Transportation of hazardous materials via pipeline. A historical overview

The transportation of hazardous materials via pipelines is often considered a safer alternative to other transportation modalities such as railway, road and ship. However, pipelines often cross industrial and highly populated areas, so that their failure can pose a significant risk to the surrounding environment and the exposed population: the possible release of flammable and/or toxic materials in such areas can generate catastrophic events with very severe consequences. A number of accidents have actually occurred in the past years, and even when no deaths or injured are reported, significant damages to the surrounding environment often occur. This suggests that, given the extremely wide extension of the network worldwide, and the very high amounts of transported materials, a careful analysis is still required. In addition, the construction of pipelines also involves the contribution of expertise from a range of technical areas. As a consequence, the occurrence of accidents and the impact of their consequences, depend on the combination of a large number of parameters. In the present paper, an analysis of data relative to pipelines transporting hazardous materials has been carried out, and the influence of specific issues connected with their type and operation, has been assessed

Ukrainian refugee crisis management in the Local Health Authority Roma 1: the challenges of implementing public health policies and lessons learned

Background: The conflict between Russia and Ukraine has strained the health systems of countries that welcome war refugees on all levels, from national to local. Despite the Public Health guidelines regarding assistance being published on the topic, the scientific literature currently lacks evidence on the experience of applying theory in practice. This study aims to describe evidence-based practices that were implemented and to provide a detailed description of emerging problems and solutions pertaining Ukrainian refugee assistance in the context of one of the biggest Local Health Authorities in Italy (LHA Roma 1). Methods: LHA Roma 1 developed a strategic plan based on local expertise, national and international guidelines to ensure infectious disease prevention and control, as well as continuity of care for non-communicable diseases and mental health. Results: The insertion of Ukrainian refugees in the National Health System through an identification code assignment and other services such as COVID-19 swab and vaccination were provided either in one of the three major assistance hubs or in local district level ambulatories spread throughout the LHA. Many challenges were faced during the implementation phase of the outlined practice guidelines, which required sensible and timely solutions. These challenges include the necessity of rapid resource provision, overcoming linguistic and cultural barriers, guaranteeing a standard of care across multiple sites and coordination of interventions. Public Private Partnerships, the creation of a centralized multicultural and multidisciplinary team and the mutually beneficial collaboration with the local Ukrainian community were essential to guarantee the success of all operations. Conclusions: The experience of LHA Roma 1 helps shed light on the importance of leadership in emergency settings and how a dynamic relationship between policy and practice would allow each intervention to be modulated according to the local environment, to better realize the potential of local realities to provide appropriate health interventions to all those in need

The CUORE cryostat: an infrastructure for rare event searches at millikelvin temperatures

The CUORE experiment is the world's largest bolometric experiment. The detector consists of an array of 988 TeO2 crystals, for a total mass of 742 kg. CUORE is presently taking data at the Laboratori Nazionali del Gran Sasso, Italy, searching for the neutrinoless double beta decay of 130Te. A large custom cryogen-free cryostat allows reaching and maintaining a base temperature of about 10 mK, required for the optimal operation of the detector. This apparatus has been designed in order to achieve a low noise environment, with minimal contribution to the radioactive background for the experiment. In this paper, we present an overview of the CUORE cryostat, together with a description of all its sub-systems, focusing on the solutions identified to satisfy the stringent requirements. We briefly illustrate the various phases of the cryostat commissioning and highlight the relevant steps and milestones achieved each time. Finally, we describe the successful cooldown of CUORE

Search for Neutrinoless Double-Beta Decay of 130^{130}Te with CUORE-0

We report the results of a search for neutrinoless double-beta decay in a 9.8~kg$\cdot$yr exposure of $^{130}$Te using a bolometric detector array, CUORE-0. The characteristic detector energy resolution and background level in the region of interest are $5.1\pm 0.3{\rm~keV}$ FWHM and $0.058 \pm 0.004\,(\mathrm{stat.})\pm 0.002\,(\mathrm{syst.})$~counts/(keV$\cdot$kg$\cdot$yr), respectively. The median 90%~C.L. lower-limit sensitivity of the experiment is $2.9\times 10^{24}~{\rm yr}$ and surpasses the sensitivity of previous searches. We find no evidence for neutrinoless double-beta decay of $^{130}$Te and place a Bayesian lower bound on the decay half-life, $T^{0\nu}_{1/2}>$~$2.7\times 10^{24}~{\rm yr}$ at 90%~C.L. Combining CUORE-0 data with the 19.75~kg$\cdot$yr exposure of $^{130}$Te from the Cuoricino experiment we obtain $T^{0\nu}_{1/2} > 4.0\times 10^{24}~\mathrm{yr}$ at 90%~C.L.~(Bayesian), the most stringent limit to date on this half-life. Using a range of nuclear matrix element estimates we interpret this as a limit on the effective Majorana neutrino mass, $m_{\beta\beta}< 270$ -- $760~\mathrm{meV}$.Comment: 6 pages, 5 figures, updated version as published in PR

Analysis Techniques for the Evaluation of the Neutrinoless Double-Beta Decay Lifetime in 130^{130}Te with CUORE-0

