First Direct Measurement Constraining the

The rate of the final step in the astrophysical αp process, the ^{34}Ar(α,p)^{37}K reaction, suffers from large uncertainties due to a lack of experimental data, despite having a considerable impact on the observable light curves of x-ray bursts and the composition of the ashes of hydrogen and helium burning on accreting neutron stars. We present the first direct measurement constraining the ^{34}Ar(α,p)^{37}K reaction cross section, using the Jet Experiments in Nuclear Structure and Astrophysics gas jet target. The combined cross section for the ^{34}Ar,Cl(α,p)^{37}K,Ar reaction is found to agree well with Hauser-Feshbach predictions. The ^{34}Ar(α,2p)^{36}Ar cross section, which can be exclusively attributed to the ^{34}Ar beam component, also agrees to within the typical uncertainties quoted for statistical models. This indicates the applicability of the statistical model for predicting astrophysical (α,p) reaction rates in this part of the αp process, in contrast to earlier findings from indirect reaction studies indicating orders-of-magnitude discrepancies. This removes a significant uncertainty in models of hydrogen and helium burning on accreting neutron stars.

Preliminary investigation of Brain Network Activation (BNA) and its clinical utility in sport-related concussion.

BACKGROUND: The clinical diagnosis and management of patients with sport-related concussion is largely dependent on subjectively reported symptoms, clinical examinations, cognitive, balance, vestibular and oculomotor testing. Consequently, there is an unmet need for objective assessment tools that can identify the injury from a physiological perspective and add an important layer of information to the clinician's decision-making process. OBJECTIVE: The goal of the study was to evaluate the clinical utility of the EEG-based tool named Brain Network Activation (BNA) as a longitudinal assessment method of brain function in the management of young athletes with concussion. METHODS: Athletes with concussion (n = 86) and age-matched controls (n = 81) were evaluated at four time points with symptom questionnaires and BNA. BNA scores were calculated by comparing functional networks to a previously defined normative reference brain network model to the same cognitive task. RESULTS: Subjects above 16 years of age exhibited a significant decrease in BNA scores immediately following injury, as well as notable changes in functional network activity, relative to the controls. Three representative case studies of the tested population are discussed in detail, to demonstrate the clinical utility of BNA. CONCLUSION: The data support the utility of BNA to augment clinical examinations, symptoms and additional tests by providing an effective method for evaluating objective electrophysiological changes associated with sport-related concussions.

First Direct Measurement of (12)C((12)C,n)(23)Mg at Stellar Energies.

Neutrons produced by the carbon fusion reaction (12)C((12)C,n)(23)Mg play an important role in stellar nucleosynthesis. However, past studies have shown large discrepancies between experimental data and theory, leading to an uncertain cross section extrapolation at astrophysical energies. We present the first direct measurement that extends deep into the astrophysical energy range along with a new and improved extrapolation technique based on experimental data from the mirror reaction (12)C((12)C,p)(23)Na. The new reaction rate has been determined with a well-defined uncertainty that exceeds the precision required by astrophysics models. Using our constrained rate, we find that (12)C((12)C,n)(23)Mg is crucial to the production of Na and Al in pop-III pair instability supernovae. It also plays a nonnegligible role in the production of weak s-process elements, as well as in the production of the important galactic γ-ray emitter (60)Fe.

Determining the rp-process flow through 56Ni: resonances in 57Cu(p,γ)58Zn identified with GRETINA.

An approach is presented to experimentally constrain previously unreachable (p, γ) reaction rates on nuclei far from stability in the astrophysical rp process. Energies of all critical resonances in the (57)Cu(p,γ)(58)Zn reaction are deduced by populating states in (58)Zn with a (d, n) reaction in inverse kinematics at 75 MeV/u, and detecting γ-ray-recoil coincidences with the state-of-the-art γ-ray tracking array GRETINA and the S800 spectrograph at the National Superconducting Cyclotron Laboratory. The results reduce the uncertainty in the (57)Cu(p,γ) reaction rate by several orders of magnitude. The effective lifetime of (56)Ni, an important waiting point in the rp process in x-ray bursts, can now be determined entirely from experimentally constrained reaction rates.

Biochemical differentiation between cancerous and normal human colorectal tissues by micro-Raman spectroscopy.

