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There are 3 types of cartilage found in the human body: hyaline cartilage, elastic cartilage, and fibrocartilage. Fibrocartilage may be found in intervertebral discs, symphysis pubis, tendinous insertions, acetabular labrums, and the temporomandibular joint. Specifically, in the foot and ankle we mainly see fibrocartilage in tendinous insertions and in areas where tendons wrap around boney prominence. Histologically, fibrocartilage is comprised of an extracellular matrix that contains glycosaminoglycans, proteoglycans, and collagens. This composition allows for a hydrophilic environment, which allows tissue to withstand high compressive forces seen in weight bearing.

A 62–year–old man repeatedly subjected to PTCA + stent with severe left ventricular dysfunction and estimated FE 15%. After some hospitalizations for heart failure in 2015 he underwent an AICD implant Biventricular. Followed up in our clinics dedicated to heart failure, the patient did not present the characters of the CRT responder presenting a constant high end–systolic volume (224 ml) and none FE improvement of 15%. There was also an asthenia and tendency to inactivity and elevated NT Pro BNP levels despite optimal medical therapy even with entresto 24/26 mg x 2 / day. It has been decided to submit the patient enrolled in the cardiac transplant and / or VAD implantation lists to an implantation procedure of CCM system (cardiac contractility modulation). After two active fixation placement leads on the interventricular septum and connection to the CCM system housed in the subcutaneous pocket right contralateral to the biventricular AICD, the patient was monitored. We have noticed since the first days conditions of hemodynamic stability. Scheduled CCM therapy delivery for 10 hours a day. Following subsequently in the follow up at 3 – 6 – 12 – 18 months the patient showed an improvement of minneshota quality of life questionnaire in heart failure: MLWHFQ (44 at baseline, 17 at two months, 15 to six months, 10 to 12 months and 3 to 18 months), an increase in FE from 15 to 23 up to 26%, a reduction of the NTPROBNP from 13444 to 1178 then climbed back to 5549 and 3712 at 18 months for atrial fibrillation, without any requires re–hospitalization, an increased physical activity of the patient detected by the sensors of the two devices

A 72–year–old woman with hypertension for thirty years, resuscitated from cardiac arrest during prosthetic surgery of the right knee in January 2020, with external heart massage and orotracheal intubation. On examination Holter performed in February 2021, presence of couples and R / T phenomenon with Lown 1B–3–4A–5 class. The patient is subjected to coronary angiography which showed only mild atheroma without stenosis hemodynamically significant of the arterial districts explored. On the Echocardiogram, FE estimated at 60%. Based on the anamnestic data and the feedback from the fifth class of Lown at the Holter, it was decided to implant a dual chamber defibrillator for secondary prevention. The vulnerable point of refractory ventricular notoriously falls below 300 msec and in the clinical case in question there is a comparison to the holter of fifth class of lown with phenomenon R on T and coupling interval of 276 msec. The precocity of the ventricular ectopias is already in itself a risk factor for MI, reinforced in the case of clincio in question from a history of resuscitated cardiac arrest in a hospital setting. Not indicated to ours opinion of the electrophysiological inducibility study, given the positive clinical history and dynamic ECG according to Holter who examines the arrhythmic phenomenon in its spontaneous and natural way of presenting itself in circadian rhythm. The reproducibility in the laboratory with the SEI, of the electrical vulnerability was in fact in the recent years downsized, due to high specificity but low sensitivity, as there is in the clinical reality of patient neurovegetative and biohumoral fluxuonary factors, which favor the induction of malignant arrhythmias and that escape the predictive laboratory analysis. Making the patient safe with the implant of the bicameral AICD resulted from a clinical – diagnostic – instrumental analysis and after extensive discussion by the heart team in our Operating Unit.

