The Bacau (Romania) phosphogypsum stacks as a source of radioactive threat: a case study.

For a detailed characterization of the 5.7 106 mt phosphogypsum (PG) stack in the vicinity of Bacau city, Romania, the air dose rate (ADR) was measured in 72 points covering the stack surface, while 10 samples of stack material were collected for future analysis. Radiometric determinations showed for the ADR values varying between 364 ± 53 and 489 ± 8 nSv/h, with some extreme values of 2775 ± 734 nSv/h, significantly exceeding 90 nSv/h, the average value reported for the Romanian territory. High-resolution gamma-ray spectroscopy (HRGS), performed on 10 samples collected from the entire PG stack evidenced only the presence of 226Ra as the major radioactive element with a specific activity varied between 820 ± 150 and 5278 ± 264 Bq/kg for hot spots. Further analysis performed on a similar number of samples by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), X-ray fluorescence (XRF), scanning electron microscopy (SEM) and energy dispersive X-ray spectrometry (EDX), evidenced, beside gypsum as the main component, traces of brushite (CaHPO4·2H2O) and ardealite (Ca2(PO3OH)(SO4)·4H2O), as well as the presence of small acicular celestine (SrSO4) agglomerates. XRF determinations of the mass fractions of major elements evidenced values such as SiO2 (2.31 ± 0.73 %), TiO2 (0.07 ± 0.01 %), Al2O3 (0.17 ± 0.04 %), Fe2O3 (0.87 ± 0.18 %), MnO (0.01 ± 0.01 %), MgO (0.17 ± 0.02 %), CaO (32.5 ± 0.82 %), Na2O (0.04 ± 0.04 %), K2O (0.05 ± 0.01 %), P2O5 (2.12 ± 0.51 %), LOI (20.2 ± 0.3 %), i.e. closer to literature reported data for PG of different provenience while the data concerning the distribution of 20 trace elements, including incompatible Sc, La, Ce, and Th were relatively closer to the upper continental crust (UCC).

Eosinophilic esophagitis as a side-effect of allergen immunotherapy: protocol for a systematic review and meta-analysis.

Summary: Background. Sensitization to food and airborne allergens is common in the majority of patients with eosinophilic esophagitis (EoE). Although there is not a direct cause-effect relationship of IgE-mediated allergy with the pathogenesis of EoE, there is a growing evidence that oral desensitization to food and sublingual immunotherapy (SLIT) may induce the development of EoE as an adverse effect. As part of the 'EoE and Allergen Immunotherapy (AIT)' Task Force funded by the European Academy of Allergy and Clinical Immunology (EAACI), a systematic approach will be followed to review the evidence from the published scientific literature on the development of EoE in children and adults under any type of AIT. Methods. This systematic review will be carried out following the PRISMA statement guidelines. Studies will be assessed for inclusion in the review according to the Population-Interventions-Comparators-Outcomes (PICO) criteria. Results. Expected outcomes will provide evidence on the AIT-EoE development connection. Conclusions. The findings from this review will be used as a reference to provide useful guidelines for physicians treating patients with EoE and/or are practicing AIT.

Isokinetic trunk training on pain, disability, and strength in non-specific low back pain patients: A systematic review and meta-analysis.

