Consistent determination of the heating rate of light-absorbing aerosol using wavelength- and time-dependent Aethalometer multiple-scattering correction.

Accurate and temporally consistent measurements of light absorbing aerosol (LAA) heating rate (HR) and of its source apportionment (fossil-fuel, FF; biomass-burning, BB) and speciation (black and brown Carbon; BC, BrC) are needed to evaluate LAA short-term climate forcing. For this purpose, wavelength- and time-dependent accurate LAA absorption coefficients are required. HR was experimentally determined and apportioned (sources/species) in the EMEP/ACTRIS/COLOSSAL-2018 winter campaign in Milan (urban-background site). Two Aethalometers (AE31/AE33) were installed together with a MAAP, CPC, OPC, a low volume sampler (PM2.5) and radiation instruments. AE31/AE33 multiple-scattering correction factors (C) were determined using two reference systems for the absorption coefficient: 1) 5-wavelength PP_UniMI with low time resolution (12 h, applied to PM2.5 samples); 2) timely-resolved MAAP data at a single wavelength. Using wavelength- and time-independent C values for the AE31 and AE33 obtained with the same reference device, the total HR showed a consistency (i.e. reproducibility) with average values comparable at 95% probability. However, if different reference devices/approaches are used, i.e. MAAP is chosen as reference instead of a PP_UniMI, the HR can be overestimated by 23-30% factor (by both AE31/AE33). This became more evident focusing on HR apportionment: AE33 data (corrected by a wavelength- and time-independent C) showed higher HRFF (+24 ± 1%) and higher HRBC (+10 ± 1%) than that of AE31. Conversely, HRBB and HRBrC were -28 ± 1% and -29 ± 1% lower for AE33 compared to AE31. These inconsistencies were overcome by introducing a wavelength-dependent Cλ for both AE31 and AE33, or using multi-wavelength apportionment methods, highlighting the need for further studies on the influence of wavelength corrections for HR determination. Finally, the temporally-resolved determination of C resulted in a diurnal cycle of the HR not statistically different whatever the source- speciation- apportionment used.

Effectiveness of Progressive Muscle Relaxation and Deep Breathing Exercise on Pain, Disability, and Sleep Among Patients With Chronic Tension-Type Headache: A Randomized Control Trial.

A randomized control trial was conducted to assess the effectiveness of progressive muscle relaxation and deep breathing exercises on pain, disability, and sleep quality among patients with chronic tension-type headache. Of the 169 randomly selected patients, 84 performed the intervention and reported less pain severity and disability and better sleep quality after 12 weeks.

Composition and origin of PM2.5 in Mediterranean Countryside.

In this work PM2.5 was collected during winter and summer in a Sardinian village (Gonnostramatza, Italy) highly affected by biomass burning emissions. A multi-technique approach was adopted for the complete PM chemical characterization. The bulk characterization was performed by IC (Ion Chromatography), HPAEC (High-Performance Anion-Exchange Chromatography), TOT (Thermal Optical Transmittance) and ED-XRF (Energy-Dispersive X-Ray Fluorescence) while XPS (X-ray Photoelectron Spectroscopy) was used for the surface characterization. Using levoglucosan as specific tracer of biomass burning emissions, the assessment of the impact of this source was carried out and it represent the major PM source at the investigate site during winter. In winter the average levoglucosan concentration is 2096 ±â€¯324 ng/m3 while during summer its concentration is negligible (18 ±â€¯7 ng/m3). Levoglucosan content in PM2.5 during winter is on average 13.7%; it is estimated that 65% of PM2.5 is due to wood burning. XPS has been exploited in this work aiming at highlighting possible differences between surface and bulk composition of PM2.5. The surface of the particulate matter resulted enriched in carbon compared to the bulk. Among the components of XPS C1s signals recorded on the samples collected during winter, it was found that the signal at 286.5 eV, which is due to the presence of COH, reflects the bulk composition of levoglucosan.

Assessment of light extinction at a European polluted urban area during wintertime: Impact of PM1 composition and sources.

