Identifying potential uses for green roof discharge based on its physical-chemical-microbiological quality

Green roofs are promising tools in sustainable urban planning, offering benefits such as stormwater management, energy savings, aesthetic appeal, and recreational spaces. They play a crucial role in creating sustainable and resilient cities, providing both environmental and economic advantages. Despite these benefits, concerns persist about their impact on water quality, especially for non-potable use, as conflicting results are found in the literature. This study presents a comparative analysis of the quantity and quality of water drained from an extensive green roof against an adjacent conventional rooftop made of fiber-cement tiles in subtropical Brazil. Over a 14-month period, the water drained from both roofs was evaluated based on physical (turbidity, apparent color, true color, electrical conductivity, total solids, total dissolved solids, suspended solids), chemical (pH, phosphate, total nitrogen, nitrate, nitrite, chlorides, sulfates, and BOD), microbiological (total coliforms and E. coli), and metal (copper, iron, zinc, lead, and chrome) concentration parameters. The discharge from the green roof was 40% lower than its counterpart measured at the control roof, while the water quality from both roofs was quite similar. However, the green roof acted as source of chlorides, electrical conductivity, color, BOD, total hardness, E. coli, phosphate, sulfate, and turbidity. On the other side, the green roof neutralized the slightly acidic character of rainwater, showcasing its potential to mitigate the effects of acid rain. The study's results underscored that the water discharged from the green roof generally aligned with non-potable standards mandated by both Brazilian and international regulations. However, the findings emphasized the imperative need for pre-treatment of the green roof discharge before its utilization, specifically adjusting parameters like turbidity, BOD, total coliforms, and E. coli, which were identified as crucial to ensure water safety and compliance with non-potable use standards.

Evaluating bioretention scale effect on stormwater retention and pollutant removal

Bioretention column studies are commonly used in laboratory to assess the performance of such structures in removal of pollutants and to investigate different conceptions aiming to increase their efficiency. However, no studies were found recommending suitable diameters or sizes, or about the uncertainties related to the transfer of results among the different scales (i.e., among different experiments or from the laboratory to field scale). This study assessed the effect of the varying diameters in experimental bioretention columns on the retention and removal of pollutants from stormwater runoff. Three sets of columns with diameters of 400 mm, 300 mm, and 200 mm were assessed. The results showed that runoff retention (R) was affected by the time interval between stormwater events, but not by the bioretention diameter, although the diameter influenced the variability of R results. The removal of TSS (95%), nitrite (98%), and phosphate (96%) did present variability among the different bioretention diameters. However, the nitrate removal was statistically different among the bioretention columns, with removal efficiency above 50% in the 300-mm and 200-mm columns, while the 400-mm columns acted as a source of nitrate by increasing its concentration in the outflow stormwater by up to 285%, suggesting that the removal of this pollutant can be influenced by the scale effect of the bioretention columns and the experiments with small bioretention diameters may not provide reliable results.

Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study

BACKGROUND AND OBJECTIVE

We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS-International Stroke Thrombectomy Register (SITS-ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies.

METHODS

We identified centres recording ≥10 consecutive patients in the SITS-ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014-2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0-2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS-MOST.

RESULTS

Results are presented in the following order: SITS-ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44-47), 46.0% (42-50), 38% (35-41) and 37% (35-41), respectively; death was 19.2% (19-21), 15.3% (12.7-18.4), 29.2% (27-32) and 28.6% (27-31); and SICH was 3.6% (3-4), 4.4% (3.0-6.4), 5.8% (4.7-7.1) and not available.

CONCLUSION

Thrombectomy in routine clinical use registered in the SITS-ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies.

