Integrated Approach of Life Cycle Assessment and Experimental Design in the Study of a Model Organic Reaction: New Perspectives in Renewable Vanillin-Derived Chemicals.

This work is focused on performing a quantitative assessment of the environmental impacts associated with an organic synthesis reaction, optimized using an experimental design approach. A nucleophilic substitution reaction was selected, employing vanillin as the substrate, a phenolic compound widely used in the food industry and of pharmaceutical interest, considering its antioxidant and antitumoral potential. To carry out the reaction, three different solvents have been chosen, namely acetonitrile (ACN), acetone (Ace), and dimethylformamide (DMF). The syntheses were planned with the aid of a multivariate experimental design to estimate the best reaction conditions, which simultaneously allow a high product yield and a reduced environmental impact as computed by Life Cycle Assessment (LCA) methodology. The experimental results highlighted that the reactions carried out in DMF resulted in higher yields with respect to ACN and Ace; these reactions were also the ones with lower environmental impacts. The multilinear regression models allowed us to identify the optimal experimental conditions able to guarantee the highest reaction yields and lowest environmental impacts for the studied reaction. The identified optimal experimental conditions were also validated by experimentally conducting the reaction in those conditions, which indeed led to the highest yield (i.e., 93%) and the lowest environmental impacts among the performed experiments. This work proposes, for the first time, an integrated approach of DoE and LCA applied to an organic reaction with the aim of considering both conventional metrics, such as reaction yield, and unconventional ones, such as environmental impacts, during its lab-scale optimization.

Innovative Bioplasticizers from Residual Cynara cardunculus L. Biomass-Derived Levulinic Acid and Their Environmental Impact Assessment by LCA Methodology.

This work is focused on the application of Life Cycle Assessment (LCA) methodology for the quantification of the potential environmental impacts associated with the obtainment of levulinic acid from residual Cynara cardunculus L. biomass and its subsequent valorization in innovative bioplasticizers for tuning the properties as well as the processability of biopolymers. This potentially allows the production of fully biobased and biodegradable bioplastic formulations, thus addressing the issues related to the fossil origin and nonbiodegradability of conventional additives, such as phthalates. Steam explosion pretreatment was applied to the epigean residue of C. cardunculus L. followed by a microwave-assisted acid-catalyzed hydrolysis. After purification, the as-obtained levulinic acid was used to synthesize different ketal-diester derivatives through a three-step selective synthesis. The levulinic acid-base additives demonstrated remarkable plasticizing efficiency when added to biobased plastics. The LCA results were used in conjunction with those from the experimental activities to find the optimal compromise between environmental impacts and mechanical and thermal properties, induced by the bioadditives in poly(3-hydroxybutyrate), PHB biopolymer.

Life Cycle Impact Assessment of Solution Combustion Synthesis of Titanium Dioxide Nanoparticles and Its Comparison with More Conventional Strategies.

This paper represents the first attempt to quantitatively and reliably assess the environmental sustainability of solution combustion synthesis (SCS) with respect to other soft chemistry strategies, which are more conventionally employed in the preparation of engineered oxide nanomaterials, namely hydrolytic and non-hydrolytic sol-gel syntheses (i. e., HSGS and NHSGS). Indeed, although SCS is well known to rely on significant reduction in the energy as well as time required for the obtainment of the desired nanocrystals, its quantitative environmental assessment and a detailed comparison with other existing synthetic pathways represents an absolute novelty of high scientific desirability in order to pursue a more sustainable development in the inorganic chemistry as well as materials science research fields. TiO2 nanoparticles were selected as the material of choice, for the production of which three slightly modified literature procedures were experimentally reproduced and environmentally evaluated by the application of the comprehensive life cycle assessment (LCA) methodology. Particularly, SCS was compared from an environmental perspective with sol-gel approaches performed both in water and in benzyl alcohol. The results of the present study were also framed among those recently obtained in a systematic study assessing seven further chemical, physical, and biological routes for the synthesis of TiO2 nanoparticles, comprising also flame spray pyrolysis (typically used in industrial productions), highlighting and quantifying the excellent environmental performances of SCS.

Aedes albopictus bionomics data collection by citizen participation on Procida Island, a promising Mediterranean site for the assessment of innovative and community-based integrated pest management methods.

