An 8-month adapted motor activity program in a young CMT1A male patient.

Background: It is unclear whether prolonged periods of training can be well tolerated. In Charcot-Marie Tooth disease (CMT). We report the effects of an 8-month, adapted motor activity (AMA) program in a 16-years-old CMT1A male patient. The program included strength, mobility, and balance training (two sessions per week, 1 h per session). Measures: Walking ability and walking velocity (Six-Minute Walking Test-6MWT, Ten Meters Walking Test-10 mW T), balance (Y-Balance Test-YBT, Berg Balance Scale-BBS), functional mobility (Short Physical Performance Battery-Short physical performance battery), fatigue (Checklist Individual strength questionnaire - CIS20R), health and quality of life (Short Form Health Survey 36 questionnaire-SF-36) were evaluated in three moments: before (T0), after 5 (T1) and 8 (T2) months of adapted motor activity. Dorsal and plantar foot flexion strength (Maximal Voluntary Contraction-maximum voluntary contraction) and neuromuscular functions (Electromyography-sEMG, interpolated twitch technique-ITT) were measured at T1 and T2. Results: Relative to T0, an amelioration of walking ability (6MWT, +9,3%) and balance (with improvements on Y-balance composite normalized mean reach of the right and left limb of 15,3% and 8,5%, respectively) was appreciable. Relative to T1, an increase in foot strength in three out of four movements (right plantar flexion, +39,3%, left plantar flexion, +22,7%, left dorsal flexion, 11,5%) was observed. Concerning voluntary muscle activation, a greater recruitment in the left, unlike right, medial gastrocnemius was observed. Conclusion: Results suggest the safety of an 8-month AMA program in a young patient affected by CMT1A.

Introducing DEPDOSE, a Tool to Calculate Dose Coefficients to Members of the Public for Radioactive Aerosols.

ABSTRACT: This paper presents DEPDOSE, an open-source computer application that combines the KDEP respiratory tract deposition fractions for inhaled aerosols with DC_PAK committed equivalent dose coefficients for a unit deposition in each region of the respiratory tract. DEPDOSE allows the user to rapidly produce tables of dose coefficients for workers and members of the public inhaling precisely defined, user-specified aerosols using the ICRP Publication 60 methodology. Combined with a plume dispersion modeling system, such as the Quick Urban & Industrial Complex (QUIC) Dispersion Modeling System, this makes it possible to predict radiation doses downstream from an accidental or intentional release of radioactive materials. For this work, a radioactive plume was calculated to members of the public downstream from a dirty bomb in Chicago. DEPDOSE is published under an open source license, and can be downloaded at https://github.com/lanl/DEPDOSE .

Review of particle deposition to and removal from clothing, skin, and hair after a radioactive airborne dispersal event.

Explosive Radiological Dispersal Devices (RDD) - aka dirty bombs - are seen as a credible method to carry out a radiological terror attack. After exploding a radioactive source, the radionuclide-laden plume will be blown downwind of ground zero, with particles falling out and potentially depositing on people caught in and under the cloud. Some of these people may not show any sign of radiation sickness and therefore not realize they have been contaminated and may take the radioactive particulate with them on their daily activities, thus spreading the radioactive particulate outside the initially contaminated area. This paper reviews the scientific literature to better understand the rate at which particulate deposits on and is removed from the different "surfaces" of a person, i.e., hair, skin, and clothing. Prior research indicates that: 1) particle deposition is usually higher on skin than on hair and clothing; 2) particle deposition is greater for a person with higher skin moisture, 3) stronger wind increases the deposition flux onto a person, and 4) the fraction of particulate deposited on the hair, skin, and clothing respectively depends on the length of the hair, assuming all the hair surface is available for deposition. The studies taken into consideration show that the largest uncertainty in particulate deposition onto a person is due to clothing type because of the different possible weave arrangements and tightness which translate into differences in actual surface area and surface roughness. A factor of 2-to-20 variation in deposition rate was found. Removal of the particulate from the contaminated person may be due to wind, a person's movement, and/or contact transfer, i.e., by touching a different clean surface. Experiments show that the majority of the particulate is resuspended within 2-6 h mostly depending on the intensity of physical activity. The largest uncertainty in particulate removal from skin depends on the skin moisture, transfer rate of single-contact, and how many objects/people a person touches per hour. No data for hair were found for particle removal and resuspension. The studies considered did not utilize radionuclides directly; however, data on adhesion of radioactive vs. their non-radioactive counterpart have shown that the uncertainty due to the radioactivity of the particles is lower than that due to other factors. An idealized scenario involving a single building in the path of the cloud showed the impact of building-influenced flow on the cloud transport path and mixing, which affects the radiological dose the downwind population is exposed to and consequently the health effects.

Longitudinal Characterization of Immune Response in a Cohort of Children Hospitalized with Multisystem Inflammatory Syndrome.

