Tracking of airborne radionuclides from the damaged Fukushima Dai-ichi nuclear reactors by European networks

Radioactive emissions into the atmosphere from the damaged reactors of the Fukushima Dai-ichi nuclear power plant (NPP) started on March 12th, 2011. Among the various radionuclides released, iodine-131 ((131)I) and cesium isotopes ((137)Cs and (134)Cs) were transported across the Pacific toward the North American continent and reached Europe despite dispersion and washout along the route of the contaminated air masses. In Europe, the first signs of the releases were detected 7 days later while the first peak of activity level was observed between March 28th and March 30th. Time variations over a 20-day period and spatial variations across more than 150 sampling locations in Europe made it possible to characterize the contaminated air masses. After the Chernobyl accident, only a few measurements of the gaseous (131)I fraction were conducted compared to the number of measurements for the particulate fraction. Several studies had already pointed out the importance of the gaseous (131)I and the large underestimation of the total (131)I airborne activity level, and subsequent calculations of inhalation dose, if neglected. The measurements made across Europe following the releases from the Fukushima NPP reactors have provided a significant amount of new data on the ratio of the gaseous (131)I fraction to total (131)I, both on a spatial scale and its temporal variation. It can be pointed out that during the Fukushima event, the (134)Cs to (137)Cs ratio proved to be different from that observed after the Chernobyl accident. The data set provided in this paper is the most comprehensive survey of the main relevant airborne radionuclides from the Fukushima reactors, measured across Europe. A rough estimate of the total (131)I inventory that has passed over Europe during this period was <1% of the released amount. According to the measurements, airborne activity levels remain of no concern for public health in Europe.

Protection from pathogenic SIVmac challenge following short-term infection with a nef-deficient attenuated virus

Infection of rhesus macaques with attenuated SIVmac is, at present, the only strategy which confers significant protection from challenge with wild-type SIVmac grown in monkey PBMC. However, initial results suggest that the protective mechanism does not develop until late after "vaccination" (approx 10 months). As part of a European study using the C8 variant of SIVmac251-32H (containing an in-frame 12-bp deletion in the nef gene), we wished to determine (a) if protection could be achieved against challenge with a "swarm" of SIVmac251-32H produced in monkey cells and (b) if protection could be demonstrated after a short period of infection with the attenuated virus. Eight Indian rhesus macaques were infected with C8 and four were challenged after 10 weeks with 50 MID50 of an uncloned stock of SIVmac251-32H grown in rhesus cells, and the other four were challenged after 20 weeks. Four animals served as naive controls. Three of the four monkeys challenged at 10 weeks and three of those challenged at 20 weeks were protected from productive superinfection. From one monkey in each group it was, however, possible to demonstrate the presence of the wild-type provirus in monkey PBMC by diagnostic PCR and anamnestic immune response. There was no apparent correlation between the levels of binding or neutralizing antibodies on the day of challenge and subsequent protection. Approximately 1 year after infection with the attenuated virus all monkeys were rechallenged with the heterologous SIVsm strain, first with 10-20 MID50 and then with 1000 MID50. Although not all of the SIVsm-inoculated naive controls became productively infected, PCR analysis failed to reveal any evidence for infection of the "immunized" monkeys.

Relationship between glyco-oxidation, antioxidant status and microalbuminuria in type 2 diabetic patients

AIMS/HYPOTHESIS

This study examined the relationship, if any, between glucose-induced oxidative stress, antioxidant status and microalbuminuria in patients with type 2 diabetes.

METHODS

The study involved 99 consecutive type 2 diabetic patients (57 men, 42 women). Patients with persistent microalbuminuria were identified and the following variables evaluated: fasting plasma glucose, HbA(1c), malonyldialdehyde (MDA), pentosidine, AGE, the total radical-trapping antioxidant parameter (TRAP), vitamin E, creatinine, estimated GFR and lipid profile.

