Theoretical Study of the d(d, p)^{3}H and d(d, n)^{3}He Processes at Low Energies

We present a theoretical study of the processes d(d,p)^{3}H and d(d,n)^{3}He at energies of interest for energy production and for big-bang nucleosynthesis. We accurately solve the four body scattering problem using the ab initio hyperspherical harmonics method, starting from nuclear Hamiltonians which include modern two- and three-nucleon interactions, derived in chiral effective field theory. We report results for the astrophysical S factor, the quintet suppression factor, and various single and double polarized observables. A first estimate of the theoretical uncertainty for all these quantities is provided by varying the cutoff parameter used to regularize the chiral interactions at high momentum.

The baryon density of the Universe from an improved rate of deuterium burning

Light elements were produced in the first few minutes of the Universe through a sequence of nuclear reactions known as Big Bang nucleosynthesis (BBN)^1,2. Among the light elements produced during BBN^1,2, deuterium is an excellent indicator of cosmological parameters because its abundance is highly sensitive to the primordial baryon density and also depends on the number of neutrino species permeating the early Universe. Although astronomical observations of primordial deuterium abundance have reached percent accuracy³, theoretical predictions^4-6 based on BBN are hampered by large uncertainties on the cross-section of the deuterium burning D(p,γ)³He reaction. Here we show that our improved cross-sections of this reaction lead to BBN estimates of the baryon density at the 1.6 percent level, in excellent agreement with a recent analysis of the cosmic microwave background⁷. Improved cross-section data were obtained by exploiting the negligible cosmic-ray background deep underground at the Laboratory for Underground Nuclear Astrophysics (LUNA) of the Laboratori Nazionali del Gran Sasso (Italy)^8,9. We bombarded a high-purity deuterium gas target¹⁰ with an intense proton beam from the LUNA 400-kilovolt accelerator¹¹ and detected the γ-rays from the nuclear reaction under study with a high-purity germanium detector. Our experimental results settle the most uncertain nuclear physics input to BBN calculations and substantially improve the reliability of using primordial abundances to probe the physics of the early Universe.

Nonresonant Density of States Enhancement at Low Energies for Three or Four Neutrons

The low energy systems of three or four neutrons are treated within the adiabatic hyperspherical framework, yielding an understanding of the low energy quantum states in terms of an adiabatic potential energy curve. The dominant low energy potential curve for each system, computed here using widely accepted nucleon-nucleon interactions with and without the inclusion of a three-nucleon force, shows no sign of a low energy resonance. However, both systems exhibit a low energy enhancement of the density of states, or of the Wigner-Smith time delay, which derives from long-range universal physics analogous to the Efimov effect. That enhancement could be relevant to understanding the low energy excess of correlated four-neutron ejection events observed experimentally in a nuclear reaction by Kisamori et al. [Phys. Rev. Lett. 116, 052501 (2016)PRLTAO0031-900710.1103/PhysRevLett.116.052501].

Erratum: Proton-Proton Weak Capture in Chiral Effective Field Theory [Phys. Rev. Lett. 110, 192503 (2013)]

This corrects the article DOI: 10.1103/PhysRevLett.110.192503.

Ionic conductivity and local structural features in Ce1-xSmxO2-x/2

Sm-Doped ceria is one of the most promising materials to be used as electrolyte in solid oxide fuel cells due to its remarkable ionic conductivity values in the intermediate temperature range. Transport properties and local structural features of Ce1-xSmxO2-x/2 (0.1 ≤ x ≤ 0.7) were studied by an impedance/μ-Raman spectroscopy coupled approach up to 1073 K. Results suggest that C-based nanosized defect clusters are responsible for the drop in ionic conductivity observed even at x = 0.2, i.e. at a Sm content lower than necessary to allow C domains to reach the percolation threshold through crystallites. Moreover, within the fluorite-type compositional region, with increasing the Sm content, defect clusters undergo a rearrangement resulting in the enlargement of C-based domains rather than in the increase of their number; at higher x, on the contrary, both the size and amount of C domains increase in parallel.

