Summary recommendations on "Analytical methods for substances in the Watch List under the Water Framework Directive".

The Watch List (WL) is a monitoring program under the European Water Framework Directive (WFD) to obtain high-quality Union-wide monitoring data on potential water pollutants for which scarce monitoring data or data of insufficient quality are available. The main purpose of the WL data collection is to determine if the substances pose a risk to the aquatic environment at EU level and subsequently to decide whether a threshold, the Environmental Quality Standards (EQS) should be set for them and, potentially to be listed as priority substance in the WFD. The first WL was established in 2015 and contained 10 individual or groups of substances while the 4th WL was launched in 2022. The results of monitoring the substances of the first WL showed that some countries had difficulties to reach an analytical Limit of Quantification (LOQ) below or equal to the Predicted No-Effect Concentrations (PNEC) or EQS. The Joint Research Centre (JRC) of the European Commission (EC) organised a series of workshops to support the EU Member States (MS) and their activities under the WFD. Sharing the knowledge among the Member States on the analytical methods is important to deliver good data quality. The outcome and the discussion engaged with the experts are described in this paper, and in addition a literature review of the most important publications on the analysis of 17-alpha-ethinylestradiol (EE2), amoxicillin, ciprofloxacin, metaflumizone, fipronil, metformin, and guanylurea from the last years is presented.

Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadows.

PURPOSE: The use of dual mobility cups in total hip arthroplasty has gained popularity in light of the fact it enables to reduce dislocation through increased jumping distance (JD) and impingement-free arc of movement. Modular Dual Mobility Cup (modular DMC) systems have been recently introduced to enable the use of dual mobility cups with standard metal-backed shells. The objective of this study was twofold: calculate the JD for each modular DMC system and conduct a systematic literature review to report clinical outcomes and reasons for failure of this construct. METHODS: The JD was calculated using the Sariali formula: JD = 2Rsin [(π/2 - Ψ - arcsin (offset/R))/2]. A qualitative systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search for English and French articles between January 2000 and July 2020 was run on PubMed, EMBASE, Google Scholar, and Scopus with the primary objective of finding articles about modular DMC systems. RESULTS: We identified eight 8 different manufacturers of modular DMC systems and 327 publications on the subject. After screening for duplicates and eligibility, we identified 229 publications: 206 articles were excluded because they contained no reports on modular DMC systems, whereas other three were not included because they focused on biomechanical aspects. Among the 11 included articles, 2 were prospective case series, 9 were retrospective case series. True dislocation occurred in 25 cases (0.9%), and six of them were solved by closed reduction without necessity of revision, while all 5 intraprosthetic dislocations were operated. CONCLUSIONS: Modular DMCs are a valid method to deal with complex THA instability, with good clinical and patient-reported outcomes, low complication rates, and low revision rates at early follow-up. We would advise cautious optimism on the role of modular DMC implants, as it seems safer to use ceramic instead of metallic heads whenever possible to avoid the increase cobalt and chromium trace ion serum levels.

Use of dual-mobility cup in primary total hip arthroplasties: an Italian regional register (RIPO) study on three thousand, seven hundred and ten cases.

PURPOSE: The purpose of the study was to investigate the outcome of dual-mobility cup (DM) compared with a standard cup (SC) in primary total hip arthroplasty (THA) in the long-term follow-up based on a regional Italian joint registry (RIPO). METHODS: The Registry of Prosthetic Orthopaedic Implant (RIPO) was consulted, looking for all primary THAs implanted from 2000 to 2019. Three thousand seven hundred ten were dual-mobility cup (DM) total hip arthroplasties (THA) and 85.816 were standard cup (SC) THAs, on a total of 89.526 primary THA. Demographics, survival rates and causes of revision were evaluated and compared between the two groups. RESULTS: The use of DM progressively increased from 0.4% in 2000 to 7.5% in 2018 of all primary THAs. Revision rate was 3.5% (128 on 3710) for DMC and 4.7% (4061 on 85,816) for SC. DM presented lower dislocation rate if compared to SC with 22-28-mm femoral head diameter. However, DM showed a higher risk of revision for any causes than SC with 32-mm femoral head diameter in long-term follow-up. Nevertheless, no significant difference was measured in terms of demographics and surgical approach for dislocation rate. CONCLUSIONS: The DM cup represents a valid implant solution and has a lower dislocation rate than 22-28-mm SC. A slight increase in the use of DM implants over time was observed in the RIPO. However, a larger population and a longer follow-up are needed to further monitor the survival rate of new-generation DM implants.

