Characterization of hand forces exerted during non-powered hospital bed pushing and pulling tasks.

Accurate assessment of biomechanical risk associated with pushing/pulling tasks represents a challenging issue, especially in the health system where personnel are often required to maneuver beds and carts. Most studies in this field have been carried out in the laboratory, while few data have been collected under actual working conditions. This study aims to characterize the forces exerted during non-powered hospital bed maneuvering. Twenty participants were required to move a bed (equipped with a customized handlebar to measure exerted forces) along an actual hospital path including straight, turn and maneuver phases. The results show that higher forces are associated with the initial phase (peak and mean values 222 and 68 N) while the straight, turn and maneuvering phases required similar (lower) efforts. The combined effect of left, right and transversal forces suggests that the trunk of the operator might experience axial rotation, thus calling for further investigations of this aspect.

Urban biowaste-derived sensitizing materials for caffeine photodegradation.

Caffeine-photosensitized degradation has been studied in the presence of bio-based materials derived from urban biowaste after aerobic aging. A peculiar fraction (namely bio-based substances (BBSs)), soluble in all the pH range, has been used as photosensitizing agent. Several caffeine photodegradation tests have been performed, and positive results have been obtained in the presence of BBSs and H2O2, without and with additional Fe(II) (photo-Fenton-like process). Moreover, hybrid magnetite-BBS nanoparticles have been synthesized and characterized, in order to improve the sensitizer recovery and reuse after the caffeine degradation. In the presence of such nanoparticles and H2O2 and Fe(II), the complete caffeine degradation has been attained in very short time. Both homogeneous and heterogeneous processes were run at pH = 5, milder condition compared to the classic photo-Fenton process.

Iodinated X-ray contrast agents: Photoinduced transformation and monitoring in surface water.

Conventional wastewater treatment methods have shown to be unsuitable for a complete elimination of iodinated X-ray contrast agents (ICMs), which have thus been found in wastewater treatment plant (WWTP) effluent and in surface water. Once in the surface water, they could be transformed through different processes and form several transformation products that may need to be monitored as well. To this end, we studied the abatement and transformation of ICMs by combining laboratory experiments with in field analyses. We irradiated different aqueous solutions of the selected pollutants in the presence of TiO2 as photocatalyst, aimed to promote ICMs degradation and to generate photoinduced transformation products (TPs) similar to those occurring in the environment and effluent wastewater. This experimental strategy has been applied to the study of three ICMs, namely iopromide, iopamidol and diatrizoate. A total of twenty-four, ten, and ten TPs were detected from iopamidol, diatrizoate and iopromide, respectively. The analyses were performed using a liquid chromatography-LTQ-FT-Orbitrap mass spectrometer. The mineralization process and acute toxicity evolution were assessed as well over time and revealed a lack of mineralization for all ICMs and the formation of harmful byproducts. After characterizing these transformation products, WWTP effluent and surface water taken from several branches of the Chicago River were analyzed for ICMs and their TPs. HRMS with MS/MS fragmentation was used as a confirmatory step for proper identification of compounds in water and wastewater samples. All three of ICM were detected in the effluent and surface water samples, while no significant amount of TPs were detected.

Study of the photochemical transformation of 2-ethylhexyl 4-(dimethylamino)benzoate (OD-PABA) under conditions relevant to surface waters.

We studied the aquatic environmental fate of 2-ethylhexyl 4-(dimethylamino)benzoate (OD-PABA), a widespread sunscreen, to assess its environmental persistence and photoinduced transformation. Direct photolysis is shown to play a key role in phototransformation, and this fast process is expected to be the main attenuation route of OD-PABA in sunlit surface waters. The generation of transformation products (TPs) was followed via HPLC/HRMS. Five (or four) TPs were detected in the samples exposed to UVB (or UVA) radiation, respectively. The main detected TPs of OD-PABA, at least as far as HPLC-HRMS peak areas are concerned, would involve a dealkylation or hydroxylation/oxidation process in both direct photolysis and indirect phototransformation. The latter was simulated by using TiO2-based heterogeneous photocatalysis, involving the formation of nine additional TPs. Most of them resulted from the further degradation of the primary TPs that can also be formed by direct photolysis. Therefore, these secondary TPs might also occur as later transformation intermediates in natural aquatic systems.