Human colorectal tissues obtained by ten cancer patients have been examined by multiple micro-Raman spectroscopic measurements in the 500-3200 cm-1 range under 785 nm excitation. Distinct spectral profiles are recorded from different spots on the samples: a predominant 'typical' profile of colorectal tissue, as well as those from tissue topologies with high lipid, blood or collagen content. Principal component analysis identified several Raman bands of amino acids, proteins and lipids which allow the efficient discrimination of normal from cancer tissues, the first presenting plurality of Raman spectral profiles while the last showing off quite uniform spectroscopic characteristics. Tree-based machine learning experiment was further applied on all data as well as on filtered data keeping only those spectra which characterize the largely inseparable data clusters of 'typical' and 'collagen-rich' spectra. This purposive sampling evidences statistically the most significant spectroscopic features regarding the correct identification of cancer tissues and allows matching spectroscopic results with the biochemical changes induced in the malignant tissues.

Implementation of active injury management (AIM) in youth with acute concussion: A randomized controlled trial.

BACKGROUND: Nearly 2 million youth seek acute medical care following concussion in the U.S. each year. Current standard of care recommends rest for the first 48 h after a concussion. However, research suggests that prolonged rest may lengthen recovery time especially for patients with certain risk profiles. Research indicates that physical activity and behavioral management interventions (sleep, stress management) may enhance recovery. To date, there is limited empirical evidence to inform acute (<72 h) concussion recommendations for physical activity and behavioral management in adolescents. OBJECTIVE: To determine the effectiveness of physical activity and behavioral management for acute concussion in adolescents and young adults, and to evaluate the role of patient characteristics on treatment response. METHODS: This multicenter prospective randomized controlled trial will determine which combination of physical activity and behavioral management is most effective for patients 11-24 years old who present to the emergency department or concussion clinic within 72 h of injury. Participants are randomized into: 1) rest, 2) physical activity, 3) mobile health application (mHealth) behavioral management, or 4) physical activity and mHealth app conditions. Assessments at enrollment, 3-5 days, 14 days, 1 month, and 2 months include: concussion symptoms, balance, vestibular-ocular and cognitive assessments, quality of life, and recovery time. Somatic symptoms and other risk factors are evaluated at enrollment. Compliance with treatment and symptoms are assessed daily using actigraph and daily self-report. The primary study outcome is symptoms at 14 days. CONCLUSION: Prescribed physical activity and behavioral management may improve outcomes in youth following acute concussion.

Visible light induced wetting of nanostructured N-F co-doped titania films.

Nitrogen and fluorine co-doped TiO(2) films have been prepared by dip coating of a modified titania sol-gel based on a nitrogen precursor and a nonionic fluorosurfactant as pore template and fluorine source. The modified NF-TiO(2) films absorb in the visible spectral range, between 400-510 nm and undergo reversible hydrophilic conversion under visible light to a final contact angle of 8°, in contrast to the UV limited optical response of their undoped anatase TiO(2) analogues. The phenomenon takes place at a rate slower than the corresponding one observed for the UV stimulated superhydrophilic effect. The wetting response of the N-F doped TiO(2) films correlates well with the variation of their optical properties and surface morphological characteristics and most importantly with their photocatalytic activity, rendering these materials very promising for self-cleaning applications under visible light.

Photo-induced effects on self-organized TiO2 nanotube arrays: the influence of surface morphology.

Self-organized TiO(2) nanotubes with packed, vertically aligned morphology and different lateral characteristics were grown on Ti metal substrates by controlled electrochemical anodization in phosphate/HF and ethylene glycol/HF electrolytes. The wetting, photo-induced superhydrophilicity, and photocatalytic activity of the nanotubular materials were investigated under ultraviolet irradiation. The photoactivity of the TiO(2) nanotube arrays was analysed in terms of their morphological characteristics that were determined by means of scanning electron microscopy and atomic force microscopy in conjunction with geometrical modelling. The wetting and the UV-induced superhydrophilicity could be accordingly modelled by the Cassie-Baxter mode arising from the large scale roughness of the nanotubular arrays in combination with the Wenzel mode due to the small scale roughness induced by ridges at the outer tube surface. The photocatalytic activity of the TiO(2) nanotube arrays was further found to correlate quantitatively with the variation of the geometric roughness factor, verifying the strong impact of morphology on the photo-induced properties of the vertically oriented TiO(2) tubular architecture.

Impact of Factors that Affect Reading Skill Level on King-Devick Baseline Performance Time.