Hip stability parameters with dual mobility, modular dual mobility and fixed bearing in total hip arthroplasty: an analytical evaluation.

BACKGROUND: Use of dual mobility (DM) in total hip arthroplasty has gained popularity due to the ability to reduce dislocation through increased jumping distance and impingement-free arc of movement. Recently, modular dual mobility (modDM) systems were introduced to give the possibility to use DM with standard metal-backed shells, however few has been studied to date regarding how jumping distance and the center of rotation change with modDM. The objective of this study was to evaluate, through analytical simulation, how jumping distance, center of rotation and arc of movement change between DM and standard cups with modDM or fixed bearings (FB). METHODS: 3D-models of DM and standard press-fit cups with modDM or FB liners were used to simulate DM, modDM and FB implant configurations, matched for same cup size, according to same cup position and different femoral head diameters. Jumping distance was calculated and center of rotation lateralization and oscillation angles were measured for each size of these three implant configurations. RESULTS: Jumping distance with modDM was reduced by -3.9 mm to -8.6 mm in comparison with DM, from 48 to 64 mm size, but resulted comparable to polyethylene 36 mm FB and increased by + 1.1 mm and + 1.4 mm than ceramic 36 and 40 mm FBs for sizes > 54 mm. ModDM lateralized the center of rotation up to + 2.5 mm and + 4.0 mm in comparison with DM and FBs, respectively. Oscillation angle with modDM resulted higher than + 16°, + 23°, + 17° and + 14° in comparison to DM, 28 mm, 32 mm and 36 mm FB cups, respectively, for 56 mm cup size. CONCLUSIONS: According to its specific design, modDM might change hip stability parameters in comparison to DM, worsening jumping distance and center of rotation position, but increasing arc of movement. As not restoring stability parameters in the same fashion, modDM implants should be properly used when DM cups are not feasible.

Management of a Lumbar Burst Fracture Occurring After a Sneeze in a Patient Affected by Systemic Mastocytosis: A Case Report.

CASE: We present a 36-year-old man with L1 burst fracture after a sneeze. He was in follow-up for indolent systemic mastocytosis (ISM), and osteoporosis was treated with bisphosphonate. Owing to neurologic impairment, posterior decompressive laminectomy and thoraco-lumbar fusion with cemented screws were performed. CONCLUSION: Vertebral fractures in young patients affected by ISM required a multidisciplinary approach and a careful preoperative planning to achieve acceptable results. These fractures are so rare that even an experienced spine surgeon may not come across them during his whole career. Nevertheless, diagnostic tool improvement makes its diagnosis more frequent, that is why every spine surgeon should know this disease.

Posterior Osteotomy and Osteosynthesis for Malunited Atlas Fracture: A Surgical Technique.

Conservative treatment is commonly accepted and widely used for most atlas compression fractures. Malunion due to mismatching of the articular surfaces in C0-C1 and C1-C2 is therefore frequent even without associated instability. Such a result is considered acceptable in the elderly with low functional requests but should be avoided in young patients. Authors describe a new surgical technique to reduce and fix a nonunion and malunited fracture of the atlas through a posterior arch osteotomy followed by articular masses stabilization with polyaxial screws and precurved titanium rod. Rod prebending reduces lateral inclination of the screw heads during the reduction maneuver through compression applied between screw heads making it effective.

Estrogenicity of chemical mixtures revealed by a panel of bioassays.

