Confirmatory validation analysis of the PROFFIT questionnaire to assess financial toxicity in cancer patients.

BACKGROUND: The Patient Reported Outcome for Fighting FInancial Toxicity (PROFFIT) questionnaire was developed to measure financial toxicity (FT) and identify its determinants. The aim of the present study was to confirm its validity in a prospective cohort of patients receiving anticancer treatment. PATIENTS AND METHODS: From March 2021 to July 2022, 221 patients were enrolled at 10 Italian centres. Selected items of the EORTC-QLQ-C30 questionnaire represented the anchors, specifically, question 28 (Q-28) on financial difficulties, and questions 29-30 measuring global health status/quality of life (HR-QOL). The study had 80% power to detect a 0.20 correlation coefficient (r) between anchors and PROFFIT-score (items 1-7, range 0-100, 100 indicating maximum FT) with bilateral alpha 0.05 and 80% power. Confirmatory factor analysis was conducted. FT determinants (items 8-16) were described. RESULTS: Median age of patients was 65 years, 116 (52.5%) were females, 96 (43.4%) had low education level. Confirmatory factor analysis confirmed goodness of fit of the PROFFIT-score. Significant partial correlation of PROFFIT-score was found with Q-28 (r = 0.51) and HR-QOL (r = -0.23). Mean (SD) PROFFIT-score at baseline was 36.5 (24.9); it was statistically significantly higher for patients living in South Italy, those with lower education level, those who were freelancer/unemployed at diagnosis and those who reported significant economic impact from the COVID-19 pandemic. Mean (SD) scores of determinants ranged from 17.6 (27.1) for item 14 (support from medical staff) to 49.0 (36.3) for item 10 (expenses for medicines or supplements). PROFFIT-score significantly increased with worsening response to determinants. CONCLUSIONS: External validation of PROFFIT-score in an independent sample of patients was successful. The instrument is now being used in clinical studies.

Tomografía computarizada coronaria en urgencias: importancia de la experiencia del radiólogo / Coronary computed tomography in emergencies: the importance of the radiologist's experience

Introducción: La incorporación de la angiografía coronaria por tomografía computarizada (ACTC) a la atención sanitaria en las urgencias hospitalarias hace necesaria una adecuada capacitación para la interpretación de esta prueba de imagen. Esta capacitación puede afectar al grado de concordancia interobservador de los radiólogos que evalúan dichos estudios. Objetivo: Evaluar la concordancia interobservador en función de la experiencia en la interpretación de ACTC realizadas a pacientes que acuden a urgencias por dolor torácico agudo (DTA) con probabilidad baja-intermedia de síndrome coronario agudo (SCA). Materiales y método: Estudio de concordancia interobservador en la evaluación de ACTC realizadas en contexto urgente utilizando CAD-RADS como registro de resultados. Se crearon parejas de observadores entre un total de 8 evaluadores (4 staff y 4 en formación). Se estimó el grado de concordancia global y entre subgrupos de acuerdo con su experiencia mediante el coeficiente kappa. Resultados: La concordancia fue sustancial entre radiólogos experimentados y en formación (k= 0,627; IC95%: 0,436-0,826), así como para todas las parejas de evaluadores (k=0,661; IC95%: 0,506-0,823) para todas las categorías CAD-RADS en conjunto. El grado de acuerdo del grupo de radiólogos experimentados fue superior al de los radiólogos en formación en todos los análisis realizados. La concordancia fue excelente para CAD-RADS global (k= 0,950; IC95%: 0,896-1) y para CAD-RADS ≥ 4 (k = 1), observando un menor acuerdo para CAD-RADS ≥ 3 (k= 0,754; IC95%: 0,246-1,255). Los valores del personal en formación para estas categorías fueron k= 0,623, k= 0,596 y k= 0,473, respectivamente. Conclusión: La concordancia entre radiólogos staff en la evaluación de ACTC realizadas a pacientes en el contexto de urgencias es excelente. El grado de acuerdo es menor cuando el personal inexperto forma parte de las parejas analizadas...(AU)

