Gamma-ray sources imaging and test-beam results with MACACO III Compton camera.

Hadron therapy is a radiotherapy modality which offers a precise energy deposition to the tumors and a dose reduction to healthy tissue as compared to conventional methods. However, methods for real-time monitoring are required to ensure that the radiation dose is deposited on the target. The IRIS group of IFIC-Valencia developed a Compton camera prototype for this purpose, intending to image the Prompt Gammas emitted by the tissue during irradiation. The system detectors are composed of Lanthanum (III) bromide scintillator crystals coupled to silicon photomultipliers. After an initial characterization in the laboratory, in order to assess the system capabilities for future experiments in proton therapy centers, different tests were carried out in two facilities: PARTREC (Groningen, The Netherlands) and the CNA cyclotron (Sevilla, Spain). Characterization studies performed at PARTREC indicated that the detectors linearity was improved with respect to the previous version and an energy resolution of 5.2 % FWHM at 511 keV was achieved. Moreover, the imaging capabilities of the system were evaluated with a line source of 68Ge and a point-like source of 241Am-9Be. Images at 4.439 MeV were obtained from irradiation of a graphite target with an 18 MeV proton beam at CNA, to perform a study of the system potential to detect shifts at different intensities. In this sense, the system was able to distinguish 1 mm variations in the target position at different beam current intensities for measurement times of 1800 and 600 s.

Consensus on complementary feeding from the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition: COCO 2023.

Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.

Influence of weather conditions and projected climate change scenarios on the suitability of Vitis vinifera cv. Carignan in Rioja DOCa, Spain.

Grape development and its quality are highly dependent on soil and weather conditions. Under the progressive warming, which can affect the suitability of typical varieties grown in a given area, the knowledge of the vine response to changes in climate is essential to stablish strategies to maintain the viticulture sector. This research presents an analysis of phenology and grape composition of the Carignan cultivar, during a 13-year period, at two locations in Rioja DOCa. Based on the results obtained and the projected changes in climate under climate change scenarios (RC4.5 and RCP8.5), the response of this cultivar was evaluated. Differences in the phenological dates of up to 18, 29 and 40 days, for flowering, veraison and harvest, respectively, were observed between the warmest and the coolest years. An advance of up to 5, 8 and 11 days, respectively, for the mentioned stages, is projected under the RCP4.5 scenario by 2050, which could be near 1.5*times higher under the RCP8.5 scenario. These advances will be mainly driven by the temperatures recorded in the previous period. Grape acidity was mainly driven by water availability, in particular during ripening, which imply a slight projected reduction due to precipitation changes but not significant effect due to increasing temperatures. The phenolic composition could be positively affected by increasing temperatures and increasing water deficits, since this variety does not always reach a complete maturity at present. Thus, under the projected warming scenarios, the suitability of Carignan in Rioja DOCa was confirmed.

Survival of COVID-19 with Multimorbidity Patients.

BACKGROUND: The outbreak of SARS-CoV-2 abruptly disseminated in early 2020, overcoming the capacity of health systems to respond the pandemic. It was not until the vaccines were launched worldwide that an increase in survival was observed. The objectives of this study were to analyse the characteristics of survivors and their relationship with comorbidities. We had access to a database containing information on 16,747 hospitalized patients from Mexico, all infected with SARS-CoV-2, as part of a regular follow-up. The descriptive analysis looked for clusters of either success or failure. We categorized the samples into no comorbidities, or one and up to five coexisting with the infection. We performed a logistic regression test to ascertain what factors were more influential in survival. The main variable of interest was survival associated with multimorbidity factors. The database hosted information on hospitalized patients from Mexico between March 2020 through to April 2021. Categories 2 and 3 had the largest number of patients. Survival rates were higher in categories 0 (64.8%), 1 (57.5%) and 2 (51.6%). In total, 1741 (10.5%) patients were allocated to an ICU unit. Mechanical ventilators were used on 1415 patients, corresponding to 8.76%. Survival was recorded in 9575 patients, accounting for 57.2% of the sample population. Patients without comorbidities, younger people and women were more likely to survive.

Upgrade and absolute calibration of the JET scintillator-based fast-ion loss detector.

