Morphological and Structural Evaluation of Hydration/Dehydration Stages of MgSO4 Filled Composite Silicone Foam for Thermal Energy Storage Applications

Salt hydrates, such as MgSO4·7H2O, are considered attractive materials for thermal energy storage, thanks to their high theoretical storage density. However, pure salt hydrates present some challenges in real application due to agglomeration, corrosion and swelling problems during hydration/dehydration cycles. In order to overcome these limitations, a composite material based on silicone vapor-permeable foam filled with the salt hydrate is here presented. For its characterization, a real-time in situ environmental scanning electron microscopy (ESEM) investigation was carried out in controlled temperature and humidity conditions. The specific set-up was proposed as an innovative method in order to evaluate the morphological evolution of the composite material during the hydrating and dehydrating stages of the salt. The results evidenced an effective micro-thermal stability of the material. Furthermore, dehydration thermogravimetric/differential scanning calorimetric (TG/DSC) analysis confirmed the improved reactivity of the realized composite foam compared to pure MgSO4·7H2O.This work was partially funded by the Ministerio de Ciencia, Innovación y Universidades de España (RTI2018-093849-B-C31). This work was partially supported by ICREA under the ICREA Academia program

Clinical and prognostic implications of the genetic diagnosis of hereditary NET syndromes in asymptomatic patients

Neuroendocrine tumors (NETs) can be sporadic or they can arise in complex hereditary syndromes. Patients with hereditary NETs can be identified before the development of tumors by performing genetic screenings. The aim of the study was to evaluate the clinical and prognostic impact of a preclinical genetic screening in subjects with hereditary NET syndromes. 46 subjects referred for hereditary NET syndrome [22 MEN1, 12 MEN2, 12 Familial Paragangliomatosis (FPGL)] were enrolled and divided in 2 groups (group A, 20 subjects with clinical appearance of NET before the genetic diagnosis; group B, 26 subjects with genetic diagnosis of hereditary NET syndromes before the clinical appearance of NETs). The main outcome measures were severity of disease, prognosis, and survival. The rate of surgery for MEN1-, MEN2-, FPGL4-related tumors was 90% in group A and 35% in group B (p<0.01). Both symptoms related to tumors and symptoms related to therapies were significantly less frequent in group B than in group A (p<0.05). Tumor stage was locally advanced or metastatic in 50% of group A and in no one of group B (p<0.01). The mortality rate was 25% in group A and 0% in group B (p<0.05). An early genetic screening for hereditary NET syndromes results in an improvement in clinical presentation and morbidity. A potential impact of the genetic screening on the mortality rate of these subjects is suggested and needs to be investigated in further and more appropriate studies

Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence

none34noopende Girolamo, Giovanni; Buizza, Chiara; Sisti, Davide; Ferrari, Clarissa; Bulgari, Viola; Iozzino, Laura; Boero, Maria Elena; Cristiano, Giuseppe; De Francesco, Alessandra; Giobbio, Gian Marco; Maggi, Paolo; Rossi, Giuseppe; Segalini, Beatrice; Candini, Valentina; Andreose, Suor; Basso, Pasquale; Beneduce, Rossella; Bertolotti, Pietro; Braida, Vanda; Bonelli, Marina; Bongiorno, Fanny; Bussi, Riccardo; Castagno, Elisa; Dominicis, Fabio; Ghersi, Loredana; Greppo, Stefania; Sodano, Alessandro Jaretti; Leporatti, Massimo; Presti, Eleonora Lo; Milone, Valeria; Panigada, Fausto; Pasquadibisceglie, Livia; Rigamonti, Danilo; Rillosi, Lucianade Girolamo, Giovanni; Buizza, Chiara; Sisti, Davide; Ferrari, Clarissa; Bulgari, Viola; Iozzino, Laura; Boero, Maria Elena; Cristiano, Giuseppe; De Francesco, Alessandra; Giobbio, Gian Marco; Maggi, Paolo; Rossi, Giuseppe; Segalini, Beatrice; Candini, Valentina; Andreose, Suor; Basso, Pasquale; Beneduce, Rossella; Bertolotti, Pietro; Braida, Vanda; Bonelli, Marina; Bongiorno, Fanny; Bussi, Riccardo; Castagno, Elisa; Dominicis, Fabio; Ghersi, Loredana; Greppo, Stefania; Sodano, Alessandro Jaretti; Leporatti, Massimo; Presti, Eleonora Lo; Milone, Valeria; Panigada, Fausto; Pasquadibisceglie, Livia; Rigamonti, Danilo; Rillosi, Lucian

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p &lt; 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p &lt; 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p &lt; 0.0001) or urgent (20.4% vs. 38.5%; p &lt; 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p &lt; 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P &lt; .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

L\u2019alterazione del processo emozionale nella Malattia di Parkinson: feedback facciale e risposta autonomica

