2D shear wave elastography in evaluation of prognostic factors in breast cancer.

PURPOSE: To evaluate the reproducibility of the 2D shear wave elastography (2D-SWE) method and to identify the prognostic factors of breast lesions. METHODS: In this prospective study, 44 female patients were consecutively included from January 2020 to September 2021. All patients showing visible masses at B-mode ultrasound underwent to clinical evaluation, followed by qualitative and quantitative 2D-SWE by two different operators with over 15-year and 2-year experience, respectively. Subsequently, patients underwent to surgical treatment after core needle biopsy. Reproducibility of qualitative and quantitative 2D-SWE was evaluated by Cohen's kappa and intraclass correlation coefficient (ICC). Clinical, imaging, and histopathological data and 2D-SWE evaluations were analysed with Spearman's rank correlation test. RESULTS: The mean age of the patients was 55 years ± 12. The mean histological and ultrasound tumour size of were 23.1 mm ± 13.2 and 17.2 mm ± 10.2, respectively. The interobserver agreement showed a good reproducibility limited to the qualitative evaluation colour maps (Cohen's kappa = 0.603) and to the quantitative evaluation E ratio (ICC = 0.771). Correlation analysis between the ultrasound and 2D-SWE values and the clinical-pathological parameters showed a significant relationship between E ratio and Elston-Ellis grading (P < 0.030) and between tumour size and Elston-Ellis grading (P < 0.041). CONCLUSION: The 2D-SWE has shown good reproducibility among operators with different experience. It could be a promising tool in the evaluation of some prognostic factors in ultrasound visible breast cancer.

Probiotics as a promising prophylactic tool to reduce levels of toxic or potentially toxic elements in bees.

Bees are precious living beings for our planet. Thanks to their essential service of pollination, these insects allow the maintenance of biodiversity and the variety and amount of food available. Unfortunately, we are observing an increasingly devastating reduction of bee families and other pollinating insects for factors related to human activities, environmental pollution, diseases and parasites, compromise of natural habitats, and climate change. We show that probiotics can protect bees from element pollution. We collected bees, beeswax, honey, pollen, and propolis directly from hives in a rural area of central Italy to investigate the content of 41 elements in control (not supplemented with probiotics) and experimental (supplemented with probiotics) groups. Our data show a significantly lower concentration of some elements (Ba, Be, Cd, Ce, Co, Cu, Pb, Sn, Tl, and U) in experimental bees than in control groups, indicating a possible beneficial effect of probiotics in reducing the absorption of chemicals. This study presents the first data on element levels after probiotics have been fed to bees and provides the basis for future research in several activities relating to the environment, agriculture, economy, territory, and medicine.

Determination of 40 Elements in Powdered Infant Formulas and Related Risk Assessment.

The aim of the study was to analyze all powdered infant formulas authorized and commercialized in Italy at the time of the study to measure the concentrations of 40 elements, and to estimate the infants' intake of some toxic heavy metals for assessing possible related health risks. For this purpose, an optimized multi-element method was used through inductively coupled plasma mass spectrometry. Be, B, Al, Zr, Nb, Sb, Te, W, V, Cr and As concentrations were

Apparent diffusion coefficient values in borderline breast lesions upgraded and not upgraded at definitive histopathological examination after surgical excision.

PURPOSE: The study aims were to evaluate if the apparent diffusion coefficient (ADC) value could distinguish between breast lesions classified as B3 at core needle biopsy (CNB) that show or do not show atypia or malignancy at definitive histopathological examination (DHE) after surgical excision. MATERIAL AND METHODS: From January 2013 to December 2017, 141 patients with a B3 breast lesion underwent magnetic resonance imaging and were included in the study. The ADC value was assessed drawing a ROI outlining the entire lesion, evaluating the mean (ADCmean) and minimum ADC values (ADCmin). RESULTS: Both ADCmean and ADCmin values showed a statistically significant difference between B3 lesions without and with malignancy or, for B3a lesions, atypia at DHE. They both showed a statistically significant difference also between B3a lesions without or with atypia or malignancy at DHE, but only ADCmin (not ADCmean) showed statistically significant difference between B3b lesions without or with malignancy at DHE. CONCLUSIONS: The ADC value could help distinguish between B3a lesions without or with atypia/malignancy at DHE after surgical excision and between B3b lesions without or with malignancy at DHE. Therefore, it could be used to help guide the diagnostic-therapeutic pathway of these lesions, particularly of B3a lesions.

