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Integrating diverse expert opinions in hazard and risk projects is essential to managing subjective decisions and quantifying uncertainty to produce stable and trustworthy results. A structured procedure is necessary to organize the gathering of experts' opinions while ensuring transparency, accountability, and independence in judgements. We propose a novel Multiple-Expert management Protocol (MEP) to address this challenge, providing procedural guidelines for conducting single to multi-hazard risk analyses. MEP establishes a workflow to manage subjectivity rooted in (i) moderated and staged group interactions, (ii) trackable blind advice through written elicitations with mathematical aggregation, (iii) participatory independent review, (iv) close cooperation between scientific and managerial coordination, and (v) proper and comprehensive documentation. Originally developed for stress testing critical infrastructure, MEP is designed as a single, flexible, technology-neutral procedural workflow applicable to various sectors. Moreover, its scalability allows it to adapt from high to low-budget projects and from complex probabilistic multi-hazard risk assessments to standard single-hazard analyses, with different experts' degree and type of involvement depending on available funding and emerging controversies. We present two compelling case studies to showcase MEP's practical applicability: a multi-hazard risk analysis for a port infrastructure and a single-hazard regional tsunami hazard assessment. [ABSTRACT FROM AUTHOR]

The catalytic conversion of CO 2 to CH 4 (Sabatier reaction) has been studied to develop an after-treatment process at vehicles exhausts. Three different formulations of Ru commercial catalysts, two in powder and one in pellets shape, were tested and characterized by means of X-ray powder diffraction, scanning electron microscopy (SEM-EDX), N 2 adsorption at −196 °C and temperature-programmed reduction (TPR). Experimental results show a high CO 2 conversion (X CO2 = 0.96 @ T = 280 °C) for one powder catalyst formulation whereas the other one has maximum CO 2 conversion = 0.69. In both cases a high CH 4 selectivity is measured. High CO 2 conversion (X CO2 = 0.92 @ T = 300 °C) is obtained also with pellet catalysts but only at lower GHSV values. The different behavior of the catalysts was ascribed to the different physicochemical properties and the key parameters for the application development of the process were identified. In particular, the possibility to use pellets or monolithic reactors, thus minimizing the pressure drops in the reactor, makes possible a commercial application in the treatment of vehicles exhausts. • Ru catalysts guarantee high CO 2 conversion to CH 4 even in pellet shape. • Ru content can be limited to 1.5 wt% for a thickness of 0.5 mm on catalyst surface. • Catalyst performances make it possible the application of monolithic reactors. [ABSTRACT FROM AUTHOR]

Morphological, textural and surface properties are reported of Fe-doped aluminosilicate nanotubes (NTs) of the imogolite type (IMO, (OH) 3 Al 2 O 3 SiOH). Two samples with 1.4 wt% Fe were obtained by either direct synthesis (Fe-1.4-IMO) or post synthesis loading (Fe-L-IMO). Since formation of Fe 2 O 3 clusters was observed in both cases, a third sample with a lower Fe content corresponding to 0.70 wt% Fe was prepared by direct synthesis, with the aim of preventing clusters formation (Fe-0.70-IMO). The samples were characterized by: High Resolution Transmission Electron Microscopy (HRTEM); X-ray Diffraction (XRD); N 2 sorption isotherms; Thermo-Gravimetric Analysis (TGA); Diffuse Reflectance (DR) UV–vis and IR spectroscopies; electrophoretic mobility in water (ζ-potential) and adsorption of the azo-dye Acid Orange 7 (NaAO7) from water solutions. With Fe-0.70-IMO, Al 3+ isomorphic substitution by Fe 3+ was the main process occurring, leading to a material with formula (OH) 3 Al 1.975 Fe 0.025 O 3 SiOH, in which formation of Fe(OH)Al groups occurred at NTs outer surface. With Fe-1.4-IMO, some of the formed Fe(OH)Al groups probably acted as nucleation seeds, due to the natural tendency of iron to form Fe–O–Fe bridges, being responsible of the (undesired) formation of some Fe 2 O 3 clusters. Comparison with Fe-L-IMO, in which only the formation of Fe 2 O 3 clusters was, in principle, expected, showed on the contrary that some isomorphic substitution occurred also by post-synthesis loading. The intrinsic acidity of Fe(OH)Al groups was marginally different from that of Al(OH)Al groups, as shown by both IR spectroscopy and ζ-potential measurements, but the presence of iron modified the adsorption properties of IMO. Interaction with AO7 − anions in water, indeed, occurred in different ways: i) with proper IMO, besides electrostatic interaction with the positively charged external surface of nanotubes, AO7 − anions preferentially adsorb via H-bonding on inner SiOH groups; ii) with both Fe-0.70-IMO and Fe-1.4-IMO, Fe 3+ cations of Fe(OH)Al groups act as coordination centres for N atoms in the AO7 − moiety; iii) with Fe-L-IMO, larger Fe 2 O 3 clusters likely hinder AO7 − adsorption. [ABSTRACT FROM AUTHOR]

