The pandemic within the pandemic: the surge of neuropsychological disorders in Italian children during the COVID-19 era

Background: Quarantine and isolation measures during COVID-19 pandemic may have caused additional stress and challenged the mental health of the youth. Aim of the study is to investigate the COVID-19 pandemic impact on neuropsychological disorders (NPD) of Italian children and adolescents to provide general pediatric recommendations. Material and methods: A retrospective multicenter observational study was planned by the Italian Pediatric Society (SIP) to explore the impact of COVID-19 on the access of children to pediatric Emergency Departments (pED) for the evaluation of neuropsychological symptoms, collecting the classification codes of diagnoses between March 1, 2019 and March 2, 2021. The period study was split into two sub-periods: a pre COVID-19 period (from March 1 2019 to March 1, 2020) and a COVID-19 period (from March 2, 2020 to March 2, 2021). As additional information, data on NPD hospitalizations in any pediatric department of the involved centers were recorded. Results: During the study period, a total of 533,318 children were admitted to the pED involved in the study. Despite a 48.2% decline of pED admissions, there was a significant increase (83.1%) in patient admissions for NPD. The most frequent NPD conditions which increased during the COVID-19 pandemic were suicidal ideation (+ 147%), depression (+ 115%), eating disorder (+ 78.4%), and psychosis (+ 17.2%). During the pandemic period, a 39.5% increase in NPD hospitalizations was observed as well. The NPD disorders that mostly required hospitalizations were suicidal ideation (+ 134%), depression (+ 41.4%), eating disorder (+ 31.4%), and drug abuse (+ 26.7%). COVID-19 pandemic had a major impact on children's health, mainly on their NPD development. Neuropsychological assessment should be required at the primary level, in the pediatrician's office, to facilitate early capture of the sign of impairment and provide an adequate treatment. Conclusion: SIP underlines the psychological consequences of COVID 19 pandemic on the youngest and recommends an early identification of NPD in the pediatric population to avoid other serious consequences for children's physical and mental health

Power to liquid through waste as a carbon source. A technical and economic assessment

The combination of a power to methanol process with the use of waste for carbon supply turns out to be a cleaver solution for sustainable chemical production and waste management as well as long-term energy storage. In the current work, an innovative scheme which integrates waste and energy conversion to produce methanol is addressed. Within the proposed configuration syngas is produced from waste gasification and enriched with hydrogen produced through water electrolysis, in order to accomplish methanol synthesis requirements. A techno-economic and environmental analysis of the hybrid scheme is proposed together with its comparison with waste to methanol and direct power to methanol technologies. Direct waste conversion into methanol is today the most attractive solution. In a near future, however, considering the increase of the renewable share of power and reduction of power cost, the hybrid scheme may become a quite attractive solution

Simultaneous decarbonisation of steel and Oil&Gas industry by MSW gasification. Economic and environmental analysis

The aim of this study is to provide a complete energy, economic and environmental analysis of a waste to chemical process that treats a feed mixture composed of Refused Derived Fuel and Plasmix, transforming it into syngas. The process was implemented in the Aspen Plus® simulation environment, where also a sensitivity analysis returning the maximum value of humidity allowable in three different scenarios of waste mixture has been carried out. Moreover, an economic analysis has been performed in which, on the basis of capital expenditure, operating costs and revenues of the plant, Net Present Value (NPV) and Internal Rate of Return (IRR) has been assessed, finding a value of 599 M€ and 28% respectively. Finally, environmental analysis has been performed; a comparison between the carbon dioxide emissions of the case “as it is now” versus “how it could be” with the waste to chemical process implemented has been carried out in which it was calculated a saving of around 581 kt/y of CO2 emitted in the atmosphere

SARS-CoV-2 variants preferentially emerge at intrinsically disordered protein sites helping immune evasion

The SARS-CoV-2 pandemic is maintained by the emergence of successive variants, highlighting the flexibility of the protein sequences of the virus. We show that experimentally determined intrinsically disordered regions (IDRs) are abundant in the SARS-CoV-2 viral proteins, making up to 28% of disorder content for the S1 subunit of spike and up to 51% for the nucleoprotein, with the vast majority of mutations occurring in the 13 major variants mapped to these IDRs. Strikingly, antigenic sites are enriched in IDRs, in the receptor-binding domain (RBD) and in the N-terminal domain (NTD), suggesting a key role of structural flexibility in the antigenicity of the SARS-CoV-2 protein surface. Mutations occurring in the S1 subunit and nucleoprotein (N) IDRs are critical for immune evasion and antibody escape, suggesting potential additional implications for vaccines and monoclonal therapeutic strategies. Overall, this suggests the presence of variable regions on S1 and N protein surfaces, which confer sequence and antigenic flexibility to the virus without altering its protein functions

The electrification of conventional industrial processes. The use of mechanical vapor compression in an EtOH–water distillation tower

The aim of this study is to analyze the exergetic, environmental, and economic impact of the electrification of a bio-refinery plant, considering the application of Mechanical Vapor Compression (MVC) to a conventional water–ethanol distillation column in the context of bioethanol production. The process was implemented in AspenPlus® and Aspen Exchange Design and Rating (EDR) simulation environments, where a sensitivity analysis was also carried out, considering four scenarios characterized by different compressions’ operative conditions, and including a Coefficient of Performance (CoP) analysis of the proposed solution with MVC. Exergetic and economic analyses were performed, and the relevant impacts on Operative Expenditure (OpEx) and Capital Expenditure (CapEx) were analyzed. Comparing the base case scenario with the proposed solution, a reduction of operative costs of around 63% was achieved. Finally, an environmental analysis was carried out, showing a remarkable reduction in the carbon footprint of the unit, with a carbon dioxide emission reduction of almost 80% for the MVC solution, in line with RED target requirements

Skin reactions due to anti-epileptic drugs: several case-reports with long-term follow-up.

In this study, the clinical findings and management of allergic skin reactions induced by the most used antiepileptic drugs, Lamotrigine (LMT) and Carbamazepine (CBZ), were evaluated. Lamotrigine is an antiepileptic drug recently released in several countries; it is effective for a variety of seizure types in adults and children, both as an add-on agent and in monotherapy, and it is generally well tolerated. Clinical and epidemiologic evidence suggest serious cutaneous reactions to antiepileptic drugs are more likely to occur during the first 8 weeks and they appear to increase when drugs are administered with other anticonvulsants, such as Valproate (VPA). We selected 10 patients who presented an idiosyncratic skin rash when treated with carbamazepine (8 patients) and lamotrigine (2 patients) administered as monotherapy, and we followed up on these patients for several years. Seven reactions were mild/severe cutaneous eruptions; one Toxic Epidermal Necrolysis, a case of Stevens-Johnson and a case of Hypersensitivity Syndrome. All severe skin drug reactions were induced by Carbamazepine. In five patients the AEDs were ceased abruptly (sometimes with the administration of a different molecule), tapered in four and continued unchanged in one. We conclude that the discontinuation of the drug with substitution with another is the most effective treatment and that corticosteroids are helpful in mild cutaneous reactions, while in severe skin reactions, such as Toxic Epidermal Necrolysis, corticosteroids are only a complementary therapy since intravenous immunoglobulins are the first choice treatment