Development and machine learning-based calibration of low-cost multiparametric stations for the measurement of CO2 and CH4 in air.

The pressing issue of atmospheric pollution has prompted the exploration of affordable methods for measuring and monitoring air contaminants as complementary techniques to standard methods, able to produce high-density data in time and space. The main challenge of this low-cost approach regards the in-field accuracy and reliability of the sensors. This study presents the development of low-cost stations for high-time resolution measurements of CO2 and CH4 concentrations calibrated via an in-field machine learning-based method. The calibration models were built based on measurements parallelly performed with the low-cost sensors and a CRDS analyzer for CO2 and CH4 as reference instrument, accounting for air temperature and relative humidity as external variables. To ensure versatility across locations, diversified datasets were collected, consisting of measurements performed in various environments and seasons. The calibration models, trained with 70 % for modeling, 15 % for validation, and 15 % for testing, demonstrated robustness with CO2 and CH4 predictions achieving R2 values from 0.8781 to 0.9827 and 0.7312 to 0.9410, and mean absolute errors ranging from 3.76 to 1.95 ppm and 0.03 to 0.01 ppm, for CO2 and CH4, respectively. These promising results pave the way for extending these stations to monitor additional air contaminants, like PM, NOx, and CO through the same calibration process, integrating them with remote data transmission modules to facilitate real-time access, control, and processing for end-users.

Soil processes modify the composition of volatile organic compounds (VOCs) from CO2- and CH4-dominated geogenic and landfill gases: A comprehensive study.

Degradation mechanisms affecting non-methane volatile organic compounds (VOCs) during gas uprising from different hypogenic sources to the surface were investigated through extensive sampling surveys in areas encompassing a high enthalpy hydrothermal system associated with active volcanism, a CH4-rich sedimentary basin and a municipal waste landfill. For a comprehensive framework, published data from medium-to-high enthalpy hydrothermal systems were also included. The investigated systems were characterised by peculiar VOC suites that reflected the conditions of the genetic environments in which temperature, contents of organic matter, and gas fugacity had a major role. Differences in VOC patterns between source (gas vents and landfill gas) and soil gases indicated VOC transformations in soil. Processes acting in soil preferentially degraded high-molecular weight alkanes with respect to the low-molecular weight ones. Alkenes and cyclics roughly behaved like alkanes. Thiophenes were degraded to a larger extent with respect to alkylated benzenes, which were more reactive than benzene. Furan appeared less degraded than its alkylated homologues. Dimethylsulfoxide was generally favoured with respect to dimethylsulfide. Limonene and camphene were relatively unstable under aerobic conditions, while α-pinene was recalcitrant. O-bearing organic compounds (i.e., aldehydes, esters, ketones, alcohols, organic acids and phenol) acted as intermediate products of the ongoing VOC degradations in soil. No evidence for the degradation of halogenated compounds and benzothiazole was observed. This study pointed out how soil degradation processes reduce hypogenic VOC emissions and the important role played by physicochemical and biological parameters on the effective VOC attenuation capacity of the soil.

Impact on air quality of carbon and sulfur volatile compounds emitted from hydrothermal discharges: The case study of Pisciarelli (Campi Flegrei, South Italy).

Volcanoes are currently to be regarded as natural sources of air pollutants. Climatic and environmental forcing of large volcanic eruptions are well known, although gases emitted through passive degassing during periods of quiescence or hydrothermal activity can also be highly dangerous for the environment and public health. Based on compositional and isotopic data, a survey on the spatial distribution in air of the main volatile compounds of carbon (CO2 and CH4) and sulfur (H2S and SO2) emitted from the fumarolic field of Pisciarelli (Campi Flegrei, Pozzuoli, Naples), a hydrothermal area where degassing activity has visibly increased since 2009, was carried out. The main goals of this study were (i) to evaluate the impact on air quality of these natural manifestations and (ii) inquire into the behavior of the selected chemical species once released in air, and their possible use as tracers to distinguish natural and anthropogenic sources. Keeling plot analysis of CO2 and CH4 isotopes revealed that the hydrothermal area acts as a net source of CO2 in air, whilst CH4 originated mainly from anthropogenic sources. Approaching the urban area, anthropogenic sources of CO2 increased and, at distances greater than 800 m from the Pisciarelli field, they prevailed over the hydrothermal signal. While hydrothermal CO2 simply mixed with that in the atmospheric background, H2S was possibly affected by oxidation processes. Therefore, SO2 measured in the air near the hydrothermal emissions had a secondary origin, i.e. generated by oxidation of hydrothermal H2S. Anthropogenic SO2 was recognized only in the furthest measurement site from Pisciarelli. Finally, in the proximity of a geothermal well, whose drilling was in progress during our field campaign, the H2S concentrations have reached values up to 3 orders of magnitude higher than the urban background, claiming the attention of the local authorities.