In this paper, results from receptor modelling performed on a well-characterised PM1 dataset were combined to chemical light extinction data (bext) with the aim of assessing the impact of different PM1 components and sources on light extinction and visibility at a European polluted urban area. It is noteworthy that, at the state of the art, there are still very few papers estimating the impact of different emission sources on light extinction as we present here, although being among the major environmental challenges at many polluted areas. Following the concept of the well-known IMPROVE algorithm, here a tailored site-specific approach (recently developed by our group) was applied to assess chemical light extinction due to PM1 components and major sources. PM1 samples collected separately during daytime and nighttime at the urban area of Milan (Italy) were chemically characterised for elements, major ions, elemental and organic carbon, and levoglucosan. Chemical light extinction was estimated and results showed that at the investigated urban site it is heavily impacted by ammonium nitrate and organic matter. Receptor modelling (i.e. Positive Matrix Factorization, EPA-PMF 5.0) was effective to obtain source apportionment; the most reliable solution was found with 7 factors which were tentatively assigned to nitrates, sulphates, wood burning, traffic, industry, fine dust, and a Pb-rich source. The apportionment of aerosol light extinction (bext,aer) according to resolved sources showed that considering all samples together nitrate contributed at most (on average 41.6%), followed by sulphate, traffic, and wood burning accounting for 18.3%, 17.8% and 12.4%, respectively.

Size-segregated aerosol in a hot-spot pollution urban area: Chemical composition and three-way source apportionment.

In this work, a comprehensive characterisation and source apportionment of size-segregated aerosol collected using a multistage cascade impactor was performed. The samples were collected during wintertime in Milan (Italy), which is located in the Po Valley, one of the main pollution hot-spot areas in Europe. For every sampling, size-segregated mass concentration, elemental and ionic composition, and levoglucosan concentration were determined. Size-segregated data were inverted using the program MICRON to identify and quantify modal contributions of all the measured components. The detailed chemical characterisation allowed the application of a three-way (3-D) receptor model (implemented using Multilinear Engine) for size-segregated source apportionment and chemical profiles identification. It is noteworthy that - as far as we know - this is the first time that three-way source apportionment is attempted using data of aerosol collected by traditional cascade impactors. Seven factors were identified: wood burning, industry, resuspended dust, regional aerosol, construction works, traffic 1, and traffic 2. Further insights into size-segregated factor profiles suggested that the traffic 1 factor can be associated to diesel vehicles and traffic 2 to gasoline vehicles. The regional aerosol factor resulted to be the main contributor (nearly 50%) to the droplet mode (accumulation sub-mode with modal diameter in the range 0.5-1 µm), whereas the overall contribution from the two factors related to traffic was the most important one in the other size modes (34-41%). The results showed that applying a 3-D receptor model to size-segregated samples allows identifying factors of local and regional origin while receptor modelling on integrated PM fractions usually singles out factors characterised by primary (e.g. industry, traffic, soil dust) and secondary (e.g. ammonium sulphate and nitrate) origin. Furthermore, the results suggested that the information on size-segregated chemical composition in different size classes was exploited by the model to relate primary emissions to rapidly-formed secondary compounds.

Implementing constrained multi-time approach with bootstrap analysis in ME-2: An application to PM2.5 data from Florence (Italy).

Advanced receptor models have been recently developed and tested in order to improve the resolution of apportionment problems reducing rotational ambiguity of results and aiming at identifying a larger number of sources. In particular, multi-time model is a factor analysis method able to compute source profiles and contributions using aerosol compositional data with different time resolutions. Unlike traditional factor analysis, each measured value can be inserted into multi-time model with its original time schedule, thus all temporal information can be effectively used in the modelling process. In this work, multi-time model was expanded in order to impose constraints on modelled factors aiming at improving the source identification. Moreover, as far as we know for the first time, a suitable bootstrap technique was implemented in the multi-time scheme to estimate the uncertainty of the final constrained solutions. These implemented approaches were tested on a PM2.5 (particulate matter with aerodynamic diameter <2.5 µm) dataset composed of 24-h samples collected during one year and hourly data sampled in parallel for two shorter periods in Florence (Italy). The daily samples were chemically characterised for elements, ions and carbonaceous components while elemental concentrations only were available for high-time resolved samples. The application of the advanced model revealed the major contribution from traffic (accounting for 37% of PM2.5 as annual average) and allowed an accurate characterisation of involved emission processes. In particular, exhaust and non-exhaust emissions were identified. The constraints imposed in the continuation run led to a better description of the factor associated to nitrates and also of biomass burning profile and the bootstrap results gave useful information to assess the reliability of source apportionment solutions. Finally, the comparison with the results computed by ME-2 base model applied to daily and hourly compositional data separately demonstrated the advantages provided by the multi-time approach.

