Evaluation of Chlorella vulgaris and Scenedesmus obliquus growth on pretreated organic solid waste digestate.

In this research Scenedesmus obliquus and Chlorella vulgaris growth was tested on digestate sludge obtained from the anaerobic co-digestion treatment of the organic fraction of municipal solid waste (OFMSW) together with waste activated sludge (WAS). Digestate was diluted 1:10 and tested in three batch experimental conditions: with no pre-treatments (noPT), after centrifugation (AC) and after filtration (AUF), in order to evaluate microalgae limiting growth factors. The best growth was obtained by C. vulgaris on digestate AC compared to S. obliquus, reaching 479 ± 31 cell million ml-1 and 131 ± 12 cell million ml-1 respectively. Ammonia removal evaluated in C. vulgaris and S. obliquus cultures was 99.2% ± 0.3 and 98.146% ± 0.008 in AC condition, respectively. Considering that AUF showed similar microalgae growth values, the digestate pretreatment for microalgae growth, could be limited to centrifugation.

A review of the occurrence of selected micropollutants and microorganisms in different raw and treated manure - Environmental risk due to antibiotics after application to soil.

This study consists of a review based on 104 papers published between 1980 and 2019, which dealt with the occurrence of pharmaceuticals, hormones and a selection of microorganisms in raw and treated manure from different types of animal farms. The selected pharmaceuticals and hormones are those regularly administered to livestock for treating and preventing diseases. Worldwide, manure is commonly spread on soil as a fertilizer due to its nutrient content. However, this practice also represents a potential pathway for micropollutant release into the environment. In this context, this study evaluates the predicted concentrations of some antibiotics in soil after the application of swine slurry on soil and compares them with corresponding measured concentrations found in the literature. Enrofloxacin, oxytetracycline and chlortetracycline were the antibiotics with the highest concentrations that were found in raw and treated manure and that showed a high risk together with sulfamethazine. Future research should focus on monitoring other pathogens, parent compounds and their main metabolites in raw and treated manure, studying the spread and development of antibiotic resistance genes in the environment due to residues of antibiotics in manure applied to soil, and evaluating predicted no effect concentrations of pharmaceuticals and hormones commonly administered to livestock with regard to terrestrial organisms.

A review of selected microcontaminants and microorganisms in land runoff and tile drainage in treated sludge-amended soils.

The objective of this study is to provide a snapshot of the quality of surface runoff and tile drainage in sludge-amended soil in terms of 57 microcontaminants, including pharmaceuticals, hormones and fragrances, and 5 different species of bacteria. It also discusses the main factors affecting their occurrence (soil characteristics, applied sludge load and rate, sludge application method, rain intensity and frequency). It is based on 38 investigations carried out by different research groups in Canada, Australia, the USA and Ireland. The most frequently investigated compounds were hormones, the antiseptics triclosan and triclocarban, the analgesics and anti-inflammatories acetaminophen, ibuprofen and naproxen, the antibiotic sulfamethoxazole, the lipid regulator gemfibrozil and the psychiatric drug carbamazepine. Of all the bacteria, E. coli was the most monitored species. It was found that concentrations of the studied pollutants in surface runoff and tile drainage may vary, depending on many factors. They are generally lower than those observed in the secondary municipal effluent and in surface water, but their contribution to the deterioration of surface water quality might be relevant, mainly in wide rural areas. In this context, the reported data or their ranges represent an attempt to provide reference thresholds and bands of observed concentrations for a rough estimation of the contribution made by the release of the selected pollutants into surface water bodies via surface runoff and tile drainage.

Potential effects of TiO2 nanoparticles and TiCl4 in saltwater to Phaeodactylum tricornutum and Artemia franciscana.

Nanosized titanium dioxide (nTiO2) is widespread in many commercial products and several authors investigated its ecotoxicity effects focusing mainly on freshwater environments. Data on saltwater species are still lacking or present contradicting results. We compared for the first time the toxicity of TiCl4 and nTiO2 considering standard toxicity tests with microalgae Phaeodactylum tricornutum (growth inhibition test, 1.8-90mg/L) and crustacean Artemia franciscana (mortality test, 0.5-64mg/L). For A. franciscana, two alternative scenarios were considered beside standard protocol: i) darkness; and ii) starvation. About microalgae, results evidenced that effects of TiCl4 (EC50=63mg/L) were greater than nTiO2 (no EC50), but IC10 and IC20 were significantly lower suggesting that nTiO2 is more harmful than TiCl4 at lower concentrations. The effects of TiCl4 to crustaceans larvae in all exposure scenarios were lower compared to nTiO2 (EC50(96h)=15mg/L - standard protocol). During toxicity testing, the absence of light generally lowered nTiO2 effects while starvation increased the toxicity of both TiCl4 and nTiO2.

