to these practices prior to enforcement of the policy could help design an effective implementation strategy. Methods A cross-sectional survey was conducted with clinical and non-clinical staff in a Mental Health Trust to understand smoking cessation practices and attitudes to the implementation of a completely smoke-free policy. Results There were 631 responses. Most participants disagreed with the policy on wards (59.6%) and throughout all mental health settings (57.4%). Clinicians expressed significantly lower organizational policy support (P =  0.001) than non-clinicians (P  = 0.001). Psychiatrists were more supportive of the organizational items than nurses and allied health professionals. Clinicians' attitudes towards smoking cessation practices were less positive for those who were current smokers (P  < 0.001), but more positive for clinicians who had received or were interested in attending smoking cessation training (P  < 0.001). Conclusions Partial and completely smoke-free policies remain unsupported by staff in mental health settings. Smoking cessation training appears to reinforce rather than alter attitudes towards smoking cessation. [ABSTRACT FROM AUTHOR]

Permanent Rare Earth magnets are becoming more and more important in efficient motors and generators with high energy density. Among them NdFeB magnets are the most employed, with NdFeB having higher remanence, high coercivity and energy product. Nevertheless,their poor corrosion resistance makes them susceptible to degradation of the magnetic properties. One possible solution is the development of innovative polymeric composite magnetic materials. The preparation of NdFeB powders filled polymeric matrix (PEEK), with a double goal of protecting the magnetic alloy is proposed, thus preventing it from corrosion, and to realize a new material that can be shaped in the form of filaments. This material was used as feedstock in the 3D printing process to produce high performance magnets with customized and optimized design. The PEEK-NdFeB filaments were produced with three percentages of filler amount(i.e. 25, 50 and 75 wt%). PEEK neat filaments were produced as reference. The influence of the filler on the main thermomechanical properties of the resulting composites, as well as its effect onthe 3D printing process were evaluated by means of different investigation techniques (DSC, DMTA, XRD, tensile testing). The magnetic properties exhibited by Fused Filament Fabrication (FFF) printed parts confirmed the feasibility of employing such a combination of an innovative manufacturing technique and high-performance PEEK-NdFeB compounds. The characterization carried out on both neat and composite filaments evidenced that the presence of the filler slightly decreased the thermal stability, increased the elastic modulus while decreasing ductility and maximum tensile strength. By means of DSC analysis, it was confirmed that the crystallinity is influenced by the presence of the filler. Magnetic measurement performed on the 3D printed parts demonstrate that interesting magnetic properties were achieved, confirming the feasibility of the magnetic 3D printed composite with PEEK. [ABSTRACT FROM AUTHOR]

Objective: Individual placement and support (IPS) has shown consistently better outcomes on competitive employment for patients with severe mental illness than traditional vocational rehabilitation. The evidence for efficacy originates from few countries, and generalization to different countries has been questioned. This has delayed implementation of IPS and led to requests for country‐specific RCTs. This meta‐analysis examines if evidence for IPS efficacy can be generalized between rather different countries. Methods: A systematic search was conducted according to PRISMA guidelines to identify RCTs. Overall efficacy was established by meta‐analysis. The generalizability of IPS efficacy between countries was analysed by random‐effects meta‐regression, employing country‐ and date‐specific contextual data obtained from the OECD and the World Bank. Results: The systematic review identified 27 RCTs. Employment rates are more than doubled in IPS compared with standard vocational rehabilitation (RR 2.07 95% CI 1.82–2.35). The efficacy of IPS was marginally moderated by strong legal protection against dismissals. It was not moderated by regulation of temporary employment, generosity of disability benefits, type of integration policies, GDP, unemployment rate or employment rate for those with low education. Conclusions: The evidence for efficacy of IPS is very strong. The efficacy of IPS can be generalized between countries. [ABSTRACT FROM AUTHOR]