Correlations imposed by the unitary limit between few-nucleon systems, nuclear matter, and neutron stars

The large values of the singlet and triplet two-nucleon scattering lengths locate the nuclear system close to the unitary limit. This particular position strongly constrains the low-energy observables in the three-nucleon system as depending on one parameter, the triton binding energy, and introduces correlations in the low-energy sector of light nuclei. Here we analyze the propagation of these correlations to infinite nuclear matter showing that its saturation properties, the equation of state of β-stable nuclear matter, and several properties of neutron stars, as their maximum mass, are well determined solely by a few number of low-energy quantities of the two- and three-nucleon systems. In this way we make a direct link between the universal behavior observed in the low-energy region of few-nucleon systems and fundamental properties of nuclear matter and neutron stars.

Erratum: Chiral Effective Field Theory Predictions for Muon Capture on Deuteron and ^{3}He [Phys. Rev. Lett. 108, 052502 (2012)]

This corrects the article DOI: 10.1103/PhysRevLett.108.052502.

Light-Nuclei Spectra from Chiral Dynamics

In recent years local chiral interactions have been derived and implemented in quantum Monte Carlo methods in order to test to what extent the chiral effective field theory framework impacts our knowledge of few- and many-body systems. In this Letter, we present Green's function Monte Carlo calculations of light nuclei based on the family of local two-body interactions presented by our group in a previous paper in conjunction with chiral three-body interactions fitted to bound- and scattering-state observables in the three-nucleon sector. These interactions include Δ intermediate states in their two-pion-exchange components. We obtain predictions for the energy levels and level ordering of nuclei in the mass range A=4-12, accurate to ≤2% of the binding energy, in very satisfactory agreement with experimental data.

Publisher's Note: JLab Measurements of the ^{3}He Form Factors at Large Momentum Transfers [Phys. Rev. Lett. 119, 162501 (2017)]

This corrects the article DOI: 10.1103/PhysRevLett.119.162501.

JLab Measurements of the ^{3}He Form Factors at Large Momentum Transfers

The charge and magnetic form factors, F_{C} and F_{M}, respectively, of ^{3}He are extracted in the kinematic range 25  fm^{-2}≤Q^{2}≤61  fm^{-2} from elastic electron scattering by detecting ^{3}He recoil nuclei and scattered electrons in coincidence with the two High Resolution Spectrometers of the Hall A Facility at Jefferson Lab. The measurements find evidence for the existence of a second diffraction minimum for the magnetic form factor at Q^{2}=49.3  fm^{-2} and for the charge form factor at Q^{2}=62.0  fm^{-2}. Both minima are predicted to exist in the Q^{2} range accessible by this Jefferson Lab experiment. The data are in qualitative agreement with theoretical calculations based on realistic interactions and accurate methods to solve the three-body nuclear problem.

Participation of Australian Aboriginal and Torres Strait Islander families in a parent support programme: longitudinal associations between playgroup attendance and child, parent and community outcomes

BACKGROUND

Playgroups are a relatively unique form of family support programme that is common in Australia which has high community acceptance and significant government investment. However, limited evidence exists regarding the effectiveness of playgroups to achieve better outcomes for children and their parents. This study describes patterns of playgroup participation for Aboriginal and Torres Strait Islander families with young children and examines the extent to which participation from birth to three years is associated with subsequent child, parent and community outcomes.

METHODS

This study uses three years of longitudinal data for 622 Aboriginal and Torres Strait Islander children who were participants in the Longitudinal Study of Indigenous Children (LSIC). Longitudinal associations between playgroup attendance when children were age 2 and 3 years and outcome measures for child vocabulary, motor skills, behaviour problems, prosocial development, parent home learning engagement, resilience, advice-seeking and health service use, and community trustworthiness were examined using path analysis.

RESULTS

Rates of playgroup participation in this sample group were generally lower than for Australian children overall. Playgroup attendance when children were age 2 to 3 years was associated with higher parental engagement in home learning activities when children were aged 4 years which, in turn, was associated with stronger expressive vocabulary scores for children.

