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Polycyclic aromatic hydrocarbons are of great concern due to their persistence, bioaccumulation and toxic properties. The occurrence, source and ecological risk assessment of 26 polycyclic aromatic hydrocarbons in industrial and agricultural effluents affecting the Wadi El Bey watershed were investigated by means of gas chromatographic/mass spectrometric analysis (GC/MS). Total PAHs (∑ 26 PAH) ranged from 1.21 to 91.7 µg/L. The 4- and 5-ring compounds were the principal PAHs detected in most of 5 sites examined. Diagnostic concentration ratios and molecular indices were performed to identify the PAH sources. Results show that PAHs could originate from petrogenic, pyrolytic and mixed sources. According to the ecotoxicological assessment, the potential risk associated with PAHs affecting agricultural and industrial effluents ranged from moderate to high for both aquatic ecosystem and human health. The toxic equivalency factor (TEF) approach indicated that benzo[a]pyrene and benz[a]anthracene were the principal responsible for carcinogenic power of samples.

Background and Aims: Most of the evidence supporting endoscopic submucosal dissection (ESD) comes from Asia. European data are primarily reported by specialized referral centers and thus may not be representative of common European ESD practice. The aim of this study is to understand the current state of ESD practice across Italian endoscopy centers. Methods: All Italian endoscopists who were known to perform ESD were invited to complete a structured questionnaire including: operator features and competencies, ESD training details and clinical outcomes over a 2-year period. Results: Twenty-nine operators from 23 centers (69% response rate) completed the questionnaire: 18 (62%) were 150 in 8 (27.5%). Colorectal ESD was predominant for operators with an experience >80 cases. En-bloc resection rates ranged from 77.2 to 97.2% depending on the anatomic location with an R0 resection rate range of 75.3–93.6%. ESD perforation rates in the colon and rectum were significantly lower when experience was >150 compared to 80–150 cases (p < 0.0001 and p = 0.006 for colon and rectum, respectively). Conclusion: ESD in Italy is performed by a significant number of operators. Overall, Italian endoscopists performing ESD have achieved a good competence level. However, there is much variability in training protocols, initial supervision of procedures, practice settings, case mix and procedural volume/year that are likely responsible for some of the suboptimal resectional outcomes and increased perforation risk, mainly in the colon. Standardized training programs, practice parameters and auditing of outcomes are required.

Introduction: Metastatic spread in invasive lobular carcinoma (ILC) of breast mainly occurs in bones, gynecological organs, peritoneum, retroperitoneum, and gastrointestinal (GI) tract. Metastases to the GI tract may arise many years after initial diagnosis and can affect the tract from the tongue to the anus, stomach being the most commonly involved site. Clinical presentations are predominantly nonspecific, and rarely asymptomatic. CEA, CA 15–3, and CA 19–9 may be informative for symptomatic patients who have had a previous history of breast cancer. Case presentation: We introduce the case of asymptomatic colonic metastasis from breast carcinoma in a 67-year-old woman followed-up for Luminal A ILC. Diagnosis was performed through positron emission tomography/computed tomography (PET/CT) scan and contrast-enhancement spectral mammography (CESM), steering endoscopist to spot the involved intestinal tract and in ruling out further dissemination in the breast parenchyma. Conclusion: In colonic metastases, tumor markers might not be totally reliable. In asymptomatic cases, clinical conditions might be underappreciated, missing local or distant recurrence. CT and PET/CT scan might be useful in diagnosing small volume diseases, and steering endoscopist toward GI metastasis originating from the breast. CESM represents a tolerable and feasible tool that rules out multicentricity and multifocality of breast localization. Moreover, particular patients could tolerate it better than magnetic resonance imaging (MRI).

Psychotropic substances (PSs) are known to affect air and waters, while scarce attention has been paid to their occurrence in settled dusts although they can reach important concentrations there; moreover, no procedures have been developed for this specific purpose. In this study, a list of PSs (i.e., nicotine, cotinine, caffeine, cocaine, cannabinol, Δ9-tetrahydrocannabinol, cannabidiol, amphetamine, heroin, and methadone) were characterized in dusts from Rome and Fiumicino international airport, Italy, and from Ouargla city, Algeria. The analytical procedure, based on ultra-sonic bath extraction, silica column chromatography, and GC-MSD analysis, provided good recovery, uncertainty, sensitivity, and lack of interferences for all substances except amphetamine. In NIST SRM-2585 house dust, nicotine, cotinine, caffeine, cocaine, and cannabinol accounted for ~5.95, 0.87, 4.17, 7.0, and 2.2 μg/g, respectively; on the other hand, methadone, tetrahydrocannabinol, cannabidiol, and heroin (all