RESULTS

Patients were divided into two groups, i.e. 37 individuals without microalbuminuria (AER <20 microg/min) and 62 with microalbuminuria (AER > or =20 microg/min). The following variables were significantly higher in patients with microalbuminuria than in those without microalbuminuria (mean +/- SD): fasting plasma glucose 9.41 +/- 2.88 vs 8.19 +/- 1.93 mmol/l, p < 0.05; HbA(1c) 7.97 +/- 1.51 vs 7.39 +/- 1.03%, p < 0.05; MDA 1.18 +/- 0.35 vs 1.02 +/- 0.29 micromol/l, p < 0.05; pentosidine 98.5 +/- 24.6 vs 82.9 +/- 20.9 pmol/ml, p < 0.005; and AGE 13.2 +/- 4.8 vs 10.6 +/- 3.8 microg/mg protein, p < 0.01. However, vitamin E and TRAP did not differ between the two groups. Serum creatinine values and estimated GFR were similar in the two groups. Only in patients with microalbuminuria were significant linear correlations seen between AER and both oxidation (HbA(1c) r = 0.33, p < 0.01; MDA r = 0.59, p < 0.001; pentosidine r = 0.48, p < 0.001; and AGE r = 0.44, p < 0.001) and antioxidation variables (vitamin E r = -0.55, p < 0.001; TRAP r = -0.49, p < 0.001). Considering all variables together, multiple regression revealed a correlation between microalbuminuria and vitamin E, TRAP, HbA(1c) and MDA, but not pentosidine or AGE.

CONCLUSIONS/INTERPRETATION

Our data suggest that microalbuminuria in type 2 diabetic patients might be promoted by an insufficient counter-regulation of the antioxidant system in the event of increased glyco-oxidation/glycation.

Development and validation of an indirect enzyme immunoassay for detection of antibody to Brucella abortus in milk

An indirect enzyme immunoassay for detection of antibody to Brucella abortus in bovine milk was developed and validated using 6238 milk samples from Canadian herds (brucellosis free) and 202 samples from herds infected with B. abortus (from Argentina and Chile). The assay utilized lipopolysaccharide as the antigen, immobilized on the polystyrene matrix, whole milk to test and a mouse monoclonal antibody, specific for an epitope of bovine IgG1, conjugated with horseradish peroxidase. The sensitivity of the assay was 95.2% +/- 3.7% at a confidence limit of 95% for samples from B. abortus infected herds obtained from chile and 98.7% +/- 0.3% at a confidence limit of 95% for samples from similar herds in Argentina. Of the negative milk samples tested, 77 gave a result above the threshold value of 0.200 optical density units. When the 77 false positive samples were retested using 7.5 mM (final concentration) of EDTA and ethyleneglycol-bis-aminoether-N,N,N', N'-tetraacetic acid (EGTA), the number of false positive reactions was reduced to 3, giving a diagnostic specificity of 99.95%. The divalent cation chelating agents did not affect positive reactions and the sensitivity remained the same. Based on control samples included with each assay, the performance of the assay was consistent.

Determination of 222Rn emanation fraction and diffusion coefficient in concrete using accumulation chambers and the influence of humidity and radium distribution

In this paper we present a laboratory method for the determination of diffusion coefficient, D, as well as the 222Rn emanation fraction, f, in concrete core samples. It is based either on the analyses of the growth curves of the radon in the air volume surrounding a sample enclosed in an accumulation chamber (Lucas cell or RADIM device) or using the charcoal adsorption method. Samples used have a special geometry allowing the assumption of a one-dimensional diffusion of radon in material. Radium was enhanced in the concrete samples by adding radium bromide solution or uranium ore. A strong dependence of the emanation fraction on the enhancing method was observed. For the sample enhanced with uranium ore the specific exhalation rate was about ten times smaller. A marked dependence of radon exhalation on the water content was also observed.

Desaturase activities and metabolic control in type 2 diabetes

The aim of this study was to elucidate the effects of a poor glycemic control on fatty acid composition and desaturase activities in type 2 diabetic patients. Plasma phospholipid fatty acid composition and desaturase activities (estimated from fatty acid product to precursor ratios) were measured in 30 type 2 diabetic patients during poor metabolic control and after achieving a good metabolic control. Significant changes were recorded in the percentages of palmitic, stearic, dihomo-gamma-linolenic, docosatetraenoic and docosapentaenoic acid. The delta-5 desaturase activity was significantly higher with poor than with good metabolic control. The changes identified in plasma phospholipid fatty acid composition and the desaturase activity in type 2 diabetic patients go in the opposite direction to those described in similar conditions in type 1 diabetic patients and may be relevant to a better understanding of the role of metabolic control in the progression of chronic complications in type 2 diabetic patients.