The role of direct photolysis and indirect photochemistry in the environmental fate of ethylhexyl methoxy cinnamate (EHMC) in surface waters.

The aquatic environmental fate of ethylhexyl methoxy cinnamate (EHMC), one of the most used UVB filters worldwide, was studied by assessing its environmental persistence and photoinduced transformations. The role of direct and indirect photolysis was evaluated. Direct photolysis was shown to play a key role, and this process is expected to be the main attenuation route of EHMC in sunlit surface waters. In contrast, the reaction with OH radicals would be negligible and that with (3)CDOM* would at most be a secondary process. The measurement of the quantum yield of direct photolysis and of the rate constants of reaction with photogenerated transient species (or, sometimes, the use of reasonable values for the latter) allowed the prediction of the EHMC half-life time in surface waters, by means of a validated photochemical model. The predicted EHMC lifetime is of the order of hours to a few days in fair-weather summertime, and the main factors controlling the EHMC phototransformation in sunlit surface waters would be the water depth and the dissolved organic carbon (DOC) content. The formation of transformation products (TPs) was followed as well via HPLC/HRMS. Three TPs were detected in the samples exposed to UVA radiation, while one additional TP was detected in the samples exposed to UVB radiation. The detected TPs comprised 4-methoxybenzaldehyde, a hydroxylated derivative and dimeric species. Through the use of heterogeneous photocatalysis with TiO2, seven additional TPs were identified, most of them resulting from the further degradation of primary TPs formed through direct photolysis and that might be detected in aquatic systems as well. The photodegradation of EHMC in the presence of TiO2 yielded more toxic TPs than the parent compound (as determined with the Vibrio fischeri Microtox assay). The increased toxicity is partially accounted for by the formation of 4-methoxybenzaldehyde.

Proximal humeral fracture fixation: multicenter study with carbon fiber peek plate.

BACKGROUND: Locking plate fixation is a reliable treatment for many displaced proximal humeral fractures. Carbon fiber-reinforced-poly-ether-ether-ketone (CFR-PEEK) plates have recently been introduced as an alternative to traditional metallic plates. METHODS: In a multicenter study involving the Orthopedic Services of 6 Italian hospitals, 182 patients with a proximal humeral fracture were treated with a Diphos H (Lima Corporate, San Daniele del Friuli, Italy) CFR-PEEK plate, 160 of whom were followed clinically and radiographically for 2 years or more. Fractures were classified by Neer's system. The functional results were assessed by Constant and DASH scores. RESULTS: The average time to radiographic healing was 5.6 months in 158 of 160 cases. Mean Constant score was 76, and mean DASH score was 28 at 2 years. There were two nonunions (one septic and one aseptic) and 13 cases of partial (9) or massive (4) humeral head necrosis. In three of the 78 patients treated with the first-generation plates, hardware breakage happened during the operation and the plate was replaced. There was no failure among the cases treated with the thicker second-generation plate. In eight cases, there was a perforation of the humeral head by the cephalic screws. CONCLUSIONS: CFR-PEEK plates proved as reliable as metallic plates in the treatment of proximal humeral fractures. The advantages of these new devices include a better visualization of fracture reduction during intraoperative fluoroscopic assessment and easy hardware removal due to the absence of screw-plate cold fusion.

Photocatalytic degradation of chlorophenols in soil washing wastes containing Brij 35. Correlation between the degradation kinetics and the pollutants-micelle binding.

The photocatalytic degradations of 4-chlorophenol (CP), 4-chloro-2-methylphenol (CMP), 4-chloro-3,5-dimethylphenol (CDMP) and 4-chloro-2-isopropyl-5-methylphenol (CIMP) were investigated in water and in simulated soil washing wastes containing Brij 35 (polyoxyethylene(23)dodecyl ether) in the presence of TiO2 dispersions. A neat inhibition of substrate decomposition proportional to their growing hydrophobicity was observed in the washing wastes for CP, CMP and CDMP, whereas CIMP showed a different behaviour. The mineralization of the organic chlorine of CP and CIMP was relatively fast and complete, whereas it was much slower for CMP and CDMP. Micellar solubilization and substrate adsorption onto the semiconductor play opposite roles on the degradation kinetics, and a breakpoint between the corresponding induced effects was evidenced when the pollutants become completely bound to the micellar aggregates.