Introduction: Incorporating coronary computed tomography angiography (CTA) in the hospital workup for suspected acute coronary syndrome requires appropriate skills for interpreting this imaging test. Radiologists’ skills can affect the interobserver agreement in evaluating these studies. Objective: To determine the interobserver agreement according to radiologists’ experience in the interpretation of coronary CTA studies done in patients who present at the emergency department with acute chest pain and low-to-intermediate probability of acute coronary syndrome. Materials and methods: We studied the interobserver agreement in the urgent evaluation of coronary CTA studies in which CAD-RADS was used to register the findings. We created pairs of observers among a total of 8 assessors (4 attending radiologists and 4 radiology residents). We used the kappa coefficient to estimate the overall concordance and the concordance between subgroups according to their experience. Results: The agreement was substantial between experienced radiologists and residents (k = 0.627; 95%CI: 0.436 – 0.826) as well as between all the pairs of observers (k=0.661; 95%CI: 0.506 – 0.823) for all the CAD-RADS together. The degree of agreement within the group of experienced radiologists was greater than that within the group of residents in all the analyses. The agreement was excellent for the overall CAD-RADS (k=0.950; 95% CI: 0.896 – 1) and for CAD-RADS ≥ 4 (k=1); the agreement was lower for CAD-RADS ≥ 3 (k = 0.754; 95% CI: 0.246 – 1.255). The agreement for the residents for these categories was k= 0.623, k=0.596, and k=0.473, respectively. Conclusion: The agreement among attending radiologists regarding the assessment of urgent coronary CTA studies is excellent. The agreement is lower when residents are paired with attending radiologists...(AU)

Coronary computed tomography in emergencies: The importance of the radiologist's experience.

INTRODUCTION: Incorporating coronary computed tomography angiography (CTA) in the hospital workup for suspected acute coronary syndrome requires appropriate skills for interpreting this imaging test. Radiologists' skills can affect the interobserver agreement in evaluating these studies. OBJECTIVE: To determine the interobserver agreement according to radiologists' experience in the interpretation of coronary CTA studies done in patients who present at the emergency department with acute chest pain and low-to-intermediate probability of acute coronary syndrome. MATERIALS AND METHODS: We studied the interobserver agreement in the urgent evaluation of coronary CTA studies in which CAD-RADS was used to register the findings. We created pairs of observers among a total of 8 assessors (4 attending radiologists and 4 radiology residents). We used the kappa coefficient to estimate the overall concordance and the concordance between subgroups according to their experience. RESULTS: The agreement was substantial between experienced radiologists and residents (k=0.627; 95%CI: 0.436-0.826) as well as between all the pairs of observers (k=0.661; 95%CI: 0.506-0.823) for all the CAD-RADS together. The degree of agreement within the group of experienced radiologists was greater than that within the group of residents in all the analyses. The agreement was excellent for the overall CAD-RADS (k=0.950; 95% CI: 0.896-1) and for CAD-RADS ≥ 4 (k=1); the agreement was lower for CAD-RADS ≥ 3 (k=0.754; 95% CI: 0.246-1.255). The agreement for the residents for these categories was k=0.623, k=0.596, and k=0.473, respectively. CONCLUSION: The agreement among attending radiologists regarding the assessment of urgent coronary CTA studies is excellent. The agreement is lower when residents are paired with attending radiologists. These findings should be taken into consideration when implementing coronary CTA in emergency departments and in the organisation of radiological staff for interpreting and reporting this imaging test.

Role of structural disorder in the vibrational spectra of sol-gel γ and δ-Al2O3 nanoparticles.