Summary In this prospective study, we evaluate the impact of adherence to a diagnostic and therapeutic protocol on prosthetic joint infections (PJI) diagnostic accuracy and outcome. Patients and methods Patients with early or delayed PJI referred over a 5-year period were included. Diagnosis was based on characteristic clinical signs, radiographic findings and microbiological evidence. Antibiotics were chosen on the basis of microbiological findings, and drugs active against methicillin-resistant staphylococci were administered if no microbiological evidence had been obtained. Results Inclusion criteria were met in 159 cases (median age 64 years, males 45%). 56 were early infections and 103 delayed infections. Comorbidities were reported in 99 (62%) cases. Positive cultures were obtained in 122/159 (77%), coagulase-negative staphylococci were cultured in 20%, Staphylococcus aureus in 28%, and Pseudomonas aeruginosa in 7%. In early infections, cure rate after debridement and antibiotic therapy was 80%. In delayed infections, cure rate after two-stage exchange was 85%. Of 28 patients with delayed infection treated with antibiotics without surgery, only 8 (29%) infections were suppressed 48 weeks after treatment discontinuation. Rifampin afforded a better outcome. Conclusion Appropriate diagnostic and surgical procedures and microbiologically driven antibiotic therapy including rifampin are recommended to improve diagnostic accuracy and outcome. [ABSTRACT FROM AUTHOR]

Despite the potential for protection against a broad spectrum of pathogens, the availability of an increased number of effective vaccines could lead to a significant reduction in vaccination coverage as the result of issues with implementation of new vaccines within existing protocols. To overcome these problems, the development of combined vaccines has been promoted. The use of combined vaccines offers a number of potential benefits, including a reduction in the number of patient visits, reduced complications associated with multiple intramuscular injections, decreased costs of stocking and administering separate vaccines, and a lowering of the risk of delayed or missed vaccinations. The hexavalent vaccine includes antigens against diphtheria, tetanus, acellular pertussis ( DTaP), hepatitis B ( HBsAg), poliomyelitis (P1, P2, P3) and Haemophilus influenzae type B (Hib) infections. The primary goal of this review is to discuss the immunogenicity, efficacy, safety and tolerability of several hexavalent preparations that are either commercially available or still under development. [ABSTRACT FROM AUTHOR]