The JET FILD is a scintillator-based Fast-ion Loss Detector optimized to measure fusion-born alpha-particle losses. This work covers its upgrade and absolute calibration in preparation for the following JET DT experiments. A fast scintillator material (TG-Green) has been installed in the JET FILD. A heater jacket is installed around the fiber bundle, responsible for transmitting the light from the scintillator plate, to anneal the fiber obscuring due to neutron damage. The JET FILD has been upgraded with a 1 Mpx camera and 2 MHz photomultiplier data acquisition hardware. Full-orbit simulations give an estimate of the shading effects on the scintillator plate of the first wall structures and provide a synthetic signal of the JET FILD. A detector instrument function enables absolute values of fast-ion losses using calibration factors. The calibration factors are made available in a shot-to-shot basis for the characterized species and energies and with corrections for the diagnostic conditions. The fast acquisition system sets the Nyquist frequency (1 MHz) above the typical mode frequencies (≈102 kHz), thus making it possible to identify MHD-induced fast-ion losses.

Dosimetry with gafchromic films based on a new micro-opto-electro-mechanical system.

This work presents the first tests performed with radiochromic films and a new Micro‒Opto‒Electro-Mechanical system (MOEMS) for in situ dosimetry evaluation in radiotherapy in real time. We present a new device and methodology that overcomes the traditional limitation of time-delay in radiochromic film analysis by turning a passive detector into an active sensor. The proposed system consists mainly of an optical sensor based on light emitting diodes and photodetectors controlled by both customized electronic circuit and graphical user interface, which enables optical measurements directly. We show the first trials performed in a low‒energy proton cyclotron with this MOEMS by using gafchromic EBT3 films. Results show the feasibility of using this system for in situ dose evaluations. Further adaptation is ongoing to develop a full real‒time active detector by integrating MOEM multi‒arrays and films in flexible printed circuits. Hence, we point to improve the clinical application of radiochromic films with the aim to optimize radiotherapy treatment verifications.

Microdosimetry in low energy proton beam at therapeutic-equivalent fluence rate with silicon 3D-cylindrical microdetectors.

In this work we show the first microdosimetry measurements on a low energy proton beam with therapeutic-equivalent fluence rates by using the second generation of 3D-cylindrical microdetectors. The sensors belong to an improved version of a novel silicon-based 3D-microdetector design with electrodes etched inside silicon, which were manufactured at the National Microelectronics Centre (IMB-CNM, CSIC) in Spain. A new microtechnology has been employed using quasi-toroid electrodes of 25µm diameter and a depth of 20µm within the silicon bulk, resulting in a well-defined cylindrical radiation sensitive volume. These detectors were tested at the 18 MeV proton beamline of the cyclotron at the National Accelerator Centre (CNA, Spain). They were assembled into an in-house low-noise readout electronics to assess their performance at a therapeutic-equivalent fluence rate. Microdosimetry spectra of lineal energy were recorded at several proton energies starting from 18 MeV by adding 50µm thick tungsten foils gradually at the exit-window of the cyclotron external beamline, which corresponds to different depths along the Bragg curve. The experimentalyF¯values in silicon cover from (5.7 ± 0.9) to (8.5 ± 0.4) keV µm-1in the entrance to (27.4 ± 2.3) keV µm-1in the distal edge. Pulse height energy spectra were crosschecked with Monte Carlo simulations and an excellent agreement was obtained. This work demonstrates the capability of the second generation 3D-microdetectors to assess accurate microdosimetric distributions at fluence rates as high as those used in clinical centers in proton therapy.

MACACO II test-beam with high energy photons.

The IRIS group at IFIC Valencia is developing a three-layer Compton camera for treatment monitoring in proton therapy. The system is composed of three detector planes, each made of a [Formula: see text] monolithic crystal coupled to a SiPM array. Having obtained successful results with the first prototype (MACACO) that demonstrated the feasibility of the proposed technology, a second prototype (MACACO II) with improved performance has been developed, and is the subject of this work. The new system has an enhanced detector energy resolution which translates into a higher spatial resolution of the telescope. The image reconstruction method has also been improved with an accurate model of the sensitivity matrix. The device has been tested with high energy photons at the National Accelerator Centre (CNA, Seville). The tests involved a proton beam of 18 MeV impinging on a graphite target, to produce 4.4 MeV photons. Data were taken at different system positions of the telescope with the first detector at 65 and 160 mm from the target, and at different beam intensities. The measurements allowed successful reconstruction of the photon emission distribution at two target positions separated by 5 mm in different telescope configurations. This result was obtained both with data recorded in the first and second telescope planes (two interaction events) and, for the first time in beam experiments, with data recorded in the three planes (three interaction events).

