New ^{59}Fe Stellar Decay Rate with Implications for the ^{60}Fe Radioactivity in Massive Stars

The discrepancy between observations from γ-ray astronomy of the ^{60}Fe/^{26}Al γ-ray flux ratio and recent calculations is an unresolved puzzle in nuclear astrophysics. The stellar β-decay rate of ^{59}Fe is one of the major nuclear uncertainties impeding us from a precise prediction. The important Gamow-Teller strengths from the low-lying states in ^{59}Fe to the ^{59}Co ground state are measured for the first time using the exclusive measurement of the ^{59}Co(t,^{3}He+γ)^{59}Fe charge-exchange reaction. The new stellar decay rate of ^{59}Fe is a factor of 3.5±1.1 larger than the currently adopted rate at T=1.2  GK. Stellar evolution calculations show that the ^{60}Fe production yield of an 18 solar mass star is decreased significantly by 40% when using the new rate. Our result eliminates one of the major nuclear uncertainties in the predicted yield of ^{60}Fe and alleviates the existing discrepancy of the ^{60}Fe/^{26}Al ratio.

Study protocol for DICE trial: Video-assisted thoracoscopic surgery decortication versus interventional radiology guided chest tube insertion for the management of empyema

Background

Empyema is a common thoracic surgery presentation, defined as pus in the pleural space. Despite the commonality of empyema, consensus on initial management remains ambiguous. Two standard of care treatment options include inserting a chest tube (thoracostomy) and the administration of intrapleural fibrinolytics, or an initial surgical approach, surgical decortication. Due to the complexity of this pleural space infection, often repeat interventions are required after initial management in order to achieve source control and resolution of clinical symptoms. This study aims to identify the most effective initial management option for empyema.

Study design

We present a study protocol for a randomized control trial (RCT) comparing adult individuals with empyema to one of two standard of care initial management options. Participants will be randomized into either interventional radiology guided chest tube insertion with intrapleural fibrinolytics (Dornase 5 mg and Alteplase 10 mg intrapleural twice daily for three days) or video-assisted thoracoscopic surgery (VATS) decortication.

Methods

All adults with empyema meeting inclusion criteria will be invited to participate. They will be randomized into one of two intervention groups; interventional radiology guided chest tube insertion with fibrinolytics or initial VATS decortication. Each intervention will take place within 48 hours of randomization. The primary outcome will be the rate of re-intervention within 30 days. Re-intervention is defined as repeat chest tube insertion, VATS decortication, or decortication via thoracotomy. Secondary outcomes include a change in the size of empyema, length of stay, morbidity, as well as 30-day and 90-day mortality, as well as quality of life measurements.

Anticipated impact

This study is aimed at identifying the most effective initial management option for individuals with empyema.

COVID-19 stigma

Introduction

‘Health‐related stigma’ is typically known as social rejection or exclusion of individuals and populations suffering from specific health problems. Results on previous infectious diseases showed that stigma can be experienced by survivors but also by health‐care workers (HCW). Several factors contribute to stigma associated with infectious diseases, such as people’s knowledge, myths and stories transmitted by the mass and social media and psychosocial variables, such as risk perception and fear of being infected. COVID‐19 is a new disease with many unknown aspects and, naturally, people are afraid of the unknown.

Objectives

To reflect on infectious diseases and social stigma during covid-19 pandemics.

Methods

Pubmed and Google Scholar search.

Results

Stigmatization can considerably increase psychosomatic distress and disturbance and can negatively affect people with infection and those at risk of infection in seeking medical care. HCWs and volunteers working in the field may also become stigmatized, leading to higher rates of distress, stress, and burnout When people avoid groups or geographic areas related to infectious diseases, this can pose significant economic losses. Thus, stigma is more than a mere negative outcome of infectious diseases; it is both a factor that contributes to the epidemics and pandemics and a disease in itself.

Conclusions

Anticipating disease‐related stigma during the COVID‐19 pandemic enables policy‐makers to address it, restricting its adverse effects. The hidden burden caused by this stigma can cause severe consequences for patients, HCW, and public health measures, so, coordinated psychological interventions to overcome this crisis seems essential.

Stendhal syndrome: Can art make you ill?

