An Italian survey on dietary habits and changes during the COVID-19 lockdown

The World Health Organization has declared the coronavirus outbreak a Public Health Emergency of International Concern; the outbreak has led to lockdowns in several parts of the world, and sudden changes in people’s lifestyles. This study explores the impact of the first coronavirus disease 2019 (COVID-19) pandemic period on dietary habits, lifestyle changes, and adherence to the Mediterranean diet among the Italian population, through an online questionnaire, conducted from April to May 2020, involving 1519 participants. The 14-point Mediterranean Diet Adherence Screener (MEDAS) highlighted a medium Mediterranean diet adherence in 73.5% of responders, which principally included the younger population, aged 18–30 years (p < 0.05). In regards to changes in eating habits, 33.5% of responders declared an influence of the pandemic period on nutritional practice. A decrease in alcohol consumption was reported by 81% of responders, while an increase in frozen food consumption was reported by 81.3% of responders. In addition, 58.8% reported positive weight modification (40.8%, +1–3 kg); physical activity reduction was reported for 70.5% of responders. Our study contributes toward amplifying the investigation on the dietary habits and changes of the Italian population during the COVID-19 lockdown, although the pandemic is ongoing. Similar studies should be performed around the world to understand how the emergency has impacted people’s habits

An innovative in-situ DRAINage system for advanced groundwater reactive TREATment (in-DRAIN-TREAT)

The removal of groundwater contamination is a complex process due to the hydro-geochemical characteristics of the specific site, related maintenance and the possible presence of several types of pollutants, both organic and inorganic. In recent decades, there has been an increasing drive towards more sustainable treatment for contaminated groundwater as opposed to “intensive” treatments, i.e. with high requirements for onsite infrastructure, energy and resource use. In this study, a new remediation technology is proposed, combining the use of advanced drainage systems with adsorption processes, termed “In-situ reactive DRAINage system for groundwater TREATment” (In-DRAIN-TREAT). By taking advantage of the groundwater natural gradient, In-DRAIN-TREAT collects the contaminated groundwater via a drainage system and treats the polluted water directly into an active cell located downstream, avoiding external energy inputs. Preliminary results indicate the applicability and high efficiency of In-DRAIN-TREAT when compared with a permeable reactive barrier (PRB). In-DRAIN-TREAT is applied to remediate a theoretical aquifer with low permeability, contaminated by a 13 m wide hexavalent chromium (CrVI) plume. This is achieved in less than a year, via a drain DN500, 32 m long, a 30 m3 treatment cell filled with activated carbon and no energy consumption. A comparison with permeable barriers also shows a preliminary 63% volume reduction, with a related 10% decrease of remediation costs

From intensive care to step-down units: Managing patients throughput in response to COVID-19

Quality problem or issue: The on-going COVID-19 pandemic may cause the collapse of healthcare systems because of unprecedented hospitalization rates. Initial assessment: A total of 8.2 individuals per 1000 inhabitants have been diagnosed with COVID-19 in our province. The hospital predisposed 110 beds for COVID-19 patients: On the day of the local peak, 90% of them were occupied and intensive care unit (ICU) faced unprecedented admission rates, fearing system collapse. Choice of solution: Instead of increasing the number of ICU beds, the creation of a step-down unit (SDU) close to the ICU was preferred: The aim was to safely improve the transfer of patients and to relieve ICU from the risk of overload. Implementation: A nine-bed SDU was created next to the ICU, led by intensivists and ICU nurses, with adequate personal protective equipment, monitoring systems and ventilators for respiratory support when needed. A second six-bed SDU was also created. Evaluation: Patients were clinically comparable to those of most reports from Western Countries now available in the literature. ICU never needed supernumerary beds, no patient died in the SDU, and there was no waiting time for ICU admission of critical patients. SDU has been affordable from human resources, safety and economic points of view. Lessons learned: COVID-19 is like an enduring mass casualty incident. Solutions tailored on local epidemiology and available resources should be implemented to preserve the efficiency and adaptability of our institutions and provide the adequate sanitary response

