Search Results (13)

Groundwater is one of the major sources of water supply for human needs. But anthropic activities such as agriculture are causing significant volume depletion and quality deterioration, favoring microbial contamination that has a negative impact on human health. The geological characteristics of the ground can influence the transport of microorganisms, especially if made of permeable rock. Furthermore, irrigation with untreated or partially treated wastewater can represent an additional health risk due to the potential transmission of pathogens to food. The aim of our research is to provide an interdisciplinary perspective on this issue by integrating hygienic, geological, and agronomic skills. Water samplings are scheduled seasonally by four monitoring campaigns in five sampling points placed in two Southern Italy regions, Apulia (one point at the outlet and two wells near the wastewater plant at Carpignano Salentino, Lecce province, Italy) and Sicily (two wells at Scicli and Pozzallo, Ragusa province, Italy) Laboratory experiments of microorganism transport in permeable rocks will be carried out under saturated and unsaturated conditions. A mathematical model of transport through porous media will be implemented and validated with laboratory measurements. The model will be used to develop a monitoring tool to control sites in Apulia and Sicily where periodic cultural and molecular detection of pathogenic bacteria, viruses, and protozoa will also be taken. In addition, an analysis of the microbiological contamination of herbaceous crops due to the use of low-quality water will be conducted to assess the Quantitative Microbial Risk Assessment (QMRA). The project will provide methodological tools to evaluate anthropogenic pressures and their impact on environmental matrices. The results will allow these pressures to be modulated to minimize environmental and agri-food microbiological contamination and protect public health. Full article

Since the discovery of the first-generation ALK inhibitor, many other tyrosine kinase inhibitors have been demonstrated to be effective in the first line or further lines of treatment in patients with advanced non-small cell lung cancer with EMLA4-ALK translocation. This review traces the main milestones in the treatment of ALK-positive metastatic patients and the survival outcomes in the first-line and second-line settings with different ALK inhibitors. It presents the two options available for first-line treatment at the present time: sequencing different ALK inhibitors versus using the most potent inhibitor in front-line treatment. The efficacy outcomes of different ALK inhibitors in the first-line setting; the molecular profile of the disease, including mutation resistances and ALK variants and co-mutations; and patients’ co-morbidities and inhibitor toxicities should be taken into account to address the choice of the first-line treatment, as suggested in this review. Full article

Wastewater treatment plants (WWTPs) provide optimal conditions for the environmental spread of Legionella. As part of the Evaluation of Sanitary Risk Related to the Discharge of Wastewater to the Ground (SCA.Re.S) project, this study was conducted to evaluate the presence of Legionella in WWTP effluent and in groundwater samples collected from two wells located downstream from the plant. The samples were analyzed to determine the concentrations of Legionella spp using the standard culture-based method and molecular techniques, followed by genomic sequencing analysis. Legionella was detected only with the molecular methods (except in one sample of effluent positive for L. pneumophila serogroup 6), which showed viable Legionella pneumophila and L. non-pneumophila through the use of free DNA removal solution in both the effluent and groundwater, with concentrations that progressively decreased downstream from the plant. Viable L. pneumophila appeared to be slightly more concentrated in warm months. However, no significant differences (p ≥ 0.05) in concentrations between cold and warm months were observed. A genotypic analysis characterized the species present in the samples and found that uncultured Legionella spp, as yet undefined, constituted the prevalent species in all the samples (range 77.15–83.17%). WWTPs play an important role in the hygienic and sanitary quality of groundwater for different uses. The application of Legionella control systems during the purification of effluents is warranted to prevent possible outbreaks of legionellosis. Full article

Pathogenic microorganisms released onto the soil from point or diffuse sources represent a public health concern. They can be transported by rainwater that infiltrates into subsoil and reach the groundwater where they can survive for a long time and contaminate drinking water sources. As part of the SCA.Re.S. (Evaluation of Health Risk Related to the Discharge of Wastewater on the Soil) project, we reviewed a selection of field-scale studies that investigated the factors that influenced the fate of microorganisms that were transported from the ground surface to the groundwater. A total of 24 studies published between 2003 and 2022 were included in the review. These studies were selected from the PubMed and Web of Science databases. Microbial contamination of groundwater depends on complex interactions between human activities responsible for the release of contaminants onto the soil, and a range of environmental and biological factors, including the geological, hydraulic, and moisture characteristics of the media traversed by the water, and the characteristics and the viability of the microorganisms, which in turn depend on the environmental conditions and presence of predatory species. Enterococci appeared to be more resistant in the underground environment than thermotolerant coliforms and were suggested as a better indicator for detecting microbial contamination of groundwater. Full article

