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Edible portions of 12 marine organisms from several areas of the Adriatic Sea, Italy, were collected during Spring 1997 and analysed for 32 organochlorine pesticides residues and 27 polychlorobiphenyl congeners. Only eight organochlorine pesticides - hexachlorobenzene (HCB), hexachlorocyclohexane (HCH) isomers, diphenyl-dichloro-trichloroethane (DDT) group, dieldrin - were determined at levels in the range <0.01-19.88 ng g[sup -1] wet weight, with 1,1'-dichloro-2,2'-bis(4-chlorophenyl)ethylene (DDE) being the more relevant single organochlorine. The contamination by organochlorine pesticides was comparable in organisms from the North, Centre and South Adriatic. Polychlorinated biphenyls (PCBs) were determined at levels in the range <0.05-14.46 ng g[sup -1], with CB 101, 118, 138, 153, 180 and 187 being more relevant (penta-, hexa- and hepta-chlorinated congeners). The sum of PCBs congeners determined were in the range 1.18-69.05 ng g[sup -1]. The contamination by PCBs is more relevant in organisms from the North Adriatic Sea owing to the antropic discharge from major rivers such as Po and Adige that flow through highly industrialized and densely populated areas. [ABSTRACT FROM AUTHOR]

The reproduction number of an infectious disease, such as CoViD-19, can be described through a modified version of the susceptible-infected-recovered (SIR) model with time-dependent contact rate, where mobility data are used as proxy of average movement trends and interpersonal distances. We introduce a theoretical framework to explain and predict changes in the reproduction number of SARS-CoV-2 in terms of aggregated individual mobility and interpersonal proximity (alongside other epidemiological and environmental variables) during and after the lockdown period. We use an infection-age structured model described by a renewal equation. The model predicts the evolution of the reproduction number up to a week ahead of well-established estimates used in the literature. We show how lockdown policies, via reduction of proximity and mobility, reduce the impact of CoViD-19 and mitigate the risk of disease resurgence. We validate our theoretical framework using data from Google, Voxel51, Unacast, The CoViD-19 Mobility Data Network, and Analisi Distribuzione Aiuti., (© 2021. The Author(s).)

Background: The number of patients undergoing joint arthroplasty is increasing worldwide. An Enhanced Recovery After Surgery (ERAS) pathway for hip and knee arthroplasty was introduced in an Italian high-volume research hospital in March 2018., Methods: The aim of this mixed methods observational study is to perform a health technology assessment (HTA) of the ERAS pathway, considering 938 procedures performed after its implementation, by means of a hospital-based approach derived from the EUnetHTA (European Network for Health Technology Assessment) Core Model. The assessment process is based on dimensions of general relevance, safety, efficacy, effectiveness, economic and financial impact, equity, legal aspects, social and ethical impact, and organizational impact. A narrative review of the literature helped to identify general relevance, safety and efficacy factors, and a set of relevant sub-dimensions submitted to the evaluation of the professionals who use the technology through a 7-item Likert Scale. The economic and financial impact of the ERAS pathway on the hospital budget was supported by quantitative data collected from internal or national registries, employing economic modelling strategies to identify the amount of resources required to implement it., Results: The relevance of technology under assessment is recognized worldwide. A number of studies show accelerated pathways to dominate conventional approaches on pain reduction, functional recovery, prevention of complications, improvements in tolerability and quality of life, including fragile or vulnerable patients. Qualitative surveys on clinical and functional outcomes confirm most of these benefits. The ERAS pathway is associated with a reduced length of stay in comparison with the Italian hospitalization average for the same procedures, despite the poor spread of the pathway within the country may generate postcode inequalities. The economic analyses show how the resources invested in training activities are largely depreciated by benefits once the technology is permanently introduced, which may generate hospital cost savings of up to 2054,123.44 € per year., Conclusions: Galeazzi Hospital's ERAS pathway for hip and knee arthroplasty results preferable to traditional approaches following most of the HTA dimensions, and offers room for further improvement. The more comparable practices are shared, the before this potential improvement can be identified and addressed.

Potentially toxic elements are widespread soil contaminants, whose occurrence could entail a concern for human health upon ingestion of fruit and vegetables harvested in a polluted area. This work set out to evaluate the concentrations of lead and cadmium as well as the levels of thirteen heavy metals for which a limit value is yet to be established by the food safety authorities, in order to perform a risk characterization related to the dietary intake of these metals and to provide a scientific opinion with wider relevance in the light of current worldwide regulatory issues. The sampling consisted of fruit and vegetables grown in a potentially contaminated area of southern Italy due to the illegal dump of hazardous wastes. An evaluation of the dietary exposure through the calculation of the Hazard Index (HI), the Maximum Cumulative Ratio (MCR) and the Target Cancer Risk (TCR) was adopted to this end. The results revealed that about the 30% of samples showed quantifiable levels of chemicals and no significant difference emerged between the potentially polluted area and the nearby cities that were selected as a control landfill site. The overall risk characterization for non-carcinogenic endpoints showed that the HI did not reach unsafe values, except for a small number of samples mainly because of aberrant occurrences and, in any case, the cumulative toxicity was mainly driven by thallium and vanadium. As far as the carcinogenic effects of arsenic are concerned, the distribution of TCR values broadly lay below the safety threshold; a certain percentage of data, however, exceeded this limit and should be taken into account for the enforcement of future regulatory thresholds., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

As certified by the World Health Organization (WHO), exposure assessment represents a key stage in epidemiological studies that aim to evaluate health risks linked to contaminated sites. The assessment procedure is contingent on the availability of data relating to environmental and food compartments and on any other available scientific evidence, such as data on toxicity and human biomonitoring. This chapter outlines the procedure that should be adopted in order to conduct an accurate exposure assessment and presents three case studies involving different types of contaminated sites where this approach was applied.