An optimized method for sample preparation and elemental analysis of extra-virgin olive oil by inductively coupled plasma mass spectrometry.

The accurate determination of trace elements in vegetable edible oils is still an analytical challenge, owing to their low concentration levels and the complex matrix of the vegetable oils. The aim of this study was to develop a fast and simple analytical method to quantify 45 elements in small mass samples (0.5 g) of extra virgin olive oils by inductively coupled plasma mass spectrometry. To evaluate the best and fastest sample preparation procedure, ultrasonic extraction and wet digestion methods were compared using oil certified reference material with different reagent mixtures, reagent volumes, and times for sample extraction or digestion. The use of 5 mL reagent mixture F [10% (v/v) HNO3 and H2O2, 2:1 (v/v)] for sample digestion in a water bath (95 °C, 40 min) was found to produce satisfactory results in all cases as validated from sample recovery experiments over three different extra virgin olive oil samples.

Urinary Mercury Levels and Predictors of Exposure among a Group of Italian Children.

Urinary mercury (Hg) levels are suitable to assess long-term exposure to both elemental and inorganic Hg. In this study, the urinary Hg levels of 250 children (aged 6-11 years) from three areas with different anthropogenic impacts in the Rieti province, central Italy, were assessed. The Hg concentrations were in the range of 0.04-2.18 µg L-1 with a geometric mean equal to 0.18 µg L-1 [95% confidence interval (CI), 0.17-0.20 µg L-1] or 0.21 µg g-1 creatinine (95% CI, 0.19-0.23 µg g-1 creatinine), and a reference value calculated as 95th percentile of 0.53 µg L-1 (95% CI, 0.44-0.73 µg L-1) or 0.55 µg g-1 creatinine (95% CI, 0.50-0.83 µg g-1 creatinine). In all cases, urinary Hg data were below the HBM-I values (7 µg L-1 or 5 µg g-1 creatinine) established for urine, while the 95th percentile was above the German Human Biomonitoring Commission's RV95 (0.4 µg L-1) set for children without amalgam fillings. A significant correlation (p < 0.05) was found between creatinine-corrected results and residence area, with higher urinary Hg levels in children living in the industrial area. Multiple linear regression analysis showed that creatinine was the main predictor of urinary Hg.

Element Levels and Predictors of Exposure in the Hair of Ethiopian Children.

Children's development and health may be affected by toxic heavy metal exposure or suboptimal essential element intake. This study aimed to provide updated information regarding the concentrations of 41 elements in children's hair (aged under 18) living in a rural area of the Benishangul-Gumuz region, Ethiopia. The highest average levels (as a geometric mean) for toxic heavy metals were obtained for Al (1 mg kg-1), Pb (3.1 mg kg-1), and Ni (1.2 mg kg-1), while the lowest concentrations among the essential elements were found for Co (0.32 mg kg-1), Mo (0.07 mg kg-1), Se (0.19 mg kg-1), and V (0.8 mg kg-1). Hair analysis was combined with a survey to evaluate relationships and variations among subgroups and potential metal exposure predictors. Females showed significantly higher concentrations for most hair elements, excluding Zn, than males, and the 6-11 years age group reported the highest levels for Be, Ce, Co, Fe, La, Li, Mo, and Na. The main predictors of exposure to toxic elements were fish consumption for Hg and drinking water for Ba, Be, Cs, Li, Ni, Tl, and U. The data from this study can be used to develop prevention strategies for children's health and protection in developing countries.

Effectiveness of Different Sample Treatments for the Elemental Characterization of Bees and Beehive Products.

Bee health and beehive products' quality are compromised by complex interactions between multiple stressors, among which toxic elements play an important role. The aim of this study is to optimize and validate sensible and reliable analytical methods for biomonitoring studies and the quality control of beehive products. Four digestion procedures, including two systems (microwave oven and water bath) and different mixture reagents, were evaluated for the determination of the total content of 40 elements in bees and five beehive products (beeswax, honey, pollen, propolis and royal jelly) by using inductively coupled plasma mass and optical emission spectrometry. Method validation was performed by measuring a standard reference material and the recoveries for each selected matrix. The water bath-assisted digestion of bees and beehive products is proposed as a fast alternative to microwave-assisted digestion for all elements in biomonitoring studies. The present study highlights the possible drawbacks that may be encountered during the elemental analysis of these biological matrices and aims to be a valuable aid for the analytical chemist. Total elemental concentrations, determined in commercially available beehive products, are presented.