Effects of mineral amendments on trace elements leaching from pre-treated marine sediment after simulated rainfall events.

Bauxite extraction by-products (red mud) were used to evaluate their potential ability to stabilize trace elements from dredged and aerated/humidified marine sediment. The investigated by-products were: bauxaline®(BX) that is a press-filtered red mud; bauxsol™(BS) that is a press-filtered red mud previously washed with excess of seawater, and gypsum neutralized bauxaline® (GBX). These materials were separately mixed to dredged composted sediment sample considering 5% and 20% sediment: stabilizer ratios. For pilot experiments, rainfall events were regularly simulated for 3 months. Concentrations of As, Mo, Cd, Cr, Zn, Cu, and Ni were analyzed in collected leachates as well as toxicity. Results showed that Cd, Mo, Zn, and Cu were efficiently stabilized in the solid matrix when 20% of BX, BS, and GBX was applied. Consequently, toxicity of leachates was lower than for the untreated sediment, meaning that contaminants mobility was reduced. A 5% GBX was also efficient for Mo, Zn and Cu stabilization. In all scenarios, As stabilization was not improved. Compared to all other monitored elements, Mo mobility seemed to depend upon temperature-humidity conditions during pilot experiments suggesting the need of further investigations.

Saltwater ecotoxicology of Ag, Au, CuO, TiO2, ZnO and C60 engineered nanoparticles: An overview.

This review paper examined 529 papers reporting experimental nanoecotoxicological original data. Only 126 papers referred to saltwater environments (water column and sediment) including a huge variety of species (n=51), their relative endpoints and engineered nanoparticles (ENPs) (n=38). We tried to provide a synthetic overview of the ecotoxicological effects of ENPs from existing data, refining papers on the basis of cross-cutting selection criteria and supporting a "mind the gap" approach stressing on missing data for hazard and risk assessment. After a codified selection procedure, attention was paid to Ag, Au, CuO, TiO2, ZnO and C60 ENPs, evidencing and comparing the observed nanoecotoxicity range of effect. Several criticisms were evidenced: i) some model organisms are overexploited like microalgae and molluscs compared to annelids, echinoderms and fish; ii) underexploited model organisms: mainly bacteria and fish; iii) exposure scenario variability: high species-specific and ENP scenarios including organism life stage and way of administration/spiking of toxicants; iv) scarce comparability between results due to exposure scenario variability; v) micro- and mesocosms substantially unexplored; vi) mixture effects: few examples are available only for ENPs and traditional pollutants; mixtures of ENPs have not been investigated yet; vii) effects of ions and ENPs: nAg, nCuO and nZnO toxicity aetiology is still a matter of discussion; viii) size and morphology effects of ENPs: scarcely investigated, justified and understood. Toxicity results evidenced that: nAu>nZnO>nAg>nCuO>nTiO2>C60.

Phytotoxicity of ionic, micro- and nano-sized iron in three plant species.

Potential environmental impacts of engineered nanoparticles (ENPs) can be understood taking into consideration phytotoxicity. We reported on the effects of ionic (FeCl3), micro- and nano-sized zerovalent iron (nZVI) about the development of three macrophytes: Lepidium sativum, Sinapis alba and Sorghum saccharatum. Four toxicity indicators (seed germination, seedling elongation, germination index and biomass) were assessed following exposure to each iron concentration interval: 1.29-1570mg/L (FeCl3), 1.71-10.78mg/L (micro-sized iron) and 4.81-33,560mg/L (nano-iron). Exposure effects were also observed by optical and transmission electron microscopy. Results showed that no significant phytotoxicity effects could be detected for both micro- and nano-sized zerovalent irons, including field nanoremediation concentrations. Biostimulation effects such as an increased seedling length and biomass production were detected at the highest exposure concentrations. Ionic iron showed slight toxicity effects only at 1570mg/L and, therefore, no median effect concentrations were determined. By microscopy, ENPs were not found in palisade cells or xylem. Apparently, aggregates of nZVI were found inside S. alba and S. saccharatum, although false positives during sample preparation cannot be excluded. Macroscopically, black spots and coatings were detected on roots of all species especially at the most concentrated treatments.