Introduction

A psychosomatic disorder, Stendhal Syndrome, causes tachycardia, dizziness, sweating, disorientation, fainting, and confusion when someone is looking at artwork with which he or she connects deeply emotionally. In 1817, a French author named Marie-Henri Beyle, whose pseudonym was Stendhal, described his experience visiting the Basilica of Santa Croce in Florence and feeling overwhelmed by all the beauty and rich history surrounding him. Over a century later, visitors to Florence continued to suffer from similar symptoms. In 1979, Dr. Graziella Magherini, Chief of Psychiatry at the Hospital of Santa Maria Nuova in Florence, observed more than 100 tourists who were hospitalized after looking at art in Florence and coined the term Stendhal Syndrome.

Objectives

To review literature on Stendhal syndrome, a bizarre travel-related syndrome.

Methods

PubMed and Google Scholar search using the keywords Stendhal syndrome, travel syndromes, culture shock

Results

Victims are typically impressionable, single people between 26-40 years old, who are stressed by travel and may be struggling with jet lag. For art lovers, the thrill of arriving somewhere like Florence that gathers so much famous art is like meeting all your heroes at once. This strange aesthetic sickness is surely evidence of the special power of Renaissance art.

Conclusions

Stendhal Syndrome does not currently appear in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Psychiatrists have however, documented the syndrome in medical journals and advise that tourists pace themselves in art museums and get enough rest in between viewings of Italy’s breathtaking, powerful masterpieces.

Asymptomatic severe aortic stenosis: what is the current role of exercise stress test and NT-proBNP in patient risk stratification

Funding Acknowledgements

Type of funding sources: None.

Introduction

Aortic stenosis (AS) is prevalent in the elderly population. When severe and the patient is symptomatic or left ventricular dysfunction arises, the prognosis deteriorates and valve replacement (AVR) is recommended. During the asymptomatic phase regular clinical evaluation is advised to detect early onset of symptoms and/or signs of myocardial maladaptation. Due to the inherent difficulties in the evaluation of symptoms, especially in the elderly, as well as the change in prognosis when symptoms appear (even if not perceived), it is crucial to evaluate the behavior of patients with effort and signs of myocardial injury.

Methods

An observational and retrospective study that included 74 patients followed at the Cardiology Service by severe AS (aortic valve area ≤ 1cm2 and/or aortic transvalvular mean gradient ≥40mmHg), who underwent exercise stress test (EST) and NT-proBNP evaluation for risk stratification. The outcome studied was hospitalization for heart failure (HF), or referral to SV, or death during the follow-up period. Independent predictors were obtained using multivariate Cox regression.

Results

Non-progression or decrease in systolic blood pressure (SBP) in EST is the only independent predictor of a short-term adverse event (p = 0.025). This parameter, NT-proBNP levels and interventricular septal thickness (IVS) were independent predictors of a medium (two (p = 0.025; p = 0.014; p = <0.001), three (p = 0.015; p = 0.007; p = 0.001) and four years (p = 0.007; p = 0.049; p = 0.005)) and a long term adverse event (p = 0.006; p = 0.028; p = 0.005).

Conclusion

In asymptomatic patients with severe AS, no progression or decrease in SBP in EST, increased NT-proBNP levels and thickness of IVS were independent predictors of hospitalization for HF, need for VS or death in short, medium and long term.

β Decay of ^{61}V and its Role in Cooling Accreted Neutron Star Crusts

The interpretation of observations of cooling neutron star crusts in quasipersistent x-ray transients is affected by predictions of the strength of neutrino cooling via crust Urca processes. The strength of crust Urca neutrino cooling depends sensitively on the electron-capture and β-decay ground-state-to-ground-state transition strengths of neutron-rich rare isotopes. Nuclei with a mass number of A=61 are predicted to be among the most abundant in accreted crusts, and the last remaining experimentally undetermined ground-state-to-ground-state transition strength was the β decay of ^{61}V. This Letter reports the first experimental determination of this transition strength, a ground-state branching of 8.1_{-3.1}^{+4.0}%, corresponding to a log ft value of 5.5_{-0.2}^{+0.2}. This result was achieved through the measurement of the β-delayed γ rays using the total absorption spectrometer SuN and the measurement of the β-delayed neutron branch using the neutron long counter system NERO at the National Superconducting Cyclotron Laboratory at Michigan State University. This method helps to mitigate the impact of the pandemonium effect in extremely neutron-rich nuclei on experimental results. The result implies that A=61 nuclei do not provide the strongest cooling in accreted neutron star crusts as expected by some predictions, but that their cooling is still larger compared to most other mass numbers. Only nuclei with mass numbers 31, 33, and 55 are predicted to be cooling more strongly. However, the theoretical predictions for the transition strengths of these nuclei are not consistently accurate enough to draw conclusions on crust cooling. With the experimental approach developed in this work, all relevant transitions are within reach to be studied in the future.

