ß-Delayed One and Two Neutron Emission Probabilities Southeast of

The ß-delayed one- and two-neutron emission probabilities (P_{1n} and P_{2n}) of 20 neutron-rich nuclei with N≥82 have been measured at the RIBF facility of the RIKEN Nishina Center. P_{1n} of ^{130,131}Ag, ^{133,134}Cd, ^{135,136}In, and ^{138,139}Sn were determined for the first time, and stringent upper limits were placed on P_{2n} for nearly all cases. ß-delayed two-neutron emission (ß2n) was unambiguously identified in ^{133}Cd and ^{135,136}In, and their P_{2n} were measured. Weak ß2n was also detected from ^{137,138}Sn. Our results highlight the effect of the N=82 and Z=50 shell closures on ß-delayed neutron emission probability and provide stringent benchmarks for newly developed macroscopic-microscopic and self-consistent global models with the inclusion of a statistical treatment of neutron and γ emission. The impact of our measurements on r-process nucleosynthesis was studied in a neutron star merger scenario. Our P_{1n} and P_{2n} have a direct impact on the odd-even staggering of the final abundance, improving the agreement between calculated and observed Solar System abundances. The odd isotope fraction of Ba in r-process-enhanced (r-II) stars is also better reproduced using our new data.

Ultrafast plasmonic photoemission in the single-cycle and few-cycle regimes.

Due to the highly increased interest in the development of state-of-the-art applications of photoemission in ultrafast electron microscopy, development of photocathodes and many more applications, a correct theoretical understanding of the underlying phenomena is needed. Within the framework of the single active electron approximation the most accurate results can be obtained by the direct solution of the time-dependent Schrödinger equation (TDSE). In this work, after a brief presentation of a numerically improved version of a mixed 1D-TDSE method, we investigated the characteristics of electron spectra obtained from the surface of metal nanoparticles irradiated with ultrashort laser pulses. During our investigation different decay lengths of the plasmonic-enhanced incident field in the vicinity of the metal were considered. Using the simulated spectra we managed to identify the behavior of the cutoff energy as a function of decay length in the strong-field, multiphoton and transition regimes.

Successful Prediction of Total α-Induced Reaction Cross Sections at Astrophysically Relevant Sub-Coulomb Energies Using a Novel Approach.

The prediction of stellar (γ,α) reaction rates for heavy nuclei is based on the calculation of (α,γ) cross sections at sub-Coulomb energies. These rates are essential for modeling the nucleosynthesis of so-called p nuclei. The standard calculations in the statistical model show a dramatic sensitivity to the chosen α-nucleus potential. The present study explains the reason for this dramatic sensitivity which results from the tail of the imaginary α-nucleus potential in the underlying optical model calculation of the total reaction cross section. As an alternative to the optical model, a simple barrier transmission model is suggested. It is shown that this simple model in combination with a well-chosen α-nucleus potential is able to predict total α-induced reaction cross sections for a wide range of heavy target nuclei above A≳150 with uncertainties below a factor of 2. The new predictions from the simple model do not require any adjustment of parameters to experimental reaction cross sections whereas in previous statistical model calculations all predictions remained very uncertain because the parameters of the α-nucleus potential had to be adjusted to experimental data. The new model allows us to predict the reaction rate of the astrophysically important ^{176}W(α,γ)^{180}Os reaction with reduced uncertainties, leading to a significantly lower reaction rate at low temperatures. The new approach could also be validated for a broad range of target nuclei from A≈60 up to A≳200.

[Use of synthetic slings and mesh implants in the treatment of female stress urinary incontinence and prolapse : Statement of the Working Group on Urological Functional Diagnostics and Female Urology of the Academy of the German Society of Urology]. / Einsatz von synthetischen Band- und Netzimplantaten bei der Behandlung von Belastungsinkontinenz und Descensus genitalis der Frau : Stellungnahme des Arbeitskreises Urologische Funktionsdiagnostik und Urologie der Frau der Akademie der Deutschen Gesellschaft für Urologie.