Unpaved road conservation planning at the catchment scale

In addition to soil losses on hillslopes, unpaved rural roads, especially when poorly designed and maintained, can be a significant contributor to the erosive processes seen at the catchment scale. In areas with deep soils, the solutions primarily focus on channeling excess surface runoff into settling ponds or terraces. However, few studies have addressed runoff control from roads on steep slopes in areas of shallow soil. Modeling hydrological processes at the catchment scale is a useful strategy for choosing the most effective and least costly conservation practices to control surface runoff. This study applies a mathematical model to a monitored catchment in southern Brazil to better understand the effects of conservation practices on unpaved roads and their impact on the hydrological and erosive dynamics of a small rural catchment. We calibrated the LISEM model using data from eight stormwater events and evaluated how three different road conservation scenarios-low (LI), medium (MI), and high intensity (HI)-contributed to sediment yield (SY), surface runoff volume (Qe), and peak flow (Qp) reduction. The LI and MI scenarios involved installation of hydraulic structures to control the road surface runoff (i.e. road ditch graveling, diversion weirs and grass waterways) while the HI scenario added surface runoff control practices (grass strips) to surrounding crop fields, in addition to the practices included in the MI scenario. Based on these scenarios, the results showed a Qe reduction at the catchment outlet from - 3.5% (LI) to - 22.5% (HI). The Qp and SY varied from + 6.0% (LI) to - 292.5% (HI) and from + 20.0% (LI) to - 963.9% (HI), respectively. These results show that the low- and medium-intensity practices were not effective in controlling surface runoff from roads, based on the Qe, Qb, and SY observed at the catchment's outlet. On the other hand, when MI scenarios were complemented with practices to control surface runoff in the cultivated areas, a significant reduction in surface runoff (Qe and Qp) and SY was verified.

Monitoring sediment yield for soil and water conservation planning in rural catchments

Sediment yield in river catchments can cause siltation of reservoirs and channels, carries contaminants adhered to sediment particles, and represents water erosion at the catchment scale, leading to decreased agricultural productivity. Hydrological monitoring enables the understanding of overland flow and soil erosion dynamics. In this study, we analyzed whether the relationship between precipitation (P), water flow (Q), and suspended sediment concentration (SSC) during rainfall events shows the usefulness of hydrological and sedimentological monitoring in soil and water conservation projects to river catchments. We conducted a study in the Lajeado Ferreira catchment in southern Brazil. This catchment is characterized by high soil fragility and erosion rates because of relief and intense tobacco cultivation. The small size of the catchment (120 ha) allowed a better understanding of the processes that occurred between hillslope and watercourses. We analyzed 43 rainfall-runoff events (P-Q), and we selected characteristic variables of each event and related them to independent variables (climate, land use, and soil management) and their seasonality using regression techniques. We also conducted a hysteresis analysis to understand the behavior of SSC in relation to runoff. The results showed a high relation of sediment yield (SY) with maximum water flow of the event (Q_max), and linear regression models showed the best performance between characteristic variables. In addition, the seasonal variability of the land coverage presented greater influence on the SY than the precipitation itself.

Functional and radiological outcomes after bridging therapy versus direct thrombectomy in stroke patients with unknown onset: Bridging therapy versus direct thrombectomy in unknown onset stroke patients with 10-point ASPECTS

BACKGROUND AND PURPOSE

The aim was to assess functional and radiological outcomes after bridging therapy (intravenous thrombolysis plus mechanical thrombectomy) versus direct mechanical thrombectomy (MT) in unknown onset stroke patients.

METHODS

A cohort study was conducted on prospectively collected data from unknown onset stroke patients who received endovascular procedures at ≤6 h from symptom recognition or awakening time.

RESULTS

Of the 349 patients with a 10-point Alberta Stroke Program Early Computed Tomography Score (ASPECTS), 248 received bridging and 101 received direct MT. Of the 134 patients with 6-9-point ASPECTS, 123 received bridging and 111 received direct MT. Each patient treated with bridging was propensity score matched with a patient treated with direct MT for age, sex, study period, pre-stroke disability, stroke severity, type of stroke onset, symptom recognition to groin time (or awakening to groin time), ASPECTS and procedure time. In the two matched groups with 10-point ASPECTS (n = 73 vs. n = 73), bridging was associated with higher rates of excellent outcome (46.6% vs. 28.8%; odds ratio 2.302, 95% confidence interval 1.010-5.244) and successful recanalization (83.6% vs. 63%; odds ratio 3.028, 95% confidence interval 1.369-6.693) compared with direct MT; no significant association was found between bridging and direct MT with regard to rate of symptomatic intracerebral hemorrhage (0% vs. 1.4%). In the two matched groups with 6-9-point ASPECTS (n = 45 vs. n = 45), no significant associations were found between bridging and direct MT with regard to rates of excellent functional outcome (44.4% vs. 31.1%), successful recanalization (73.3% vs. 76.5%) and symptomatic intracerebral hemorrhage (0% vs. 0%).

