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This cross-sectional study aimed to establish the association between serum ferritin levels and organ iron overload (IO) and overall morbidity in transfusion-dependent thalassemia (TDT) patients. One hundred and three TDT patients (40.03 ± 9.15 years; 57.3% females) with serum ferritin < 2500 ng/mL were included. IO was assessed by T2* magnetic resonance imaging. Three groups were identified based on mean serum ferritin levels

This work intends to lay the foundations for a theoretical framework of citizen science combining social and organizational implications with the support of information technologies. The proposed theoretical framework moves towards a shared and common research process between experts and citizens to deal with environmental and social challenges. The role and capacity of online communities is explored and their engagement capacity by means of web-based digital platforms supporting crowdsourcing activities. In this contribution, authors highlight the most common practices, methods and issues of citizen science approaches adopted from multidisciplinary application fields to obtain insights for designing a new participative approach for organizational studies. To reach this goal, authors illustrate the results of a systematic meta-review analysis, consisting of an accurate selection and revision of journal review articles in order to highlight concepts, methods, research design approaches and tools adopted in citizen science approaches.

We evaluated gender differences in knowledge and perception of cardiovascular disease (CVD) among Italian thalassemia major (TM) patients. An anonymous questionnaire was completed by 139 β-TM patients (87 (62.7%) females, 40.90 ± 8.03 years). Compared to females, males showed a significantly higher frequency of CVDs, and they less frequently selected tumors in general as the greatest health problem for people of the same age and gender (48.1% vs. 66.7%; p = 0.031) and as the greatest danger to their future health (26.9% vs. 43.7%; p = 0.048). CVDs were designated as the greatest danger to their future health by a significantly higher percentage of males than females (53.8% vs. 36.8%; p = 0.048). Both males and females showed a good knowledge of cardiovascular risk factors and preventive measures for CVDs. No gender differences were detected in the subjective well-being and the perceived cardiovascular risk. The perceived risk was not influenced by age, presence of cardiovascular risk factors, or disease, but no patient with a low perceived CVD risk had myocardial iron overload. Our findings highlight the need to implement future educational programs aimed at increasing the awareness of CVD as the greatest health issue, especially among the female TM population, and at informing TM patients of the different actors, besides iron, that play a role in the development of cardiovascular complications.

High-solid anaerobic digestion (HSAD) of sewage sludge is a promising alternative to conventional anaerobic digestion (AD) as it reduces treatment volumes, transportation costs and energy consumption for heating and increases the fertilizing potential of sewage sludge. By centralizing sludge treatment, HSAD represents an opportunity to improve the energy balance of sewage sludge valorization compared to conventional AD. Nevertheless, HSAD of sewage sludge poses several challenges due to structural and rheological characteristics of dewatered sludge and to toxic compounds originating during (H2S, NH3, siloxanes, volatile organic compounds) and before (polyelectrolytes added prior to dewatering) the anaerobic treatment. This work critically reviews HSAD of sewage sludge with the objective to promote process enhancement for energy self-sufficiency and good practices for agricultural utilization of digestate. Advantages and drawbacks of HSAD are discussed in depth and practical solutions to solve critical issues at full scale are proposed. Guidelines for conducting cost-benefit analysis of the process are also provided.

Introduction: Renal dysfunction is a frequent complication in patients suffering from β-thalassemia major (β-TM). The aim of this study was to analyze the renal function and urine metabolomic profile of β-TM patients undergoing transfusions and deferasirox (DFX) therapy, in order to better characterize and shed light on the pathogenesis of renal disease in this setting. Methods and Subjects: 40 patients affected by β-TM treated with DFX and 35 age- and gender-matched healthy controls were enrolled in the study. Renal function was assessed. Glomerular filtration rate (GFR) was estimated with CKD-EPI and Schwartz formula for adults and children, respectively. Renal tubular function and maximal urine concentration ability were tested. Urine specimens were analyzed by nuclear magnetic resonance spectroscopy to identify the urinary metabolite profiles. Results: The study of renal function in β-TM patients revealed normal estimated (e)GFR mean values and the albumin-to-creatinine ratio was Discussion: The major finding of this work is that β-TM patients and controls exhibit different concentrations of some metabolites in the urine. Early recognition of urinary abnormalities may be useful to detect and prevent kidney damage.