Elemental concentration and migratability in bioplastics derived from organic waste.

In line with the Circular Economy approach, the production of polyhydroxyalkanoate (PHA) with organic waste as the feedstock may a biotechnological application to reduce waste and recover high-value materials. The potential contaminants that could transfer from bio-waste to a PHA include inorganic elements, such as heavy metals. Hence, the total content and migratability of certain elements were evaluated in several PHA samples produced from different origins and following different methods. The total content of certain elements in PHA ranged between 0.0001 (Be) and 49,500 mg kg-1 (Na). The concentrations of some alkaline (Na and K) and alkaline earth (Ca and Mg) metals were highest, which are of little environmental concern. The feedstock type and PHA stabilisation and extraction procedures affected the element contents. Several sets of experiments were conducted to evaluate the migration of elements from the PHA samples under different storage times, temperatures, and pH levels. The total contents of some heavy metals (As, Cd, Fe, Hg, Ni, Pb, and Zn) in PHA produced from fruit waste or crops (commercial PHA) were lower than those in the PHA samples produced from the mixture of the organic fraction of municipal waste and sludge from wastewater treatment. Both the PHA obtained by extraction from wet biomass (acid storage) with aqueous phase extraction reagents and commercial PHA were below the migration limits stipulated by the current Toy Safety Directive and by Commission Regulation (EU) October 2011 on plastic materials and articles intended to come into contact with food under frozen and refrigerated conditions.

Biomonitoring of Mercury in Hair among a Group of Eritreans (Africa).

Small-scale or artisanal mining, using gold-mercury amalgamation to extract gold from ore, is a significant source of exposure for the workers and nearby populations. Few studies on hair mercury (Hg) have been conducted in Africa despite the fact that Africa has several gold deposits. No studies have been conducted in Eritrea that is one of the emerging gold producing countries in Africa. The aim of the study was to assess the Hg concentration in hair samples (n = 120) of a population living in Asmara, capital of Eritrea, and to evaluate the influence of some factors on the Hg levels in hair. Information on age, height, weight, occupation, smoking and fish consumption of participants were collected via questionnaire. Hair Hg concentration was significantly higher among women compared to men (p < 0.001) and among women preparing spicy products in Medeber market compared to those who did other jobs (p = 0.010). These results highlight the need for routine biomonitoring surveys and for health promotion campaigns devoted to local decision makers and workers.

Apparent diffusion coefficient value in breast papillary lesions without atypia at core needle biopsy.

PURPOSE: The main aim of the study was to assess if the mean apparent diffusion coefficient (ADC) value was significantly different between papillary lesions (PL) without atypia and PLs with atypical or malignant foci. A secondary objective was to evaluate if patients mean age, MRI BI-RADS® descriptors and assessment category were significantly different between these two PL groups. METHODS: In this eight year retrospective study were included 122 patients (mean age, 51 years; range, 24-78) with 122 PLs without atypia at micro-histological examination after core needle biopsy (CNB) performed under sonographic guidance. All patients underwent surgical excision biopsy within 3 months after CNB. All patients underwent MRI examination before surgical excision, including STIR, DWI and Dynamic Contrast-Enhanced sequences. RESULTS: Mean ADC value difference between PLs without and with atypia or malignant foci was statistically significant (p < 0.0001). Mean ADC value optimal threshold in order to distinguish the two groups was 1.418 × 10-3 mm2/s. A mean ADC value ≤ 1.418 × 10-3 mm2/s could predict atypical or malignant foci within a PL with 83.9% sensitivity and 75.8% specificity. No statistically significant difference was found with regard to patients mean age, MRI BI-RADS® descriptors and assessment category between these two PL groups. CONCLUSIONS: Mean ADC value of PLs without atypia at CNB is an efficient tool in order to help distinguish between PLs without and with atypical or malignant foci at final pathology on surgical excision, and it could be used to help decide how to manage these lesions.