In the last decades, the colonization of Mediterranean Europe and of other temperate regions by Aedes albopictus created an unprecedented nuisance problem in highly infested areas and new public health threats due to the vector competence of the species. The Sterile Insect Technique (SIT) and the Incompatible Insect Technique (IIT) are insecticide-free mosquito-control methods, relying on mass release of irradiated/manipulated males, able to complement existing and only partially effective control tools. The validation of these approaches in the field requires appropriate experimental settings, possibly isolated to avoid mosquito immigration from other infested areas, and preliminary ecological and entomological data. We carried out a 4-year study in the island of Procida (Gulf of Naples, Italy) in strict collaboration with local administrators and citizens to estimate the temporal dynamics, spatial distribution, and population size of Ae. albopictus and the dispersal and survival of irradiated males. We applied ovitrap monitoring, geo-spatial analyses, mark-release-recapture technique, and a citizen-science approach. Results allow to predict the seasonal (from April to October, with peaks of 928-9,757 males/ha) and spatial distribution of the species, highlighting the capacity of Ae. albopictus population of Procida to colonize and maintain high frequencies in urban as well as in sylvatic inhabited environments. Irradiated males shown limited ability to disperse (mean daily distance travelled <60m) and daily survival estimates ranging between 0.80 and 0.95. Overall, the ecological characteristics of the island, the acquired knowledge on Ae. albopictus spatial and temporal distribution, the high human and Ae. albopictus densities and the positive attitude of the resident population in being active parts in innovative mosquito control projects provide the ground for evidence-based planning of the interventions and for the assessment of their effectiveness. In addition, the results highlight the value of creating synergies between research groups, local administrators, and citizens for affordable monitoring (and, in the future, control) of mosquito populations.

Cost analysis of a long-term randomized controlled study in biliary duct-to-duct anastomotic stricture after liver transplantation.

Multiple plastic stent (MPS) for biliary anastomotic stricture (AS) after liver transplantation requires multiple procedures with consequent costs. To compare the success, adverse events and treatment-related costs of fully covered self-expandable metal stents (FCSEMS) versus MPS. Thirty liver transplant (LT) patients with clinically relevant naïve AS were prospectively randomized to FCSEMS or MPS, with stent numbers increased at 3-month intervals. Treatment costs per patient were calculated for endoscopic retrograde cholangiopancreatography (including all devices and stents) and overall hospital stay. Radiological success was achieved in 73% of FCSEMS (median indwelling period of 6 mos) and 93% of MPS patients (P = NS) (median period of 11 mos). AS recurrence occurred in 36% of FCSEMS and 7% of MPS patients (P = NS), and AS re-treatment was needed in 53% and 13% (P < 0.01), respectively, during follow-up of 60 (34-80) months. Stents migrated after 29% and 2.6% of FCSEMS and MPS procedures, respectively (P < 0.01). Including re-treatments, long-term clinical success was achieved in 28/30 (93%) patients. Overall treatment-related costs were similar between groups. In the subgroup of LT patients in clinical remission after first-line treatment, treatment costs were 41% lower per FCSEMS patient compared with MPS patients. FCSEMS did not perform better than MPS. FCSEMS migration increased the rate of re-treatment and costs.

Effectiveness and economic assessment of routine larviciding for prevention of chikungunya and dengue in temperate urban settings in Europe.

In the last decades, several European countries where arboviral infections are not endemic have faced outbreaks of diseases such as chikungunya and dengue, initially introduced by infectious travellers from tropical endemic areas and then spread locally via mosquito bites. To keep in check the epidemiological risk, interventions targeted to control vector abundance can be implemented by local authorities. We assessed the epidemiological effectiveness and economic costs and benefits of routine larviciding in European towns with temperate climate, using a mathematical model of Aedes albopictus populations and viral transmission, calibrated on entomological surveillance data collected from ten municipalities in Northern Italy during 2014 and 2015.We found that routine larviciding of public catch basins can limit both the risk of autochthonous transmission and the size of potential epidemics. Ideal larvicide interventions should be timed in such a way to cover the month of July. Optimally timed larviciding can reduce locally transmitted cases of chikungunya by 20% - 33% for a single application (dengue: 18-22%) and up to 43% - 65% if treatment is repeated four times throughout the season (dengue: 31-51%). In larger municipalities (>35,000 inhabitants), the cost of comprehensive larviciding over the whole urban area overcomes potential health benefits related to preventing cases of disease, suggesting the adoption of more localized interventions. Small/medium sized towns with high mosquito abundance will likely have a positive cost-benefit balance. Involvement of private citizens in routine larviciding activities further reduces transmission risks but with disproportionate costs of intervention. International travels and the incidence of mosquito-borne diseases are increasing worldwide, exposing a growing number of European citizens to higher risks of potential outbreaks. Results from this study may support the planning and timing of interventions aimed to reduce the probability of autochthonous transmission as well as the nuisance for local populations living in temperate areas of Europe.

Assessment of the Effectiveness of a Seasonal-Long Insecticide-Based Control Strategy against Aedes albopictus Nuisance in an Urban Area.