Low serum 25-hydroxyvitamin D levels are associated with left ventricular hypertrophy in essential hypertension

BACKGROUND AND AIM

Low serum 25-hydroxyvitamin D [25(OH)D] levels may have an important role in predisposing to hypertension and myocardial disease. We investigated the relationship between 25(OH)D and left ventricular (LV) structure and function, assessed by echocardiography, in a series of patients with essential hypertension (EH).

METHODS AND RESULTS

Sixty-two newly diagnosed never-treated patients (32 male/30 female), aged 18-65 years, with grade 1-2 hypertension, no diabetes, no obesity, no hyperlipidemia, and no cardiopulmonary, renal, or hepatic disease, were studied. Twenty-four healthy normotensive sex-, age-, BMI-matched subjects served as controls. Hypertensive patients with 25(OH)D deficiency, defined as serum 25(OH)D levels <50 nmol/L, had higher prevalence of LV hypertrophy (LVH) than their 25(OH)D-sufficient counterparts (57.1 vs 17.6%, P = 0.02); no differences between the two groups were found in blood pressure levels as well as in other biochemical and hormone parameters. There was an inverse correlation between LV mass index and 25(OH)D levels (r = -0.366, P < 0.003) and a direct correlation between LV mass index and BMI (r = 0.333, P < 0.006) in the entire hypertensive population. The two variables remained independently associated with LVH at multivariable logistic regression analysis (OR 1.05, P < 0.005 and OR 1.25, P = 0.03, respectively). Prevalence of 25(OH)D deficiency was similar in EH patients and controls (45.1 vs 41.6%, P = 0.89), whereas no correlation between echocardiographic parameters and hormone levels was found.

CONCLUSIONS

In the absence of major cardiovascular risk factors, 25(OH)D deficiency is a frequent finding in EH patients and is independently associated with LVH.

Caring for nursing home residents with COVID-19: a "hospital-at-nursing home" intermediate care intervention

Background

Nursing home (NH) residents have been dramatically affected by COVID-19, with extremely high rates of hospitalization and mortality.

Aims

To describe the features and impact of an assistance model involving an intermediate care mobile medical specialist team (GIROT, Gruppo Intervento Rapido Ospedale Territorio) aimed at delivering “hospital-at-nursing home” care to NH residents with COVID-19 in Florence, Italy.

Methods

The GIROT activity was set-up during the first wave of the pandemic (W1, March–April 2020) and became a structured healthcare model during the second (W2, October 2020–January 2021). The activity involved (1) infection transmission control among NHs residents and staff, (2) comprehensive geriatric assessment including prognostication and geriatric syndromes management, (3) on-site diagnostic assessment and protocol-based treatment of COVID-19, (4) supply of nursing personnel to understaffed NHs. To estimate the impact of the GIROT intervention, we reported hospitalization and infection lethality rates recorded in SARS-CoV-2-positive NH residents during W1 and W2.

Results

The GIROT activity involved 21 NHs (1159 residents) and 43 NHs (2448 residents) during W1 and W2, respectively. The percentage of infected residents was higher in W2 than in W1 (64.5% vs. 38.8%), while both hospitalization and lethality rates significantly decreased in W2 compared to W1 (10.1% vs 58.2% and 23.4% vs 31.1%, respectively).

Discussion

Potentiating on-site care in the NHs paralleled a decrease of hospital admissions with no increase of lethality.

Conclusions

An innovative “hospital-at-nursing home” patient-centred care model based on comprehensive geriatric assessment may provide a valuable contribution in fighting COVID-19 in NH residents.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40520-021-01959-z.

Definition of the upper reference limit for thyroglobulin antibodies according to the National Academy of Clinical Biochemistry guidelines: comparison of eleven different automated methods

Purpose

In the last two decades, thyroglobulin autoantibodies (TgAb) measurement has progressively switched from marker of thyroid autoimmunity to test associated with thyroglobulin (Tg) to verify the presence or absence of TgAb interference in the follow-up of patients with differentiated thyroid cancer. Of note, TgAb measurement is cumbersome: despite standardization against the International Reference Preparation MRC 65/93, several studies demonstrated high inter-method variability and wide variation in limits of detection and in reference intervals. Taking into account the above considerations, the main aim of the present study was the determination of TgAb upper reference limit (URL), according to the National Academy of Clinical Biochemistry guidelines, through the comparison of eleven commercial automated immunoassay platforms.