Due to a safety alert issued by the US Food and Drug Administration (FDA) in 2011 for transvaginal mesh implants to treat female prolapse as a result of numerous reports of complications such as infection, chronic pain, dyspareunia, vaginal erosion, shrinkage and erosion into other organs nearly all industrial products have been withdrawn from the market in the meantime. The United Kingdom, Australia, and New Zealand extended warnings and prohibitions even on the implantation of midurethral slings (TVT, TOT). In view of these current international controversies regarding the use of implanted materials for the treatment of stress incontinence and prolapse and the lack of clear guidelines for the use of biomaterials, the opinion of the Working Group on Urological Functional Diagnostics and Female Urology should provide clarity. The Opinion is based on the SCENIHR Report of the "European Commission's Scientific Committee on Emerging and Newly Identified Health Risks", the "Consensus Statement of the European Urology Association and the European Urogynaecological Association on the Use of Implanted Materials for Treating Pelvic Organ Prolapse and Stress Urinary Incontinence" and in compliance with relevant EAU and national guidelines and the opinion of the Association for Urogynaecology and Plastic Pelvic Floor Reconstruction (AGUB eV). In addition, recommendations are given for the future handling of implants of slings and meshes for the treatment of stress incontinence and prolapse from a urologic viewpoint.

Half-life measurement of 65Ga with γ-spectroscopy.

The literature half-life value of 65Ga is based on only one experiment carried out more than 60 years ago and it has a relatively large uncertainty. In the present work this half-life is determined based on the counting of the γ-rays following the ß-decay of 65Ga. Our new recommended half-life is t1/2 = (15.133 ±â€¯0.028) min which is in agreement with the literature value but almost one order of magnitude more precise.

Daclatasvir and Sofosbuvir With or Without Ribavirin in Liver Transplant Recipients: A Single-Center Real-World Study.

BACKGROUND: Treatment with direct-acting antiviral drugs in interferon-free regimens is currently recommended for viral hepatitis C recurrence after liver transplantation. There are limited data regarding its results in this population, and no optimal treatment scheme has yet been singled out. METHODS: We report our real-world results in liver transplant (LT) recipients. All patients were hepatitis C virus (HCV) monoinfected and completed a 12-week treatment course, followed 12 weeks later by HCV polymerase chain reaction testing with 12 IU/mL sensibility. Liver fibrosis was graded with the use of biopsies taken <12 months before treatment and stratified as early (0-1) or moderate to advanced (2-4) according to the Metavir score. RESULTS: Median postoperative time was 5.2 years. Genotype 3 was found in 66.7% of the sample. The following regimens were prescribed: daclatasvir-sofosbuvir with (n = 11) or without (n = 28) ribavirin. Genotypes 1 and 3 were evenly distributed between the regimens. Sustained virologic response (SVR) was obtained in 24 out of 28 patients (85.7%) who received daclatasvir-sofosbuvir and in all patients (100%) who received daclatasvir-sofosbuvir-ribavirin (global SVR 89.7%). All patients that failed treatment had genotype 3 HCV. Fibrosis was evaluated in 79.5% of the sample: 48.4% had early and 51.6% had moderate to advanced fibrosis, for which ribavirin was more commonly prescribed (P = .001). CONCLUSIONS: The SVR rate in our LT recipients was similar to that previously reported in the literature. The addition of ribavirin to DAA treatment appears to be justified in this population.

Management of Portal Hypertension After Liver Transplantation.