PMS53 Association Between Teriparatide Adherence and Health Care Utilization and Costs in Real World United States Kyphoplasty/Vertebroplasty Patients

The Gulf of Follonica (Italy) is impacted by the chemical pollution from ancient mining activity and present industrial processes. This study was aimed to determine the bioavailability of dioxin-like compounds (DLCs) in coastal marine environment and to assess the genotoxic potential of waste waters entering the sea from an industrial canal. Moderately high levels of DCLs compounds ( 11 PCDDs + PCDFs 2.18\u201329.00 pg/g dry wt) were detected in Mytilus galloprovincialis transplanted near the waste waters canal and their corresponding Toxic Equivalents (TEQs) calculated. In situ exposed mussels did not show any genotoxic effect (by Comet and Micronucleus assay). Otherwise, laboratory exposure to canal waters exhibited a reduced genomic template stability (by RAPD-PCR assay) but not DNA or chromosomal damage. Our data reveal the need to focus on the levels and distribution of DLCs in edible species from the study area considering their potential transfer to humans through the consumption of sea food

Experimental and simulation study of the restoration of a thallium (I)-contaminated aquifer by Permeable Adsorptive Barriers (PABs)

Permeable Adsorptive Barriers (PABs), filled with a commercial activated carbon, are tested as a technique for the remediation of a thallium (I)-contaminated aquifer located in the south of Italy. Thallium adsorption capacity of the activated carbon is experimentally determined through dedicated laboratory tests, allowing to obtain the main modelling parameters to describe the adsorption phenomena within the barrier. A 2D numerical model, solved by using a finite element approach via COMSOL Multi-physics®, is used to simulate the contaminant transport within the aquifer and for the PAB design. Investigations are carried out on an innovative barrier configuration, called Discontinuous Permeable Adsorptive Barrier (PAB-D). In addition, an optimization procedure is followed to determine the optimum PAB-D parameters, and to evaluate the total costs of the intervention. A PAB-D made by an array of wells having a diameter of 1.5 m and spaced at a distance of 4 m from each other, is shown to be the most cost-effective of those tested, and ensures the aquifer restoration within 80 years. The simulation outcomes demonstrate that the designed PAB-D is an effective tool for the remediation of the aquifer under analysis, since the contaminant concentration downstream of the barrier is below the thallium regulatory limit for groundwater, also accounting for possible desorption phenomena. Finally, the best PAB-D configuration is compared with a continuous barrier (PAB-C), resulting in a 32% saving of adsorbing material volume, and 36% of the overall costs for the PAB-D

Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study

Background: Major depressive disorder is a mental illness associated with chronic conditions like cardiovascular disease (CVD). Circulating inflammation has been proposed as a potential mechanism underlying this link, although the role of specific biomarkers, gender, and symptom domains is not well elucidated. Methods: We performed multivariable Cox regressions of first hospitalization/all-cause mortality and CVD, ischemic heart (IHD), and cerebrovascular disease (CeVD) causes vs. depression severity in an Italian population cohort (N = 13,191; age ≥ 35 years; 49.3% men; 4,856 hospitalizations and 471 deaths, median follow-up 7.28 and 8.24 years, respectively). In models adjusted for age, sex, and socioeconomic status, we estimated the proportion of association explained by C-reactive protein (CRP), platelet count, granulocyte-to-lymphocyte ratio (GLR), and white blood cell count (WBC). Gender-by-depression interaction and gender-stratified analyses were performed. Associations of polychoric factors tagging somatic and cognitive symptoms with incident clinical risks were also tested, as well as the proportion explained by a composite index of circulating inflammation (INFLA score). Results: Significant proportions of the influence of depression on clinical risks were explained by CRP (4.8% on IHD hospitalizations), GLR (11% on all-cause mortality), and WBC (24% on IHD/CeVD hospitalizations). Gender-by-depression interaction was significantly associated only with all-cause mortality (p = 0.03), with moderate depression showing a + 60% increased risk in women, but not in men. Stable associations of somatic, but not of cognitive, symptoms with increased hospitalization risk were observed (+ 16% for all causes, + 14% for CVD causes), with INFLA score explaining small but significant proportions of these associations (2.5% for all causes, 8.6% for IHD causes). Conclusions: These findings highlight the importance of cellular components of inflammation, gender, and somatic depressive symptoms in the link between depression and clinical (especially CVD) risks, pointing to the existence of additional pathways through which depression may play a detrimental effect on the cardiovascular system

