Proton Shell Gaps in N=28 Nuclei from the First Complete Spectroscopy Study with FRIB Decay Station Initiator.

The first complete measurement of the ß-decay strength distribution of _{17}^{45}Cl_{28} was performed at the Facility for Rare Isotope Beams (FRIB) with the FRIB Decay Station Initiator during the second FRIB experiment. The measurement involved the detection of neutrons and γ rays in two focal planes of the FRIB Decay Station Initiator in a single experiment for the first time. This enabled an analytical consistency in extracting the ß-decay strength distribution over the large range of excitation energies, including neutron unbound states. We observe a rapid increase in the ß-decay strength distribution above the neutron separation energy in _{18}^{45}Ar_{27}. This was interpreted to be caused by the transitioning of neutrons into protons excited across the Z=20 shell gap. The SDPF-MU interaction with reduced shell gap best reproduced the data. The measurement demonstrates a new approach that is sensitive to the proton shell gap in neutron rich nuclei according to SDPF-MU calculations.

Crossing N=28 Toward the Neutron Drip Line: First Measurement of Half-Lives at FRIB.

New half-lives for exotic isotopes approaching the neutron drip-line in the vicinity of N∼28 for Z=12-15 were measured at the Facility for Rare Isotope Beams (FRIB) with the FRIB decay station initiator. The first experimental results are compared to the latest quasiparticle random phase approximation and shell-model calculations. Overall, the measured half-lives are consistent with the available theoretical descriptions and suggest a well-developed region of deformation below ^{48}Ca in the N=28 isotones. The erosion of the Z=14 subshell closure in Si is experimentally confirmed at N=28, and a reduction in the ^{38}Mg half-life is observed as compared with its isotopic neighbors, which does not seem to be predicted well based on the decay energy and deformation trends. This highlights the need for both additional data in this very exotic region, and for more advanced theoretical efforts.

Auditory processing in remitted major depression: a long-term follow-up investigation using 3T-fMRI.

Major depression is accompanied by cortical dysfunction including impaired auditory processing of non-speech stimuli. In a previous study, we could show that potent antidepressant treatment with electroconvulsive therapy (ECT) did not lead to full functional normalization of altered fMRI activation patterns in response to sine tones although depressive symptoms improved and remission was achieved in the majority of patients. In a next step, a longitudinal follow-up investigation was conducted looking on neuronal activation over time along with full remission in a subgroup of patients of the previous study in order to address the question whether changes in neuronal activation patterns reflect a more state- or trait-dependent characteristic. Results showed that although clinically remitted, patients still exhibited an increased activity of the secondary auditory cortex and multimodal recruitment of the left cuneus, an area of the visual system. However, activity of recruited secondary visual network had decreased over time. A positive correlation was observed between the number of hospital admissions during the follow-up period and activity of the secondary visual area of the left cuneus at baseline prior to ECT. Thus, although the persistence of differences in activation patterns after sine tone presentation in this follow-up investigation could argue for a potential trait marker of depression characterized by alterations in auditory processing, attenuation of neuronal activation in some areas over time suggests that changes might in part also be state-dependent.

Chronic low back pain, depression, and attributional style.

Twenty consecutive, chronic low back pain patients admitted to our pain treatment unit completed the Attributional Style Questionnaire (an instrument that detects a cognitive style that is correlated with, and that predicts, depression) and the Beck Depression Inventory. An age, sex, and education-matched group of normal subjects, a group of patients with asymptomatic essential hypertension, and a group of patients with end-stage renal disease receiving dialysis treatment served as controls. The majority of the chronic-pain and renal-dialysis patients had elevated depression scores, whereas none of the normal subjects or hypertensive patients were outside the nondepressed range. The Attributional Style scores of the pain and renal dialysis patients were significantly deviant from the normal control group, but no more so than those of the patients with hypertension. The results of this study suggest that individuals with a chronic medical condition, either symptomatic (chronic low back pain or renal disease) or asymptomatic (essential hypertension) in nature, develop an attributional style characteristic of depression. These data neither lend support nor refute the thesis that chronic pain syndromes are a variant of, or a masked, depression. Rather, this research implies that a more important question is what identifiable risk factors (for example, attributional style) predispose patients with chronic pain to develop a depressive illness.

Ifosfamide. Patient care management.

Ifosfamide is an antineoplastic drug with efficacy and activity in numerous cancers. This drug can be administered safely in a hospital setting if toxicities and side effects are monitored frequently by a well-informed and educated nursing staff. Problems may occur in any bodily system, such as the kidney, central nervous system (CNS), gastrointestinal tract, and bone marrow. This article reviews appropriate ways to monitor for complications and plan correct nursing interventions. Ifosfamide (Ifex, Mead Johnson) is an alkylating agent that is not cell cycle specific. One of its metabolites, acrolein, is responsible for hematuria. Concurrent administration of mesna (Mesnex, Mead Johnson) is used to prevent this complication. The metabolite chloroacetaldehyde may be responsible for CNS toxicities. When kidney function and electrolytes are within normal limits and psychotropic medications are not given concomitantly, this rarely occurs. Gastrointestinal toxicities are usually not severe, but may include occasional nausea and vomiting. Hematologic toxicity includes platelet-sparing myelosuppression, which can be successfully supported with the administration of growth factors.

[Obturator nerve block for transurethral surgery. comparing ropivacaine 0.75 % vs. prilocaine 1 %]. / Vergleich der Motorblockade zwischen Ropivacain 0,75 % und Prilocain 1 % bei der direkten Obturatoriusblockade zur transurethralen Blasentumorresektion -- ein neuer Ansatz zur Bewertung des Motorblocks mit der MRC-Skala.

OBJECTIVE: Obturator nerve block is used for transurethral resection of lateral bladder wall tumors to prevent adductor muscle spasm and associated complications. Therefore, the local anesthetic applied should provide an adequate motor blockade. Ropivacaine 0.75 % was compared to prilocaine 1 % and motor blockade assessment performed by the Medical Research Council (MRC)-scale. METHODS: 40 patients (20 per group) scheduled for transurethral resection were randomized to either receiving 10 ml ropivacaine 0.75 % or prilocaine 1 % for direct obturator nerve block in a controlled user-blinded study. Motor block was assessed with the MRC-scale 5 and 10 minutes after local anesthetic injection followed by an assessment 120 and 180 minutes after surgery. Surgery was performed in equally distributed spinal or general anesthesia, intraoperative adductor spasm intensity was evaluated by surgeon's ranking. RESULTS: Motor blockade intensity was significantly higher with ropivacaine 0.75 % at all time points of assessment. Intraoperatively, severe spasm only occurred in the prilocaine 1 %-group. CONCLUSION: Ropivacaine 0.75 % is a more appropriate agent for direct obturator nerve block than prilocaine 1 %, providing a faster onset and a more intense and longer-lasting motor blockade. This may reduce surgical complications and facilitate early surgical re-intervention. In this study, MRC-scale was appropriate for motor blockade assessment in a peripheral nerve block.