Advances in porphyrins and chlorins associated with polysaccharides and polysaccharides-based materials for biomedical and pharmaceutical applications

Over the last decade, the convergence of advanced materials and innovative applications has fostered notable scientific progress within the biomedical and pharmaceutical fields. Porphyrins and their derivatives, distinguished by an extended conjugated π-electron system, have a relevant role in propelling these advancements, especially in drug delivery systems, photodynamic therapy, wound healing, and (bio)sensing. However, despite their promise, the practical clinical application of these macrocycles is hindered by their inherent challenges of low solubility and instability under physiological conditions. To address this limitation, researchers have exploited the synergistic association of porphyrins and chlorins with polysaccharides by engineering conjugated systems and composite/hybrid materials. This review compiles the principal advances in this growing research field, elucidating fundamental principles and critically examining the applications of such materials within biomedical and pharmaceutical contexts. Additionally, the review addresses the eventual challenges and outlines future perspectives for this poignant research field. It is expected that this review will serve as a comprehensive guide for students and researchers dedicated to exploring state-of-the-art materials for contemporary medicine and pharmaceutical applications.

Use of the CuFe2O4/biochar composite to remove methylene blue, methyl orange and tartrazine dyes from wastewater using photo-Fenton process

In this study, CuFe₂O₄ ferrite was supported on biochar produced from malt biomass residues as a photocatalyst for degradation of methylene blue (MB), methyl orange (MO), and tartrazine (TZ) dyes. XRD, FT-IR, and FE-SEM were used to characterize the crystallinity and morphology of the samples. The characterization showed that the ferrite was uniformly supported on the surface of the biochar, confirming the formation of the composite. Degradation tests showed that CuFe₂O₄ degraded approximately 50, 47, and 62% of MB, MO, and TZ dyes, respectively, after 60 min of reaction. On the other hand, the CuFe₂O₄/biochar composite showed a significant increase in dye degradation, ~ 100%, for all three dyes. This increase in degradation efficiency may be due to less agglomeration of supported particles and due to decreased recombination of electron/hole pairs. Thus, results showed that the photocatalyst composite produced in this study is an effective alternative for removing dyes from wastewater.

Sanitary sewage disinfection with ultraviolet radiation and ultrasound

Currently, the world is facing a horrible situation due to SARS-CoV-2. Though its RNA was found in wastewater, there are still no studies on RNA contamination detected in sewage. Hence, a possible treatment of sewage is suggested in this work. The disinfection stage is extremely important in the treatment of effluents, minimizing the impacts on the receiving body of water and promoting public health. In this context, the sequential use of ultrasound and ultraviolet radiation, on a bench scale, was investigated as a way to improve the disinfection of anaerobically treated effluents. Two types of treated effluents were tested, by septic tank and anaerobic filter, for which, two ultrasound frequencies, 25 and 40 kHz, and four doses of UV, 3.6; 9.0; 18 and 36 mJ cm^-2 were applied. Physicochemical and microbiological parameters were observed for individual and sequential assays. The better quality of the anaerobic filter effluent influenced the performance of both processes, decreasing the concentration of organic load and turbidity, even though a concentration of total coliforms and Escherichia coli occurred in the lowest quality effluent (septic tank). The application of ultrasound has a positive effect on the inactivation of total coliforms and E. coli up to 1.0 log and provides better conditions for ultraviolet radiation to be sequentially applied. The UV radiation applied for the septic tank and the anaerobic filter inactivates 2.5 log for total coliforms and 3.5 log for E. coli, respectively. It is suggested that the disinfection methods applied in this work to inactivate gram-negative bacteria (E. coli) can also be applied to secondary treatment effluents, as well as being better tested for viruses, protozoa, and helminths.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13762-021-03764-7.

Degradation of ramipril by residues from the brewing industry: A new carbon-based photocatalyst compound

This study is a pioneer in the use of hydrochar as a support for photocatalytic oxide and its application and evaluation as a catalyst in degradation reactions of ramipril. Novel composites were easily prepared by the support TiO₂ or ZnO nanoparticles on the malt bagasse hydrochar. The preparation of the hydrochar requires low synthesis temperature (250 °C), generating the energy savings of the process. The production of the new composites was well supported by different analytical techniques XRD, FTIR, SSA, SEM, EDS, and reflectance diffuse. The effect of different proportions of TiO₂ or ZnO on the composites was investigated on the degradation efficiency of the pharmaceutical ramipril, without pH adjustment. Composites with a 5:1 hydrochar/TiO₂ or ZnO ratio (MH5T and MH5Z, respectively) showed degradations of 72 and 98% of ramipril at 120 min. This remarkable performance may be associated with the decrease in band gap energy and the electron-hole recombination rate. In addition, the composites were more efficient than metal oxides pristine, and this may be related to the fact that hydrochar have a high concentration of phenolic, hydroxyl, and carboxylic functional groups on their surface. Radical identification tests indicated that h⁺, O₂•^-, and •OH were the reactive species involved in the degradation. The proposed mechanism was studied via LC-MS/MS indicated that the ramipril molecule degrades into low m/z intermediates in the first 60 min of reaction using the MH5Z.