CONCLUSIONS

Bridging at ≤ 6 h of symptom recognition or awakening time was associated with better functional and radiological outcomes in unknown onset stroke patients with 10-point ASPECTS.

Manual thromboaspiration technique as a first approach for endovascular stroke treatment: A single-center experience

BACKGROUND

For intracranial large vessel occlusion in acute ischemic stroke (AIS), a high degree of revascularization in the minimal amount of time predicts good outcomes. Recently, different studies have shown that the direct aspiration first pass technique (ADAPT technique) for AIS obtains high recanalization rates, fast interventions and low costs when it works as first attempt. This study retrospectively describes revascularization efficacy, duration of procedure, intra and post-procedural complications, early and after 90-days clinical outcome in a group of patients who underwent ADAPT as the primary endovascular approach, eventually followed by stent retriever thrombectomy, for recanalization of large vessels in the anterior circulation.

MATERIALS AND METHODS

We analyzed clinical and procedural data of patients treated from April 2014 to August 2015. Recanalization was assessed according to the Thrombolysis in Cerebral Infarction score. Clinical outcome was evaluated at discharge and after 3 months (modified Rankin Scale, mRS).

RESULTS

Overall, 71 patients (mean age of 69.7 years) were treated. Sites of occlusion were anterior circulation (including seven tandem extracranial-intracranial occlusions). In 39 patients i.v. rtPA was attempted. Recanalization of the target vessel was obtained in 87.3% of cases whereas direct aspiration alone was successful in 46/71cases (64.8%) with an average puncture-to-revascularization time of 43.1 minutes. Symptomatic intracranial hemorrhage occurred in 7.8% and embolization to new territories in 5.6%. In total, 38 patients (53.5%) had a good outcome at 90 days follow-up.

CONCLUSIONS

In our series, the manual thromboaspiration technique has been shown as fast and safe, with good rates of vessel revascularization in 87.3% of patients and neurological outcome <3 mRS in 53.5% of patients.

Mammaglobin B (SCGB2A1) is a novel tumour antigen highly differentially expressed in all major histological types of ovarian cancer: implications for ovarian cancer immunotherapy

Background:

We studied the genetic fingerprints of ovarian cancer and validated the potential of Mammaglobin b (SCGB2A1), one of the top differentially expressed genes found in our analysis, as a novel ovarian tumour rejection antigen.

Methods:

We profiled 70 ovarian carcinomas including 24 serous (OSPC), 15 clear-cell (CC), 24 endometrioid (EAC) and 7 poorly differentiated tumours, and 14 normal human ovarian surface epithelial (HOSE) control cell lines using the Human HG-U133 Plus 2.0 chip (Affymetrix). Quantitative real-time PCR and immunohistochemistry staining techniques were used to validate microarray data at RNA and protein levels for SCGB2A1. Full-length human-recombinant SCGB2A1 was used to pulse monocyte-derived dendritic cells (DCs) to stimulate autologous SCGB2A1-specific cytotoxic T-lymphocyte (CTL) responses against chemo-naive and chemo-resistant autologous ovarian tumours.

Results:

Gene expression profiling identified SCGB2A1 as a top differentially expressed gene in all histological ovarian cancer types tested. The CD8+ CTL populations generated against SCGB2A1 were able to consistently induce lysis of autologous primary (chemo-naive) and metastatic/recurrent (chemo-resistant) target tumour cells expressing SCGB2A1, whereas autologous HLA-identical noncancerous cells were not lysed. Cytotoxicity against autologous tumour cells was significantly inhibited by anti-HLA-class I (W6/32) monoclonal antibody. Intracellular cytokine expression measured by flow cytometry showed a striking type 1 cytokine profile (i.e., high IFN-γ secretion) in SCGB2A1-specific CTLs.

Conclusion:

SCGB2A1 is a top differentially expressed gene in all major histological types of ovarian cancers and may represent a novel and attractive target for the immunotherapy of patients harbouring recurrent disease resistant to chemotherapy.

