Further Evidence for Shape Coexistence in

Isomers close to doubly magic _{28}^{78}Ni_{50} provide essential information on the shell evolution and shape coexistence near the Z=28 and N=50 double shell closure. We report the excitation energy measurement of the 1/2^{+} isomer in _{30}^{79}Zn_{49} through independent high-precision mass measurements with the JYFLTRAP double Penning trap and with the ISOLTRAP multi-reflection time-of-flight mass spectrometer. We unambiguously place the 1/2^{+} isomer at 942(10) keV, slightly below the 5/2^{+} state at 983(3) keV. With the use of state-of-the-art shell-model diagonalizations, complemented with discrete nonorthogonal shell-model calculations which are used here for the first time to interpret shape coexistence, we find low-lying deformed intruder states, similar to other N=49 isotones. The 1/2^{+} isomer is interpreted as the bandhead of a low-lying deformed structure akin to a predicted low-lying deformed band in ^{80}Zn, and points to shape coexistence in ^{79,80}Zn similar to the one observed in ^{78}Ni. The results make a strong case for confirming the claim of shape coexistence in this key region of the nuclear chart.

Isomeric Excitation Energy for

The excitation energy of the 1/2^{-} isomer in ^{99}In at N=50 is measured to be 671(37) keV and the mass uncertainty of the 9/2^{+} ground state is significantly reduced using the ISOLTRAP mass spectrometer at ISOLDE/CERN. The measurements exploit a major improvement in the resolution of the multireflection time-of-flight mass spectrometer. The results reveal an intriguing constancy of the 1/2^{-} isomer excitation energies in neutron-deficient indium that persists down to the N=50 shell closure, even when all neutrons are removed from the valence shell. This trend is used to test large-scale shell model, ab initio, and density functional theory calculations. The models have difficulties describing both the isomer excitation energies and ground-state electromagnetic moments along the indium chain.

First Glimpse of the N=82 Shell Closure below Z=50 from Masses of Neutron-Rich Cadmium Isotopes and Isomers.

We probe the N=82 nuclear shell closure by mass measurements of neutron-rich cadmium isotopes with the ISOLTRAP spectrometer at ISOLDE-CERN. The new mass of ^{132}Cd offers the first value of the N=82, two-neutron shell gap below Z=50 and confirms the phenomenon of mutually enhanced magicity at ^{132}Sn. Using the recently implemented phase-imaging ion-cyclotron-resonance method, the ordering of the low-lying isomers in ^{129}Cd and their energies are determined. The new experimental findings are used to test large-scale shell-model, mean-field, and beyond-mean-field calculations, as well as the ab initio valence-space in-medium similarity renormalization group.

Precision Mass Measurements of

The neutron-rich isotopes ^{58-63}Cr were produced for the first time at the ISOLDE facility and their masses were measured with the ISOLTRAP spectrometer. The new values are up to 300 times more precise than those in the literature and indicate significantly different nuclear structure from the new mass-surface trend. A gradual onset of deformation is found in this proton and neutron midshell region, which is a gateway to the second island of inversion around N=40. In addition to comparisons with density-functional theory and large-scale shell-model calculations, we present predictions from the valence-space formulation of the ab initio in-medium similarity renormalization group, the first such results for open-shell chromium isotopes.

Binding Energy of

The masses of the neutron-rich copper isotopes ^{75-79}Cu are determined using the precision mass spectrometer ISOLTRAP at the CERN-ISOLDE facility. The trend from the new data differs significantly from that of previous results, offering a first accurate view of the mass surface adjacent to the Z=28, N=50 nuclide ^{78}Ni and supporting a doubly magic character. The new masses compare very well with large-scale shell-model calculations that predict shape coexistence in a doubly magic ^{78}Ni and a new island of inversion for Z<28. A coherent picture of this important exotic region begins to emerge where excitations across Z=28 and N=50 form a delicate equilibrium with a spherical mean field.

[Deployment of the checklist "Patient safety in the operating room" in two Lorraine hospitals. Performances and difficulties]. / Déploiement de la check-list "Sécurité du patient au bloc opératoire" dans deux hôpitaux lorrains. Performances et difficultés.

