RESUMO
A near-threshold proton resonance in ^{11}B at E_{ex}=11.44±0.04 MeV is observed via the reaction ^{10}Be(d,n)^{11}Beâ^{10}Be+p in inverse kinematics, measured with a beam of the radioactive isotope ^{10}Be. The resonance energy at E_{res}=211(40) keV is consistent with a proton signal observed by Ayyad et al. in the ß-delayed proton decay of ^{11}Be. By comparison to a distorted wave Born approximation calculation, a 0.27(6) spectroscopic factor is extracted and a tentative (â=0) character is assigned for this resonance. The significant cross section in the proton-transfer (d,n) reaction, as well as the observation of its proton-decay signal, point to the threshold-resonance character of this state. The position of this state, its structure, and strong coupling to the s-wave continuum represent an ideal case to study quantum near-threshold many-body dynamics of unstable states. The presence of this state is an important step toward understanding the excessively large beta-delayed proton-decay branch of ^{11}Be.
RESUMO
BACKGROUND: The clinical relevance of patient-reported outcomes score changes is often unclear. Especially in patients undergoing surgery due to lower extremity metastases - where surgery is performed in the palliative setting and the goal is to optimize functional mobility, relieve pain and improve overall quality of life. This study assessed the minimal clinically important difference (MCID) of Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference, Cancer-specific Physical Function, and Global (Physical and Mental Health) in patients treated surgically for impending or completed pathologic fractures. METHODS: Patients undergoing surgery for osseous metastasis of the lower extremity because of an impending or completed pathologic fracture were consecutively enrolled in this tertiary center study. Patients completed the three PROMIS questionnaires preoperatively (n = 56) and at postoperative follow-up (n = 33) assessment one to three months later. Of the 23 patients that did not complete the postoperative survey, 5 patients died within 1-3 months and 18 patients were alive at 3-months but did not respond or show up at their postoperative consult. Thirty-one patients (94%) of the 33 included patients reported at least minimal improvement and two patients (6.1%) no change 1-3 months after the surgery based on an anchor-based approach. RESULTS: The PROMIS MCIDs (95% confidence interval) for Pain Interference was 7.5 (3.4-12), Physical Function 4.1 (0.6-7.6), Global Physical Health 4.2 (2.0-6.6), and Global Mental Health 0.8 (-4.5-2.9). CONCLUSION: This prospective study successfully defined a MCID for PROMIS Pain Interference of 7.5 (3.4-12), PROMIS Physical Function of 4.1 (0.6-7.6), and Global Physical Health of 4.2 (2.0-6.6) in patients with (impending) pathological fractures due to osseous metastases in the lower extremity; no MCID could be established for PROMIS Global Mental Health. Defining a narrower MCID value for each subpopulation requires a large, prospective, multicenter study. Nevertheless, the provided MCID values allow guidance to clinicians to evaluate the impact of surgical treatment on a patient's QoL. LEVEL OF EVIDENCE: Level II Diagnostic study.
Assuntos
Extremidade Inferior , Diferença Mínima Clinicamente Importante , Metástase Neoplásica , Qualidade de Vida , Humanos , Extremidade Inferior/cirurgia , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Centros de Atenção TerciáriaRESUMO
OBJECTIVES: The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975-2016 in Spain. STUDY DESIGN: A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975-2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods. RESULTS: HIV/AIDS shaped the increasing trend period of infectious diseases in 1989-1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995-1999 and 1999-2016. Lung cancer fell gradually from 1994 in men (-0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980-2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes. CONCLUSIONS: Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.
Assuntos
Causas de Morte/tendências , Acidentes de Trânsito/mortalidade , Síndrome da Imunodeficiência Adquirida/mortalidade , Adulto , Idoso , Causalidade , Demência/mortalidade , Feminino , Humanos , Estudos Longitudinais , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Isquemia Miocárdica/mortalidade , Neoplasias Pancreáticas/mortalidade , Espanha , Suicídio/estatística & dados numéricosRESUMO
The ^{36}Ar(n,γ)^{37}Ar (t_{1/2}=35 d) and ^{38}Ar(n,γ)^{39}Ar (269 yr) reactions were studied for the first time with a quasi-Maxwellian (kTâ¼47 keV) neutron flux for Maxwellian average cross section (MACS) measurements at stellar energies. Gas samples were irradiated at the high-intensity Soreq applied research accelerator facility-liquid-lithium target neutron source and the ^{37}Ar/^{36}Ar and ^{39}Ar/^{38}Ar ratios in the activated samples were determined by accelerator mass spectrometry at the ATLAS facility (Argonne National Laboratory). The ^{37}Ar activity was also measured by low-level counting at the University of Bern. Experimental MACS of ^{36}Ar and ^{38}Ar, corrected to the standard 30 keV thermal energy, are 1.9(3) and 1.3(2) mb, respectively, differing from the theoretical and evaluated values published to date by up to an order of magnitude. The neutron-capture cross sections of ^{36,38}Ar are relevant to the stellar nucleosynthesis of light neutron-rich nuclides; the two experimental values are shown to affect the calculated mass fraction of nuclides in the region A=36-48 during the weak s process. The new production cross sections have implications also for the use of ^{37}Ar and ^{39}Ar as environmental tracers in the atmosphere and hydrosphere.