It was recently reported that frailty status can negatively influence the clinical course of patients with inflammatory bowel diseases (IBDs). Our recent study demonstrated that 20% of patients with an IBD are frail, and disease activity increases the risk of frailty. In the present study, we prospectively monitored this subgroup of frail patients, assessed whether the frailty status was reversible, and analyzed factors associated with frailty reversibility. Of the sixty-four frail patients with IBD enrolled, five (8%) were lost during the follow-up period and one (2%) underwent a colectomy. Eleven out of the fifty-eight (19%) patients maintained a frail phenotype during a median follow-up of 8 months (range 6–19 months), and thirty-five (60%) and twelve (21%) became pre-frail or fit, respectively. A comparison of the 58 patients at baseline and at the end of the study showed that frail phenotype reversibility occurred more frequently in patients who achieved clinical remission. A multivariate analysis showed that the improvement of the frail phenotype was inversely correlated with the persistence of clinically active disease (OR:0.1; 95% CI: 0.02–0.8) and a history of extra-intestinal manifestations (OR:0.1; 95% CI: 0.01–0.6) and positively correlated with the use of biologics (OR: 21.7; 95% CI: 3.4–263). Data indicate that the frail phenotype is a reversible condition in most IBD patients, and such a change relies on the improvement in disease activity. Full article

The clinical management of metastatic melanoma has been changed by BRAF (BRAFi) and MEK inhibitors (MEKi), which represent a standard treatment for BRAF-mutant melanoma. In oligoprogressive melanoma patients with BRAF mutations, target therapy can be combined with loco-regional radiotherapy (RT). However, the association of BRAF/MEK inhibitors and RT needs to be carefully monitored for potential increased toxicity. Despite the availability of some reports regarding the tolerability of RT + target therapy, data on simultaneous RT and BRAFi/MEKi are limited and mostly focused on the BRAFi vemurafenib. Here, we report a series of metastatic melanoma patients who received fractioned RT regimens for oligoprogressive disease in combination with the BRAFi dabrafenib and the MEKi trametinib, which have continued beyond progression. None of the cases developed relevant adverse events while receiving RT or interrupted dabrafenib and trametinib administration. These cases suggest that a long period of dabrafenib/trametinib interruption during radiotherapy for oligoprogressive disease can be avoided. Prospective trials are warranted to assess the efficacy and safety of the contemporary administration of BRAF/MEK inhibitors and radiotherapy for oligoprogressive disease. Full article

Climate change and anthropogenic pressures are the main drivers of the quantitative and qualitative depletion of water bodies, worldwide. Nowadays, in many urban areas, discharging effluents from wastewater treatment plants (WWTPs) into surface water bodies is a management solution to face the problem of water scarcity and sustain environmental flows. Although this practice can cause some concerns in public opinion about possible ecological side-effects and impairment of quality on receiving streams, it is an important contribution to the environmental baseflow of ephemeral streams, but also to groundwater recharge, especially during dry seasons, and in semi-arid and arid regions. This latter occurs through losing reaches along the streambed, though many factors may affect the infiltration rate, such as spatial distribution of streambed sediments and bedrock or the presence of channel lining. Moving from such premises, this study focuses on the Canale Reale River, an effluent-fed stream located nearby the city of Brindisi on the south-eastern side of the Apulia Region, in Italy. The Canale Reale flows through the Torre Guaceto protected wetland, located along the Adriatic coast. It collects effluents from four WWTPs with wastewater contributing for about 16.5% of the annual volume of channel drainage (i.e., 3.82 Mm³ out of 23.02 Mm³ along its 50 km long course). Within the framework of a complex geological setting, the Canale Reale River crosses different lithologies, which implies different streambed infiltration conditions. Using the Reach Length Water Balance method (RLWB), the transmission losses between the watercourse and the underlying aquifers were investigated. Particularly, the method allowed for the estimation of a spatially-average value of the riverbed’s infiltration rate applicable to the whole river course as well as the minimum, average, and maximum potential transmission losses ($T{L}_P$) from the river to the underlying groundwater systems. Combining the estimated $T{L}_P$ values and the Flow Duration Curve (FDC) allowed for the inferring of the Transmission Loss Duration Curves (TLDC). Finally, the water volume infiltrating during an average hydrological year was estimated to be 6.25 Mm³, 61% of which was due to treated wastewater discharge. The results obtained confirm that the practice of increasing the river flow rates with WWTP effluents reduces the dry riverbed periods, with potential improvements to the river’s ecological sustainability and relevant enhancement of groundwater recharge. Full article