Toxicity of acrylamide after degradation by conjugated (UV/H2O2) photolysis in microalgae

Acrylamide (AA) is routinely used in laboratories and industries, and its disposal is always a problem; consequently, offering an alternative for their treatment contributes to conducting research in a responsible way. Therefore, in this work, acrylamide solutions were degraded by ultraviolet radiation and hydrogen peroxide (H₂O₂), and their toxicity was evaluated using a Desmodesmus quadricauda microalgae growth assay. The AA solutions were exposed to different dosages of H₂O₂ and different exposure times to UV radiation. The degradation was evaluated by liquid chromatography, which allowed the identification of the acrylamide peak and subsequent by-product peaks. A 100% degradation of the 1.5 mg L^-1 AA solution with UV/H₂O₂ (0.034 g L^-1) was achieved in just 10 min. The by-products formed did not inhibit the growth of D. quadricauda microalgae. The number of D. quadricauda individuals that grew in acrylamide solutions exposed to 20 and 30 min of UV radiation, with 0.034 g L^-1 of H₂O₂, was very similar to the number of individuals that grew in the control solution. Thus, the treatment proposed in this work using H₂O₂ combined with ultraviolet radiation degraded acrylamide into by-products with reduced toxicity.

Relationship of the physicochemical properties of novel ZnO/biochar composites to their efficiencies in the degradation of sulfamethoxazole and methyl orange

Three different composites were produced, based on zinc oxide and biochar (ZnO/biochar), varying the type of biomass (Salvinia molesta: SM; exhausted husk of black wattle: EH; and sugarcane bagasse: SB), with pyrolysis under mild conditions at 350 and 450 °C. Evaluation was made of the capacities of the composites for photocatalytic degradation of sulfamethoxazole antibiotic (SMX) and methyl orange dye (MO). The properties of the prepared composites were influenced by the biomass source, with larger crystallite size (SB), lower band gap energy (SM), higher specific surface area (SB), and larger pore size (SM) resulting in higher photocatalytic efficiency. Good degradation results were obtained using these innovative photocatalysts prepared at low temperatures, when compared to ZnO/biochar materials reported in previous studies. The best degradation capacities were obtained for the composites produced at 450 °C from SB and SM, with 99.3 and 97% degradation of SMX after 45 min, and 90.8 and 88.3% degradation of MO after 120 min, respectively.

Resolving the thickness of peat deposits with contact-less electromagnetic methods: A case study in the Venice coastland

Peat soils are typical deposits characterizing wetlands and reclaimed farmlands. They are important carbon reservoirs and when degraded (e.g., erosive processes, fires, draining and plowing) massive carbon dioxide volumes are released. This leads to increase greenhouse effect and induce serious land subsidence. Thus, mapping the volume of peat deposits is crucial in order to estimate the carbon mass and the potential release of carbon dioxide and consequent loss in soil elevation. Despite the importance of such estimations, forecasting and quantifying the peat thickness is still a challenge. Direct sediment coring provides local information that is difficult to extend to large territories. Indirect geophysical methods are unable to resolve lithological contrasts in the presence of saltwater contamination in coastal areas. In this work, we show the results obtained using two contact-less electromagnetic methods for the characterization of peat deposits in a peatland site of the Venice coastland, Italy. Specifically, a multi-frequency portable instrument (FDEM) and an airborne time-domain electromagnetic one (AEM), known for their very high and relatively low vertical resolution respectively, were used to collect data over a former wetland then reclaimed for agricultural purposes. Additional electrical resistivity tomography (ERT) data are used together with sediment core data to assess the effectiveness and accuracy of the contact-less methods. Results show that both FDEM and AEM are very effective in detecting the presence of the peat layer, despite its low thickness (<2 m) and the high electro-conductive subsoil because of saltwater contamination. However, the AEM method overestimated the peat thickness while the FDEM could accurately resolve the peat thickness even where the layer was thinner than 1 m. When compared to the electrical features extracted from the ERT, discrepancies are on average lower than 30%; when compared to the borehole data, discrepancies are on average slightly higher than 6%.

TiO2 nanoparticles coated with deep eutectic solvents: characterization and effect on photodegradation of organic dyes

Deep eutectic solvents (DES) have been used to modulate the catalytic activity of TiO₂ nanoparticles.

Magnetic Resonance-compatible needle-like probe based on Bragg grating technology for measuring temperature during Laser Ablation

Temperature monitoring in tissue undergone Laser Ablation (LA) may be particularly beneficial to optimize treatment outcome. Among many techniques, fiber Bragg grating (FBG) sensors show valuable characteristics for temperature monitoring in this medical scenario: good sensitivity and accuracy, and immunity from electromagnetic interferences. Their main drawback is the sensitivity to strain, which can entail measurement error for respiratory and patient movements. The aims of this work are the design, the manufacturing and the characterization of a needle-like probe which houses 4 FBGs. Three FBGs have sensitive length of 1 mm and are used as temperature sensors; one FBG with length of 10 mm is used as reference and to sense eventual strain. The optical fiber housing the FBGs was encapsulated within a needle routinely used in clinical practice to perform MRI-guided biopsy. Two materials were used for the encapsulation: i) thermal paste for the 3 FBGs used for temperature monitoring, to maximize the thermal exchange with the needle; ii) epoxy resin for the reference FBG, to improve its sensitivity to strain. The static calibration of the needle-like probe was performed to estimate the thermal sensitivity of each FBG; the step response was investigated to estimate the response time. FBGs 1 mm long have thermal sensitivity of 0.01 nm·°C(-1), whereas the reference FBG presents 0.02 nm·°C(-1). For all FBGs, the response time was in the order of 100 ms. Lastly, experiments were performed on ex vivo swine liver undergoing LA to i) evaluate the possible presence of measurement artifact, due to the direct absorption of laser light by the needle and ii) assess the feasibility of the probe in a quasi clinical scenario.

