Effects of cognitive load and different exercise intensities on perceived effort in sedentary university students: a follow up of the Cubo Fitness Test validation

Work and intellectually fatiguing environments can significantly influence the health of individuals, which is strictly bound to motor efficiency. In particular, desk workers and university students may have a sedentary lifestyle and a condition of mental fatigue caused by daily routine, which could impair motor efficiency. The assessment is a starting point for enhancing awareness of the individual’s psychophysical condition through the perception of one’s body motor efficiency, motivating to move towards improvement. This way, a submaximal test based on perceived exertion was developed (Cubo Fitness Test, CFT) and validated in previous studies. Hence, two further studies were employed to enhance the consistency and accuracy of this instrument in different conditions. The first study investigated the internal responsiveness of CFT, evaluating if mental fatigue could affect motor efficiency. The second study investigated which perceived intensity (weak, moderate, strong, or absolute maximum) could be more reliable for applying the CFT (as previous research focused the investigation only on moderate intensity). In the first investigation, participants assessed two stimuli (mental fatigue induced with a Stroop color-word task and a neutral condition based on the vision of a documentary) lasting 60 min each. The quality of psychophysical recovery (total quality recovery) and the mood state (Italian Mood State questionnaire) were evaluated before the stimuli. After the fatiguing or the neutral task, the mood state was newly assessed, together with the evaluation of the workload’s characteristics (Nasa TLX) and the CFT motor efficiency. In the second investigation, participants had to perform CFT twice for each at different intensities of Borg’s Scale of perceived exertion. Researchers successfully requested to fill out the NASA TLX questionnaire regarding the perceived workload characteristics of CFT, and the reliability of each intensity was assessed. Results seem to enhance the consistency and the accuracy of the instrument. Indeed, findings evidenced that CFT is not influenced by mental fatigue conditions typical of the intellectual work of desk workers and university students for which this test was specifically conceived. Moreover, moderate and strong perceived intensity are the most adequate conditions to assess motor efficiency in these populations

One step minilaparotomy-assisted transmesenteric portal vein recanalization combined with transjugular intrahepatic portosystemic shunt placement: A novel surgical proposal in pediatrics

Transjugular intrahepatic portosystemic shunt (TIPS) placement is a standard procedure for the treatment of portal hypertension complications. When this conventional approach is not feasible, alternative procedures for systemic diversion of portal blood have been proposed. A one-step interventional approach, combining minilaparotomy-assisted transmesenteric (MAT) antegrade portal recanalization and TIPS, is described in an adolescent with recurrent esophageal varice bleeding and portal cavernoma (PC). A 16-year-old girl was admitted to our Unit because of repeated bleeding episodes over a short period of time due to esophageal varices in the context of a PC. A portal vein recanalization through an ileocolic vein isolation with the MAT approach followed by TIPS during the same session was performed. In the case of failed portal recanalization, this approach, would also be useful for varice endovascular embolization. Postoperative recovery was uneventful. Treatment consisting of propanolol, enoxaparin and a proton pump inhibitor was prescribed after the procedure. One month post-op, contrast enhanced computed tomography confirmed the patency of the portal and intrahepatic stent grafts. No residual peritoneal fluid was detected nor opacification of the large varices. Endoscopy showed good improvement of the varices. Doppler ultrasound confirmed the accelerated flow in the portal stent and hepatopetal flow inside the intrahepatic portal branches. Three months post-op, TIPS maintained its hourglass shape despite a slight expansion. Portal hypertension and life threatening conditions related to PC would benefit from one-step portal recanalization. MAT-TIPS is feasible and safe for the treatment of PC even in children. This minimally invasive procedure avoids or delays surgical treatment or re-transplantation when necessary in pediatric patients

Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study

Background: Gastro-esophageal reflux disease (GERD), requiring surgical correction, and nutritional problems are reported after long-gap esophageal atresia (LGEA) repair and might jeopardize the postoperative course in some babies. We report an exploratory evaluation of the role of transgastric jejunostomy (TGJ) as a temporary nutritional tool before surgery for GERD in LGEA. Methods: Seven infant patients operated on for LGEA with intra-thoracic gastro-esophageal junction (GEJ) and growth failure, requiring improvement in their nutritional profile in anticipation of surgery, were retrospectively evaluated. Post-surgical follow-up, including growth evolution, complications, and parental quality of life (QoL), were considered. Results: The TGJ was placed at a mean age of 8.6 ± 5.6 months. The procedure was uneventful and well-tolerated in all seven cases. At 6.6 ± 2.0 months after TGJ placement, significant weight gain (weight z-score −2.68 ± 0.8 vs −0.9 ± 0.2, p < 0.001) was recorded, allowing the GERD surgery to proceed. A significant difference in hospital admissions between 3 months before and post-TGJ insertion was noted (4.8 ± 0.75 vs. 1.6 ± 0.52, p < 0.01). A significant amelioration of QoL after TGJ placement was also recorded; in particular, the biggest improvements were related to parents’ perceptions of the general health and emotional state of their babies (p < 0.001). Conclusions: The placement of TGJ as a temporary nutritional tool in selected cases of LGEA could improve nutritional conditions and parental QoL before fundoplication, allowing successful surgical treatment of GERD to be carried out