The efficacy and tolerability of a sunitinib 3-week administration schedule in metastatic renal cell carcinoma patients: report of three cases

Sunitinib, an orally multitargeted tyrosine kinase inhibitor and standard first-line treatment for metastatic renal cell carcinoma, is usually administered on a 6-week schedule. Toxicities reported with this drug are usually of moderate grade, which results in good treatment tolerability and patients' compliance. However, in some cases high-grade or prolonged toxicities require temporary treatment interruption or dose adjustment, possibly resulting in reduced treatment efficacy. We describe three cases of metastatic renal cell carcinoma patients (a 53-year-old male, a 70-year-old woman, and a 65-year-old woman) who received a shortened 3-week sunitinib administration schedule, 2 weeks daily administration followed by 1 week of rest (2/1) due to toxicities developed on the classic 6-week schedule, which would have required a temporary treatment interruption or a dose reduction. Treatment was generally well tolerated with manageable toxicities. A 3-week administration schedule of sunitinib may represent a valid alternative for managing toxicity while maintaining the planned dose intensity over a 6-weeks period of time. Sunitinib may thus be administered using a flexible dosing schedule to meet individual patient needs, achieving better tolerability and maintaining significant response to treatment.

Strain-specific pathogenicity of putative host-adapted and nonadapted strains of Streptococcus uberis in dairy cattle

Streptococcus uberis is an important cause of intramammary infection in dairy cattle. Strains of Strep. uberis appear to differ in their ability to cause disease based on previous epidemiological studies. We explored the pathogenicity of 2 strains of Strep. uberis, where one strain represented a putatively host-adapted type based on its ability to cause persistent infection and to spread from cow to cow in a lactating herd. This type was part of a clonal complex that is commonly associated with bovine mastitis. The other strain, which was isolated from a transient infection in a single animal in the same herd and did not belong to any known clonal complex, was selected as putatively nonadapted type. Cows (6 per strain) were experimentally challenged in a single hind quarter and the adjacent hind quarter was used as mock challenged control quarter. Both strains showed an equal ability to grow in the milk of challenge animals in vitro. All cows that were challenged with the putatively host-adapted strain developed clinical signs of mastitis, including fever and milk yield depression as well as elevated somatic cell count due to influx of polymorphonuclear leucocytes and lymphocytes. The cytokine response followed a specific order, with an increase in IL-1β, IL-6, and IL-8 levels at the time of first SCC elevation, followed by an increase in IL-10, IL-12p40, and tumor necrosis factor-α levels approximately 6h later. In 4 of 6 animals, IL-17A was detected in milk between 57 and 168 h postchallenge. The increase in IL-17A levels coincided with inversion of the prechallenge CD4(+)-to-CD8(+) T lymphocyte ratio, which was observed from 96 h postchallenge. This was followed by normalization of the CD4(+)-to-CD8(+) ratio due to continued increase of the CD8(+) concentration up to 312 h postchallenge. Spontaneous resolution of infection was observed in 5 animals and coincided with a measurable IL-17A response in 4 animals, suggesting that IL-17 may be involved in the resolution of intramammary infection. With the exception of minor elevation of IL-8 levels, no clinical, cytological, or immunological response was detected in quarters challenged with the nonadapted strain. The observed strain-specific pathogenicity was consistent across animals, implying that it is determined by pathogen factors rather than host factors.

[Neuroimaging and definition of transient ischemic attack]

AIM

Transient ischemic attack (TIA) has to be considered an "alarm bell" of a more or less severe organic or systemic vasculopathy. Positive findings at neuroimaging means tissue damage. The purpose of this retrospective study was to assess the role of neuroimaging in the management of patients presenting with TIA, and to consider the relative implications.

METHODS

In a consecutive series of 82 patients (53 males, 29 females, mean age: 65.9±13.1 years) admitted for TIA, it was possible to review the history and the clinical data of 66 patients, including ABCD2 score, laboratory including plasmatic D-dimer, and neuroimaging data including computed tomography (CT) and magnetic resonance imaging including diffusion-weighted with apparent diffusion coefficient measure (DWI-ADC) obtained at diagnosis and by a week later (16 by CT, and 50 by DWI-ADC). Thirty-three patients underwent DWI-ADC within 24 hours from symptoms onset. Statistical analysis has been performed by non-parametric tests (χ2 and Mann-Whitney), and logistic regression by a commercially available software.

