Challenges and opportunities for more efficient water use and circular wastewater management. The case of Campania Region, Italy.

By 2050, global demand for water is expected to increase by some 55% due to population growth and urbanization. The utilization of large amounts of freshwater in the world, generate huge volumes of wastewater of which, globally, more than 80% is discharged without treatment, thus causing impacts on aquatic ecosystems, human health and economic productivity. More sustainable practices of wastewater management are expected as a way towards circular bioeconomy (CBE) processes, whose goal is to implement closed systems promoting the systematic use of recycling, reuse and recovery of bioproducts and by-products and the reduction of waste generation. This approach, if adopted in the water and wastewater sector, can ensure environmental, economic and social benefits. The reuse of wastewater, on the one hand, reduces the volume of wastewater and the pressure on water bodies; on the other hand, the recovery of nutrients (P or N) and/or other high value bioproducts (biogas, cellulose, biopolymers) from wastewater offers numerous advantages in terms of supplying new raw bio-based materials that can be refed back to supply chains (thus substituting fossil resources) and, at the same time, producing cleaner water to be reused. Nevertheless, while in Europe many industries have demonstrated the ability to recycle and reuse water, in many regions of Italy the sustainable management of water and wastewater is not yet consolidated. In this study we explore the available technological, economic and environmental options concerning water use and wastewater treatment and we apply them to design appropriate scenarios for improved use efficiency and circular management. A comprehensive literature review of the most promising wastewater treatment processes for resources and energy valorization was conducted. The recovery of PHAs, struvite, nitrogen and algal biomass, as potential substitutes for conventional PET, phosphate and nitrogen chemical fertilizers and electricity, respectively, in addition to reusable treated water, were hypothesized and carefully discussed. Resulting scenarios are tested against the present situation of Campania Region (situated in Southern Italy) based on population and demand statistics, in order to develop strategies and policies potentially applicable locally and elsewhere.

Bio-products from algae-based biorefinery on wastewater: A review.

Increasing resource demand, predicted fossil resources shortage in the near future, and environmental concerns due to the production of greenhouse gas carbon dioxide have motivated the search for alternative 'circular' pathways. Among many options, microalgae have been recently 'revised' as one of the most promising due to their high growth rate (with low land use and without competing with food crops), high tolerance to nutrients and salts stresses and their variability in biochemical composition, in so allowing the supply of a plethora of possible bio-based products such as animal feeds, chemicals and biofuels. The recent raising popularity of Circular Bio-Economy (CBE) further prompted investment in microalgae, especially in combination with wastewater treatment, under the twofold aim of allowing the production of a wide range of bio-based products while bioremediating wastewater. With the aim of discussing the potential bio-products that may be gained from microalgae grown on urban wastewater, this paper presents an overview on microalgae production with particular emphasis on the main microalgae species suitable for growth on wastewater and the obtainable bio-based products from them. By selecting and reviewing 76 articles published in Scopus between 1992 and 2020, a number of interesting aspects, including the selection of algal species suitable for growing on urban wastewater, wastewater pretreatment and algal-bacterial cooperation, were carefully reviewed and discussed in this work. In this review, particular emphasis is placed on understanding of the main mechanisms driving formation of microalgal products (such as biofuels, biogas, etc.) and how they are affected by different environmental factors in selected species. Lastly, the quantitative information gathered from the articles were used to estimate the potential benefits gained from microalgae grown on urban wastewater in Campania Region, a region sometimes criticized for poor wastewater management.

Viral clearance after early corticosteroid treatment in patients with moderate or severe covid-19.