Impact of charge collection efficiency and electronic noise on the performance of solid-state 3D microdetectors.

Microdosimetry has been traditionally performed through gaseous proportional counters, although in recent years different solid-state microdosimeters have been proposed and constructed for this task. In this paper, we analyze the response of solid-state devices of micrometric size with no intrinsic gain developed by CNM-CSIC (Spain). There are two major aspects of the operation of these devices that affect the reconstruction of the probability distributions and momenta of stochastic quantities related to microdosimetry. For micrometric volumes, the drift and diffusion of the charge carriers gives rise to a partial charge collection efficiency in the peripheral region of the depleted volume. This effect produces a perturbation of the reconstructed pulse height (i.e. imparted energy) distributions with respect to the actual microdosimetric distributions. The relevance of this deviation depends on the size, geometry and operating conditions of the device. On the other hand, the electronic noise from the single-event readout set-up poses a limit on the minimum detectable lineal energy when the microdosimeter size is reduced. This article addresses these issues to provide a framework on the physical constraints for the design and operation of solid-state microdosimeters.

Grey monazite (rare earths) mining in centre of Spain: Characterization and pre-operational radiological evaluation.

A radiological evaluation associated to the future mining of grey monazite nodules enriched in light rare-earths, from a modest superficial deposit located in the centre of Spain, has been performed at pre-operational level, and the main results are shown in this paper. Although the monazite nodules in the deposit are clearly enriched in radionuclides from the uranium and thorium series with activity concentrations higher than 1 Bq/g, the size of these nodules (in the 0.5 mm-2 mm grain size interval), its refractory behaviour that prevents the leaching or dissemination of natural radionuclides to waters or other ecosystem compartments and consequently the impact in the food chain, and its presence quite diluted in the deposit at concentrations of 2.5-3 kg/m3, conducted to conclude that pre-operationally the area to be mined for the extraction of the monazite is generating a negligible radiological impact in the public and the nearby environment. Additionally, the extraction of the raw material and the restoration of the area after mining (i.e. the mining activities which will be done in-situ, in the mining area) will be exempted of any radiological regulation attending to the European Union legislation being expected that will not generate a radiological impact.

First nationwide antimicrobial susceptibility surveillance for Neisseria gonorrhoeae in Brazil, 2015-16.

Objectives: Gonorrhoea and antimicrobial resistance (AMR) in Neisseria gonorrhoeae are major public health concerns globally. Enhanced AMR surveillance for gonococci is essential worldwide; however, recent quality-assured gonococcal AMR surveillance in Latin America, including Brazil, has been limited. Our aims were to (i) establish the first nationwide gonococcal AMR surveillance, quality assured according to WHO standards, in Brazil, and (ii) describe the antimicrobial susceptibility of clinical gonococcal isolates collected from 2015 to 2016 in all five main regions (seven sentinel sites) of Brazil. Methods: Gonococcal isolates from 550 men with urethral discharge were examined for susceptibility to ceftriaxone, cefixime, azithromycin, ciprofloxacin, benzylpenicillin and tetracycline using the agar dilution method, according to CLSI recommendations and quality assured according to WHO standards. Results: The levels of resistance (intermediate susceptibility) to tetracycline, ciprofloxacin, benzylpenicillin and azithromycin were 61.6% (34.2%), 55.6% (0.5%), 37.1% (60.4%) and 6.9% (8.9%), respectively. All isolates were susceptible to ceftriaxone and cefixime using the US CLSI breakpoints. However, according to the European EUCAST cefixime breakpoints, 0.2% (n = 1) of isolates were cefixime resistant and 6.9% (n = 38) of isolates had a cefixime MIC bordering on resistance. Conclusions: This study describes the first national surveillance of gonococcal AMR in Brazil, which was quality assured according to WHO standards. The high resistance to ciprofloxacin (which promptly informed a revision of the Brazilian sexually transmitted infection treatment guideline), emerging resistance to azithromycin and decreasing susceptibility to extended-spectrum cephalosporins necessitate continuous surveillance of gonococcal AMR and ideally treatment failures, and increased awareness when prescribing treatment in Brazil.

Spectral characterization of laser-accelerated protons with CR-39 nuclear track detector.