Data-Inspired and Physics-Driven Model Reduction for Dissociation: Application to the O2 + O System.

This work presents an in-depth discussion on the nonequilibrium dissociation of O2 molecules colliding with O atoms, combining quasi-classical trajectory calculations, master equation, and dimensionality reduction. A rovibrationally resolved database for all of the elementary collisional processes is constructed by including all nine adiabatic electronic states of O3 in the QCT calculations. A detailed analysis of the ab initio data set reveals that for a rovibrational level, the probability of dissociating is mostly dictated by its deficit in internal energy compared to the centrifugal barrier. Because of the assumption of rotational equilibrium, the conventional vibrational-specific calculations fail to characterize such a dependence. Based on this observation, a new physics-based grouping strategy for application to coarse-grained models is proposed. By relying on a hybrid technique made of rovibrationally resolved excitation coupled to coarse-grained dissociation, the new approach is compared to the vibrational-specific model and the direct solution of the rovibrational state-to-state master equation. Simulations are performed in a zero-dimensional isothermal and isochoric chemical reactor for a wide range of temperatures (1500-20,000 K). The study shows that the main contribution to the model inadequacy of vibrational-specific approaches originates from the incapability of characterizing dissociation, rather than the energy transfers. Even when constructed with only twenty groups, the new reduced-order model outperforms the vibrational-specific one in predicting all of the QoIs related to dissociation kinetics. At the highest temperature, the accuracy in the mole fraction is improved by 2000%.

Bayesian Machine Learning Approach to the Quantification of Uncertainties on Ab Initio Potential Energy Surfaces.

This work introduces a novel methodology for the quantification of uncertainties associated with potential energy surfaces (PESs) computed from first-principles quantum mechanical calculations. The methodology relies on Bayesian inference and machine learning techniques to construct a stochastic PES and to express the inadequacies associated with the ab initio data points and their fit. By combining high fidelity calculations and reduced-order modeling, the resulting stochastic surface is efficiently forward propagated via quasi-classical trajectory and master equation calculations. In this way, the PES contribution to the uncertainty on predefined quantities of interest (QoIs) is explicitly determined. This study is done at both microscopic (e.g., rovibrational-specific rate coefficients) and macroscopic (e.g., thermal and chemical relaxation properties) levels. A correlation analysis is finally applied to identify the PES regions that require further refinement, based on their effects on the QoI reliability. The methodology is applied to the study of singlet (11A') and quintet (25A') PESs describing the interaction between O2 molecules and O atoms in their ground electronic state. The investigation of the singlet surface reveals a negligible uncertainty on the kinetic properties and relaxation times, which are found to be in excellent agreement with the ones previously published in the literature. On the other hand, the methodology demonstrated significant uncertainty on the quintet surface, due to inaccuracies in the description of the exchange barrier and the repulsive wall. When forward propagated, this uncertainty is responsible for the variability of 1 order of magnitude in the vibrational relaxation time and of factor four in the exchange reaction rate coefficient, both at 2500 K.

Volatile organic compounds (VOCs) in solid waste landfill cover soil: Chemical and isotopic composition vs. degradation processes.

