Epidemiology of Hypoalbuminemia in Hospitalized Patients: A Clinical Matter or an Emerging Public Health Problem?

Serum albumin levels are strongly associated with the morbidity, prognosis, and mortality rates of patients with hypoalbuminemia, which is a frequent problem during hospitalization. An observational retrospective study was carried out to analyze changes in albumin levels in hospitalized patients at the "Fondazione Policlinico Tor Vergata-PTV" in 2018. The prevalence of preexisting hypoalbuminemia at the time of discharge from hospital was investigated using a sample of 9428 patients. Information was collected from the discharge files recorded in the central informatics system of the hospital. Analysis of albumin levels at admission and at discharge was conducted by classes of albuminemia and then stratified by age. At the time of admission, hypoalbuminemia was found to be present in more than half of the sample, with no sex differences. The serum albumin level tended to decrease with age, with pathologic levels appearing from 50 years and progressive worsening thereafter. The condition of marked and mild hypoalbuminemia was more prevalent in patients over 65 years of age. Our findings suggest that hypoalbuminemia should be considered a dangerous condition in itself and a serious public health problem. We aimed to emphasize the role of albumin as useful marker of the in-hospital malnutrition and frailty, to be integrated in the routinely assessment of patients for reconsidering ad hoc healthcare pathways after discharge from hospital, especially when dealing with fragile populations

Dust tracking techniques applied to the STARDUST facility: First results

An important issue related to future nuclear fusion reactors fueled with deuterium and tritium is the creation of large amounts of dust due to several mechanisms (disruptions, ELMs and VDEs). The dust size expected in nuclear fusion experiments (such as ITER) is in the order of microns (between 0.1 and 1000 μm). Almost the total amount of this dust remains in the vacuum vessel (VV). This radiological dust can re-suspend in case of LOVA (loss of vacuum accident) and these phenomena can cause explosions and serious damages to the health of the operators and to the integrity of the device. The authors have developed a facility, STARDUST, in order to reproduce the thermo fluid-dynamic conditions comparable to those expected inside the VV of the next generation of experiments such as ITER in case of LOVA. The dust used inside the STARDUST facility presents particle sizes and physical characteristics comparable with those that created inside the VV of nuclear fusion experiments. In this facility an experimental campaign has been conducted with the purpose of tracking the dust re-suspended at low pressurization rates (comparable to those expected in case of LOVA in ITER and suggested by the General Safety and Security Report ITER-GSSR) using a fast camera with a frame rate from 1000 to 10,000 images per second. The velocity fields of the mobilized dust are derived from the imaging of a two-dimensional slice of the flow illuminated by optically adapted laser beam. The aim of this work is to demonstrate the possibility of dust tracking by means of image processing with the objective of determining the velocity field values of dust re-suspended during a LOVA

The free license codes as decision support system (DSS) for the emergency planning to simulate radioactive releases in case of accidents in the new generation energy plants

The radiological risk is related to a wide range of activities, beginning with the medical and military ones and including those connected to the industrial and research activities such as nuclear fusion. A valid tool to predict the consequences of the accidents and reduce the risk is represented by computing systems that allow modeling the evolution of a possible release of radioactive materials over time and space. In addition to proprietary codes there are free license codes, like Hot-Spot, that allow providing a set of tools to simulate diffusion in case of accidents involving radioactive materials and analyze the safety and security of the facilities in which the radioactive material is manipulated. The case studies scenario’s consists in two simulations accidents scenario the first to biomass plant and the second at nuclear fission plant. The simulation of the radioactive contamination have been conducted with the code HOT SPOT, a free license code. The results of the simulation and data discussion will be presented in this work by the authors

Infectious Diseases Seeker (IDS): An Innovative Tool for Prompt Identification of Infectious Diseases during Outbreaks

Background: Several technologies for rapid molecular identification of pathogens are currently available; jointly with monitoring tools (i.e., web-based surveillance tools, infectious diseases modelers, and epidemic intelligence methods), they represent important components for timely outbreak detection and identification of the involved pathogen. The application of these approaches is usually feasible and effective when performed by healthcare professionals with specific expertise and skills and when data and resources are easily accessible. Contrariwise, in the field situation where healthcare workers or first responders from heterogeneous competences can be asked to investigate an outbreak of unknown origin, a simple and suitable tool for rapid agent identification and appropriate outbreak management is highly needed. Most especially when time is limited, available data are incomplete, and accessible infrastructure and resources are inadequate. The use of a prompt, user-friendly, and accessible tool able to rapidly recognize an infectious disease outbreak and with high sensitivity and precision may be a game-changer to support emergency response and public health investigations. Methods: This paper presents the work performed to implement and test an innovative tool for prompt identification of infectious diseases during outbreaks, called Infectious Diseases Seeker (IDS). IDS is a standalone software that runs on the most common operative systems. It has been built by integrating a database containing an interim set of 60 different disease causative agents and COVID-19 data and is able to work in an off-line mode without requiring a network connection. Results: IDS has been applied in a real and complex scenario in terms of concomitant infectious diseases (yellow fever, COVID-19, and Lassa fever), as can be in the second part of 2020 in Nigeria. The outcomes have allowed inferring that yellow fever (YF), and not Lassa fever, was affecting the area under investigation. Conclusions: Our result suggests that a tool like IDS could be valuable for the quick and easy identification and discrimination of infectious disease outbreaks even when concurrent outbreaks occur, like for the case study of YF and COVID-19 pandemic in Nigeria