Shape Changes in the N=28 Island of Inversion: Collective Structures Built on Configuration-Coexisting States in ^{43}S

The neutron-rich nuclei in the N=28 island of inversion have attracted considerable experimental and theoretical attention, providing great insight into the evolution of shell structure and nuclear shape in exotic nuclei. In this work, for the first time, quadrupole collectivity is assessed simultaneously on top of the 3/2^{-} ground state and the 7/2^{-} shape-coexisting isomer of ^{43}S, putting the unique interpretation of shape and configuration coexistence at N=27 and 28 in the sulfur isotopic chain to the test. From an analysis of the electromagnetic transition strengths and quadrupole moments predicted within the shell model, it is shown that the onset of shape coexistence and the emergence of a simple collective structure appear suddenly in ^{43}S with no indication of such patterns in the N=27 isotone ^{45}Ar.

First Direct Measurement of ^{22}Mg(α,p)^{25}Al and Implications for X-Ray Burst Model-Observation Comparisons

Type-I x-ray bursts can reveal the properties of an accreting neutron star system when compared with astrophysics model calculations. However, model results are sensitive to a handful of uncertain nuclear reaction rates, such as ^{22}Mg(α,p). We report the first direct measurement of ^{22}Mg(α,p), performed with the Active Target Time Projection Chamber. The corresponding astrophysical reaction rate is orders of magnitude larger than determined from a previous indirect measurement in a broad temperature range. Our new measurement suggests a less-compact neutron star in the source GS1826-24.

Tissue characterization and myocardium strain by cardiac magnetic resonance imaging in the early detection of anthracycline cardiotoxicity

Background

Cardiotoxicity (CT) remains an important cause of morbidity and mortality in patients with lymphomas treated with anthracyclines. Current strategies for early detection of CT during chemotherapy are not yet fully established.

Purpose

To evaluate the performance of cardiac magnetic resonance with T1 mapping and myocardium strain by feature tracking during chemotherapy in detecting anthracycline CT in patients with lymphoma.

Methods

From June 2017 to March 2019, patients with lymphoma planned to start chemotherapy with anthracyclines were evaluated by a cardiologist to check the eligibility criteria. At baseline (Time 1), at the end of 3° cycle (Time 2) and 30 days after the final cycle (Time 3), patients were evaluated through cardiac biomarkers, electrocardiogram and cardiac magnetic resonance (CMR). Strain, MapT1 and extracellular volume (ECV) were evaluated in all patients. CT was defined as drop of the left ventricular fraction (LVEF) >10% or LVEF decrease below 50%. A p value <0.05 was considered statistically significant.

Result

We included 48 patients, mean age was 45.32 (± 17.84) years-old and 25 (52.1%) were female. The prevalence of hypertension, diabetes and dyslipidemia was 18.8%, 10.4% and 10.4%, respectively. CT was diagnosed in 13 patients (27%). At baseline, there was no difference between cardiotoxicity group (CTG) and no cardiotoxicity group (nCTG) in CMR diastolic volume, systolic volume, nativeT1 map and global longitudinal strain (GLS), respectively (116 [103.6–138.1]ml vs 136.3 [115.7–173.8], p=0.069), (46 [38.0–58.5] ml vs 63.0 [44.5–74.2, p=0.069), (1540.6 [1478.3–1591.1]ms vs 1514.8 [1487.5–1786.3]ms, p=0.568) and (−15.94±2.91% vs −14.84±2.65%, p=0.243). Regarding the others CMR parameters, we showed that comparing CTG patients with nCTG patients at Time 3, systolic volumes were higher (54.8 [45.0–67.0] ml vs 78.51 [53.9–96.3] ml, p=0.007), right ejection fraction was lower (53.41±9.73% vs 46.29±3.93%, p=0.002), LVEF was lower (58.7±5.69% vs 46.67±8.12%, p<0.001) and GLS and radial strain were also reduced (−13.92±1.76% vs −12.44±2.7%, p=0.043) and (22.9 [21.18–27.43]% vs 19.84 [17.12–21.73], p=0.017), respectively. We did not observe any difference between groups in the native T1 map between groups at Time 2 and 3 1537.75 (1493.76–1589.72)ms vs 1601.99 (1501.12–1673.44)ms (p 0.383) and 1538.43 (1479.03–1633.6)ms and 1612.85 (1522.74–1638.34) ms (p=0.289). Similarly, the ECV value was no difference between groups at Time 2 and 3 (25.17 [23.62–32.83]% vs 24.42 [22.75–27.47], p=0.281 and 27.5 [23.59 - 31,9]% vs 27.2 [23.84–28.47]%, p=0.529, respectively).