Solitary pancreatic head metastasis from tibial adamantinoma: a rare indication to pancreaticoduodenectomy

Pancreatic metastases are rare, <2% of all pancreatic neoplasia. This is the first case of pancreatic metastasis from adamantinoma, a rare, low grade and slow growing tumor which is frequently localized in long bones. We describe a case of a 45-year-old woman presenting with increased bilirubin level. Computed tomography and ecoendoscopic ultra sonography revealed a pancreatic head mass. Fine-needle aspiration biopsy was consistent with metastatic adamantinoma. The patient was submitted to a standard pancreaticoduodenectomy. As in the case presented, standard pancreatic resections are safe and feasible options to treat non-pancreatic primary tumor improving patient’s survival and quality of life.

Tapered fiber optic applicator for laser ablation: Theoretical and experimental assessment of thermal effects on ex vivo model

Laser Ablation (LA) is a minimally invasive technique for tumor removal. The laser light is guided into the target tissue by a fiber optic applicator; thus the physical features of the applicator tip strongly influence size and shape of the tissue lesion. This study aims to verify the geometry of the lesion achieved by a tapered-tip applicator, and to investigate the percentage of thermally damaged cells induced by the tapered-tip fiber optic applicator. A theoretical model was implemented to simulate: i) the distribution of laser light fluence rate in the tissue through Monte Carlo method, ii) the induced temperature distribution, by means of the Bio Heat Equation, iii) the tissue injury, by Arrhenius integral. The results obtained by the implementation of the theoretical model were experimentally assessed. Ex vivo porcine liver underwent LA with tapered-tip applicator, at different laser settings (laser power of 1 W and 1.7 W, deposited energy equal to 330 J and 500 J, respectively). Almost spherical volume lesions were produced. The thermal damage was assessed by measuring the diameter of the circular-shaped lesion. The comparison between experimental results and theoretical prediction shows that the thermal damage discriminated by visual inspection always corresponds to a percentage of damaged cells of 96%. A tapered-tip applicator allows obtaining localized and reproducible damage close to spherical shape, whose diameter is related to the laser settings, and the simple theoretical model described is suitable to predict the effects, in terms of thermal damage, on ex vivo liver. Further trials should be addressed to adapt the model also on in vivo tissue, aiming to develop a tool useful to support the physician in clinical application of LA.

Temperature influence on the response at low airflow of a variable orifice flowmeter

In mechanical ventilation, in particular when neonates are ventilated, it is crucial to accurately control the amount of the gas delivered to the patients. Mechanical ventilators are equipped with one of more flowmeters. The signal of the flowmeter is used as feedback to control the amount of gas delivered to the patients. Therefore, the accuracy of the flowmeter plays a crucial role in the accurate adjustment of the gas amount delivered by the ventilator. Among several solutions, variable area orifice meters (VAOMs) have several valuable features (e.g., good accuracy, and adequate frequency response), moreover they have the main advantage, with respect to orifice meters, related to the linearity of the response. Despite of their spread in this field, there are not studies focused on the analysis of the air temperature influence on VAOMs response. This study focuses on this topic by investigating the gas temperature influence on the response of a commercial VAOM. Experiments have been performed at low airflow (up to 1.5 L·min^-1) and at four different temperatures (i.e., from 22°C to 38°C) covering the range of interest in the field of artificial ventilation. Results show that the response of the VAOM under test is sensitive to temperature: at constant airflow the higher the temperature the higher the sensor output. This analysis may be useful to add correction to sensor output in order to reject the influence of temperature, so to minimize the measurement error due to this factor.

Miniaturized photogenerated electro-optic axicon lens Gaussian-to-Bessel beam conversion

We experimentally demonstrate an electro-optic Gaussian-to-Bessel beam-converter miniaturized down to a 30×30  μm pixel in a potassium-lithium-tantalate-niobate (KLTN) paraelectric crystal. The converter is based on the electro-optic activation of a photoinduced and reconfigurable volume axicon lens achieved using a prewritten photorefractive funnel space-charge distribution. The transmitted light beam has a tunable depth of field that can be more than twice that of a conventional beam with the added feature of being self-healing.

Diffraction-free light droplets for axially-resolved volume imaging

An ideal direct imaging system entails a method to illuminate on command a single diffraction-limited region in a generally thick and turbid volume. The best approximation to this is the use of large-aperture lenses that focus light into a spot. This strategy fails for regions that are embedded deep into the sample, where diffraction and scattering prevail. Airy beams and Bessel beams are solutions of the Helmholtz Equation that are both non-diffracting and self-healing, features that make them naturally able to outdo the effects of distance into the volume but intrinsically do not allow resolution along the propagation axis. Here, we demonstrate diffraction-free self-healing three-dimensional monochromatic light spots able to penetrate deep into the volume of a sample, resist against deflection in turbid environments, and offer axial resolution comparable to that of Gaussian beams. The fields, formed from coherent mixtures of Bessel beams, manifest a more than ten-fold increase in their undistorted penetration, even in turbid milk solutions, compared to diffraction-limited beams. In a fluorescence imaging scheme, we find a ten-fold increase in image contrast compared to diffraction-limited illuminations, and a constant axial resolution even after four Rayleigh lengths. Results pave the way to new opportunities in three-dimensional microscopy.

