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The treatment of municipal wastewater produces clean water and sewage sludge (MSS), the management of which has become a serious problem in Europe. The typical destination of MSS is to spread it on land, but the presence of heavy metals and pollutants raises environmental and health concerns. Bioconversion mediated by larvae of black soldier fly (BSFL) Hermetia illucens (Diptera, Stratiomyidae: Hermetiinae) may be a strategy for managing MSS. The process adds value by generating larvae which contain proteins and lipids that are suitable for feed and/or for industrial or energy applications, and a residue as soil conditioner. MSS from the treatment plant of Ladispoli (Rome province) was mixed with an artificial fly diet at 50% and 75% (fresh weight basis) to feed BSFL. Larval performance, substrate reduction, and the concentrations of 12 metals in the initial and residual substrates and in larval bodies at the end of the experiments were assessed. Larval survival (> 96%) was not affected. Larval weight, larval development, larval protein and lipid content, and waste reduction increased in proportion the increase of the co-substrate (fly diet). The concentration of most of the 12 elements in the residue was reduced and, in the cases of Cu and Zn, the quantities dropped under the Italian national maximum permissible content for fertilizers. The content of metals in mature larvae did not exceed the maximum allowed concentration in raw material for feed for the European Directive. This study contributes to highlight the potential of BSF for MSS recovery and its valorization. The proportion of fly diet in the mixture influenced the process, and the one with the highest co-substrate percentage performed best. Future research using other wastes or by-products as co-substrate of MSS should be explored to determine their suitability., (© 2022. The Author(s).)

Purpose: This study was designed to present the 5-year results of patients with multicentric breast cancer who underwent sentinel lymph node biopsy (SLNB) in a single institution., Methods: Between June 1999 and December 2007, 337 patients with multicentric breast cancer and a clinically negative axilla underwent lymphatic mapping by a single periareolar/peritumoral (n = 306) or a double peritumoral or subdermal injection (n = 31) of (99m)Tc-HSA nanocolloids. The sentinel lymph node (SLN) was evaluated by intraoperative frozen section and axillary dissection was performed only in cases of positive SLNB., Results: The median age of the patients was 48 (range, 22-81) years. The mean number of hot spots identified was 1.4 in the whole series, 1.3 in patients who received a single injection, and 1.7 in those who received a double injection (P < 0.001). The mean number of removed SLNs was 1.7 (median, 1; range, 1-7) with an identification rate of 100%. A total of 138 patients with negative SLNB (n = 134) or isolated tumor cells in the SLN (n = 4) did not receive completion axillary lymph node dissection (CALND). In these latter patients, a total of 27 events (19.5%) occurred with 3 patients (2.2%) developing axillary recurrences after a median follow-up of 5 years (range, 17-134 months)., Conclusions: Axillary lymph node reappearance was infrequent among patients with multicentric breast cancer, having negative SLNB and no CALND. We recommend SLNB as the standard procedure for nodal staging in patients with multicentric breast cancer and a clinically negative axilla.