Methods

The sera of 120 healthy males, selected from a population survey in the province of Verona, Italy, were tested for TgAb concentration using eleven IMA applied on as many automated analyzers: AIA-2000 (AIA) and AIA-CL2400 (CL2), Tosoh Bioscience; Architect (ARC), Abbott Diagnostics; Advia Centaur XP (CEN) and Immulite 2000 XPi (IMM), Siemens Healthineers; Cobas 6000 (COB), Roche Diagnostics; Kryptor (KRY), Thermo Fisher Scientific BRAHMS, Liaison XL (LIA), Diasorin; Lumipulse G (LUM), Fujirebio; Maglumi 2000 Plus (MAG), Snibe and Phadia 250 (PHA), Phadia AB, Thermo Fisher Scientific. All assays were performed according to manufacturers’ instructions in six different laboratories in Friuli-Venezia Giulia and Veneto regions of Italy [Lab 1 (AIA), Lab 2 (CL2), Lab 3 (ARC, COB and LUM), Lab 4 (CEN, IMM, KRY and MAG), Lab 5 (LIA) and Lab 6 (PHA)]. Since TgAb values were not normally distributed, the experimental URL (e-URL) was established at 97.5 percentile according to the non-parametric method.

Results

TgAb e-URLs showed a significant inter-method variability. Considering the same method, e-URL was much lower than that suggested by manufacturers (m-URL), except for ARC and MAG. Correlation and linear regression were unsatisfactory. Consequently, the agreement between methods was poor, with significant bias in Bland–Altman plot.

Conclusions

Despite the efforts for harmonization, TgAb methods cannot be used interchangeably. Therefore, additional effort is required to improve analytical performance taking into consideration approved protocols and guidelines. Moreover, TgAb URL should be used with caution in the management of differentiated thyroid carcinoma patients since the presence and/or the degree of TgAb interference in Tg measurement has not yet been well defined.

Prediction of lung cancer risk for radon exposures based on cellular alpha particle hits

To explore the role of the multiplicity of cellular hits by radon progeny alpha particles for lung cancer incidence, the number of single and multiple alpha particle hits were computed for basal and secretory cells in the bronchial epithelium of human airway bifurcations. Hot spots of alpha particle hits were observed at the branching points of bronchial airway bifurcations. The effect of single and multiple alpha particle intersections of bronchial cells during a given exposure period, selected from a Poisson distribution, on lung cancer risk were simulated by a transformation frequency--tissue response model, based on experimentally observed cellular transformation and survival functions. Calculations of lung cancer risk at low radon exposure levels suggest that single hits produce a linear-dose response relationship, while the superposition of single and increasing multiple hits at higher exposure levels may also be approximated by a quasi-linear dose-effect curve. The simulations predict a carcinogenic enhancement effect for radon progeny accumulations at bifurcation branching sites, which may increase current risk estimates.

Indicators of the Fukushima radioactive release in NW Romania

As a result of the Fukushima nuclear release, (131)I was found in different environmental media (rainwater, sheep and cow milk, herbage, sheep meat and thyroid tissue) in north-west Romania. On April 4, 2011 a maximum value of 1.40 ± 0.21 Bq/L in (131)I activity was found in rainwater obtained from the Arad region. The obtained value corresponded with the maximum of (131)I concentration in air, as measured by Toma et al. (2011) for the Piteşti area. One day later, sheep milk from the Cluj area was found to contain a maximum activity of 9.22 ± 0.95 Bq/L. A value of 0.85 ± 0.07 μSv was calculated as the total monthly effective dose received by the population as a result of the ingestion of sheep milk and sheep meat contaminated with (131)I. Only rainwater samples contained (134)Cs and (137)Cs at levels close to minimum detectable activity. Since the determined values could be influenced by Chernobyl (137)Cs, the (137)Cs concentrations are subject to uncertainty. The radioiodine transfer coefficients (Fm) and the concentration ratio (CR) from herbage to sheep milk, as well as sheep meat, from the Cluj-Apahida area are also presented.