Time course of proadrenomedullin in the early phase of septic shock. A comparative study with other proinflammatory proteins.

AIM: It has been shown that pro-adrenomedullin is a good marker of the severity of septic shock but there are no data on the early changes in serum pro-adrenomedullin concentrations in patients with shock. METHODS: Twenty-one patients with septic shock and 21 healthy subjects studied as controls. Serum concentrations of pro-adrenomedullin, procalcitonin, ferritin, CRP and IL-6 were determined in all subjects at the initial observation. Patients with septic shock were also studied after 24 and 48 hours. RESULTS: The concentrations of the acute phase proteins were significantly higher in patients with septic shock than in the control subjects during the entire study period (P<0.001). Only procalcitonin significantly decreased on the third day of observation with respect to both the first day (P=0.002) and the second day (P=0.006). Proadrenomedullin (P=0.017) and IL-6 (P=0.001) showed an AUC significantly different from the null hypothesis in differentiating the patients who survived and those who did not. The sensitivity and specificity of pro-adrenomedullin in the assessment of death were 71.4% and 72.7%, respectively, while IL-6 had a sensitivity of 92.9% and a specificity of 60.6%. CONCLUSION: Proadrenomedullin is a reliable prognostic marker in patients with shock; further studies on a more consistent number of septic patients will definitively assess whether proadrenomedullin may replace the current prognostic markers in critically ill patients with shock due to sepsis.

Ecofriendly in-line process monitoring: a case study. Anthracene photodegradation in the presence of refuse-derived soluble bio-organics.

Photodegradation of anthracene has been studied in aqueous solutions containing soluble bio-organic substances isolated from urban refuse. To perform a preliminary rapid feasibility study of this process while reducing the amount of analytical effort and reagents, an experimental set-up was developed comprising a Teflon coil surrounding a UV-lamp and coupled with an in-line spectrofluorimeter. In this fashion only few millilitres of solution are needed to study the degradation process. Furthermore, the in-line spectroscopic approach enables monitoring of the process without consumption of reagents. Additional studies by liquid chromatography and use of toxicity tests clearly indicated that the apparent inhibition effect of bio-organic compounds on anthracene degradation is not relevant. The results imply that urban refuse may be used as an auxiliary in the recovery of polycyclic aromatic hydrocarbons from contaminated soil by washing, without deleterious effects on the photodegradation of anthracene and other aromatic pollutants.

Photocatalytic degradation of bentazone in soil washing wastes containing alkylpolyoxyethylene surfactants.

Three alkylpolyoxyethylene surfactants bearing the same hydrophobic chain and a different number of oxyethylene groups were investigated as suitable candidates for the soil washing treatment of contaminated soil samples containing bentazone. Comparable good recoveries of the pesticide were obtained working with these surfactants. The photocatalytic treatment of the collected washing wastes, performed in the presence of suspended TiO(2) particles under irradiation with simulated sunlight, leads to the effective degradation of bentazone residues after a time depending on the nature and concentration of the chosen amphiphile. Brij 35 was found to be the best surfactant candidate, giving the faster abatement of the pesticide in the collected wastes. The overall treatment time depends on the bentazone mineralization kinetics, markedly slow in the presence of surfactants. Useful information about the photocatalytic degradation route was obtained from the HPLC-MS analysis of transient intermediates formed in water.

Removal and degradation of aromatic compounds from a highly polluted site by coupling soil washing with photocatalysis.

The possible application of two environmental remediation technologies - soil washing and photocatalysis - to remove and decompose various aromatic pollutants present in excavated soils of a contaminated industrial site has been investigated. Aqueous solutions containing the non-ionic surfactant Brij 35 were used to extract the contaminants from the soil samples. The photocatalytic treatment of the obtained washing wastes, performed in the presence of TiO(2) suspensions irradiated with simulated sunlight, showed a slow abatement of the toxic compounds due to the relevant concentrations of organics in the waste. A neat improvement of the process performances, obtained by operating in the presence of added potassium peroxydisulfate, suggests a feasible treatment route.

Impact of dredging in a shallow coastal lagoon: Microtox Basic Solid-Phase Test, trace metals and Corophium bioassay.