The benefits of vaccination are clearly demonstrated by the eradication or enormous decline in the incidence of many vaccine-preventable diseases, but the coverage of many highly recommended vaccines is still frequently inadequate and children continue to suffer from diseases that could have been prevented. The main aim of this paper is to discuss the recognized barriers to the vaccination of children and adolescents confronting national health systems, providers and parents, and the ways in which they can be overcome. Most of the problems underlying limited vaccination coverage among children are due to a lack of understanding on the part of healthcare providers and parents, which underlines the need for educational programmes specifically addressed to each of these groups. It is also essential that all of the physicians providing immunization develop approaches that acknowledge parents' concerns and respectfully try to correct any misinformation. Other means of extending vaccine coverage include the implementation of adequate systems for recording vaccine administration and the activation of effective reminder/recall systems, the provision of immunization services in some medical care specialties or by integrating healthcare sites, and the elimination or reduction of all the problems that currently limit access to vaccination services. However, it will take the combined efforts of healthcare systems and providers to pull down all of the barriers. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2012; 18 (Suppl. 5): 42-49 Abstract Influenza is common in infants and children: attack rates vary from 23% to 48% each year during inter-pandemic periods, and are even higher during pandemics. Severe cases occur more frequently in children with underlying chronic diseases; however, epidemiological studies have clearly shown that influenza also causes an excess of medical examinations, drug prescriptions and hospitalizations in otherwise healthy children (particularly those aged <5 years), as well as a considerable number of paediatric deaths. Childhood influenza also has a number of social and economic consequences. However, many European health authorities are still reluctant to include influenza vaccinations in their national vaccination programmes for healthy children because, among other things, there are doubts concerning their real ability to evoke a protective immune response, especially in children in the first years of life. New hope for the solution of these problems has come from the introduction of vaccines containing more antigens and the possibility of intradermal administration. However, further studies are needed to establish whether universal influenza vaccination in the first years of life should be recommended, and with which vaccine. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2012; 18 (Suppl. 5): 85-92 Abstract The administration of vaccines is not usually recommended in pregnant women because of a fear of severe adverse events for the fetus. However, contraindication to vaccination applies only to vaccines based on live attenuated viruses for the theoretical possibility that they might infect the fetus. In contrast, the use of several inactivated vaccines is useful and recommended. As a result of the transplacental passage of antibodies, maternal immunization can reduce the risk of vaccine-preventable diseases that may occur in the first months of life before the start or completion of the suggested vaccination schedule. One of the best examples is vaccination against influenza that can protect pregnant women from a disease that can lead to hospitalization and death in a significantly higher number of cases than in the general population and can induce protective specific antibody levels as well as being effective in infants in the first months of life. Other examples are vaccinations against tetanus, pertussis, pneumococcal infections and Haemophilus influenzae type b infection. This review analyses the advantages and limitations of maternal immunization as revealed by experience and the main publications. [ABSTRACT FROM AUTHOR]

A predator's foraging performance is related to its ability to acquire sufficient information on environmental profitability. This process can be affected by the patchy distribution and clustering of food resources and by the food intake process dynamics. We simulated body mass growth and behaviour in a forager acting in a patchy environment with patchy distribution of both prey abundance and body mass by an individual-based model. In our model, food intake was a discrete and stochastic process and leaving decision was based on the estimate of net energy gain and searching time during their foraging activities. The study aimed to investigate the effects of learning processes and food resource exploitation on body mass and survival of foragers under different scenarios of intra-patch resource distribution. The simulation output showed that different sources of resource variability between patches affected foraging efficiency differently. When prey abundance varied across patches, the predator stayed longer in poorest patches to obtain the information needed and its performance was affected by the cost of sampling and the resulting assessment of the environment proved unreliable. On the other hand, when prey body mass, but not abundance, varied among the patches the predator was quickly able to assess local profitability. Both body mass and survival of the predator were greatly affected by learning processes and patterns of food resource distribution. [Copyright &y& Elsevier]

Abstract: We propose a simple explanation of unconventional thermodynamical and magnetic properties observed for Sr2RuO4. Actually, our two-phase model of superconductivity, based on a straight generalization of the Ginzburg–Landau theory, does predict two jumps in the heat capacity as well as a double curve for the dependence of the critical temperature on an external magnetic field. Such theoretical previsions well agree with the currently available experimental data for Sr2RuO4. [Copyright &y& Elsevier]

