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An abstract of the study "A new on-board sensor for biventricular pacing therapy optimisation," by E. Marcelli et al, is presented.

By implementing advanced wastewater treatment technologies coupled with digital tools, high-quality water is produced to be reused within the industry, enhancing process efficiency and closing loops. This paper investigates the impact of three innovation tools (process, circular and digital) in a Solvay chemical plant. Four technologies of the wastewater treatment plant "WAPEREUSE" were deployed, predicting their performance by process modelling and simulation in the PSM Tool. The environmental impact was assessed using Life Cycle Assessment and compared to the impact of the current industrial effluent discharge. The circularity level was assessed through three alternative closed-loop scenarios: (1) conventional treatment and discharge to sea (baseline), (2) conventional and advanced treatment by WAPEREUSE and discharge to sea, (3) conventional and advanced treatment by WAPEREUSE and industrial water reuse through cross-sectorial symbiotic network, where effluents are exchanged among the process industry, municipality and a water utility. Scenario 1 has the lowest pollutants' removal efficiency with environmental footprint of 0.93 mPt/m 3 . WAPEREUSE technologies decreased COD by 98.3%, TOC by 91.4% and nitrates by 94.5%. Scenario 2 had environmental footprint of 1.12 mPt/m 3 . The cross-sectorial symbiotic network on the industrial value chain resulted in higher industrial circularity and sustainability level, avoiding effluents discharge. Scenario 3 is selected as the best option with 0.72 mPt per m 3 , reducing the environmental footprint by 21% and 36% compared to Scenarios 1 and 2, respectively., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Polyethylene (PE) pipes have been widely used in drinking water distribution systems across the world. In many cases, chlorine dioxide (ClO 2 ) is used to maintain a residual disinfectant concentration in potable water. Practical experiences have shown that the lifetime of PE pipes is significantly reduced due to exposure to drinking water with ClO 2 . Recently, many companies have proposed new PE pipes with a modified formulation, which are more resistant to chlorine dioxide. However, a standardized test method for evaluating the long-term performances of PE pipes is still missing. This literature review was performed to provide a description of chlorine dioxide uses and degradation mechanisms of polyethylene pipes in real water distribution systems. Current accelerated aging methods to evaluate long-term performances of PE pipes exposed to ClO 2 are described and discussed along with the common technics used to characterize the specimens. Accelerate aging methods can be distinguished in immersion aging tests and pressurized pipe loop tests. Wide ranges of operational conditions (chlorine dioxide concentration, water pressure, water temperature, etc.) are applied, resulting in a great variety of results. It was concluded that pressurized looping tests applying semi-realistic operational conditions could better replicate the aging mechanisms occurring in service. Despite this, the acceleration and the evaluation of the long-term performance are still difficult to determine precisely. Further experimentation is needed to correlate chemical-mechanical characterization parameters of PE pipes with their lifetime in service., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Isofuranodiene (IFD) is a sesquiterpene occurring in several plant species, which proved to have multiple anticancer activities. IFD has a lipophilic nature and, hence, a very low water solubility and a poor bioavailability; moreover, it is not stable, undergoing the "Cope rearrangement" to the less active curzerene. The use of appropriate delivery systems can thus be considered as a valid tool to enhance IFD bioavailability, solubility, stability and at the same time also to improve its intracellular uptake and pharmacological activity. Within this frame, monoolein (GMO) nanoparticles loaded with IFD were prepared and their enhanced anticancer activity, compared to pristine IFD, was assessed. In this study, for the first time, an in vitro Fourier Transform Infrared and Raman Microspectroscopy approaches were exploited to evaluate the effects of IFD, alone and loaded in GMO nanoparticles, on MDA-MB 231 breast cancer cell line. The anti-cancer effects of IFD were evidenced by both the spectroscopic techniques and discriminated from the GMO-induced changes in the culture environment; moreover, a synergistic effect of IFD and GMO administration can be envisaged by the experimental results., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Production of cost-efficient composite materials with desired physicochemical properties from low-cost waste material is much needed to meet the growing needs of the industrial sector. As a step forward, the current study reports for the first time an effective utilization of industrial metal (inorganic) waste as well as fall leaves (organic waste), to produce three types of nanomaterials at the same time; "Titanium Doped Activated Carbon Nanostructures (Ti-ACNs)", "Nanocellulose (NCel)", and combination of both "Titanium Doped Activated Carbon Cellulose Nanocomposite (Ti-AC-Cel-NC)". X-ray diffraction (XRD), transmission electron microscopy (TEM) and microanalysis (EDXS) measurements reveal that the Ti-ACNs material is formed by Ti-nanostructures, generally poorly crystalized but in some cases forming hexagonal Ti-crystallites of 15 nm, embedded in mutated graphene clouds. Micro- Fourier transform infrared spectroscopy (micro-FTIR) confirms that the chemical structure of NCel with bond vibrations between 1035 to 2917 cm -1 remained preserved during Ti-AC-Cel-NC formation. The prepared materials (Ti-ACNs, Ti-AC-Cel-NC) have demonstrated rapid removal of organic pollutants (Crystal Violet, Methyl Violet) from wastewater through surface adsorption and photocatalysis. In the first 20 min, Ti-ACNs have adsorbed ≈87% of the organic pollutants and further photocatalyzed them up to ≈96%. When Ti-ACNs are combined with NCel, their efficiency is increased of about four times. This performance originates from the adsorption by mutated graphene-like carbon and assisted photocatalysis by Ti nanostructures as well as the good supporting capacity of NCel for the homogenous Ti-ACNs distribution., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Monoolein-based cubic and hexagonal mesophases were investigated as matrices for insulin loading, at low pH, as a function of temperature and in the presence of increasing amounts of oleic acid, as a structural stabilizer for the hexagonal phase. Synchrotron small angle X-ray diffraction, rheological measurements, and attenuated total reflection-Fourier transform infrared spectroscopy were used to study the effects of insulin loading on the lipid mesophases and of the effect of protein confinement in the 2D- and 3D-lipid matrix water channels on its stability and unfolding behavior. We found that insulin encapsulation has only little effects both on the mesophase structures and on the viscoelastic properties of lipid systems, whereas protein confinement affects the response of the secondary structure of insulin to thermal changes in a different manner according to the specific mesophase: in the cubic structure, the unfolding toward an unordered structure is favored, while the prevalence of parallel β-sheets, and nuclei for fibril formation, is observed in hexagonal structures.