Submicrometric catalyst patterns have been fabricated by atomic force nanolithography and the subsequent selective growth of carbon nanotubes has been successfully verified. Rectangular stripes (∼350 nm wide) were engraved onto a polymethylmethacrylate film, deposited onto SiO2/Si, by polymer removal with atomic force microscopy nanoindentation. Metallic catalyst patterns were subsequently obtained after 3 nm Ni deposition and lift-off of the residual polymer. Multiwalled carbon nanotubes were then grown by thermal chemical vapor deposition onto the Ni stripes. The various steps of nanopatterning and of carbon nanotubes growth are also studied by scanning electron microscopy and Raman measurements. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for nontractional diabetic macular edema.Methods: PUBMED, MEDLINE and CENTRAL were reviewed using the following terms (or combination of terms): diabetic macular edema, nontractional diabetic macular edema, internal limiting membrane peeling, vitrectomy, Müller cells. Randomized and nonrandomized studies were included. The eligible studies compared anatomical and functional outcomes of vitrectomy with or without ILM peeling for tractional and nontractional diabetic macular edema. Postoperative best-corrected visual acuity and central macular thickness were considered, respectively, the primary and secondary outcomes. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects.Results: Four studies with 672 patients were eligible for analysis. No significant difference was found between postoperative best-corrected visual acuity or best-corrected visual acuity change of ILM peeling group compared with nonpeeling group. There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups.Conclusions: The visual acuity outcomes in patients affected by nontractional diabetic macular edema using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger prospective and randomized study would be necessary. [ABSTRACT FROM AUTHOR]

The Morphological Quality Index (MQI) and the Morphological Quality Index for monitoring (MQIm) have been applied to eight case studies across Europe with the objective of analyzing the hydromorphological response to various restoration measures and of comparing the results of the MQI and MQIm as a morphological assessment applied at the reach scale, with a conventional site scale physical-habitat assessment method. For each restored reach, the two indices were applied to the pre-restoration and post-restoration conditions. The restored reach was also compared to an adjacent, degraded reach. Results show that in all cases the restoration measures improved the morphological quality of the reach, but that the degree of improvement depends on many factors, including the initial morphological conditions, the length of the restored portion in relation to the reach length, and on the type of intervention. The comparison with a conventional site scale physical-habitat assessment method shows that the MQI and MQIm are best suited for the evaluation of restoration effects on river hydromorphology at the geomorphologically-relevant scale of the river reach. [ABSTRACT FROM AUTHOR]

Background: To demonstrate the efficacy of intravitreal ranibizumab (IVR) in combination with reduced-fluence photodynamic therapy (RF-PDT) in patients with choroidal neovascularization (CNV) secondary to pathologic myopia. Methods: Sixty patients affected by myopic CNV (mCNV) were randomized to receive either ranibizumab 0.5 mg monotherapy (RM; n = 20), standard fluence PDT (SF-PDT, n = 20) or RF-PDT combination therapy ( n = 20). Subsequently, IVR was injected as needed. All patients were evaluated for 48 weeks. Results: Mean BCVA change at 48 weeks was + 0.2 and +15 letters with SF or RFPDT plus ranibizumab, respectively, compared with +16.8 letters with RM. At 48 weeks, mean central foveal thickness (CFT) decrease from baseline was 58 ± 15 μm, 91.4 ± 43.8 μm, and 85 ± 41.5 μm for the verteporfin SF, RF and RM groups, respectively. Macular sensitivity improvement was + 0.4 db, + 1.9 dB and + 2.7 dB for the verteporfin SF, RF and RM groups, respectively. Conclusions: Ranibizumab monotherapy or combined with RF-PDT improved BCVA and macular sensitivity in patients affected by mCNV, whereas CFT results were reduced. SF-PDT combination regimen mostly stabilized vision at 48 weeks. Among all groups, the RF-PDT seemed to reduce the number of ranibizumab retreatments. [ABSTRACT FROM AUTHOR]

The aerosol size-segregated chemical composition was analyzed at an urban (Bologna) and a rural site (San Pietro Capofiume) in the Po Valley, Italy, during June and July 2012, to investigate sources and mechanisms of secondary aerosol formation during the summer. A significant enhancement of secondary organic and inorganic aerosol mass was observed under anticyclonic conditions with recirculation of planetary boundary layer air, but with substantial differences between the urban and the rural site. The data analysis, including a Principal Component Analysis (PCA) on the size-resolved dataset of chemical concentrations, indicated that the photochemical oxidation of inorganic and organic gaseous precursors was an important mechanism of secondary aerosol formation at both sites. In addition at the rural site a second formation process, explaining the largest fraction (22%) of the total variance, was active at night-time, especially under stagnant conditions. Nocturnal chemistry in the rural Po Valley was associated with the formation of ammonium nitrate in large accumulation mode (0.42-1.2 µm) aerosols favored by local thermodynamic conditions (higher relative humidity and lower temperature compared to the urban site). Nocturnal concentrations of fine nitrate were, in fact, on average five times higher at the rural site than in Bologna. The water uptake by this highly hygroscopic compound under high RH conditions provided the medium for increased nocturnal aerosol uptake of water soluble organic gases and possibly also for aqueous chemistry, as revealed by the shifting of peak concentrations of secondary compounds (WSOC and sulfate) toward the large accumulation mode (0.42-1.2 µm). Contrarily, the diurnal production of WSOC (proxy for secondary organic aerosol) by photochemistry was similar at the two sites but mostly affected the small accumulation mode of particles (0.14-0.42 µm) in Bologna, while a shift to larger accumulation mode was observed at the rural site. A significant increment in carbonaceous aerosol concentration (for both WSOC and WINC) at the urban site was recorded mainly in the size range 0.05-0.14 µm indicating a direct influence of traffic emissions on the mass concentrations of quasi-ultrafine particles. [ABSTRACT FROM AUTHOR]