We differentiated the left ventricle non-compaction (LVNC) from hypertrabeculated myocardium due to a negative remodeling in thalassemia intermedia (TI) patients applying linear and planimetric criteria and comparing the cardiovascular magnetic resonance (CMR) findings. CMR images were analyzed in 181 TI patients enrolled in the Myocardial Iron Overload in Thalassemia Network and 27 patients with proved LVNC diagnosis. The CMR diagnostic criteria applied in TI patients were: a modified linear CMR Petersen’s criterion based on a more restrictive ratio of diastolic NC/C > 2.5 at segmental level and the combination of planimetric Grothoff’s criteria (percentage of trabeculated LV myocardial mass LV–MM ≥ 25% of global LV mass and total LV–MMI NC ≥ 15 g/m2). Seventeen TI patients showed at least one positive NC/C segment. Compared to LVNC patients, these patients showed a lower frequency of segments with non-compaction areas (2.41 ± 1.33 vs 5.48 ± 2.26; P < 0.0001), significantly lower LV–MM NC percentage (10.99 ± 4.09 vs 28.20 ± 4.27%; P < 0.0001), LV–MMI (7.58 ± 4.86 vs 19.88 ± 5.02 g/m2; P < 0.0001) and extension of macroscopic fibrosis (0.44 ± 0.18 vs 4.65 ± 2.89; P = 0.004), and significantly higher LV ejection fraction (61.29 ± 5.17 vs 48.50 ± 17.55%; P = 0.016) and cardiac index (4.80 ± 1.49 vs 3.46 ± 1.11 l/min/m2; P = 0.002). No TI patient fulfilled the Grothoff’s criteria. All TI patients with an NC/C ratio > 2.5 showed morphological and functional CMR parameters significantly different from the patients with a proved diagnosis of LVNC. Differentiation of LVNC from hypertrabeculated LV in β-TI patients due to a negative heart remodeling depends on the selected CMR criterion. We suggest using planimetric Grothoff’s criteria to improve the specificity of LVNC diagnosis.

The present study reports data on a 20 months campaign monitoring enteric viruses (hepatitis A, norovirus, rotavirus, astrovirus, sapovirus, and aichivirus) and bacteria (Salmonella spp.) in seawater. The aim of this work was to assess the potential correlation among the presence of viruses/bacteria and different environmental factors like seasonality, water discharge sources (treated and untreated wastewater, mixed waters and raw water) as well as influence of the Italian lockdown measure against COVID-19 pandemic. Results showed different prevalence of the investigated viruses with values equal to 16 % for norovirus GI, 15.1 % for norovirus GII, followed by 13.8 % for astrovirus, and 13.3 % for sapovirus. Rotavirus was detected in the 8.4 % of samples and aichivirus was detected with the lowest prevalence of 3.5 %. Hepatitis A virus was never identified in the monitoring campaign. Salmonella spp. was detected with a prevalence of 36.6 %. Statistical analysis displayed a high correlation for the two noroviruses simultaneous detection (NGI and NGII) while a lower correlation was found for co-presence of noroviruses with astrovirus, sapovirus or Salmonella spp. A significant decrease of enteric pathogens in seawater was observed during the restrictions period. Results on seasonality highlighted a higher viral prevalence correlated to the wet season for all the pathogens but rotavirus and aichivirus, which instead showed an opposite trend and a higher incidence in the dry season. With respect to discharge typology, some viruses displayed a higher prevalence in treated waters (astrovirus, rotavirus, sapovirus and aichivirus) while the other investigated pathogens (noroviruses and Salmonella spp.) showed a higher prevalence in mixed waters. The main observations of this work were used to define a potential monitoring strategy that could be useful for sanitary Authorities to implement surveillance plans aimed at preventing possible sanitary outbreaks and/or environmental quality deterioration.

BACKGROUND Cardiac MRI plays a critical role in the management of thalassemic patients. No accurate biventricular reference values are available. PURPOSE To establish the ranges for normal left ventricular (LV) and right ventricular (RV) volumes and ejection fraction (EF) and LV mass normalized to body surface area (BSA), age, and gender in a large cohort of well-treated beta-thalassemia major (β-TM) patients without heart damage using a multiparametric MRI. STUDY TYPE Retrospective/cohort study. POPULATION In all, 251 β-TM patients with no known risk factors or cardiac disease, normal electrocardiogram, no macroscopic myocardial fibrosis, and all cardiac segments with T2 * ≥20 msec, and 246 healthy subjects. FIELD STRENGTH/SEQUENCE 1.5T/cine steady-state free precession (SSFP), gradient-echo T2 *, late gadolinium enhancement (LGE) images. ASSESSMENT Biventricular end-diastolic volume, end-systolic volume, stroke volume, and LV mass were normalized to BSA (EDVI, ESVI, SVI). STATISTICAL TESTS Comparisons between the two groups was performed with two-samples t-test or Wilcoxon's signed rank test. For more than two groups, one-way analysis of variance (ANOVA) or a Kruskal-Wallis test were applied. RESULTS Compared to controls, males with β-TM showed significantlt higher LVEDVI in all the age groups, while for the other volumes the difference was significant only within one or more age groups. In females the volumes were comparable between β-TM patients and healthy subjects in all the age groups. In the male β-TM population we found a significant effect of age on LVEDVI (P = 0.017), LVESVI (P = 0.001), RVESVI (P = 0.029), and RVEF (P = 0.031), while for females none of the biventricular parameters were significantly different among the age groups (LVEDVI: P = 0.614; LVESVI: P = 0.449; LVSVI: P = 0.186; LV mass index: P = 0.071; LVEF: P = 0.059; RVEDVI: P = 0.374; RVESVI: P = 0.180; RVSVI: P = 0.206; RVEF: P = 0.057). In β-TM patients all biventricular volume indexes as well as the LV mass index were significantly larger in males than in females (P