Objective: The operative timing and management of acute traumatic aortic rupture are matters of debate. We reviewed our experience with endovascular repair of acute traumatic aortic rupture, focusing on these topics., Methods: From 1998 to 2007, 31 patients were referred to our institute for acute traumatic rupture of the descending aorta. In 11 patients (group I) an early stent graft procedure was performed, whereas in 16 patients (group II) endovascular repair was delayed. The median time from trauma was 24 hours in group I and 1.5 months in group II. Eight (25.8%) patients had a short proximal neck (<5 mm from the left subclavian artery). Of these, 2 had the left subclavian artery totally covered by the endoprosthesis, and 2 had the left subclavian artery partially covered. Four patients with a posttraumatic pseudoaneurysm involving the left subclavian artery (3 patients) or the left common carotid artery (1 patient) underwent conventional open surgical intervention., Results: Technical success was obtained in all patients. There were neither intraoperative nor perioperative deaths. Cerebellar stroke was detected in 1 patient after the intentional closure of the left subclavian artery. Follow-up (32.7 +/- 27.5 months) was 100% complete. No late deaths, endoleaks, or complications occurred., Conclusion: The endovascular approach was a safe and flexible procedure in traumatic aortic rupture and allowed us to fit the operative timing to every patient's clinical and imaging findings. In the presence of an inadequate proximal landing zone, conventional open surgical intervention still remains a favorable option as an alternative to endovascular procedures if a surgical revascularization of the left subclavian artery, carotid artery, or both is necessary.