INTRODUCTION: Post-transplantation portal hypertension has severe complications, such as esophageal varix bleeding, therapy refractory ascites, extreme splenomegaly, and graft dysfunction. The aim of our study was to analyze the effectiveness of the therapeutic strategies and how to visualize the procedure. METHODS: A retrospective study involving liver transplantation patients from the Semmelweis University Department of Transplantation and Surgery was performed between 2005 and 2015. The prevalence, etiology, and leading complications of the condition were determined. The applied interventions' effects on the patients' ascites volume, splenic volume, and the occurrence of variceal bleeding were determined. Mean portal blood flow velocity and congestion index values were calculated using Doppler ultrasonography. RESULTS: The prevalence of post-transplantation portal hypertension requiring intervention was 2.8%. The most common etiology of the disease was portal anastomotic stenosis. The most common complications were esophageal varix bleeding and therapy refractory ascites. The patients' ascites volume decreased significantly (2923.3 ± 1893.2 mL vs. 423.3 ± 634.3 mL; P < .05), their splenic volume decreased markedly. After the interventions, only one case of recurrent variceal bleeding was reported. The calculated Doppler parameters were altered in the opposite direction in cases of pre-hepatic versus intra- or post-hepatic portal hypertension. After the interventions, these parameters shifted towards the physiologic ranges. CONCLUSION: The interventions performed in our clinic were effective in most cases. The patients' ascites volume, splenic volume, and the prevalence of variceal bleeding decreased after the treatment. Doppler ultrasonography has proved to be a valuable imaging modality in the diagnosis and the follow-up of post-transplantation portal hypertension.

Toward the Full Quantum Dynamical Description of Photon Induced Processes in D2.

The dissociative ionization (multiphoton regime) of the D2+ ion by ultrashort laser pulses has been studied theoretically using ab initio calculations. The combined ionization and dissociation spectrum was explored for fixed molecular axis orientations. In accordance with previous investigations, the dominant features in the obtained joint energy spectrum were multiphoton peaks. In addition to this, in the present work, photoelectron angular distributions were analyzed as well. By performing a partial wave analysis for each multiphoton peak, we have identified the number of absorbed photons. Moreover, we also found that the angular distribution can significantly change inside a multiphoton peak as a function of electron and nuclear kinetic energy.

Biodegradable airway stents in infants - Potential life-threatening pitfalls.

OBJECTIVE: The solution of severe tracheobronchial obstructions in early childhood means a great challenge. Biodegradable stents were intended to be a minimally invasive temporary solution which may decrease the number of interventions and limit the possible complications of stenting procedures. However, our first experiences have brought out a new, - especially in childhood - potentially life-threatening complication of this concept. METHODS: Five SX-ELLA biodegradable polydioxanone stents was applied in three patients because of severe tracheobronchial obstruction: congenital tracheomalacia (7 day-old), acquired tracheomalacia (10 month-old), and congenital trachea-bronchomalacia (10 month-old). RESULTS: The breathing of all children improved right after the procedure. We observed degradation of the stent from the 5th postoperative week which resulted in large intraluminar fragments causing significant airway obstruction: one patient died of severe pneumonia, the other baby required urgent bronchoscopy to remove the obstructing 'foreign body' from the trachea. In the third case repeated stent placements successfully maintained the tracheal lumen. CONCLUSIONS: Polydioxanone stents may offer an alternative to metallic or silastic stents for collapse or external compression of the trachea in children; however, large decaying fragments mean a potential risk especially in the small size pediatric airway. The fragmentation of the stent, which generally starts in the 4-6 postoperative weeks, may create large sharp pieces. These may be anchored to the mucosa and covered by crust leading to obstruction. As repeated interventions are required, we do not consider the application of biodegradable stents unambiguously advantageous.

Two-Proton Radioactivity of

In an experiment with the BigRIPS separator at the RIKEN Nishina Center, we observed two-proton (2p) emission from ^{67}Kr. At the same time, no evidence for 2p emission of ^{59}Ge and ^{63}Se, two other potential candidates for this exotic radioactivity, could be observed. This observation is in line with Q value predictions which pointed to ^{67}Kr as being the best new candidate among the three for two-proton radioactivity. ^{67}Kr is only the fourth 2p ground-state emitter to be observed with a half-life of the order of a few milliseconds. The decay energy was determined to be 1690(17) keV, the 2p emission branching ratio is 37(14)%, and the half-life of ^{67}Kr is 7.4(30) ms.

Role of Contrast-Enhanced Ultrasound in the Follow-up of Kidney Transplant Patients.