BACKGROUND: Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of SARS-CoV-2 infection caused by hyperactivation of the immune system. METHODS: this is a retrospective analysis of clinical data, biochemical parameters, and immune cell subsets in 40 MIS-C patients from hospital admission to outpatient long-term follow-up. RESULTS: MIS-C patients had elevated inflammatory markers, associated with T- and NK-cell lymphopenia, a profound depletion of dendritic cells, and altered monocyte phenotype at disease onset, while the subacute phase of the disease was characterized by a significant increase in T- and B-cell counts and a rapid decline in activated T cells and terminally differentiated B cells. Most of the immunological parameters returned to values close to the normal range during the remission phase (20-60 days after hospital admission). Nevertheless, we observed a significantly reduced ratio between recently generated and more differentiated CD8+ T- and B-cell subsets, which partially settled at longer-term follow-up determinations. CONCLUSIONS: The characterization of lymphocyte distribution in different phases of MIS-C may help to understand the course of diseases that are associated with dysregulated immune responses and to calibrate prompt and targeted treatments.

Dirty bomb source term characterization and downwind dispersion: Review of experimental evidence.

Dirty bombs are considered one of the easiest forms of radiological terrorism, a form of terrorism based on the deliberate use of radiological material to cause adverse effects in a target population. One U.S. Government official has even described a dirty bomb attack as "all but inevitable". While people in the vicinity of the blast may experience acute radiation effects, people downwind may unknowingly be contaminated by the radioactive airborne particulate and face increased long-term cancer risk. The likelihood of increased cancer risk depends on the radionuclide used and its specific activity, its aerosolization potential, the particle sizes generated in the blast, and where a person is with respect to the detonation. Different studies have reported that plausible radionuclides for dirty bomb include 60Co, 90Sr, 137Cs, 192Ir, 241Am based on their availability in commercial sources as well as safeguards, the amount needed for adverse health effects, previous mishandling of radionuclides and malicious uses. In order to have increased long-term cancer risk, the radionuclide would have to deposit inside the body by entering the respiratory tract and then possibly migrate to other organs or bones (ground shine is not considered in this paper because areas affected by the event will likely become inaccessible). This implies that the particles will have to be smaller than 10 µm to be inhaled. Experiments involving the detonation of dirty bombs have shown that particles or droplets smaller than 10 µm are generated, independently from the initial radionuclide or its state (e.g., powder, solution). Atmospheric tests have shown that in unobstructed terrain, the radionuclide laden cloud can travel kilometers downwind even for relatively small amounts of explosives. Buildings in the path of the cloud can change the dose rate. For instance, in one experiment with a single building, the dose rate was 1-2 orders of magnitude lower behind the obstacle compared to its front face. For people walking around, the amount of particulate deposited on them and inhaled will depend on their path relative to the cloud, resulting in the counterintuitive result that the closer people may actually not be the ones more at risk because they could simply miss the bulk of the cloud in their wandering. In summary, the long-term cancer risk for people caught in a dirty bomb cloud away from the detonation requires considering where and when the people are, which radionuclide was used, and the layout of the obstacles (e.g., buildings, vegetation) in the path of the cloud.

The Viareggio LPG railway accident: event reconstruction and modeling.

This manuscript describes in detail the LPG accident occurred in Viareggio on June 2009 and its modeling. The accident investigation highlighted the uncertainty and complexity of assessing and modeling what happened in the congested environment close to the Viareggio railway station. Nonetheless, the analysis allowed comprehending the sequence of events, the way they influenced each other, and the different possible paths/evolutions. The paper describes suitable models for the quantitative assessment of the consequences of the most probable accidental dynamics and its outcomes. The main finding is that after about 80 s from the beginning of the release the dense-gas cloud reached the surrounding houses that were destroyed successively by internal explosions. This fact has two main implications. First, it shows that the adopted modeling framework can give a correct picture of what happened in Viareggio. Second, it confirms the need to develop effective mitigation measures because, in case of this kind of accidents, there is no time to apply any protective emergency plans/actions.

Accidents involving liquids: a step ahead in modeling pool spreading, evaporation and burning.

The manuscript focuses on the modeling of industrial accidents involving liquid substances, i.e. liquid pools. The paper discusses how to improve Webber's model (1990) for evaluating the liquid pool dynamics in terms of spreading (onto land and water) and evaporation rates. In particular, our attention was devoted to the following points: friction term in presence of film boiling; evaluation of the friction velocity; determination of the wind profile index; evaluation of the conductive heat flux; the pool radius dynamics; turbulent mixing onto water; dispersion model input data. The paper presents, also, how to couple the proposed model to the pool burning dynamics. This allows simulating the burning of a spreading pool. Thanks to its prompt response in terms of CPU time, the proposed model is helpful not only under risk assessment or under emergency preparedness, but also during accident response. A comparison between experimental data and the model predictions validates the model effectiveness in simulating real accidental events.

On pool spreading around tanks: geometrical considerations.

The paper discusses a straightforward approach for evaluating the distance covered by a spreading liquid pool, when the axisymmetric hypothesis is no longer valid. This distance is evaluated by a three-steps methodology: the pre-processing of input data (bund radius, if present, and radial velocity); the simulation of pool spreading by a model based on the axisymmetric hypothesis; and the post-processing of results. The paper reports some geometrical correlations to pre- and post-process the data, with regard to four case-studies. Some numerical examples are also presented to prove that the pre-processed input data and post-processed results differ from those based on the axisymmetric hypothesis. Finally, we validate our modeling approach with the experimental data of Cronin and Evans [P.S. Cronin, J.A. Evans, A series of experiments to study the spreading of liquid pools with different bund arrangements, HSE Contract Research Report 405/2002, Advantica Technologies Limited, 2002].