Seasonal-long larvicide treatments and/or outdoor space-spray applications of insecticides are frequently applied to reduce Aedes albopictus nuisance in urban areas of temperate regions, where the species has become a permanent pest affecting people's quality of life and health. However, assessments of the effectiveness of sequential interventions is a difficult task, as it requires to take into account the cumulative and combined effect of multiple treatments, as well as the mosquito seasonal dynamics (rather than mosquito abundance before and after single treatments). We here present the results of the effectiveness assessment of a seasonal-long calendar-based control intervention integrating larvicide treatments of street catch basins and night-time adulticide ground spraying in the main University hospital in Rome (Italy). Cage-experiments and an intensive monitoring of wild mosquito abundance in treated and untreated sites were carried out along an entire season. Sticky traps were used to monitor adult abundance and site-specific eco-climatic variations (by recording water left over in each trap), in order to disentangle the effect of insecticide treatments from eco-climatic drivers on mosquito seasonal dynamics. Despite the apparent limited impact of single adulticide sprayings assessed based on mortality in caged and wild mosquitoes, the results of the temporal analysis showed that mosquito seasonal patterns were initially comparable in the two sites, diverged in the absence of diverging eco-climatic conditions and remained stable afterwards. This allowed to attribute the lack of the expected Ae. albopictus population expansion in the treated site to the combined effect of multiple adulticide sprayings and larvicide treatments carried out during the whole season. The approach proposed was proved to be successful to assess effects of seasonal-long control treatments on adult mosquito population dynamics and could represent a valuable instrument to assess the effectiveness of other control interventions, to evaluate their actual cost-benefits and to possibly minimize space-spraying applications to reduce mosquito nuisance.

Right coronary artery arising from pulmonary trunk: assessment with conventional coronary angiography and multislice computed tomography coronary angiography.

We present a case of a 59-year-old man who was admitted to the hospital because of atypical chest pain and dyspnea. Conventional coronary angiography showed an anomalous origin of the right coronary artery from the pulmonary trunk. The patient underwent multislice computed tomography in order to clarify the origin and course of the anomalous vessel. The aim of this report is to emphasize the role of multislice computed tomography as an accurate noninvasive imaging tool in the evaluation of coronary artery anomalies.

[Anomalous origin of the circumflex artery from the right aortic sinus: assessment with conventional coronary angiography and multislice computed tomography]. / Origine anomala dell'arteria circonflessa dal seno di Valsalva destro: valutazione mediante tomografia computerizzata multistrato ed angiografia coronarica convenzionale.

Anomalous origin of the circumflex coronary artery from the right sinus of Valsalva is the most common coronary anomaly. This anomaly is thought to be of little clinical significance without the presence of severe narrowing of the vessel. A 43-year-old woman was referred to our institution for evaluation of atypical chest pain and equivocal results of the exercise stress test. We decided to perform multislice computed tomography coronary angiography before any other invasive studies. The scan was performed with a 16-row scanner (Aquilion 16 CFX, Toshiba Medical Systems, Tokyo, Japan) after intravenous administration of non-ionic contrast material. Scans revealed that the circumflex coronary artery originated from the right sinus of Valsalva; the initial course was retro-aortic until it reached its target in the atrioventricular groove; peripheral distribution of the circumflex coronary artery was then normal. The anomalous vessel presented a significant stenosis in its proximal tract. Coronary angiography confirmed that the origin of the circumflex coronary artery was from the right aortic sinus and the significant stenosis of the proximal portion of this vessel. This case confirms the full capability and accuracy of multislice computed tomography with the aid of post-processing techniques in the identification and evaluation of the ectopic origin of the left circumflex coronary artery from the right sinus of Valsalva, displaying accurately the origin, size, course, and relationship of the anomalous vessel with respect to surrounding structures.

Valoración de la punción biopsia con aguja fina y de la biopsia por congelación en el diagnóstico y tratamiento del nódulo tiroideo / Determine the role of frozen section and fine needle aspiration biopsy of thyroid nodules

Antecedentes: el advenimiento de la PBA ha posibilitado una mejor selección de pacientes portadores de patología tiroidea para la cirugía. Objetivo: determinar el rol de la punción y la biopsia por congelación en el manejo quirúrgico de la patología tiroidea. Lugar de aplicación: Servicio de Cirugía General División A; Servicio de Endocrinología y Servicio de Anatomía Patológica del Hospital de Agudos J.M. Ramos Mejía. Diseño: retrospectivo consecutivo. Método: se evaluó la correlación de los hallazgos de la PBA, la congelación y el estudio histopatológico final en el diagnóstico de la patología tiroidea. Población: se analizaron 541 pacientes estudiados con PBA y congelación operados en el Hospital Ramos Mejía. Resultados: de los 541 operados se diagnosticó cáncer en 163 pacientes (30 por ciento). La PBA diagnosticó 111 que fueron confirmados por la congelación e informó 104 casos como dudosos de los cuales 31 fueron cáncer. Dentro del grupo de los "dudosos" hubo mayor prevalencia de carcinoma en los subgrupos "sospechoso de malignidad" y en las "proliferaciones foliculares de alto grado". Conclusiones: se podría prescindir de la utilización de la biopsia por congelación ante una PBA maligna. En cambio ante una benigna o dudosa consideramos completar con la congelación intraoperatoria. Debido a la diferencia de prevalencia de carcinoma en el grupo de los dudosos justificamos mantener separadas las categorías citológicas: SM (sospechoso de malignidad), PFAG (proliferación folicular de alto grado), PFBG (proliferación folicular de bajo grado), PFH (proliferación folicular de Hürthle)