Estrogenic compounds are widely released to surface waters and may cause adverse effects to sensitive aquatic species. Three hormones, estrone, 17ß-estradiol and 17α-ethinylestradiol, are of particular concern as they are bioactive at very low concentrations. Current analytical methods are not all sensitive enough for monitoring these substances in water and do not cover mixture effects. Bioassays could complement chemical analysis since they detect the overall effect of complex mixtures. Here, four chemical mixtures and two hormone mixtures were prepared and tested as reference materials together with two environmental water samples by eight laboratories employing nine in vitro and in vivo bioassays covering different steps involved in the estrogenic response. The reference materials included priority substances under the European Water Framework Directive, hormones and other emerging pollutants. Each substance in the mixture was present at its proposed safety limit concentration (EQS) in the European legislation. The in vitro bioassays detected the estrogenic effect of chemical mixtures even when 17ß-estradiol was not present but differences in responsiveness were observed. LiBERA was the most responsive, followed by LYES. The additive effect of the hormones was captured by ERα-CALUX, MELN, LYES and LiBERA. Particularly, all in vitro bioassays detected the estrogenic effects in environmental water samples (EEQ values in the range of 0.75-304 × EQS), although the concentrations of hormones were below the limit of quantification in analytical measurements. The present study confirms the applicability of reference materials for estrogenic effects' detection through bioassays and indicates possible methodological drawbacks of some of them that may lead to false negative/positive outcomes. The observed difference in responsiveness among bioassays - based on mixture composition - is probably due to biological differences between them, suggesting that panels of bioassays with different characteristics should be applied according to specific environmental pollution conditions.

A rapid screening method for testing the efficiency of masks in breaking down aerosols.

The highest risk of novel coronavirus SARS-CoV-2 to be spread through human-to-human transmission has boosted the use of personal protective equipment at worldwide level. In Europe, the medical face masks must be tested to certify the essential requirements in agreement with European Standard EN 14683:2019, and face masks for industrial use in agreement with European Standard EN 149:2009. Due to the need of large quantitative of medical and non-medical face masks in coronavirus outbreak, several Italian industries are working for shift a portion of their manufacturing capacity for producing medical and non-medical face mask. For screening evaluation of the effectiveness of personal protective equipment produced by reconverted industries, ARPA Lazio and the Department of Chemical Science and Technologies of Tor Vergata University have set-up an analytical system able to simulate the respiratory action and to measure the percentage of particles that pass through the face masks using optical particle counter (based on the EN 16890: 2017 that uses the same light scattering principle to evaluate the filter filtration efficiency). This set-up was challenged using face masks produced by reconverted industries and the data were compared with ones obtained using medical face mask.

Revision of a Monoblock Metal-on-Metal Cup Using a Dual Mobility Component: Is It a Reasonable Option?

Revision of large-diameter, monoblock acetabular components for both hip resurfacing arthroplasty and metal-on-metal (MoM) total hip arthroplasty (THA) is correlated to a high amount of complications. For this reason, performing a limited revision by conversion to a dual mobility (DM) without acetabular component exchange has been proposed in order to limit these complications. Although DM bearing offers an easy solution avoiding the intraoperative and time-associated complications, concern about polyethylene wear and stability remains due to the difference regarding the design, the coverage angle and the clearance of the two implants. In order to evaluate the performance of this new solution with the new material to prevent the possibility of failure it is essential to conduct a review of the literature A qualitative systematic review of the literature has been conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, EMBASE, Google Scholar, and Scopus for English and French articles between January 2000 and October 2019 was performed, with the primary objective of finding articles about dual mobility bearing coupling with large metal-on-metal cup in the case of hip revision procedure. Various combinations of the key words were used in the search strategy. Thirteen articles with DM bearing mated with MoM cup were analyzed. Of the 130 hip revisions selected, with a follow-up from 6 to 53 months, there were a total of 14 with complications (10.77%): four true dislocations (3.08%); six intra-prosthetic dislocations (IPD, 4.6%), two of which presented plastic deformation and polyethylene wear; four other complications (3.08%), included a cup osteolysis, a clicking noise, a superficial infection and a periprosthetic fracture. All the mentioned true dislocations occurred during the first month while IPDs appeared during the first two years from the index revision. In conclusion, according to the literature analyzed, we can stress that the concerns and doubts about mating a DM bearing with large MoM cup cannot be dissolved. It has been pointed out that a DM bearing is not designed for a MoM cup; it is not mechanically tested on MoM cups, which presents different clearance and coverage angles. Predictable complications may occur, such as IPD, polyethylene wear and true dislocation. These complications have been reported at an even higher rate than they were in the eighties, when the first generation of DM implants were of a lower quality of polyethylene and the characteristic of the design was less optimal than modern ones.

Neglected pulmonary thromboembolism in a traumatic anterior hip dislocation: A case report.

We report the case of treatment delay for an early onset of pulmonary embolism due to thrombosis in the femoral vein occurred in a traumatic anterior hip dislocation. Mistakes interpretations of clinical findings and pre-operative chest CT-angiography has endangered our patient's life because of the medical report was focused only on acute traumatic injuries. After all, we were not able to find in the literature any similar report that could explain the pathogenesis of this early onset and help us in the patient management. We have tried to list a number of practical suggestions to use in emergency room in these situations.

