Proton fields delivered by the active scanning technique can be interfered with the intrafractional motion. This in-silico study seeks to mitigate the dosimetric impacts of motion artifacts, especially its interplay with the time-modulated dose delivery. Here four-dimensional (4d) robust optimization and dose repainting, which is the multiple application of the same field with reduced fluence, were combined. Two types of repainting were considered layered and volumetric repainting. The time-resolved dose calculation, which is necessary to quantify the interplay effect, was integrated into the treatment planning system and validated. Nine clinical cases of hepatocellular carcinoma (HCC) showing motion in the range of 0.4-1.5cm were studied. It was found that the repainted delivery of 4D robustly optimized plans reduced the impact of interplay effect as quantified by the homogeneity index within the clinical target volume (CTV) to a tolerable level. Similarly, the fractional over- and underdosage was reduced sufficiently for some HCC cases to achieve the purpose of motion management. This holds true for both investigated types of repainting with small dosimetric advantages of volume repainting over layered repainting. Volume repainting, however, cannot be applied clinically in proton centers with slow energy changes. Thus, it served as a reference in the in-silico evaluation. It is recommended to perform the dynamic dose calculation for individual cases to judge if robust optimization in conjunction with repainting is sufficient to keep the interplay effect within bounds. To describe rates and types of critical incidents in Intensive Care Units. A retrospective study in four intensive care units of an Academic Hospital located in the North-East of Italy. All critical incidents recorded in an incident reporting system database from 2013 to 2017 were collected. 160 critical incidents emerged. The rate was 1.7/100 intensive care-patient admissions, and 2.86/1000 in intensive care-patient days. Nurses reported most of the critical incidents (n=113, 70.6%). In 2013 there were 19 (11.9%) critical incidents which significantly increased by 2017 (n=38, 23.7%; p=0.034). The most frequent critical incidents were medication/intravenous fluids issues (n=35, 21.9%) and resources and organisational management (n=35, 21.9%). Less frequently occurring incidents concerned medical devices/equipment (n=29, 18.1%), clinical processes/procedures (n=18, 11.3%), documentation (n=14, 8.8%) and patient accidents (n=13, 8.1%). Rare incidents included behaviour, clinical administration, nutrition, blood products and healthcare associated infection. Over a five-year period, documented incidents were steadily increasing in four Italian intensive care units. A voluntary incident reporting system might provide precious information on safety issues occurring in units. at both policy and professional levels.Over a five-year period, documented incidents were steadily increasing in four Italian intensive care units. A voluntary incident reporting system might provide precious information on safety issues occurring in units. at both policy and professional levels.The current Canadian and Romanian model predictions for tritium dose following an atmospheric tritiated hydrogen gas (HT) release is based on a default Canadian Standards Association (CSA) conversion factor of HT to tritiated water (HTO) of 4.3%. The determination of an empirical site specific value for the conversion factor was essential for the CANDU Cernavoda Nuclear Power Plant (NPP) in Romania to verify if the CSA value is appropriate for use at this site. Given the role of soil characteristics on the conversion of HT to HTO, on-site experiments would provide the best evaluation of the conversion factor. The objective of the study was to define the soil HT to HTO conversion parameters specific to the Cernavoda NPP site. In June 2016, a series of experiments were conducted to meet this objective. First, the in situ deposition velocity of D2 gas, as a surrogate for HT gas, was obtained using an exposure chamber. Diffusion of D2 into the soil was then evaluated based on the measurements of DHO concentrations in the exposed soil. As soil microbes play a role in the conversion of HT to HTO, this work included a microbiological characterization of the soil, which targeted total soil bacteria (cultivable and gene-based) and hydrogen oxidizing bacteria (cultivable and gene-based). The fraction of hydrogen oxidizing cultivable soil bacteria represented 14-20% of the total cultivable bacteria population estimated as 2.8-29.2 × 105 cfu/g of soil. The empirically derived HT to HTO conversion factor was lower than the default value (4.3%). It fell between 0.9% and 2.0%. The default value is therefore more conservative than the Cernavoda site-specific derived value obtained from the study. The oral administration of insulin has so far been precluded by gastro-intestinal enzyme degradation and poor intestinal absorption. Preliminary evidence for peptide uptake by the gut has recently been obtained, by our research group, following the administration of nanostructured lipid-carrier suspensions loaded with glargine insulin in healthy animal models. In this experimental study, glargine insulin-loaded nanostructured lipid carriers have been converted into solid oral dosage forms (tablets, capsules), that are more suitable for administration in humans and have prolonged shelf-life. The liquid and solid oral dosage forms were tested for glargine insulin uptake and glucose responsivity in healthy and streptozotocin-induced diabetic rats (6 animals in each group). A suitable composition gave redispersible solid oral dosage forms from glargine insulin-loaded carriers, using both spray-drying and freeze-drying. It was observed that the liquid and solid formulations had relevant hypoglycaemic effects in healthy rats, while only capsules were efficacious in diabetic rats; probably because of gut alterations in these animal models. Detected glargine insulinaemia was consistent with a glycaemic profile. The formulations under study showed their potential as oral glucose-lowering agents, particularly when used as capsules. However, further study is needed to produce a useful orally-active insulin preparation.The formulations under study showed their potential as oral glucose-lowering agents, particularly when used as capsules. Flonoltinib However, further study is needed to produce a useful orally-active insulin preparation.