Alumina nanopowders belonging to the γ and δ transition phases have been characterized by infrared and Raman spectroscopies. A quantitative interpretation of their vibrational spectra has been provided and related to their crystal structure, with particular emphasis on structural disorder and features not predicted by group-theoretical considerations. Both phases show very similar infrared dielectric functions, but with clear instances of mode-splitting in the δ phase, which are related to ordering in the tetrahedral Al positions. Raman spectroscopy was unable to resolve any modes in the sample identified as γ phase, but the full lattice vibrational region could be measured for the δ sample under UV and red excitation lines. Raman spectra are more complex than those obtained by infrared spectroscopy and cannot be completely explained by factor group analysis, in the absence of dedicated theoretical studies. Finally, the luminescent properties of these materials have been qualitatively explored and linked to disorder and substitutional impurities. In general, the results contained in this work prove that vibrational spectroscopies are powerful tools for quantitative analyses of these disordered nanomaterials and suggest the need for more theoretical work to understand their vibrational properties.

Statistical (n, γ ) cross section model comparison for short-lived nuclei.

Neutron-capture cross sections of neutron-rich nuclei are calculated using a Hauser-Feshbach model when direct experimental cross sections cannot be obtained. A number of codes to perform these calculations exist, and each makes different assumptions about the underlying nuclear physics. We investigated the systematic uncertainty associated with the choice of Hauser-Feshbach code used to calculate the neutron-capture cross section of a short-lived nucleus. The neutron-capture cross section for 73 Zn (n, γ ) 74 Zn was calculated using three Hauser-Feshbach statistical model codes: TALYS, CoH, and EMPIRE. The calculation was first performed without any changes to the default settings in each code. Then an experimentally obtained nuclear level density (NLD) and γ -ray strength function ( γ SF ) were included. Finally, the nuclear structure information was made consistent across the codes. The neutron-capture cross sections obtained from the three codes are in good agreement after including the experimentally obtained NLD and γ SF , accounting for differences in the underlying nuclear reaction models, and enforcing consistent approximations for unknown nuclear data. It is possible to use consistent inputs and nuclear physics to reduce the differences in the calculated neutron-capture cross section from different Hauser-Feshbach codes. However, ensuring the treatment of the input of experimental data and other nuclear physics are similar across multiple codes requires a careful investigation. For this reason, more complete documentation of the inputs and physics chosen is important. Supplementary Information: The online version contains supplementary material available at 10.1140/epja/s10050-023-00920-0.

Design and function of targeted endocannabinoid nanoparticles.

Nanoparticles and nano-delivery systems are constantly being refined and developed for biomedical applications such as imaging, gene therapy, and targeted delivery of drugs. Nanoparticles deliver beneficial effects by both release of their cargo and by liberation of their constitutive structural components. The N-acylethanolamines linoleoyl ethanolamide (LEA) and oleoyl ethanolamide (OEA) both exhibit endocannabinoid-like activity. Here, we report on their ability to form nanoparticles that when conjugated with tissue-specific molecules, are capable of localizing to specific areas of the body and reducing inflammation. The facilitation of pharmacological effects by endocannabinoids at targeted sites provides a novel biocompatible drug delivery system and a therapeutic approach to the treatment, patient management and quality of life, in conditions such as arthritis, epilepsy, and cancer.

Expert recommendations about the use of gadoxetic acid in patients with liver metastases in Spain.

BACKGROUND AND AIMS: Magnetic resonance imaging (MRI) with gadoxetic acid is widely used in clinical practice in Spain for the diagnosis, treatment, and follow-up of patients with liver metastases, although its use varies. This paper aims to provide recommendations for the use of MRI with gadoxetic acid in the detection and diagnosis of liver metastases in clinical practice in Spain. MATERIAL AND METHODS: This project was undertaken by a group of nine experts who analyzed a series of recommendations about the use of gadoxetic acid extracted from international consensus documents. From this analysis, the experts decided to reject, adopt, contextualize, or adapt each of the recommendations. Once established, the final recommendations were voted on by the same group of experts. RESULTS: The experts reached a consensus about five recommendations related to the use of this imaging technique in the management of liver metastases in three clinical situations: (i) in the detection, (ii) in the diagnosis and preoperative characterization, and (iii) in the detection after a chemotherapy treatment. CONCLUSION: The results support a clinical benefit for MRI with gadoxetic acid in the detection of liver metastases, favoring preoperative planning, especially in metastases measuring less than 1 cm, thus facilitating early diagnosis of metastatic spread.