Fate of Large-Scale Structure in Modified Gravity After GW170817 and GRB170817A.

The coincident detection of gravitational waves (GW) and a gamma-ray burst from a merger of neutron stars has placed an extremely stringent bound on the speed of GWs. We showed previously that the presence of gravitational slip (η) in cosmology is intimately tied to modifications of GW propagation. This new constraint implies that the only remaining viable source of gravitational slip is a conformal coupling to gravity in scalar-tensor theories, while viable vector-tensor theories cannot now generate gravitational slip at all. We discuss structure formation in the remaining viable models, demonstrating that (i) the dark-matter growth rate must now be at least as fast as in general relativity (GR), with the possible exception of that beyond the Horndeski model, and (ii) if there is any scale dependence at all in the slip parameter, it is such that it takes the GR value at large scales. We show a consistency relation that must be violated if gravity is modified.

Cosmology and fundamental physics with the Euclid satellite.

Euclid is a European Space Agency medium-class mission selected for launch in 2020 within the cosmic vision 2015-2025 program. The main goal of Euclid is to understand the origin of the accelerated expansion of the universe. Euclid will explore the expansion history of the universe and the evolution of cosmic structures by measuring shapes and red-shifts of galaxies as well as the distribution of clusters of galaxies over a large fraction of the sky. Although the main driver for Euclid is the nature of dark energy, Euclid science covers a vast range of topics, from cosmology to galaxy evolution to planetary research. In this review we focus on cosmology and fundamental physics, with a strong emphasis on science beyond the current standard models. We discuss five broad topics: dark energy and modified gravity, dark matter, initial conditions, basic assumptions and questions of methodology in the data analysis. This review has been planned and carried out within Euclid's Theory Working Group and is meant to provide a guide to the scientific themes that will underlie the activity of the group during the preparation of the Euclid mission.

Innovative analytical method for the determination of underivatized tributyltin and pentachlorophenol in seawater by gas chromatography-triple quadrupole mass spectrometry.

Tributyltin (TBT) and pentachlorophenol (PCP) are listed as priority substances that warrant monitoring in the European Water Framework Directive (WFD 2000/60/CE), since TBT and PCP were identified as environmental endocrine disruptors and exhibit considerable toxicity toward both aquatic organisms and mammals even at very low levels. This paper shows a novel approach to analyze underivatized tributyltin (TBT) and pentachlorophenol (PCP) in seawater based on capillary gas chromatography-triple quadrupole mass spectrometry. The optimized extraction method for TBT an PCP in water involved liquid-liquid microextraction with toluene. The reduced extract was added with a solvent mix, composed of methanol and trimethylsilyl derivatives of methanol (MeOTMS), that allowed good chromatographic resolution of underivatized TBT and PCP, interacting as a lubricant along the glass liner during the injection phase. The proposed method showed good linearity and repeatability (RSD%<20% at 0.05 ng L-1 for TBT and 0.2 µg L-1 for PCP). The overall recoveries were 74% and 106% for TBT and PCP, respectively. Very low quantification limits that met the strict statutory and regulatory demands were achieved: 0.002 ng L-1 for TBT and 0.050 µg L-1 for PCP.

A miniaturized bismuth-based sensor to evaluate the marine organism Styela plicata bioremediation capacity toward heavy metal polluted seawater.

Cadmium and lead are highly toxic heavy metals which cause a severe worldwide pollution. In addition to the toxic effect produced by the direct exposure, they can be bioconcentrated and accumulated in living organisms, including humans. Herein, a miniaturized and disposable electrochemical sensor was improved for the simultaneous detection of cadmium and lead ions to study the bioremediation of polluted seawater in presence of the filter-feeding marine organism Styela plicata. A screen-printed electrode modified in situ with a bismuth film was selected using the anodic stripping analysis as detection technique. This sensor was coupled with a portable potentiostat and the detection of cadmium and lead ions was carried out by Square Wave Anodic Stripping Voltammetry, allowing the simultaneous detection of both heavy metals at ppb level (LOD=0.3ppb for lead, 1.5ppb for cadmium). This analytical tool was then applied to assess the bioremediation capacity of S. plicata through a bioremediation experiment, in which the organism has been exposed to seawater artificially polluted with 1000ppb of Cd2+ and Pb2+. The matrix effect of both seawater and acid digested biological samples was evaluated. A bioconcentration phenomenon was observed for both heavy metals through the analysis of S. plicata tissues. In details, Pb2+ resulted to be about 2.5 times more bioconcentrated than Cd2+, giving an effective bioremediation level in seawater of 13% and 40% for Cd2+ and Pb2+, respectively. Thus, our results demonstrate the capability of S. plicata to bioremediate Cd2+ and Pb2+ polluted seawater as well as the suitability of the electrochemical sensor for contaminated marine environment monitoring and bioremediation evaluation.