Riparian vegetation actively interacts with fluvial systems affecting river hydrodynamics, morphodynamics and groundwater. These interactions can be coupled because both vegetation and hydromorphology (i.e. the combined scientific study of hydrology and fluvial geomorphology) involve dynamic processes with similar temporal and spatial scales. To predict and assess the consequences of restoration measures, maintenance operations or human pressures in rivers, managers and planners may wish to model these interactions considering the different and interdisciplinary implications in the fields of ecology, geomorphology and hydrology. In this paper, we review models that are currently available and that incorporate the processes that relate riparian vegetation to hydromorphology. The models that are considered include those emphasizing hydraulic-geomorphological processes (such as flow resistance, sediment transport and bank dynamics) as well as those emphasizing ecological processes (seed dispersal, plant survival, growth, succession and mortality). Models interpreting the coupled evolution between riparian vegetation and river morphology and groundwater are also presented. The aim is to provide an overview of current modelling capabilities and limitations and to identify future modelling challenges. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

As part of an hierarchical, multi-scale, hydromorphological framework for European rivers that has been developed within the REFORM project, a procedure for classifying rivers has been devised. The procedure includes components that categorise river channel morphology, floodplain morphology, flow regime, and groundwater-surface water interactions, and is designed for operational use in the context of river management. Channel morphology is classified at a first level by a basic river typology interpreted using remotely sensed images, and at a second level by an extended river typology that integrates information from field observations. Floodplains are classified by adopting the Nanson and Croke typology with specific reference to the types of floodplain that are most likely to be encountered widely across Europe. Nine flow regime types are identified using a series of hydrological indicators. Finally, where groundwater has a significant influence on river flows, a range of potential groundwater-surface water interactions are identified reflecting the morphological river type and its geological and climatic setting. Within the REFORM project, the river typology has been tested using case studies representative of a wide variety of European catchment conditions. Four case studies are used to illustrate the classification procedure and to discuss its main strengths and limitations. [ABSTRACT FROM AUTHOR]

This paper introduces this special issue of Aquatic Sciences. It outlines a multi-scale, hierarchical framework for developing process-based understanding of catchment to reach hydromorphology that can aid design and delivery of sustainable river management solutions. The framework was developed within the REFORM (REstoring rivers FOR effective catchment Management) project, funded by the European Union's FP7 Programme. Specific aspects of this 'REFORM framework' and some applications are presented in other papers in this special issue. The REFORM framework is founded on previous hierarchical frameworks, sixteen examples of which are reviewed. However, the REFORM framework has some particular properties that reflect the European context for which it was developed. The framework delineates regional landscapes into nested spatial units at catchment, landscape unit, segment, reach, geomorphic unit and finer scales. Reaches, regardless of their 'naturalness', are assigned to a river type based on valley confinement, planform and bed material. Indicators are quantified at each spatial scale to feed three groups of assessments. First, contemporary indicators at reach and geomorphic unit scales investigate present processes, forms and human pressures within each reach. These feed assessments of present reach hydromorphological function/alteration, including whether the reach is functioning appropriately for its type; riparian corridor function and alteration; and hydromorphological adjustment. Second, indicators at catchment to segment scales investigate water and sediment production and delivery to reaches and how these are affected by human pressures now and in the past. These are used to construct an inventory of changes over space and time. Third, historical reach and geomorphic unit scale indicators are used to construct the trajectory of reach-scale changes. Contemporary reach-scale assessments, space-time inventory, and trajectory of changes are then combined to establish how river reaches of different type, subject to different human pressures, and located in different environmental contexts behave in response to changes at all considered spatial scales. These support forecasts of the likely responses of reaches to future scenarios (e.g., changes in climate, land cover, channel interventions). [ABSTRACT FROM AUTHOR]