OBJECTIVE: To evaluate the implementation of the checklist HAS 2010 in two Lorraine health facilities to identify objectively brakes and levers to suggest possible improvements. STUDY DESIGN: Descriptive survey. MATERIAL AND METHODS: Operating rooms of the Neurosciences building Central University Hospital, Nancy, Belle-Isle Hospital participating public hospital service, Metz. Two stages: a retrospective audit allowed to objectify quantitatively the presence of CL in the patient record and monitor compliance with the instructions of filling. A survey by self-administered questionnaire to professionals to assess the use of CL. RESULTS: CL was present in 50 % and 100 % records. The filling did not comply with instructions of the HAS (occupancy, three different times, time out before incision, stop the procedure if "no") and it was hard for about 30 % of participants, some items have problems of understanding. CL has strengthened information sharing about one third of respondents, over half of them are of interest, it has already helped to prevent errors. The deployment strategy influences directly the involvement of professionals. The evaluation of the use of CL cannot be done only through an audit record; the association with a self-administered questionnaire appears to be relevant. CONCLUSION: Good adhesion to the concept, hope for better results after stock enhancement: optimize information and training of all professionals, avoid duplication with other documents. The audit record alone is not a good tool for evaluating the use of LBC, we must associate a self-administered questionnaire.

Profiling fetal cardiac function in twin-twin transfusion syndrome.

OBJECTIVES: Cardiomyopathy in the recipient twin is a marker of severity in twin-twin transfusion syndrome (TTTS), making it a potentially valuable tool for staging the disease. This study aimed to provide a quantitative description of cardiac function in the recipient twin. METHODS: Consecutive monochorionic pregnancies complicated with TTTS and treated by percutaneous laser coagulation underwent fetal echocardiography before surgery. An unsupervised classification analysis was conducted to identify groups of twins with similar cardiac profiles. The predictive value of the recipient twin's preoperative cardiac function based on these profiles was assessed, using perinatal death of at least one twin as the main outcome. The cardiac function profiles that we identified were compared with the current Quintero staging. RESULTS: A total of 107 pregnancies were included, with six of these lost to follow-up; 63/107 complete cases were available for multivariate description of the recipient's cardiac function. Three different preoperative cardiac profiles were identified with increasing right and left myocardial performance index, decreasing right and left shortening fraction, and increasing ductus venosus pulsatility index. Although the three groups represented progressive stages of the syndrome-related cardiomyopathy, no correlation was found with pregnancy outcome. Of Quintero Stage 1 cases, 55% showed significant alterations of cardiac function in the recipient twin. CONCLUSIONS: Progressive cardiomyopathy can be assessed quantitatively in the recipient twin and does not influence pregnancy outcome when fetoscopic laser coagulation is the first-line treatment. Compared with the current staging, cardiac profiling allows discrimination of cases with significant myocardial dysfunction.

Evaluation from population registry data of health care expenditure during the 6 months after cancer diagnosis.

It is currently estimated in France, that the cost of cancer has risen to $3.8 billion, with an annual growth of 5-10%. This represents approximately 6% of all health expenditure. The data from the Registry of Tumors in the Doubs region have enabled us to make an evaluation of health expenditure, reimbursed by the French Securite Sociale (S.S.), and its distribution in relation to different activities (diagnosis, type of treatment, follow-up, transport), according to cancer site. In 1984, the average cost per patient within the first 6 months of the illness was evaluated at $4,000. The results show major differences for the cancer sites, care facilities and budget items. Diagnosis assessment represents 27% of all expenditure, surgery 37%, radiotherapy, chemotherapy and transport, 11% each. All kinds of expenses are fully reimbursed by the French S.S. and transportation, which at the beginning used to avoid hospitalization, is now used as a comfort system and represents a high cost to the S.S. The different costs for the same illness between private, general public and university hospitals do not reflect a difference in care, but rather different systems of calculating and functioning. Till now there has not been any logical evaluation of care in the French health system.