Background: Penetrating atherosclerotic ulcer is an acute aortic syndrome with a high incidence of complications and rupture. Until now, no generally accepted therapeutic regimen has been established because the natural history of penetrating atherosclerotic ulcers is extremely variable. We investigated the technical feasibility and the early and mid-term results of endovascular stent graft treatment in a consecutive series of patients who had penetrating ulcers., Methods: From July 1997 to December 2006, 19 patients (14 men and 5 women) with a mean age of 71.8 +/- 7.2 years were treated for penetrating ulcers. Seven patients presented with an acute and symptomatic penetrating atherosclerotic ulcer, and in 12 patients, the ulcerative process was chronic. Clinical and imaging follow-up was performed in all patients using computed tomography or magnetic resonance imaging., Results: Technical success (insertion and deployment of the stent graft) was achieved in 18 of 19 cases. Neither paraplegia nor other perioperative complications occurred. Two patients treated under emergency conditions in whom the aortic syndrome was recognized after the acute onset died in the hospital (11.1%) of multiorgan failure. Follow-up has been completed in all patients, with a median time of 22 months (range, 3 to 108 months). Endoleaks occurred in 3 patients: 1 had surgical repair (5.6%), 1 leak sealed spontaneously, and 1 sealed after a second endovascular procedure. Late death occurred in 4 patients from non-aortic causes., Conclusions: Endovascular stent graft repair is a low-invasive, attractive, and rational treatment option in aortic ulcers that provides satisfactory perioperative and mid-term results.

To quantify cardiac apex rotation (CAR), the authors recently proposed the use of a Coriolis force sensor (gyroscope) as an alternative to other complex techniques. The aim of this study was to evaluate the effects of right ventricular (RV) pacing on CAR. A sheep heart was initially paced from the right atrium to induce a normal activation sequence at a fixed heart rate (AAI mode) and then an atrioventricular pacing was performed (DOO mode, AV delay = 60 ms). A small gyroscope was epicardially glued on the cardiac apex to measure the angular velocity (Ang V). From AAI to DOO pacing mode, an increase (+9.2%, p < 0.05) of the maximum systolic twisting velocity (Ang VMAX) and a marked decrease (-19.9%, p < 0.05) of the maximum diastolic untwisting velocity (Ang VMIN) resulted. RV pacing had negligible effects (-3.1%, p = 0.09) on the maximum angle of CAR, obtained by integrating Ang V. The hemodynamic parameters of systolic (LVdP/dtMAX) and diastolic (LVdP/dtMIN) cardiac function showed slight variations (-3.8%, p < 0.05 and +3.9%, p < 0.05, respectively). Results suggest that cardiac dyssynchrony induced by RV pacing can alter the normal physiological ventricular twist patterns, particularly affecting diastolic untwisting velocity.

The aim of the present study was to investigate outcomes of implantable cardioverter-defibrillator (ICD) treatment in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We reviewed baseline/follow-up data of 15 consecutive ARVC patients (mean age 55 +/- 15 years) and 30 randomly drawn patients with coronary artery disease (CAD) (mean age 60 +/- 10 years) with matching durations of follow-up (all implanted with ICDs for primary/secondary prevention of sudden death). At implant, appropriate placement of the RV lead was more difficult in ARVC patients. During follow-up (median 41 months), appropriate interventions for any ventricular tachyarrhythmias occurred in 8 (53%) ARVC patients and 17 (57%) CAD patients, but the occurrence of high rate (>240 beats/min) ventricular tachyarrhythmias was higher in ARVC patients. Inappropriate ICD interventions occurred in 5 (33%) ARVC patients and 10 (33%) CAD patients. Lead-related adverse events requiring surgical revision occurred in 7 (47%) ARVC patients as compared with 4 (13%) CAD patients (P = 0.0004). While ICD implantation is highly effective for prevention of sudden death in ARVC, it does carry elevated burdens of long-term lead-related adverse events. These findings underline the need of careful follow-up in ARVC aimed at early recognition of complications that can impair ICD function.

