Sources and space-time distribution of the electromagnetic pulses in experiments on inertial confinement fusion and laser-plasma acceleration.

When high-energy and high-power lasers interact with matter, a significant part of the incoming laser energy is transformed into transient electromagnetic pulses (EMPs) in the range of radiofrequencies and microwaves. These fields can reach high intensities and can potentially represent a significative danger for the electronic devices placed near the interaction point. Thus, the comprehension of the origin of these electromagnetic fields and of their distribution is of primary importance for the safe operation of high-power and high-energy laser facilities, but also for the possible use of these high fields in several promising applications. A recognized main source of EMPs is the target positive charging caused by the fast-electron emission due to laser-plasma interactions. The fast charging induces high neutralization currents from the conductive walls of the vacuum chamber through the target holder. However, other mechanisms related to the laser-target interaction are also capable of generating intense electromagnetic fields. Several possible sources of EMPs are discussed here and compared for high-energy and high-intensity laser-matter interactions, typical for inertial confinement fusion and laser-plasma acceleration. The possible effects on the electromagnetic field distribution within the experimental chamber, due to particle beams and plasma emitted from the target, are also described. This article is part of a discussion meeting issue 'Prospects for high gain inertial fusion energy (part 2)'.

Ultrafast electron and proton bunches correlation in laser-solid matter experiments.

The interaction of an ultra-intense laser with a solid state target allows the production of multi-MeV proton and ion beams. This process is explained by the target normal sheath acceleration (TNSA) model, predicting the creation of an electric field on the target rear side, due to an unbalanced positive charge. This process is related to the emission of relativistic ultrafast electrons, occurring at an earlier time. In this work, we highlight the correlations between the ultrafast electron component and the protons by their simultaneous detection by means of an electro-optical sampling and a time-of-flight diagnostics, respectively, supported by numerical simulations showing an excellent agreement.

Baricitinib as rescue therapy in a patient with COVID-19 with no complete response to sarilumab.

A patient with COVID-19-related severe respiratory failure, with insufficient response to an antiretroviral therapy, hydroxychloroquine and Interleukin-6 (IL-6) antagonist therapy, presented a prompt resolution of the respiratory function and improvement in the radiological picture after baricitinib at an oral dose of 4 mg per day for 2 weeks.

Rhabdomyolysis and fluctuating asymptomatic hyperCKemia associated with CACNA1S variant.

BACKGROUND AND PURPOSE: CACNA1S encodes Cav 1.1, a voltage sensor for muscle excitation-contraction coupling, which activates the ryanodine receptor 1 (RYR1) leading to calcium release from the sarcoplasmic reticulum. CACNA1S mutations cause hypokalemic periodic paralysis, malignant hyperthermia and congenital myopathy. RYR1 mutations result in congenital myopathy, malignant hyperthermia and rhabdomyolysis. METHODS: The aim was to describe a novel phenotype associated with a CACNA1S variant at a site previously linked to hypokalemic periodic paralysis. RESULTS: The patient presented with fluctuating asymptomatic creatine kinase elevation after an episode of rhabdomyolysis but has no history of periodic paralysis. His muscle biopsy showed core-like structures occurring mainly in type 2 fibers. He carries a novel Cav 1.1 variant (p.Arg528Leu) affecting a highly conserved amino acid. Different mutations at the same location cause hypokalemic periodic paralysis. CONCLUSION: This case underscores the similarity between the phenotypes caused by mutations in two functionally linked proteins, RYR1 and Cav 1.1.

Gender may be related to the side of the motor syndrome and cognition in idiopathic Parkinson's disease.

BACKGROUND: and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease. INTRODUCTION: Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains. MATERIAL AND METHODS: We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. RESULTS: Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task. CONCLUSION: We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.

Measuring the principal Hugoniot of inertial-confinement-fusion-relevant TMPTA plastic foams.