The aim of this study was to evaluate the impact of early treatment with corticosteroids on SARS-CoV-2 clearance in hospitalized COVID-19 patients. Retrospective analysis on patients admitted to the San Raffaele Hospital (Milan, Italy) with moderate/severe COVID-19 and availability of at least two nasopharyngeal swabs. The primary outcome was the time to nasopharyngeal swab negativization. A multivariable Cox model was fitted to determine factors associated with nasopharyngeal swab negativization. Of 280 patients included, 59 (21.1%) patients were treated with steroids. Differences observed between steroid users and non-users included the proportion of patients with a baseline PaO2/FiO2 ≤ 200 mmHg (45.8% vs 34.4% in steroids and non-steroids users, respectively; p = 0.023) or ≤ 100 mmHg (16.9% vs 12.7%; p = 0.027), and length of hospitalization (20 vs 14 days; p < 0.001). Time to negativization of nasopharyngeal swabs was similar in steroid and non-steroid users (p = 0.985). According to multivariate analysis, SARS-CoV-2 clearance was associated with age ≤ 70 years, a shorter duration of symptoms at admission, a baseline PaO2/FiO2 > 200 mmHg, and a lymphocyte count at admission > 1.0 × 109/L. SARS-CoV-2 clearance was not associated with corticosteroid use. Our study shows that delayed SARS-CoV-2 clearance in moderate/severe COVID-19 is associated with older age and a more severe disease, but not with an early use of corticosteroids.

Single-shot d-scan technique for ultrashort laser pulse characterization using transverse second-harmonic generation in random nonlinear crystals.

We demonstrate a novel dispersion-scan (d-scan) scheme for single-shot temporal characterization of ultrashort laser pulses. The novelty of this method relies on the use of a highly dispersive crystal featuring antiparallel nonlinear domains with a random distribution and size. This crystal, capable of generating a transverse second-harmonic signal, acts simultaneously as the dispersive element and the nonlinear medium of the d-scan device. The resulting in-line architecture makes the technique very simple and robust, allowing the acquisition of single-shot d-scan traces in real time. The retrieved pulses are in very good agreement with independent frequency-resolved optical grating measurements. We also apply the new single-shot d-scan to a terawatt-class laser equipped with a programmable pulse shaper, obtaining an excellent agreement between the applied and the d-scan retrieved dispersions.

Soluble endothelial protein C receptor (sEPCR) as an inflammatory biomarker in naive HIV-infected patients during ART.

BACKGROUND: After the advent of ART, non-AIDS-related comorbidities are the main causes of death in HIV patients. Multiple biomarkers have been studied as markers of disease. We wanted to test soluble endothelial protein C receptor (sEPCR) in an HIV setting. OBJECTIVES: The primary objective was to determine whether sEPCR decreases after 48 weeks of ART in naive HIV patients. Secondary objectives were to compare sEPCR levels between patients with chronic HIV infection (CHI) and primary HIV infection (PHI) and to analyse if there is a correlation between sEPCR and both immunovirological parameters and different markers of inflammation. PATIENTS AND METHODS: We analysed sEPCR in 33 patients with CHI and 19 patients with PHI naive to ART. sEPCR was compared together with immunovirological parameters (HIV RNA and CD4 cell count) and IL-6 or D-dimer (DD). RESULTS AND CONCLUSIONS: After 48 weeks of ART, in CHI, the sEPCR decrease was significant (P = 0.0006) and sEPCR at baseline was correlated with both CD4 cell increase (r = +0.463, P = 0.007) and HIV RNA decrease (r = -0.363, P = 0.038). In PHI, sEPCR was stable (P = 0.35); there was a correlation between 48 week DD change and IL-6 change (r = +0.696, P = 0.0009) and also between 48 week DD change and sEPCR change (r = +0.553, P = 0.014). Despite the small sample size, we hypothesize that sEPCR levels reflect coagulant pathway activation caused by the endothelial damage during chronic infection more than a marker of the cytokine storm that occurs during PHI. Alternatively, in PHI, the link found between sEPCR and DD secondary to IL-6 suggests sEPCR is an indirect marker of inflammation.

Life Cycle Assessment of Mixed Municipal Solid Waste: Multi-input versus multi-output perspective.