Receptor modelling of airborne particulate matter in the vicinity of a major steelworks site.

In this study, the Multilinear Engine (ME-2) receptor model was applied to speciated particulate matter concentration data collected with two different measuring instruments upwind and downwind of a steelworks complex in Port Talbot, South Wales, United Kingdom. Hourly and daily PM samples were collected with Streaker and Partisol samplers, respectively, during a one month sampling campaign between April 18 and May 16, 2012. Daily samples (PM10, PM2.5, PM2.5-10) were analysed for trace metals and water-soluble ions using standard procedures. Hourly samples (PM2.5 and PM2.5-10) were assayed for 22 elements by Particle Induced X-ray Emission (PIXE). PM10 data analysis using ME-2 resolved 6 factors from both datasets identifying different steel processing units including emissions from the blast furnaces (BF), the basic oxygen furnace steelmaking plant (BOS), the coke-making plant, and the sinter plant. Steelworks emissions were the main contributors to PM10 accounting for 45% of the mass when including also secondary aerosol. The blast furnaces were the largest emitter of primary PM10 in the study area, explaining about one-fifth of the mass. Other source contributions to PM10 were from marine aerosol (28%), traffic (16%), and background aerosol (11%). ME-2 analysis was also performed on daily PM2.5 and PM2.5-10 data resolving 7 and 6 factors, respectively. The largest contributions to PM2.5-10 were from marine aerosol (30%) and blast furnace emissions (28%). Secondary components explained one-half of PM2.5 mass. The influence of steelworks sources on ambient particulate matter at Port Talbot was distinguishable for several separate processing sections within the steelworks in all PM fractions.

Plasma leptin and vascular endothelial growth factor (VEGF) in normal subjects at high altitude (5050 m).

CONTEXT: High altitude (HA) is a model of severe hypoxia exposure in humans. We hypothesized that nocturnal hypoxemia or acute maximal exercise at HA might affect plasma leptin and VEGF levels. OBJECTIVES: Plasma leptin, VEGF and other metabolic variables were studied after nocturnal pulse oximetry and after maximal exercise in healthy lowlanders on the 3rd-4th day of stay in Lobuche (5050 m, HA) and after return to sea level (SL). RESULTS: Leptin was similar at SL or HA in both pre- and post-exercise conditions. Pre-exercise VEGF at HA was lower, and cortisol was higher, than at SL, suggesting that nocturnal intermittent hypoxia associated with periodic breathing at HA might affect these variables. CONCLUSIONS: Leptin levels appear unaffected at HA, whereas nocturnal hypoxic stress may affect plasma VEGF. Future HA studies should investigate the possible role of nocturnal intermittent hypoxemia on metabolism.

Morphometry examination of placenta in birth weight of full-term newborns in Puducherry, India.

irth weight is an important determinant of child survival, healthy growth and development. Low birth weight is a well-established risk factor for adverse long term health, particularly cardiovascular disease and metabolic syndrome. The ability of the fetus to grow and thrive in utero is presumed to be a function of the placenta. The present study was aimed to assess the morphometry examination of placenta in normal and low birth weight babies in the Union territory of Puducherry. Morphometry examination includes Placenta weight, number of cotyledons, maternal and fetal surface area and site of umbilical cord insertion were measured in normal and low birth weigh babies. Result showed among 200 subjects, mean birth weight of normal and low birth babies were 2806 and 2058 g, respectively. The prevalence rate of low birth babies (less than 2500 g) was 22%. The placental morphometry study namely placental weight, number of cotyledons, maternal and fetal surface area and insertion of umbilical cord at centre were significantly (p<0.001) reduced in the low birth weight babies when compared with normal birth weight babies. Study revealed that morphometry analysis of placenta significantly influences the birth weight of new born. In conclusion, study recommends the early measurements of placenta by non-invasive techniques like ultrasonography will be helpful in early prediction of low birth weight fetus in utero itself and for better management to avoid such low birth weight.

