Classification and distribution of freshwater microplastics along the Italian Po river by hyperspectral imaging.

In this work, freshwater microplastic samples collected from four different stations along the Italian Po river were characterized in terms of abundance, distribution, category, morphological and morphometrical features, and polymer type. The correlation between microplastic category and polymer type was also evaluated. Polymer identification was carried out developing and implementing a new and effective hierarchical classification logic applied to hyperspectral images acquired in the short-wave infrared range (SWIR: 1000-2500 nm). Results showed that concentration of microplastics ranged from 1.89 to 8.22 particles/m3, the most abundant category was fragment, followed by foam, granule, pellet, and filament and the most diffused polymers were expanded polystyrene followed by polyethylene, polypropylene, polystyrene, polyamide, polyethylene terephthalate and polyvinyl chloride, with some differences in polymer distribution among stations. The application of hyperspectral imaging (HSI) as a rapid and non-destructive method to classify freshwater microplastics for environmental monitoring represents a completely innovative approach in this field.

Non-destructive characterization of mechanically processed waste printed circuit boards - particle liberation analysis.

This work aimed to develop and propose methods for evaluating the metal degree of liberation to characterize the metal deportment/concentration and liberation/association of mechanically processed waste Printed Circuit Boards (PCBs) that hold the complex and heterogeneity structure and metal distribution/association. Waste PCBs passed through a series of mechanical processing (i.e. comminution, sieving) for the metal recovery were characterized to understand and to evaluate the metal distribution and degree of liberation of the metals in order to optimize the comminution process, avoiding excessive fine particle production. The characterizations were performed at laboratory scale, as well as utilizing large scale experimental facilities, i.e. a portable X-Ray Fluorescence (XRF), micro-XRF and Synchrotron X-Ray Tomography. The proposed methods confirmed that metal liberation was very high in the fine size fraction (0.125-0.350 mm) while many locked particles were identified in the coarse size fraction (0.350-0.500 mm). Such results were analyzed and were discussed in order to better understand metal deportment/concentration behaviors. The advantages and disadvantages related to the different characterization approaches were identified and discussed in this paper, as well as their methodological developments in a waste PCBs' mechanical processing perspective.

Teriparatide (rhPTH) treatment in children with syndromic hypoparathyroidism.

BACKGROUND: Subcutaneous recombinant human parathormone [rhPTH (1-34)] has been introduced for hypoparathyroidism treatment, allowing avoidance of vitamin D and calcium side effects. OBJECTIVE: Our objective was to evaluate rhPTH (1-34) safety and efficacy in pediatric patients with genetically proved syndromic hypoparathyroidism. METHODS: The study was a 2.5-year self-controlled trial on six pediatric patients (four males, two females, age 9.8±5.1 years) with syndromic hypoparathyroidism including three with autoimmune polyendocrinopathy candidiasis ectodermal dysplasia (APECED) syndrome, two with DiGeorge syndrome, and one with hypoparathyroidism-deafness-renal dysplasia syndrome. We compared patients' clinical and biochemical outcome of conventional treatment based on oral administration of calcium (1-1.5 g/day in three doses) plus oral calcitriol (6.5-33 ng/kg per day in two to three doses) with the outcome obtained with rhPTH (1-34) (teriparatide, 12.5 µg bid). Therapy shift was conducted introducing rhPTH (1-34) while progressively withdrawing calcium and vitamin D. Blood calcium, phosphorus, alkaline phosphatase, and urinary calcium-to-creatinine ratio (mg/mg) before and during rhPTH therapy were compared. RESULTS: rhPTH treatment allowed complete calcium and vitamin D withdrawal in two patients, calcium withdrawal in three and reduction of vitamin D dose in two. During rhPTH (1-34), mean blood calcium, phosphorus, and alkaline phosphatase were not significantly modified, whereas significant reduction of the calciuria-to-creatininuria ratio (0.55±0.31 vs. 0.1±0.1, p=0.02) was obtained. The number of tetanic episodes was reduced in four patients during teriparatide treatment compared to conventional treatment. CONCLUSION: In children with syndromic hypoparathyroidism, substitutive treatment with rhPTH (1-34) maintains adequate blood calcium levels and allows prompt normalization of urinary calcium excretion, through direct action on the kidney and through calcium and vitamin D therapy layoff.

Combined treatment with bicalutamide and anastrozole in a young boy with peripheral precocious puberty due to McCune-Albright Syndrome.