Nuclear Glycogen Inclusions in Canine Parietal Cells

Nuclear glycogen inclusions occur infrequently in pathologic conditions but also in normal human and animal tissues. Their function or significance is unclear. To the best of the authors' knowledge, no reports of nuclear glycogen inclusions in canine parietal cells exist. After initial observations of nuclear inclusions/pseudoinclusions during routine histopathology, the authors retrospectively examined samples of gastric mucosa from dogs presenting with gastrointestinal signs for the presence of intranuclear inclusions/pseudoinclusions and determined their composition using histologic and electron-microscopic methods. In 24 of 108 cases (22%), the authors observed various numbers of intranuclear inclusions/pseudoinclusions within scattered parietal cells. Nuclei were characterized by marked karyomegaly and chromatin margination around a central optically empty or slightly eosinophilic area. The intranuclear inclusions/pseudoinclusions stained positive with periodic acid-Schiff (PAS) and were diastase sensitive, consistent with glycogen. Several PAS-positive/diastase-sensitive sections were further examined by transmission electron microscopy, also using periodic acid-thiocarbohydrazide-silver proteinate (PA-TCH-SP) staining to identify polysaccharides. Ultrastructurally, the nuclear inclusions were composed of electron-dense particles that were not membrane bound, without evidence of nuclear membrane invaginations or cytoplasmic organelles in the nuclei, and positive staining with PA-TCH-SP, confirming a glycogen composition. No cytoplasmic glycogen deposits were observed, suggesting that the intranuclear glycogen inclusions were probably synthesized in loco. Nuclear glycogen inclusions were not associated with gastritis or colonization by Helicobacter-like organisms ( P > .05). Our findings suggest that nuclear glycogen inclusions in canine parietal cells could be an incidental finding. Nevertheless, since nuclear glycogen is present in several pathologic conditions, further investigations could be warranted to determine their true significance.

Integration of monitoring and motor-training units for a tele-rehabilitation service

A tele-rehabilitation system has been designed for general use. The service can extend the rehabilitation treatment of patients affected by neurological diseases such as stroke or multiple sclerosis to their home, while under the control, supervision and responsibility of a hospital. Part of the initial work involved identifying the functional blocks of a tele-rehabilitation service. There are three parties involved in the tele-rehabilitation service: the health provider (the central unit of the system), the health operator (the medical unit of the system, generally a therapist) and the home platform (a central console with a high level of modularity). Tele-rehabilitative services that are easy to use could radically change the routine care and rehabilitation process.

Optical measurement of breathing: algorithm volume calibration and preliminary validation on healthy trained subjects

The use of optical technologies may be beneficial when measuring breathing biomechanics. The purpose of this study was twofold: i) to enhance the optoelectronic plethysmography (OEP) algorithm performance for the volume estimation by the use of a novel volume calibration procedure and ii) to compare the OEP volumes gained by a commercial optoelectronic system against actual respiratory volumes measured by a breath-by-breath gas analyzer (BbB). The OEP volume algorithm calibration was performed by the use of a novel volume calibration procedure based on both a calibrator device that delivered known volumes changes and one ad-hoc designed software for the static and dynamic calibration analysis. OEP algorithm threshold, accuracy, repeatability and the volume algorithm calibration were investigated. Tidal volume (VT) measurements performed simultaneously by the calibrated OEP algorithm and BbB analyzer were compared. VT measured simultaneously by OEP and BbB was collected during submaximal exercise tests in five trained healthy participants in two conditions (with hunched shoulders and in normal shoulder position). The two methods were compared by linear regression and Bland-Altman analysis in both positions. The average difference between methods and the discrepancy were calculated. The OEP-BbB correlation was high in both positions, R2=0.92 and R2=0.97 for hunch and normal one, respectively. Bland-Altman analysis demonstrated that OEP algorithm systematic difference was lower than 100mL. The limits of agreement assessed in both positions are comparable. The difference between measurements suggesting that OEP may be a useful tool to analyze chest wall volume changes and breathing mechanics during intense exercise.

A novel tool and procedure for in-situ volumetric calibration of motion capture systems for breathing analysis

Optical motion capture systems are widely used in biomechanics although have not been significantly explored for measuring volumes and volume variations yet. The aim of this study was to propose and test a completely novel procedure for the calibration of motion capture systems for the breathing analysis in terms of volume measurements, by the use of a tool consisting in an ad-hoc designed in-situ calibration device (CD) and two algorithms for calibration. Both the calibration tool and the calibration procedure performed in the range 0-2780mL on an Optoelectronic Plethysmography (OEP) system are presented. The CD delivered known volume (ΔVCD) variations to the OEP; the two algorithms performed the calibration by the comparison between ΔVCD and OEP recorded volume (ΔVOEP), in both static and dynamic conditions. Discrimination threshold, accuracy, precision and repeatability for the volume variation measurements have been evaluated, as well as the calibration curve of the OEP. OEP volume threshold of ±8.92mL was assessed; the volume measurement accuracy was always better than 6.0% of measured volume, and a volume repeatability of ±2.7mL was found. Lastly, the calibration curve was assessed to be ΔVOEP= 0.962·ΔVCD. Results demonstrate that the proposed calibration procedure can be useful to provide an in-situ accurate calibration of motion capture systems in the volume analysis, to optimize the hardware and the software of the available system for volume measurement as well as to establish the motion capture system appropriateness, in terms of technical suitability and data quality.

Preoperative oral immunonutrition versus standard preoperative oral diet in well nourished patients undergoing pancreaticoduodenectomy

BACKGROUND

Pancreaticoduodenectomy is still associated to high morbility, especially due to pancreatic surgery related and infectious complications: many risk factors have already been advocated. Aim of this study is to evaluate the role of preoperative oral immunonutrition in well nourished patients scheduled for pancreaticoduodenectomy.