Costotransverse screw fixation in a severe cervicothoracic deformity because of a type 1 neurofibromatosis: case report.

BACKGROUND CONTEXT: Spinal implant placement may be challenging in cases of severe cervicothoracic spinal deformities and anatomical anomalies as in Type 1 neurofibromatosis. Intralaminar screwing of the thoracic spine has been described in few cases in which pedicles were hypoplasic. The costovertebral joints have never been used before as an anchorage point for screws. PURPOSE: The purpose of the study was to describe a new thoracic fixation technique to be used in severe deformities whenever the posterior arch (laminae and pedicles) is not available because of anatomic abnormalities. STUDY DESIGN: This is a case report. METHODS: An 18-year-old woman with progressive tetraparesis caused by increasing deformity of cervicothoracic spine underwent evaluation and surgical treatment: procedure and techniques were described. The clinical features, the radiological findings, and the outcomes were assessed. Complications and local recurrences were also recorded. RESULTS: Costotransverse joint screwing was successfully used in one case of severe cervicothoracic spine deformity with major hypoplasia of the pedicles. The posterior arch of one thoracic vertebra became mobile soon after periosteal stripping probably because of iatrogenic fracture of the only existent pedicle. The four-cortical trajectory of the screws resulted in a good bone purchase allowing the surgeon to complete the procedure. No local or general complications were recorded during 2 years of follow-up. CONCLUSIONS: The procedure was used as a salvage technique during a difficult surgery where a local complication forced a change of strategy. Although the implant remained stable long enough to achieve fusion, it still consists of placing a screw through a joint that remains slightly mobile. This could possibly result in a screw loosening in the long period if fusion is not achieved. We suggest the use of this technique when all the other options have been explored and excluded for anatomical reasons.

Occipital condyles congenital dislocation and condylus tertius: an unstable association revealing a new abnormality of the craniocervical junction.

STUDY DESIGN: A case report. OBJECTIVE: To describe a unique craniocervical junction anomaly and its implications both on mobility and stability of the skull base. SUMMARY OF BACKGROUND DATA: Congenital variations in the craniocervical junction (CVJ) are rare and frequently symptomless. Mild traumas may commonly rouse symptoms which help to unveil such anomalies through radiological investigations. METHODS: A 73-year-old woman developed a monoparesis of the right arm after a mild craniofacial trauma. Neurological examination revealed hyper-reflexia in the upper limbs, confirming the strength impairment in the right one. Radiology showed a post-traumatic bulbo-medullary contusion sustained by a unique and unstable association of the first occipital condyles congenital dislocation ever reported with a rare condylus tertius. The patient underwent posterior decompression and occipitocervical screw-rod fixation and fusion. Clinico-radiological follow-up highlighted a gradual recovery of the neurologic impairment and the posterior decompression with resolution of the spinal cord contusion. RESULTS: Although apparently stable the hyperostosis and the irregularly shaped condylar surfaces behind the 3-points mechanism of skull base support played a critical role in determining axial instability. The imbalance due to skull-cervical spine malpositioning may consequently trigger a vicious cycle of development of osteophytes leading to spinal cord narrowing with neurologic decline. A surgical strategy providing for posterior decompression and fixation satisfied the need to solve both bulbo-medullary constriction and skull base instability. CONCLUSION: Clinical evidences about CVJ anomalies are lacking and symptoms, when present, tend to be vague. Although extremely rare clinicians should be aware of CVJ variations by engaging to improve their knowledge of imaging anatomy, embryology, CVJ basic craniometry and anatomic relationships. Studies on developmental control genes may offer future perspectives of early diagnosis and targeted treatments. LEVEL OF EVIDENCE: 4.