CONCLUSION

The findings from this study suggest that playgroup participation can enhance the home learning environments for Aboriginal and Torres Strait Islander children. Playgroups as a parent support programme hold strong potential to reach and engage families, particularly in areas of high geographic isolation, which can realize improved outcomes for children, parents and communities.

Erratum: Implication of the Proton-Deuteron Radiative Capture for Big Bang Nucleosynthesis [Phys. Rev. Lett. 116, 102501 (2016)]

This corrects the article DOI: 10.1103/PhysRevLett.116.102501.

Implication of the Proton-Deuteron Radiative Capture for Big Bang Nucleosynthesis

The astrophysical S factor for the radiative capture d(p,γ)^{3}He in the energy range of interest for big bang nucleosynthesis (BBN) is calculated using an ab initio approach. The nuclear Hamiltonian retains both two- and three-nucleon interactions-the Argonne v_{18} and the Urbana IX, respectively. Both one- and many-body contributions to the nuclear current operator are included. The former retain for the first time, besides the 1/m leading order contribution (m is the nucleon mass), also the next-to-leading order term, proportional to 1/m^{3}. The many-body currents are constructed in order to satisfy the current conservation relation with the adopted Hamiltonian model. The hyperspherical harmonics technique is applied to solve the A=3 bound and scattering states. Particular attention is paid in this second case in order to obtain, in the energy range of BBN, an uncertainty on the astrophysical S factor of the order or below ∼1%. Then, in this energy range, the S factor is found to be ∼10% larger than the currently adopted values. Part of this increase (1%-3%) is due to the 1/m^{3} one-body operator, while the remaining is due to the new more accurate scattering wave functions. We have studied the implication of this new determination for the d(p,γ)^{3}He S factor on the deuterium primordial abundance. We find that the predicted theoretical value for ^{2}H/H is in excellent agreement with its experimental determination, using the most recent determination of the baryon density of the Planck experiment, and with a standard number of relativistic degrees of freedom N_{eff}=3.046 during primordial nucleosynthesis. This calls for a more accurate measurement of the astrophysical S factor in order to confirm the present predictions.

Measurement of double-polarization asymmetries in the quasielastic (3)He[→](e[→],e(')d) process

We present a precise measurement of double-polarization asymmetries in the ^{3}He[over →](e[over →],e^{'}d) reaction. This particular process is a uniquely sensitive probe of hadron dynamics in ^{3}He and the structure of the underlying electromagnetic currents. The measurements have been performed in and around quasielastic kinematics at Q^{2}=0.25(GeV/c)^{2} for missing momenta up to 270  MeV/c. The asymmetries are in fair agreement with the state-of-the-art calculations in terms of their functional dependencies on p_{m} and ω, but are systematically offset. Beyond the region of the quasielastic peak, the discrepancies become even more pronounced. Thus, our measurements have been able to reveal deficiencies in the most sophisticated calculations of the three-body nuclear system, and indicate that further refinement in the treatment of their two-and/or three-body dynamics is required.

JLab measurement of the 4He charge form factor at large momentum transfers

The charge form factor of 4He has been extracted in the range 29  fm(-2) ≤ Q2 ≤ 77  fm(-2) from elastic electron scattering, detecting 4He recoil nuclei and electrons in coincidence with the high resolution spectrometers of the Hall A Facility of Jefferson Lab. The measurements have uncovered a second diffraction minimum for the form factor, which was predicted in the Q2 range of this experiment. The data are in qualitative agreement with theoretical calculations based on realistic interactions and accurate methods to solve the few-body problem.

Effect of three-nucleon interactions in p-(3)He elastic scattering

We present a detailed study of the effect of different three-nucleon interactions in p-(3)He elastic scattering at low energies. In particular, two interactions have been considered: one derived from effective field theory at next-to-next-to-leading order and one derived from a more phenomenological point of view-the so-called Illinois model. The four-nucleon scattering observables are calculated by using the Kohn variational principle and the hyperspherical harmonics technique, and the results are compared with available experimental data. We have found that the inclusion of both interactions improves the agreement with the experimental data, in particular, for the proton vector analyzing power.