Exercise intolerance at high altitude (5050 m): critical power and W'.

The relationship between work rate (WR) and its tolerable duration (t(LIM)) has not been investigated at high altitude (HA). At HA (5050 m) and at sea level (SL), six subjects therefore performed symptom-limited cycle-ergometry: an incremental test (IET) and three constant-WR tests (% of IET WR(max), HA and SL respectively: WR(1) 70±8%, 74±7%; WR(2) 86±14%, 88±10%; WR(3) 105±13%, 104±9%). The power asymptote (CP) and curvature constant (W') of the hyperbolic WR-t(LIM) relationship were reduced at HA compared to SL (CP: 81±21 vs. 123±38 W; W': 7.2±2.9 vs. 13.1±4.3 kJ). HA breathing reserve (estimated maximum voluntary ventilation minus end-exercise ventilation) was also compromised (WR(1): 25±25 vs. 50±18 l min(-1); WR(2): 4±23 vs. 38±23 l min(-1); WR(3): -3±18 vs. 32±24 l min(-1)) with near-maximal dyspnea levels (Borg) (WR(1): 7.2±1.2 vs. 4.8±1.3; WR(2): 8.8±0.8 vs. 5.3±1.2; WR(3): 9.3±1.0 vs. 5.3±1.5). The CP reduction is consistent with a reduced O(2) availability; that of W' with reduced muscle-venous O(2) storage, exacerbated by ventilatory limitation and dyspnea.

An integrated approach to assess air pollution threats to cultural heritage in a semi-confined environment: the case study of Michelozzo's Courtyard in Florence (Italy).

An example of an integrated approach to assess air pollution threats to cultural heritage in a semi-confined environment is presented in this work, where the monitoring campaign carried out at the Michelozzo's Courtyard (in Palazzo Vecchio, Florence, Italy) is used as a case study. A wide research project was carried out, with the main aim of obtaining the first quantitative data on air quality and microclimate conditions inside the Courtyard, and, if possible, identifying the main causes of degradation and suggesting appropriate conservation strategies. The investigation adopted a holistic approach involving thermographic measurements on the wall paintings, microclimatic analysis, gaseous pollutant monitoring, atmospheric particles characterisation and dry deposition compositional analysis. Attention was focused on the wall painting depicting the city of Hall because of its anomalous and critical conservation conditions, which are visible at a glance, due to the contrast between a wide darker zone around the central subject of the painting and external lighter areas.

Cardiopulmonary exercise testing in the functional and prognostic evaluation of patients with pulmonary diseases.

Exercise testing is increasingly utilized to evaluate the level of exercise intolerance in patients with lung and heart diseases. Cardiopulmonary exercise testing (CPET) is considered the gold standard to study a patient's level of exercise limitation and its causes. The 2 CPET protocols most frequently used in the clinical setting are the maximal incremental and the constant work rate tests. The aim of this review is to focus on the main respiratory diseases for which exercise tolerance is indicated; for example, chronic obstructive pulmonary disease, interstitial lung disease, primary pulmonary hypertension and cystic fibrosis. This review also focuses on the variables/indices that are utilized in the functional and prognostic evaluation. The recognition of abnormal response patterns of ventilatory, cardiac and metabolic limitation to exercise may help in the diagnostic evaluation. In addition, CPET indexes can provide important functional and prognostic information regarding patients with pulmonary disease. Exercise indices, such as peak oxygen uptake (V'O(2 peak)), ventilatory equivalents for carbon dioxide production (V'(E)-/V'CO(2)) and arterial oxygen saturation (S(p)O(2)), have in fact proven to be better predictors of prognosis than lung function measurements obtained at rest. Moreover, useful information on the effects of therapeutic interventions may be obtained by CPET by studying the changes in endurance capacity during high-intensity constant work rate protocols.

Characterization of particulate matter sources in an urban environment.