RESUMO
The existence of ^{26}Al (t_{1/2}=7.17×10^{5} yr) in the interstellar medium provides a direct confirmation of ongoing nucleosynthesis in the Galaxy. The presence of a low-lying 0^{+} isomer (^{26}Al^{m}), however, severely complicates the astrophysical calculations. We present for the first time a study of the ^{26}Al^{m}(d,p)^{27}Al reaction using an isomeric ^{26}Al beam. The selectivity of this reaction allowed the study of â=0 transfers to T=1/2, and T=3/2 states in ^{27}Al. Mirror symmetry arguments were then used to constrain the ^{26}Al^{m}(p,γ)^{27}Si reaction rate and provide an experimentally determined upper limit of the rate for the destruction of isomeric ^{26}Al via radiative proton capture reactions, which is expected to dominate the destruction path of ^{26}Al^{m} in asymptotic giant branch stars, classical novae, and core collapse supernovae.
RESUMO
The oxidation of CO on Pt(111) was investigated simultaneously by near ambient pressure X-ray photoelectron spectroscopy and online gas analysis. Different CO:O2 reaction mixtures at total pressures of up to 1 mbar were used in continuous flow mode to obtain an understanding of the surface chemistry. By temperature-programmed and by isothermal measurements, the onset temperature of the reaction was determined for the different reactant mixtures. Highest turnover frequencies were found for the stoichiometric mixture. At elevated temperatures, the reaction becomes diffusion-limited in both temperature-programmed and isothermal measurements. In the highly active regime, no adsorbates were detected on the surface; it is therefore concluded that the catalyst surface is in a metallic state, within the detection limits of the experiment, under the applied conditions. Minor bulk impurities such as silicon were observed to influence the reaction up to total inhibition by formation of non-platinum oxides.
RESUMO
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.
RESUMO
The 1809-keV γ ray from the decay of (26)Al(g) is an important target for γ-ray astronomy. In the convective C/Ne burning shell of massive presupernova stars, the (23)Na(α,p)(26)Mg reaction directly influences the production of (26)Al. We have performed a direct measurement of the (23)Na(α,p)(26)Mg reaction cross section at the appropriate astrophysically important energies. The stellar rate calculated in the present work is larger than the recommended rate by nearly a factor of 40 and could strongly affect the production of (26)Al in massive stars.
RESUMO
Measurements of the excitation function for the fusion of (24)Mg+(30)Si (Q=17.89 MeV)have been extended toward lower energies with respect to previous experimental data. The S-factor maximum observed in this large, positive-Q-value system is the most pronounced among such systems studied thus far. The significance and the systematics of an S-factor maximum in systems with positive fusion Q values are discussed. This result would strongly impact the extrapolated cross sections and reaction rates in the carbon and oxygen burnings and, thus, the study of the history of stellar evolution.
RESUMO
The interaction between neutron-rich nuclei plays an important role for understanding the reaction mechanism of the fusion process as well as for the energy production through pycnonuclear reactions in the crust of neutron stars. We have performed the first measurements of the total fusion cross sections in the systems (10,14,15)C+(12)C using a new active target-detector system. In the energy region accessible with existing radioactive beams, a good agreement between the experimental and theoretical cross sections is observed. This gives confidence in our ability to calculate fusion cross sections for systems which are outside the range of today's radioactive beam facilities.
RESUMO
KNOWLEDGE TRANSFER STATEMENT: The challenges and recommendations outlined in this commentary will serve as steppingstones to process the concepts of translational science, facilitate training for future scientists, and serve as an approach for the early investigators in the field of translational science.