Conclusions

Cardiotoxicity is a frequent complication in anthracycline treated patients. CMR evaluation, through analysis of volumes, ejection fraction and strain might early identify these patients, allowing prevention strategies to be initiated to improve cardiovascular outcomes.

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Fundação de Apoio a pesquisa do estado de São Paulo - FAPESP

Electron Storage in Electroactive Biofilms

Microbial electrochemical technologies (METs) are promising for sustainable applications. Recently, electron storage during intermittent operation of electroactive biofilms (EABs) has been shown to play an important role in power output and electron efficiencies. Insights into electron storage mechanisms, and the conditions under which these occur, are essential to improve microbial electrochemical conversions and to optimize biotechnological processes. Here, we discuss the two main mechanisms for electron storage in EABs: storage in the form of reduced redox active components in the electron transport chain and in the form of polymers. We review electron storage in EABs and in other microorganisms and will discuss how the mechanisms of electron storage can be influenced.

The association between sympatho-vagal balance and central blood pressures

Purpose

High central blood pressure is more predictive of cardiovascular disease (CVD) versus high peripheral blood pressure. Measures of central pressures (CPs) include, central systolic blood pressure (CSBP) and central diastolic blood pressure. Measures of central pressures augmentation (CPsA) include augmentation pressure (AP) and the augmentation index @ 75 beats·min-1 (AIx@75). Increased sympathetic tone (ST) is also associated with CVD. The low to high frequency ratio (LF/HF) is often used to determine sympatho-vagal balance. Given the association between ST, CPs, CPsA and CVD there is a need to understand the association between these predictors of CVD. The aims of this study were to examine the association between the LF/HF ratio, CPs, and CPsA in men and women collectively and based on gender.

Methods

We measured the LF/HF ratio, CSBP, AP, and AIx@75 in 102 participants (41F/61M). The LF/HF ratio was determined via power spectral density analysis. CSBP, AP, and AIx@75 were determined via applanation tonometry.

Results

The LF/HF ratio was inversely associated with AP (r = -0.26) and AIx @75 (r = -0.29) in the combined group of men and women. The LF/HF ratio was inversely associated with CSBP (r = -0.27), AP (r = -0.28), and AIx@75 (r = -0.32) in men, but not in women.

Conclusion

There is an inverse association between the LF/HF ratio, AP, and AIx@75 in men and women combined. The association between the LF/HF ratio, CSBP, AP, and AIx@75, differs based on gender.

Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation

Neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) show overlap in their clinical features. We performed an analysis of relapses with the aim of determining differences between the two conditions. Cases of NMOSD and age- and sex-matched MS controls were collected from across Australia and New Zealand. Demographic and clinical information, including relapse histories, were recorded using a standard questionnaire. There were 75 cases of NMOSD and 101 MS controls. There were 328 relapses in the NMOSD cases and 375 in MS controls. Spinal cord and optic neuritis attacks were the most common relapses in both NMOSD and MS. Optic neuritis (p < 0.001) and area postrema relapses (P = 0.002) were more common in NMOSD and other brainstem attacks were more common in MS (p < 0.001). Prior to age 30 years, attacks of optic neuritis were more common in NMOSD than transverse myelitis. After 30 this pattern was reversed. Relapses in NMOSD were more likely to be treated with acute immunotherapies and were less likely to recover completely. Analysis by month of relapse in NMOSD showed a trend toward reduced risk of relapse in February to April compared to a peak in November to January (P = 0.065). Optic neuritis and transverse myelitis are the most common types of relapse in NMOSD and MS. Optic neuritis tends to occur more frequently in NMOSD prior to the age of 30, with transverse myelitis being more common thereafter. Relapses in NMOSD were more severe. A seasonal bias for relapses in spring-summer may exist in NMOSD.