This paper forms a post-script to a Special Issue of Aquatic Sciences devoted to the rationale, nature and application of a multi-scale, hierarchical framework for developing process-based understanding of catchment to reach hydrology and fluvial geomorphology (termed hydromorphology). It considers some potential future directions for hydromorphological frameworks in relation to their use as 'tool kits' for hydromorphological river assessment and management; the ways in which such development needs to be integrated with other river sciences and data sets to support integrated management of river ecosystems; and the stakeholder context in which development needs to take place to ensure maximum benefits for both humans and river ecosystems. [ABSTRACT FROM AUTHOR]

The multi-scale hierarchical framework developed within the REFORM project, for the study of the functioning of river reaches and their catchments, was applied to the Magra River catchment (Northern Tuscany, Italy). The Magra River is a quite dynamic gravel-bed river that has undergone severe channel adjustments over the last century (i.e. incision and narrowing). The REFORM framework was then applied in order to (1) explore the locations and causes of these adjustments, and (2) assess how different river reaches responded to specific human activities (i.e. land use changes, dams, gravel mining). The work aims at providing information to aid sustainable river management and restoration. In accordance with the framework, initially, all the relevant spatial units (i.e. from the catchment to the reach scale) were delineated and then characterised in further detail. Then, a summary of the trajectories of change following human impact was provided. Combined with an overview of the main human pressures still influencing the river system, this allowed us to define the current conditions at the river reach scale. Finally, the knowledge acquired in the previous parts was assembled to build a better understanding of current river conditions and controls on past changes, as well as to enable the formulation of some future scenarios. The latter analysis was focussed on a couple of reaches located in a sensitive and relatively low impacted segment, in order to better highlight the interpretative power of the hierarchical framework. The framework was applied by combining the knowledge derived from previous studies and the computation of additional and relevant indicators. This study demonstrated the helpfulness of the hierarchical framework in diagnosing problems and supporting management strategies for a medium-sized, gravel-bed river catchment. [ABSTRACT FROM AUTHOR]

Laboratory experiments suggest that water-soluble products from the gas-phase oxidation of volatile organic compounds can partition into atmospheric waters where they are further oxidized to form low volatility products, providing an alternative route for oxidation in addition to further oxidation in the gas-phase. These products can remain in the particle phase after water evaporation forming what is termed as aqueous secondary organic aerosol (aqSOA). However, few studies have attempted to observe ambient aqSOA. Therefore, a suite of measurements, including near real-time WSOC (water-soluble organic carbon), inorganic anions/cations, organic acids, and gas-phase glyoxal, were made during the PEGASOS (Pan-European Gas-AeroSols-climate interaction Study) 2012 campaign in the Po Valley, Italy to search for evidence of aqSOA. Our analysis focused on two specific periods: Period A on 19-21 June and Period B on 3-5 July to represent the first and second halves of the study, respectively. The large scale circulation was predominately from the west in both periods. Plus back trajectory analysis suggested all sites sampled similar air masses during both periods allowing for comparison of Periods A and B. The data collected during both periods were divided into times of increasing relative humidity (RH) and decreasing RH with the aim of diminishing the influence of dilution and mixing on SOA concentrations and other measured variables. Evidence for local aqSOA formation was only observed during Period A. When this occurred, there was a correlation of WSOC with organic aerosol (R² = 0.86), aerosol liquid water (R² = 0.69), RH (R² = 0.45), and aerosol nitrate (R² = 0.71). Additionally, this was only observed during times of increasing RH, which coincided with dark conditions. Comparisons of WSOC with oxygenated organic aerosol (OOA) factors determined from application of positive matrix factorization analysis on the aerosol mass spectrometer observations of the submicron non-refractory organic particle composition suggested that the WSOC in Periods A and B differed (Period A WSOC vs. OOA-2 R² = 0.85 and OOA-4 R² = 0.03 whereas Period B WSOC vs. OOA-2 R² = 0.03 and OOA-4 R² = 0.64). OOA-2 had a high O/C (oxygen/carbon) ratio of 0.77, providing evidence that aqueous processing was occurring during Period A. Key factors for local aqSOA production during Period A appear to include: air mass stagnation, which allows aqSOA precursors to accumulate in the region; the formation of substantial local particulate nitrate during the overnight hours, which enhances water uptake by the aerosol; and the presence of significant amounts of ammonia, which may contribute to ammonium nitrate formation and subsequent water uptake and/or play a more direct role in the aqSOA chemistry. [ABSTRACT FROM AUTHOR]