Duchenne muscular dystrophy (DMD) is a rare genetic disease leading to progressive muscle wasting, respiratory failure, and cardiomyopathy. Although muscle fibrosis represents a DMD hallmark, the organisation of the extracellular matrix and the molecular changes in its turnover are still not fully understood. To define the architectural changes over time in muscle fibrosis, we used an mdx mouse model of DMD and analysed collagen and glycosaminoglycans/proteoglycans content in skeletal muscle sections at different time points during disease progression and in comparison with age-matched controls. Collagen significantly increased particularly in the diaphragm, quadriceps, and gastrocnemius in adult mdx, with fibrosis significantly correlating with muscle degeneration. We also analysed collagen turnover pathways underlying fibrosis development in cultured primary quadriceps-derived fibroblasts. Collagen secretion and matrix metalloproteinases (MMPs) remained unaffected in both young and adult mdx compared to wt fibroblasts, whereas collagen cross-linking and tissue inhibitors of MMP (TIMP) expression significantly increased. We conclude that, in the DMD model we used, fibrosis mostly affects diaphragm and quadriceps with a higher collagen cross-linking and inhibition of MMPs that contribute differently to progressive collagen accumulation during fibrotic remodelling. This study offers a comprehensive histological and molecular characterisation of DMD-associated muscle fibrosis; it may thus provide new targets for tailored therapeutic interventions. Full article

This study evaluated whether some chemical and microbial contaminants in treated sewage effluents from two wastewater treatment plants (WWTP) reached the groundwater when they drained through a fractured karst vadose zone (WWTP-K) and a porous vadose zone (WWTP-P). Forty-five samples of sewage water (SW), treated water (TW), and monitoring well (MW), collected from WWTP-P (24) and WWTP-K (21), were analyzed for a range of microbiological and chemical properties. The E. coli and Salmonella counts were below the limits outlined in the Legislative Decree 152/06 in effluents from both types of WWTP. Enteric viruses were found in 37.5% and 12.5% of the SW and TW from WWTP-P, respectively. The percentages of Pepper mild mottle virus isolated were higher in TW (62.5% in WWTP-P, 85.7% in WWTP-K) than in SW and MW. The residual concentrations of contaminants of emerging concern (CEC) of each drug category were higher in the MW downstream of WWTP-K than of WWTP-P. Our results showed that the porous vadose zone was more effective at reducing the contaminant loads than the fractured karst one, especially the CEC, in the effluent. The legislation should include other parameters to minimize the risks from treated effluent that is discharged to soil. Full article

At the local scale, environmental parameters often require monitoring by means of affordable measuring techniques and technologies given they need to be frequently surveyed. Streamflow in riverbeds or in channels is a hydrological variable that needs to be monitored in order to keep the runoff regimes under control and somehow forecast floods, allowing prevention of damage for people and infrastructure. Moreover, measuring such a variable is always extremely important for the knowledge of the environmental status of connected aquatic ecosystems. This paper presents a new approach to assessing hydrodynamic features related to a given channel by means of a beamforming technique that was applied to video sensing. Different features have been estimated, namely the flow velocity, the temperature, and the riverbed movements. The applied beamforming technique works on a modified sum and delay method, also using the Multiple Signal Classification algorithm (MUSIC), by acting as Synthetic Aperture Radar (SAR) post-processing. The results are very interesting, especially compared to the on-site measured data and encourage the use of affordable video sensors located along the channel or river course for monitoring purposes. The paper also illustrates the use of beamforming measurements to be calibrated by means of conventional techniques with more accurate data. Certainly, the results can be improved; however, they indicate some margins of improvements and updates. As metrics of assessment, a histogram of greyscale/pixels was adopted, taking into account the example of layers and curve plots. They show changes according to the locations where the supporting videos were obtained. Full article