Daily time series measurements of elements or compounds are widely used to apportion the contribution of specific sources of particulate matter concentration in the atmosphere. We present results obtained for the urban area of Genoa (Italy) based on several hundred of PM10, PM2.5 and PM1 daily samples collected in sites with different geo-morphological and urbanization characteristics. Elemental concentrations of Na to Pb were obtained through Energy Dispersive X-Ray Fluorescence (ED-XRF), and the contributions of specific sources of particulate matter (PM) concentration were apportioned through Positive Matrix Factorization (PMF). By sampling at different sites we were able to obtain, in each PM fraction, the average and stable values for the tracers of specific sources, in particular traffic (Cu, Zn, Pb) and heavy oil combustion (V, Ni). We could also identify and quote the contamination of anthropogenic PM in "natural" sources (sea, soil dust). Sampling at several sites in the same urban area allowed us to resolve local characteristics as well as to quote average values.

Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects.

AIM: To test the hypothesis that obese individuals may either hyperinflate or deflate the lung when exercising. In both cases breathlessness is an inescapable consequence. METHODS: Ventilatory variables, end-expiratory lung volume and end-inspiratory lung volume, and dyspnoea score (Borg scale) were studied in 20 class II-III obese subjects and 14 healthy controls during incremental symptom-limited cycle exercise. RESULTS: Ventilation increased with increasing work rate, in obese and in control subjects; most obese subjects had to increase end-expiratory lung volume to escape from flow limitation; in contrast, like controls, a few subjects deflated the lung on heavy-to-peak exercise. Dyspnoea was equal in degree at anaerobic threshold and peak exercise in obese as in control subjects, and in obese who hyperinflated as in those who deflated the lung. In particular, end-expiratory lung volume at baseline (r = -0.84, P = 0.04) was negatively correlated with changes in Borg score in obese who did not hyperinflate: the lower the former the higher the latter. On the other hand, tidal volume (r = 0.54, P = 0.045) and decrease in inspiratory reserve volume (r = 0.59, P = 0.028) were positively correlated with the Borg score in obese subjects who hyperinflated. No other independent variable correlated with the Borg score. CONCLUSIONS: We conclude that not all obese subjects had to increase end-expiratory lung volume on heavy-to-peak exercise. Changes in dyspnoea for unit changes in ventilation were similar in obese who did hyperinflate as well as in those who did not, suggesting that the increase in respiratory neural drive, associated with an increase in ventilation, is an important source of dyspnoea in obese as well as in control subjects.

3-D segmentation algorithm of small lung nodules in spiral CT images.

Computed tomography (CT) is the most sensitive imaging technique for detecting lung nodules, and is now being evaluated as a screening tool for lung cancer in several large samples studies all over the world. In this report, we describe a semiautomatic method for 3-D segmentation of lung nodules in CT images for subsequent volume assessment. The distinguishing features of our algorithm are the following. 1) The user interaction process. It allows the introduction of the knowledge of the expert in a simple and reproducible manner. 2) The adoption of the geodesic distance in a multithreshold image representation. It allows the definition of a fusion--segregation process based on both gray-level similarity and objects shape. The algorithm was validated on low-dose CT scans of small nodule phantoms (mean diameter 5.3--11 mm) and in vivo lung nodules (mean diameter 5--9.8 mm) detected in the Italung-CT screening program for lung cancer. A further test on small lung nodules of Lung Image Database Consortium (LIDC) first data set was also performed. We observed a RMS error less than 6.6% in phantoms, and the correct outlining of the nodule contour was obtained in 82/95 lung nodules of Italung-CT and in 10/12 lung nodules of LIDC first data set. The achieved results support the use of the proposed algorithm for volume measurements of lung nodules examined with low-dose CT scanning technique.

Pathophysiological adaptations to walking and cycling in primary pulmonary hypertension.

Exercise tolerance inversely correlates with the severity of the disease in patients with idiopathic pulmonary arterial hypertension (IPAH). Cycling and walking protocols are commonly utilized in the evaluation of exercise intolerance in IPAH, but little information exists on possible differences in ventilatory and gas exchange adaptations to these exercise modalities. In a group of patients with moderate to severe IPAH (n = 13), we studied the ventilatory, cardiovascular and gas exchange adaptations to maximal incremental walking (W) and maximal incremental cycling (C). During W, compared to C, the ventilatory equivalents for CO(2) output (V'(E)/V'CO(2)) were significantly higher either expressed as the rate of increment (56 +/- 5 vs. 45 +/- 3; P < 0.0001) or as the absolute values at anaerobic threshold (AT) and at peak exercise. At AT, the increase in V'(E)/V'CO(2) during W was associated with a significant lower value of end-tidal carbon dioxide. At peak W, compared to peak C, dyspnea sensation was higher and arterial oxygen saturation (SpO(2)) was lower (87 +/- 2 vs. 91 +/- 2, P < 0.001). In patients with IPAH the physiologic information obtained with W are different from those obtained with C. Tolerance to W exercise is limited by high ventilatory response and dyspnea sensation. W should be used to assess the degree of lung gas exchange inefficiency and arterial O(2) desaturation during exercise.