The global nitrogen (N) cycle at the beginning of the 21st century has been shown to be strongly influenced by the inputs of reactive nitrogen (Nr) from human activities, including combustion-related NOx, industrial and agricultural N fixation, estimated to be 220 TgNyr-1 in 2010, which is approximately equal to the sum of biological N fixation in unmanaged terrestrial and marine ecosystems. According to current projections, changes in climate and land use during the 21st century will increase both biological and anthropogenic fixation, bringing the total to approximately 600 TgNyr-1 by around 2100. The fraction contributed directly by human activities is unlikely to increase substantially if increases in nitrogen use efficiency in agriculture are achieved and control measures on combustion-related emissions implemented. Some N-cycling processes emerge as particularly sensitive to climate change. One of the largest responses to climate in the processing of Nr is the emission to the atmosphere of NH3, which is estimated to increase from 65 TgNyr-1 in 2008 to 93 TgNyr-1 in 2100 assuming a change in global surface temperature of 5 °C in the absence of increased anthropogenic activity. With changes in emissions in response to increased demand for animal products the combined effect would be to increase NH3 emissions to 135 TgNyr-1. Another major change is the effect of climate changes on aerosol composition and specifically the increased sublimation of NH4NO3 close to the ground to form HNO3 and NH3 in a warmer climate, which deposit more rapidly to terrestrial surfaces than aerosols. Inorganic aerosols over the polluted regions especially in Europe and North America were dominated by (NH4)2SO4 in the 1970s to 1980s, and large reductions in emissions of SO2 have removed most of the SO2-4 from the atmosphere in these regions. Inorganic aerosols from anthropogenic emissions are now dominated by NH4NO3, a volatile aerosol which contributes substantially to PM10 and human health effects globally as well as eutrophication and climate effects. The volatility of NH4NO3 and rapid dry deposition of the vapour phase dissociation products, HNO3 and NH3, is estimated to be reducing the transport distances, deposition footprints and inter-country exchange of Nr in these regions. There have been important policy initiatives on components of the global N cycle. These have been regional or country-based and have delivered substantial reductions of inputs of Nr to sensitive soils, waters and the atmosphere. To date there have been no attempts to develop a global strategy to regulate human inputs to the nitrogen cycle. However, considering the magnitude of global Nr use, potential future increases, and the very large leakage of Nr in many forms to soils, waters and the atmosphere, international action is required. Current legislation will not deliver the scale of reductions globally for recovery from the effects of Nr deposition on sensitive ecosystems, or a decline in N2O emissions to the global atmosphere. Such changes would require substantial improvements in nitrogen use efficiency across the global economy combined with optimization of transport and food consumption patterns. This would allow reductions in Nr use, inputs to the atmosphere and deposition to sensitive ecosystems. Such changes would offer substantial economic and environmental co-benefits which could help motivate the necessary actions. [ABSTRACT FROM AUTHOR]

High-resolution aerosol mass spectrometer measurements were performed, for the first time, at the Mt. Cimone Global Atmosphere Watch (GAW) station between June and July 2012, within the EU project PEGASOS and the ARPA-Emilia-Romagna project SUPERSITO. Submicron aerosol was dominated by organics (63%), with sulfate, ammonium and nitrate contributing the remaining 20, 9 and 7%, respectively. Organic aerosol (OA) was in general highly oxygenated, consistent with the remote character of the site; our observations suggest that oxidation and secondary organic aerosol (SOA) formation processes occurred during aerosol transport to high altitudes. All of the aerosol component concentrations as well as the OA elemental ratios showed a clear daily trend, driven by the evolution of the planetary boundary layer (PBL) and by the mountain wind regime. Higher loadings and lower OA oxidation levels were observed during the day, when the site was within the PBL, and therefore affected by relatively fresh aerosol transported from lower altitudes. Conversely, lower loadings and higher OA oxidation levels were observed at night, when the top of Mt. Cimone resided in the free troposphere although affected by the transport of residual layers on several days of the campaign. Analysis of the elemental ratios in a Van Krevelen space shows that OA oxidation follows a slope comprised between ..0.5 and ..1, consistent with addition of carboxylic groups, with or without fragmentation of the parent molecules. The increase of carboxylic groups during OA ageing is confirmed by the increased contribution of organic fragments containing more than one oxygen atom in the free troposphere night-time mass spectra. Finally, positive matrix factorization was able to deconvolve the contributions of relatively fresh OA (OOAa) originating from the PBL, more aged OA (OOAb) present at high altitudes during periods of atmospheric stagnation, and very aged aerosols (OOAc) transported over long distances in the free troposphere. [ABSTRACT FROM AUTHOR]