This paper analyses four strategies for managing the Mixed Municipal Solid Waste (MMSW) in terms of their environmental impacts and potential advantages by means of Life Cycle Assessment (LCA) methodology. To this aim, both a multi-input and a multi-output approach are applied to evaluate the effect of these perspectives on selected impact categories. The analyzed management options include direct landfilling with energy recovery (S-1), Mechanical-Biological Treatment (MBT) followed by Waste-to-Energy (WtE) conversion (S-2), a combination of an innovative MBT/MARSS (Material Advanced Recovery Sustainable Systems) process and landfill disposal (S-3), and finally a combination of the MBT/MARSS process with WtE conversion (S-4). The MARSS technology, developed within an European LIFE PLUS framework and currently implemented at pilot plant scale, is an innovative MBT plant having the main goal to yield a Renewable Refined Biomass Fuel (RRBF) to be used for combined heat and power production (CHP) under the regulations enforced for biomass-based plants instead of Waste-to-Energy systems, for increased environmental performance. The four scenarios are characterized by different resource investment for plant and infrastructure construction and different quantities of matter, heat and electricity recovery and recycling. Results, calculated per unit mass of waste treated and per unit exergy delivered, under both multi-input and multi-output LCA perspectives, point out improved performance for scenarios characterized by increased matter and energy recovery. Although none of the investigated scenarios is capable to provide the best performance in all the analyzed impact categories, the scenario S-4 shows the best LCA results in the human toxicity and freshwater eutrophication categories, i.e. the ones with highest impacts in all waste management processes.

Dynamics of adaptive and innate immunity in patients treated during primary human immunodeficiency virus infection: results from Maraviroc in HIV Acute Infection (MAIN) randomized clinical trial.

We evaluated the dynamics of innate and adaptive immunity in patients treated with combined antiretroviral therapy (cART) during primary human immunodeficiency virus infection (PHI), enrolled in a prospective randomized trial (MAIN, EUDRACT 2008-007004-29). After 48 weeks of cART, we documented a reduction in activated B cells and CD8(+) T cells. Natural killer cell and dendritic cell frequencies were measured and a decrease in CD16(+) CD56(dim) with a reciprocal rise in CD56(high) natural killer cells and an increase in myeloid and plasmacytoid dendritic cells were recorded. In conclusion, 48 weeks of cART during PHI showed significant benefits for both innate and adaptive immunity.

Maraviroc 150 mg daily plus lopinavir/ritonavir, a nucleoside/nucleotide reverse transcriptase inhibitor-sparing regimen for HIV-infected naive patients: 48-week final results of VEMAN study.

Non-conventional strategies with nucleoside/nucleotide reverse transcriptase inhibitor-sparing regimens in antiretroviral naive human immunodeficiency virus (HIV) -infected patients have been explored in clinical trials. A prospective, open-label, randomized (1:1), multicentre, proof-of-concept trial (VEMAN study, EUDRACT number 2008-006287-11) was conducted assigning HIV-infected naive patients to once-daily maraviroc plus lopinavir/ritonavir (MVC group) or to tenofovir/emtricitabine plus lopinavir/ritonavir (TDF/FTC group). Clinical and laboratory data were collected at baseline, and after 4, 12, 24, 36 and 48 weeks with the objective to evaluate the 48-week virological and immunological efficacy. HIV-1 DNA load and CD4(+) T-cell subsets were analysed on frozen peripheral blood mononuclear cells collected at baseline, 4 and 48 weeks to explore the trend in HIV reservoirs. Fifty patients were randomized and included in the analysis. During follow up, HIV-1 RNA decreased similarly in both groups and, at week 48, all patients in the MVC group and 22/24 (96%) in the TDF/FTC group had < 50 copies/ml of HIV-1 RNA. CD4(+) trend during follow up was higher in maraviroc-treated patients (MVC group: 286 (183-343) versus TDF/FTC group: 199 (125-285); Mann-Whitney U-test: p 0.033). A significant 48-week increase of CCR5(+) CD4(+) T cells and CD4(+) effector memory cells was observed among maraviroc-treated patients (Wilcoxon signed rank test: p 0.016 and p 0.007, respectively). No significant variations were found in naive and central memory CD4(+) T cells. Among naive patients with an R5 virus, treatment with maraviroc and lopinavir/ritonavir was shown to provide a virological response compared to a triple therapy and a greater immunological benefit.