Deaths with acute cerebral lesions in ICU: does the number of potential organ donors depend on predictable factors?

BACKGROUND: As the potentiality of deceased organ donation mostly depends on the number of brain deaths (BDs), the aim of this study is to quantify rates and probabilities of BD declaration in Italy. METHODS: Deaths with acute cerebral lesion (ACLDs) in the Italian ICUs have been prospectively collected. A total of 27,490 ACDLs occurred in 5 years. Age, gender, etiology, timing of death and ICU Region have been utilized for multivariate analysis. RESULTS: The global ratio of BD declarations to ACLDs was 39.9%. The rates of ACLDs, BD declarations and actual donors were 93.5, 37.3 and 19.7 pmp respectively. Wide variability resulted among Regions, with 148.2 ACLDs, 77.8 BD declarations and 42 donors pmp as benchmark. The probability of being BD declared was significantly higher in stroke compared with head injury (OR 1.6, P<0.001) and in females (OR 1.5, P<0.001), with half the Regions missing around 50% of BD declarations compared with the benchmark, particularly in elderly patients. CONCLUSION: Predictable factors associated with BD declaration can be identified in ACLD management. Positive factors leading to the identification of potential organ donors, i.e., the capacity of declaring BD in all the patients fulfilling BD criteria irrespective of age and etiology, could be captured in the best performing regions and reproduced throughout the Country. The implementation of simple indicators based on prospective ACLD monitoring, i.e. the declared BDs to ACLDs in ICU ratio, may be helpful in achieving efficiency targets and reliable comparisons of outcomes in the identification of BD potential organ donors.

Ecotoxicity of engineered TiO2 nanoparticles to saltwater organisms: an overview.

The innovative properties of nanomaterials make them suitable for various applications in many fields. In particular, TiO2 nanoparticles (nTiO2) are widely used in paints, in cosmetics and in sunscreens that are products accessible to the mass market. Despite the great increase in the use of such nanomaterials, there is a paucity of general information about their potential effects to the aquatic species, especially to saltwater ones. Moreover, the difficulties of determining the effective exposure scenario make the acquired information low comparable. In this work, questions about the complexity of the real exposure scenario determination are discussed. The state of the art, concerning the experimental activities with nTiO2 toward the saltwater organisms is firstly illustrated, providing statistical information about the different matrices, organisms and nanoparticles employed. A comparison of the nTiO2 ecotoxicity effects, grouped by taxonomic classes, is provided illustrating their relative experimental conditions. Findings show the need to develop specific protocols for toxicity tests with ENPs to control the variability of experimental conditions. Some advices are finally proposed for the future experimental activities.

Checklist for anesthesiological process: analysis of risks.

BACKGROUND: Several methods are reported in the literature to analyze medically undesirable events during hospital care. Each method has several limitations, so no one has been defined as the standard tool to be able to detect failure during a medical process. The aim of this study was to compare an anesthesiological perioperative checklist with traditional Regional Incident Reporting (RIR) form in detecting and describing failures. METHODS: We analyzed RIR number of reports, seriousness and contributing factors. We also analyzed anesthesiological checklist data for: number of reports, seriousness of incident, contributing factors and distribution in macro-phases. RESULTS: We screened 2681 patients who underwent gynecological and obstetrical surgeries. RIR showed only the most harmful events in 0.4% of surgeries. Conversely, we recorded 135 failures with anesthesiological checklists (3.3%), of which 123 (91.1%) were solved. Categories of incident in checklists were: failures for medical device/equipment (N.=30, 22.2%), for treatment/procedures (N.=25, 18.5%), for clinical assessment (N.=22, 16.2%), for consent/communication (N.=19, 14%), for medication (N.=16, 11.8%) and for documentation (N.=8, 5.9%). Ninety-four failures (69.6%) resulted in no harm for the patient, 41 (30.3%) in reversible damage and there were no cases of permanent damage/death. Contributing factors in checklists were mainly related to team (43.7%), task factors (28.1%) and work environment (22.2%). Failures detected in macro-phases were related to: clinical assessment (31.8%), presurgical re-assessment (23.7%), preparation for anesthesia (30.3%), anesthesia conduction (8.8%) and awakening (5.1%). CONCLUSION: An anesthesiological checklist compared with traditional RIR provided a more sensible and complete framework for incident analysis during the perioperative period in patients undergoing gynecological and obstetrical surgeries.

Models for institutional and professional accreditation of haemophilia centres in Italy.