Prosody abilities in a large sample of affective and non-affective first episode psychosis patients

Objective: Prosody comprehension deficits have been reported in major psychoses. It is still not clear whether these deficits occur at early psychosis stages. The aims of our study were to investigate a) linguistic and emotional prosody comprehension abilities in First Episode Psychosis (FEP) patients compared to healthy controls (HC); b) performance differences between non-affective (FEP-NA) and affective (FEP-A) patients, and c) association between symptoms severity and prosodic features. Methods: A total of 208 FEP (156 FEP-NA and 52 FEP-A) patients and 77 HC were enrolled and assessed with the Italian version of the “Protocole Montréal d'Evaluation de la Communication” to evaluate linguistic and emotional prosody comprehension. Clinical variables were assessed with a comprehensive set of standardized measures. Results: FEP patients displayed significant linguistic and emotional prosody deficits compared to HC, with FEP-NA showing greater impairment than FEP-A. Also, significant correlations between symptom severity and prosodic features in FEP patients were found. Conclusions: Our results suggest that prosodic impairments occur at the onset of psychosis being more prominent in FEP-NA and in those with severe psychopathology. These findings further support the hypothesis that aprosodia is a core feature of psychosis

Erectile and sexual dysfunction in male and female patients with celiac disease: A cross-sectional observational study

Introduction: Sexual function is often impaired in patients with chronic illnesses. Several patients with chronic gastrointestinal and liver disorders have been shown to suffer from sexual dysfunction, and celiac disease is a highly prevalent gastroenterological disorder. Aim: The aim of this study was to investigate the sexual function incidence and the risk factors for sexual dysfunction in both male and female celiac disease patients. Methods: Two hundred and eighty-four patients (170 females, 114 males) participated in this cross-sectional observational study in an anonymous manner. Female sexual function was assessed through the Female Sexual Function Index questionnaire. Male sexual function was assessed through the International Index of Erectile Function-5 questionnaire. Clinical-demographic variables were recorded. We investigated differences in the patient-reported outcomes among the different subgroups and whether there were clinical-demographic predictors of sexual dysfunction in our setting. Main outcome measures: Prevalence and assessment of sexual dysfunction in celiac disease patients. Results: In the female group, 85 subjects (50%) had a total score compatible with sexual dysfunction: 43 (61.42%) showed low desire, 79 (46.47%) showed arousal disorder, 66 (38.82%) lubrication disorder, and 84 (49.41%) inability of obtaining an orgasm. Also, a large proportion of our female patients, 161 (94.70%), showed sexual discomfort during intercourse. In the male group, 79 patients (62.2%) showed scores compatible with normal erectile function, eight (7.01%) had mild erectile dysfunction, 24 (21.05%) mild to moderate erectile dysfunction, and three (2.63%) presented severe erectile dysfunction. Altered body mass index was significantly associated with sexual dysfunction both in male and female patients. Early age at diagnosis was a significant predictor of sexual dysfunction in male celiac disease patients. Conclusions: A significant proportion of celiac disease patients present sexual dysfunction. Early age at diagnosis and high body mass index seem to predict sexual dysfunction in this clinical setting. Assessment of sexual function should be part of the initial evaluation of celiac disease patients in order to establish a prompt diagnosis and early treatment