The King-Devick (K-D) test is often used as part of a multimodal assessment to screen for sport-related concussion. However, the test involves reading numbers, and little is known about variation in baseline performance on the K-D by reading skill level. We conducted a cross-sectional study analyzing data from the Concussion Assessment, Research and Education (CARE) Consortium to assess differences in baseline performance on the K-D associated with factors that impact reading skill level (learning disorder [LD] and primary home language other than English [PHLOTE]), while controlling for covariates (gender, type of sport, attentional issues, history of concussion and modality of administration). We had a sample of 2311 student-athletes (47% female), and multivariate regression indicated an average K-D performance time of 40.4 s. Presence of LD was associated with a 3.3 s slower K-D time (95% CI 1.9-4.7, p < 0.001), and PHLOTE was associated with a 2.6 s slower K-D time (95% CI 1.2-4.0, p < 0.001), after controlling for other covariates. These results suggest caution in the use of normative data with the K-D. Future studies should explore the impact of factors associated with reading skill level on sensitivity of the K-D in detecting concussion.

Early detection of subclinical HIV sensory polyneuropathy using intraepidermal nerve fibre density quantification: association with HIV stage and surrogate markers.

The linear intraepidermal nerve fibre density (IENFD) and secondary branching were evaluated from skin biopsy of both the distal calf and the proximal thigh after staining with protein gene product 9.5 in 94 individuals of an HIV outpatient cohort. Possible correlations with clinical and electrophysiological evidence of distal sensory polyneuropathy (DSP), patients' demographics, antiretroviral history and HIV surrogate markers were analysed. Reduced IENFD was recognized in the majority of this population (mean +/- standard deviation [SD] IENFD in the calf and the thigh was 3.19 +/- 1.91 and 7.07 +/- 3.5 fibres/mm, respectively). One-third of the patients with low IENFD had no clinical or electrophysiological evidence of DSP. The level of prior immunosuppression as expressed by lower nadir CD4 count, more advanced HIV stage and prior exposure to combinations of neurotoxic antiretrovirals was associated with more decreased IENFD. Increased SB was associated with symptomatic DSP.

Distal sensory polyneuropathy in HIV-positive patients in the HAART era: an entity underestimated by clinical examination.

The aim of this study was to determine the prevalence of distal sensory polyneuropathy (DSP) in our HIV-positive patients under highly active antiretroviral therapy (HAART) and to investigate correlations with clinical, laboratory and demographic factors. One hundred consecutive HIV-positive patients underwent clinical and electrophysiological evaluation for DSP. Correlations with HIV stage, CD4 count, nadir CD4 count, viral load (VL), disease duration, age, sex and type of antiretrovirals were examined. Thirty-six percent of the patients had DSP (13% clinical, 23% subclinical diagnosed by electrophysiology). The prevalence of DSP was affected in a statistically significant manner by the diagnosis of AIDS (P = 0.00033), age (P = 0.0102), nadir CD4 count (P = 0.0087) and exposure to two neurotoxic antiretrovirals (P = 0.0189). Advanced HIV stage, sex, time from diagnosis, current CD4 count and VL did not seem to affect the prevalence of DSP. Clinical examination plus electrophysiology reveals that DSP affects 36% of patients under HAART, although subclinical in 2/3 of cases. Age, severe prior immunosuppression and the combined use of zalcitabine (ddC), stavudine (d4T) and didanosine (ddI) are important risk factors.

Raman scattering study of ß-Sr(0.33)V(2)O(5) in charge disordered and ordered phase.

Polarized Raman spectra of the strontium vanadium oxide bronze ß-Sr(0.33)V(2)O(5) are measured in the temperature range between 300 and 77 K. The charge ordering phase transition at about 165 K is characterized by the appearance of new Raman-active modes in the spectra, as well as through an abrupt change of the phonon frequencies and dampings. The Raman scattering spectra of ß-Sr(0.33)V(2)O(5) in the charge disordered phase are in apparent resemblance with those of α'-NaV(2)O(5), which suggests that there is a similar charge-phonon dynamics in both compounds. We also suggest that the electrons are delocalized into V(1)-O(5)-V(3) orbitals in the mixed valence state of ß-Sr(0.33)V(2)O(5).

Extranodal non-Hodgkin lymphoma presenting as a soft tissue mass in the proximal femur in a HIV(+) patient.

Primary soft tissue non-Hodgkin lymphomas (NHL) are very rare especially among HIV-1 infected patients. We describe a patient with HIV-1 infection who presented with acute pain of the right proximal femur. The clinical and laboratory investigation revealed a high grade centroblastic B-cell lymphoma of soft tissue. The patient was treated by surgical resection of the tumor, chemotherapy and local radiotherapy with no serious side effects. After 36 mdnths of follow up he is in excellent clinical condition, with his lymphoma in complete remission.

