Resistance welding of carbon fibre reinforced PEKK by means of CNT webs

Single lap shear specimens were manufactured using resistance welding of carbon fibre reinforced substrates by means of CNT web-based heating elements. Heating elements were manufactured by embedding the CNT web layers between layers of PEKK/glass fibre and connecting them to copper electrodes. An experimental campaign explored their electrothermal behaviour influencing the welding process. Single lap shear specimens were then welded at a pressure of 0.05 MPa and different levels of power and duration. An optimum bond was obtained with a specific power of 80–90 kW/m2 and a time of 150 s, achieving a shear strength of 30 MPa. Post-mortem analysis revealed that fracture propagated within the substrates. This work represents a further step in the integration of CNT web-based heating elements in an industrial welding process

Interface infectious keratitis after anterior and posterior lamellar keratoplasty. Clinical features and treatment strategies. A review

Interface infectious keratitis (IIK) is a novel corneal infection that may develop after any type of lamellar keratoplasty. Onset of infection occurs in the virtual space between the graft and the host where it may remain localised until spreading with possible risk of endophthalmitis. A literature review identified 42 cases of IIK. Thirty-one of them occurred after endothelial keratoplasty and 12 after deep anterior lamellar keratoplasty. Fungi in the form of Candida species were the most common microorganisms involved, with donor to host transmission of infection documented in the majority of cases. Donor rim cultures were useful to address the infectious microorganisms within few days after surgery. Due to the sequestered site of infection, medical treatment, using both topical and systemic antimicrobials drugs, was ineffective on halting the progression of the infection. Injection of antifungals, right at the graft–host interface, was reported successful in some cases. Spreading of the infection with development of endophthalmitis occurred in five cases after Descemet stripping automated endothelial keratoplasty with severe sight loss in three cases. Early excisional penetrating keratoplasty showed to be the treatment with the highest therapeutic efficacy, lowest rate of complications and greater visual outcomes

Impatto dell'epidemia di COVID-19 sulla salute mentale degli infermieri di Terapia Intensiva. Uno studio multicentrico Italiano

Aim: The aim of this study was to evaluate variations in ICU nurses ' mental health status over the COVID-19 outbreak by quantifying the extent of symptoms of depression, anxiety and PTSD over time. Methods: This study was an Italian multicenter prospective cohort study assessing caseness of anxiety, depression and PTSD at 6 and 12 months from the beginning of the COVID-19 outbreak in Italy. Results: A total of 359 nurses, 233 (64.9%) were males and 126 (35.1%) were females were enrolled. At 6 months the caseness prevalence for anxiety, depression and PTSD were 31.3%, 32.1% and 18.7% respectively. At 12 months the caseness prevalence for anxiety, depression and PTSD were 34.8%, 36.4% and 24.1 % respectively. No statistically significant increase between 6 and 12 months was recorded for the caseness prevalence anxiety (p= .29) and depression (p= .19). However, an increase for the caseness prevalence PTSD at 12 months was observed (p= .049). The significant risk factors for the 221 patients with at least one disorders were age 31-40 (RR= 1.44, IC= 1.25-1.89; p < .001), female gender (RR= 1.31, IC= 1.02-1.51; p=. 042) and had 0-5 years of professional experience (RR= 1.36, IC= 1.02-1.63; p = .031). Conclusion: The results of our study may provide support for the implementation of some interventions for well-being in COVID-19 outbreak condition. Key words: Anxiety, Depression, Post-Traumatic stress disorder, Covid-19, Nurses, Mental health.Scopo: Lo scopo di questo studio era valutare le variazioni dello stato di salute mentale degli infermieri in terapia intensiva durante l'epidemia di COVID-19 quantificando l'entità dei sintomi di depressione, ansia e PTSD nel tempo. Metodi: Si tratta di uno studio di coorte prospettico multicentrico italiano che ha valutato la presenza di di ansia, depressione e PTSD a 6 e 12 mesi dall'inizio dell'epidemia di COVID-19. Risultati: Sono stati arruolati un totale di 359 infermieri, 233 (64.9%) uomini e 126 (35.1%) donne. A 6 mesi dall’inizio della pandemia, la prevalenza di disturbi di ansia, depressione e disturbo da stress post-traumatico era rispettivamente del 31.3%, 32.1% e 18.7%. A 12 mesi la prevalenza per ansia, depressione e PTSD era rispettivamente del 34.8%, 36.4% e 24.1%. Nessun aumento statisticamente significativo tra 6 e 12 mesi è stato registrato per l’ansia (p = .29) o la depressione (p = .19). Tuttavia, è stato osservato un aumento del disturbo da stress post-traumatico a 12 mesi (p = .049). I fattori di rischio significativi per i 221 pazienti con almeno un disturbo, erano un età di 31-40 (RR = 1.44, IC = 1.25-1.89; p < .001), sesso femminile (RR = 1.31, IC = 1.02-1.51; p = .042) e avere un esperienza professionale di 0-5 anni (RR = 1.36, IC = 1.02-1.63; p = .031). Conclusioni: I risultati del nostro studio possono fornire supporto per l'implementazione di alcuni interventi per il benessere lavorativo nella condizione di epidemia di COVID-19. Parole chiave: Ansia, depressione, disturbo da stress post-traumatico, Coronavirus, Infermieri, salute mentale