The Health Commission of the Conference between the Italian State and Regions recognized the need to establish an institutional accreditation model for Haemophilia Centres (HCs) to be implemented by 21 Regions in order to provide patients with haemophilia and allied inherited coagulations disorders with high and uniform standards of care. The Italian National Blood Centre, on behalf of the Commission, convened a panel of clinicians, patients, experts, representatives from Regions and Ministry of Health. The agreed methodology included: systematic literature review and best practice collection, analysis of provisions and regulations of currently available services, priority setting, definition of principles and criteria for the development of recommendations on the optimal requirements for HCs. The result was the formulation of two recommendations sets. Two sets of recommendations were produced. The first concerns regional policy planning, in which the following aspects of comprehensive haemophilia care should be considered for implementation: monitoring and auditing, multidisciplinary approach to clinical care, protocols for emergency management, home treatment and its monitoring, patient registries, drug availability and procurement, recruitment and training of health care professionals. The second set concerns the accreditation process and lists 23 organizational requirements for level 1 HCs and 4 additional requirements for level 2 HCs. These recommendations help to provide Italian Regional Health Authorities with an organizational framework for the provision of comprehensive care to patients with inherited coagulation disorders based on current scientific evidence.

National policies for risk management in Italy.

The Ministry of Health in Italy considers risk management (RM) to be one of the specific objectives to be developed by its national policies, as suggested by the European Union recommendations and by several international organizations, such as the World Health Organization (WHO), the Council of Europe, and the Organization for Economic Cooperation and Development. The National Health Plan stated the need to guarantee and monitor safety of health care and biomedical technology, with the development of a standardized computerized method to collect and analyze data on adverse events and with specific actions for education and training of all stakeholders, which is to be conducted at different levels of the health system governance, national, regional, and local. Over a 4-year period, the National Observatory for the Monitoring of Sentinel Events has collected data on 385 sentinel events, with a mortality rate of 54.8%. Compared with earlier reports, we have observed a reduction from 41% to 17% of sentinel events classified in the "nonspecified sentinel event" and an increase from 20% to 40% of cases in which an action plan has been developed. A manual for root cause analysis has been released with the aim of offering health operators an instrument to analyze the occurrence of an adverse event. Ten recommendations and a manual for safety in the operating room, which includes a checklist for safe surgery adapted on the basis of WHO suggestions, have been published. To date, eight guidelines for safety have been released to improve stakeholders' accountability. The Ministry of Health has also elaborated a program of specific actions to be developed over the next 2 years in several areas of RM. These initiatives confirm the strategic role of policies for RM in our country, allowing for a dynamic and proactive process, ensuring continuity of action and promoting a deep understanding of patient safety issues.

Overview of ecotoxicological studies performed in the Venice Lagoon (Italy).

This work reports on the state of the art of the bioindicators used to assess environmental quality (regarding chemical pollutant impacts) in the Venice lagoon. After a brief description of the roles, advantages and limitations of bioindicators in marine and transitional environments and a summary of the Venice lagoon characteristics, the ecotoxicological methods used during scientific studies and research projects in the Lagoon are reported. Since not all data are available and no database can be formulated, the main evidence from toxicity bioassays, biomarkers and bioaccumulation analyses since the end of the 1970s is spatially synthesized using maps and discussed according to the four Venice lagoon basins. The majority of indicators showed that the Lido basin (north-central lagoon), affected by the presence of the industrial area and the city of Venice, is the one most highly impacted (particularly in the sites located within or in front of the industrial area, which showed very high sediment toxicity and high levels of DNA damage). The Malamocco basin (south-central lagoon) seems to be the least problematic. The southern basin (Chioggia basin) was shown to be impacted by urban contaminants from the town of Chioggia. The northern basin (Treporti basin) presented both impacted sites (high toxicity and high bioaccumulation factor) and relatively unpolluted sites (absence of toxicity, absence of imposex and low levels of bioaccumulation). This review can serve as a basis on which to select pragmatic, cost-effective biomonitoring techniques for environmental effects in lagoon ecosystems.

Seawater ecotoxicity of monoethanolamine, diethanolamine and triethanolamine.