Erythropoietic response to hypoxaemia in diffuse idiopathic pulmonary fibrosis, as opposed to chronic obstructive pulmonary disease.

The aim of this study was to assess the erythropoietic response to hypoxaemia in patients with diffuse idiopathic pulmonary fibrosis (DIPF), and to speculate on the underlying mechanisms. Patients on an established chronic respiratory failure due to DIPF or chronic obstructive pulmonary disease (COPD) were studied. The erythropoietic response to hypoxaemia in both conditions was assessed. We studied 18 patients with DIPF and 29 patients with COPD in respiratory failure in a stable stage, free from acute infection and congestive heart failure. Blood gases, erythrocytic parameters, as well the serum levels of iron, ferritin and erythropoietin were determined. All the DIPF patients studied, apart from two, had normal or subnormal haematocrit values. The patients with COPD had an inconsistant response to hypoxaemia; 12 had normal or subnormal haematocrit values and the remaining 17 were erythraemic. The mean value of erythropoietin (EPO) in both DIPF and COPD patients was significantly higher than normal. In conclusion, patients with DIPF exhibit a lack of erythropoietic response to hypoxaemia, despite the augmented erythropoietin levels. This may reflect a defective bone marrow erythropoietic response in DIPF patients. It is suggested that the pathophysiology of DIPF underlies this mechanism.

[Myocardial perfusion scintigraphy using 99mTC-tetrofosmin: a comparison with coronary angiography]. / Myokard-Perfusionsszintigraphie mit 99mTc-Tetrofosmin: Ein Vergleich mit der koronaren Angiographie.

AIM: Coronary angiography is still the most reliable method for the detection of coronary artery disease. In this study we compared to this method the accuracy of 99mTc-Tetrofosmin myocardial SPECT. METHOD: Fifty two patients (38 male and 14 female) were studied with stress-rest 99mTc-Tetrofosmin myocardial SPECT. Two independent observers evaluated the uptake of the radiotracer using a score from 0 to 4. All patients underwent coronary angiography and the results were compared to SPECT findings. We considered as hemodynamic significant any obstruction greater than 50% and as ischemic any myocardial region with radiotracer uptake less than 4 at stress. RESULTS: There was good segmental correspondence between tetrofosmin scintigram and angiography. Sensitivity 72.2-91.1%, specificity 80.0-88.2%, ppv 76.4-88.5% and npv 83.3-85.7%, depending on the obstructed vessel. CONCLUSION: 99mTc-Tetrofosmin myocardial SPECT is a reliable alternative for the detection of CAD.

Efficacy of ondansentron treatment for acute emesis with different dosing schedules 8 vs 32 mg. A randomized study.

The aim of the present randomized study was to evaluate which dose of Ondansentron (OND)(32 versus 8 mg) is appropriate for the antiemetic treatment of a uniform group of patients (pts) with Non Small Cell Lung Cancer (NSCLC) who were treated with Cisplatin (CDDP) 100 mg/m2 in combination with other less emetogenic drugs. One hundred and ten patients, with histologically confirmed NSCLC entered this randomized study. They were between 50 - 70 years old, with no previous Chemotherapy, with a PS (Karnofsky) >60%. They were randomized into two groups; Group A: OND as a 32 mg dose the first 24 hours, followed by 8 mg every 8 hrs for the following four days, combined with dexamethasone, 8 mg i.v. the first day, and 8 mg p.o., in the morning, the following three days. Group B: OND as a 8 mg dose every day for 4 days, combined with dexamethasone 8 mg i.v. and 8 mg p.o. the following three days. In this randomized study, of the 110 patients who entered, 106 were evaluable. Clinical parameters were similar between the examined groups. A higher number of patients of Group A presented complete response (P 0.0001), compared to patients of Group B who failed (P 0.004), during the first 24 hours. In the 3 days that followed, a higher number of pts of Group A presented complete response to the antiemetic therapy (P 0.001, P 0.0001), while Group B failed (P 0.007, P 0.001, P 0.019), or presented minor response (P 0.0001, P 0.004). Patients who had no antiemetic response needed additional therapy and were excluded from the evaluatio (13 pts of Group B). Retches (P 0.0001, P 0.005), and nausea (P 0.0001, P were also frequent in Group B. We concluded that reduced OND doses (8 mg) are inadequate in the prevention of emesis after high dose CDDP (100 mg/m2) and should be avoided.

