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COVID-19 pandemic following the outbreak in China and Western Europe, where it finally lost the momentum, is now devastating North and South America. It has not been identified the reason and the molecular mechanisms of the two different patterns of the pulmonary host responses to the virus from a minimal disease in young subjects to a severe distress syndrome (ARDS) in older subjects, particularly those with previous chronic diseases (including diabetes) and cancer. The Management of the Istituto Nazionale Tumori - IRCCS “Fondazione Pascale” in Naples (INT-Pascale), along with all Health professionals decided not to interrupt the treatment of those hospitalized and to continue, even if after a careful triage in order not to allow SARS-CoV-2 positive subjects to access, to take care of cancer patients with serious conditions. Although very few (n = 3) patients developed a symptomatic COVID-19 and required the transfer to a COVID-19 area of the Institute, no patients died during the hospitalization and completed their oncology treatment. Besides monitoring of the patients, all employees of the Institute (physicians, nurses, researchers, lawyers, accountants, gatekeepers, guardians, janitors) have been tested for a possible exposure. Personnel identified as positive, has been promptly subjected to home quarantine and subdued to health surveillance. One severe case of respiratory distress has been reported in a positive employees and one death of a family member. Further steps to home monitoring of COVID-19 clinical course have been taken with the development of remote Wi-Fi connected digital devices for the detection of early signs of respiratory distress, including heart rate and oxygen saturation.In conclusion cancer care has been performed and continued safely also during COVID-19 pandemic and further remote home strategies are in progress to ensure the appropriate monitoring of cancer patients.

Being able to predict the behavior of trace elements in the environment is crucial for environmental risk assessment studies. For this reason, modeling, in addition to experimental methods, has become an indispensable tool to better understand the (bio)-geochemistry of trace elements and the processes involved in their availability, transport and ecotoxicity. In this chapter we briefly outline the development of geochemical modeling over time and its basic principles. A comprehensive description of the state-of-the-art ion-binding and surface complexation models presently available for dissolved and particulate organic matter, metal (hydr)oxides of aluminum, iron, manganese and silica and clay minerals is given. A significant part of this chapter is dedicated to the application of these models for studying surface waters and soils. The most common model platforms used for this purpose together with the available (thermodynamic) databases of model parameters are summarized. In two separate sections we highlight the application of an assemblage model (with submodels for the various adsorbents) to describe trace element solid-solution partitioning and speciation in surface waters and soils; here particular attention is given to the derivation of site-specific inputs concerning the geochemical reactive metal content and the contents of adsorbents metal (hydr)oxides, clay and organic matter). Consideration is therefore given to the most recent developments in bio-geochemical modeling to link metal speciation to bioavailability, biotic accumulation and toxicity. Finally, future prospects of geochemical modeling are discussed, giving an overview of the potential directions for development.

Aim: HtrA1, a member of the High Temperature Requirement Factor A family of oxidative stress-response proteases seems to play a role as a tumor suppressor, being down-regulated in a series of human cancers during their progression. Particularly, low HtrA1 mRNA levels have been observed in breast cancer patients with more aggressive clinical features. These have been shown to relate to a longer disease free and overall survival, with more pronounced effects in axillary nodes positive patients. Subjects and Methods: We have analyzed for immunohistochemical HtrA1 expression a series of 66 sentinel node positive breast cancers through Tissue Micro Array technology. Results: HtrA1 was absent to low in 29 cases, medium in 19 cases and high in 18 cases. Our data revealed a positive significant relation between HtrA1 expression level and estrogen (p=0,002) and progestinic receptor expression (p=0.003) and a negative correlation with histological grading (p=0.028), proliferation index (p=0.05), common BC histotypes (p=0.040), luminal A and B subtypes (p=0.001), metastasis development (p

We measured, by immunohistochemistry, HMGA1 protein expression in 212 breast tissue specimens: 6 normal samples, 28 hyperplastic lesions (13 with cellular atypia), 11 fibroadenomas, 10 in situ ductal carcinomas, 144 ductal carcinomas, and 13 lobular carcinomas. HMGA1 was not expressed in normal breast tissue; HMGA1 staining was intense in 40% of hyperplastic lesions with cellular atypia and in 60% of ductal carcinomas and weak in fibroadenomas and in hyperplastic lesions without cellular atypia. Because HMGA1 expression was similar among ductal breast carcinomas with different histologic grading, we evaluated the association between HMGA1 expression and that of other markers of breast carcinoma invasion (estrogen and progesterone receptors, Ki-67 antigen, and ErbB2) in 21 cases of grade 3 breast ductal carcinomas and 7 cases of breast lobular carcinomas. We found that HMGA1 expression tended to be associated only with c-erbB-2 expression (Spearman rho: 0.36; P=0.065). Taken together, these results suggest that HMGA1 expression might be a novel indicator for the diagnosis and prognosis of human breast cancer.