Wetted-foam layers are of significant interest for inertial-confinement-fusion capsules, due to the control they provide over the convergence ratio of the implosion and the opportunity this affords to minimize hydrodynamic instability growth. However, the equation of state for fusion-relevant foams are not well characterized, and many simulations rely on modeling such foams as a homogeneous medium with the foam average density. To address this issue, an experiment was performed using the VULCAN Nd:glass laser at the Central Laser Facility. The aim was to measure the principal Hugoniot of TMPTA plastic foams at 260mg/cm^{3}, corresponding to the density of liquid DT-wetted-foam layers, and their "hydrodynamic equivalent" capsules. A VISAR was used to obtain the shock velocity of both the foam and an α-quartz reference layer, while streaked optical pyrometry provided the temperature of the shocked material. The measurements confirm that, for the 20-120 GPa pressure range accessed, this material can indeed be well described using the equation of state of the homogeneous medium at the foam density.

Gender may be related to the side of the motor syndrome and cognition in idiopathic Parkinson's disease.

BACKGROUND: and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease. INTRODUCTION: Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains. MATERIAL AND METHODS: We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. RESULTS: Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task. CONCLUSION: We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.

Accurate spectra for high energy ions by advanced time-of-flight diamond-detector schemes in experiments with high energy and intensity lasers.

Time-Of-Flight (TOF) methods are very effective to detect particles accelerated in laser-plasma interactions, but they show significant limitations when used in experiments with high energy and intensity lasers, where both high-energy ions and remarkable levels of ElectroMagnetic Pulses (EMPs) in the radiofrequency-microwave range are generated. Here we describe a novel advanced diagnostic method for the characterization of protons accelerated by intense matter interactions with high-energy and high-intensity ultra-short laser pulses up to the femtosecond and even future attosecond range. The method employs a stacked diamond detector structure and the TOF technique, featuring high sensitivity, high resolution, high radiation hardness and high signal-to-noise ratio in environments heavily affected by remarkable EMP fields. A detailed study on the use, the optimization and the properties of a single module of the stack is here described for an experiment where a fast diamond detector is employed in an highly EMP-polluted environment. Accurate calibrated spectra of accelerated protons are presented from an experiment with the femtosecond Flame laser (beyond 100 TW power and ~ 1019 W/cm2 intensity) interacting with thin foil targets. The results can be readily applied to the case of complex stack configurations and to more general experimental conditions.

Novel dual HIV maintenance therapy with nevirapine plus lamivudine retain viral suppression through 144 weeks-A proof-of-concept study.

OBJECTIVES: The aim of this proof-of-concept study is to test feasibility and efficacy of NVP plus Lamivudine (3TC) as novel simplified HIV maintenance dual therapy (DT) strategy. METHODS: Patients under combined antiretroviral treatment (cART) with fully suppressed HIV plasma viral load (pVL) >24 months-whereof >6 months on an NVP- containing regimen-were switched to oral NVP plus 3TC for 24 weeks. Patients could then decide whether to continue DT or return to the previous cART. HIV pVL was monitored monthly until week 144. The primary outcome was confirmed viral failure (RNA >100 copies/ml). Low-level detection of HIV-RNA in plasma was compared in each patient with pre-study viral load measurements. RESULTS: Twenty patients were included, switched to DT and all completed week 24. One patient decided thereafter to discontinue study participation for personal reasons. After a total of 144 observation weeks, none of the patients failed. The frequency of low- level HIV-RNA detection was not different from the period before randomization. CONCLUSIONS: Our findings are surprising but given the nature of a proof-of-concept study, the results do not support the use of this dual regimen. However, as this dual HIV maintenance strategy was feasible and effective, over a period of 144 weeks, we suggest NVP plus 3TC warrants further evaluation as potential maintenance option in patients tolerating nevirapine. A properly sized multicentre non-inferiority trial is ongoing to further evaluate the value of this DT maintenance strategy.