Coronavirus (CoV), is a single-stranded positive-sense RNA virus, which is characterized by a coronal-shaped spinous process on its surface and is the largest known RNA virus. Recently, the new outbreak of CoV was first found in Wuhan, China at the end of 2019, however, the infection is worldwide and causing high pathogenicity and mortality rates, especially in the aged population. Unfortunately, there is no available strategy to control the infection or treat patients. By reviewing the life cycle of CoV infection in host cells, including: virion attachment and entry, genome transcription and replication, and virion assembly and release, we focused on the role of viral proteins in the viral life cycle and summarized how their function could be targeted for the prevention/therapy of CoV. Thus, this information would pave the way to precisely design the antiviral drug component/vaccine against CoVs.

The aim of the study was to investigate whether the COVID-19 pandemic and related measures had an influence on colorectal cancer (CRC) presentation, management, and outcomes; it was a retrospective monocentric study. CRC patients undergoing surgery during the COVID-19 pandemic (1 March 2020–28 February 2022) (group B) were compared with patients operated on in the previous two years (1 March 2018–29 February 2020) in the same unit (group A). The primary outcome was to investigate whether there were differences in concern regarding the stage at presentation, as a whole and after dividing groups based on cancer location (right colon cancer, left colon cancer, rectal cancer). Secondary outcomes included differences in the number of patients admitted from emergency departments and emergency surgeries between periods, and differences in the postoperative outcomes. A subanalysis within the pandemic group was conducted on the same outcomes, dividing the aforementioned group based on pandemic trends. Two hundred and eighty (280) were operated on during the study period: 147 in group A and 133 in group B. Stage at presentation was similar between groups; however, the subgroups analysis showed that in the pandemic group, the number of early-stage left colon cancer occurrences almost halves, yet not significantly. Emergency department referral was more common in group B (p-value: 0.003); in group B, they also had longer operations and there was a more frequent use of ostomy. No differences in the number of postoperative complications nor in the postoperative outcomes were found. Patients with CRC were more frequently referred through the emergency department during the COVID-19 pandemic and left-sided cancers appear to be generally diagnosed at a more advanced stage. Postoperative outcomes showed that high specialized colorectal units can deliver standard high-level treatment under high-pressure external conditions.

Traditional electron microscopy (EM) can be complemented with analytical EM to increase objective sample information enabling feature identification. Energy dispersive X-ray (EDX) imaging provides semi-quantitative elemental composition of the sample with high spatial resolution (~10nm) in ultrathin sections. However, EDX imaging of biological samples is still challenging as a routine method because many elements are at the detection limit for this technique. Moreover, samples undergo extensive preparation before analysis, which can introduce disruptive X-ray cross-talk or artifacts. EDX data can, for instance, be skewed by (i) osmium interference with endogenous phosphorus, (ii) chlorine present in EPON-embedded tissues, (iii) lead interference with endogenous sulfur, and (iv) potential spectral overlaps with grid material, contrast agents, and the in-microscope sample holder. Here, we highlight how to circumvent these potential pitfalls and outline how we approach sample preparation and analysis for detection of different elements of interest. Utilization of well-considered a priori sample preparation techniques will best ensure conclusive EDX experiments.

Autoimmune β-cell destruction leads to type 1 diabetes, but the pathophysiological mechanisms remain unclear. To help address this void, we created an open-access online repository, unprecedented in its size, composed of large-scale electron microscopy images (‘nanotomy’) of human pancreas tissue obtained from the Network for Pancreatic Organ donors with Diabetes (nPOD; www.nanotomy.org). Nanotomy allows analyses of complete donor islets with up to macromolecular resolution. Anomalies we found in type 1 diabetes included (i) an increase of ‘intermediate cells’ containing granules resembling those of exocrine zymogen and endocrine hormone secreting cells; and (ii) elevated presence of innate immune cells. These are our first results of mining the database and support recent findings that suggest that type 1 diabetes includes abnormalities in the exocrine pancreas that may induce endocrine cellular stress as a trigger for autoimmunity., Type 1 diabetes is associated with autoimmune destruction of pancreatic beta-cells. Here the authors compose a large-scale electron microscopy image data base of pancreatic organ donor tissue to enable data mining and further understanding of the disease.