The photo-catalytic degradation of a textile azo-dye as Methyl Orange was studied in an innovative unit constituted by a channel over which a layer of titanium dioxide (TiO2) catalyst in anatase form was deposited and activated by UVB irradiation. The degradation kinetics were followed after variation of the chemical, physical, and hydraulic/hydrodynamic parameters of the system. For this purpose, the influence of the TiO2 dosage (g/cm3), dye concentration (mg/L), pH of the solution, flow-rate (L/s), hydraulic load (cm), and irradiation power (W) were evaluated on the degradation rates. It was observed that the maximum dosage of TiO2 was 0.79 g/cm3 while for higher dosage a reduction of homogeneity of the cement conglomerate occurred. The Langmuir&ndash, Hinshelwood (LH) kinetic model was followed up to a dye concentration around 1 mg/L. It was observed that with the increase of the flow rate, an increase of the degradation kinetics was obtained, while the further increase of the flow-rate associated with the modification of the hydraulic load determined a decrease of the kinetic rates. The results also evidenced an increase of the kinetic rates with the increase of the UVB intensity. A final comparison with other dyes such as Methyl Red and Methylene Blue was carried out in consideration of the pH of the solution, which sensibly affected the removal efficiencies.

COVID-19 (coronavirus disease) is a global pandemic that started in China in 2019 and has negatively affected all economic sectors of the world, including agriculture. However, according to estimates in different countries, agriculture has suffered less than other sectors such as construction, industry and tourism, so agricultural development can be a good option to compensate for the economic damage caused to other sectors. The quality of available water and soil resources for agricultural development is not only limited, but is also decreasing incrementally, so the use of saline and unconventional soil and water resources is inevitable. Biosaline agriculture or haloculture is a system in which highly saline water and soil resources are used sustainably for the economic production of agricultural crops. It seems that in the current situation of the world (with COVID-19's impact on agriculture on the one hand and the quantitative and qualitative decline of freshwater and soil on the other), haloculture with a re-reading of territorial capabilities has good potential to provide a part of human food supply. In this review article, the potential of haloculture to offset the adverse impacts of the pandemic is analyzed from five perspectives: increasing the area under cultivation, using unconventional water, stabilizing dust centers, increasing the body's immune resistance, and reducing losses in agribusiness due to the coronavirus. Overall, haloculture is an essential system, which COVID-19 has accelerated in the agricultural sector., Graphical abstract Image 1

The aim of this study was to evaluate if eco-friendly lubricants had an additional advantage over conventional synthetic lubricants in terms of emulsion treatment of metalworking wastewater. To these purpose, two fresh commercial synthetic cutting oil emulsions were compared with an emulsion obtained from a new cutting oil produced from the reuse of slaughtering waste (CADT-605 from Kimya Srl, Bari, Italy). The breaking of the fresh emulsions was carried out with the addition of small amounts of sulfuric acid (2&ndash, 20 mL/L) followed by pH neutralization by means of calcium hydroxide. During the two-step treatments, COD, BOD5 and non-ionic surfactant (NIS) concentrations were monitored in the aqueous phase. The results demonstrated that the best results were obtained with the emulsion produced with the bio-based lubricant. In addition, this cutting oil was tested in a metalworking plant within 30 days and the resulting spent emulsion was treated with the proposed process. In all the cases, the treatment led to a drastic decrease of the COD, BOD5 and NIS contents that allow the discharge of resulting aqueous phase in sewers or in surface water bodies, together with the other wastewater produced by the plant, in agreement with the Italian regulation.

