Impact of the COVID-19 pandemic on Italian students' mental health and relationships: differences between adolescent males and females.

BACKGROUND: The negative effects of the COVID-19 pandemic on the mental health of young people have been reported, often with possible differences between the sexes. This study explores the impact of the COVID-19 pandemic on the differences in mental health status and healthy behaviors between adolescent males and females. METHODS: An online questionnaire exploring sociodemographic characteristics, living conditions, mental health, behaviors, and relationships during the implementation of the COVID-19 social restriction measures, was administered to 16-18 years old high school students living in the metropolitan area of Turin. The World Health Organization-5 Well-Being Index (WHO-5) questionnaire was used to evaluate self-perceived psychological health status. Descriptive analyses of the sample were carried out by sex. Chi-squared test and the associated P value were evaluated. The spatial sign method was used to assess multivariate differences by sex. RESULTS: Seventy-two Italian high school students completed the questionnaire. Sixty-eight percent of the students reported psychological problems, more often females (86% vs. 50%). Those living with multiple cohabitants and in dwellings with less personal space reported lower well-being. Females were also more likely to report stress when talking about COVID-19, difficulties in concentration and in falling asleep, daytime sleepiness, less physical activity, and concerns about losing control of eating. Finally, females spent more time with family members and, compared to males, found it harder to spend time and share experiences with friends and schoolmates. CONCLUSIONS: The pandemic has greatly impacted adolescents in terms of their mental well-being, routines, relationships with friends, and sleeping and eating patterns. Females reported more stress, boredom, bad mood, eating concerns, reduced relationships with friends, and possible difficulty in falling asleep than did males. These issues should be addressed when developing and promoting support programs, particularly at school.

Polymer Blends Based on 1-Hexadecyl-3-methyl Imidazolium 1,3-Dimethyl 5-Sulfoisophthalate Ionic Liquid: Thermo-Mechanical, Surface Morphology and Antibacterial Properties.

In this study, antibacterial polymer blends based on Polyvinyl Chloride (PVC) and Polystyrene-Ethylene-Butylene-Styrene (SEBS), loaded with the ionic liquid (IL) 1-hexadecyl-3-methyl imidazolium 1,3-dimethyl 5-sulfoisophthalate (HdmimDMSIP) at three different concentrations (1%, 5%, and 10%), were produced. The IL/blends were characterized by their thermo-mechanical properties, surface morphology, and wettability. IL release from the blends was also evaluated. The agar diffusion method was used to test the antibacterial activity of the blends against Staphylococcus epidermidis and Escherichia coli. Results from thermal analyses showed compatibility between the IL and the PVC matrix, while phase separation in the SEBS/IL blends was observed. These results were confirmed using PY-GC MS data. SEM analyses highlighted abundant IL deposition on PVC blend film surfaces containing the IL at 5-10% concentrations, whereas the SEBS blend film surfaces showed irregular structures similar to islands of different sizes. Data on water contact angle proved that the loading of the IL into both polymer matrices induced higher wettability of the blends' surfaces, mostly in the SEBS films. The mechanical analyses evidenced a lowering of Young's Modulus, Tensile Stress, and Strain at Break in the SEBS blends, according to IL concentration. The PVC/IL blends showed a similar trend, but with an increase in the Strain at Break as IL concentration in the blends increased. Both PVC/IL and SEBS/IL blends displayed the best performance against Staphylococcus epidermidis, being active at low concentration (1%), whereas the antimicrobial activity against Escherichia coli was lower than that of S. epidermidis. Release data highlighted an IL dose-dependent release. These results are promising for a versatile use of these antimicrobial polymers in a variety of fields.

Mechanical, Wear and Thermal Behavior of Polyethylene Blended with Graphite Treated in Ball Milling.

Additive manufacturing, civil, and biomechanical applications are among the most important sectors, where the filler's presence can significantly improve the quality of polymeric products blends. The high market demand of new low-cost material to be used as shock absorbers and mechanical joints arouses our curiosity to study a relatively common commercial polymer and filler. The possible improvement by blending high-density polyethylene (HDPE) and graphite was investigated for these sectors. To achieve this objective, we have prepared HDPE/graphite nanocomposites following mechanical treatment to understand which parameter provides the researched properties. As widely reported in the literature, milling treatment leads to the decrease of the particle size and the exfoliation of graphitic layers. Therefore, graphite has been previously treated with a ball mill for different times (1-16 h) to enhance its lubricating action. We checked an improvement in stiffness, yielding strength, thermal stability, and, in particularly, wear resistance that increased by 65% with respect to that of polyethylene (PE). A treatment time of eight hours in ball milling could be enough to give an appreciable improvement. The wear behavior of HDPE with treated graphite has not been deeply investigated so far, and it could be important because HDPE is considered a "carrier polymer" for different low-friction applications.