May-Thurner syndrome (MTS) is a rare condition in which patients develop iliofemoral deep venous thrombosis owing to an anatomic variant in which the right common iliac artery overlies and compresses the left common iliac vein against the lumbar spine. Data regarding lower extremity trauma in patients with previously diagnosed MTS are rare. We discuss the operative approach for ankle trauma occurring 3 weeks after endovascular surgery for the treatment of MTS.

In the paper, authors discuss the development and performance evaluation of an e-health Android App, which allows to monitor and classify ECG-related features. The mobile platform is composed of a wearable and non-obtrusive sensor and a smartphone, which collects and process data during the daily life. The main goal of this work has been the development of a real-time, wireless monitoring tool that is not related to an indoor environment. Five physiological quantities are continuously measured: Heart Rate (HR) and 4 ECG time intervals (i.e., QT, ST, PR, QR); together with the complete ECG waveform, these parameters are displayed in real-time, while the user is performing different activities, indoor or outside. A visual feedback (i.e., colour bars, according to the level of the measured quantities) is provided to the user, together with the possibility to save data for further analysis. A pilot study has been conducted to evaluate the accuracy and the uncertainty of the data computed in real-time by the mobile application, to those derived from a reference system (i.e., ECG signal coming from a standard electrocardiograph), in post-processing. Results have shown a good agreement with gold standard instrumentation. The Bland-Altman test has identified a high correlation between the data computed by the App with respect to the ones from the gold standard (i.e., R2 equal or higher than 90%), with a slight underestimation of the time intervals (3.6±1.5 ms for QT, 4.1±1.7 ms for ST, 3.0±1.2 ms for QR and 11.9±1.9 ms for PR interval).

Nanometer-scale identification of multiple targets is crucial to understand how biomolecules regulate life. Markers, or probes, of specific biomolecules help to visualize and to identify. Electron microscopy (EM), the highest resolution imaging modality, provides ultrastructural information where several subcellular structures can be readily identified. For precise tagging of (macro)molecules, electron-dense probes, distinguishable in gray-scale EM, are being used. However, practically these genetically-encoded or immune-targeted probes are limited to three targets. In correlated microscopy, fluorescent signals are overlaid on the EM image, but typically without the nanometer-scale resolution and limited to visualization of few targets. Recently, analytical methods have become more sensitive, which has led to a renewed interest to explore these for imaging of elements and molecules in cells and tissues in EM. Here, we present the current state of nanoscale imaging of cells and tissues using energy dispersive X-ray analysis (EDX), electron energy loss spectroscopy (EELS), cathodoluminescence (CL), and touch upon secondary ion mass spectroscopy at the nanoscale (NanoSIMS). ColorEM is the term encompassing these analytical techniques the results of which are then displayed as false-color at the EM scale. We highlight how ColorEM will become a strong analytical nano-imaging tool in life science microscopy.

Objective: There is a growing body of evidence implicating obesity as having a negative effect on the development and treatment of diabetic foot disease. The aim of this study was to increase the body of knowledge on the effects of obesity on foot function, specifically as it relates to peak plantar pressures in the total contact cast (TCC). Our investigational objectives were to compare the effect of two different TCC designs on mean peak plantar pressures, and to evaluate the efficacy of two TCC constructs with increasing body mass. Method: The primary outcome measure was mean peak plantar pressure in the heel, midfoot, forefoot and first metatarsal as measured with an in-shoe pressure measurement system. The variables were patient weight (from ‘normal’ body mass index (BMI) to ‘overweight’, ‘obese’ and ‘morbidly obese’) and the TCC construct (with both a standard and alternate cast design). The standard TCC is considered the gold standard for off-loading of the diabetic foot. The alternate TCC was designed to use the essential offloading component of the traditional TCC, namely the total contact leg section, with use of an open cell polyurethane foam to transfer load from the foot to the lower leg, thereby offloading the foot by suspending it within a padded fiberglass walking cast. Results: We did not observe statistically significant differences in mean peak plantar pressures in any plantar foot anatomic area or with any body mass between the two TCC designs. Conclusion: Based on the results, we concluded that the alternate TCC design provides another viable TCC construct option for practitioners working with the neuropathic foot. This investigation also provides specific data on changes that occur in peak plantar pressures with use of the total contact cast and variable BMIs. Declaration of interest: none