Open-ocean intake systems require extensive and advanced pretreatment unit operation to produce feed water with low membrane fouling potential in seawater reverse osmosis (SWRO) facilities. Alternatively, subsurface intake systems tend to produce high quality raw seawater even before pretreatment. Subsurface intakes extract seawater indirectly through the geological structure of shoreline or nearshore sediments. Water percolation through geological units provides physical and biological treatment, so that the raw seawater is microbiologically stable with relatively low particulate and organics content. Overall, utilization of subsurface intakes will reduce the intensity of pretreatment, which reduces operating cost, lowers chemical and energy consumption, and reduces environmental impacts. An important aspect in the feasibility of a subsurface intake is the compatibility of the local geological environment. In this study, a field investigation was conducted at Ras Abu Ali Island in the Arabian Gulf. This location currently contains an of existing oil company facilities and a proposed governmental marine fish hatchery facility. Recreational, commercial, and domestic potable water uses require the need to use the SWRO process to meet demands. Characterization of the shoreline and marine offshore bottom were performed as well as observation of tidal fluctuations and wave heights. A specific grid area was chosen where 35 sediment samples were collected from the seabed floor for laboratory analysis of grain size distribution, sediment porosity, and hydraulic conductivity. Onsite observation showed that the marine bottom has a low slope creating a wide intertidal area. The lowest tidal zone is more than 150 m from the shoreline defining a far seaward boundary for the intake construction point. A relatively thin layer of mixed-type sediment (carbonate and siliciclastic) covers the marine hardground bottom. The unlithified bottom sediment contains a low mud percentage (less than 1%) with porosity ranging between 0.29 and 0.41 and hydraulic conductivities up to 22.5 m3/d. It was determined that seabed gallery development is suitable at this location. Preliminary design for a seabed gallery filter was developed using a series of cells. Each gallery cell represents a unit that can be simply duplicated to meet the overall intake capacity requirement. Each gallery cell is designed to have minimum 8 m/d infiltration rate through five layers of engineered sand and gravel. The total thickness of the filter bed is 4.5 m (2 m top layer). The dimensions of the proposed cells are 100 × 30 m and each cell will conservatively provide 24,000 m3/d of filtered water. The design is flexible to meet the required capacity. For example, a SWRO desalination plant which produces 54,000 m3/d product water from 38,000 mg/L salinity seawater at a 45% conversion rate will require a minimum of 6 cells using the preliminary design. [ABSTRACT FROM PUBLISHER]

High resolution aerosol mass spectrometer measurements have been performed, for the first time, at the Mt. Cimone Global Atmospheric Watch (GAW) station between June and July 2012, within the EU project PEGASOS and the ARPA--Emilia Romagna project SUPERSITO. Sub-micron aerosol was dominated by organics (63%) with sulphate, ammonium and nitrate contributing for the remaining 20, 9 and 7%, respectively. Organic aerosol (OA) was in general highly oxygenated, consistent with the remote character of the site; our observations suggest that oxidation and secondary organic aerosol (SOA) formation processes occurred during aerosol transport to high altitudes. All of the aerosol component concentrations as well as the OA elemental ratios showed a clear daily trend, driven by the evolution of the planetary boundary layer (PBL) and by the mountain wind regime. Higher loadings and lower OA oxidation levels were observed during the day, when the site was within the PBL, and therefore affected by relatively fresh aerosol transported from lower altitudes. Conversely, lower loadings and higher OA oxidation levels were observed at night, when the top of Mt. Cimone resided in the free troposphere although affected by the transport of residual layers on several days of the campaign. Analysis of the elemental ratios in a Van Krevelen space shows that OA oxidation follows a slope comprised between -0.5 and -1, consistent with addition of carboxylic groups, with or without fragmentation of the parent molecules. The increase of carboxylic groups during OA ageing is confirmed by the increased contribution of organic fragments containing more than one oxygen atom in the free troposphere night-time mass spectra. Finally, positive matrix factorization was able to deconvolve the contributions of relatively fresh OA (OOAa) originating from the PBL, more aged OA (OOAb) present at high altitudes during periods of atmospheric stagnation, and very aged aerosols (OOAc) transported over long distances in the free troposphere. [ABSTRACT FROM AUTHOR]