The aim of this work was to measure survival of the amphipod Corophium insidiosum and luminescence inhibition in the marine bacterium Vibrio fisheri on surface sediment samples collected from a shallow coastal lagoon (Pialassa Baiona, northern Adriatic Italian coast) before execution of dredging operations to deepen the main inner channel of the lagoon and restore the water circulation. Trace metal (Cd, Cu, Cr, Hg, Ni, Pb) concentrations, grain size and organic carbon matter content as loss of ignition were also measured. Toxicity testing with V. fisheri was carried out according to the Microtox Basic Solid-Phase Test (BSPT) protocol. The preliminary outcomes of this work show that: (a) the investigated area can be categorised as moderately degraded; (b) there is no evident spatial pattern in sediment toxicity and trace metal concentrations; (c) Microtox responses are not biased by sediment characteristics such as silt, clay and organic matter content.

Sulfur speciation in mercury-contaminated sediments of a coastal lagoon: the role of elemental sulfur.

Chemical equilibrium studies have predicted that elemental sulfur (S0) could play a crucial role in mercury mobility in salt marsh sediments. This prompted us to consider the occurrence of S0 in conjunction with the degree of contamination in sediments of a coastal wetland (Pialassa Baiona, Italy) impacted by inputs of mercury derived from past industrial activity. The distribution of S0, total Hg, soluble sulfates and acid-soluble sulfides was studied in five sediment cores collected in two ponds of the lagoon. Sulfides, sulfates and S0 exhibited vertical profiles typical of salt marsh systems, with concentrations declining with depth. Mercury enrichment (2-23 mg kg-1) was detected at the surface strata where the highest concentrations of sulfides and S0 were found (up to 1.70 and 0.9 g kg-1, respectively). The effect of elevated levels of sulfides and elemental sulfur on the fate of mercury in the lagoon is discussed.

Heavy metal determinations in algae and clams and their possible employment for assessing the sea water quality criteria.

An empirical criterion for a possible classification of sea water quality is proposed. It is based on the knowledge of metal content in algae (Ulva Rigida) and clams (Tapes Philippinarum), two species present in marine ecosystems. The elements considered are Hg, Cu, Pb, Cd, Zn. The analytical technique employed is Differential Pulse Anodic Stripping Voltammetry (DPASV) in the case of Cu, Pb, Cd, Zn, while the determination of mercury is obtained by the Cold Vapour Atomic Absorption Spectroscopy (CV-AAS) technique with SnCl2 as reducing agent. The analytical procedure has been verified on three standard reference materials: Sea Water BCR-CRM 403, Ulva Lactuca BCR-CRM 279 and Mussel Tissue BCR-CRM 278. For all the elements, in addition to detection limits, accuracy and precision are given: the former, expressed as relative error (e), and the latter, expressed as relative standard deviation (Sr), were in all cases lower than 6%.

Gas chromatographic-mass spectrometric analysis of products arising from pyrolysis of amino acids in the presence of hexamethyldisilazane.

Alpha-amino acids were pyrolysed at 600 degrees C in the presence of hexamethyldisilazane (HMDS) and the formed volatile products were analysed on line by gas chromatography-mass spectrometry (GC-MS). Glycine, alanine, valine, leucine, isoleucine, norleucine, methionine, phenylalanine yielded principally the trimethylsilyl (TMS) ester of the parent amino acid. TMS esters of carboxylic acids arising from reductive deamination were observed for serine, threonine and aspartic acid. Decarboxylation resulted in the formation of amines which represented abundant products released from tyrosine, cysteine and methionine. Cyclic compounds arising from the condensation of two amino acids were revealed as characteristic products of glycine, alanine, serine, proline and hydroxyproline. Degradation products of the side chain were released at relatively high levels from tryptophane, tyrosine and hystidine. Since each amino acid produced a characteristic distribution of TMS products, in-situ pyrolysis/silylation with HMDS may find application as a screening technique for the detection of amino acids and related materials in complex matrices. The potentiality of the procedure was tested on a dipeptide (Tyr-Leu).

Continuous monitoring of photocatalytic treatments by flow injection. Degradation of dicamba in aqueous TiO2 dispersions.