McCune-Albright Syndrome (MAS) is a congenital endocrine disorder due to mosaic tissutal hyper-function. We describe a boy with a molecularly confirmed MAS, clinically evident with congenital café-au-lait spots, bone fibrous dysplasia, hyperthyroidism, and renal phosphate wasting syndrome. At 4.6 years of age he disclosed a rapid progression of peripheral puberty, so we decided to treat him with bicalutamide 25 mg/day and anastrozole 1 mg/day. Combined third generation aromatase inhibitors - competitive androgen receptor blockers were employed in familial male precocious puberty (FMPP). Combined treatment was performed for 49 months from the age of 4.6 to 6.7 years. The patient underwent clinical, laboratory, and instrumental evaluation twice a year from the first admission to the current age. This treatment caused a rapid normalization of growth velocity, subsequent reduction of penile androgenization, and stabilization of testicular volume. The therapy was well tolerated for all its duration and neither side effects, nor secondary hypothalamic activation were noted. This report provides further evidence of effectiveness and safety of combined third generation aromatase inhibitors - competitive androgen receptor blockers in male precocious peripheral puberty, firstly employed in male MAS, and contributes to expand the spectrum of disorders in which their employment may reveal promising.

Bone impairment in phenylketonuria is characterized by circulating osteoclast precursors and activated T cell increase.

BACKGROUND: Phenylketonuria (PKU) is a rare inborn error of metabolism often complicated by a progressive bone impairment of uncertain etiology, as documented by both ionizing and non- ionizing techniques. METHODOLOGY: Peripheral blood mononuclear cell (PBMC) cultures were performed to study osteoclastogenesis, in the presence or absence of recombinant human monocyte-colony stimulating factor (M-CSF) and receptor activator of NFκB ligand (RANKL). Flow cytometry was utilized to analyze osteoclast precursors (OCPs) and T cell phenotype. Tumour necrosis factor α (TNF-α), RANKL and osteoprotegerin (OPG) were quantified in cell culture supernatants by ELISA. The effects of RANKFc and anti-TNF-α antibodies were also investigated to determine their ability to inhibit osteoclastogenesis. In addition, bone conditions and phenylalanine levels in PKU patients were clinically evaluated. PRINCIPAL FINDINGS: Several in vitro studies in PKU patients' cells identified a potential mechanism of bone formation inhibition commonly associated with this disorder. First, PKU patients disclosed an increased osteoclastogenesis compared to healthy controls, both in unstimulated and M-CSF/RANKL stimulated PBMC cultures. OCPs and the measured RANKL/OPG ratio were higher in PKU patients compared to healthy controls. The addition of specific antagonist RANKFc caused osteoclastogenesis inhibition, whereas anti-TNF-α failed to have this effect. Among PBMCs isolated from PKU patients, activated T cells, expressing CD69, CD25 and RANKL were identified. Confirmatory in vivo studies support this proposed model. These in vivo studies included the analysis of osteoclastogenesis in PKU patients, which demonstrated an inverse relation to bone condition assessed by phalangeal Quantitative Ultrasound (QUS). This was also directly related to non-compliance to therapeutic diet reflected by hyperphenylalaninemia. CONCLUSIONS: Our results indicate that PKU spontaneous osteoclastogenesis depends on the circulating OCP increase and the activation of T cells. Osteoclastogenesis correlates with clinical parameters, suggesting its value as a diagnostic tool for an early assessment of an increased bone resorption in PKU patients.

Bone quantitative ultrasound in congenital and acquired childhood multiple pituitary failure.

The aim of the present study is to investigate bone status by phalangeal quantitative ultrasound (QUS) in a cohort of hypopituitaric pediatric subjects, and to relate measurement outcome to their clinical, laboratory, and therapeutical features. Forty-three hypopituitaric children were submitted to bone measurement by QUS with DBM sonic bone profiler 1200 (IGEA, Carpi, Modena, Italy). This method measures bone transmission time (BTT) and amplitude-dependent speed of sound (AD-SoS) of an ultrasound beam crossing the first four phalanges of the hand and provides respective standard deviation scores (SDS). These two parameters provide information on bone mineral density and structure. Clinical, laboratory and therapeutical features were considered to look for correlations. Overall BTT and AD-SoS SDS were significantly reduced (-0.87 +/- 1.52, p = 0.001, and -0.97 +/- 1.56, p = 0.001) as well as respective height- or bone age-corrected SDS. Bone condition proved significantly worse in subjects with higher number of hormonal deficiencies (p = 0.001 for both parameters) and in those with acquired hypopituitarism (p = 0.020 for BTT and p = 0.010 for AD-SoS) than in those with congenital forms. In participants under growth hormone (GH) treatment, regression analysis revealed that QUS measurement outcome was significantly associated with age at GH therapy start (p = 0.001), time interval before therapy initiation (p = 0.011), treatment duration (p = 0.007) and administered dosage (p = 0.036). Our data show that childhood hypopituitarism is associated with bone morbidity, detectable at QUS measurement independently of potential confounders as stature and bone age. Skeletal impairment is related to acquired hypopituitarism, number of hormonal deficiencies and duration of disease before replacement therapies, whereas GH treatment duration and doses are associated with a better skeletal condition. Phalangeal QUS measurements of BTT and AD-SoS promise as a reliable method for obtaining quantitative measurements of bone disease in individuals with hypopituitarism but more studies are needed for verification.