Prevalencia de Dientamoeba fragilisy otros protozoários intestinales en porcinos de una granja en la región Andina de Colombia / Prevalence of Dientamoeba fragilis and other intestinal protozoa from a swine farm at the Andean region of Colombia

RESUMEN Dientamoeba fragilis es un protozoário que parasita el intestino grueso del hombre y animales domésticos. Hasta el momento, aún no son claros aspectos de su ciclo de vida, como el rango de hospedadores, reservorios, mecanismo de infección, entre otros. Se postula que el cerdo es un hospedador natural para este protozoario y que, debido a su cercanía con el humano, podría facilitar una transmisión zoonótica. En Colombia no existen a la fecha estudios sobre la presencia de D. fragilis en hospedadores animales, incluidos los cerdos, y los datos sobre la prevalencia de otros protozoarios intestinales en estos animales son escasos. El objetivo fue determinar la frecuencia de protozoarios intestinales, incluyendo D. fragilis, en cerdos de una granja tecnificada de una zona rural de Medellín (región Andina de Colombia). Se recolectaron muestras de materia fecal de 70 cerdos en etapa de preceba, que fueron evaluadas mediante examen directo, tinción tricrómica y Ziehl-Neelsen modificado. Se realizaron análisis univariados con medidas de frecuencia relativa y tendencia central y análisis bivariados para la exploración de factores de riesgo. Se detectó la presencia de D. fragilis en un 13% de las muestras y de otros parásitos como Entamoeba spp. (66%), Blastocystis spp. (64%), Balantioides coli (36%), Cryptosporidium spp. (36%), Iodamoeba butschlii (17%), coccidias (4%) y Giardia spp. (1,4%). En este primer reporte de D. fragilis en cerdos en Colombia se observó la alta prevalencia de otros protozoarios patógenos, lo que corrobora el papel de los cerdos como importantes reservorios de infecciones humanas. Estudios sobre la presencia de este protozoario tanto en cerdos como en el personal encargado de su manejo contribuirían al conocimiento sobre su dinámica de transmisión.

ABSTRACT Dientamoeba fragilis is a protozoan that parasitizes the large intestine of humans and domestic animals. To date, some aspects regarding D. fragilis life cycle, including hosts, reservoirs, infection mechanism, among others, are not yet clear. Swine are considered natural hosts for this protozoan, therefore their close contact with humans promotes its zoonotic transmission. In Colombia there are no studies on the presence of D. fragilis in animal hosts, including pigs, and data about other intestinal protozoa are scarce. The objective was to determine the prevalence of intestinal protozoan, including D. fragilis, in pigs raised in a farm from a rural area of Medellin (Andean region of Colombia). Fecal samples from 70 pigs in prefattening stage were collected. Direct fecal smear examination, trichrome and modified Ziehl-Neelsen stain were used in the study. Univariate analysis (frequency distribution and central tendency measures) and bivariate analysis were used to explore risk factors. Dientamoeba fragilis was found in 13% of the evaluated fecal samples. Other parasites detected included: Entamoeba spp. (66%), Blastocystis spp. (64%), Balantioides coli (36%), Cryptosporidium spp. (36%), Iodamoeba butschlii (17%), coccidias (4%), and Giardia spp. (1,4%). This is the first report of D. fragilis in swine in Colombia, and the high prevalence of other pathogen protozoa was also observed, which corroborates the role of pigs as important reservoirs for human infections. Studies focused on the evaluation of both swine and swine-exposed farm workers should be done in order to know the dynamics of transmission of this parasite.