La malattia di Parkinson (PD) presenta tipicamente un\u2019alterazione nell\u2019elaborazione e nel riconoscimento delle emozioni, ma non \ue8 ancora noto se perdano del tutto tale capacit\ue0 o se la compromissione riguardi la percezione dell\u2019emozione in s\ue9, la regolazione fisiologica in risposta a stimoli emotivi o la decodifica delle emozioni altrui. Questo studio si propone di indagare i meccanismi di riconoscimento emotivo in tali pazienti, utilizzando alcune misure: la valutazione esplicita delle emozioni (Self-Assessment Manikin, SAM) e la reattivit\ue0 implicita (conduttanza cutanea, SCR; la risposta elettromiografica, EMG). Sono stati selezionati 20 pazienti sulla base di una valutazione neuropsicologica, abbinati per et\ue0 e scolarit\ue0 a 34 volontari sani. Ai pazienti era chiesto di osservare e valutare immagini emotivamente salienti, scelte dall\u2019International Affective Picture System (IAPS) durante la rilevazione autonomica con biofeedback. L\u2019integrazione di dati comportamentali e autonomici ha consentito un confronto diretto tra la valutazione soggettiva delle emozioni (valenza e arousal) e la reazione fisiologica corrispondente. In secondo luogo, la misura elettromiografica (zigomatico e corrugatore) ha evidenziato il ruolo che la modulazione centrale e periferica ha sulla risposta emotiva. I pazienti in risposta a stimoli negativi ad alto arousal hanno mostrato valori SCR inferiori rispetto ai soggetti sani confermati anche a livello elettromiografico: ad una ridotta mimica corrugatoria \ue8 collegata una risposta periferica ridotta. I pazienti PD sembrano quindi non rispondere adeguatamente alle categorie emozionali che vengono considerate salienti in condizioni normali; il fenomeno si osserva soprattutto per una categoria emotiva specifica, per la quale ad una capacit\ue0 preservata di riconoscimento delle emozioni non corrisponde un\u2019adeguata risposta autonomica

Perceiving emotions in Autism Spectrum Disorders: cortical and peripheral effects during intra- and inter-species social interactions

Convergent evidence showed that children with Autistic Spectrum Disorders (ASD) have often to deal with some social deficits and their consequences, such as rejection, social anxiety, and negative peer interactions. Thus, the need to develop alternative strategies to improve social communication has recently emerged and become an important goal. One recent possibility consists in the introduction of therapies based on human-animal interactions: it has been largely demonstrated, in fact, that animals can improve social exchange among humans. This effect could be of primary relevance for individuals with disabilities, to encourage a positive experience and reinforce socio-emotional development. Nonetheless, it’s still largely unknown what are the psychological and neural mechanisms that can mediate the emotional and empathic processes related to such effects. To explore cognitive and affective components related to these research questions, a multi-method approach with electroencephalographic (EEG) and autonomic activity recording was applied to explore central and peripheral responsivity of ASD children during an emotional task. It has been proven, in fact, that they typically show impaired autonomic responsivity to social cues and anomalies in electrocortical patterns during emotional tasks. A small pilot group made up of 8 children with ASD (M age = 8.5, SD = 1.9) was shown 144 affective pictures (positive vs. negative vs. neutral) depicting both Human-Human (HH) and Human-Animal (HA) interactions. For what concerns EEG data, a decreased activity in alpha power was found with respect to HH stimuli (increased cortical activity). Similar results in ASD have been interpreted as the recourse to more voluntary-driven mechanisms to process and interpret affective stimuli (higher/ controlled mental functions), instead of recruiting phylogenetically ancient structures responsible for the execution of automatic brain functions. For what concerns autonomic activity, cardiovascular indices (both Blood Volume Pulse, BVP, and Heart Rate, HR) showed increased activity for positive stimuli. Finally, SCL showed increased responses for negative HA stimuli, which probably triggered significant automatic orienting/defensive responses. Such results will be compared to those obtained by a matched control group. The present work provided significant neuroscientific evidence on emotion perception in ASD to different social agents, with important highlights for future therapeutic support and interventions

Facial feedback effect explains the autonomic impairment in PD for emotional recognition

Parkinson\u2019s Disease (PD) is a degenerative neurological disorder of the central nervous system with a strong impact on both social and emotional level. Parkinson patients typically present with emotional processing impairment in emotional experience and emotion recognition. However, it is not yet known whether these patients have lost the capability to feel the emotions intrinsically, to modulate to emotional experience associating subjective response with physiological modulations, or to decipher emotions in others. The present research aims at investigating the contribution of central, peripheral and facial feedback measures in PD patients when they processed emotional cues using a multilevel approach, comparting selfreport (appraisal), autonomic (Skin Conductance Response, SCR) and motor electromyographic (EMG zygomaticus and corrugators facial muscles) measures. The integration of these measures allowed firstly a direct comparison between the explicit appraisal of emotions (with specific reference to the two parameters of valence and arousal) and the autonomic responsiveness to emotions. Secondly the role of EMG (zygomaticus and corrugators muscle) in determining the central and peripheral modulation was explored. Indeed the facial feedback model supposed that the autonomic facial response by facial muscles may affect both the emotional appraisal and the physiological modulation. 20 patients have been selected and 34 healthy volunteers (HC), matched for age and education. PD patients observed and evaluated affective pictures that were chosen from International Affective Picture System (IAPS). These pictures concerned four types of stimuli: 10 pleasant \u2013 low and high arousal; 10 unpleasant \u2013 low and high arousal, 5 neutral. PD patients seemed to not adequately answer to the emotional categories which were considered salient in standard conditions (HC). Indeed, there was an autonomic impairment for a category- specific emotion (negative and high arousal). Particularly, patients have revealed an inadequate sensibility (reduced SCR) only for negative emotional condition. In parallel EMG behavior was disrupted (reduced corrugators activity) in response to negative high arousal emotional cues. However, PD patients were able to correctly categorize the emotional cues based on their valence/arousal, probably due to a \u201cgap\u201d between this central process and the autonomic system activity. Then, the regression analysis pointed out the predictive role of the corrugators activity to explain the impaired autonomic response: a reduced corrugators mimic was linked to a reduced peripheral responsiveness toward the negative and high arousal emotional stimuli