The suture button technique represents an accepted method of fixation for acute or chronic injury to the tibiofibular syndesmosis. The objective of the present investigation was to assess the anatomic risk to the superficial medial neurovascular structure with insertion of a syndesmotic suture button and to measure the distance of the button to the greater saphenous vein during a standardized insertion. A syndesmotic suture button was inserted with a standardized technique in 20 fresh frozen cadaveric limbs. Of 20 suture buttons, 14 (70.0%) were inserted posterior to the greater saphenous vein, 2 (10.0%) were inserted anterior to the greater saphenous vein, and 4 (20.0%) were inserted directly onto the greater saphenous vein. A total of 11 suture buttons (55.0%) were inserted with some entrapment of a medial neurovascular structure. The absolute mean ± standard deviation distance of the suture button to the greater saphenous vein was 4.88 ± 4.44 mm. The results of the present investigation have indicated that a risk of entrapment of superficial medial neurovascular structures exists with insertion of a suture button for syndesmotic fixation and that a medial incision should be used to ensure that structures are not entrapped.

The clinical value of routine postoperative radiographic evaluation after orthopedic procedures has recently been called into question. The objective of the present investigation was to evaluate the ability of foot and ankle surgeons to accurately and reliably assess postoperative radiographs after first metatarsal-phalangeal joint arthrodesis. Thirty sets of digital radiographs from 11 patients who had undergone first metatarsal-phalangeal joint arthrodesis were retrospectively evaluated by 5 podiatric physicians board-certified in foot surgery. The surgeons were asked to answer several questions, including whether the radiograph appeared to be4 or4 postoperative weeks; whether the radiograph appeared to be8 or8 postoperative weeks; their estimation of the postoperative week; and whether they would allow the patient to begin weightbearing based on the radiographic findings. With respect to whether the radiographs were4 or4 postoperative weeks, surgeons made accurate assessments 63.33% of the time (95 of 150; range 56.67% to 73.33%), with a kappa of 0.220. With respect to whether the radiographs were8 or8 postoperative weeks, surgeons made accurate assessments 60.0% of the time (90 of 150; range 53.33% to 70.0%), with a kappa of 0.203. With respect to the estimation of the postoperative week of the radiograph, surgeons accurately assessed the radiographs within a 4-week period 34.0% of the time (54 of 150; range 26.67% to 46.67%), with a kappa of 0.425. With respect to allowing the patient to bear weight according to the radiographic findings, the surgeons were in complete agreement 26.67% of the time (8 of 30), with a kappa of 0.251. These results provide evidence against the serial routine use of postoperative radiographs for the first metatarsal-phalangeal joint arthrodesis in the absence of a specific clinical indication.

Dorsiflexory wedge osteotomy is indicated for the correction of structural and irreducible first metatarsal deformity to effectively shorten and elevate a plantar flexed first ray. This is most commonly due to fixed forefoot valgus deformity, the cavovarus foot type, and diabetic foot pathologic features involving an ulceration or preulcerative area on the plantar aspect of the first metatarsal head. Surgeons can subjectively judge the amount of correction, such as by restoring the frontal plane alignment of the forefoot, or objectively by returning Meary's angle to a parallel relationship on a weightbearing lateral radiograph. With this tip, we propose an objective measurement, with calculation and use of Meary's angle, to preoperatively quantify the amount of desired correction. In the present study, we applied basic geometric principles based on triangles to calculate the relationship between the width of the excised wedge and the angular degrees of achieved dorsiflexion. We hope these data will provide both objective and reasonable estimates for reconstructive foot and ankle surgeons working with these deformities and with this procedure.