Results from time integrated measurements of indoor radon, thoron and their decay product concentrations in schools in the Republic of Macedonia

As part of a survey on concentrations of radon, thoron and their decay products in different indoor environments of the Balkan region involving international collaboration, measurements were performed in 43 schools from 5 municipalities of the Republic of Macedonia. The time-integrated radon and thoron gas concentrations (CRn and CTn) were measured by CR-39 (placed in chambers with different diffusion barriers), whereas the equilibrium equivalent radon and thoron concentrations (EERC and EETC) were measured using direct radon-thoron progeny sensors consisting of LR-115 nuclear track detectors. The detectors were deployed at a distance of at least 0.5 m from the walls as well as far away from the windows and doors in order to obtain more representative samples of air from the breathing zone; detectors were exposed over a 3-month period (March-May 2012). The geometric mean (GM) values [and geometric standard deviations (GSDs)] of CRn, CTn, EERC and EETC were 76 (1.7), 12 (2.3), 27 (1.4) and 0.75 Bq m(-3) (2.5), respectively. The equilibrium factors between radon and its decay products (FRn) and thoron and its decay products (FTn (>0.5 m)) were evaluated: FRn ranged between 0.10 and 0.84 and FTn (>0.5 m) ranged between 0.003 and 0.998 with GMs (and GSDs) equal to 0.36 (1.7) and 0.07 (3.4), respectively.

Comparative assessment of erosion and deposition rates on cultivated land in the Transylvanian Plain of Romania using ¹³⁷Cs and ²¹⁰Pbex

Soil erosion and sedimentation are natural landscape forming processes. However, they can be accelerated by human activities and therefore increase negative impacts on agricultural production as well as disturbing watershed management. Romania currently faces major environmental challenges and pressure on soil and water resources due to unsustainable farming practices and inappropriate tillage practices. The present work represents the first attempt to test the combined use of radionuclide approaches (i.e. (137)Cs and (210)Pb(ex)) to quantify soil erosion changes in cultivated Transylvanian fields (Romania) at different temporal scales. Fourteen soil cores were collected along two transects in a cultivated field and two reference sites were selected to establish the mean reference inventories for both (137)Cs and (210)Pb(ex). A value of 5460 ± 880 Bq m(-2) (n = 10; CV = 16%) was determined for the (137)Cs mean reference inventory for both sites, given as areal activity ± standard deviation, at 2σ confidence interval. As regarding (210)Pb(ex) reference inventory, its value (9640 Bq m(-2)) is only given by the areal activity of one soil core from the second site. The high erosion rates obtained with the (210)Pb(ex) approach are an effect of the up and down ploughing practices which took place at the time of the local agricultural cooperative starting in the late 1950s. The middle-term redistribution rates provided by the (137)Cs technique highlighted preponderant deposition processes in the field investigated, reflecting the changes in the cultivation system with ploughing across the slope at the beginning of 1990s.

Biomarkers, imaging and disease activity indices in patients with early axial spondyloarthritis: the Italian arm of the SpondyloArthritis-Caught-Early (SPACE) Study

The study aimed to evaluate biomarkers facilitating early diagnosis of axial spondyloarthritis (axSpA) and correlations between them and disease activity parameters and imaging indexes. Patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years) participating in the Italian arm of the SpondyloArthritis-Caught-Early SPACE study underwent a physical examination, questionnaires, laboratory tests, X-rays and MRI of the spine and sacroiliac joints (SIJ). An expert rheumatologist formulated axSpA diagnosis in accordance with Assessment of SpondyloArthritis International Society (ASAS) criteria. Disease activity and physical functioning were assessed using imaging, clinical and serological indices. Spine and SIJ MRI and X-rays were scored independently by 2 readers using the SPARCC, mSASSS and NY-criteria. Patients were classified as: subjects with signs of radiographic sacroiliitis (r-axSpA), subjects with signs of sacroiliitis on SIJ-MRI but not on X-rays (nr-axSpA MRI SIJ+) or subjects with no signs of sacroiliitis on MRI/X-rays but with >2 SpA features and signs of bone oedema on MRI spine (nr-axSpA MRI SIJ-/undifferentiated SpA). Significant differences were found in the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ scores. Biomarker levels were not significantly increased in any of the patient groups. The correlations between IL-17 and IL-23 and other indices were not significant; correlations were found between IL-22 and BASFI, BASG1, HAQ, VAS pain, between mSASSS and MMP3, and between the latter and hsCRP. Although not significantly higher in any of the three groups, IL-22, MMP3 and hsCRP values were correlated with some disease activity indexes and with mSASSS. Large observational studies are required to confirm these preliminary findings.