Background: The 70-gene tumor expression profile ‘‘MammaPrint’’ was established as a powerful predictor of disease outcome in breast cancer. The St Gallen 2009 recommendations include gene-expression signatures as an indicator for adjuvant therapy. Here we determined in an Italian cohort how the 70-gene profile could assist in patient management. Methods: Fresh tumor samples (n=584) from breast cancer patients (clinical T1-4N0- 3M0) aged 26 to 98 years (median age 63 years), were collected in 12 Italian hospitals IN 2008 and 2009 by core needle biopsy or from a surgical specimen (study protocol MP 090). We assessed agreement between the treatment advice as recommended by the 2009 St Gallen Highlights and classification according to the 70-gene MammaPrint profile. Results: According to the St Gallen 2009 treatment recommendations, 4 patients could forego any adjuvant treatment (50%) and 198 would be recommended adjuvant chemotherapy being either Grade III, or 34LN, or >5cm, or ER

Background: The 70-gene tumor expression profile ‘‘MammaPrint’’ was established as a powerful predictor of disease outcome in breast cancer. The St Gallen 2009 recommendations include gene-expression signatures as an indicator for adjuvant therapy. Here we determined in an Italian cohort how the 70-gene profile could assist in patient management. Methods: Fresh tumor samples (n=584) from breast cancer patients (clinical T1-4N0- 3M0) aged 26 to 98 years (median age 63 years), were collected in 12 Italian hospitals IN 2008 and 2009 by core needle biopsy or from a surgical specimen (study protocol MP 090). We assessed agreement between the treatment advice as recommended by the 2009 St Gallen Highlights and classification according to the 70-gene MammaPrint profile. Results: According to the St Gallen 2009 treatment recommendations, 4 patients could forego any adjuvant treatment (50%) and 198 would be recommended adjuvant chemotherapy being either Grade III, or 34LN, or >5cm, or ER

Sewage treatment and sewage sludge (also called biosolids) represent a serious environmental issue that has affected modern society for the past century. In response to this, an increasing number of controls and resulting regulations have been introduced to avoid polluting our rivers and seas with pathogens, oxygen-demanding organic debris, potentially toxic elements (PTEs) and eutrophying nutrients. Over the past few decades, improved technology and more stringent regulations, driven in Europe by the increasingly precautionary European Community (EC) legislation, have worked together to achieve a net decrease of the amount of some of the pollutants, both through treatment of the wastewater and by cutting or forbidding the intake of contaminants at source. The growing importance of cleaning up wastewater before returning it to natural waters has led to (1) a vast increase of the quantity and the quality of the sludge resulting from the treatment of wastewater, with a greater amount of pollutants removed during the treatment process; (2) a greater effort towards the reuse and recycling of the sludge as opposed to disposal (e.g. landfilling, incineration). One of the consequences of this situation is a rising interest in using soils (agricultural or not) to address the latter through various applications. In fact, as the sludge has to be disposed off safely, soils can be used as a system of assimilating, recycling or disposing off the sewage sludge. Science and legislation are trying to provide the safest possible route to accomplish these targets, but the subject is not free from controversy, often causing hot debates between the interested parties. This chapter aims to review the improved standards achieved with sewage sludge, touching in particular the British experience in the field of regulating the disposal and reuse of these materials.

Background: There are many instruments available in literature to evaluate the influence of acne on Qualify of Life (QoL), but many of these questionnaires rarely are performed in daily clinical practice. Many of these instruments require a long time for the compilation, and often they are not self completed. There are no simple and intuitive instrument that can be completed by patients alone, with a graphical representation of the results. Objective: To develop a new, rapid and intuitive graphic instrument to a questionnaire allowing both a quick assessment of the impact of acne on patients and, at the same time, increase patient's compliance and self-esteem. Methods: In our study 50 patients were recruited and questionnaire was administered following the main items evaluated in the validated index of QoL from previous studies for acne patients. We have applied an intuitive graph representation, the "Radar Graph", and other statistical methods like the Decisional Map and the Principal Component Analysis, to this questionnaire allowing a quick assessment of the impact of acne on patients. Results: The questionnaire evaluated have 10 items regarding 3 different area: the objective symptoms such as negative perception of their image (imperfection), sting and insomnia; the subjective symptoms such as depression, perception of illness, lack of serenity and shame; and the relational difficulties such as social relationships, working relationships, and intimate relations. The answers are given on a 10-point visual analogue scale. Conclusion: Our survey can be a new, rapid and intuitive graphic instrument to use in clinical practice.