Sindrome di Burnout tra il personale infermieristico italiano durante l'emergenza COVID 19. Indagine conoscitiva multicentrica

AIM: To analyze the prevalence of Burnout defined by the MBI-GS among Italian nursing staff during the COVID-19 emergency. INTRODUCTION: The recent health emergency which in the first half of 2020 has seen Italy involved in the management of patients with COVID-19 (COronaVIrus Disease 19), has led to further stress for hospitals both in terms of beds and in terms of workload for healthcare workers. METHOD: A multicenter study was conducted. A convenience sample of 208 nurses participated in the study. Between March 20 and July 20, 2020, the Maslach Burnout Inventory-General Survey (MBI-GS) questionnaire was made available online by using the Google Forms platform in order to detect and measure the severity of Burnout Syndrome (BOS). RESULTS: BOS-related symptoms (medium or high score) for individual MBI-GS domains were identified in at least 68% of nurses. One hundred and sixty-one nurses (77.4%) had a risk of emotional exhaustion, 143 (68.7%) of depersonalization, and 162 (77.9%) of reduced professional accomplishment. High risk was observed among nurses who managed COVID patients at their own operating unit (RR = 1.27, p = 0.016). Severe BOS risk was observed in 146 nurses analyzed (70.2%) with an increased risk among Intensive Care nurses (n = 79/84, 94% vs n = 67/124, 54%) (x2 = 38.324; p <0.001). CONCLUSIONS: Our results suggest that the nurses during the coronavirus pandemic, had high levels of work-related suffering and were at risk of physical and emotional exhaustion. Further research should be undertaken to establish causal relationships between BOS and personal and environmental risk factors among healthcare professionals in relation to the COVID-19.SCOPO: Analizzare la prevalenza del Burnout definito dal MBI-GS tra il personale infermieristico italiano durante l’emergenza COVID-19. INTRODUZIONE: La recente emergenza sanitaria che nella prima metà del 2020 ha visto l’Italia coinvolta nella gestione dei pazienti affetti da COVID-19 (COronaVIrus Disease 19), ha comportato un ulteriore stress per gli ospedali sia in termini di posti letto sia in termini di carico di lavoro per il personale sanitario. METODO: È stato condotto uno studio trasversale multicentrico. Un campione di convenienza composto da 208 infermieri ha partecipato allo studio. Tra il 20 Marzo e il 20 Luglio 2020, il questionario Maslach Burnout Inventory-General Survey (MBI-GS), è stato somministrato tramite la piattaforma Google Forms al fine di rilevare e misurare la gravità della Sindrome di Burnout (BOS). RISULTATI: I sintomi BOS-correlati (punteggio medio o alto) per i singoli domini della MBI-GS sono stati identificati in almeno il 68% degli infermieri. Cento-sessantuno infermieri (77.4%) presentavano un rischio di esaurimento emotivo, 143 (68.7%) di depersonalizzazione, e 162 (77.9%) di ridotta realizzazione personale. Un maggior rischio è stato osservato tra gli infermieri che gestivano pazienti COVID presso la propria unità operativa (RR=1.27, p= 0.016). Il rischio di BOS severa, è stata osservata in 146 infermieri analizzati (70.2%) con un incremento del rischio tra gli infermieri di Terapia Intensiva (n= 79/84, 94% vs n= 67/124, 54%) (x2= 38.324; p< 0.001). CONCLUSIONI: I risultati suggeriscono come gli infermieri durante la pandemia siano stati a rischio di esaurimento fisico ed emotivo. Ulteriori ricerche dovrebbero essere intraprese per stabilire relazioni causali tra BOS e fattori di rischio personale e ambientale in relazione all’esperienza COVID-19

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

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

Molecular typing of Acinetobacter baumannii by automated repetitive-sequence-based PCR

Acinetobacter baumannii has been increasingly reported as a significant causative organism of various nosocomial infections. Here we describe three different outbreaks of multidrug resistant A. baumannii started in the Intensitive Care Unit and then involving other wards of San Carlo Borromeo hospital in Milan, Italy. In order to characterize the clinical strains isolates, molecular typing using semi-automated repetitive-sequence-based PCR (rep-PCR) was performed.Among the sixty-one strains analyzed, three main cluster (C1, C2, C3) were detected: C1 included six indistinguishable strains, C2 five and C3 thirty. No correlation was observed between chemosensitivity and ribotyping pattern and an high rate of carbapenems resistance was founded