Improving Keyword-Based Topic Classification in Cancer Patient Forums with Multilingual Transformers.

Online forums play an important role in connecting people who have crossed paths with cancer. These communities create networks of mutual support that cover different cancer-related topics, containing an extensive amount of heterogeneous information that can be mined to get useful insights. This work presents a case study where users' posts from an Italian cancer patient community have been classified combining both count-based and prediction-based representations to identify discussion topics, with the aim of improving message reviewing and filtering. We demonstrate that pairing simple bag-of-words representations based on keywords matching with pre-trained contextual embeddings significantly improves the overall quality of the predictions and allows the model to handle ambiguities and misspellings. By using non-English real-world data, we also investigated the reusability of pretrained multilingual models like BERT in lower data regimes like many local medical institutions.

Hemorragia retrobulbar espontánea asociada a consumo de anticoagulantes / Spontaneous retrobulbar haemorrhage associated with anticoagulants

La hemorragia retrobulbar es un sangrado en la región intraorbitaria retroseptal que genera un síndrome compartimental orbitario. Se presenta el caso de una mujer de 86 años que acudió a Urgencias por dolor ocular y pérdida de visión en ojo izquierdo de seis horas de evolución. Presentaba tratamiento anticoagulante con 300 mg/día de Dabigatrán por fibrilación auricular como único antecedente médico. La exploración clínica fue compatible con hemorragia retrobulbar, diagnóstico confirmado por TAC urgente, realizándose de forma inmediata una cantotomía con cantolisis. Se realizó RMN orbitaria que descartó la existencia de malformaciones arteriovenosas como factor desencadenante, diagnosticándose de hemorragia retrobulbar espontánea asociada a consumo de anticoagulantes. La singularidad de este caso radica en formar parte del pequeño porcentaje de hemorragias retrobulbares que no se asocian a causa traumática ni postquirúrgica así como en ilustrar una localización muy poco frecuente de sangrado asociado a anticoagulación.(AU)

Retrobulbar hemorrhage consists of bleeding in the retroseptal intraorbital region generating an orbital compartment syndrome. We present the case of an 86-year-old woman who came to the Emergency Room due to ocular pain and loss of vision in the left eye of six hours of evolution. The only medical history was atrial fibrillation on anticoagulant treatment with Dabigatran 300mg daily. The clinical examination was compatible with retrobulbar hemorrhage and the urgent CT confirmed the diagnosis, performing immediately after a canthotomy with cantolysis. In the absence of triggering factors, an orbital MRI was performed which ruled out the existence of arteriovenous malformations, diagnosing spontaneous retrobulbar hemorrhage associated with the use of anticoagulants. The uniqueness of this case is that it forms part of the small percentage of retrobulbar hemorrhages that are not associated with trauma or postsurgical causes, as well as in illustrating a very rare location of bleeding associated with anticoagulation.(AU)

[Spontaneous retrobulbar haemorrhage associated with anticoagulants].

Retrobulbar hemorrhage consists of bleeding in the retroseptal intraorbital region generating an orbital compartment syndrome. We present the case of an 86-year-old woman who came to the Emergency Room due to ocular pain and loss of vision in the left eye of six hours of evolution. The only medical history was atrial fibrillation on anticoagulant treatment with Dabigatran 300mg daily. The clinical examination was compatible with retrobulbar hemorrhage and the urgent CT confirmed the diagnosis, performing immediately after a canthotomy with cantolysis. In the absence of triggering factors, an orbital MRI was performed which ruled out the existence of arteriovenous malformations, diagnosing spontaneous retrobulbar hemorrhage associated with the use of anticoagulants. The uniqueness of this case is that it forms part of the small percentage of retrobulbar hemorrhages that are not associated with trauma or postsurgical causes, as well as in illustrating a very rare location of bleeding associated with anticoagulation.

[Sepsis Code: dodging mortality in a tertiary hospital]. / Código Sepsis: esquivando la mortalidad en un hospital terciario.