The possibility of equipping diaphragm walls as ground heat exchangers to meet the full or partial heating and cooling demands of overlying or adjacent buildings has been explored in recent years. In this paper, the factors affecting the energy performance of diaphragm walls equipped as heat exchangers are investigated through finite-element modelling. The numerical approach employed is first validated using available experimental data and then applied to perform parametric analyses. Parameters considered in the analysis include panel width, the ratio between the wall and excavation depths, heat transfer pipe spacing, concrete cover, heat carrier fluid velocity, concrete thermal properties and the temperature difference between the air within the excavation and the soil behind the wall. The results indicate that increasing the number of pipes by reducing their spacing is the primary route to increasing energy efficiency in the short term. However, the thermal properties of the wall concrete and the temperature excess within the excavation space are also important, with the latter becoming the most significant in the medium to long term. This confirms the benefits of exploiting the retaining walls installed for railway tunnels and metro stations where additional sources of heat are available.

Background and Aims Linked-color imaging (LCI), a new image-enhancing technology emphasizing contrast in mucosal color, has been demonstrated to substantially reduce polyp miss rate as compared with standard white-light imaging (WLI) in tandem colonoscopy studies. Whether LCI increases adenoma detection rate (ADR) remains unclear. Methods Consecutive subjects undergoing screening colonoscopy after fecal immunochemical test (FIT) positivity were 1:1 randomized to undergo colonoscopy with LCI or WLI, both in high-definition systems. Insertion and withdrawal phases of each colonoscopy were carried out using the same assigned light. Experienced endoscopists from 7 Italian centers participated in the study. Randomization was stratified by gender, age, and screening round. The primary outcome measure was represented by ADR. Results Of 704 eligible subjects, 649 were included (48.9% men, mean age ± standard deviation, 60.8 ± 7.3 years) and randomized to LCI (n = 326) or WLI (n = 323) colonoscopy. The ADR was higher in the LCI group (51.8%) than in the WLI group (43.7%) (relative risk, 1.19; 95% confidence interval, 1.01-1.40). The proportions of patients with advanced adenomas and sessile serrated lesions were, respectively, 21.2% and 8.6% in the LCI arm and 18.9% and 5.9% in the WLI arm (not significant for both comparisons). At multivariate analysis, LCI was independently associated with ADR, along with male gender, increasing age, and adequate (Boston Bowel Preparation Scale score ≥6) bowel preparation. At per-polyp analysis, the mean ± standard deviation number of adenomas per colonoscopy was comparable in the LCI and WLI arms, whereas the corresponding figures for proximal adenomas was significantly higher in the LCI group (.72 ± 1.2 vs .55 ± 1.07, P = .05) Conclusions In FIT-positive patients undergoing screening colonoscopy, the routine use of LCI significantly increased the ADR. (Clinical trial registration number: NCT03690297 .)

II S.A.L. Rapporto Tecnico prot. 506 del 19 febbraio 2020, Rapporto predisposto nell'ambito dell'Accordo tra il Ministero dell'Ambiente e della Tutela del Territorio e del Mare - Direzione Generale per i Rifiuti e l'Inquinamento ed il CNR-IIA, sottoscritto il 15 dicembre 2015 e successivamente modificato ed integrato con atti del 16 dicembre 2016 e del 15 dicembre 2017 SUCCESSIVAMENTE RIMODULATO, UNIFICATO ED INTEGRATO CON L'ACCORDO DEL 21 DICEMBRE 2018

Lo stato dell'arte della ricerca sull'inquinamento degli ambienti ospedalieri, nella prospettiva dell'applicazione e dell'aggiornamento della normativa

Submarine buried pipelines interact with shallow soil layers that are often loose and prone to fluidization/liquefaction. Such occurrence is a possible consequence of pore pressure build-up induced by hydrodynamic loading, earthquakes, and/or structural vibrations. When liquefaction is triggered in sand, the soil tends to behave as a viscous solid–fluid mixture of negligible shear strength, possibly unable to constrain pipeline movements. Therefore, pipelines may experience excessive displacement, for instance, in the form of vertical flotation or sinking. To date, there are no well-established methods to predict pipe displacement in the event of liquefaction. To fill such a gap, this work proposes a computational fluid dynamics (CFD) framework enriched with soil mechanics principles. It is shown that the interaction between pipe and liquefied sand can be successfully analyzed via one-phase Bingham fluid modeling of the soil. Postliquefaction enhancement of rheological properties, viscosity, and yield stress can also be accounted for by linking soil–pipe CFD simulations to a separate analysis of the pore pressure dissipation. The proposed approach is thoroughly validated against the results of small-scale pipe flotation and pipe dragging tests from the literature.