Landfills for solid waste disposal release to the atmosphere a large variety of volatile organic compounds (VOCs). Bacterial activity in landfill cover soils can play an important role in mitigating VOC emission. In order to evaluate the effects of degradation processes and characterize VOCs composition in landfill cover soil, gases from 60 sites and along 7 vertical profiles within the cover soil were collected for chemical and isotopic analysis at two undifferentiated urban solid waste disposal sites in Spain: (i) Pinto (Madrid) and (ii) Zurita (Fuerteventura, Canary Islands). The CO2/CH4 ratios and δ13C-CO2 and δ13C-CH4 values were controlled by either oxidation or reduction processes of landfill gas (LFG). VOCs were dominated by aromatics, alkanes and O-substituted compounds, with minor cyclics, terpenes, halogenated and S-substituted compounds. Degradation processes, depending on both (i) waste age and (ii) velocity of the uprising biogas through the soil cover, caused (i) an increase of degradation products (e.g., CO2, O-substituted compounds) and (ii) a decrease of degradable components (e.g., CH4, alkanes, alkylated aromatics, cyclic and S-substituted compounds). Terpenes, halogenated compounds, phenol and furans were unaffected by degradation processes and only depended on waste composition. These results highlight the fundamental role played by microbial activity in mitigating atmospheric emissions of VOCs from landfills. Nevertheless, the recalcitrant behaviour shown by compounds hazardous for health and environment remarks the importance of a correct landfill management that has to be carried out for years after the waste disposal activity is completed, since LFG emissions can persist for long time.

Dissolved organic matter in a tropical saline-alkaline lake of the East African Rift Valley.

Saline-alkaline lakes of the East African Rift are known to have an extremely high primary production supporting a potent carbon cycle. To date, a full description of carbon pools in these lakes is still missing. More specifically, there is not detailed information on the quality of dissolved organic matter (DOM), the main carbon energy source for heterotrophs prokaryotes. We report the first exhaustive description of DOM molecular properties in the water column of a meromictic saline-alkaline lake of the East African Rift. DOM availability, fate and origin were studied either quantitatively, in terms of dissolved organic carbon (DOC) and nitrogen (DON) or qualitatively, in terms of optical properties (absorbance) and molecular characterization of solid-phase extracted DOM (SPE-DOM) through negative electrospray ionization Fourier-transform ion cyclotron resonance mass spectrometry (FT-ICR-MS). DOM availability was high (DOC ∼ 8.1 mM in surface waters) and meromixis imprinted a severe quantitative and qualitative change on DOM pool. At the surface, DOM was rich in aliphatic and moderately in aromatic molecules and thus mirroring autochthonous microbial production together with photodegradation. At the bottom changes were extreme: DOC increased up to 5 times (up to 50 mM) and, molecular signature drifted to saturated, reduced and non-aromatic DOM suggesting intense microbial activity within organic sediments. At the chemocline, DOC was retained indicating that this interface is a highly reactive layer in terms of DOM processing. These findings underline that saline-alkaline lakes of the East African Rift are carbon processing hot spots and their investigation may broaden our understanding of carbon cycling in inland waters at large.

Seasonal and diurnal variations of greenhouse gases in Florence (Italy): Inferring sources and sinks from carbon isotopic ratios.

In this study, the results of a continuous monitoring of (i) CO2 fluxes, and (ii) CO2 and CH4 concentrations and carbon isotopic ratios (δ13C-CO2 and δ13C-CH4) in air, carried out from 7 to 21 July 2017 and from October 10 to December 15, 2017 in the city centre of Florence, are presented. The measurements were performed from the roof of the historical building of the Ximenes Observatory. CO2 flux data revealed that the metropolitan area acted as a net source of CO2 during the whole observation period. According to the Keeling plot analysis, anthropogenic contributions to atmospheric CO2 were mainly represented by vehicular traffic (about 30%) and natural gas combustion (about 70%), the latter contributing 7 times more in December than in July. Moreover, the measured CO2 fluxes were about 80% higher in fall than in summer, confirming that domestic heating based on natural gas is the dominant CO2 emitting source in the municipality of Florence. Even though the continuous monitoring revealed a shift in the δ13C-CO2 values related to photosynthetic uptake of atmospheric CO2, the isotopic effect induced by plant activity was restricted to few hours in October and, to a lesser extent, in November. This suggests that urban planning policies should be devoted to massively increase green infrastructures in the metropolitan area in order to counterbalance anthropogenic emissions. During fall, the atmospheric CH4 concentrations were sensibly higher with respect to those recorded in summer, whilst the δ13C-CH4 values shifted towards heavier values. The Keeling plot analysis suggested that urban CH4 emissions were largely related to fugitive emissions from the natural gas distribution pipeline network. On the other hand, δ13C-CH4 monitoring allowed to recognize vehicular traffic as a minor CH4 emitting source.