BACKGROUND: Contrast-enhanced ultrasound combines the advantages of native ultrasound and other contrast-enhanced imaging modalities. In selected cases it can be preferable to computerized tomographic scan among kidney transplant recipients. METHODS: We performed a retrospective study involving patients of Semmelweis University Department of Transplantation and Surgery who underwent contrast-enhanced ultrasound examination from 2011 to 2015. During this period, 251 examinations were performed, including 45 on kidney transplant patients. A Toshiba Aplio XU ultrasound device was used, and 1-1.5 mL contrast agent (Sonovue) was administered intravenously for each patient. The indications of these evaluations can be divided into 3 groups: characterization of circumscribed kidney lesions, control after radiofrequency ablation therapy, and examination of graft perfusion. RESULTS: Fully 93% of the examinations were conclusive. In the 1st group of the 37 cases where tumor-suspect lesions were investigated, 13 examinations suggested the presence of a space-occupying lesion. Of those 13 cases, 2 patients had a negative biopsy, nephrectomy was performed in 11 cases, and histologic evaluation verified a tumor in 8 samples. In the 2nd group, the ablation control examination detected a residual tumor in none of the 6 cases. Finally, in 1 of the 2 grafts where the circulation was investigated, blood flow was satisfactory, and in the other it was low. CONCLUSIONS: The contrast-enhanced ultrasound examination was conclusive in most cases. The applied contrast material is not nephrotoxic, and the method uses nonionizing radiation. These features make contrast-enhanced ultrasound highly suitable for the examination of kidney transplant patients.

Survey About the Cancer Risk of Renal Transplant Recipients.

INTRODUCTION: There is a greater risk of malignant tumors developing in kidney transplant patients. Due to this, early detection is of outmost importance, in which screening tests play an important role. METHODS: We have conducted a survey among renal transplant recipients to assess individual risk factors. RESULTS: Of 530 respondents, 55 developed post-transplantation tumors. Cutaneous tumors (36%) and kidney cancer (16%) were the most frequent. In total, 59% of recipients were over the age of 50, 61.7% were over the normal body-mass index range, 40.3% smoked or used to smoke, and 21.8% had diabetes. Five patients had hepatitis B virus and 11 were hepatitis C virus-positive. Malignancies developed significantly more frequent in men than in women (P = .04). The progressing of age (P = .0001) and the time elapsed after transplantation (P < .01) also were associated with a significant increase in the occurrence of post-transplantation tumors. CONCLUSION: We have created a database to facilitate a more personalized and efficient screening program for immunocompromised patients.

Comparison Between IGL-1 and HTK Preservation Solutions in Deceased Donor Liver Transplantation.

The effectiveness of liver preservation solutions remains in evidence. Cold ischemia time, steatosis, expanded criterion donors, operational cost, and survival represent important roles in its success. In a prospective cohort study between August 2009 and April 2014, 178 patients were allocated into an Institut Georges Lopez - 1 (IGL-1) solution group (63.5%) or histidine-tryptophan-ketoglutarate (HTK) group (36.5%). There were no differences among recipient's characteristics including age, skin color, gender, Model for End-stage Liver Disease score, acute rejection, cholestasis, and reperfusion syndrome incidences. Also, donors, age average, skin color, donor risk index, time in intensive care unit, hemodynamic variables, infections, and steatosis incidences were similar. The average cold ischemia time was 494 minutes in the IGL-1 group and 489 minutes in the HTK group (P = .77). Alanine aminotransferase and aspartate aminotransferase serum levels on the first postoperative day were 707 and 1185 mg/dL, respectively, with IGL-1 and 1298 and 2291 mg/dL, respectively, with HTK (P = .016) and similar at day 15 (P > .88). The incidence of delayed graft function was 4.5% with IGL-1 and 4.6% with HTK (P = .90). The incidence primary nonfunction was 2.7% with IGL-1 and 3.1% with HTK (P = .71). The incidence of perioperative death was 11.5% with IGL-1 and 13.8% with HTK (P = .94). The survival in 30 months was 86% in IGL-1 group and 82% in HTK group (P = .66). Both preservation solutions are efficient to liver transplantations with deceased donors. Major prospective trials are necessary to evaluate each preservation solution's particularities. The preservation solution availability in each transplantation center must guide its use at the present moment.

[Unconventional treatment procedures of the bladder in paraplegia and myelomeningocele]. / Behandlungsverfahren der Blase bei Querschnittlähmung und Myelomeningozele.