Assuntos
Pesquisa Translacional Biomédica , Ciência Translacional Biomédica , Humanos , Pesquisa Translacional Biomédica/educação , Pesquisadores/educação , Previsões , ConhecimentoRESUMO
BACKGROUND: Surgical site infection (SSI) after segmental endoprosthetic reconstruction in patients treated for oncologic conditions remains both a devastating and a common complication. The goal of the present study was to identify variables associated with the success or failure of treatment of early SSI following the treatment of a primary bone tumor with use of a segmental endoprosthesis. METHODS: The present study used the Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) data set to identify patients who had been diagnosed with an SSI after undergoing endoprosthetic reconstruction of a lower extremity primary bone tumor. The primary outcome of interest in the present study was a dichotomous variable: the success or failure of infection treatment. We defined failure as the inability to eradicate the infection, which we considered as an outcome of amputation or limb retention with chronic antibiotic suppression (>90 days or ongoing therapy at the conclusion of the study). Multivariable models were created with covariates of interest for each of the following: surgery characteristics, cancer treatment-related characteristics, and tumor characteristics. Multivariable testing included variables selected on the basis of known associations with infection or results of the univariable tests. RESULTS: Of the 96 patients who were diagnosed with an SSI, 27 (28%) had successful eradication of the infection and 69 had treatment failure. Baseline and index procedure variables showing significant association with SSI treatment outcome were moderate/large amounts of fascial excision ≥1 cm2) (OR, 10.21 [95% CI, 2.65 to 46.21]; p = 0.001), use of local muscle/skin graft (OR,11.88 [95% CI, 1.83 to 245.83]; p = 0.031), and use of a deep Hemovac (OR, 0.24 [95% CI, 0.05 to 0.85]; p = 0.041). In the final multivariable model, excision of fascia during primary tumor resection was the only variable with a significant association with treatment outcome (OR, 10.21 [95% CI, 2.65 to 46.21]; p = 0.018). CONCLUSIONS: The results of this secondary analysis of the PARITY trial data provide further insight into the patient-, disease-, and treatment-specific associations with SSI treatment outcomes, which may help to inform decision-making and management of SSI in patients who have undergone segmental bone reconstruction of the femur or tibia for oncologic indications. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Assuntos
Neoplasias Ósseas , Infecção da Ferida Cirúrgica , Humanos , Antibacterianos/uso terapêutico , Neoplasias Ósseas/patologia , Próteses e Implantes/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Tíbia/cirurgiaRESUMO
Ultrathin films of the ionic liquid 1,3-dimethylimidazolium bis(trifluoromethylsulfonyl)imide ([C(1)C(1)Im][Tf(2)N]) were deposited on differently terminated Ni(111) single crystal surfaces. The initial wetting behaviour, the growth characteristics, the molecular arrangement at the interface, and thermal reactivity were investigated using angle-resolved X-ray photoelectron spectroscopy (ARXPS). On clean Ni(111), the initial growth occurs in a layer-by-layer mode. At submonolayer coverages up to at least 0.40 ML, a preferential arrangement of the IL ions in a bilayer structure, with the imidazolium cations in contact with the Ni surface atoms and the anions on top of the cation, is deduced. For higher coverages, a transition to a checkerboard-type arrangement occurs, which is most likely due to repulsive dipole-dipole interactions in the first layer. An overall preference for a checkerboard-type adsorption behaviour, i.e., anions and cations adsorbing next to each other, is found on the oxygen-precovered O(â3×â3)R30° Ni(111) surface. The thermal stability of adsorbed IL layers on Ni(111) and on a fully oxidised Ni(111) surface was studied by heating the layers to elevated temperatures. For clean Ni(111) reversible adsorption takes place. For the oxidised surface, however, only cation-related moieties desorb, starting at ~450 K, while anion-related signals remain on the surface up to much higher temperatures.
RESUMO
OBJECTIVES: 1) To determine the prevalence of intimate partner violence (IPV) in patients seen in the emergency department with chest pain. 2)To analyse the possible association between IPV and presence/control of vascular risk factors (VRF), psychic manifestations of stress, delay in requesting care, care received, and prognosis. METHODS: The study was conducted on 125 women, and included a targeted interview, the Partner Violence Screen (PVS) test, a 30-day follow-up telephone interview, and a one-year follow-up clinical history review. RESULTS: A total of 27 patients (21.6%) had a history of IPV, which was present in 4 of them. Women with a history of IPV were younger (53.7±15.0 vs. 64.0±18.4; P=.020), had more anxiety or a depressive syndrome (57.7% vs 13.5%; P<0.001), and consulted later (35.0±65.2days vs 7.9±25.0days; P=.047). Among older women (≥65years), there was more dyslipidaemia (100% vs 60.4%; P=.039) and worse blood pressure control (good control 20% vs 78.4%; P=.007) in those with a history of IPV. There were no differences in the diagnoses, tests, length of stay, admissions or prognosis among patients with or without a history of IPV, and there were no differences according to chronology of IPV. CONCLUSIONS: The current or previous existence of IPV in patients who consult for chest pain in the emergency department is high. The existence of IPV is associated with a delay in consultation and greater anxiety, and may contribute to poor control of VRF, but does not affect the prognosis in the medium term.