METHODS

From February 2014 to June 2015, 54 well nourished patients undergoing pancreaticoduodenectomy were enrolled for 5 days preoperative oral immunonutrition. A series of consecutive patients submitted to the same intervention in the same department, with preoperative standard oral diet, was matched 1:1. For analysis demographic, pathological and surgical variables were considered. Mortality rate, overall postoperative morbility, pancreatic fistula, post pancreatectomy haemorrhage, delayed gastric emptying, infectious complications and length of hospital stay were described for each groups. Chi squared test, Fisher's Exact test and Student's T test were used for comparison. Differences were considered statistically significant at p < 0.05. Statistics was performed using a freeware Microsoft Excel (®) based program and SPSS v 10.00.

RESULTS

No statistical differences in term of mortality (2.1% in each groups) and overall morbility rate (41.6% vs 47.9%) occurred between the groups as well as for pancreatic surgery related complications. Conversely, statistical differences were found for infectious complications (22.9% vs 43.7%, p = 0.034) and length of hospital stay (18.3 ± 6.8 days vs 21.7 ± 8.3, p = 0.035) in immunonutrition group.

CONCLUSION

Preoperative oral immunonutrition is effective for well nourished patients scheduled for pancreaticoduodenectomy; it helps to reduce the risk of postoperative infectious complications and length of hospital stays.

The Third Italian Consensus Conference for Malignant Pleural Mesothelioma: State of the art and recommendations

Malignant Pleural Mesothelioma (MPM) remains a relevant public health issue, and asbestos exposure is the most relevant risk factor. The incidence has considerably and constantly increased over the past two decades in the industrialized countries and is expected to peak in 2020-2025. In Italy, a standardized-rate incidence in 2011 among men was 3.5 and 1.25 per 100,000 in men and women, respectively, and wide differences are noted among different geographic areas. The disease remains challenging in terms of diagnosis, staging and treatment and an optimal strategy has not yet been clearly defined. The Third Italian Multidisciplinary Consensus Conference on Malignant Pleural Mesothelioma was held in Bari (Italy) in January 30-31, 2015. This Consensus has provided updated recommendations on the MPM management for health institutions, clinicians and patients.

Closing system-wide yield gaps to increase food production and mitigate GHGs among mixed crop-livestock smallholders in Sub-Saharan Africa

In this study we estimate yield gaps for mixed crop-livestock smallholder farmers in seven Sub-Saharan African sites covering six countries (Kenya, Tanzania, Uganda, Ethiopia, Senegal and Burkina Faso). We also assess their potential to increase food production and reduce the GHG emission intensity of their products, as a result of closing these yield gaps. We use stochastic frontier analysis to construct separate production frontiers for each site, based on 2012 survey data prepared by the International Livestock Research Institute for the Climate Change, Agriculture and Food Security program. Instead of relying on theoretically optimal yields-a common approach in yield gap assessments-our yield gaps are based on observed differences in technical efficiency among farms within each site. Sizeable yield gaps were estimated to be present in all of the sites. Expressed as potential percentage increases in outputs, the average site-based yield gaps ranged from 28 to 167% for livestock products and from 16 to 209% for crop products. The emission intensities of both livestock and crop products registered substantial falls as a consequence of closing yield gaps. The relationships between farm attributes and technical efficiency were also assessed to help inform policy makers about where best to target capacity building efforts. We found a strong and statistically significant relationship between market participation and performance across most sites. We also identified an efficiency dividend associated with the closer integration of crop and livestock enterprises. Overall, this study reveals that there are large yield gaps and that substantial benefits for food production and environmental performance are possible through closing these gaps, without the need for new technology.

Evaluation of optoelectronic Plethysmography accuracy and precision in recording displacements during quiet breathing simulation

Opto-electronic Plethysmography (OEP) is a motion analysis system used to measure chest wall kinematics and to indirectly evaluate respiratory volumes during breathing. Its working principle is based on the computation of marker displacements placed on the chest wall. This work aims at evaluating the accuracy and precision of OEP in measuring displacement in the range of human chest wall displacement during quiet breathing. OEP performances were investigated by the use of a fully programmable chest wall simulator (CWS). CWS was programmed to move 10 times its eight shafts in the range of physiological displacement (i.e., between 1 mm and 8 mm) at three different frequencies (i.e., 0.17 Hz, 0.25 Hz, 0.33 Hz). Experiments were performed with the aim to: (i) evaluate OEP accuracy and precision error in recording displacement in the overall calibrated volume and in three sub-volumes, (ii) evaluate the OEP volume measurement accuracy due to the measurement accuracy of linear displacements. OEP showed an accuracy better than 0.08 mm in all trials, considering the whole 2m(3) calibrated volume. The mean measurement discrepancy was 0.017 mm. The precision error, expressed as the ratio between measurement uncertainty and the recorded displacement by OEP, was always lower than 0.55%. Volume overestimation due to OEP linear measurement accuracy was always <; 12 mL (<; 3.2% of total volume), considering all settings.