Occupational Exposure Assessment of Major and Trace Elements in Human Scalp Hair Among a Group of Eritrean Workers.

The aim of the study was to evaluate occupational exposure to 40 elements among a group of Eritrean adults employed at the Medeber metal market by analysing human scalp hair samples and by investigating the role of some predictors (gender, age, and body mass index-BMI) on their levels. Scalp hair samples were collected from 60 subjects (32 subjects working at the Medeber metal market and 28 subjects not working at Medeber and not employed in other industrial or artisanal activities) and were analysed through inductively coupled plasma mass spectrometry to determine the contents of 40 major and trace elements. Information on participants was collected via questionnaire. Significant differences were found in the hair levels of certain elements between subjects working at the Medeber metal market and subjects not exposed. In particular, working at the Medeber metal market increased hair levels of Be, B, Cu, Zn, Mo, Cd, Sb, Tl, Pb, and Fe from 25 to 100%, while reduced Na, K, and Rb levels from 30 to 50%. With multivariate adjustment for age, gender, and BMI, the results confirm that working at Medeber significantly increased the hair levels of Cu, Zn, Sb, Pb, and Fe. This finding reveals the need for more accurate and routine biomonitoring surveys and the necessity of health promotion campaigns both for local decision-makers and workers to increase health promotion and safety in this workplace.

A prophylactic multi-strain probiotic treatment to reduce the absorption of toxic elements: In-vitro study and biomonitoring of breast milk and infant stools.

Potential exposure to toxic elements initially occurs during gestation and after birth via breast milk, which is the principal source of nutrients for infants during the first months of life. In this study, we evaluated whether maternal oral supplementation with a multi-strain probiotic product can protect infants from exposure to arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) via breast milk. In-vitro studies of the bacterial strains present in this probiotic product showed a high bacterial tolerance for As, Cd, Hg, and Pb, and good binding capacity for Cd, Hg, and Pb (72%, 81%, and 64%, respectively) within 1 h of contact. We evaluated concentrations (5 mg L-1 for Cd and Pb, and 2 mg L-1 for Hg) that largely exceeded the provisional tolerable weekly intake of these toxic elements via food or water applicable for human consumption. Changes in the levels of these elements in breast milk and newborn stools were evaluated in the control (orally supplemented with placebo) and experimental (orally supplemented with probiotic) groups at birth (t0), 15 days (t15), and 30 days (t30) after delivery. Elemental analysis of breast milk did not show significant differences between the control and experimental groups at different stages of lactation; however, stool samples obtained from newborns of mothers supplemented with the probiotic product showed that Cd levels were significantly reduced (by 26%) at t15 compared with the levels of the controls. Our data did not show an association between concentration of toxic elements in breast milk and that in newborn stools. Indeed, the concentration of Cd, Hg, and Pb in breast milk decreased during the lactation period, whereas the levels of these elements in newborn stools were stable over time. Although our in-vitro data indicate that the consortium of these probiotic strains can absorb toxic compounds, this study was limited by its small sample size and potential uncontrolled confounding effects, such as maternal diet and lifestyle. Therefore, we could not confirm whether prophylactic use of this probiotic product can reduce the absorption of toxic elements. The risk assessment in the studied population evidenced a margin of exposure (MOE) of 1, or between 1 and 10 for Pb, and lower than 50 for As. This poses a potential risk for breastfed infants, indicating that interventions aimed to avoid breastfeeding-related health risks remain a major challenge in public health.

Optimization and validation of a fast digestion method for the determination of major and trace elements in breast milk by ICP-MS.