High resolution aerosol mass spectrometer measurements have been performed, for the first time, at the Mt. Cimone Global Atmospheric Watch (GAW) station between June and July 2012, within the EU project PEGASOS and the ARPA-Emilia Romagna project SUPERSITO. Sub-micron aerosol was dominated by organics (63 %) with sulphate, ammonium and nitrate contributing for the remaining 20, 9 and 7 %, respectively. Organic aerosol (OA) was in general highly oxygenated, consistent with the remote character of the site; our observations suggest that oxidation and secondary organic aerosol (SOA) formation processes occurred during aerosol transport to high altitudes. All of the aerosol component concentrations as well as the OA elemental ratios showed a clear daily trend, driven by the evolution of the planetary boundary layer (PBL) and by the mountain wind regime. Higher loadings and lower OA oxidation levels were observed during the day, when the site was within the PBL, and therefore affected by relatively fresh aerosol transported from lower altitudes. Conversely, lower loadings and higher OA oxidation levels were observed at night, when the top of Mt. Cimone resided in the free troposphere although affected by the transport of residual layers on several days of the campaign. Analysis of the elemental ratios in a Van Krevelen space shows that OA oxidation follows a slope comprised between -0.5 and -1, consistent with addition of carboxylic groups, with or without fragmentation of the parent molecules. The increase of carboxylic groups during OA ageing is confirmed by the increased contribution of organic fragments containing more than one oxygen atom in the free troposphere night-time mass spectra. Finally, positive matrix factorization was able to deconvolve the contributions of relatively fresh OA (OOAa) originating from the PBL, more aged OA (OOAb) present at high altitudes during periods of atmospheric stagnation, and very aged aerosols (OOAc) transported over long distances in the free troposphere. [ABSTRACT FROM AUTHOR]

Aims The study aimed at investigating the ability of biosurfactant (BS) produced by a Lactobacillus brevis isolate ( CV8 LAC) to inhibit adhesion and biofilm formation of Candida albicans on medical-grade silicone elastomeric disks ( SEDs). Methods and Results Biosurfactant activity was evaluated at physiological conditions, by means of co-incubation and precoating assays. Additionally, BS extract was tested for antifungal susceptibility against C. albicans in both planktonic and sessile form. Biofilm covered surface and hyphae and blastospores occurrence were quantified by scanning electron microscopy ( SEM) and image analysis. BS did not inhibit growth of C. albicans in both planktonic and sessile form. Nevertheless, co-incubation with 2000 μg ml−1 BS significantly reduced biofilm formation on SEDs surface by 89, 90 and 90% after 24, 48 and 72 h of incubation. Fungal adhesion and biofilm formation to precoated SEDs was reduced by 62, 53, 50 and 44% after 1·5, 24, 48 and 72 h. SEM showed a significant reduction of biofilm covered surface in precoated disks but no differences in the production of hyphae or blastospores, except at 1·5 h of incubation. Conclusions This study demonstrated that CV8 LAC BS has the ability to counteract significantly the initial deposition of C. albicans to silicone surfaces and to effectively slow biofilm growth. Significance and Impact of the Study The anti-adhesive properties of the CV8 LAC BS suggest a potential role of the coating for preventing fungal infection associated to silicone medical devices. [ABSTRACT FROM AUTHOR]

Numerous hydromorphological assessment methods have been developed in different countries during recent decades, with notable differences in their aims, scales, and approaches. Although these methods are increasingly applied to support river management, the strengths and limitations have been insufficiently investigated. This review of 121 methods analyses hydromorphological assessment methods dating from 1983 to 2013, identifying their main strengths, limitations, gaps, the potential to integrate different approaches, and the need for further improvements. For this purpose methods have been grouped into four categories: (1) physical habitat assessment; (2) riparian habitat assessment; (3) morphological assessment; (4) assessment of hydrological regime alteration. Seventeen categories of information covering general characteristics, recorded features and river processes encompassing over 90 features were recorded for each method reviewed, allowing a comparative analysis of the four assessment categories. The main gap in most methods is insufficient consideration of physical processes. Thus, an integrated hydromorphological analysis is recommended, where the morphological and hydrological components are the key parts to classify hydromorphological conditions. Additional physical and riparian habitat methods strengthen the link with ecological conditions. [ABSTRACT FROM AUTHOR]