III Italian Consensus Conference on Malignant Mesothelioma of the Pleura. Epidemiology, Public Health and Occupational Medicine related issues

The III Italian Consensus Conference on Pleural Mesothelioma (MM) convened on January 29th 2015. This report presents the conclusions of the 'Epidemiology, Public Health and Occupational Medicine' section. MM incidence in 2011 in Italy was 3.64 per 100,000 person/years in men and 1.32 in women. Incidence trends are starting to level off. Ten percent of cases are due to non-occupational exposure. Incidence among women is very high in Italy, because of both non-occupational and occupational exposure. The removal of asbestos in place is proceeding slowly, with remaining exposure. Recent literature confirms the causal role of chrysotile. Fibrous fluoro-edenite was classified as carcinogenic by IARC (Group 1) on the basis of MM data. A specific type (MWCNT-7) of Carbon Nanotubes was classified 2B. For pleural MM, after about 45 years since first exposure, the incidence trend slowed down; with more studies needed. Cumulative exposure is a proxy of the relevant exposure, but does not allow to distinguish if duration or intensity may possibly play a prominent role, neither to evaluate the temporal sequence of exposures. Studies showed that duration and intensity are independent determinants of MM. Blood related MM are less than 2.5%. The role of BAP1 germline mutations is limited to the BAP1 cancer syndrome, but negligible for sporadic cases. Correct MM diagnosis is baseline; guidelines agree on the importance of the tumor gross appearance and of the hematoxylin-eosin-based histology. Immunohistochemical markers contribute to diagnostic confirmation: the selection depends on morphology, location, and differential diagnosis. The WG suggested that 1) General Cancer Registries and ReNaM Regional Operational Centres (COR) interact and systematically compare MM cases; 2) ReNaM should report results presenting the diagnostic certainty codes and the diagnostic basis, separately; 3) General Cancer Registries and COR should interact with pathologists to assure the up-to-date methodology; 4) Necroscopy should be practiced for validation. Expert referral centres could contribute to the definition of uncertain cases. Health surveillance should aim to all asbestos effects. No diagnostic test is recommended for MM screening. Health surveillance should provide information on risks, medical perspective, and smoking cessation. The economic burden associated to MM was estimated in 250,000 Euro per case.

A micro opto-mechanical displacement sensor based on micro-diffraction gratings: design and characterization

A micro opto-mechanical displacement sensor is here presented. It is constituted by a sensing element based on two overlapped micro-diffraction gratings (MDGs). They present a platinum layer (45 nm of thick) on a glass substrate, a period of 525 µm constituted by a width of 150 µm of platinum separated (71.4% duty cycle). The working principle is based on the modulation of light intensity induced by the relative displacement between the MDGs: when a laser light perpendicularly hits the MDGs, the intensity of the transmitted light is a periodic function of the relative displacement between the two MDGs. A fiber optic is used to transport the transmitted light to a photodetector in order to avoid concerns related to the alignment between the optical components. The sensor's output is the ratio between the light intensity measured by the photodetector during the displacement of the MDGs and largest light intensity values measured in the whole range of measurement, therefore, it is lower than 1. The proposed sensor allows to discriminate displacement lower than 10 µm, using a cost effective micro-fabrication process implemented by the technique of Lift-Off. It shows a good linear behaviour in two ranges covering about one half of the MDGs period. Within the linear ranges it shows high sensitivity (about 0.5%/µm) and good accuracy (lower than 4% in the whole range of calibration); furthermore, the results show that a design with a duty cycle of 50% overcomes the marked decrease of sensitivity in a range of measurement corresponding to a grating period.

Design and characterization of a measurement system for monitoring pressure exerted by bronchial blockers: In vitro trials

Bronchial blockers (BBs) allow occluding the bronchial duct and collapsing the "dependent" lung in a number of thoracic surgery. The occlusion is obtained through a cuff that, inflated with a proper air volume, exerts a pressure, Pe, on the inner wall of the mainstem bronchus. In this work a measurement chain, based on two piezorestistive force sensors, was developed and calibrated to measure Pe exerted by six BBs, as a function of inflated volume on in vitro models (two latex ducts with diameters similar to the ones of the adult mainstem bronchi: 12 mm and 15 mm). Pe showed wide changes considering different BBs, and significantly increases with the decrease of the model's diameter, at the same inflated volume. Lastly, the minimum occlusive volume (MOV) to sail the two models was estimated for each BB. These experiments were performed by applying a pressure difference across the cuff of 25 cmH2O, in order to simulate the worst condition in a clinical scenario. Results show that MOV depends on both the type of BB and the duct diameter. The knowledge of this volume allows estimating the minimum value of Pe exerted by BBs to avoid air leakage.

Goniometric measurement for the estimation of anisotropy coefficient of human and animal pancreas

Estimation of optical properties of biologic tissues is determinant for laser dosimetry in medical applications. Tissues highly absorb and scatter the light in near infrared spectrum, where the laser provides therapeutic effects. Novel frontiers of clinical practice, e.g., the employment of laser light for the treatment of pancreatic cancer, require information about pancreas-laser interaction, which are crucial for therapy management. The property of biological tissues to scatter the light traveling through is described by the anisotropy coefficient (g). The relationship between g and the angular distribution of the scattered light is described by Henyey-Greenstein phase function. The measurement of angular distribution of scattered light is performed by the goniometric technique. This paper describes the estimation of g of ex vivo pancreas at 1064 nm, performed by a goniometric-based system, where a photodetector measures intensities of scattered light at fixed angles between -120° and 120°. A two-term Henyey-Greenstein phase function has been employed to estimate anisotropy coefficient for forward (gfs) and backward scattering (gbs). Experimental trails were performed to assess the repeatability of measurement system: percentage value of standard deviation is generally lower than 8% for angles higher (lower) than 13° (13°). Measurements were performed for the first time on healthy swine pancreas, aiming to investigate the influence of coagulation temperature: gfs decreases from 0.94 (at 25 °C) to 0.93 (at 80 °C). Afterwards, the same set up has been employed for the estimation of g of human pancreas affected by neuroendocrine tumor, which presented an estimated values for gfs of 0.89.