Preliminary results regarding the first map of residential radon in some regions in Romania

Radon represents the most important contribution of population exposure to natural ionising radiation. This article presents the first indoor radon map in some regions of Romania based on 883 surveyed buildings in the Ştei-BăiŢa radon-prone region and 864 in other regions of Romania. Indoor radon measurements were performed in the last 10 y by using CR-39 nuclear track detectors exposed for 3-12 months on ground floor levels of dwellings. Excluding the Ştei-BăiŢa radon-prone region, an average indoor radon concentration of 126 Bq m(-3) was calculated for Romanian houses. In the Ştei-BăiŢa radon-prone area, the average indoor concentration was 292 Bq m(-3). About 21 % of the investigated dwellings in the Ştei-BăiŢa radon-prone region exceed the threshold of 400 Bq m(-3), while 5 % of the dwellings in other areas of Romania exceed the same threshold. As expected, indoor radon concentration is not uniformly distributed throughout Romania. The map shows a high variability among surveyed regions, mainly due to the differences in geology. The radon emanation rate is substantially influenced by the soil characteristics, such as the soil permeability and soil gas radon concentration. Since higher permeability enables the increased migration of soil gas and radon from the soil into the building, elevated levels of indoor radon can be expected in more permeable soil environments.

Course and Lethality of SARS-CoV-2 Epidemic in Nursing Homes after Vaccination in Florence, Italy

Evidence on the effectiveness of SARS-CoV-2 vaccines in nursing home (NHs) residents is limited. We examined the impact of the BNT162b2 mRNA SARS-CoV-2 vaccine on the course of the epidemic in NHs in the Florence Health District, Italy, before and after vaccination. Moreover, we assessed survival and hospitalization by vaccination status in SARS-CoV-2-positive cases occurring during the post-vaccination period. We calculated the weekly infection rates during the pre-vaccination (1 October-26 December 2020) and post-vaccination period (27 December 2020-31 March 2021). Cox analysis was used to analyze survival by vaccination status. The study involved 3730 residents (mean age 84, 69% female). Weekly infection rates fluctuated during the pre-vaccination period (1.8%-6.5%) and dropped to zero during the post-vaccination period. Nine unvaccinated (UN), 56 partially vaccinated (PV) and 35 fully vaccinated (FV) residents tested SARS-CoV-2+ during the post-vaccination period. FV showed significantly lower hospitalization and mortality rates than PV and UV (hospitalization: FV 3%, PV 14%, UV 33%; mortality: FV 6%, PV 18%, UV 56%). The death risk was 84% and 96% lower in PV (HR 0.157, 95%CI 0.049-0.491) and FV (HR 0.037, 95%CI 0.006-0.223) versus UV. SARS-CoV-2 vaccination was followed by a marked decline in infection rates and was associated with lower morbidity and mortality among infected NH residents.

Radon and radium concentration in water from North-West of Romania and the estimated doses

In the present study, the measurements of radon were carried out using the LUK-VR system based on radon gas measurements with Lucas cells. The radium concentration in water was determined, with the same device, immediately after was established the radon equilibrium with radium. The results presented here are from a survey carried out in the N-W region of Transylvania (Romania) in which were investigated the radon concentrations in natural (spring, well and surface) and drinking (tap) waters. The results showed radon concentrations within the range of 0.4-187.3 Bq l(-1) with an average value of 15.9 Bq l(-1) whereas radium concentration varied between 0.05 and 0.825 Bq l(-1) with an average value of 0.087 Bq l(-1) for all types of water covered within this survey. The corresponding annual effective ingestion dose due to radon and radium from water was determined from drinking water used by the population inhabiting the area.