Government policies to enhance access to credit for infrastructure-based PPPs:an approach to classification and appraisal

Analysis of ways the public sector can ease the use of private money for infrastructure financing

Introduction of Potentially Allergenic Foods in the Infant's Diet during the First Year of Life in Five European Countries

Background: Little information is available on infants' age at first introduction of potentially allergenic foods as part of complementary feeding. We aimed to analyze age at the introduction of potentially allergenic foods in healthy term infants relative to recommendations in 5 European countries. Method: Recruitment was conducted from October 2002 to June 2004. A total of 1,678 infants {[}588 breastfed (BF) and 1,090 formula-fed (FF) infants] were studied. In 1,368 infants, at least one 3-day weighed food diary at the age of 1-9 and 12 completed months was available. Results: Six percent of BF infants and 13% of FF infants consumed some potentially allergenic food already prior to the recommended minimum age of 4 months, and 4% of BF infants and 11% of FF infants had already received gluten. There were significant differences in the timing of the introduction of potentially allergenic foods between the countries at the age of 4-6 months (p < 0.001). Conclusion: The time of first introduction of potentially allergenic foods in infants differed significantly between countries, and they were introduced much earlier than recommended in some countries. FF infants received potentially allergenic foods earlier than BF infants. Better information and counseling of parents is desirable. Copyright (C) 2011 S. Karger AG, Base

A Bioinspired Fluid-Filled Soft Linear Actuator

In bioinspired soft robotics, very few studies have focused on fluidic transmissions and there is an urgent need for translating fluidic concepts into realizable fluidic components to be applied in different fields. Nature has often offered an inspiring reference to design new efficient devices. Inspired by the working principle of a marine worm, the sipunculid species Phascolosoma stephensoni (Sipunculidae, Annelida), a soft linear fluidic actuator is here presented. The natural hydrostatic skeleton combined with muscle activity enables these organisms to protrude a part of their body to explore the surrounding. Looking at the hydrostatic skeleton and protrusion mechanism of sipunculids, our solution is based on a twofold fluidic component, exploiting the advantages of both pneumatic and hydraulic actuations and providing a novel fluidic transmission mechanism. The inflation of a soft pneumatic chamber is associated with the stretch of an inner hydraulic chamber due to the incompressibility of the liquid. Actuator stretch and forces have been characterized to determine system performance. In addition, an analytical model has been derived to relate the stretch ability to the inlet pressure. Three different sizes of prototypes were tested to evaluate the suitability of the proposed design for miniaturization. The proposed actuator features a strain equal to 40–50% of its initial length—depending on size—and output forces up to 18 N in the largest prototypes. The proposed bioinspired actuator expands the design of fluidic actuators and can pave the way for new approaches in soft robotics with potential application in the medical field

Evaluating assumptions of scales for subjective assessment of thermal environments – Do laypersons perceive them the way, we researchers believe?

International audienc

Sedimentary response of the Po Basin to Mid-Late Pleistocene glacio-eustatic oscillations

The Middle and Late Pleistocene were characterized by high-amplitude climate and sea-level oscillations that deeply influenced the evolution of alluvial and coastal systems worldwide. Through the correlation of 43 cores and 168 well data, with the aid of pollen, meiofauna, 14C, ESR and IRSL data, this work provides a detailed reconstruction of the Middle Pleistocene to Holocene stratigraphy of the Po Basin and explores the sedimentary response of the Po-Adriatic alluvial-coastal system to glacio-eustatic oscillations and other concomitant forcing factors. The Middle Pleistocene to Holocene sedimentary succession of the Po Basin is composed of alluvial, paralic, coastal and shallow-marine facies associations arranged in an overall shallowing-upward trend. This general trend is punctuated by the rhythmical alternation of progradationally stacked coastal wedges with thick alluvial deposits. At landward locations, where the coastal facies wedge out, the depositional cyclicity records alternating paralic and alluvial facies associations. The overall shallowing-upward trend documents the longer-term, progressive filling of the basin driven by high sediment supply which overcame the rate of creation of accommodation induced by subsidence. The cyclic arrangement of facies, paralleled by rhythmical changes in vegetation, reflects Milankovitch-scale, glacio-eustatic oscillations in the 100 ka band. Increasing subsidence towards the sea and the activity of selected sectors of the buried Apennine thrust front, might have enhanced the seaward migration of coastal wedges. This study provides clues on the sedimentary response of a low-gradient coastal system to dramatic climatic and eustatic changes. The model of basin evolution presented here may help predict the environmental modifications of coastal areas in near future scenarios of climate and sea-level change

Acquisti sanitari: la pandemia e il consolidamento del mercato. L’urgenza di traiettorie evolutive

Il capitolo presenta una fotografia dettagliata sugli acquisti legati alla gestione della pandemia e presenta gli esempi di acquisti value-based realizzati da ESTAR Toscana

Procurement sanitario: aggiornamento sullo stato della centralizzazione degli acquisti e tendenze emergenti nell’attuazione del PNRR