CR-39 nuclear track material is frequently used for the detection of protons accelerated in laser-plasma interactions. The measurement of track densities allows for determination of particle angular distributions, and information on the kinetic energy can be obtained by the use of passive absorbers. We present a precise method of measuring spectral distributions of laser-accelerated protons in a single etching and analysis process. We make use of a one-to-one relation between proton energy and track size and present a precise calibration based on monoenergetic particle beams. While this relation is limited to proton energies below 1 MeV, we show that the range of spectral measurements can be significantly extended by simultaneous use of absorbers of suitable thicknesses. Examples from laser-plasma interactions are presented, and quantitative results on proton energies and particle numbers are compared to those obtained from a time-of-flight detector. The spectrum end points of continuous energy distributions have been determined with both detector types and coincide within 50-100 keV.

Treating hummingbirds as feathered bees: a case of ethological cross-pollination.

Hummingbirds feed from hundreds of flowers every day. The properties of these flowers provide these birds with a wealth of information about colour, space and time to guide how they forage. To understand how hummingbirds might use this information, researchers have adapted established laboratory paradigms for use in the field. In recent years, however, experimental inspiration has come less from other birds, and more from looking at other nectar-feeders, particularly honeybees and bumblebees, which have been models for foraging behaviour and cognition for over a century. In a world in which the cognitive abilities of bees regularly make the news, research on the influence of ecology and sensory systems on bee behaviour is leading to novel insights in hummingbird cognition. As methods designed to study insects in the laboratory are being applied to hummingbirds in the field, converging methods can help us identify and understand convergence in cognition, behaviour and ecology.

Molecular Detection of Leishmania DNA in Wild-Caught Phlebotomine Sand Flies (Diptera: Psychodidae) From a Cave in the State of Minas Gerais, Brazil.

Leishmania spp. are distributed throughout the world, and different species are associated with varying degrees of disease severity. In Brazil, Leishmania transmission involves several species of phlebotomine sand flies that are closely associated with different parasites and reservoirs, and thereby giving rise to different transmission cycles. Infection occurs during the bloodmeals of sand flies obtained from a variety of wild and domestic animals, and sometimes from humans. The present study focused on detection of Leishmania DNA in phlebotomine sand flies from a cave in the state of Minas Gerais. Detection of Leishmania in female sand flies was performed with ITS1 PCR-RFLP (internal transcribed spacer 1) using HaeIII enzyme and genetic sequencing for SSUrRNA target. The survey of Leishmania DNA was carried out on 232 pools and the parasite DNA was detected in four: one pool of Lutzomyia cavernicola (Costa Lima, 1932), infected with Le. infantum (ITS1 PCR-RFLP), two pools of Evandromyia sallesi (Galvão & Coutinho, 1939), both infected with Leishmania braziliensis complex (SSUrRNA genetic sequencing analysis), and one pool of Sciopemyia sordellii (Shannon & Del Ponte, 1927), infected with subgenus Leishmania (SSUrRNA genetic sequencing analysis). The present study identified the species for Leishmania DNA detected in four pools of sand flies, all of which were captured inside the cave. These results represent the first molecular detection of Lu cavernicola with Le infantum DNA, Sc sordellii with subgenus Leishmania DNA, and Ev sallesi with Leishmania braziliensis complex DNA. The infection rate in females captured for this study was 0.17%.

The Mexican consensus on probiotics in gastroenterology. / Consenso mexicano sobre probióticos en gastroenterología.

INTRODUCTION: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology. MATERIALS AND METHODS: Controlled clinical trials, meta-analyses, and systematic reviews published up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases, humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologists treating adult patients and 14 pediatric gastroenterologists formulated statements that were voted on until agreement>70% was reached. The level of evidence based on the GRADE system was evaluated for each statement. RESULTS AND CONCLUSIONS: Eleven statements on the general concepts of probiotics and 27 statements on the use of probiotics in gastrointestinal diseases in both adults and children were formulated. The consensus group recommends the use of probiotics under the following clinical conditions: the prevention of diarrhea associated with antibiotics, the treatment of acute infectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enterocolitis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief from irritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis, and the treatment of covert and overt hepatic encephalopathy.

Removal naturally occurring radionuclides from drinking water using a filter specifically designed for Drinking Water Treatment Plants.