Carbon isotopic signature of interstitial soil gases reveals the potential role of ecosystems in mitigating geogenic greenhouse gas emissions: Case studies from hydrothermal systems in Italy.

Volcanic and hydrothermal areas largely contribute to the natural emission of greenhouse gases to the atmosphere, although large uncertainties in estimating their global output still remain. Nevertheless, CO2 and CH4 discharged from hydrothermal fluid reservoirs may support active soil microbial communities. Such secondary processes can control and reduce the flux of these gases to the atmosphere. In order to evaluate the effects deriving from the presence of microbial activity, chemical and carbon (in CO2 and CH4) isotopic composition of interstitial soil gases, as well as diffuse CO2 fluxes, of three hydrothermal systems from Italy were investigated, i.e. (i) Solfatara crater (Campi Flegrei), (ii) Monterotondo Marittimo (Larderello geothermal field) and (iii) Baia di Levante in Vulcano Island (Aeolian Archipelago), where soil CO2 fluxes up to 2400, 1920 and 346 g m-2 day-1 were measured, respectively. Despite the large supply of hydrothermal fluids, 13CO2 enrichments were observed in interstitial soil gases with respect to the fumarolic gas discharges, pointing to the occurrence of autotrophic CO2 fixation processes during the migration of deep-sourced fluids towards the soil-air interface. On the other hand, (i) the δ13C-CH4 values (up to ~48‰ vs. V-PDB higher than those measured at the fumarolic emissions) of the interstitial soil gases and (ii) the comparison of the CO2/CH4 ratios between soil gases and fumarolic emissions suggested that the deep-sourced CH4 was partly consumed by methanotrophic activity, as supported by isotope fractionation modeling. These findings confirmed the key role that methanotrophs play in mitigating the release of geogenic greenhouse gases from volcanic and hydrothermal environments.

Impact of a hospital-wide multifaceted programme for reducing carbapenem-resistant Enterobacteriaceae infections in a large teaching hospital in northern Italy.

We performed a quasi-experimental study of a multifaceted infection control programme for reducing carbapenem-resistant Enterobacteriaceae (CRE) transmission and bloodstream infections (BSIs) in a 1420-bed university-affiliated teaching hospital during 2010-2014, with 30 months of follow-up. The programme consisted of the following: (a) rectal swab cultures were performed in all patients admitted to high-risk units (intensive-care units, transplantation, and haematology) to screen for CRE carriage, or for any room-mates of CRE-positive patients in other units; (b) cohorting of carriers, managed with strict contact precautions; (c) intensification of education, cleaning and hand-washing programmes; and (d) promotion of an antibiotic stewardship programme carbapenem-sparing regimen. The 30-month incidence rates of CRE-positive rectal cultures and BSIs were analysed with Poisson regression. Following the intervention, the incidence rate of CRE BSI (risk reduction 0.96, 95% CI 0.92-0.99, p 0.03) and CRE colonization (risk reduction 0.96, 95% CI 0.95-0.97, p <0.0001) significantly decreased over a period of 30 months. After accounting for changes in monthly census and percentage of externally acquired cases (positive at ≤72 h), the average institutional monthly rate of compliance with CRE screening procedures was the only independent variable associated with a declining monthly incidence of CRE colonization (p 0.002). The monthly incidence of CRE carriage was predictive of BSI (p 0.01). Targeted screening and cohorting of CRE carriers and infections, combined with cleaning, education, and antimicrobial stewardship measures, significantly decreased the institutional incidence of CRE BSI and colonization, despite endemically high CRE carriage rates in the region.