Thermo-mechanical, antimicrobial and biocompatible properties of PVC blends based on imidazolium ionic liquids.

The aim of this study was the development of antimicrobial polyvinylchloride (PVC) blends loaded with 0.1-10% (w/w) of the ILs 1-hexadecyl-3-methylimidazolium 1,3-dimethyl 5-sulfoisophthalate (HdmimDMSIP) and 1-octyloximethyl-3-methylimidazolium hexafluorophosphate (OOMmimPF6). The synthetized ILs were characterized by 1HNMR, MALDI-TOF, DSC and TGA. PVC/ILs films were obtained by solvent casting.Thermal and mechanical properties (tensile stress TS and elongation at break EB), morphology by SEM, surface wettability, antimicrobial activity, cytotoxicity and ILs release in sterile water from PVC/ILs film blends were determined. Results demonstrated that the presence of both ILs in PVC formulation slightly affected thermal and mechanical properties of blends. The loading of both ILs into PVC matrix made PVC/ILs films hydrophilic, especially at the highest concentration of HdmimDMSIP. The PVC/ILs blends displayed antibacterial activity up to ILs lowest concentrations (0.1-0.5%). The inhibition of Escherichia coli growth was lower than that showed toward Staphylococcus epidermidis. The addition of 10% ILs concentration resulted excessive as demonstrated by accumulation of ILs on film surfaces (SEM) and ILs high release from PVC/ILs blends during the first day of water immersion. Biocompatibility studies highlighted that the addition of low amounts of both ILs into PVC matrix is not cytotoxic for mouse fibroblast cells (L929), supporting their potential use for biomedical porposes.

Current controversies and future perspectives on treatment of intensive care unit delirium in adults.

Delirium is the most frequent manifestation of acute brain dysfunction in intensive care unit (ICU). Although antipsychotics are widely used to treat this serious complication, recent evidence has emphasized that these agents did not reduce ICU delirium (ICU-D) prevalence and did not improve survival, length of ICU or hospital stay after its occurrence. Of note, no pharmacological strategy to prevent or treat delirium has been identified, so far. In this scenario, new scientific evidences are urgently needed. Investigations on specific ICU-D subgroups, or focused on different clinical settings, and studies on medications other than antipsychotics, such as dexmedetomidine or melatonin, may represent interesting fields of research. In the meantime, because there is some evidence that ICU-D can be effectively prevented, the literature suggests strengthening all the strategies aimed at prevention through no-pharmacological approaches mostly focused on the correction of risk factors. The more appropriate strategy useful to treat established delirium remains the use of antipsychotics managed by choosing the right doses after a careful case-by-case analysis. While the evidence regarding the use of dexmedetomidine is still conflicting and sparse, this drug offers interesting perspectives for both ICU-D prevention and treatment. This paper aims to provide an overview of current pharmacological approaches of evidence-based medicine practice. The state of the art of the on-going clinical research on the topic and perspectives for future research are also addressed.

Analgesic evaluation of ultrasound-guided Pericapsular Nerve Group (PENG) block for emergency hip surgery in fragile patients: a case series.

BACKGROUND: Emergency hip surgery is common especially in elderly patients. Very often we are faced with elderly and fragile patients with several comorbidities. In these cases a careful pain control is crucial to reduce length of stay, costs, postoperative complications and mortality. Currently the Fascia Iliaca Block (FIB) and the Femoral Nerve Block (FNB) are the main techniques used for this purpose. CASES PRESENTATION: Recently, a new method has been described under ultrasound-guidance, the Pericapsular Nerve Group (PENG) block. In this case series we try to point out the importance of this novel, safe and effective ultrasound-guided locoregional analgesic technique as an alternative to FIB or FNB based on our clinical experience. CONCLUSION: In this case series the PENG block has been proved to be safe and effective, but more and larger-sized studies are needed to better assess the method in future before it becomes an established analgesic technique for hip surgery.

Chemotherapy-related cognitive impairment: mechanisms, clinical features and research perspectives.

The term chemotherapy-related cognitive impairment (CRCI), or cognitive dysfunction, or chemo fog, or chemo brain, is referred to a decline in a variety of neuropsychological tasks after chemotherapy, or following other anticancer treatments such as radiation therapy or surgery, in patients with non-central nervous system cancers. Furthermore, several pieces of evidence suggest that clinical manifestations of cognitive impairment may occur in cancer patients, prior to chemotherapy or in those not treated with cancer therapies. In these circumstances, it should be more appropriate to use the term cancer-related cognitive dysfunction. Because there is no consensus about its definition and diagnostic criteria, no specific test for CRCI diagnose exists. Whatever the cause, this manifestation of central nervous system toxicity is of increasing concern as the survival rates for cancer have improved steadily and, in turn, cognitive dysfunction can negatively impact the patients and cancer survivors' quality of life. The aim of this work is to offer an overview of the topic and recommendations for future research.