On the Optimal Indoor Air Conditions for SARS-CoV-2 Inactivation. An Enthalpy-Based Approach

In the CoViD-19 pandemic, the precautionary approach suggests that all possible measures should be established and implemented to avoid contagion, including through aerosols. For indoor spaces, the virulence of SARS-CoV-2 could be mitigated not only via air changes, but also by heating, ventilation, and air conditioning (HVAC) systems maintaining thermodynamic conditions possibly adverse to the virus. However, data available in literature on virus survival were never treated aiming to this. In fact, based on comparisons in terms of specific enthalpy, a domain of indoor comfort conditions between 50 and 60 kJ/kg is found to comply with this objective, and an easy-to-use relationship for setting viable pairs of humidity and temperature using a proper HVAC plant is proposed. If confirmed via further investigations on this research path, these findings could open interesting scenarios on the use of indoor spaces during the pandemic

Parents' and caregivers' role toward childhood vaccination in Albania: assessment of predictors of vaccine hesitancy

Background. Vaccination has saved millions of lives through the protection of individuals and populations from communicable diseases. Vaccine hesitancy, defined as the delay in acceptance or refusal of vaccines despite the availability of vaccination services, has become a growing global concern. The objective of this study was to investigate parents'/caregivers' hesitancy toward childhood vaccination and its predictors in Albania.Study design. A cross-sectional survey was conducted.Methods. The data comes from a survey conducted on a sample of parents/caregivers (89.6% mothers) of children aged 6 months to 8 years at health care vaccination centers in seven Albanian cities from December 2020 to February 2021. Parents/caregivers (one per child) were interviewed by trained healthcare staff using a standardized questionnaire on six main content domains, including immunization behavior, beliefs about vaccine safety and efficacy, attitudes about vaccines, vaccination confidence, estimation of vaccine delay, and the intention to immunize children against SARS-CoV-2, and a self-reported hesitancy. The Albanian Ministry of Health approved the questionnaire, after it was translated, validated and adapted to the local setting. Statistical analyses included independent sample t-tests (p<0.05) and a logistic regression (OR; 95% C.I.).Results. A total of 475 parents/caregivers of children aged from 6 months to 8 years, attending childhood vaccination in public health services, were interviewed. To the question "how hesitant you are about childhood vaccination", a high number of parents/caregivers (46%) responded that they do not feel hesitant at all, and 32% were not hesitant, a small number of parents/caregivers said they are very hesitant (5%) or somewhat hesitant (12%)

Hesitancy toward Childhood Vaccinations: Preliminary Results from an Albanian Nursing Staff's Investigation

Healthcare professionals are important models for their patients since their individual knowledge and attitudes toward vaccination can influence the patient's willingness to adhere to vaccination campaigns. After developing a structured questionnaire, it was administered to a sample of nursing staff working in public vaccination centers in Albania (December 2020-January 2021), in order to conduct a preliminary investigation aimed at describing knowledge, attitudes, beliefs, and hesitancy toward childhood vaccinations. Among the sample of nurses involved in the administration of vaccines (n.64, 92% females), most of them were confident about vaccines and favorable to childhood vaccinations (90%). However, when specifically investigating beliefs, nearly a quarter of the sample showed to be hesitant; 22% were unsure or partially agreed that vaccines might cause conditions such as autism and multiple sclerosis. A high risk of hesitancy was identified in the youngest staff especially when their work experience was below 10 years or when they graduated less than 10 years before (OR: 5.3, CI: 1.4-19.5; and OR: 4.2 CI: 1.2-14.6). Similarly, a low acceptance rate (54%) was detected for future childhood SARS-CoV-2 vaccines among the nurses, which is a sign of high levels of vaccine hesitancy. With regard to knowledge about childhood vaccine contraindications, none of the nurses identified all the ten correct answers, while only 13% answered at least six questions correctly. These preliminary results highlight the need of investigating more Albanian nursing staff's knowledge and attitudes toward child vaccinations, therefore investing in tailored training. Due to the ongoing Covid-19 pandemic and the roll-out of mass vaccination, the role of healthcare workers remains crucial and needs more support to manage the changing public opinion as well as quickly evolving vaccine technologies

CBRN risk scenarios

Events of dispersion of Chemical, Biological, Radiological and Nuclear (CBRN) materials due to natural, accidental or intentional events are considered risk situations and nowadays represent one of the most critical concerns for safety and security. Safe management of these materials, in particular the certainty of its location and control of their transport, is a key issue to be sure that no diversion to unwanted and unauthorized uses occurs. Particularly relevant in the control of the transportation is a stringent cross-border traffic control aimed at avoiding their illicit traffic. Starting from the processes on risk scenarios developed for radiological and nuclear material control, Sogin, in collaboration with the University of Rome “Tor Vergata”, have defined a standard approach for analyzing the preparation of the border points in relation to both safety and security. The proposed approach take into consideration all the relevant aspects of the control such as instrumentation, control procedures and information exchange within the domestic infrastructure and with the other side of the border