The changing face of multiple sclerosis: Prevalence and incidence in an aging population.

OBJECTIVE: To assess multiple sclerosis (MS) incidence from 1998 to 2007, and MS prevalence on 31 December 2007, in the province of Genoa, Italy. METHODS: We identified MS cases diagnosed before 31 December 2007 by analyzing archives of hospitals with neurological or rehabilitation wards, the local Italian MS society, family doctor records and requests for oligoclonal band analysis on cerebrospinal fluid (CSF). RESULTS: A total of 1312 MS patients were residing in the province of Genoa on the prevalence day; 431 (32.85%) were men and 881 (67.15%) were women; mean age was 50.6 (± 13.9). The overall crude MS prevalence rate was 148.5/100,000; 103.1/100,000 in men and 189.1/100,000 in women. The crude mean annual MS incidence rate was 6.6 cases/100,000 (4.4/100,000 men; 8.6/100,000 women). Mean age at diagnosis was 39.5 ± 12.3 (men: 39.9 ± 13.0; women: 39.3 ± 11.9). A mean annual incidence of 4 MS patients ≥ 60 was observed. CONCLUSIONS: We observed an increased MS prevalence in the province of Genoa, compared to 1997. The mean age at diagnosis was relatively high (39 years old), 18% of our MS patients were over 65, and a notable incidence increase was seen in patients over 60. This has important implications, in terms of the need to organize the health system to better serve elderly MS patients, especially considering comorbidities and different medical needs of elderly MS patients; and to increase awareness within the medical community about the increasing risk of newly-presenting MS in the older population.

Retrotransposon characterisation and fingerprinting of apple clones by S-SAP markers.

Retrotransposons have been found to comprise the most common class of transposable elements in eukaryotes and to occur in high copy number in plant genomes. Several of these elements have been sequenced and were found to display a high degree of heterogeneity and insertional polymorphism, both within and between species. The dispersion, ubiquity and prevalence of retrotransposons in plant genomes provide an excellent basis for the development of marker systems and, hence, may be good molecular candidates in distinguishing among apple clones, when they represent bud mutations of the original variety, considering that the random amplified polymorphic DNA (RAPD), amplified fragment length polymorphism (AFLP) and simple sequence repeat (SSR) used thus far in fingerprinting analyses have failed to meet discrimination expectations. The technique called sequence-specific amplified polymorphism (S-SAP), which makes it possible to identify dominant markers for the detection of variation in the DNA flanking the retrotransposon insertion site, was used in the present study to distinguish several clones of the cultivars 'Gala' and 'Braeburn' in apple fingerprinting. Moreover, our results suggest that the bud mutations, which have generated new patented varieties of 'Gala' and 'Braeburn', appear to derive from retrotransposon insertion.

[OCTOPUS: longitudinal study on carpal tunnel syndrome and work]. / OCTOPUS: uno studio longitudinale su Sindrome del Tunnel Carpale ed attività lavorative.

Carpal tunnel syndrome (CTS), the commonest nerve entrapment syndrome, is one of the most frequent occupational disorders related to manual work. Both occupational and personal risk factors make it difficult to recognize the true origin of its occurrence and to devise prevention strategies. Most of the information available about occupational CTS originates from cross-sectional studies on various job titles, where the prevalence of the disease has been reported to vary between 0.6% and 61%. Few longitudinal studies are available on occupational CTS. Consensus has been reached about the criteria to diagnose CTS in epidemiological studies. However, different methods are used by different investigators to assess exposure to repetition and force, the two factors which appear to be most important in originating the disease. This could help explain the difficulty in establishing a sound exposure-effect relationship (an indispensable basis for setting exposure limits). To help fill the gap in knowledge regarding occupational CTS incidence and its relationship to occupational exposure we are performing a large longitudinal multisector study, denominated OCTOPUS. OCTOPUS has been designed to assess the incidence of CTS in a large cohort of workers employed in different sectors and exposed to different level of repetitive and forceful manual work and to relate the incidence of the disease to the possible casual factors and their variation over time. Herein, the study protocol is described.