Proton-proton weak capture in chiral effective field theory

The astrophysical S factor for proton-proton weak capture is calculated in chiral effective field theory over the center-of-mass relative-energy range 0-100 keV. The chiral two-nucleon potential derived up to next-to-next-to-next-to leading order is augmented by the full electromagnetic interaction including, beyond Coulomb, two-photon and vacuum-polarization corrections. The low-energy constants entering the weak current operators are fixed so as to reproduce the A=3 binding energies and magnetic moments and the Gamow-Teller matrix element in tritium β decay. Contributions from S and P partial waves in the incoming two-proton channel are retained. The S factor at zero energy is found to be S(0)=(4.030±0.006)×10(-23) MeV fm(2), with a P-wave contribution of 0.020×10(-23) MeV fm(2). The theoretical uncertainty is due to the fitting procedure of the low-energy constants and to the cutoff dependence.

Chiral effective field theory predictions for muon capture on deuteron and {3}He

The muon-capture reactions {2}H(μ{-},ν{μ})nn and {3}He(μ{-},ν{μ}){3}H are studied with nuclear potentials and charge-changing weak currents, derived in chiral effective field theory. The low-energy constants (LECs) c{D} and c{E}, present in the three-nucleon potential and (c{D}) axial-vector current, are constrained to reproduce the A=3 binding energies and the triton Gamow-Teller matrix element. The muon-capture rates on deuteron and {3}He are predicted to be 399±3  sec{-1} and 1494±21  sec{-1}, respectively. The spread accounts for the cutoff sensitivity, as well as uncertainties in the LECs and electroweak radiative corrections. By comparing the calculated and precisely measured rates on {3}He, a value for the induced pseudoscalar form factor is obtained in good agreement with the chiral perturbation theory prediction.

Thermal neutron captures on d and 3He

We report on a study of the nd and n(3)He radiative captures at thermal neutron energies, using wave functions obtained from either chiral or conventional two- and three-nucleon realistic potentials with the hyperspherical-harmonics method, and electromagnetic currents derived in chiral effective field theory up to one loop. The predicted nd and n(3)He cross sections are in good agreement with data, but exhibit a significant dependence on the input Hamiltonian. A comparison is also made between these and new results for the nd and n(3)He cross sections obtained in the conventional framework for both potentials and currents.

The role of admission surveillance cultures in patients requiring prolonged mechanical ventilation in the intensive care unit

We undertook a prospective observational cohort study in intensive care unit (ICU) patients requiring mechanical ventilation for four days or more to evaluate normal and abnormal bacterial carriage on admission detected by surveillance cultures of throat and rectum. We assessed the importance of surveillance and diagnostic cultures for the early detection of resistance to third generation cephalosporins employed as the parenteral component of the selective decontamination of the digestive tract. Finally, we sought the risk factors of abnormal carriage on admission to the ICU. During the 58-month study 621 patients were included: 186 patients (30%) carried abnormal flora including methicillin-resistant Staphylococcus aureus (MRSA) and aerobic Gram negative bacilli (AGNB) on admission to the ICU Both MRSA and AGNB carriers were more commonly present in the hospital group of patients than in patients referred from the community (P < 0.001), although overgrowth was equally present both in community and in hospital patients. The incidence of infections during ICU stay was higher in abnormal (n=120, 64.5%) than in normal carriers (n=185, 42.5%) (P < 0.0001), with an odds ratio of 2.46 (95% confidence interval 1.72 to 3.51). Third generation cephalosporins covered ICU admission flora in 482 (78%) of the studied population. AGNB resistant to cephalosporins and MRSA were detected in surveillance cultures of 139 patients (22%), while the same resistant micro-organisms were identified only in 49 diagnostic samples (7.9%). Parenteral cephalosporins were modified in patients with abnormal flora (P < 0.0001). One hundred and ninety-six patients received antibiotics before admission to the ICU and 42% carried AGNB resistant to cephalosporins. Previous antibiotic use was the only risk factor for abnormal carriage in the multivariate analysis (OR 3.5; 95% confidence interval 2.1 to 5.8). The knowledge of carriage on admission using surveillance cultures may help intensivists to identify patients with abnormal carriage on admission and resistant bacterial strains at an early stage even when diagnostic samples are negative. Third generation cephalosporins covered admission flora in about 80% of the enrolled population and were modified in patients with abnormal flora who received antibiotic therapy before ICU admission. Our finding of overgrowth present on admission may justify the immediate administration of enteral antimicrobials.