The established treatment of neurogenic lower urinary tract dysfunction (NLUTD) in patients with spinal cord injury (SCI) or meningomyelocele (MMC) is mainly conservative and is aimed at the lower urinary tract. For example, oral antimuscarinic medication is the standard treatment of neurogenic detrusor overactivity. Recently, however, treatment aiming directly or indirectly at the innervation of the urinary tract has gained increasing attention. Current evidence does not justify the use of nerve rerouting but the existing preliminary data are more promising for MMC patients than for those with SCI. Sacral neuromodulation is already a therapeutic option for incomplete SCI patients. Initial data from a pilot study indicate that in patients with complete SCI implementation in the spinal shock phase may prevent the development of NLUTD. Licensing of onabotulinum toxin A (Botox®) facilitated its clinical use for treating NLUTD but it is limited to the indication of neurogenic detrusor overactivity incontinence with a dosage of 200 IU. The mentioned unconventional treatments, although discussed controversially, are promising future treatment options for NLUTD.

Measurement of the -3 keV resonance in the reaction 13C(α,n)16O of importance in the s-process.

The (13)C(α,n)(16)O reaction is the neutron source for the main component of the s-process, responsible for the production of most nuclei in the mass range 90

Hypnosis for cataract surgery in an American Society of Anesthesiologists physical status IV patient.

A 73-year-old morbidly obese female patient (weight 125 kg, height 156 cm) was scheduled for cataract surgery of her right eye. Due to a number of severe co-morbidities general anaesthesia was contraindicated. However the patient was very anxious and requested sedation if the procedure was to be undertaken under local anaesthesia. She responded very positively to the proposal of utilising perioperative hypnosis. Hypnotic induction was achieved with the heavy eyelid technique, putting the patient into trance within 30 seconds. Continuous relaxing suggestions as described by the patient herself the day before surgery were used to maintain the trance state. She later reported that she was not aware of being in the operating room, but experienced profound relaxation during the procedure. Perioperative hypnosis proved to be a satisfactory option for sedation in this high-risk patient and should be actively considered for similar easily suggestible patients who are undergoing minor surgery.

Assessment of a cardiac output device using arterial pulse waveform analysis, Vigileo, in cardiac surgery compared to pulmonary arterial thermodilution.

Many devices are available to assess cardiac output (CO) in critically ill patients and in the operating room. Classical CO monitoring via a pulmonary artery catheter involves continuous cardiac output (CCO) measurement. The second generation of Flotrac/Vigileo monitors propose an analysis of peripheral arterial pulse waves to calculate CO (APCO) without calibration. The aim of our study was to compare the CO between the Swan Ganz catheter and the VigileoT. In this observational study, nine patients undergoing coronary artery bypass grafting were prospectively included. APCO, mean (CCO) and instantaneous CO (ICO) were measured. Perioperative and postoperative assessments were performed up to 24 hours post-surgery. Measurements were recorded every minute, resulting in the collection of 6492 data pairs. Comparison of APCO and ICO showed a limited bias of -0.1 l/min but an important percentage error of 48%. Corresponding values were -0.1 l/min and 46% for the APCO versus CCO comparison, and 0 and 17% for ICO versus CCO comparison. Large inter-individual variability does exist. During cardiac surgery and after leaving the operating room, Vigileo is not clinically equivalent to continuous thermodilution by pulmonary artery catheter Nevertheless, the connection between CCO and ICO relates the difference between APCO and CCO more to the different algorithms used. Further efforts should be concentrated on assessing the ability of this device to track changes in cardiac output.

[Vision loss after spine surgery: a case report]. / Cécité bilatérale en postopératoire d'une chirurgie du rachis.

We report the case of a 36-year-old man who underwent neurosurgery for a T9 spine fracture consecutive to a fall. The patient had complete postoperative blindness which did not totally recover during the hospital stay. Decreased visual acuity and postoperative vision loss are not uncommon in spine surgery. Such postoperative complications in spine surgery are severe. To avoid them, it is mandatory to identify the contributing factors and set up a preventive strategy.