RESULTS

CT and/or DWI-ADC showed signs of acute ischemic lesions in 23/66 (35%) patients. 12 out of the 35 patients with a 24-hour DWI-ADC follow-up were positive. Statistical analysis showed that positive neuroimaging was significantly associated only with familial history of cardiovascular diseases (P<0.012) and previous TIA/stroke (P<0.046).

CONCLUSION

In this patients series, at least 35% of patients with TIA had a positive neuroimaging, especially DWI-ADC. Positive neuroimaging seems an independent factor. Patients with TIA need an early assessment by neuroimaging including DWI-ADC, in order to obtain a correct classification and prognosis.

Response and safety of sunitinib in a heavily pre-treated metastatic non-small cell lung carcinoma patient

BACKGROUND

The activity of sunitinib, a multitargeted tyrosine kinase inhibitor with antiangiogenic and antitumor activities, has been explored in several solid malignancies such as breast, lung, prostate and pancreatic cancer. Currently it is approved for the treatment of metastatic renal cell carcinoma and gastrointestinal stromal tumors. Non-small cell lung cancer usually presents at an advanced or metastatic stage at diagnosis. Treatment options are limited for this disease, therefore symptom palliation and patient's quality of life are primary objectives of therapy.

CASE REPORT

We describe the case of a patient (male, 67 years old) with heavily pre-treated metastatic non-small cell lung carcinoma who received sunitinib according to the following 3-week schedule: 50 mg daily for 2 weeks followed by a 1-week rest. The patient completed six months of therapy achieving a major disease response without high-grade toxicities.

CONCLUSION

In this case, sunitinib shows promising single-agent activity in pretreated non-small cell lung cancer, with a good toxicity profile and flexible administration schedule.

[Idiopathic sudden hearing loss: role of the posterior communicating cerebral arteries of the Willis' circle]

Sudden hearing loss (SHL) is a neurosensorial hearing loss of variable entity with an onset of less than three days. In most cases (85-90%) it is of unknown etiology (idiopathic sudden hearing loss--ISHL). The most accredited hypotheses for origin are: viral, immunitary and vascular. ISHL accounts for approximately 1% of all neurosensorial hearing loss; onset is most frequent in winter, i.e. January and February, and it most frequently affects women, particularly at 15 and between 40-50 years of age. In order to evaluate the role of vascular condition on the onset of ISHL, we focused our attention on the circle of Willis. The results confirm that, in the absence of cerebro-vascular pathology, posterior communicating arteries (PCAs) that cannot be activated--evaluated by transcranial Doppler (TCD)--are associated with ISHL. Moreover, hemodynamic alterations detected in the basilar artery in ISHL patients are correlated with the final prognosis for hearing. These observations highlight the importance of TCD in testing subjects at risk for idiopathic SHL and show that PCAs are essential in maintaining normal cochlear function.

Non-functioning posterior communicating arteries of circle of Willis in idiopathic sudden hearing loss

Most cases of sudden hearing loss have no identifiable cause. A link between compensatory blood flow through the circle of Willis and recovery from sudden hearing loss has, however, been suggested. We assessed 22 patients with sudden hearing loss who had no cerebrovascular disease, and 41 controls matched for age and sex. We took ultrasonographic doppler flow measurements of the extracranial carotid and vertebrobasilar systems and independent audiological measurements. 12 patients with sudden hearing loss, compared with four controls had bilateral non-functioning posterior communicating arteries (p=0.00019). Our findings suggest a strong association between a non-functioning posterior communicating artery of the circle of Willis and sudden hearing loss.

Prevention of child abuse and neglect through early diagnosis of serious disturbances in the mother-child relationship in Italy

At the obstetrical clinic of Modena University and a family center of the same municipality during the first six months of 1980 a questionnaire based on "Risks of Child Abuse" by Kempe, Gray and others was administered to 33 expectant mothers during the third trimester of pregnancy, a few days after delivery, and a month and one-half after childbirth, for the purpose of examining the mother-child relationship. Two principal groups of "risk factors" which may lead to child abuse and neglect appeared: mothers with preceding personal and social experiences, and cases of medical intervention (e.g., prematurity, caesarean). Use of a questionnaire that permitted early diagnosis made possible help in establishing a good mother-child relationship in the first months of life. Such help can be given by the hospital and public centers both before and after birth.