Assuntos
Dor no Peito/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Programas de Rastreamento/métodos , Adulto , Fatores Etários , Idoso , Feminino , Seguimentos , Humanos , Entrevistas como Assunto , Tempo de Internação , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevalência , Prognóstico , Fatores de Risco , Parceiros Sexuais , Fatores de TempoRESUMO
BACKGROUND AND OBJECTIVES: The value of gadolinium enhanced magnetic resonance imaging (MRI) sequences for extremity osteosarcoma resection planning is unverified. We evaluate the performance of intravenous gadolinium enhanced MRI for identification of neurovascular bundle involvement (NBI) and intraarticular extension (IAE) in patients with osteosarcoma. METHODS: Two pediatric radiologists independently analyzed MRI examinations of patients with pathology proven extremity osteosarcoma for NBI and IAE. Initial evaluation utilized only non-contrast MRI images (PRE) and, after 2 weeks, subsequent evaluation included both the pre and post contrast images (POST). Cohen's Kappa and McNemar's test were calculated to assess agreement between PRE and POST image interpretations of NBI and IAE. RESULTS: 56 patients with 90 preoperative MRI examinations were analyzed. PRE and POST interpretations were rarely discordant; 4/90 cases for NBI (Kappa 0.91) and 2/90 cases for IAE (Kappa 0.95). McNemar's test did not show a difference between PRE and POST imaging (NBI p=0.62; IAE p=0.48). CONCLUSION: No significant difference between PRE and POST image interpretation was found. A high level of agreement between PRE and POST image interpretation suggests that pre-contrast MRI may be sufficient for pre-surgical planning for pediatric patients with long bone osteosarcoma.
Assuntos
Neoplasias Ósseas/patologia , Osso e Ossos/patologia , Meios de Contraste , Imageamento por Ressonância Magnética/métodos , Variações Dependentes do Observador , Osteossarcoma/patologia , Cuidados Pré-Operatórios , Adolescente , Adulto , Neoplasias Ósseas/cirurgia , Osso e Ossos/cirurgia , Criança , Feminino , Seguimentos , Gadolínio , Humanos , Masculino , Osteossarcoma/cirurgia , Prognóstico , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVES: To describe the clinical characteristics and prognosis (hospital mortality at 30 days and 12 months and emergency department readmission at 30 days for acute heart failure) of patients treated in hospital emergency departments for new-onset or de novo acute heart failure (NOAHF) and to compare the patients with those who consult for chronic decompensated heart failure (CDHF). PATIENTS: NOVICA is a secondary analysis of the Epidemiology of Acute Heart Failure in Emergency Departments registry. We compared demographic variables, baseline characteristics and data from acute episodes and follow-up at 30 days and 12 months of patients with NOAHF and CDHF. RESULTS: We analysed 8647 patients, with 3288 cases of NOAHF (38%) and 5359 cases of CDHF (62%). NOAHF was associated with lower comorbidity, better baseline state, less severe acute episode data, less use of diuretics in intravenous infusion and oxygen therapy and lower hospitalization rates. The patients with NOAHF were admitted more often to cardiology and intensive care units, and the patients with CDHF were admitted more often to short-stay units. Rates of crude mortality at 30 days and 12 months and readmission at 30 days were higher for the patients with NOAHF. In the adjusted analysis, however, only the rate of readmission at 30 days was lower for NOAHF (p<.001). CONCLUSIONS: Patients admitted to hospital emergency departments for NOAHF show a different clinical profile from patients with CDHF. In the adjusted analysis, there were no differences between the 2 groups regarding hospital mortality, 30-day mortality or 12-month mortality.