Shift Work: Work ability and quality of life of professionals from IPSS

Introduction Shift work can influence the health and well-being of individuals due to changes in biological rhythms, causing psychological and physical disruption, hampering family relationship, social and work ability. However, the shift work of auxiliary of direct / educational action of Private Social Solidarity Institution (PSSI) is essential to ensure continuity in the provision of the best hygienic and health care to the users of these institutions every day.

Objectives The objective of this study was to evaluate the quality of life and the work capacity of Direct-Action Assistants (n = 29).

Methodology Respondents were subjected a monitoring of the heart function PB – Blood Pressure for 24 hours and answered a questionnaire (Work Ability Index and Quality of Life Index).

Results Of the 29 workers evaluated 90% were women and 10% men, aged 45.5 (± 10.47) years and exercise time of 7.1 (± 3.18) years. Physical examination revealed a mean 24 h Systolic Blood Pressure of 119.3 (± 11.8) mm Hg and 24 h Diastolic Blood Pressure of 72.6 (± 7.3) mm Hg. The mean Body Mass Index (BMI) (kg / m2) was 25.6 (± 3.5), and 24.1% of the participants were overweight and 13.7% obesity grade I. From this analysis, we found that overweight individuals have a tendency to increase the Blood Pressure compared to normal weight individuals. Although the working class has a good ability to work 69%, they are not optimistic about the future.

Conclusion We concluded that workers can be adjusted the constant changes of schedules established by their institutions, and are able to carry out their work, however, individuals with 6 or more years of work in the present-day regime shifts already feel some symptoms of physical and psychological wear, and thus speeding up their aging.

[Inherited bleeding disorders in adolescents with excessive menstrual bleeding. Should we evaluate the fibrinolytic pathway?]

INTRODUCTION

Heavy Menstrual Bleeding (EMB) is a frequent problem in adolescence. The prevalence of inherited bleeding disorders (IBD) as a cause of EMB is not well established and the involvement of fibri nolytic pathway defects has been poorly explored.

OBJECTIVE

To determine the prevalence of IBD and fibrinolysis defects in adolescents with EMBs.

PATIENTS AND METHOD

93 adolescents (11 to 18 years old) were included. Personal and family history of bleeding were obtained through a standard ized questionnaire. The following lab tests were performed: prothrombin time (PT), activated partial thromboplastin time (aPTT), von Willebrand factor quantification, and platelet count and function. Those patients who were not diagnosed with IBD were further evaluated with clot lysis time assay.

RESULTS

41 patients (44%) were diagnosed as IBD (Von Willebrand disease n = 28, platelet func tion defects n=8, mild hemophilia n = 5. Decreased clot lysis time was found in 31 patients. 54% of patients diagnosed with IBD had EMB as the first hemorrhagic manifestation.

CONCLUSION

These results support the need to evaluate the coagulation process, including the fibrinolytic pathway in the study of adolescents with EMB.

Practical recommendations for the perioperative management of the patient with suspection or serious infection by coronavirus SARS-CoV

En diciembre del 2019, la Comisión Municipal de Salud y Sanidad de Wuhan (provincia de Hubei, China) informó de una serie de casos de neumonía de etiología desconocida. El 7 de enero del 2020, las autoridades chinas identificaron como agente causante del brote un nuevo tipo de virus de la familia Coronaviridae, denominado SARS-CoV-2. Desde entonces, se han notificado miles de casos con una diseminación global. Las infecciones en humanos provocan un amplio espectro clínico que va desde infección leve del tracto respiratorio superior, hasta síndrome de distrés respiratorio agudo grave y sepsis. No existe un tratamiento específico para SARS-CoV-2, motivo por lo que los aspectos fundamentales son establecer medidas adecuadas de prevención y el tratamiento de soporte y manejo de las complicaciones.