Clinical use of Heliox in asthma and COPD.

Heliox is a low density gas mixture of helium and oxygen commonly used in deep diving (> 6 ATM). This mixture has been also used for clinical purposes, particularly in the critical care setting. Due to of its physical proprieties, Heliox breathing reduces air flow resistances within the bronchial tree; in patients with obstructive lung diseases Heliox may also reduce the work of breathing and improve pulmonary gas exchange efficiency. Beneficial effects have been documented in severe asthma attacks and in patients with chronic obstructive pulmonary disease. A reduction in WOB during mechanical ventilation and an increase in exercise endurance capacity have also been described in COPD. Heliox has been also used in the treatment of upper airways obstruction, bronchiolitis and bronchopulmonary dysplasia. Despite the encouraging results, Heliox use in routine practice remains controversial because of technical implications and high costs.

Elemental characterization of PM10, PM2.5 and PM1 in the town of Genoa (Italy).

The particulate matter (PM) concentration and composition, the PM10, PM2.5, PM1 fractions, were studied in the urban area of Genoa, a coastal town in the northwest of Italy. Two instruments, the continuous monitor TEOM and the sequential sampler PARTISOL, were operated almost continuously on the same site from July 2001 to September 2004. Samples collected by PARTISOL were weighted to obtain PM concentration and then analysed by PIXE (particle induced X-ray emission) and by ED-XRF (energy dispersion X-ray fluorescence), obtaining concentrations for elements from Na to Pb. Some of the filters used in the TEOM microbalance were analysed by ED-XRF to calculate Pb concentration values averaged over 7-30 d periods.

Seasonal variation of 210Pb activity concentration in outdoor air of Milan (Italy).

Weekly measurements of 210Pb activity concentration on aerosol particles were performed at ground level in outdoor air in Milan (Italy) during the years 2000-2001. The experimental method was based on the delayed alpha spectrometry of in-grown 210Po activity detected on airborne particles collected on a filter support. On the same filter the 214Pb activity concentration was also measured during the sampling. 210Pb weekly concentration values showed a great variability and the average monthly values exhibited a seasonal pattern characterised by maxima in winter and minima in spring-summer. The same seasonal trend was also observed in 214Pb concentration values. 210Pb average yearly values were 0.70 and 0.82 mBq/m3 in 2000 and 2001, respectively, in good agreement with literature data registered at continental sites of similar latitude and longitude. The activity ratio 210Pb/214Pb was used to evaluate the residence time of fine aerosols in the urban air of Milan, which was 1-2 days.

Water and sodium imbalance in COPD patients.

Water retention and hyponatraemia are typically observed in the final stages of Chronic Obstructive Pulmonary Disease (COPD) and the onset of edema is a poor prognostic factor. For several years the pathogenesis of edema in COPD patients was attributed to heart impairment because of pulmonary hypertension, but the evidence that cardiac output is often adequate for the metabolic demands has suggested, since 1960, that the pathogenesis of edema in these patients would be correlated with gas exchange impairment and in particular with carbon dioxide (CO2) retention. The gas exchange impairment induces, in these patients several hormonal abnormalities: renin (Rn), angiotensin II (AnII), aldosterone (Ald), atrial natriuretic peptide (ANP), vasopressin (ADH) and endothelial factors are some of the factors involved. The systemic response to hypercapnia has the effect of reducing the renal blood flow and, as a result, increasing water and sodium retention with the final effect of edema and hyponatraemia. The aim of this brief review is to highlight the current knowledge on renal/hormonal abnormalities in COPD and their therapeutic implications.