Time-resolved absolute measurements by electro-optic effect of giant electromagnetic pulses due to laser-plasma interaction in nanosecond regime.

We describe the first electro-optical absolute measurements of electromagnetic pulses (EMPs) generated by laser-plasma interaction in nanosecond regime. Laser intensities are inertial-confinement-fusion (ICF) relevant and wavelength is 1054 nm. These are the first direct EMP amplitude measurements with the detector rather close and in direct view of the plasma. A maximum field of 261 kV/m was measured, two orders of magnitude higher than previous measurements by conductive probes on nanosecond regime lasers with much higher energy. The analysis of measurements and of particle-in-cell simulations indicates that signals match the emission of charged particles detected in the same experiment, and suggests that anisotropic particle emission from target, X-ray photoionization and charge implantation on surfaces directly exposed to plasma, could be important EMP contributions. Significant information achieved on EMP features and sources is crucial for future plants of laser-plasma acceleration and inertial-confinement-fusion and for the use as effective plasma diagnostics. It also opens to remarkable applications of laser-plasma interaction as intense source of RF-microwaves for studies on materials and devices, EMP-radiation-hardening and electromagnetic compatibility. The demonstrated extreme effectivity of electric-fields detection in laser-plasma context by electro-optic effect, leads to great potential for characterization of laser-plasma interaction and generated Terahertz radiation.

Value of negative predischarge exercise testing in identifying patients at low risk after acute myocardial infarction treated by systemic thrombolysis.

Although thrombolytic therapy reduces mortality in patients with acute myocardial infarction (AMI), it is associated with a greater incidence of successive coronary events, and there is still no ideal diagnostic and therapeutic strategy for such patients. The present study verifies the value of negative predischarge exercise testing in identifying low-risk patients treated with thrombolysis after AMI. One hundred fifty-seven consecutive patients with an uncomplicated clinical course underwent maximal or symptom-limited exercise testing (Bruce treadmill protocol) within 15 days of AMI in the absence of therapy. The location of the AMI was anterior in 51 patients, inferior in 85 and non-Q-wave in 21. All of the patients were followed for 6 months. Death and nonfatal reinfarction were considered as major coronary events, and the recurrence of angina as a minor event. Exercise test results were negative in 105 patients (group 1) and positive for angina or ST depression greater than or equal to 0.1 mV in 52 (group 2). No deaths occurred during follow-up; there were 3 reinfarctions (3%) and 7 cases (7%) of postinfarction angina in group 1, and 2 reinfarctions (4%) and 21 cases (40%) of postinfarction angina in group 2. By the end of follow-up, 90% of the patients with negative exercise test results were event-free (97% in the case of major events). These results show that thrombolytic therapy does not affect the value of negative postinfarction exercise testing in identifying low-risk patients.

Value of transthoracic two-dimensional echocardiography in predicting viability in patients with healed Q-wave anterior wall myocardial infarction.

The role of transthoracic echocardiography as a predictor of recovery after revascularization has not yet been established. Two-dimensional echocardiography was performed in 15 patients with a healed anterior wall myocardial infarction and severe, isolated stenosis of the left anterior descending coronary artery before, and 3 to 6 months after angiographically confirmed successful revascularization. The asynergic segments were classified into 2 groups according to 2 different echocardiographic patterns: those showing a normal acoustic reflectance with normal end-diastolic thickness (pattern A segments) and those showing an increase in acoustic reflectance and reduced end-diastolic thickness (pattern B segments). We hypothesized that pattern A segments were more likely to recover (viable myocardium) and that pattern B segments were consistent with irreversibility. A total of 240 segments in the 15 patients were evaluated before and after revascularization. Sixty-seven segments were asynergic; of these, 52 were judged to have pattern A and 15 pattern B. Of the 52 pattern A segments, 27 were hypokinetic and 25 akinetic. All of the pattern B segments were akinetic (n = 9) or dyskinetic (n = 6). Pattern A was predictive of postoperative recovery in 39 of 52 segments (75%) (p < 0.0001); pattern B was predictive of irreversibly damaged tissue in 13 of 15 segments (87%) (p < 0.0001). Thus, in patients with healed anterior wall myocardial infarction, resting transthoracic echocardiography is a simple and reliable predictor of the behavior of asynergic segments after revascularization.