BACKGROUND: Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated with the occurrence of low back pain and its severity. Trunk strength training is helpful in the treatment of Non-specific low back pain (NSLBP) patients. However, we do not know the effects of trunk isokinetic training (IKT) on pain intensity, disability, and trunk strength. OBJECTIVE: This systematic review aimed to determine the effects of trunk IKT in NSLBP patients on pain intensity, disability, and trunk flexor and extensor isokinetic strength. METHODS: We searched PubMed, Web of Science, Scopus, CENTRAL, and PEDro, from January 2001 until March 2021 and updated to November 2022. Randomized controlled trials (RCTs) that investigated the effect of IKT in adult participants with NSLBP on pain intensity, disability, or isokinetic trunk strength were included. Mean difference (MD) and 95% confidence intervals (95% CI) were calculated for pain. Bias was assessed using the Cochrane risk of bias (RoB) tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Among 1750 retrieved articles, eight were included in this review. Meta-analysis comparing IKT (trunk isokinetic training, n= 134) with control groups (conventional exercises, n= 133) revealed that IKT decreases pain intensity (MD -1.50 (95% CI: -2.60; -0.39)) immediately post-intervention, and one month (MD -1.97 (95% CI: -2.92; -1.03)) and at six months follow-up (MD -2.48 (95% CI: -2.77; -2.19)), although with a very low to low quality according to the GRADE rating. Besides, IKT decreases disability and increases isokinetic trunk strength, but with scant evidence. CONCLUSIONS: Trunk IKT could be a novel clinical tool for pain management in patients with NSLBP, although evidence is scarce. In addition, few RCTs exist for IKT on disability or trunk isokinetic strength in patients with NSLBP. Therefore, further research on this topic is needed.

XAIRE: An ensemble-based methodology for determining the relative importance of variables in regression tasks. Application to a hospital emergency department.

Nowadays it is increasingly important in many applications to understand how different factors influence a variable of interest in a predictive modeling process. This task becomes particularly important in the context of Explainable Artificial Intelligence. Knowing the relative impact of each variable on the output allows us to acquire more information about the problem and about the output provided by a model. This paper proposes a new methodology, XAIRE, that determines the relative importance of input variables in a prediction environment, considering multiple prediction models in order to increase generality and avoid bias inherent in a particular learning algorithm. Concretely, we present an ensemble-based methodology that promotes the aggregation of results from several prediction methods to obtain a relative importance ranking. Also, statistical tests are considered in the methodology in order to reveal significant differences between the relative importance of the predictor variables. As a case study, XAIRE is applied to the arrival of patients in a Hospital Emergency Department, which has resulted in one of the largest sets of different predictor variables in the literature. Results show the extracted knowledge related to the relative importance of the predictors involved in the case study.

Resonance Excitations in

The anomaly in lithium abundance is a well-known unresolved problem in nuclear astrophysics. A recent revisit to the problem tried the avenue of resonance enhancement to account for the primordial ^{7}Li abundance in standard big-bang nucleosynthesis. Prior measurements of the ^{7}Be(d,p)^{8}Be^{*} reaction could not account for the individual contributions of the different excited states involved, particularly at higher energies close to the Q value of the reaction. We carried out an experiment at HIE-ISOLDE, CERN to study this reaction at E_{c.m.}=7.8 MeV, populating excitations up to 22 MeV in ^{8}Be for the first time. The angular distributions of the several excited states have been measured and the contributions of the higher excited states in the total cross section at the relevant big-bang energies were obtained by extrapolation to the Gamow window using the talys code. The results show that by including the contribution of the 16.63 MeV state, the maximum value of the total S factor inside the Gamow window comes out to be 167 MeV b as compared to earlier estimate of 100 MeV b. However, this still does not account for the lithium discrepancy.

Competition between Allowed and First-Forbidden ß Decay: The Case of

The ß decay of ^{208}Hg into the one-proton hole, one neutron-particle _{81}^{208}Tl_{127} nucleus was investigated at CERN-ISOLDE. Shell-model calculations describe well the level scheme deduced, validating the proton-neutron interactions used, with implications for the whole of the N>126, Z<82 quadrant of neutron-rich nuclei. While both negative and positive parity states with spin 0 and 1 are expected within the Q_{ß} window, only three negative parity states are populated directly in the ß decay. The data provide a unique test of the competition between allowed Gamow-Teller and Fermi, and first-forbidden ß decays, essential for the understanding of the nucleosynthesis of heavy nuclei in the rapid neutron capture process. Furthermore, the observation of the parity changing 0^{+}→0^{-}ß decay where the daughter state is core excited is unique, and can provide information on mesonic corrections of effective operators.

High concentrations of atorvastatin reduce in-vitro function of conventional T and regulatory T cells.