An increasing body of evidence has implicated obesity as having a negative effect on the development, treatment, and outcome of lower extremity pathologic entities, including diabetic foot disease. The objective of the present study was to increase the body of knowledge with respect to the effects of obesity on foot function. Specifically, we attempted to (1) describe the relationship between an increasing body mass index (BMI) on plantar foot pressures during gait, and (2) evaluate the efficacy of commonly prescribed off-loading devices with an increasing BMI. A repeated measures design was used to compare the peak plantar foot pressures under multiple test conditions, with the volunteers acting as their own controls. The primary outcome measure was the mean peak plantar pressure in the heel, midfoot, forefoot, and first metatarsal, and the 2 variables were modification of patient weight (from "normal" BMI to "overweight," "obese," and "morbidly obese") and footwear (from an athletic sneaker to a surgical shoe, controlled ankle motion walker, and total contact cast). Statistically significant increases in the peak plantar pressures were observed with increasing volunteer BMI weight class, regardless of the off-loading device used. The present investigation has provided unique and specific data with respect to the changes that occur in the peak plantar pressures with variable BMIs across different anatomic levels and with commonly used off-loading devices. From our results, we have concluded that although the plantar pressures increase with increasing weight, it appears that at least some reduction in pressure can be achieved with an off-loading device, most effectively with the total contact cast, regardless of the patient's BMI.

Skin popping refers to the act of subcutaneous injection of intravenous drugs, a practice that often results in the development of cellulitis and the formation of soft tissue abscesses. Although the foot and ankle represent common injection sites, few data have described the presentation and natural history of this pathologic entity. The objective of the present study was to retrospectively assess the descriptive demographic data of a patient cohort admitted for lower extremity skin and soft tissue infection caused by intravenous drug abuse. Fifty skin popping lesions in 49 patients were identified during a 733-day data collection period (August 1, 2010 to August 31, 2012) that had been treated by the in-patient podiatric surgical service for lower extremity infection caused by intravenous drug abuse at an urban, level-one trauma center. With respect to patient race, our hospital has a typical in-patient census of 55% black patients and 25% white patients. The present patient cohort consisted of 12% black patients and 65% white patients. The mean length of stay was 5.71 ± 3.56 days, and 42 patients (85.71%) underwent some form of surgical debridement, with 31 (63.27%) having undergone a formal procedure in the operating room. Six patients (12.24%) left the hospital against medical advice or refused intervention at some definitive point of care, and 36 (73.47%) did not return for scheduled outpatient follow-up visits. Three cases (6%) resulted in minor amputation. The microbiologic culture data and common antibiotic prescriptions used in the diagnosis and treatment, respectively, of these patients have been summarized. We hope these original descriptive data can be used by other physicians treating patients at similar urban practices to improve the care of these sometimes difficult-to-treat patients and better serve this population as a whole.

Pseudoainhum is a disorder of unknown etiology that is usually congenital and nonprogressive. One theory states it is caused by amnion band constriction in utero. These constriction bands lead, not only to a less cosmetically appealing foot, but also to long-term neurovascular compromise, resulting in amputation of the digit. The described surgical approaches have been limited within published data. The 2 procedures that have been described are either a Z-plasty or amputation, depending on the degree of the deformity. The present case report provides an alternative surgical approach to a pseudoainhum deformity of a third digit.

OBJECTIVES--To distinguish the effects of juvenile rheumatoid arthritis (JRA) on bone mineralisation from those possibly caused by steroid therapy. METHODS--Bone mineral status was evaluated in 20 children (five boys and 15 girls) with active JRA who never received steroids. Seven had oligoarticular, nine had polyarticular, and four had systemic JRA. Bone mineral content (BMC) was assessed by single beam photon absorptiometry and expressed as a Z score relative to normal values in healthy children. Serum calcium, phosphate, and alkaline phosphatase were measured by colorimetric methods. Whole parathyroid hormone was assayed by Immuno Radiometric Assay. Serum osteocalcin was measured by specific radioimmunoassay. Nutrient intake was assessed by a 24 hours dietary recall. BMC and nutrient intake were also assessed in an age and sex matched control group. RESULTS--BMC was -1.5 (SEM 0.8) Z scores in patients and 0.4 (0.3) in the control group (p = 0.02). BMC averaged -4.9 (2) Z scores in the systemic JRA group, -1 (0.6) in the polyarticular group and 0.3 (0.7) in oligoarticular JRA patients. Serum calcium, phosphate and osteocalcin values were normal in all patients. No significant difference was found between JRA patients and controls in calcium, phosphate, energy, and protein intake. CONCLUSION--JRA subjects have significantly reduced BMC even in the absence of any steroid therapy. Bone demineralisation appears to depend more on disease activity and on reduced motility than on reduced nutrient intake.