We describe in detail the methods used to obtain the lower bound on the lifetime of neutrinoless double-beta ($0\nu\beta\beta$) decay in $^{130}$Te and the associated limit on the effective Majorana mass of the neutrino using the CUORE-0 detector. CUORE-0 is a bolometric detector array located at the Laboratori Nazionali del Gran Sasso that was designed to validate the background reduction techniques developed for CUORE, a next-generation experiment scheduled to come online in 2016. CUORE-0 is also a competitive $0\nu\beta\beta$ decay search in its own right and functions as a platform to further develop the analysis tools and procedures to be used in CUORE. These include data collection, event selection and processing, as well as an evaluation of signal efficiency. In particular, we describe the amplitude evaluation, thermal gain stabilization, energy calibration methods, and the analysis event selection used to create our final $0\nu\beta\beta$ decay search spectrum. We define our high level analysis procedures, with emphasis on the new insights gained and challenges encountered. We outline in detail our fitting methods near the hypothesized $0\nu\beta\beta$ decay peak and catalog the main sources of systematic uncertainty. Finally, we derive the $0\nu\beta\beta$ decay half-life limits previously reported for CUORE-0, $T^{0\nu}_{1/2}>2.7\times10^{24}$ yr, and in combination with the Cuoricino limit, $T^{0\nu}_{1/2}>4.0\times10^{24}$ yr.Comment: 18 pages, 18 figures. (Version 3 reflects only minor changes to the text. Few additional details, no major content changes.

Measurement of the Two-Neutrino Double Beta Decay Half-life of 130^{130}Te with the CUORE-0 Experiment

We report on the measurement of the two-neutrino double beta decay half-life of $^{130}$Te with the CUORE-0 detector. From an exposure of 33.4 kg$\cdot$y of TeO$_2$, the half-life is determined to be $T_{1/2}^{2\nu}$ = [8.2 $\pm$ 0.2 (stat.) $\pm$ 0.6 (syst.)] $\times$ 10$^{20}$y. This result is obtained after a detailed reconstruction of the sources responsible for the CUORE-0 counting rate, with a specific study of those contributing to the $^{130}$Te neutrinoless double beta decay region of interest.Comment: Corrected typo in section 9: 3.43E5 Bq/kg should have read 3.43E-5 Bq/k

Antipsychotic prescribing for vulnerable populations: a clinical audit at an acute Australian mental health unit at two-time points

Background: Antipsychotics are recognised as a critical intervention for schizophrenia and bipolar disorder. Guidelines globally endorse the routine practice of antipsychotic monotherapy, at the minimum effective dose. Even in treatmentresistant schizophrenia, clozapine use is endorsed before combining antipsychotics. This aim of this study was to review antipsychotic polytherapy alone, high-dose therapy alone, polytherapy and highdose prescribing patterns in adults discharged from an inpatient mental health unit at two time-points, and the alignment of this prescribing with clinical guideline recommendations. Additionally, associations with polytherapy and high-dose antipsychotic prescribing, including patient and clinical characteristics, were explored. Methods: A retrospective clinical audit of 400 adults (200 patients at two different time-points) discharged with at least one antipsychotic. Preliminary findings and education sessions were provided to physicians between Cohorts. Outcomes (polytherapy alone, high-dose therapy alone, polytherapy and high-dose therapy) were compared between study Cohorts using chi-squared and rank-sum tests. Associations between outcomes and covariates were assessed using multivariable logistic regression. Results: Most patients (62.5%) were discharged on a single antipsychotic within the recommended dose range. There was a clear preference for prescribing second generation antipsychotics, and in this respect, prescribing is aligned with current evidence-based guidelines. However, sub-optimal prescribing practices were identified for both Cohorts in relation to polytherapy and high-dose antipsychotic rates. Involuntary treatment, frequent hospitalisations and previous clozapine use significantly increased the risk of all three prescribing outcomes at discharge. Conclusions: In a significant minority, antipsychotic prescribing did not align with clinical guidelines despite increased training, indicating that the education program alone was ineffective at positively influencing antipsychotic prescribing practices. Further consideration should be given when prescribing antipsychotics for involuntary patients, people with frequent hospitalisations, and those who have previously trialled clozapine

Calcium-Dependent Increases in Protein Kinase-A Activity in Mouse Retinal Ganglion Cells Are Mediated by Multiple Adenylate Cyclases

Neurons undergo long term, activity dependent changes that are mediated by activation of second messenger cascades. In particular, calcium-dependent activation of the cyclic-AMP/Protein kinase A signaling cascade has been implicated in several developmental processes including cell survival, axonal outgrowth, and axonal refinement. The biochemical link between calcium influx and the activation of the cAMP/PKA pathway is primarily mediated through adenylate cyclases. Here, dual imaging of intracellular calcium concentration and PKA activity was used to assay the role of different classes of calcium-dependent adenylate cyclases (ACs) in the activation of the cAMP/PKA pathway in retinal ganglion cells (RGCs). Surprisingly, depolarization-induced calcium-dependent PKA transients persist in barrelless mice lacking AC1, the predominant calcium-dependent adenylate cyclase in RGCs, as well as in double knockout mice lacking both AC1 and AC8. Furthermore, in a subset of RGCs, depolarization-induced PKA transients persist during the inhibition of all transmembrane adenylate cyclases. These results are consistent with the existence of a soluble adenylate cyclase that plays a role in calcium-dependent activation of the cAMP/PKA cascade in neurons

The characteristics and activities of child and adolescent mental health services in Italy: a regional survey

<p>Abstract</p> <p>Background</p> <p>To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS). This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence.</p> <p>The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants) with a target population of 633,725 subjects aged 0-17 years.</p> <p>Methods</p> <p>Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009), which were then analysed in detail.</p> <p>Results</p> <p>Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%). First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years.</p> <p>Conclusion</p> <p>The percentage of young people in contact with CAMHS for mental disorders is in line with those observed in previous epidemiological studies. The overall number of child psychiatrists per 100,000 inhabitants is one of the highest in Europe and it is comparable with the most well equipped areas in the US. This comparison should be interpreted with caution, however, because in Italy, child psychiatrists also treat neurological disorders. Critical areas requiring improvement are: the uneven utilisation of standardised assessment procedures and the limited availability of dedicated emergency services during non-office hours (e.g., nights and holidays).</p