Case Report: Eosinophilic Myenteric Ganglionitis in a Child With Hirschsprung's Disease: A Challenge in Pseudo-Obstruction

Introduction: The presentation of eosinophilic myenteric ganglionitis (EMG) can be similar to that of Hirschsprung's disease (HD). In a limited number of cases of pediatric patients, the diagnosis of both EMG and HD are reported. A case of pseudo-obstruction in EMG occurring in a child with HD diagnosis is discussed with literature review. Case Presentation: A boy aged 2 years and 6 months presented with intractable constipation and abdominal distension. Histological HD diagnosis was carried out and transanal Soave pullthrough was performed. At the age of 3 years and 2 months, an infectious enterocolitis occurred. One month later, he presented with constipation, marked abdominal distension and melena. Full thickness colonic biopsies revealed eosinophilic myenteric ganglionitis. Specific IgE tests were positive for several foods. Dietary exclusion was adopted with resolution of clinical symptoms and histologic remission. Conclusion: EMD may occur in patients with HD. At the onset, EMD may be associated with functional intestinal obstruction. The use of an elimination diet proved effective for the relief of symptoms. Long term follow-up is mandatory to define the timing of the reintroduction of foods

DAYTIME SLEEPINESS IN MID AND MODERATE ALZHEIMER'S DISEASE AND ITS RELATIONSHIP WITH COGNITIVE IMPAIRMENT

The increased tendency to fall asleep during the daytime together with increased wakefulness during the night has been demonstrated in patients with advanced Alzheimer's disease (AD). The aim of this study was to assess daytime sleep propensity in a cohort of patients with mild/moderate AD and to correlate it with cognitive impairment. Twenty drug-free AD patients meeting the NINCDS-ADRDA criteria for probable AD were evaluated. According to their Clinical Dementia Rating scores, subjects were classified into mild (CDR1; n = 11) and moderate (CDR2; n = 9) dementia patients. A group of 12 healthy subjects was taken as controls. The subjects were evaluated by the multiple sleep latency test (MSLT) after their nocturnal sleep pattern had been assessed by a polysomnographic recording throughout the night before. Both groups of AD patients showed a higher level of daytime sleepiness, which was statistically significant for mean daytime sleep latency (MDSL) (controls versus CDR1 and versus CDR2, CDR1 versus CDR2) and for 10:00 and 12:00 hour naps (controls versus CDR1, controls versus CDR2). In the entire group of AD patients, MDSL was significantly related with MMSE, De Renzi's Token test, verbal fluency, verbal digit span, story recall, Raven's Progressive Matrices, Weigl test and Benton's three-dimensional test. These data indicate that an increased sleep propensity during daytime occurs also in patients with mild/moderate AD detected by objective neurophysiological techniques

Graphene Powder Processing For Water Solar Distillation using Nanofluids

Recently graphene and graphene-based hybrid materials have attracted much attention due to outstanding chemical and physical properties. Thanks to their high thermal conductivity graphene-based nanomaterials constitute excellent candidates for water-based nanofluids. This class of new materials can be beneficially exploited in water purification technologies using renewable energy. Solar distillation efficiency to produce clean water can be improved through the use of nanofluids. In this work we studied the plasma route processing effects of graphene powders in terms of ability to produce graphene-water based nanofluids. The powders were treated by radio-frequency sputtering by which metal oxide and silicon oxide were deposited onto the surface of the graphene powders, forming hybrid graphene-inorganic nanomaterials in order to enhance the solubility in water. The surface modification was studied by means of x-ray photoelectron spectroscopy and transmission electron microscopy. The graphene based materials suspension stability in water and the surface wettability were studied by means of UV-Vis. spectrophotometry and contact angle measurement respectively. Preliminary results showed a significant improvement of the graphene solubility in water by the plasma treatment

The Challenges of a Children’s Hospital during the COVID-19 Pandemic: The Pediatric Surgeon’s Point of View

During the coronavirus disease of 2019 (COVID-19) emergency, in the pediatric surgical setting, it has been essential to avoid and contain infections as well as to protect both the patients and the surgical team. During this emergency, procedures and workflow were adapted to provide the safest possible environment for both the surgical team and the patients. Pediatric surgical activities were reorganized during the COVID-19 pandemic at the “Vittore Buzzi” Children’s Hospital, which is a pediatric/maternal hospital located in Milan (Lombardy Region), Italy. Resources were optimized in order to maintain high levels of care and quality of assistance. During the COVID-19 emergency, the pediatric surgical department at the “Vittore Buzzi” Children’s Hospital became an acute care surgical service. For the reorganization of surgical activities, institutional protocols were adapted in order to preserve the pediatric-specific characteristics of our service; five crucial points were specifically addressed. The pediatric surgical procedures carried out during the initial two months of the Italian lockdown are also reported. Continuity of care was maintained for children affected by severe diseases, such as tumors and neurosurgical conditions, whose treatment could not be deferred. Telemedicine and telecommunication were adopted as quick-support modalities for pre- and post-operative care. This reorganization allowed us to preserve the “pediatric specificity” and all care-related procedures offered at this high-quality/high-volume surgical care referral center