Regulatory T cells (Tregs ) modulate the magnitude of immune responses and possess therapeutic potential in an array of immune diseases. Statins reduce the activation and proliferation of conventional T cells (Tcons ), and they seem to up-regulate the frequency and function of Tregs . However, there is a lack of simultaneous evaluation of the in-vitro effect of statins on the functional profile of Tregs versus Tcons . Herein, magnetically purified Tcons and Tregs were stimulated with CD3/CD28/interleukin (IL)-2 in the presence of atorvastatin (ATV) at 1 or 10 µM. The suppressive function of Tregs , the expression of markers associated with Treg function, activation levels, cytokine production and calcium flux in both subpopulations were assessed by flow cytometry. ATV had no cytotoxic effect on T cells at the concentrations used. Interestingly, 10 µM ATV hampered the suppressive capacity of Tregs . Moreover, this higher concentration reduced the expression of forkhead box protein 3 (FoxP3), cytotoxic T lymphocyte antigen (CTLA-4) and programmed death 1 (PD-1). In Tcons , ATV at 10 µM decreased PD-1 and CD45RO expression. The expression of CD25, CD69, CD95, CD38, CD62L, CCR7 and perforin was not affected in both subpopulations or at any ATV concentrations. Remarkably, 10 µM ATV increased the percentage of tumour necrosis factor (TNF)-α-producing Tregs . Although there was a reduction of calcium flux in Tcons and Tregs , it was only significant in 10 µM ATV-treated Tcons . These results suggested that 10 µM ATV affects the cellular functions of both populations; however, this concentration particularly affected several aspects of Treg biology: its suppressive function, cytokine production and expression of Treg -specific markers.

Impact Of "eHealth" in Allergic Diseases and Allergic Patients.

The emergence of new technology enables allergists and patients to compile data and receive feedback regarding key symptoms, risk behavior, and/or management. The term "eHealth" refers to a diverse group of tools that use computerized technologies to improve both the efficacy and the efficiency of the health care industry. eHealth comprises a variety of technologies, as follows: mobile devices (mHealth) in medical care, including electronic diaries, wearable sensors, and adherence monitoring; health informatics (eg, electronic health records, computerized physician order entry, clinical decision support); telemedicine, which is the use of information and communication technologies for the management of diseases and medical education; social media platforms, and the analysis of information acquired through these platforms using "big data" technologies. In this review, we summarize the latest findings on the use of eHealth technology and the relevance of eHealth to allergic conditions.

First Accurate Normalization of the ß-delayed α Decay of

The ^{12}C(α,γ)^{16}O reaction plays a central role in astrophysics, but its cross section at energies relevant for astrophysical applications is only poorly constrained by laboratory data. The reduced α width, γ_{11}, of the bound 1^{-} level in ^{16}O is particularly important to determine the cross section. The magnitude of γ_{11} is determined via sub-Coulomb α-transfer reactions or the ß-delayed α decay of ^{16}N, but the latter approach is presently hampered by the lack of sufficiently precise data on the ß-decay branching ratios. Here we report improved branching ratios for the bound 1^{-} level [b_{ß,11}=(5.02±0.10)×10^{-2}] and for ß-delayed α emission [b_{ßα}=(1.59±0.06)×10^{-5}]. Our value for b_{ßα} is 33% larger than previously held, leading to a substantial increase in γ_{11}. Our revised value for γ_{11} is in good agreement with the value obtained in α-transfer studies and the weighted average of the two gives a robust and precise determination of γ_{11}, which provides significantly improved constraints on the ^{12}C(α,γ) cross section in the energy range relevant to hydrostatic He burning.

Social Media as a Tool for the Management of Food Allergy in Children.