OBJECTIVE: In the hospital of La Princesa, the "Sepsis Code" (CSP) began in 2015, as a multidisciplinary group that provides health personnel with clinical, analytical and organizational tools, with the aim of the detection and early treatment of patients with sepsis. The objective of this study is to evaluate the impact of CSP implantation on mortality and to determine the variables associated with an increase in it. METHODS: A retrospective analytical study of patients with CSP alert activation from 2015 to 2018 was conducted. Clinical-epidemiological variables, analytical parameters, and severity factors such as admission to critical care units (UCC) and the need for amines were collected. Statistical significance was established at p < 0.05. RESULTS: We included 1,121 patients. The length of stay was 16 days and 32% required admission to UCC. Mortality showed a statistically significant linear downward trend from 24% in 2015 to 15% in 2018. The predictive mortality variables with statistically significant association were lactate > 2 mmol/L, creatinine > 1.6 mg/dL and the need for amines.>5.0%, mortality at the time of chart review 62.0%, and 6-months-post-discharge readmission 47.7%. CONCLUSIONS: The implementation of Sepsis Code decreases the mortality of patients with sepsis and septic shock. The presence of a lactate > 2 mmol/L, creatinine > 1.6 mg/dL and/or the need to administer amines in the first 24 hours, are associated with an increase in mortality in the patient with sepsis.

Smoking habit in parents and exposure to environmental tobacco smoke in elementary school children of Milan.

INTRODUCTION: Children with smoking parents are potentially exposed to Environmental Tobacco Smoke (ETS). The aims of this study were: 1) to assess ETS exposure in Milan schoolchildren, by measuring urinary cotinine (COT-U), 2) to compare the parents' perception of children ETS exposure, with the actual ETS exposure measured by COT-U, 3) to explore the factors influencing COT-U, including smoking bans at home, the season, and children characteristics. METHODS: One-hundred school children (7-11 years) and their parents were recruited for the study in Spring 2018 (n = 81) and in Winter 2019 (n = 94), 75 children participated to both campaigns, for a sum of 175 observations. A questionnaire was submitted to parents to collect information about smoking habits in the house. COT-U was measured by LC-MS/MS in spot urine sample collected in the morning from children. RESULTS: Detectable COT-U levels were found in 42% and 57% of children, in spring and winter, in contrast with 17% and 13% of parents acknowledging ETS exposure. Children living with smokers or e-cigarette users (vapers) (30% of the participants) had higher COT-U levels than children not living with smokers or vapers (median 0.67, 0.46, and <0.1 µg/L in spring, and 0.98, 0.85, and 0.11 µg/L in winter, respectively). Increasingly higher COT-U levels were observed in children living in homes where smoking was completely banned, allowed in the external parts of the home, or allowed in some rooms. The multiple regression analysis confirmed the positive significant effect of living with smokers, a partial smoking ban and absence of smoking ban at home, the winter season, and BMI as determinants of COT-U. CONCLUSION: ETS exposure resulted in measurable urinary cotinine in children. Smoking parents underestimate exposure to ETS of their children. Living with smokers is a determinant of COT-U, only slightly mitigated by adopting partial smoking ban.

Scattering of light by ZnO nanorod arrays.

The optical properties of ZnO nanorod (NR) arrays were investigated by optical total transmittance (TT) and diffuse reflectance (DR) spectroscopy in the visible region. The NRs were grown electrochemically in a three-electrode cell over a glass/fluorine-doped tin oxide (FTO) substrate. The mean length, radius, and density of NR samples were characterized by scanning electron microscopy. The results were correlated with the observed optical properties. Since light scattering for these NR arrays is highly dependent on their morphology, therefore, a model for light scattering based in the Mie theory for cylinders was implemented to understand the observed spectra. The mean scattering and extinction cross sections were calculated from the morphology of the samples. They were used to fit the DR spectra. From the fittings, the TT spectra of the samples could be calculated. A good agreement with the experimental results was obtained. This indicates that the implemented model represents well the observed scattering phenomena.