Zygomycosis in Italy: a survey of FIMUA-ECMM (Federazione Italiana di Micopatologia Umana ed Animale and European Confederation of Medical Mycology)

The aims of the study were to analyze the clinical and epidemiological characteristics and treatments for patients who developed zygomycosis enrolled in Italy during the European Confederation of Medical Mycology of medical mycology survey. This prospective multicenter study was performed between 2004 and 2007 at 49 italian Departments. 60 cases of zygomycosis were enrolled: the median age was 59.5 years (range 1-87), with a prevalence of males (70%). The majority of cases were immunocompromised patients (42 cases, 70%), mainly hematological malignancies (37). Among non-immunocompromised (18 cases, 30%), the main category was represented by patients with penetrating trauma (7/18, 39%). The most common sites of infection were sinus (35%) with/without CNS involvement, lung alone (25%), skin (20%), but in 11 cases (18%) dissemination was observed. According to EORTC criteria, the diagnosis of zygomycosis was proven in 46 patients (77%) and in most of them it was made in vivo (40/46 patients, 87%); in the remaining 14 cases (23%) the diagnosis was probable. 51 patients received antifungal therapy and in 30 of them surgical debridement was also performed. The most commonly used antifungal drug was liposomal amphotericin B (L-AmB), administered in 44 patients: 36 of these patients (82%) responded to therapy. Altogether an attributable mortality rate of 32% (19/60) was registered, which was reduced to 18% in patients treated with L-AmB (8/44). Zygomycosis is a rare and aggressive filamentous fungal infection, still associated with a high mortality rate. This study indicates an inversion of this trend, with a better prognosis and significantly lower mortality than that reported in the literature. It is possible that new extensive, aggressive diagnostic and therapeutic procedures, such as the use of L-AmB and surgery, have improved the prognosis of these patients.

Integral relations for three-body continuum states with the adiabatic expansion

The application of the hyperspherical adiabatic expansion to describe three-body scattering states suffers from the problem of very slow convergence. Contrary to what happens for bound states, a huge number of hyper-radial equations has to be solved, and even if done, the extraction of the scattering amplitude is problematic. In this Letter we show how to obtain accurate scattering phase shifts using the hyperspherical adiabatic expansion. To this aim two integral relations, derived from the Kohn variational principle, are used. The convergence of this procedure is as fast as for bound states.

Isospin mixing in the nucleon and 4He and the nucleon strange electric form factor

In order to isolate the contribution of the nucleon strange electric form factor to the parity-violating asymmetry measured in 4He(e-->],e')4He experiments, it is crucial to have a reliable estimate of the magnitude of isospin-symmetry-breaking (ISB) corrections in both the nucleon and 4He. We examine this issue in the present Letter. Isospin admixtures in the nucleon are determined in chiral perturbation theory, while those in 4He are derived from nuclear interactions, including explicit ISB terms. A careful analysis of the model dependence in the resulting predictions for the nucleon and nuclear ISB contributions to the asymmetry is carried out. We conclude that, at the low momentum transfers of interest in recent measurements reported by the HAPPEX Collaboration at Jefferson Lab, these contributions are of comparable magnitude to those associated with strangeness components in the nucleon electric form factor.

Systemic and organ dysfunction response during infusion of recombinant human activated protein C (rhAPC) in severe sepsis and septic shock

AIM

The aim of this study was the assessment of the efficacy of recombinant human activated protein C (rhAPC) in septic patients.