BACKGROUND: Food allergy markedly impairs quality of life, and avoiding the offending food requires extensive patient education. Social media have been proven a useful source of information for other chronic conditions. Our aim was to describe how pediatric patients with food allergy and their families are using social media. METHODS: We performed a cross-sectional study in the pediatric allergy unit of a tertiary hospital. Patients with food allergy were questioned about their disease and their use of social media. The survey was completed by the patients themselves in the case of those aged over 13 years and by parents or guardians in the case of younger patients. RESULTS: We included 193 patients (162 guardians, 31 adolescents). Social media were used by 109 guardians (67.3%) and 29 adolescents (90.3%), of whom 30.3% and 6.9%, respectively, used them for food allergy-related purposes. The most popular websites were Facebook for guardians (52.2%) and YouTube for teenagers (80.6%). Having cow's milk and/or egg allergy was the only feature related to using social media for food allergy. Using social media for information on food allergy did not correlate with the frequency of recent reactions, self-scored knowledge about food allergy, or opinion on evidence-based or alternative therapies for the disease. CONCLUSIONS: Most patients and guardians of patients with food allergy used social media. However, only a small portion accessed used them to increase their knowledge of the disease.

Food protein-induced enterocolitis syndrome by fish: Not necessarily a restricted diet.

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow's milk or soy. Recent researches show that fish is 1 of the most important triggers of FPIES in the Mediterranean countries. Due to the risk of multiple-food FPIES, avoiding foods in the same category or that often occur together may be reasonable. The aim of this study was to evaluate the evolution and follow-up of FPIES related to fish over a period of 20 years. We describe the clinical features of our population, discuss different approaches to oral food challenges, and analyze the possibility of introducing the culprit fish or other nonrelated fish to avoid unnecessary restricted diets.

Cat scratch disease: U.S. clinicians' experience and knowledge.

Cat scratch disease (CSD) is a zoonotic infection caused primarily by the bacterium Bartonella henselae. An estimated 12,000 outpatients and 500 inpatients are diagnosed with CSD annually, yet little is known regarding clinician experience with and treatment of CSD in the United States. Questions assessing clinical burden, treatment and prevention of CSD were posed to 3,011 primary care providers (family practitioners, internists, paediatricians and nurse practitioners) during 2014-2015 as part of the annual nationwide DocStyles survey. Among the clinicians surveyed, 37.2% indicated that they had diagnosed at least one patient with CSD in the prior year. Clinicians in the Pacific and Southern regions were more likely to have diagnosed CSD, as were clinicians who saw paediatric patients, regardless of specialty. When presented with a question regarding treatment of uncomplicated CSD, only 12.5% of clinicians chose the recommended treatment option of analgesics and monitoring, while 71.4% selected antibiotics and 13.4% selected lymph node aspiration. In a scenario concerning CSD prevention in immunosuppressed patients, 80.6% of clinicians chose some form of precaution, but less than one-third chose the recommended option of counseling patients to treat their cats for fleas and avoid rough play with their cats. Results from this study indicate that a substantial proportion of U.S. clinicians have diagnosed CSD within the past year. Although published guidelines exist for treatment and prevention of CSD, these findings suggest that knowledge gaps remain. Therefore, targeted educational efforts about CSD may benefit primary care providers.

Scattering of the Halo Nucleus

Angular distributions of the elastic, inelastic, and breakup cross sections of the halo nucleus ^{11}Be on ^{197}Au were measured at energies below (E_{lab}=31.9 MeV) and around (39.6 MeV) the Coulomb barrier. These three channels were unambiguously separated for the first time for reactions of ^{11}Be on a high-Z target at low energies. The experiment was performed at TRIUMF (Vancouver, Canada). The differential cross sections were compared with three different calculations: semiclassical, inert-core continuum-coupled-channels and continuum-coupled-channels ones with including core deformation. These results show conclusively that the elastic and inelastic differential cross sections can only be accounted for if core-excited admixtures are taken into account. The cross sections for these channels strongly depend on the B(E1) distribution in ^{11}Be, and the reaction mechanism is sensitive to the entanglement of core and halo degrees of freedom in ^{11}Be.

Phenotypical characterization of regulatory T cells in humans and rodents.