Transthoracic high-frequency echocardiographic detection of atherosclerotic lesions in the descending portion of the left coronary artery.

To assess the ability of transthoracic high-frequency two-dimensional echocardiography to detect atherosclerotic lesions in the descending portion of the left coronary artery, 30 consecutive patients with suspected coronary artery disease underwent two-dimensional echocardiographic examination 24 to 96 hours before coronary angiography. The descending portion of the left coronary artery was arbitrarily divided into a mid segment (the portion of the coronary vessel embedded in the anterior interventricular sulcus) and an apical segment (the portion turning around the cardiac apex into the posterior interventricular sulcus). The mid segment was imaged in 24 and the apical segment in 25 of the 30 patients for a total of 49 out of 60 segments (82%). Comparison of the echocardiographically visualized segments with the corresponding angiographic segments indicated that a correct echocardiographic diagnosis of significant stenosis was made in 11 out of 12 segments. There were no false positive results. Thus the sensitivity and specificity of high-frequency transthoracic echocardiography in the detection of significant stenosis in the imaged segments were 92% and 100%, respectively. Compared with angiography, additional information concerning the status of the arterial wall, the presence of calcific plaques, and the cross-sectional extent of the obstructive lesions was obtained by echocardiography in eight patients.

Knot Formation Caused by Pseudomonas syringae subsp. savastanoi on Olive Plants Is hrp-Dependent.

ABSTRACT The virulence of Pseudomonas syringae subsp. savastanoi, which causes hyperplastic symptoms (knots) on olive plants, is associated with secreted phytohormones. We identified a Tn5-induced mutant of P. syringae subsp. savastanoi that did not cause disease symptoms on olive plants although it was still able to produce phytohormones. In addition, the mutant failed to elicit a hypersensitive response in a nonhost plant. Molecular characterization of the mutant revealed that a single Tn5 insertion occurred within an open reading frame encoding a protein 92% identical to the HrcC protein of P. syringae pv. syringae. Moreover, sequence analysis revealed that the gene encoding the HrcC protein in P. syringae subsp. savastanoi was part of an operon that included five genes arranged as in other phytopathogenic bacteria. These results imply that hrp/hrc genes are functional in P. syringae subsp. savastanoi and that they play a key role in the pathogenicity of this plant pathogen.

Automated Speech-recognition Anatomic Pathology (ASAP) reporting.

Artificial intelligence speech-recognizers integrated with Laboratory information and Telefaxcommunication Systems have allowed for totally automated surgical pathology reporting. Automated Speech-Recognition Anatomic Pathology (ASAP) reporting improves the speed, text accuracy, comprehensiveness, and workflow management of diagnostic reports while eliminating support personnel. Healthcare reform goals of increased productivity and economy are furthered. Reports are rendered "as soon as possible" (ASAP) expediting appropriate clinical management and decreased length of stay and hospital costs.

Blood pressure and heart rate relationship in normotensive and hypertensive subjects.

A twenty-four-hour blood pressure (BP) monitoring was performed in 20 normotensive and 20 hypertensive subjects, matched by sex and age. Blood pressure and heart rate (HR) variability were evaluated both as absolute and percent standard deviation. In agreement with the literature no significant difference in HR and BP variability was observed between the two groups. The linear regression between HR and BP values was evaluated in both groups. The authors observed a significant difference in the relationship between these two cardiovascular variables between the two groups. In the hypertensive group the cardiovascular control of HR and BP showed a different relationship than in normotensive subjects, suggesting a different neurovegetative modulation.