[Carpal tunnel syndrome among supermarket cashiers]. / La sindrome del tunnel carpale nelle cassiere dei supermercati.

We studied Carpal Tunnel Syndrome prevalence in part time and full time female supermarket cashiers and in a control group (female primary school teachers). Subjects underwent a clinical examination in which information about personal, physiological, pathological and occupational factors were collected by a physician with a questionnaire and a self-administered Katz's hand diagram. The study protocol included median nerve conduction studies (NCS) for each worker, performed bilaterally according to the palmar technique described by J. Kimura. Case definition of Carpal Tunnel Syndrome was based on the combination of typical symptoms (classic/probable or possible) and electrodiagnostic findings according to the Consensus Criteria for the Classification of Carpal Tunnel Syndrome published by Rempel et al. in 1998. Biomechanical risk for upper limb was assessed by a group of trained observer using videotape and scales of hand activity level (HAL) and normalized peak of force (PF) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH): supermarket cashier job tasks resulted on the threshold limit value line, confirming high biomechanical risk factors for CTS. Both symptoms and case prevalence resulted higher in supermarket cashiers than in control group and in full time cashiers if compared with part time ones. This difference between groups of part-/full-time cashiers could be due to total hours of exposure during the week and/or to the amount of recovery time between work sessions. Further longitudinal study could give more information about the role of different biomechanical risk factors in the onset of cumulative trauma disorders of the upper limb.

Rhinasthma: a new specific QoL questionnaire for patients with rhinitis and asthma.

INTRODUCTION: To date we have available specific instruments assessing health-related quality of life (HRQL) in rhinoconjunctivitis or in asthma, but not instruments evaluating rhinitis and asthma together, although they often coexist. The aim of our study was to develop and validate a specific quality of life (QoL) questionnaire for adult patients with rhinoconjunctivitis, asthma or both. MATERIALS AND METHODS: A pool of 42 items covering the main symptoms and problems related to respiratory allergy, was generated based on literature review and clinical experience. The items were randomly listed and presented to 148 consecutive outpatients 46 suffering from asthma (age 32.9 +/- 14.3 years), 53 suffering from rhinoconjunctivitis (age 32.6 +/- 11.5 years) and 49 from asthma and rhinoconjunctivitis (age 35.6 +/- 12.2 years). The patients were asked to indicate which item they had directly experienced and for each of them, its importance on a four-point scale (1 = not important; 4 = very important). Twelve items were cancelled from the list, because of low importance or redundance. In the instrument validation phase, 104 patients (42 with rhinoconjunctivitis alone and 62 with asthma and rhinoconjunctivitis) were evaluated with the generic instrument SF-36 and the new questionnaire (RHINASTHMA). RESULTS: RHINASTHMA was able to differentiate patients with rhinitis from those with both rhinitis and asthma. In stable condition, RHINASTHMA showed good reliability. The factor analysis extracted three factors with a good reliability (0.93, 0.87, 0.76). DISCUSSION: RHINASTHMA is the first tool aimed at evaluating HRQL impairment in patients with rhinitis and/or asthma. It provides a short and simple assessment, and has overall psychometric properties. This is of relevance because of the frequent asthma-rhinitis comorbidity.

Controlled study of preseasonal immunotherapy with grass pollen extract in tablets: effect on bronchial hyperreactivity.