Land use, climate and transport of nutrients: evidence emerging from the Lake Vico Case Study [corrected].

Soil erosion is a Europe-wide problem, causing both loss of soil fertility and pollution due to nutrient transport into water bodies. This process is particularly important in the Mediterranean area, where the climate, characterised by long periods of drought followed by intense precipitation, favours soil erosion. Research carried out in this field has amply described this process, showing that climate and land use/land cover (LU/LC) are the two main factors regulating this phenomenon. However, the interaction between these factors is complex and experimental research is needed to understand the nutrient loads deriving from different land uses. This paper shows the results of a long-term monitoring project carried out in the Lake Vico basin (central Italy), using high resolution data and runoff samples to determine the phosphorus (P) export from four different LU/LC classes resulting from the same climatic event. The results highlight the fundamental role that LU/LC plays in terms of phosphorus load. Furthermore, the results appear to indicate that the maximum rainfall registered for 30' (I 30, max), rather than the total quantity of precipitation, has the greatest effect on levels of erosion, and consequently on the migration of nutrients rather than the total quantity of precipitation can affect on erosion and therefore the migration of nutrients. These data could contribute to scientific planning support for land management choices aimed at controlling water pollution from non-point pollution sources.

Vulnerability and risk evaluation of agricultural nitrogen pollution for Hungary's main aquifer using DRASTIC and GLEAMS models.

In recent years, the significant improvement in point source depuration technologies has highlighted problems regarding, in particular, phosphorus and nitrogen pollution of surface and groundwater caused by agricultural non-point (diffuse) sources (NPS). Therefore, there is an urgent need to determine the relationship between agriculture and chemical and ecological water quality. This is a worldwide problem, but it is particularly relevant in countries, such as Hungary, that have recently become members of the European Community. The Italian Foreign Ministry has financed the PECO (Eastern Europe Countries Project) projects, amongst which is the project that led to the present paper, aimed at agricultural sustainability in Hungary, from the point of view of NPS. Specifically, the aim of the present work has been to study nitrates in Hungary's main aquifer. This study compares a model showing aquifer intrinsic vulnerability to pollution (using the DRASTIC parameter method; Aller et al. [Aller, L., Truman, B., Leher, J.H., Petty, R.J., 1986. DRASTIC: A Standardized System for Evaluating Ground Water Pollution Potential Using Hydrogeologic Settings. US NTIS, Springfield, VA.]) with a field-scale model (GLEAMS; Knisel [Knisel, W.G. (Ed.), 1993. GLEAMS--Groudwater Leaching Effects of Agricultural Management Systems, Version 3.10. University of Georgia, Coastal Plain Experimental Station, Tifton, GA.]) developed to evaluate the effects of agricultural management systems within and through the plant root zone. Specifically, GLEAMS calculates nitrate nitrogen lost by runoff, sediment and leachate. Groundwater monitoring probes were constructed for the project to measure: (i) nitrate content in monitored wells; (ii) tritium (3H) hydrogen radioisotope, as a tool to estimate the recharge conditions of the shallow groundwater; (iii) nitrogen isotope ratio delta15N, since nitrogen of organic and inorganic origin can easily be distinguished. The results obtained are satisfactory, above all regarding the DRASTIC evaluation method, which is shown to satisfactorily explain both low and high aquifer vulnerability, and furthermore proves to be a good tool for zoning hydrogeological regions in terms of natural system susceptibility to pollution. The GLEAMS model, however, proves not to be immediately usable for predictions, above all due to the difficulty in finding sufficient data for the input parameters. It remains a good tool, but only after an accurate validation, for decision support systems, in the specific case to integrate intrinsic vulnerability, from DRASTIC (or similar methods), with land use nitrate loads from GLEAMS, or similar methods. The PECO project has proved a positive experience to highlight the fundamental points of a decision support system, aimed to mitigate the nitrate risk for groundwater coming from Hungarian agricultural areas.