Background A history of previous cardiac disease increases the maternal mortality risk by as much as 100%. There is no consensus on the absolute contraindications to vaginal delivery in valvular heart disease, but central regional anesthesia is traditionally considered contraindicated in patients with severe aortic stenosis. Case presentation A 29-year-old primigravid woman with severe aortic stenosis was admitted to the obstetrics department for programmed labor induction. With epidural anesthesia and mini-invasive hemodynamic monitoring labor and operative vaginal delivery were well tolerated, and hemodynamic stability was always maintained. Conclusions Epidural analgesia and oxytocin induction are possible for the labor management of parturients with severe aortic stenosis given that continuous non-invasive followed by invasive hemodynamic monitoring can be provided and given the absence of any obstetric or cardiologic contraindications and the strong will of the patient.

Water and environmental monitoring, observation and decision support systems (DSS) are being transformed by a wealth of open and big data that are increasingly available, accurate and timely. Consolidated technologies of earth observation, remote sensing, geospatial modelling and visualization systems are stimulating earth, hydrological and environmental sciences that are reacting not only with increasing scientific production, but with novel solutions-oriented methods, tools and algorithms. Procedures, methods and tools are more and more available for analysis, interpretation and mapping of river and basin coastal landscape features and hydro-environmental dynamics. Citizen science are further empowering the capabilities of DSS by gathering and sharing data on the human behaviour component to better understand the nature-human-urban interplay. Citizens, empowered by mobile devices, act as data and information producers, receivers and transmitters supporting the assessment of the effects of human-derived observations, feedbacks and actions sensing. Emerging hardware and software technologies (e.g. machine learning, artificial intelligence, IoT, etc.) are creating amazing opportunities for these DSS linked to the development of the human-machine interface and its use for promoting practical environmental and social actions to manage and mitigate natural hazard and climatic risks. The National System for Environmental Protection (SNPA) by the Italian Institute for Environmental Protection and Research (ISPRA) is supporting and implementing a wide and diverse range of research, applied research, learning and communication activities, both at the national and international level, in collaborating with leading academic, professional and international organizations, for integrating citizen science, open data and big data into next generation water and environmental decision support systems. This contribution, while depicting the overall SINA framework (Italian Environmental Information System) and ongoing and planned activities by ISPRA SNPA and SINA, presents recent outcomes of research initiatives developed within the Water JPI, UNEP INFORAC, National Plan for Climate Adaptation (PNACC), Marine pollution, Biodiversity, the Water, Food and Energy Nexus among others. Insights from joint research efforts and working groups are presented and shared while pursuing further synergies and stimulate the discussion on this crucial topic for national and international agencies, like ISPRA, that seek to transfer research data, models and tools into institutional and operational activities.

Introduzione Il trauma cranico (TBI – Traumatic Brain Injury) è una delle principali cause di morte e disabilità al mondo. Il danno cerebrale primario è rappresentato dal trauma, mentre il danno cerebrale secondario è l’evoluzione, limitabile, del danno primario. Esso necessita di una gestione precoce, che inizi immediatamente dopo il trauma e che preveda il raggiungimento di precisi target terapeutici correlati ad un miglior outcome. Attualmente le indicazioni per la gestione del TBI provengono dalle Linee Guida del 2008 (LG 2008), ma in questi anni la letteratura scientifica si è arricchita di molti studi che costituiscono un importante fonte di aggiornamento e miglioramento della gestione preospedaliera dei pazienti con trauma cranico. Scopo dello studio: valutare l’aderenza alle raccomandazioni delle LG 2008 e della più recente letteratura sulla gestone del TBI moderato e severo. Metodo: studio retrospettivo monocentrico. Criteri di inclusione: età > 18 anni, GCS 90% per O2 terapia, 95% per SpO2 e sAP>90mmHg, 85.5% per sAP>110mmHg

Aim: to evaluate the relationship between uric acid (UA), hepatic and cardiac iron overload (T2*-MRI), ferritin, endocrinological diseases and cardiac complications in a large thalassemia major (TM) cohort. Methods: A total of 369 TM patients (187 men; 33 ± 6 years) were retrospectively studied, from the myocardial iron overload in thalassemia (MIOT) electronic databank. Results: Multiple regression model identified male sex (p 3 mg/g/dw), heart failure, endocrinopathies, ferritin (>2000 ng/l), alanine transaminase (>40 UI/l) and/or aspartate transaminase (>35 UI/l) and/or glutamyl transferase (>64 UI/l). Discussion: UA appears directly associated to T2* and inversely with derivatives of reactive oxygen species, and as such reduced according to increased oxidative stress and cardiac iron overload in TM patients.