Breast milk guarantees all the nutrients required by infants during their first few months of life and remains the most important food source for their health and growth. However, the mother may transfer potentially toxic chemicals to the suckling infant through breastfeeding. The aim of this study was to optimize and validate a fast method for the determination of a total content of 34 elements (Al, As, B, Ba, Be, Bi, Ca, Cd, Co, Cr, Cs, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, Rb, Sb, Se, Si, Sn, Sr, Te, Ti, Tl, U, V, and Zn) in liquid and lyophilized breast milk. The samples were subjected to HNO3:H2O2 (2:1) digestion in an open vessel heated in a water bath (WBD; 80 °C) and subsequently analysed by quadrupole inductively coupled plasma mass spectrometry equipped with a collision-reaction interface. The performance of the proposed method was evaluated in terms of selectivity, detection and quantification limits, linearity, accuracy, and robustness by using standard reference materials and filed samples of breast milk. Compared to microwave-assisted acid digestion, the proposed open vessel digestion allows a significant reduction in treatment time and sample manipulation, while maintaining a similar analytical performance. Masses of 0.5 g of breast milk were efficiently digested with the WBD treatment allowing a residual carbon content lower than 60 mg L-1 and a residual acidity lower than 0.87 mol L-1 in final digested samples. Thus, it shows great potential for application to routine analysis. The method provides satisfactory detection limits and good performance (trueness and recovery percentages 80-111%; coefficient of variation <10%; and relative repeatability <15%) and allows a high sample throughput for multi-elemental determination in human biomonitoring studies.

Morphological MR features and quantitative ADC evaluation in invasive breast cancer: Correlation with prognostic factors.

OBJECTIVE: Assess the correlation between MRI characteristics of invasive breast cancer and tumor prognostic features. MATERIALS AND METHODS: 95 women with invasive breast cancer underwent pre-treatment MR. Morphological findings and quantitative ADC were retrospectively evaluated. RESULTS: Smaller size, round shape, spiculated margins and homogeneous internal enhancement pattern on dynamic MRI were independently associated with established predictors of good prognosis, while larger size and rim enhancement pattern were related to predictors of poor prognosis. A positive correlation was observed between ADC value and clinical stage. CONCLUSIONS: MRI may be a useful tool for breast cancer aggressiveness prediction and for guiding subsequent clinical-therapeutic management.

Time-resolved measurements of water-soluble ions and elements in atmospheric particulate matter for the characterization of local and long-range transport events.

Chemical composition of atmospheric PM(10) was determined at 2-h resolution during a 10-d field study carried out in the urban area of Rome, Italy. Extractable and residual fractions of elements were determined on 2-h samples by inductively coupled plasma mass spectrometry, a rather widespread analytical technique; daily chemical characterization of macro- and micro-components was also carried out and the mass closure was obtained. Interpretation of the variations in PM(10) composition was carried out in the light of the meteorological conditions and, in particular, of the mixing properties of the lower atmosphere, evaluated by monitoring natural radioactivity due to radon 222 decay. The combination of time-resolved sampling, chemical fractionation and monitoring of the dilution properties of the atmosphere allowed a reliable identification of long-range transport events and of local phenomena, which could not be detected by daily samplings. This kind of study can be effective for gathering detailed information about tracers at local scale, which are really valuable for interpreting the results of traditional low-resolution monitoring studies.

Relevance of Sb(III), Sb(V), and Sb-containing nano-particles in urban atmospheric particulate matter.

A quick and reliable analytical method for the separation and quantification of extractable Sb(III) and Sb(V) in atmospheric particulate matter (PM) by ion chromatography(IC)-inductively coupled plasma-mass spectrometry (ICP-MS) has been optimized, validated on pairs of real, equivalent PM(10) samples and applied to a field monitoring campaign in a urban site. Both Sb(III) and Sb(V) forms were detected in real samples with Sb(III)/Sb(V) ratios up to 1.5. These two Sb species accounts only for a portion, of variable magnitude, of the total extractable Sb (10-70%); anyway, no other soluble Sb species were detected in the samples. The analysis of size-segregated samples collected by a 13-stage impactor showed that the recovery of [Sb(III) + Sb(V)] versus total extractable Sb is almost quantitative in the coarse fraction while it is below than 10% in the fine fraction. In the extracted solution from particles below 1 mum we could highlight the presence of Sb-containing suspended solid nano-particles, which probably constitute the missing fraction. The contribution of nano-particles can be estimated as the difference between ICP-MS and IC-ICP-MS data, as small size solid bodies are able to pass through the nebulizer and reach the plasma torch, while they are retained by the chromatographic column. The aggregation state of these nano-particles seems to be easily altered when they are suspended in a water solution; a similar behavior could be hypothesized when in contact with biological fluids. It has been confirmed that brake pad abrasion is the prevalent source of Sb(III) in PM and that Sb(V) may be formed by oxidation during the braking processes. Differing from other environmental matrices, there is no evidence of any spontaneous oxidative conversion within the two species.