As a complement to clinical disease surveillance, the monitoring of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in wastewater can be used as an early warning system for impending epidemics. This study investigated the dynamics of SARS-CoV-2 in untreated wastewater with respect to the trend of coronavirus disease 2019 (COVID-19) prevalence in Southern Italy. A total of 210 wastewater samples were collected between May and November 2020 from 15 Apulian wastewater treatment plants (WWTP). The samples were concentrated in accordance with the standard of World Health Organization (WHO, Geneva, Switzerland) procedure for Poliovirus sewage surveillance, and molecular analysis was undertaken with real-time reverse-transcription quantitative PCR (RT-(q) PCR). Viral ribonucleic acid (RNA) was found in 12.4% (26/210) of the samples. The virus concentration in the positive samples ranged from 8.8 × 10² to 6.5 × 10⁴ genome copies/L. The receiver operating characteristic (ROC) curve modeling showed that at least 11 cases/100,000 inhabitants would occur after a wastewater sample was found to be positive for SARS-CoV-2 (sensitivity = 80%, specificity = 80.9%). To our knowledge, this is the first study in Italy that has applied wastewater-based epidemiology to predict COVID-19 prevalence. Further studies regarding methods that include all variables (meteorological phenomena, characteristics of the WWTP, etc.) affecting this type of wastewater surveillance data would be useful to improve data interpretation. Full article

This study investigated the environmental contamination of groundwater as a consequence of the discharge of treated wastewater into the soil. The investigation focused on a wastewater treatment plant located in an area fractured by karst in the Salento peninsula (Apulia, Italy). Water samples were collected at four sites (raw wastewater, treated wastewater, infiltration trench, and monitoring well), monthly from May to December 2019 (with the exception of August), and were tested for (1) panel of bacteria; (2) enteric viruses; and (3) chemical substances. A gradual reduction in the concentration of bacteria, viruses and contaminants of emerging concern was observed across the profile of soil fissured by karst. All monitored bacteria were absent from the monitoring well, except for Pseudomonas aeruginosa. Pepper mild mottle virus and adenovirus were detected at all sampling sites. Personal care products and X-ray contrast media showed the greatest decrease in concentration from infiltration trench to the monitoring well, while the highest residual concentrations in the monitoring well were found for anticonvulsants (78.5%), antimicrobials (41.3%), and antipsychotic drugs (38.6%). Our results show that parameters provided by current law may not always be sufficient to evaluate the sanitary risk relating to the discharge of treated wastewater to the soil. Full article

According to Italian Ministerial Decree No. 185 of 12 June 2003, water is considered suitable for irrigation if levels of fecal bacteria (i.e., Escherichia coli and Salmonella) are within certain parameters. The detection of other microorganisms is not required. The aim of this study is to determine the bacteriological quality of groundwater used for irrigation and the occurrence of enteric viruses (Norovirus, Enterovirus, Rotavirus, Hepatovirus A), and to compare the presence of viruses with the fecal bacteria indicators. A total of 182 wells was analyzed. Widespread fecal contamination of Apulian aquifers was detected (141 wells; 77.5%) by the presence of fecal bacteria (i.e., E. coli, Salmonella, total coliforms, and enterococci). Considering bacteria included in Ministerial Decree No. 185, the water from 35 (19.2%) wells was unsuitable for irrigation purposes. Among 147 wells with water considered suitable, Norovirus, Rotavirus, and Enterovirus were detected in 23 (15.6%) wells. No Hepatovirus A was isolated. Consequently, 58 wells (31.9%) posed a potential infectious risk for irrigation use. This study revealed the inadequacy of fecal bacteria indicators to predict the occurrence of viruses in groundwater and it is the first in Italy to describe the presence of human rotaviruses in well water used for irrigation. Full article