The possible use of flow injection (FI) to monitor the photocatalytic mineralization of dicamba (3,6-dichloro-2-methoxybenzoic acid) present at the trace level in aqueous solutions containing TiO2 suspensions has been evaluated. Experiments were performed in a stirred photochemical reactor equipped with a simple FI manifold, integrating an online filtration unit able to perform the monitoring of the UV absorbance of the irradiated solution every 4 min. The light source used was a medium pressure mercury lamp (125 W). During the initial steps of the reaction the formation of UV absorbing intermediates, which completely disappear in less than 80 min, was evidenced. Additional HPLC, DOC and chloride ion measurements carried out on manually taken samples confirmed the complete mineralization of dicamba within about 90 min. The proposed on-line monitoring looks particularly suitable for the control of degradation treatments where primary degradation and mineralization steps take place after a comparable irradiation time.

Anthropogenically derived mercury in sediments of Pialassa Baiona, Ravenna, Italy.

Pialassa Baiona, a coastal wetland near the city of Ravenna, has been impacted for two decades (1958-1978) by industrial discharges containing mercury and floating agglomerates of residues of polymerization processes. Although the industrial use of mercury completely ceased in the early 90's, surface sediments are still highly contaminated, mercury concentrations decreasing from the southern sub-basin, close to the discharge point, to the farthest northern border. Concentrations of total mercury, synthetic polymers (determined by pyrolysis-GC/MS), total organic carbon, C/N ratio, total sulfur and 210Pb dating, were determined in sediment cores collected in the southern and northern sub-basins. Mercury and polymers exhibited parallel profiles with a peak corresponding to the historic emission record in the southern core, while in northern cores peaks of maximum concentration display a delay reflecting the time required for the pollutants to migrate. A recently developed mercury sequential extraction procedure was applied to the most polluted layers to study inorganic mercury speciation. Results indicate differences between the southern and northern areas, suggesting a more efficient binding of mercury to sediments in the southern sub-basin.

High performance liquid chromatography versus gas chromatography in the analysis of proteinaceous painting ligands.

High performance liquid chromatography (HPLC) and gas chromatography (GC) were compared for the analysis of the amino acid composition in painting ligands.

Improved exercise tolerance by cardiac rehabilitation after myocardial infarction in the elderly: results of a preliminary, controlled study.

Elderly patients are commonly excluded from cardiac rehabilitation after myocardial infarction (MI). The present controlled, non-randomized trial was undertaken as a preliminary study to compare some effects of cardiac rehabilitation between patients younger and older than 65 years without contraindications to physical exercise. Baseline total work capacity (TWC) was assessed by a maximal ergometric stress testing 4 weeks after MI. Patients were then prospectively enrolled into an 8-week ambulatory rehabilitation program (R-group: age < or = 65 N = 16; age > 65 N = 16). Those who refused or who could not participate in the program because of logistic difficulties served as controls (NR-group: age < or = 65 N = 16; age > 65 N = 14). In spite of non-randomized allocation, clinical characteristics did not differ between either treatment groups or age groups. TWC was re-assessed at 8 weeks from baseline evaluation in all patients. The number of completed training sessions in the R-group, and the proportion of sessions which were suspended for physiological or pathological (adverse events during exercise) causes were similar under and over 65 years. TWC increased (p < 0.001) in the R-group, the improvement being similar in the two age cohorts (< or = 65: +55% vs > 65: +65%, NS). A spontaneous enhancement of TWC (+37%, p < 0.001) occurred among younger controls as well. Only older controls did not improve their TWC; moreover, their +16% change was significantly (p < 0.05) less than the +65% increase obtained by the R-group of the same age.(ABSTRACT TRUNCATED AT 250 WORDS)

[Young nurses grow. The pathways and experiences of nurses newly employed in psychiatry]. / Giovani infermieri crescono. Percorsi ed esperienze di infermieri neo-assunti in psichiatria.

Three years after the first interview to a sample of 27 newly employed Registered Nurses in the Department of Mental Health, a second interview was administered to the nurses still working in the psychiatric services (30% of the original sample had already left), to analyze any changes related to their professional education, experiences and expectations. 5 of the nurses still remaining would like to make a change, while the others (14) expressed very high levels of motivation and satisfaction. The structure of the educational curriculum and the policy of internal mobility in the different psychiatric services are seen as main determinants of what has been observed.