METHODS

A continuous observational prospective study on ICU patients with severe sepsis and septic shock was carried out. Applying the inclusion criteria of a national trial on the use of rhAPC, 15 patients (12 males and 3 females) were enrolled, mean age was 65.9 (SD 9.6), APACHE II score was > or =25. The following variables were assessed on 7 time-points (T1-T7): overall SOFA score; organ-specific SOFA score; APACHE II score; PCR, APTT, INR, fibrinogen, platelet count. Wilcoxon's statistical test and Spearman's correlation test (rho coefficient) between the SOFA and APACHE II scores were used. Test results with a P value below 0.05 were deemed significant.

RESULTS

A significant correlation was identified between the APACHE II and SOFA scores. No significant change was found in Friedman's test and the respiratory, haematological and hepatic SOFA score, whereas cardiovascular, renal and neurological SOFA scores showed a significant trend between the ranks at the 7 time-points (chi2=14; df=6; P=0.029). During rhAPC treatment Friedman's test showed significant changes of PCR values over the 7 time-points (chi2=19.2; df=6; P=0.02). Wilcoxon's test indicated a significant decrease in the values recorded during the T2-T6 period. On day 28, 12 of the 15 patients originally enrolled were still alive. Mortality rate was therefore 20% (CI 95%).

CONCLUSIONS

RhAPC is the first biological agent approved for the treatment of severe sepsis and septic shock. Our experience is confined to patients with severe sepsis and septic shock, and some severity indexes showed a modulation of the inflammatory processes and haemostatic balance, 2 factors which play a key role in the evolution of sepsis and organ dysfunction.

Control of imported and acquired methicillin-resistant Staphylococcus aureus (MRSA) in mechanically ventilated patients: a dose-response study of enteral vancomycin to reduce absolute carriage and infection

This study aimed to quantify the animate source provided by the patients using the concept of "absolute carriage" by multiplying the carrier rate by the level of carriage; and to compare the impact of a low and high dose of an oropharyngeal vancomycin gel on the absolute MRSA carriage and infection. In all, 265 patients were included, 126 were MRSA positive. Fifty-five patients received 2% vancomycin gel during the first year whilst 4% vancomycin gel was given to 50 patients during the second year. Surveillance swabs of throat and rectum were obtained from all eligible patients on admission and then twice weekly. The vancomycin protocol was started as soon as the surveillance cultures were positive for MRSA. Those patients received one gram of enteral vancomycin daily, divided into four doses. During the first year 2% vancomycin gel 4 ml (80 mg) was applied in the oropharynx in four doses in addition to the enteral solution (Group A). During the second year 4% vancomycin gel 4 ml (160 mg) was used (Group B). The absolute carriage was high during both periods: 3.6 for Group A, and 3.2 for Group B. The 4% vancomycin protocol significantly reduced the absolute carriage, compared to the 2% vancomycin protocol: 2.6 versus 1.5 (P < 0.01). Significant reduction in secondary endogenous infections was found in the second year: seven versus 15 patients (P < 0.05). A total of 3,588 microbiological samples were processed. Neither Staphylococcus aureus with intermediate sensitivity to vancomycin (VISA) nor vancomycin-resistant enterococci (VRE) were detected.

Polarization transfer in 4He(e-->,e'p-->)3H: is the ratio G E p/G M p ) modified in the nuclear medium?

Polarization observables in the (4)He(e-->,e'p-->)(3)H reaction are calculated using accurate three- and four-nucleon bound-state wave functions, a realistic model for the nuclear electromagnetic current operator, and a treatment of final-state interactions with an optical potential. In contrast to earlier studies, no significant discrepancies are found between theory and experiment both for the ratio of transverse to longitudinal polarization transfers and for the induced polarization, when free-nucleon electromagnetic form factors are used in the current operator. The present results challenge the current interpretation of the experimental data in terms of medium-modified form factors.