The occurrence of naturally occurring radionuclides in drinking water can pose health hazards in some populations, especially taking into account that routine procedures in Drinking Water Treatment Plants (DWTPs) are normally unable to remove them efficiently from drinking water. In fact, these procedures are practically transparent to them, and in particular to radium. In this paper, the characterization and capabilities of a patented filter designed to remove radium from drinking water with high efficiency is described. This filter is based on a sandwich structure of silica and green sand, with a natural high content manganese oxide. Both sands are authorized by Spanish authorities to be used in Drinking Water Treatment Plants. The Mn distribution in the green sand was found to be homogenous, thus providing a great number of adsorption sites for radium. Kinetic studies showed that the 226Ra adsorption on green sand was influenced by the content of major cations solved in the treated water, but the saturation level, about 96-99%, was not affected by it. The physico-chemical parameters of the treated water were unaltered by the filter. The efficiency of the filter for the removal of 226Ra remained unchanged with large water volumes passed through it, proving its potential use in DWTP. This filter was also able to remove initially the uranium content due to the presence of Fe2O3 particles in it, although it is saturated faster than radium.

Conceptual design of the ITER fast-ion loss detector.

A conceptual design of a reciprocating fast-ion loss detector for ITER has been developed and is presented here. Fast-ion orbit simulations in a 3D magnetic equilibrium and up-to-date first wall have been carried out to revise the measurement requirements for the lost alpha monitor in ITER. In agreement with recent observations, the simulations presented here suggest that a pitch-angle resolution of ∼5° might be necessary to identify the loss mechanisms. Synthetic measurements including realistic lost alpha-particle as well as neutron and gamma fluxes predict scintillator signal-to-noise levels measurable with standard light acquisition systems with the detector aperture at ∼11 cm outside of the diagnostic first wall. At measurement position, heat load on detector head is comparable to that in present devices.

Quantitative comparison of initial soil erosion processes and runoff generation in Spanish and German vineyards.

The aim of this study was to enable a quantitative comparison of initial soil erosion processes in European vineyards using the same methodology and equipment. The study was conducted in four viticultural areas with different characteristics (Valencia and Málaga in Spain, Ruwer-Mosel valley and Saar-Mosel valley in Germany). Old and young vineyards, with conventional and ecological planting and management systems were compared. The same portable rainfall simulator with identical rainfall intensity (40mmh(-1)) and sampling intervals (30min of test duration, collecting the samples at 5-min-intervals) was used over a circular test plot with 0.28m(2). The results of 83 simulations have been analysed and correlation coefficients were calculated for each study area to identify the relationship between environmental plot characteristics, soil texture, soil erosion, runoff and infiltration. The results allow for identification of the main factors related to soil properties, topography and management, which control soil erosion processes in vineyards. The most important factors influencing soil erosion and runoff were the vegetation cover for the ecological German vineyards (with 97.6±8% infiltration coefficients) and stone cover, soil moisture and slope steepness for the conventional land uses.

Childhood tuberculosis and human immunodeficiency virus status in Brazil: a hierarchical analysis.

SETTING: Human immunodeficiency virus (HIV) infection may impact tuberculosis (TB) diagnosis, clinical presentation and treatment outcomes in children as the signs and symptoms of both diseases overlap. OBJECTIVE: To compare the sociodemographic and clinical profiles of childhood TB according to HIV status in Brazil. METHODS: This was a cross-sectional study of data on subjects aged <15 years retrieved from the Brazilian National Electronic Disease Registry (Sistema de Informação de Agravos de Notificação) database on TB to compare TB-HIV coinfected patients and patients with TB only registered between 2007 and 2011. A hierarchical logistic regression model was applied. RESULTS: Of 6091 cases analysed, 780 (12%) were TB-HIV patients, while 5311 (87%) presented with TB only. TB-HIV patients were more likely to be institutionalised (OR 2.22, 95%CI 1.43-3.46), to present with relapsed TB (OR 5.03, 95%CI 2.02-12.5) and be readmitted after treatment default (OR 16.7, 95%CI 4.34-64.46). They were also more likely to have unfavourable outcomes, including default (OR 2.85, 95%CI 1.81-4.49), death due to TB (OR 2.76, 95%CI 1.27-6.03) and death from other causes (OR 5.59, 95%CI 2.63-11.8). CONCLUSION: Our study highlights the challenges of using national registers for research into childhood TB.