Radiative Width of the Hoyle State from γ-Ray Spectroscopy.

The cascading 3.21 and 4.44 MeV electric quadrupole transitions have been observed from the Hoyle state at 7.65 MeV excitation energy in ^{12}C, excited by the ^{12}C(p,p^{'}) reaction at 10.7 MeV proton energy. From the proton-γ-γ triple coincidence data, a value of Γ_{rad}/Γ=6.2(6)×10^{-4} was obtained for the radiative branching ratio. Using our results, together with Γ_{π}^{E0}/Γ from Eriksen et al. [Phys. Rev. C 102, 024320 (2020)PRVCAN2469-998510.1103/PhysRevC.102.024320] and the currently adopted Γ_{π}(E0) values, the radiative width of the Hoyle state is determined as Γ_{rad}=5.1(6)×10^{-3} eV. This value is about 34% higher than the currently adopted value and will impact models of stellar evolution and nucleosynthesis.

Enhanced thermal conduction by surface phonon-polaritons.

Improving heat dissipation in increasingly miniature microelectronic devices is a serious challenge, as the thermal conduction in nanostructures is markedly reduced by increasingly frequent scattering of phonons on the surface. However, the surface could become an additional heat dissipation channel if phonons couple with photons forming hybrid surface quasiparticles called surface phonon-polaritons (SPhPs). Here, we experimentally demonstrate the formation of SPhPs on the surface of SiN nanomembranes and subsequent enhancement of heat conduction. Our measurements show that the in-plane thermal conductivity of membranes thinner than 50 nm doubles up as the temperature rises from 300 to 800 kelvin, while thicker membranes show a monotonic decrease. Our theoretical analysis shows that these thickness and temperature dependencies are fingerprints of SPhP contribution to heat conduction. The demonstrated thermal transport by SPhPs can be useful as a previously unidentified channel of heat dissipation in a variety of fields including microelectronics and silicon photonics.

Patrón de Brugada en paciente tratada con amitriptilina / The Brugada pattern in a patient treated with amitriptyline

No disponible

Annual, seasonal, and morning rush hour Land Use Regression models for black carbon in a school catchment area of Milan, Italy.

INTRODUCTION: The European Environment Agency has identified Northern Italy as one of the most polluted areas in Europe. Among air contaminants, black carbon (BC) has been identified as a sensitive marker of traffic related air pollution. This study aims to investigate the spatial distribution of BC in the catchment area of an elementary school of Milan, the biggest city in Northern Italy, using Land Use Regression (LUR) models and focusing especially on Morning Rush Hour (MRH). METHODS: Two recruitment campaigns were performed asking schoolchildren's parents and residents of the study area to host a monitoring site in their own dwellings. Finally, 34 monitoring sites and 1 reference site were sampled. BC was measured in two seasonal campaigns using eight micro-aethalometers. Six seasonal and annual LUR models were developed, 3 focused on MRH. RESULTS: Overall, median BC was 3247 and 1309 ng/m3 in the cold and warm season, respectively. In both seasons, there was a significant spatial variation between the monitoring sites. MRH values were higher than the daily values with median concentrations of 4227 and 2331 ng/m3, respectively. Developed LUR models showed that BC variability is well explained only by traffic variables; R2 ranged from 0.52 to 0.79 and from 0.65 to 0.81, for seasonal/annual and MRH LUR models respectively. DISCUSSION: LUR models based on traffic variables explain most of the measured BC distribution variability for both warm and cold season. MRH represents a critical moment for BC during all the year, with an increase of 1000 ng/m3 respective to the daily median value and differences in magnitude according to location. Our results highlight that the mobility issue is one of the most important challenges to reduce air pollution in the city of Milan and this is of particular concern for elementary schoolchildren that commute to school during MRH.