Influence of FBG sensors length on temperature measures in laser-irradiated pancreas: theoretical and experimental evaluation

Temperature distribution T(x,y,z,t) in tissue undergoing Laser-induced Interstitial Thermotherapy (LITT) plays a crucial role on treatment outcome. Theoretical and experimental assessment of temperature on ex vivo laser-irradiated pancreas is presented. The aim of this work is to assess the influence of thermometers dimensions on temperature measures during LITT. T(x,y,z,t) inside tissue is monitored by optical sensors, i.e., Fiber Bragg Gratings (FBGs): three FBGs with lengths of 10 mm and nine FBGs of 1 mm, at different distances (2 mm, 5 mm and 10 mm) and different quotes (0 mm, 2 mm and 4 mm) from the laser fiber tip are used. Theoretical punctual T(x,y,z,t) is averaged out on both 10 mm and 1 mm in order to compare numerical predictions with experimental data. Results demonstrate the influence of FBG length on T(x,y,z,t) measures. This phenomenon depends on the distance between sensor and applicator: it is particularly significant close to the applicator tip (2 mm) because of the high spatial T(x,y,z,t) gradient within the tissue. Both theoretical results and experimental ones show that just at a distance of 10 mm from the tip, differences between T(x,y,z,t) provided by FBGs of 10 mm and 1 mm are negligible.

Monitoring of temperature increase and tissue vaporization during laser interstitial thermotherapy of ex vivo swine liver by computed tomography

Laser interstitial thermotherapy (LITT) is a minimally invasive technique used to thermally destroy tumour cells. Being based on hyperthermia, LITT outcome depends on the temperature distribution inside the tissue. Recently, CT scan thermometry, based on the dependence of the CT number (HU) on tissue temperature (T) has been introduced during LITT; it is an attractive approach to monitor T because it overcomes the concerns related to the invasiveness. We performed LITT on nine ex vivo swine livers at three different laser powers, (P=1.5 W, P=3 W, P=5 W) with a constant treatment time t=200 s; HU is averaged on two ellipsoidal regions of interest (ROI) of 0.2 cm2, placed at two distances from the applicator (d=3.6 mm and d=8.7 mm); a reference ROI was placed away from the applicator (d=30 mm). The aim of this study is twofold: 1) to evaluate the effect of the T increase in terms of HU variation in ex vivo swine livers undergoing LITT; and 2) to estimate the P value for tissue vaporization. To the best of our knowledge, this is the first study focused on the HU variation in swine livers undergoing LITT at different P. The reported findings could be useful to assess the effect of LITT on the liver in terms of both T changes and tissue vaporization, with the aim to obtain an effective therapy.

Role of TachoSil® in distal pancreatectomy: a single center experience

AIM

Distal pancreatectomies (DP) are associated with high risk of postoperative complications, and in many series higher morbidity rate than duodenopancreatectomies has been reported. To evaluate the role of a collagen sponge with human fibrinogen and thrombin film (TachoSil®) in limiting the incidence of complications after DP.

METHODS

From 1996 to 2013, 221 patients have been submitted to distal pancreatectomy (± splenectomy) in our Division. A retrospective analysis has been conducted in a group of 36 consecutive and prospectively collected DP treated with intraoperative placement of TachoSil® on pancreatic stump from 2010 to 2013 (group 1). A control series of 36 consecutive patients (group 2) was matched 1:1 from hystorical database. The variables considered in the analysis were: age, gender, ASA score, pancreatic texture (hard vs. soft), histology, operative time, postoperative mortality, morbility (postoperative pancreatic fistula - POPF, postoperative hemorrage - PPH, delayed gastric emptying - DGE) and hospital stay. Differences between POPF, PPH, DGE and hospital stays between grops were investigated with χ² and t-Student test. Univariate analysis was conducted to determine factors related to POPF development. Statistical analysis was performed using freeware Microsoft Excel based program.

RESULTS

Post operative mortality was 0% in both groups. POPF were registered in 36.1% (13/36) and 41.6 % (15/36) in groups 1 and 2, respectively (P=n.s.); in group 1 we didn't observe grade C POPF, while 4 patients in control group developed grade C POPF (P<0,05). No differences were found between two groups in terms of incidence of PPH and DGE. The median duration of postoperative hospital stay in group 1 was 21.8 (7-189) days compared with 31.13 (9-249) days in group 2 (P<0.001).

CONCLUSION

The use of TachoSil® seems to be associated with lower incidence of grade C POPF but larger controlled trials are needed to surely assess the usefulness of TachoSil® in pancreatic surgery in order to reduce pancreatic specific complications and their severity.

Estimation of anisotropy coefficient and total attenuation of swine liver at 850 nm based on a goniometric technique: influence of sample thickness

Estimation of optical properties of biologic tissue is crucial for theoretical modeling of laser treatments in medicine. Tissue highly absorbs and scatters the light between 650 nm and 1300 nm, where the laser provides therapeutic effects. Among other properties, the characteristic of biological tissues to scatter the light traveling trough, is described by the anisotropy coefficient (g). The relationship between g and the distribution of the scattered light at different angles is described by Henyey-Greenstein phase function. The measurement of angular distribution of scattered light is performed by the goniometric technique. This paper describes the estimation of g and attenuation coefficient, μt, of swine liver at 850 nm, performed by an ad hoc designed goniometric-based system, where a spectrometer measures intensities of scattered light at fixed angles (0°, 30°, 45°, 60, 120°, 135° and 150°). Both one-term and two-term Henyey-Greenstein phase function have been employed to estimate anisotropy coefficient for forward (gfs) and backward scattering (gbs). Measurements are performed on samples of two thicknesses (60 um and 30 urn) to investigate the influence of this factor on g, and repeated 6 times for each thickness. The estimated values of gfs were 0.947 and 0.951 for thickness of 60 μm and 30 μm, respectively; the estimations of gfs were -0.498 and -0.270 for thickness of 60 μm and 30 μm, respectively. Moreover, μt of liver has been estimated (i.e., 90±20 cm(1)), through Lambert-Beer equation. The comparison of our results with data reported in literature encourages the use of the ad hoc designed tool for performing experiments on other tissue, and at other wavelengths.