Candida colonization in patients with esophageal disease: a prospective clinical study

The incidence of Candida infection has significantly increased over the recent years, becoming the fourth most common pathogens isolated in patients admitted to intensive care units (ICU). Mortality rates ranging between 6 and 38% have been reported to be associated with candidemia. Esophageal surgery may increase the risk of systemic Candida infection in critical patients requiring postoperative ICU admission. The aim of the present study was to assess the prevalence of Candida colonization in patients with esophageal disease undergoing surgery. Between April 1999 and April 2001, 131 patients with esophageal disease and 40 healthy volunteers were prospectively tested for Candida colonization by oral and pharyngeal swab. Candida colonization was significantly more frequent in patients with esophageal disease than in control subjects (38.9 vs 7.5%, P < 0.01); the prevalence was higher in individuals with carcinoma than in those with benign disease (51.8 vs 24%, P < 0.02), and in patients undergoing neoadjuvant chemoradiation therapy compared to those having primary surgery (55.5 vs 34.4%, P < 0.01). These data suggest that Candida colonization of the gastrointestinal tract is common in patients with esophageal disease. Pharmacological attempts to prevent or reduce the magnitude of this event may be worthwhile before surgery. However, the hypothesis that antifungal oral prophylaxis with nonabsorbable drugs may lower the incidence of candidemia in patients with gastrointestinal Candida colonization, especially in those candidates to postoperative ICU admission, should be tested by randomized double-blinded studies.

Precision measurement of the spin-dependent asymmetry in the threshold region of 3He(e, e')

We present the first precision measurement of the spin-dependent asymmetry in the threshold region of 3He(e,e') at Q2 values of 0.1 and 0.2 (GeV/c)2. The agreement between the data and nonrelativistic Faddeev calculations which include both final-state interactions and meson-exchange current effects is very good at Q2 = 0.1 (GeV/c)2, while a small discrepancy at Q2 = 0.2 (GeV/c)2 is observed.

The A(y) problem for p-3He elastic scattering

We present evidence that numerically accurate quantum calculations employing modern internucleon forces do not reproduce the proton analyzing power, A(y), for p- 3He elastic scattering at low energies. These calculations underpredict new measured analyzing powers by approximately 30% at E(c.m.) = 1.20 MeV and by 40% at E(c.m.) = 1.69 MeV, an effect analogous to a well-known problem in p-d and n-d scattering. The calculations are performed using the complex Kohn variational principle and the (correlated) hyperspherical harmonics technique with full treatment of the Coulomb force. The inclusion of the three-nucleon interaction does not improve the agreement with the experimental data.

Transverse asymmetry AT' from the quasielastic 3He(e,e') process and the neutron magnetic form factor

We have measured the transverse asymmetry A(T') in 3He(e,e(')) quasielastic scattering in Hall A at Jefferson Laboratory with high precision for Q2 values from 0.1 to 0.6 (GeV/c)(2). The neutron magnetic form factor G(n)(M) was extracted based on Faddeev calculations for Q2 = 0.1 and 0.2 (GeV/c)(2) with an experimental uncertainty of less than 2%.

Realistic calculation of the 3He + p (hep) astrophysical factor

The astrophysical factor for the proton weak capture on 3He is calculated with correlated hyperspherical harmonic wave functions corresponding to a realistic Hamiltonian consisting of the Argonne v(18) two-nucleon and Urbana-IX three-nucleon interactions. The nuclear weak current has vector and axial-vector components with one- and many-body terms. All possible transitions connecting any of the p 3He S- and P-wave channels to 4He are considered. The S factor at a p 3He center-of-mass energy of 10 keV is predicted to be 10. 1x10(-20) keV b, a factor of approximately 4.5 larger than the value adopted in the standard solar model. The P-wave transitions are found to contribute about 40% of the calculated S factor.

An uncommon cause of lower limb weakness

We describe a case of a severely mentally disabled patient diagnosed as suffering from Guillain-Barré syndrome and treated with repeated plasma exchange. However, the abrupt onset of a cardiovascular collapse prompted a more in-depth diagnostic workup which demonstrated that the neurologic symptoms were likely to be ascribed to poisoning with heavy metals from a large number of ingested coins and other metallic items.