Monoethanolamine (MEA), diethanolamine (DEA) and triethanolamine (TEA) are compounds with potential acute, sub-chronic and chronic toxicity effects towards aquatic species. A literature review highlighted the existence of a gap in the knowledge on their toxicity with saltwater testing species. A battery of toxicity tests including the alga Phaeodactylum tricornutum Bohlin, the bivalve molluscs Crassostrea gigas (Thunberg) and Mytilus galloprovincialis (Lmk), and the crustacean Artemia franciscana, was considered to update and improve the existing ecotoxicological information. Data were provided as the Effective Concentration that induces a 50% effect in the observed population (EC50), Lowest Observed Effect Concentration (LOEC) and No Observed Effect Concentration (NOEC). EC50, LOEC and NOEC values were compared with a reviewed database containing the existing ecotoxicological data from saltwater organisms.

Performance assessment of AS-SBR and UF-MBR for hotel wastewater treatment.

A large number of tourist structures in Venice (Italy) have small sized on-site treatment systems for their wastewater. Due to its historical characteristics, the city has no public sewerage system and untreated hotel wastewater represents a serious hazard for its lagoon environment. This study focused on the wastewater facilities installed in two hotels adopting an Activated Sludge Sequencing Batch Reactor (AS-SBR) and an Ultra-Filtration Membrane Biological Reactor (UF-MBR). Their performance was checked in terms of both traditional physico-chemical and ecotoxicological parameters, the importance of which has recently been recognised by EU regulatory dispositions and OSPAR indications. Acute and sub-chronic endpoints were both considered on a whole effluent toxicity basis by means of Vibrio fischeri and Crassostrea gigas, respectively. The two months monitoring survey evidenced that the UF-MBR was more efficient than the AS-SBR in providing high-quality discharges under both chemical and ecotoxicological viewpoints.

Influence of storage methods, refrigeration or freezing, on the toxicity of wastewater samples to oyster embryos.

One of the main concerns in wastewater whole effluent assessment is the sampling phase and the sample chain of custody before any toxicity evaluation. The major problem is related to establishing the correct method for sample storage in order to perform toxicity bioassays. The toxicity of some domestic and glass factory industrial wastewater samples stored both by refrigeration at 4 +/- 1 degrees C for no more than three days, and freezing at -18 +/- 1 degrees C for no more than one month was compared via the embryo larval development bioassay with the oyster Crassostrea gigas. The results showed no significant differences between the toxicities of refrigerated and frozen wastewater samples. The wastewater classification, according to a score based on four toxicity classes, showed that the preservation methods did not alter the toxicity classification of the samples. In particular, it was demonstrated that the samples considered as 'not acutely toxic' after refrigeration were also found to have this classification after freezing.

Influence of the salinity adjustment methods, salts and brine, on the toxicity of wastewater samples to mussel embryos.

One of the main problems of the Whole Effluent Toxicity is related to the use of bioindicator species representative of the target environment. Most wastewater discharges are of fresh water, so their salinity has to be adjusted when they are discharged to transitional and marine coastal waters, in order to perform toxicity bioassays with reliable organisms. At the moment, there is no optimum technique to allow sample salinity to be adjusted and no specific information regarding salinity adjustment when bivalves are being considered for toxicity test performance. This paper provides information on the potential use of different methods to adjust the salinity of hotel/domestic wastewater samples with different brands of natural and synthetic Dry Salts (DS) and HyperSaline Brine (HSB) for use in the embryo larval development bioassay with the mussel Mytilus galloprovincialis. HyperSaline Brine derived from reconstructed artificial seawater proved to be more viable for wastewater salinity adjustment than DS.

Skin permeation and distribution of two sunscreens: a comparison between reconstituted human skin and hairless rat skin.

The aims of this work were (a) to develop a simple and reproducible procedure for percutaneous absorption and distribution tests of sunscreens using one human skin culture model (Epiderm 606; reconstructed epidermis, RE), (b) to compare the said model with rat skin (RS) in vitro and (c) to evaluate the effect of different formulations. The cutaneous permeation and distribution of two UV filters, ethylhexylmethoxycinnamate (MC80) and ethylhexyltriazone (T150), using 3 different vehicles were investigated. The permeation studies demonstrated that neither MC80 nor T150 permeated through both RS and RE in spite of different thicknesses of the 2 substrates. Distribution studies demonstrated that sectioning by cryomicrotome to obtain horizontal skin layers was suitable for both RS and RE (apart from its small thickness) with a good reproducibility of data. The amounts of sunscreens retained in the 2 substrates were in the same order of magnitude for all formulations with a greater depot in RS. Different distribution profiles of the tested formulations could be ascribed to the different lipid compositions of RE and RS. Since the physicochemical characteristics of RE are closer to those of human skin, the results obtained with reconstructed human skin models could be suitable to replace human skin in 'in vitro testing'.