In order to evaluate the infectious agents associated with the first episode of severe acute wheezing in otherwise healthy infants and to define the role of each of them in recurrences, 85 patients in Italy, aged <12 months, hospitalized because of a first acute episode of wheezing, were prospectively enrolled between 1 October 2005 and 31 March 2006. Upon enrolment, nasopharyngeal swabs were collected for the real-time PCR detection of respiratory syncytial virus (RSV) types A and B, influenza virus types A and B, adenovirus, parainfluenza viruses types 1, 2, 3 and 4, rhinovirus, human metapneumovirus, human coronavirus types 229E, OC43, NL63, and HKU1, bocavirus, enterovirus, and paraechovirus; nasopharyngeal aspirates were also obtained to detect atypical bacteria. At least one infectious agent was identified in 76 children (89.4%). RSV was the most frequently detected pathogen and its prevalence was significantly higher than that of the other pathogens in both age groups, and significantly higher in the children aged 3–12 months than in those aged <3 months. Only the children with RSV infection experienced recurrent wheezing. Viral load was significantly higher in children with than in those without recurrent wheezing. This study shows that RSV is the main reason for hospitalization during the first wheezing episode in infants, and that it appears to be the only pathogen associated with a high frequency of recurrences. A high viral load seems to be strictly related to the likelihood of recurrence. [ABSTRACT FROM AUTHOR]

Abstract: A microwave assisted crystallization of paracelsian, a metastable phase for which no synthetic occurrence is at present reported, was obtained. A sample of thoroughly Ba-exchanged zeolite A was prepared and reacted in alkaline media and hydrothermal conditions under the action of microwaves (frequency 2.45GHz, irradiation power 1000W). The alkaline environment was created by using aqueous solutions of LiOH and tetraethylammonium hydroxide. Treatment temperature, reaction time and weight solid/liquid ratio ranged between 150 and 230°C, 40 and 120min, 1/5 and 1/40, respectively. The pressure was autogeneous. The action of microwaves appears to strongly enhance the ability of hydrothermal systems to produce highly metastable phases, an important observation. [Copyright &y& Elsevier]

This prospective study compared the clinical and socio-economic impact of laboratory-confirmed influenza and respiratory syncytial virus (RSV) infection on healthy children and their families. Among 1520 otherwise healthy children aged < 15 years attending the Emergency Department for acute conditions other than trauma, influenza viruses and RSV were found in 234 (15.4%) and 116 (7.6%; p < 0.0001) patients, respectively. The fact that influenza has a similar global clinical impact on the community to that of RSV infection, but represents a greater socio-economic burden, may contribute to broadening the acceptance of influenza vaccination. [ABSTRACT FROM AUTHOR]

Abstract: Nanocrystalline powders of yttria (8mol.%)-stabilized zirconia have been hydrothermally synthesized from mechanical mixture of ZrO2 xerogel and crystalline Y2O3 by conventional or microwave route, respectively. The treatments have been performed at 110 and/or 150°C for 2h up to 72h, and in the presence of diluted (0.2M) or concentrated solution (2.0M) of (KOH+K2CO3) mineralizer. To reduce the degree of agglomeration, the freshly synthesized powders has been treated under stirring with aqueous solution of poly(vinyl alcohol) (PVA 10wt.%) for 15h at pH 6.8, whereas to favour the formation of coating suspensions, the polymer absorbed powders and poly(ethylene glycol) (PEG) have been added to ethanol/water solution and stirred under ultrasonic agitation. With the different suspensions, various films have been deposited on glass substrates through withdrawal-coating. After drying at 60°C and firing at 600°C, the texture of the different films has been examined and compared with analogous films deposited by the sol–gel method. The effects of both the type of hydrothermal treatment, the concentration of the mineralizer, and the withdrawal-coating speed on the texture of the films are discussed. [Copyright &y& Elsevier]

In order to assess how outpatient parenteral antibiotic therapy (OPAT) is managed in different countries, we analyzed the data collected in the USA, UK and Italy by the International OPAT Registry using an ad hoc Access/Excel Microsoft program. The analysis of data concerned 9826 patients in the USA, 981 in the UK and 620 in Italy. Differences were observed in several aspects of OPAT management such as the infections treated and the antibiotics utilized. The duration of therapy also differed: it was much longer in Italy (56.0 average days), than in the USA (22.5 days) and UK (19.9 days). Delivery model, delivery route and infusion devices show substantial differences. The present analysis shows that OPAT is carried out with substantial differences in different countries probably according to different programmes and guidelines adopted. [Copyright &y& Elsevier]