Regulatory T cells (Tregs ) constitute a fascinating subpopulation of CD4(+) T cells due to their ability to limit the immune response against self and non-self antigens. Murine models and antibodies directed against surface and intracellular molecules have allowed elucidation of the mechanisms that govern their development and function. However, these markers used to their classification lack of specificity, as they can be expressed by activated T cells. Similarly, there are slight differences between animal models, in steady state and pathological conditions, anatomical localization and strategy of analysis by flow cytometry. Here, we revised the most common markers utilized for Treg typification by flow cytometry such as CD25, forkhead box protein 3 (FoxP3) and CD127, along with our data obtained in different body compartments of humans, mice and rats. Furthermore, we revised and determined the expression of other molecules important for the phenotypical characterization of Treg cells. We draw attention to the drawbacks of those markers used in chronic states of inflammation. However, until a specific marker for the identification of Tregs is discovered, the best combination of markers will depend upon the tissue or the degree of inflammation from which Tregs derive.

Optimizing the combined application of amendments to allow plant growth in a multielement-contaminated soil.

This study was aimed to 1) properly understand the dynamics of toxic elements (Al, Fe, Mn, Cu, Pb, Zn and As) in a sulphide-mine soil after combined application of compost from urban sewage sludge (SVC) and bottom ashes from biomass combustion (BA) and to 2) optimize the combination of both amendments for vegetation growth. Soil was amended following a D-optimal design and the mixtures (15 in total) were incubated during 30 d. At the end of the incubation, the effects of amendments on the assessed variables as well as the process modelling were evaluated by Response Surface Methodology (RSM). The process modelling confirmed that quadratic models were adequate to explain the behaviour of the assessed variables (R(2) ≥ 0.94 and Q(2) ≥ 0.75). Both amendments significantly increased pH and electrical conductivity, while reduced metal extractability. A different behaviour of As respect to metals was observed and high doses of BA sharply increased its extractability. The optimization process indicated that adequate conditions for vegetation growth would be reached adding the soil with 6.8% of SVC and 3.1% of BA (dry weight). After amendments application the germination and root elongation of three energy crops were significantly increased while lipid peroxidation was decreased. Therefore, the combined application of SVC and BA to a contaminated soil could improve soil conditions and might be expected to have an advantage during plant growth. Moreover, the RSM could be a powerful technique for the assessment of combined amendment effects on soil properties and their effective application in multielement-contaminated soils.

Anaphylaxis in Adolescent/Adult Patients Treated in the Emergency Department: Differences Between Initial Impressions and the Definitive Diagnosis.

OBJECTIVES: To contrast the initial suspected etiology of anaphylaxis with the postworkup diagnosis in patients attended at the emergency department (ED) of a tertiary-level hospital in Spain and to investigate the incidence, causes, and management of anaphylaxis. METHODS: We performed an observational study of patients aged more than 15 years who came to the ED with anaphylaxis between 2009 and 2010. All clinical records from the ED were reviewed. We recorded data on clinical management, the etiology proposed by the attending emergency physician, and the cause reported by the patient. The findings were compared with the diagnosis reached after the allergy workup. RESULTS: The incidence of anaphylaxis was 0.08%. The most common manifestation was skin-mucosal symptoms (98.3%). Anaphylaxis was diagnosed in the ED in only 44% of the cases, regardless of severity. Only 39.7% received epinephrine, which was administered more frequently when the ED physician diagnosed anaphylaxis, regardless of severity. A total of 60 patients were subsequently seen at the allergy department. The final etiology differed from the initial suspicion in the ED in 45% of cases. The frequency of anaphylaxis of uncertain origin decreased from 33.3% to 13.3%. After the allergy workup, drugs (41.7%) were considered the main cause of anaphylaxis, followed by food (25%). CONCLUSIONS: The incidence of anaphylaxis (0.08%) was double that estimated in the ED. Anaphylaxis is underdiagnosed. A correct diagnosis conditions the administration of epinephrine, regardless of the severity of symptoms. The real etiology of anaphylaxis should only be proposed after an allergy workup, which is recommended in all cases, as the real cause can differ considerably from the initial impression in the ED.