Estimation of liver iron concentration by dual energy CT images: influence of X-ray energy on sensitivity

In hemochromatosis an abnormal accumulation of iron is present in parenchymal organs and especially in liver. Among the several techniques employed to diagnose the iron overload, magnetic resonance imaging (MRI) and Computed Tomography (CT) are the most promising non-invasive ones. MRI is largely used but shows limitation including an overestimation of iron and inability to quantify iron at very high concentrations. Therefore, some research groups are focusing on the estimation of iron concentration by CT images. Single X-ray CTs are not able to accurately perform this task in case of the presence of confounding factors (e.g., fat). A potential solution to overcome this concern is the employment of Dual-Energy CT (DECT). The aim of this work is to investigate influence of the kVp and mAs on CT number sensitivity to iron concentration. A phantom with test tubes filled with homogenized porcine liver at different iron concentrations, has been scanned with DECT at different mAs. The images have been analyzed using an ad-hoc developed algorithm which allows minimizing the influence of air bubbles present in the homogenized. Data show that the sensitivity is strongly influenced by kVp (its value almost halves from 80 kVp to 140 kVp; e.g. 0.41 g·μmol(-1) and 0.19 g·μmol(-1) at 80 kVp/120 mAs and 140 kVp/60 mAs respectively), on the other hand the influence of mAs value is negligible.

Feasibility assessment of CT-based thermometry for temperature monitoring during thermal procedure: Influence of ROI size and scan setting on metrological properties

Computed tomography (CT) thermometry belongs to the wide class of non-invasive temperature monitoring techniques, which includes ultrasound and Magnetic Resonance thermometry. Non-invasive techniques are particularly attractive to be used in hyperthermal procedures for their ability to produce a three-dimensional temperature map and because they overcome the risks related to the insertion of sensing elements.

Design and development of a rheometer for biological fluids of limited availability

From studies on the dynamic characterization of human bones, it is noticed that reference data on the viscous behavior of the bone marrow are quite poor. Dependently from marrow limited availability and its opacity, we have not been able to retrieve a tool of appropriate characteristics able to measure bone marrow viscosity. Therefore, principal techniques for the viscosity measurement have been preliminarily examined, and a device suitable for viscosity measurements of biological fluids has been realized. In particular, a rotational rheometer has been developed: it is a coaxial cylinders system, where the fluid flows dragged by the inner cylinder. The device is an absolute rheometer, that is, particularly useful as nowadays it is not known the classification of the bone as far as it concerns its viscous behavior. In this work a preliminary evaluation of the metrological characteristics of the measurement system has been carried out and its main metrological performances have been evaluated.

Performances of heated humidifiers in mechanical ventilation: a preliminary intra-breath analysis

A correct humidification of gases delivered to mechanically ventilated patients is essential to avoid some complications. Heated Humidifiers (HHs) are widely used in long lasting ventilation to treat gases delivered to patients. Their performances depend on some parameters, such as environmental conditions and ventilatory settings. The aim of this work is to experimentally assess the influence of minute volume (MV), respiratory frequency (f) and the ratio between duration of inspiration and expiration (I:E) on HHs performances in terms of relative humidity (RH) at the humidification chamber outlet. The main novelty of this work is the assessment of RH oscillations during artificial ventilation. Results show marked oscillations of RH during a single breath (ripple of 20% in the worst case); oscillations decrease if f and I:E increase, on the other hand they increase with MV. Since the variation of gas temperature during a respiratory act can be neglected, the RH oscillations are related to the vapour content in the delivered gases. These results further support the hypothesis which asserts that HHs performances could be improved by using a control strategy taking into account ventilatory settings.

[Reconstruction of past asbestos exposure of dockers in the Port of Livorno]

INTRODUCTION

In the period 1957/1995 more than 200,000 tons of asbestos arrived at the Port of Livorno. This paper attempts to reconstruct the levels of exposure of the dockers during this period, given the absence of any environmental investigations.

METHODS

The estimates were calculated using the quantities unloaded annually, the number of dockers, the duration and frequency of the unloading operations, the type of packaging and the background pollution. The Time Weighted Average annual exposure allows calculation of a range of cumulative exposure for each worker with a known period of employment. The working methods were reconstructed interviewing employees and the levels of pollution used in the calculations were partly obtained from published data.

RESULTS

Significant doses were accumulated by dockers who worked at the port in the 60's and 70's. Non-coincidence of the period with the highest imports with that of highest exposure is worth highlighting. Since 1980 the annual average exposure levels were well below the level required for granting insurance compensation benefits. This suggests caution in the use of lists of beneficiaries for epidemiological purposes since the statistical power would be very low.

CONCLUSIONS

The strongest point of the research is the estimated annual TWA exposure that, regardless of the accuracy of the data, does however allow an epidemiological analysis of the cohort for subgroups with different exposure. The twenty-three cases of mesothelioma already recorded in this cohort were first employed before 1966. This method can be used to estimate exposure in other ports, where basic information is available.