In the frame of the ITER Engineering Design Activity (EDA), the European Home Team (EU HT), in collaboration with the Joint Central Team (JCT) and the three other HTs, has contributed to the development of a joint water-cooled solid breeder blanket design concept for the ITER Enhanced Performance Phase. In early 1997 the EU HT gradually arrived at a different basic layout characterized in particular by an enhanced degree of overall reactor relevance and then started a rigorous design activity for its validation. The main peculiarities of the EU HT proposal are (i) the use of beryllium in form of a pebble bed, (ii) the adoption of flat radial-poloidal cooling panels, and (iii) the confinement of the breeder pebbles in poloidally oriented circular elements. In addition to the design rationale, this paper describes the main results of the April-September 1997 design activity in the areas of neutronic, thermal, thermal-hydraulic, electromagnetic, structural, thermo-mechanical as well as tritium and safety analyses. A specific sub-section is devoted to the results of an industrial assessment of the blanket module manufacturing and assembly.

The overall OMITRON design has been recently revisited and subjected to a feasibility study jointly by the ENEA Fusion Department and the CITIF Consortium (firms FIAT, ANSALDO and ABB). As a result, it has been confirmed that the concept is sound and viable solutions exist for all the main engineering aspects of the project.

The NET Toroidal Field Coils System must be self supporting under normal and accidental magnetic loads. To ensure the required mechanical stability, the coils must be linked together to form a continuous structure of adequate stiffness. The joints must provide the electrical resistance to minimise the eddy currents and must be designed to allow the disassembly of the system by remote handling techniques in case of removal of one or more coils. The two kinds of shear keys proposed for NET are designed to react the overturning moment of the coils and to be adjusted to compensate for misalignments between the connected parts. The paper describes the design performed in NET and the results obtained with full scale mock-up tested at 77 K.

The Authors refer in this second note about the indications and surgery technic of the semilunar coronally repositioned flap.

Diabetes mellitus is accompanied constantly by functional changes in polymorphonucleated neutrophils and particularly in their chemotactic properties. Their function of impeding the invasion of the organism on the part of aggressive external factors cannot therefore be implemented. These patients are, therefore abnormally susceptible to infection and, with high frequency, also present serious periodontal disease.

Nonostante la tecnologia MBR mostri un grande trend di crescita nel numero di applicazioni in piena scala, rimane ancora poco studiato il fenomeno della formazione di schiume all’interno dei reattori biologici che può provocare non pochi problemi gestionali degli impianti. Quest’aspetto fa sì che il fenomeno è oggi di crescente interesse scientifico, anche a seguito d’ipotesi secondo cui i fenomeni di foaming e fouling potrebbero reciprocamente influenzarsi, considerando i fattori comuni di influenza (EPS, microrganismi filamentosi idrofobici, fisiologia del fango). A tal riguardo viene anche mostrato che la ricerca scientifica condotta in Italia sull’argomento è molto ben avviata, stante l’elevata incidenza percentuale del numero di pubblicazioni prodotte rispetto a quello complessivo su scala mondiale. Infine, in questo capitolo sono analizzati le possibili cause del fenomeno e i metodi per valutarne l’entità, a fenomeno avvenuto, o da usare a scopo previsionale. Inoltre, è riportato un particolare caso di studio concernente l’esercizio di un impianto pilota IA-MBR (Intermittent Aeration Membrane BioReactor) in cui, mediante una specifica analisi del foaming determinatosi, è stato possibile accertare il contestuale ruolo delle sostanze polimeriche extracellulari (EPS) e dei microrganismi filamentosi idrofobici nella formazione della schiuma