Anesthetic dreaming, anesthesia awareness and patient satisfaction after deep sedation with propofol target controlled infusion: A prospective cohort study of patients undergoing day case breast surgery.

BACKGROUND: Anesthetic dreaming and anesthesia awareness are well distinct phenomena. Although the incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep. METHODS: Fifty-one patients, undergoing surgical excision of fibroadenomas under a Bispectral index-guided deep sedation anesthesia with propofol target controlled infusion, were enrolled into this prospective study. Psychological assessment was performed through the State Trait Anxiety Inventory. A questionnaire was adopted to register dreaming and anesthesia awareness. Data were collected after emergence (t0), 24 hours (t1), 1 month (t2), 6 months (t3). RESULTS: Six patients (12%) reported anesthetic dreaming at t0 confirming the response at each subsequent evaluation. One patient (2%) confirmed dreaming during anesthesia in all, but denied it at t0. There was a high correlation between the intraoperative dream contents and the features of dreams in natural sleep. No cases of anesthesia awareness were detected. A similar level of satisfaction was observed in dreaming and no-dreaming patients. CONCLUSIONS: Anesthetic dreaming does not seem to influence satisfaction of patients undergoing deep sedation with propofol target controlled infusion. A psychological assessment would seem to improve the evaluation of possible psychological consequences in dreamer patient.

Limitation in monitoring depth of anesthesia: a case report.

Although we describe a clinical situation that most likely occurs in hundreds of operatory rooms in the world, we report this case as provocation. It concerns an unexpected awakening from an appropriate depth of anesthesia, although the BIS monitor showed a BIS index of less than 50 for a prolonged period before and after the event. Approximately 30 min after induction of anesthesia, the patient had a hypothetic sudden arousal of consciousness, with spontaneous movements, facial muscle activation, intolerance to the tracheal tube, and tearing. After immediate intravenous administration of midazolam (4 mg), the patient returned to a depth of anesthesia status, and surgery was completed uneventfully. The patient had no recall of the event when questioned during the episode, at emergence, or at 24 h, 36 h, and 7 days after surgery. Were these events spinal reflexes to pain or stimulation although the cortex was still anesthetized? Maybe this is the more rational explanation. Was the patient awake but not aware? Is it possible that our patient experienced only a transient arousal from consciousness, and that he did not have recall because the arousal time was short and we blocked memory consolidation? The latter hypothesis provides an opportunity to discuss the evidence that at the moment there is no device to assess the depth of anesthesia. We also focus on the possibility of interfering with memory processing under anesthesia.

Occurrence of Hepatozoon canis and Cercopithifilaria bainae in an off-host population of Rhipicephalus sanguineus sensu lato ticks.

Hepatozoon canis (Eucoccidiorida, Hepatozoidae) and the filarioid Cercopithifilaria bainae (Spirurida, Onchocercidae) are tick-transmitted infectious agents of dogs, highly prevalent in the Mediterranean basin in association with Rhipicephalus sanguineus sensu lato. Ticks were collected from the environment every 25±2 days in a confined location in southern Italy where a community of dogs lives, from August 2012 to July 2013. In order to study the occurrence of H. canis and C. bainae, 1091 tick specimens (770 adults; 271 nymphs, and 50 larvae) were dissected, and oocysts of H. canis and larvae of C. bainae were morphologically identified. Out of 1091 dissected ticks, 13.47% (n=147) were positive for H. canis, with the highest prevalence recorded in unfed adults (16.4%; 126/770), followed by nymphs collected as larvae and allowed to moult (14%; 7/50), unfed nymphs dissected immediately after collection (3%; 8/271), and adults collected as nymphs and allowed to moult (2%; 6/271). The highest number of H. canis-positive ticks (35.5%; 43/121; P<0.05) was recorded during the summer months (i.e., June-July). In addition, 6% of adult ticks (n=66) were positive for third-stage larvae of C. bainae, with the highest number in June (17%; 14/84; P<0.05). Based on the results reported herein, H. canis and C. bainae infections in the study area seem to be dependent on the seasonality of vector tick populations. Hence, dogs living in these areas are more exposed to both pathogens during the warmer months. These findings provide new insights into the ecology of both H. canis and C. bainae.

[The Macklin effect in the etiology for pneumediastinum in chest trauma]. / Effetto Macklin nella genesi del pneumomediastino di origine traumatica.

This case report has the scope to review the etiology and pathophysiology of pneumomediastinum in severe blunt trauma, with a special interest to its more frequent origin: the Macklin effect. The Macklin effect is a pathophysiologic process characterized by the blunt traumatic alveolar ruptures, air dissection along bronchovascular sheaths, with the formation of blunt pulmonary interstitial emphysema, radiologic marker, until the formation of a pneumomediastinum. Its premature diagnostic acknowledgment is important in the managing of the blunt chest trauma.