Obstructive sleep apnea, hypothyroidism and cognition

Objectives: To assess the impact of obstructive sleep apnea syndrome (OSAS), obesity and hypothyroidism and their potential synergic effect on sleep pattern, vigilance and cognitive functioning. Methods: Fifty OSAS patients and twenty age, sex and BMI matched healthy controls underwent in lab nocturnal polysomnography, multi- ple latency sleep test, standardized questionnaires for sleep quality, fatigue, sleepiness, TSH, fT3 and fT4 evaluation and neuropsycho- logical tests. Subjects were divided in four groups: non obese OSAS, obese OSAS, hypothyroid OSAS patients and healthy controls. Results: Hypothyroid OSAS showed worse scores in subjective sleep quality and fatigue compared with controls and non obese OSAS, with a positive correlation between TSH level and Fatigue Severity Scale and Epworth Sleepiness Scale. Mean daily sleep latency was significantly lower in all three clinical population as compared to control, while single naps latencies were different mainly for hypothyroid OSAS. Neuropsychological testing pointed out no significant differences among the three OSAS groups, but OSAS patients, considered as a whole, showed decreased performances in attentive and executive frontal tasks, compared with healthy controls. Sleep efficiency and Wake After Sleep Onset and microstructural sleep variables showed significant correlations with attentive and executive frontal tasks. Conclusions: Sleepiness and perceived fatigue occur particularly in hypothyroid OSAS patients. Cognitive deficit was similar among the three OSAS groups and impaired compared with healthy controls. The observed correlation between neuropsychological examination and macro and microstructural variables suggest a role of sleep disruption, more than respiratory disturbance per se, on cognition

GRAPHENE POWDER PROCESSING FOR WATER SOLAR DISTILLATION USING NANOFLUIDS , Nadhira Laidani, Francesca Marchetti, Hafeez Ullah, Marina Scarpa, Cecilia Maestri, Said Makhlouf, Gloria Gottardi, Ruben Bartali, Victor Micheli

Abstract: Recently graphene and graphene-based hybrid materials have attracted much attention due to outstanding chemical and physical properties. Thanks to their high thermal conductivity graphene-based nanomaterials constitute excellent candidates for water-based nanofluids. This class of new materials can be beneficially exploited in water purification technologies using renewable energy. Solar distillation efficiency to produce clean water can be improved through the use of nanofluids. In this work we studied the plasma route processing effects of graphene powders in terms of ability to produce graphene-water based nanofluids. The powders were treated by radio-frequency sputtering by which metal oxide and silicon oxide were deposited onto the surface of the graphene powders, forming hybrid graphene-inorganic nanomaterials in order to enhance the solubility in water. The surface modification was studied by means of x-ray photoelectron spectroscopy and transmission electron microscopy. The graphene based materials suspension stability in water and the surface wettability were studied by means of UV-Vis. spectrophotometry and contact angle measurement respectively. Preliminary results showed a significant improvement of the graphene solubility in water by the plasma treatment

Non-rapid eye movement sleep instability in mild cognitive impairment: a pilot study

Polysomnographic (PSG) studies in mild cognitive impairment (MCI) are not conclusive and are limited only to conventional sleep parameters. The aim of our study was to evaluate sleep architecture and cyclic alternating pattern (CAP) parameters in subjects with MCI, and to assess their eventual correlation with cognition. METHODS: Eleven subjects with MCI (mean age 68.5 ± 7.0 years), 11 patients with mild probable Alzheimer's disease (AD; mean age 72.7 ± 5.9 years), referred to the Outpatient Cognitive Disorders Clinic, and 11 cognitively intact healthy elderly individuals (mean age 69.2 ± 12.6 years) underwent ambulatory PSG for the evaluation of nocturnal sleep architecture and CAP parameters. RESULTS: Rapid eye movement sleep, CAP rate, and CAP slow components (A1 index) were decreased in MCI subjects and to a greater extent in AD patients, compared to cognitively intact controls. AD showed also decreased slow wave sleep (SWS) relative to healthy elderly individuals. MCI nappers showed decreased nocturnal SWS and A1 subtypes compared to non-nappers. Several correlations between sleep variables and neuropsychological tests were found. CONCLUSIONS: MCI and AD subjects showed a decreased sleep instability correlated with their cognitive decline. Such a decrease may be considered as a potential biomarker of underlying neurodegeneratio