The development and implementation of both economically and environmentally sustainable precision crop management systems can be greatly enhanced through the use of hyperspectral sensing. In this study, the potential of narrow-waveband hyperspectral observations for the discrimination of water-stressed tomato plants ( Solanum lycopersicum L.) was investigated in a field experiment conducted in southern Italy. The tomato crop was grown in a 1.8-ha test field that was split into two plots with different irrigation treatments: optimal and deficit water supplies, with the deficit supply using half of the water of the optimal supply in the second half of the crop growing cycle. Hyperspectral measurements were taken with a field spectroradiometer. To reduce the number of variables, principal component analysis was applied to each of six wavelength band sub-intervals across the whole wavelength interval from 400 to 1000 nm. The retained principal components were then submitted to canonical discriminant analysis. Finally, the principal components and the canonical component were interpolated using multivariate and univariate geostatistical techniques, respectively, and then mapped. The two irrigation treatments produced different plant biomass and leaf area indices, which were higher under optimal than deficit water conditions, as was the plant water potential. These data show that the correlation between the individual bands varied during the crop cycle, so it was not feasible to choose a specific band to discriminate between the water treatments. However, we show that only a combination of all of the bands that use the full spectral information with differential weighting leads to clear discrimination of the two differently irrigated areas, with a mean accuracy of 75% to 77%. The processing of hyperspectral reflectance data using canonical discriminant analysis can thus provide valuable information for the agricultural producer for the identification of within-field areas of plant stress, so as to implement site-specific irrigation strategies. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The global nitrogen (N) cycle at the beginning of the 21st century has been shown to be strongly influenced by the inputs of reactive nitrogen (Nr) from human activities, estimated to be 193T g N yr-1 in 2010 which is approximately equal to the sum of biological N fixation in terrestrial and marine ecosystems. According to current trajectories, changes in climate and land use during the 21st century will increase both biological and anthropogenic fixation, bringing the total to approximately 600 Tg N yr-1 by around 2100. The fraction contributed directly by human activities is unlikely to increase substantially if increases in nitrogen use efficiency in agriculture are achieved and control measures on combustion related emissions implemented. Some N cycling processes emerge as particularly sensitive to climate change. One of the largest responses to climate in the processing of Nr is the emission to the atmosphere of NH3, which is estimated to increase from 65 Tg N yr-1 in 2008 to 93Tg N yr-1 in 2100 assuming a change in surface temperature of 5°C even in the absence of increased anthropogenic activity. With changes in emissions in response to increased demand for animal products the combined effect would be to increase NH3 emissions to 132 Tg N yr-1. Another major change is the effect of changes in aerosol composition combined with changes in temperature. Inorganic aerosols over the polluted regions especially in Europe and North America were dominated by (NH4)2SO4 in the 1970s to 1980s, and large reductions in emissions of SO2 have removed most of the SO42- from the atmosphere in these regions. Inorganic aerosols from anthropogenic emissions are now dominated by NH4NO3, a volatile aerosol which contributes substantially to PM10 and human health effects globally as well as eutrophication and climate effects. The volatility of NH4NO3 and rapid dry deposition of the vapour phase dissociation products, HNO3 and NH3, is estimated to be reducing the transport distances, deposition footprints and inter-country exchange of Nr in these regions. There have been important policy initiatives on components of the global N cycle. For the most part they have been regional or country-based and have delivered substantial reductions of inputs of Nr to sensitive soils, waters and the atmosphere. However, considering the magnitude of global Nr use, potential future increases, and the very large leakage of Nr in many forms to soils, waters and the atmosphere, there is a very long way to go before evidence for recovery from the effects of Nr deposition on sensitive ecosystems, or a decline in N2O emissions to the global atmosphere are likely to be detected. Such changes would require substantial improvements in nitrogen use efficiency across the global economy combined with optimisation of transport and food consumption patterns. This would allow reductions in Nr use, inputs to the atmosphere and deposition to sensitive ecosystems. Such changes would offer substantial economic and environmental co-benefits which could help motivate the necessary actions. [ABSTRACT FROM AUTHOR]