BACKGROUND: Based on experimental results, the sublingual route for immunotherapy (IT) has been accepted as a viable alternative to the injection route, but few data on the effects on asthma are so far available. OBJECTIVE: In the present open controlled trial we evaluated whether a preseasonal IT with grass polllen in orosoluble tablets added to pharmacotherapy, can improve non-specific bronchial hyperreactivity. The clinical efficacy was evaluated as well. METHODS: Fifty-one patients (mean age 27.4 years) suffering from rhinoconjunctivitis and/or mild-intermittent/mild-persistent asthma due to grass pollen were allocated to two groups receiving pharmacotherapy alone (n = 25) or pharmacotherapy plus IT in tablets (n = 26). A methacholine test was performed in asthmatic subjects out of the pollen seasons at baseline and after 3 years of treatment. Symptom scores and drug intake were evaluated during pollen seasons by a diary card. RESULTS: A significant increase p = .01) in the PD20 at the methacholine test was observed in the IT group compared to the control group. A significant clinical improvement both for rhinitis (p = .001) and asthma (p = .001) was observed in the IT group, and this improvement was paralleled by a clear-cut reduction of drug intake (p = .001). An improvement of rhinitis symptoms without modification of drug intake was seen in the control group (p = .01) The treatment was well tolerated and no relevant side effect was reported during the 3 years. CONCLUSION: The investigated local IT reduced the nonspecific bronchial hyperreactivity. Furthermore, it was clinically effective and safe.

Is there a role for iodine in breast diseases?

It is hypothesized that dietary iodine deficiency is associated with the development of mammary pathology and cancer. A review of the literature on this correlation and of the author's own work on the antioxidant function of iodide in iodide-concentrating extrathyroidal cells is reported. Mammary gland is embryogenetically derived from primitive iodide-concentrating ectoderm, and alveolar and ductular cells of the breast specialize in uptake and secretion of iodine in milk in order to supply offsprings with this important trace-element. Breast and thyroid share an important iodide-concentrating ability and an efficient peroxidase activity, which transfers electrons from iodide to the oxygen of hydrogen peroxide, forming iodoproteins and iodolipids, and so protects the cells from peroxidative damage. The mammary gland has only a temporary ability to concentrate iodides, almost exclusively during pregnancy and lactation, which are considered protective conditions against breast cancer.

Efficiency of organ procurement and transplantation programs.

The number of donations per million population (pmp) per year and the number of transplants pmp/year enables one to compare donation or transplant programs made in different years in the same area or made the same year in different areas. These pmp indexes may be integrated with an evaluation system by which each organ is evaluated separately in terms of the efficiency of its procurement and transplant systems using the procurement index (percentage in terms of number of organs utilized/number of organs procurable from donors utilized in a single area during 1 year) and the transplant index (percentage in terms of number of transplants performed/number of organs harvested in a single area during 1 year). We have called them Caldes I (procurement) and Caldes II (transplant) indexes. The harvest index evaluates the efficiency of utilization of organs retrieved from suitable donors. It usually ranges between 80-90% for the kidney, 70-95% for the liver, 40-50% for the heart, and 5-15% for the lungs. The transplant index evaluates for each organ the transplant team capacity to use available organs which can be harvested locally or in different areas. It usually ranges between 60-120%. Index determination did not require information different from the standard data available. Both the harvest and transplant indexes could be used to compare the efficiency of donation and transplant programs and policies in the same area during different years or at the same time in different areas. They can be critical in evaluating: (a) marginal donor utilization, (b) marginal organ utilization, and (c) dishomogeneity of organ retrieval and organ transplantation in different regions belonging to the same area. They also enable to evaluate if organs considered not available in a single area are offered to other areas or are not retrieved at all from available donors.

Organ donation and transplantation as health programs in Italy.

Organ and tissue donation and transplantation have a role in public health programs as organizational projects designed by public health departments to increase the quality and number of donations and transplantations. These programs serve as communication projects to inform public opinion on cerebral death, organ and tissue shortages, procurement and allocation rules, and the quality of life of transplanted patients. The health department of Emilia-Romagna created a regional law and a multimedia communication program for these purposes, resulting in a 95% increase of cadaver donor in 4 years. In 1995, regional activity reached the European mean level and afterwards surpassed it. In 1997, the bone bank was activated, followed in 1998 by the heart valve and vascular segment bank. The regional health department now considers transplant activities a primary goal; human and professional relations between intensive care units and the transplant reference center are considered crucial; cooperation among health departments, medical teams involved in organ procurement and transplant activities has been fostered, and the local coordination network has been active and efficient. The public information campaign has proven important in providing information both to professionals and citizens.