Comparative study of tropisetron with the addition of dexamethasone or alprazolam in breast cancer patients receiving adjuvant chemotherapy with CEF (cyclophosphamide, epirubicin and 5-fluorouracil).

We studied tropisetron (T) in patients with breast cancer receiving standard adjuvant chemotherapy with CEF (cyclophosphamide, epirubicin and 5-fluorouracil) over 3 consecutive cycles; T was administered alone or in combination with dexamethasone (D) or alprazolam (A). 50 women entered and during the 1st cycle patients received T i.v. before chemotherapy and the same dose orally on each of the following 3 days. In the 2nd cycle, T was administered together with D and during the 3rd cycle, T was combined with A and continued with T over the ensuing 3 days post-chemotherapy. Stress was present in 23 women and was evaluated for its impact on antiemetic response. Differences in the emetogenic response were found for nausea and vomiting mainly with the addition of A. The combination of T+A was superior to T and T+D in acute emesis (P<0.001). Concerning delayed emesis, differences were detected with both T+D and T+A (being equally effective) and superior to T alone (P<0.001). The emetogenic potential was decreased by the addition of A in comparison to T alone (P=0.001). Patients without stress had no difference, while patients with stress had a significantly better antiemetic result with the addition of D or A to T. In conclusion, T provides a satisfactory result in controlling nausea and emesis caused by moderately emetogenic CT regimens. Addition of D or A improves the antiemetic effect, and A provides better coverage in women with stress, a finding worth exploration in larger confirmatory studies.

Eosinophilic granuloma of the femur in an HIV-1-positive patient.

A case of eosinophilic granuloma in the right femur of an HIV-1-infected patient is described, and the possible pathogenetic role of HIV infection in eosinophilic granuloma formation is discussed.

Tc-99m tetrofosmin myocardial perfusion imaging before and six months after percutaneous transluminal coronary angioplasty.

The role of Tc-99m tetrofosmin single-photon emission tomography (SPECT) in the evaluation of myocardial perfusion before and 6 months after successful percutaneous transluminal coronary angioplasty (PTCA) was assessed in 41 consecutive patients (32 men and 9 women). Twenty-five patients had one-vessel disease, 14 had two-vessel disease, and 2 had three-vessel disease. Thirty-six patients had dilation of one vessel and five patients dilation of two stenosed vessels, with a total of 46 dilated vessels. All patients underwent coronary angiography both before PTCA and 6 months after revascularization. Restenosis was angiographically demonstrated in 16 (39%) patients and 16 (34.8%) vessels. Tc-99m tetrofosmin myocardial SPECT was 81.3% sensitive and 88% specific for the detection of restenosis in the group of patients with a positive predictive value of 81.3% and a negative predictive value of 88%. Sensitivity, specificity, positive predictive value, and negative predictive value were 81.3%, 90%, 76.5%, and 89.7%, respectively, for restenosis detection in specific vessels. It was concluded that most patients who underwent successful PTCA (34 of 41, or 82.9%) had significant (P < 0.001) improvement in their scan image 6 months after the angioplasty, and that Tc-99m tetrofosmin myocardial SPECT is an excellent tool to follow these patients because it can detect restenosis accurately and noninvasively.

Brain activation during neurocognitive testing using functional near-infrared spectroscopy in patients following concussion compared to healthy controls.

There is no accepted clinical imaging modality for concussion, and current imaging modalities including fMRI, DTI, and PET are expensive and inaccessible to most clinics/patients. Functional near-infrared spectroscopy (fNIRS) is a non-invasive, portable, and low-cost imaging modality that can measure brain activity. The purpose of this study was to compare brain activity as measured by fNIRS in concussed and age-matched controls during the performance of cognitive tasks from a computerized neurocognitive test battery. Participants included nine currently symptomatic patients aged 18-45 years with a recent (15-45 days) sport-related concussion and five age-matched healthy controls. The participants completed a computerized neurocognitive test battery while wearing the fNIRS unit. Our results demonstrated reduced brain activation in the concussed subject group during word memory, (spatial) design memory, digit-symbol substitution (symbol match), and working memory (X's and O's) tasks. Behavioral performance (percent-correct and reaction time respectively) was lower for concussed participants on the word memory, design memory, and symbol match tasks than controls. The results of this preliminary study suggest that fNIRS could be a useful, portable assessment tool to assess reduced brain activation and augment current approaches to assessment and management of patients following concussion.