Tra i diversi vantaggi dei sistemi MBR rispetto ai sistemi CAS viene spesso annoverata la maggiore stabilità del fango MBR dovuta alla maggiore età del fango (SRT - Sludge Retention Time). Tale vantaggio è evidente nel caso di impianti CAS che vengono trasformati in impianti MBR poiché l'upgrading consente di incrementare la concentrazione di microrganismi nel reattore biologico, ottenendo una biomassa complessiva maggiore e quindi un maggior SRT. Tale vantaggio, però, non può essere generalizzato nel caso di impianti MBR di nuova costruzione. Per questi ultimi, infatti, alla maggiore concentrazione di microrganismi nelle vasche biologiche corrisponde una riduzione dei volumi delle vasche stesse rispetto al caso degli impianti CAS, che costituisce uno dei principali vantaggi della tecnologia MBR. Tale riduzione dei volumi, più o meno rilevante in funzione della sensibilità del progettista, compensa l'incremento della concentrazione dei microrganismi, con la conseguenza che la biomassa complessivamente presente nel sistema non è molto diversa da quella che si avrebbe in un sistema CAS finalizzato a trattare lo stesso liquame influente. Allo stesso modo, a pari massa di microrganismi nel sistema e pari caratteristiche del liquame influente, il quantitativo di fango prodotto dai sistemi CAS e MBR non è molto diverso e quindi non sarà molto diverso nemmeno il SRT. Pertanto non è condivisibile l'idea di ritenere il fango prodotto dagli MBR già stabile e quindi da non sottoporre a ulteriore processo di stabilizzazione nella linea fanghi dell'impianto di depurazione. Addirittura alcuni Autori ritengono consigliabile condurre il processo MBR con un SRT molto basso rispetto a quello teoricamente possibile, in modo da massimizzare la concentrazione di sostanza organica nel fango ed aumentare in tal modo il recupero energetico dovuto alla digestione anaerobica del fango stesso (Ng & Hermanowicz, 2005a). Per quanto riguarda, invece, l'effetto della digestione anaerobica sulle proprietà di disidratabilità dei fanghi MBR, non è stato possibile trovare alcun dato nella letteratura scientifica. Lo scopo del presente studio è stato, pertanto, quello di valutare le potenzialità della digestione anaerobica applicata ai fanghi provenienti da impianti MBR, sia in termini di BMP che in termini di disidratabilità.