Objective: Endovascular stent-graft placement is replacing traditional surgery in type B aortic dissection. Usually stent-graft implantation is performed under fluoroscopic and angiographic guidance, but this relatively new procedure is still burdened with some complications. We investigated the value of a developed algorithm based on transesophageal echocardiography (TEE) for guiding stent-graft implantation in type B aortic dissection., Methods: Forty-two patients with type B aortic dissection (chronic in 28 patients with aneurysmal dilatation of the false lumen, and acute complicated in 14 patients) underwent endovascular stent-graft reconstruction of the descending thoracic aorta. TEE was always performed after angiography. TEE-induced variations of the procedure, based on the algorithm, were compared with initial angiography-based decisions., Results: TEE was decisive for guidewire repositioning (not possible with fluoroscopy) from the false to the true lumen in 3 patients and for correct guidewire entrance in an elephant trunk prosthesis in another patient. After stent-graft implantation color Doppler TEE enabled detection of proximal peri-stent leaks in 13 patients, whereas only 6 (46%) of the 13 leaks were detectable at angiography (P = .008). Most leaks were subsequently eliminated with balloon dilation or further stent grafting. Pulsed Doppler TEE was also useful for differentiating true leaks (13 patients) from Dacron porosity (7 patients). A pulsed-Doppler velocity cutoff value of 50 cm/s enabled differentiation of Dacron porosity (characterized by slow blood flow) from true peri-stent leak (fast flow). After stent-graft implantation TEE demonstrated new intimal tears in the thoracic aorta in 7 patients, whereas only 2 of the 7 new tears were detectable at angiography (P = .024); in 6 of 7 patients the new distal tears were subsequently resolved with placement of additional stents, whereas in a patient with Marfan syndrome new proximal tears determined a type I endoleak, which could not be resolved. Overall, TEE furnished decisive information additional to angiography in determining successful procedural changes in 16 of 42 patients (38%). There were no in-hospital deaths, and pre-discharge spiral computed tomograms showed a good outcome of stent-graft implantation in 37 of 42 patients (88%), with 5 residual type I endoleaks, all previously detected with TEE but impossible to eliminate with either balloon molding or further stent implantation. All but 2 patients (95%) are currently alive at mean follow-up of 30 +/- 18 months., Conclusions: TEE algorithm is an easy and useful tool in the operating room to guide correct stent-graft positioning in type B aortic dissection.

Aims: The aims of this study were first, to demonstrate that Peak Endocardial Acceleration during isovolumic systole (PEA I) is related to positive peak LVdP/dt, while Peak Endocardial Acceleration during isovolumic relaxation time (PEA II) is related to aortic diastolic pressure (ADP) and to negative peak LVdP/dt; and second, to test if the simultaneous recording of PEA I and PEA II offers a new chance to monitor indexes of LV systolic and diastolic function., Methods: An implantable haemodynamic monitor, based on PEA I and PEA II measurements via a microaccelerometer sensor located in the tip of a pacing lead, screwed into the right ventricle, was tested in nine sheep at baseline and during acute haemodynamic interventions: nitrate (0.1 mg/ kg), metaraminol (0.15 mg/kg), dobutamine (5 microg/kg) infusion. ADP, positive and negative peak LVdP/dt were simultaneously recorded by an aortic and left ventricular Millar catheter., Results: PEA I changes were significantly related to positive peak LVdP/dt changes during dobutamine induced inotropic changes (r = 0.83, P < 0.001). PEA II changes were significantly related to both ADP (r = 0.91, P < 0.001) and negative peak LVdP/dt changes (r = 0.92, P < 0.001) during nitrate induced hypotension and metaraminol induced hypertension., Conclusion: The simultaneous recording of PEA I and PEA II with an implantable system offers a new chance to monitor indexes of LV systolic and diastolic function.