Criteria for the suspicion and diagnosis of acute food protein-induced enterocolitis syndrome.

Over the past decades, several panels of criteria have been proposed for the diagnosis of acute food protein-induced enterocolitis syndrome (FPIES). However, none of them have been validated by a prospective study. Such a study is not easy to carry out, because even the children who most of us would certainly believe to be suffering from acute FPIES, possibly serious, should be subject to oral food challenge (OFC). Moreover, the presence of different phenotypes of the acute FPIES may mean that some of them do not fit into any of the above criteria panels. Particularly, Vazquez-Ortiz et al. reported that milder cases (1/4 in their Southern European cohort) might not be captured by the 2017 Consensus diagnostic criteria, which are the most shared till date. Those authors, as well as all interested researchers, claim for accurate diagnostic bio-markers which, however, are not available at the moment

Isobaric first-principles molecular dynamics of liquid water with nonlocal van der Waals interactions

We investigate the structural properties of liquid water at near ambient conditions using first-principles molecular dynamics simulations based on a semilocal density functional augmented with nonlocal van der Waals interactions. The adopted scheme offers the advantage of simulating liquid water at essentially the same computational cost of standard semilocal functionals. Applied to the water dimer and to ice I-h, we find that the hydrogen-bond energy is only slightly enhanced compared to a standard semilocal functional. We simulate liquid water through molecular dynamics in the N pH statistical ensemble allowing for fluctuations of the system density. The structure of the liquid departs from that found with a semilocal functional leading to more compact structural arrangements. This indicates that the directionality of the hydrogen-bond interaction has a diminished role as compared to the overall attractions, as expected when dispersion interactions are accounted for. This is substantiated through a detailed analysis comprising the study of the partial radial distribution functions, various local order indices, the hydrogen-bond network, and the selfdiffusion coefficient. The explicit treatment of the van der Waals interactions leads to an overall improved description of liquid water

Microendoscopic Surgery of Middle Ear and Petrous Bone: Benefits Analysis

Objectives: Endoscopy has become routinely used in middle ear surgery. The aim of this study is to analyze where this tool may complement the traditional microscopic approach. This is a retrospective study done in single tertiary hospital. Methods: We reviewed 342 middle ear/petrous bone surgical procedures performed between 2005 and 2015. Only cases in which both microscopic and endoscope-assisted techniques were used have been included. Sixty-six patients received this double-technique surgery: 51 (77.2%) had middle ear/mastoid and petrous bone cholesteatomas (46 middle ear and mastoid and 5 acquired/congenital petrous bone cholesteatomas), 5 (7.5%) had glomus tympanicum tumors (GTT), 4 (6%) had an ossicular chain dislocation, 3 (4.5%) had purulent chronic otitis media, 2 (3%) had tympanosclerosis, and 1 (1.5%) had an ossicular chain malformation. Results: The endoscope was helpful to remove disease remnants not accessible by microscope in 41 (62%) of the cases; 37 (90%) were cholesteatomas, 3 (7%) were GTT, and only 1 (3%) was an open tympanosclerosis. In the remaining 25 (37.8%) cases, the endoscope was useful only to visualize the cavity since the microscope had already been successful in removing the entire lesion. Conclusions: The endoscopy can add valuable information and support to the usual microscope approach alone. The consensus of a single best technique does not yet exist, but the physician should choose the best modality or combination of modalities in order to cure the patient and prevent any possible complications or recurrence of the pathology

On the advantages and disadvantages of choice: future research directions in choice overload and its moderators

Researchers investigating the psychological effects of choice have provided extensive empirical evidence that having choice comes with many advantages, including better performance, more motivation, and greater life satisfaction and disadvantages, such as avoidance of decisions and regret. When the decision task difficulty exceeds the natural cognitive resources of human mind, the possibility to choose becomes more a source of unhappiness and dissatisfaction than an opportunity for a greater well-being, a phenomenon referred to as choice overload. More recently, internal and external moderators that impact when choice overload occurs have been identified. This paper reviews seminal research on the advantages and disadvantages of choice and provides a systematic qualitative review of the research examining moderators of choice overload, laying out multiple critical paths forward for needed research in this area. We organize this literature review using two categories of moderators: the choice environment or context of the decision as well as the decision-maker characteristics

Evidence for proton acceleration and escape from the Puppis A SNR using Fermi-LAT observations

Supernova remnants (SNRs) are the best candidates for galactic cosmic ray acceleration to relativistic energies via diffusive shock acceleration. The gamma-ray emission of SNRs can provide direct evidence of leptonic (inverse Compton and bremsstrahlung) and hadronic (proton-proton interaction and subsequently pion decay) processes. Puppis A is a ~ 4 kyr old SNR interacting with interstellar clouds which has been observed in a broad energy band, from radio to gamma-ray. We performed a morphological and spectral analysis of 14 years of observations with Fermi-LAT telescope in order to study its gamma-ray emission. We found a clear asymmetry in high-energy brightness between the eastern and western sides of the remnant, reminiscent to that observed in the X-ray emission. The eastern side, interacting with a molecular cloud, shows a spectrum which can be reproduced by a pion decay model. Moreover, we analyzed two gamma-ray sources located close to the remnant. The hardness of their spectra suggests that the gamma-ray emission can be due to particles escaping from the shock of Puppis A.Comment: Presented at the 38th International Cosmic Ray Conference (ICRC 2023), 8 pages, 2 figures, 3 table

Potential Application of Lung Ultrasound in Children with Severe Uncontrolled Asthma: Preliminary Hypothesis Based on a Case Series

: In recent years, lung ultrasound (LUS) has been increasingly used for the diagnosis of respiratory diseases in both adult and pediatric patients. However, asthma is a field in which the use of LUS is not yet well defined, or is in development. In the following case series, we describe clinical, laboratory, and radiological results, as well as detailed lung ultrasound findings of six children with asthma: some of them with acute asthma attack and with inadequately controlled allergic asthma or childhood asthma; others with acute asthma and allergic or infantile asthma adequately controlled by preventive therapy. Finally, we describe the clinical, laboratory, and imaging parameters of a child with severe allergic asthma in the absence of exacerbation. In these cases, albeit at different times, LUS played an important role in both the initial diagnostic process and follow-up. It also showed different ultrasound features depending on the severity of the individual asthma based on the type of asthmatic phenotype and control of it

Functional constipation related to cow's milk allergy in children: A management proposal.

Functional constipation (FC) is one of the most common disorders in childhood and has a neg-ative impact on the quality of life of children. Scientific evidence regarding a causal relation-ship between FC and cow's milk allergy is controversial, as it is also reported by the latest European Society for Paediatric Gastroenterology, Hepatology and Nutrition-North American Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN–NASPGHAN) rec-ommendations. In the case of FC, routine allergometric tests are not recommended and the cows' milk-free diet is only proposed in the case of laxative-resistant constipation and only following the advice of an expert. Instead, after a careful review of the literature and in view of the many clinical cases encountered in our clinical practice, we believe that it is useful to propose cows' milk-free diet as first line for the treatment of FC at least in pre-school children and in children with a personal or family history of atopy or with a previous diagnosis of cow's milk protein allergy