Il capitolo fornisce un aggiornamento degli assetti istituzionali e operativi delle centrali di acquisto regionali e dei risultati dell’attività di centralizzazione, ed approfondisce e discute le implicazioni di procurement relative alla realizzazione degli investimenti della Missione 6 del PNRR

Impact of Polyhexanide Care Bundle on Surgical Site Infections in Paediatric and Neonatal Cardiac Surgery: A Propensity Score‐Matched Retrospective Cohort Study

The primary aim of this study was to evaluate the impact of the polyhexamethylene biguanide (PHMB) care bundle on the occurrence rates of surgical site infections (SSIs) in paediatric and neonatal cardiac surgery, addressing a critical gap in paediatric-specific infection prevention protocols. A retrospective cohort study included patients under 18 years old who underwent cardiac surgery at IRCCS Policlinico San Donato. Cohort A (n = 117) received the PHMB care bundle from April to December 2023, while Cohort B (n = 801) received conventional care from September 2020 to March 2023. The 1:1 propensity score matching was used to balance covariates between cohorts, resulting in two comparable cohorts (Cohort A = 114 patients and Cohort B = 112). The study found a significant reduction in SSIs among patients receiving the PHMB care bundle compared with those receiving conventional care (1.8% vs. 7.1%, p = 0.048). The comprehensive nature of the PHMB care bundle, including educational programs, preoperative and postoperative antimicrobial treatments, and consistent application of best practices, was instrumental in achieving these outcomes. Implementing antimicrobial care bundles could significantly reduce SSIs in paediatric cardiac surgery. Future research is needed to refine the tested bundle with prospective approaches

Implementation, availability and regulatory status of an OECD accepted Reconstructed Human Epidermis model in Brazil

Introduction: In 2014, Brazil has joined the growing list of countries to ban cosmetic products from being tested on animal models. The new legislation comes into force in 2019. As a result, the interest for validated alternative testing methods for safety assessment has been increasing in academia, industry and associations. However, the lack of specific legislation on the use of biological material of human origin for toxicological tests makes the access to alternative in vitro models difficult. Furthermore, importation to Brazil is not possible on timely manner. Method: In this article, we report the implementation process of a Reconstructed Human Epidermis (SkinEthic™ RHE), an alternative model internationally accepted by OECD, through a technology transfer from EPISKIN® Lyon to Brazil. Regulatory evolution has been motivating the implementation and wide use of alternative methods to animal testing in several industry segments including cosmetic and pharmaceutical. Results: Protocol has been shown to be robust and highly reproducible. Quality control parameters (histological analysis, barrier function test and tissue viability) were performed on 24 batches assembled in Brazil. SkinEthic™ RHE model use allows the full replacement of animal test methods for skin hazards identification. It has regulatory acceptance for several toxicological endpoints, such as the Draize test for skin irritation and corrosion. It allows the reduction and refining of pre-clinical protocols through tiered strategies. Implementation of SkinEthic™ RHE protocol is just a first and important step towards a new approach of toxicological safety testing in Brazil. Conclusion: The implementation was successfully done and reported here. However, in order to follow completely the new legislation up to 2019, the availability of validated models is essential. Quality control tests done on RHE batches produced in Brazil demonstrate that the model met OECD acceptance criteria and therefore can be used for reliable prediction of irritation and corrosion classification.TÍTULO PT: Implementação, disponibilidade e contexto regulatório de um modelo de Epiderme Humana Reconstruída no Brasil aceito pela OECDIntrodução: Em 2014, o Brasil aderiu à crescente lista de países a banir testes de produtos cosméticos em modelos animais. A nova legislação entra em vigor em 2019. Como resultado, o interesse em métodos de testes alternativos validados para avaliação de segurança tem aumentado na academia, indústria e associações. No entanto, a falta de legislação específica sobre o uso de material biológico de origem humana para testes toxicológicos dificulta o acesso aos modelos alternativos in vitro. Além disso, a importação no Brasil não é possível em tempo hábil. Método: Neste artigo, relatamos o processo de implementação de um modelo de Epiderme Humana Reconstruída (SkinEthic™ RHE) internacionalmente aceito pela OECD, através de uma transferência tecnológica da Episkin Lion para o Brasil, bem como discutimos a evolução regulatória que tem motivado a implementação e a ampla utilização de métodos alternativos à experimentação animal em diversos segmentos além do cosmético e farmacêutico. Resultados: O protocolo de fabricação dos tecidos mostrou-se robusto e altamente reprodutível, considerando os parâmetros de controle de qualidade (análise histológica, função barreira e viabilidade tecidual) analisados em 24 lotes fabricados no Brasil. Conclusões: A implementação do modelo SkinEthic™ RHE é apenas um primeiro e importante passo em direção a uma nova abordagem para testes de segurança toxicológica no Brasil, realizada com êxito e aqui relatada. No entanto, para seguir plenamente a nova legislação até 2019, a disponibilidade de modelos validados é essencial. Os testes de controle de qualidade realizados nos lotes RHE produzidos no Brasil demonstram que o modelo atende aos critérios de aceitação da OCDE e, portanto, pode ser usado para uma previsão confiável de irritação e classificação de compostos corrosivos