L'allevamento di bufale rappresenta il fulcro dell'economia di alcune aree della Regione Campania, costituendo, peraltro, una peculiarità nell'ambito della Comunità Economica Europea ed un???eccellenza del Paese. Le aziende in cui sono allevati capi bufalini sono, attualmente, circa 1450 (delle quali 808 in via esclusiva e la rimanente parte di tipo misto con bovini), quasi tutte allocate nella Piana del Sele e nella Piana Campana, per un numero di capi superiore a 280000. Il latte emunto è soprattutto destinato alle produzioni casearie, ed in particolare a quella della mozzarella, sestuplicatasi negli ultimi 25 anni ed aumentata del 35% nel triennio 2008-2011. Tra i problemi più gravosi di un'azienda bufalina (ma più in generale delle aziende zootecniche) rientra certamente il soddisfacimento del fabbisogno idrico per l'abbeveraggio dei capi, l'asportazione delle deiezioni, il lavaggio dei locali e dell'impianto di mungitura, reso talvolta a maggior ragione difficoltoso dalla distanza di infrastrutture di rifornimento della riserva. Congruentemente con gli indirizzi strategici volti all'adozione, in tutti i campi, di sistemi di risparmio e riciclo dell'acqua (si citano, a titolo di esempio, le indicazioni all'uopo fornite dalla Direttiva 2000/60/CEE, dalla Relazione al Consiglio e al Parlamento Europeo datata 18/12/2008, nonché, localmente, dalla Delibera 18/4/2007 n. 659 della Regione Campania), è evidente la necessità, anche nel campo in esame, che siano individuate soluzioni tecnologiche adeguate a riguardo, tra le quali rientra il ricorso ad impianti di depurazione dei reflui aziendali, realizzati con l'obiettivo, tra gli altri, di assicurare la produzione di acqua idonea al riuso nello stesso ambito. Tale provvedimento, peraltro, rappresenta una soluzione ad un'altra criticità delle aziende zootecniche, legata all'esigenza di dover smaltire in modo appropriato i suddetti reflui, in linea con le limitazioni sempre più stringenti previste dalle norme emanate in Italia negli ultimi anni sulla base di Direttive Comunitarie. Può ben dirsi, quindi, che la necessità di ricorrere a processi e tecnologie idonei al risparmio ed al riutilizzo idrico nonché al corretto smaltimento dei reflui rappresenti, e rappresenterà sempre di più in futuro, un'esigenza imprescindibile per gli operatori del settore. Tra le soluzioni all'uopo prese in considerazione, particolare interesse ha suscitato il ricorso a cicli depurativi dei reflui che prevedono, tra le altre, una fase di digestione anaerobica, che, come è noto, assicura la produzione di biogas, utilizzabile, in primis, per ottimizzare le condizioni di svolgimento dello stesso processo depurativo (attraverso la regolazione della temperatura), ma anche, nel caso di surplus, per il soddisfacimento di ulteriori richieste energetiche da parte dell'azienda. È proprio in questa ottica che si inquadra il progetto STABULUM, finanziato, nell'ambito della Misura 124 del PSR 2007-2013, dall'Assessorato all'Agricoltura della Regione Campania all'Associazione Temporanea di Scopo (ATS) costituita da: Dipartimento di Ingegneria Civile, Edile e Ambientale (DICEA) dell'Università degli Studi di Napoli Federico II, con il ruolo di capofila e la funzione di coordinamento delle attività; Azienda Agricola Colangelo Davide, sita in Capaccio (SA); CEMS - Cooperativa ElettroMeccanica Sud, con sede in Nola (NA). Il progetto ha riguardato la realizzazione presso l'azienda Colangelo, da parte della CEMS, di un impianto integrato di depurazione di reflui bufalini, con potenzialità corrispondente al trattamento delle deiezioni prodotte da 70 capi in stabulazione libera, in grado di realizzare il recupero energetico e di garantire la produzione di acqua idonea al riutilizzo in ambito aziendale oppure allo smaltimento in linea con le disposizioni normative all'uopo vigenti. L'impianto è costituito da fasi di trattamento già, più o meno, consolidate, che sono state assemblate insieme in modo originale, costituendo un ciclo innovativo rispetto alla specifica applicazione. Nella fattispecie, è stata prevista una fase di digestione anaerobica, essenzialmente finalizzata alla degradazione della frazione carboniosa del refluo, accoppiata a processi biologici combinati aerobici/anossici, utilizzati per il trattamento della frazione liquida del digestato (vale a dire della corrente idrica che in uscita dal digestore si forma a seguito dell'operazione di centrifugazione), con contributi significativi anche in termini di riduzione del tenore di composti azotati presenti nell'effluente finale. In pratica, l'impianto è sinteticamente suddivisibile nelle tre sezioni principali di: digestione anaerobica; trattamento e valorizzazione energetica del biogas; trattamento della frazione liquida del digestato. Gli output sono costituiti da: - un effluente depurato (acqua) con caratteristiche di qualità rispettose dei limiti normativi fissati dal vigente Decreto Ministeriale sul riutilizzo delle acque reflue (DM 185/2003); - un ammendante palabile, utilizzato in seno all'azienda, ma che potrebbe anche essere inviato ad impianti di compostaggio (che ne fanno una grossa richiesta); - un effluente gassoso (biogas) ad elevato potere combustibile, utilizzato per la produzione energetica. Nel lavoro sono riportate una sintetica descrizione dell'impianto realizzato nell'ambito del Progetto (nel seguito, denominato impianto STABULUM) e l'illustrazione dei principali risultati conseguiti nel corso delle esperienze eseguite sullo stesso, sia alla scala di laboratorio che in quella di campo, precedute dalla presentazione del quadro inerente alla produzione di reflui ed al fabbisogno idrico nelle aziende zootecniche campane.

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