Does the length of stay in the intensive care unit influence the diagnostic accuracy? A clinical-pathological study

To evaluate the rate of diagnostic errors leading to preventable deaths among patients admitted to our intensive care unit (ICU), we retrospectively reviewed the medical and autopsy records of all patients who died in the ICU between 1 January 1991 and 31 December 1993. Excluded were patients with traumatic injuries, cerebrovascular accidents and primary cardiac arrest. According to their length of stay (LOS) in the ICU, patients were subdivided into Group A (LOS 0-24 hours), Group B (LOS > 24 hours-14 days), and Group C (LOS > 14 days). Errors were divided into Type 1 (failure to recognize a treatable life-threatening condition); Type 2 (failure to recognize a life-threatening condition, which treated, however, would unlikely alter the outcome), and Type 3 (failure to recognize a condition unrelated to the outcome). Overall, 159 consecutive patients were enrolled. Type 1 errors were 5% in Group A, 4% in Group B and 9% in Group C. Type 2 errors were 18% in Group A, 34% in Group B, and 30% in Group C. Fully correct diagnoses or Type 3 errors were present in 77% of patients in Group A, 62% of patients in Group B, and 61% of patients in Group C. Clinical errors of any type were not related with the LOS in the ICU or in the hospital, age and the number of underlying chronic diseases.

[Leptospirosis. Description of a clinical case and review of the literature]

Leptospirosis is a world-wide diffused anthropozoonosis due to many strains of Leptospira. Initial symptoms may be mild, although in many cases severe systemic symptoms, including high fever, hypotension, etc. may be present since the beginning. In these latter circumstances, the diagnosis of leptospirosis can be very difficult because of the complexity of clinical picture especially when the history is lacking or incomplete. A case report of a 45 year-old man admitted to the hospital after severe jaundice and fever of unknown origin associated to altered mental status, renal failure and hypoxemia is presented. Because of the presence of septic shock and severe respiratory failure, the patient was transferred to the intensive care unit. The diagnostic hypothesis, based on clinical history, was confirmed by laboratory tests (leptospiral IgM antibodies detection). Therapeutical approach with the use of selected antibiotics (penicillin 24,000,000 U for day) and therapy of septic shock led to improvement of the patient's clinical conditions who was then transferred to a regular medical ward.

[Use of the laryngeal mask in general anesthesia. Clinical experience]

GOAL OF THE STUDY

To evaluate the use of the laryngeal mask during general anesthesia.

STUDY DESIGN

We prospectively studied patients undergoing surgery with general anesthesia in spontaneous breathing.

ENVIRONMENT

Urologic and general surgical ward, with standard monitoring equipment.

PATIENTS

We studied consecutively 100 patients (ASA 1-3, 80 males, 20 females, age 64 +/- 15 years, range 19-98 years); 59 patients had a preexisting cardiopulmonary or metabolic disease. Monitoring included ECG, the arterial pressure (noninvasive), the CO2 capnography (EtCO2), the pulsossimetry (SpO2), the respiratory rate (RR) and the tidal volume/kg (TVi). The double product (DP = heart rate X systolic arterial pressure) was used as an index of cardiac stress. These parameters were recorded at 10-minute intervals throughout the procedure.

RESULTS

The heart rate, the systolic arterial pressure remained stable during the anesthesia, whereas the DP significantly decreased at t10, t20, t30 and t40. The EtCO2 decreased slightly (from 41 +/- 6 to a 36 +/- 4 mmHg; p.n.s.), SpO2 did not change (from 97 +/- 2% to 96 +/- 2%; p:n.s.). The RR significantly increased at t30 and t40 and the TVi significantly increased during the first hour. No relevant complications have been reported.

CONCLUSIONS

Anesthesia with laryngeal mask was not associated with any detrimental cardiovascular and respiratory effect.