In this investigation samples of exhaustively Ba-exchanged zeolites Ba–A, Ba–X, and Ba–LSX were subjected to thermal treatments in the temperature range 200–1550 °C for times up to 40 h. Their thermal transformations were comparatively studied by room temperature X-ray diffraction. Upon heating, the three zeolites undergo the following sequence of transformations: zeolite→amorphous phase→hexacelsian→monoclinic celsian in strongly different ways. In particular it was found that: (1) The crystallisation of nuclei of monoclinic celsian dispersed in the amorphous phase arising from the thermal collapse of the structure of zeolite Ba–A, recorded above 500 °C in a previous work, did not occur for zeolites Ba–X and Ba–LSX. (2) Zeolite Ba–A exhibited a far greater reactivity than zeolites Ba–X and Ba–LSX; actually, the conversion of hexacelsian into monoclinic celsian attained completion at 1300 °C, starting from zeolite Ba–A, whereas did not attain completion in the most severe experimental conditions experienced (1550 °C, 24 h), starting from zeolites Ba–X and Ba–LSX. Such different thermal behaviours could be reasonably ascribed to the different middle-range order occurring in the amorphous phases arising from the thermal collapse of the microporous structures of zeolites Ba–A, Ba–X, and Ba–LSX. [Copyright &y& Elsevier]

We review the purely leptonic neutrino emission processes, contributing to the energy loss rate of the stellar plasma. We perform a complete analysis up to the first order in the electromagnetic coupling constant. In particular the radiative electromagnetic corrections, at order α, to the process e+e-→νν at finite density and temperature have been computed. This process gives one of the main contributions to the cooling of stellar interior in the late stages of star evolution. As a result of the analysis we find that the corrections affect the energy loss rate, computed at tree level, by a factor (-4–1)% in the temperature and density region where the pair annihilation is the most efficient cooling mechanism. [Copyright &y& Elsevier]

• A survey study on lifestyle/dietary habits of a cohort with multiple sclerosis (MS). • A snapshot of mostly proactive MS adult women, incline to healthy behaviors. • Mediterranean Diet (MeDi) may modulate abdominal adiposity but not Body Mass Index. • MeDi may be a strategy to control cardiovascular risk and Expanded Disability Status Scale. • A dietary pattern's study provides a more realistic analysis of interdependent foods. Several studies supported the beneficial effects of the Mediterranean diet (MeDi) on chronic diseases. In Multiple Sclerosis (MS), the MeDi might interfere with systemic inflammatory state, gut microbiota, and comorbidities. The Med Diet Score (MDS) estimates the adherence to the MeDi and the cardiovascular (CV) risk. Aims of our study were i) to photograph lifestyle and diet habits of a southern Italy cohort of people with MS (pwMS), and ii) to investigate the impact of the MeDi on MS clinical outcomes. We conducted a multi-center, cross-sectional study, enrolling 435 consecutive consenting pwMS, attending the outpatient clinics for routine follow-up visits. Participants underwent a clinical examination and a 29-item self-administered questionnaire on life and dietary habits. Disease phenotype, Expanded Disability Status Scale (EDSS), MS Severity Score (MSSS), waist circumference (WC), Body Mass Index (BMI), therapies, and comorbidities, were updated. MDS was assessed and correlated with current and retrospective clinical data. 75.8% of respondents were interested in nutrition, 72.8% were non-smokers, 52.9% performed physical activity, and 45.6% used food supplements. MDS was higher in pwMS with normal WC (p = 0.031), and inversely correlated with MSSS (p = 0.013) and EDSS (p = 0.012) at survey time. MDS did not correlate with the total number of relapses (before and after diagnosis) (p = 0.372). Metabolic comorbidities were associated with an increased 10-year CV risk (r = 0.85, p = 0.002). Our findings suggest a putative beneficial effect of the MeDi on WC, MS course and disability. Given the role of chronic systemic inflammation in maintenance of autoimmunity and secondary neurodegeneration, both involved in long-term disability, we may suppose a beneficial effect of the MeDi on MS long-term disability outcomes, probably mediated by a modulation of the gut microbiota and the low-grade chronic systemic inflammation. [ABSTRACT FROM AUTHOR]