[Hepatic iron and chronic alcoholic liver disease. Histochemical findings]. / Ferro intraepatico ed epatopatia cronica etilica. Rilievi istochimici.

Histochemical methods (Perls-Turnbull-Blan) were used to assess the amount of iron present in the liver tissue (needle biopsy) of patients in various stages of chronic alcoholic liver pathology. The highest iron titres were found in the patients at the most advanced stage of the disease and there appeared to be a correlation between the size of the anatomopathological alterations and the quantity of haemosiderinic pigment.

[Indication for transcranial Doppler studies in transient ischemic attack]. / L'indagine al Doppler transcranico nell'attacco ischemico transitorio.

UNLABELLED: The diagnostic procedures for the assessment of transient ischemic attacks (TIA) include both brain imaging (computed tomography, nuclear magnetic resonance) and cerebrovascular investigation by means of ultrasound studies and angiography. Transcranial Doppler sonography (TCD) has not yet become a widely used diagnostic tool, although it allows noninvasive investigation of the intracranial cerebral circulation. The aim of this study was to assess the value of TCD investigation in patients who suffered from TIA. Eighty-one consecutive patients admitted to our General Medicine Department with a diagnosis of TIA underwent cranial computed tomography, ultrasound investigation of the extracranial cerebral arteries, and TCD. RESULTS: 39% of the TCD findings were not significant; TCD findings were highly significant in 18% of the patients with TIA, mainly for intracranial arterial stenoses and symptomatic subclavian steal; the other abnormal TCD findings were nonspecific, but in all these cases TCD yielded information on the efficiency of intracranial collateralization and the mechanisms regulating cerebral hemodynamics. These results suggest that TCD is a useful tool for the assessment of TIA.

[Limitations and usefulness of coronary stents in diverse clinical conditions. Long-term course]. / Limiti e utilità degli stent coronarici nelle varie condizioni cliniche. Decorso a lungo termine.

Since the introduction of balloon angioplasty, the acceptance and widespread application of coronary stents is the most important advance in interventional cardiology. The option of bail-out stenting has liberated interventionalists from the restrains of surgical stand-by. It has also allowed more aggressive balloon angioplasty and better short- and long-term results. This progress was enabled by improvements in deployment technique and antiplatelet therapy preventing most of the vexing problems of subacute stent thrombosis. Whereas initial registries and randomized trials focused on specific narrow patient populations, the clinical indications are broadening based on the results of new clinical trials that have focused on expanding populations, such as restenotic lesions, small vessels, total chronic occlusions, saphenous vein grafts stenoses, and acute ischemic syndromes. Despite this progress, a solution to the problem of in-stent restenosis, although less frequent than after balloon angioplasty alone, is still pending. In this review, we will discuss the process of restenosis which is the main indication for the use of stents, then we will analyze the application of stents in some particular clinical and anatomical situations and finally we will focus on in-stent restenosis which is the main limitation for stenting.

[Diagnosis of cardiocirculatory autonomic failure by the tilting method]. / Diagnosi della condizione di disautonomia cardio-circolatoria con il metodo di tilting.

The variation of SBP, DBP and HR is evaluated on tilting in a group of 34 patients affected by orthostatic hypotension versus a group of 54 healthy subjects, age and sex cross-matched. The patients affected by cardiovascular autonomic failure showed: 1) a fall of SBP greater than -19 mmHg in the 1st min; 2) a fall of the SBP average value (for 10 minutes) greater than -22 mmHg. Contrarily, the healthy subjects showed: 1) no variations of SBP values during the 1st minute and 2) a growing of SBP between the 2nd and the 10th minute; 3) a SBP average value (for 10 minutes) with a positive trend. The DBP and HR showed not differences between the groups. We suggest that the measure of SBP on standing may be considered an easy and fast method to perform a diagnosis of autonomic cardiovascular failure.