RESUMO
BACKGROUND: Femoroacetabular impingement (FAI) is a suggested diagnosis for pain in the hip in the absence of other apparent causes. It is thought to be a cause of progressive arthrosis of the hip. Our objective was to determine the prevalence of radiographic data of FAI in the adult population without hip pathology over a period of six months. MATERIAL AND METHODS: Analytical, observational, multicentric, ambispective and transverse study based on digital X-rays analysis. Measurements of the lateral center-edge angle of Wiberg, acetabular inclination, Tönnis angle and the neck shaft angle of the proximal femur were made; a pistol grip deformity of the femoral head, the triangular index and the shape of the coxofemoral joint were also evaluated. RESULTS: From a total of 212 hips evaluated, 104 were in males and 108 in females, with an average age of 42.81 years; 21 had a pistol grip deformity and a positive triangular index for cam type. The pincer type was found in 12 hips. DISCUSSION: In this multicentric study, the FAI cam type predominated in men on the right side; the pincer type predominated in women on the left side; this is similar to what has been reported in other populations. This study is limited by the wide variation in the femoral rotation; as an advantage, it was randomly carried out and provides some data on the prevalence of deformities of the hip, not previously registered.
INTRODUCCIÓN: El pinzamiento femoroacetabular (PFA) se considera actualmente la causa principal de osteoartritis idiopática o primaria de cadera. Nuestro objetivo fue determinar la prevalencia de datos radiográficos de PFA en la población adulta sin patología coxofemoral en un período de seis meses. MATERIAL Y MÉTODOS: Estudio analítico, observacional, multicéntrico, ambispectivo y transversal realizado en archivos radiográficos digitales. Se midieron los ángulos de cobertura acetabular, cervicodiafisario, inclinación acetabular y ángulo de Tönnis; el tipo de coxa, índice triangular y deformidad en mango de pistola. RESULTADOS: De 212 articulaciones coxofemorales, 49.1% (104/212) correspondieron a hombres y 50.9% (108/212) a mujeres, con edad promedio de 42.81 ± 17.9 años; 21 articulaciones (21/212, 9.9%) presentaron deformidad en mango de pistola más índice triangular positivo para cam. Para determinar el tipo pincer, correlacionamos sobrecobertura acetabular, horizontalización acetabular, ángulo de Tönnis negativo ( 0°) y tipo de coxa profunda y/o protrusio, con una prevalencia de 5.66% de pincer (12/212). DISCUSIÓN: Nuestra población es muy pequeña a pesar de involucrar varias instituciones; la prevalencia del PFA tipo cam predominó en hombres, del lado derecho. El tipo pincer predominó en mujeres, del lado izquierdo. Este estudio está limitado por la amplia variación radiológica de la rotación femoral. Por otro lado, se aportan algunos datos sobre la prevalencia de deformidades de la cadera, previamente no registrada.
Assuntos
Impacto Femoroacetabular , Acetábulo , Adulto , Feminino , Impacto Femoroacetabular/diagnóstico por imagem , Impacto Femoroacetabular/epidemiologia , Articulação do Quadril , Humanos , Masculino , Prevalência , Raios XRESUMO
Los biorreactores de sistemas de un solo uso (SUSs), también conocidos como biorreactores desechables, se han convertido en una parte integral de las instalaciones biotecnológicas de fabricación para bioproductos con un mercado potencial que espera una tasa de crecimiento de casi el 15,5% durante el período pronosticado: 2018 a 2023. Los biorreactores SUSs son más seguros, simples y flexibles al compararlos con sus contrapartes, biorreactores de acero inoxidable, por lo que su uso se está incrementando en la industria biofarmacéutica principalmente en la planificación de vías rápidas de proyectos complejos, incluidos los relacionados con la pandemia de SARS-CoV-2. Así, el uso de SUS se ha convertido en una alternativa eficaz para la producción rápida de candidatos a vacunas. Pero algunas desventajas técnicas y operativas aún obstaculizan su uso en todo el mundo. Esta revisión brinda una visión racional del uso, los tipos, los parámetros operativos y las nuevas aplicaciones de los biorreactores SUSs en la industria biofarmacéutica. Asimismo, también se discuten los parámetros apropiados y las limitaciones de este equipo, enfocándose en su uso para la producción de vacunas contra COVID-19
Single-Use-Systems (SUSs) Bioreactors, also known as disposable bioreactors, have become an integral part of biotechnology manufacturing facilities for bioproducts with a potential market expecting a growth rate of nearly 15.5% over the forecast period: 2018 to 2023. SUSs bioreactors are comparatively safe, simple, and flexible than their stainless-steel bioreactors counterparts thus, their usage is being augmented in the biopharmaceutical industry mainly in planning fast tracks of complex projects, including those related to the SARS-CoV-2 pandemic. Thus, the use of SUSs has become an effective alternative for the rapid production of vaccine candidates. However, some technical and operational disadvantages still hamper their worldwide use. This review gives a rational insight into SUSs bioreactors use, types, operational parameters and new applications in the biopharmaceutical industry. Likewise, the appropriate parameters and limitations of this equipment, focusing on its use for vaccine production against COVID-19 are also discussed