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International audience; In the last decade, there has been a renaissance of fission research resulting in new high-precision experiments and advanced fission modeling. For instance, the Chi-Nu and CEA teams supplied, for the first time, the 239Pu prompt fission neutron spectrum (PFNS) for broad ranges of incident and outgoing neutron energies. The CEA team also measured 239Pu average prompt neutron multiplicities, ν̄p, with lower statistical uncertainties and a technique significantly different than the one used in the past. The NIFFTE collaboration provided 239Pu(n,f)/235U(n,f) cross section shape ratios with uncertainties below 1% utilizing a novel detector type. Advanced fission event generators were developed, among them CGMF, FIFRELIN, FREYA, and GEF, which calculate post-scission fission observables in a correlated manner. These new experimental data and more consistent fission models change the evaluated PFNS, ν̄p, and (n,f) cross sections, some only modestly, compared to ENDF/B-VIII.0. In turn, the individual new nuclear data distinctly change simulated effective neutron multiplication factors of fast critical assemblies, but their combined impact is small, while affecting the prediction of LLNL pulsed sphere neutron leakage spectra and reaction rates only within experimental uncertainties. Also, the parameters obtained from fitting to ν̄p reproduce various post-scission fission observables within the uncertainties of experimental data. This indicates that new differential experiments and consistent fission modeling reduce compensating errors present in ENDF/B-VIII.0.

Background: A limited number of studies investigating perioperative risk factors associated with emergency appendectomy in elderly patients have been published to date. Whether older age may be associated with poorer outcomes following appendectomy is still a matter of debate. The primary aim of this study was to determine the predictors of postoperative morbidity following appendectomy in patients aged ≥ 65years. Methods: Data regarding all elderly patients who underwent emergency appendectomy from January 2017 to June 2018 admitted 36 Italian surgical departments were prospectively collected and analyzed. Baseline demographics and perioperative variables were evaluated. Uni- and multivariate analyses adjusted for differences between groups were carried out to determine possible predictors of adverse outcomes after appendectomy. Results: Between January 2017 and June 2018, 135 patients aged ≥ 65years with a diagnosis of AA met the study inclusion criteria. Twenty-six patients (19.3%) were diagnosed with some type of postoperative complication. Decreasing the preoperative hemoglobin level showed a statistically significant association with postoperative complications (OR 0.77, CI 0.61–0.97, P = 0.03). Preoperative creatinine level (P = 0.02, OR 2.04, CI 1.12–3.72), and open appendectomy (P = 0.03, OR 2.67, CI 1.11–6.38) were significantly associated with postoperative morbidity. After adjustment, the only independent predictor of postoperative morbidity was preoperative creatinine level (P = 0.04, OR 2.01, CI 1.05–3.89). Conclusions: In elderly patients with AA, perioperative risk assessment in the emergency setting must be as accurate as possible to identify modifiable risk factors that can be addressed before surgery, such as preoperative hemoglobin and creatinine levels.

International audience; The measurement of the production cross sections of exotic neutronrich heavy nuclei, in the uranium region, in the vicinity of the N = 152 deformed shell gap was carried out via multinucleon transfer reactions of 238U + 238U at 7.193 and 6.765 MeV/A using the VAMOS++ magnetic spectrometer coupled to the AGATA and ID-Fix photon detection arrays. This article reports on the status of the VAMOS++ data analysis and results on the population of the strongest (±1n) transfer channels observed from the decay of long-lived products after irradiation.

Patients with MetS or SIRS experience higher rates of mortality and morbidity, across both cardiac and noncardiac surgery. Frailty assessment has acquired increasing importance in recent years as it predisposes elderly patients to a worse outcome. The aim of our study was to investigate the influence of MetS, SIRS, and with or without frailty on elderly patients undergoing emergency surgical procedures.We analyzed data of all patients with nonmalignant diseases requiring an emergency surgical procedure from January 2017 to December 2020. The occurrence of MetS was identified using modified definition criteria used by the NCEP-ATP III Expert Panel: obesity, hypertension, diabetes, or if medication for high triglycerides or for low HDL cholesterol was taken. Systemic inflammatory response syndrome (SIRS) was evaluated according to the original consensus study (Sepsis-1). The frailty profile was investigated by the 5-modified Frailty Index (5-mFI) and the Emergency Surgery Frailty Index (EmSFI). Postoperative complications have been reported and categorized according to the Clavien-Dindo (C-D) classification system. Morbidity and mortality have been mainly considered as the 30-day standard period definition.Of the 2,318 patients included in this study, 1,010 (43.6%) fulfilled the criteria for MetS (MetsG group). Both 5-Items score and EmsFI showed greater fragility in patients with MetS. All patients with MetS showed more frequently a CACI index greater than 6. The occurrence of SIRS was higher in MetSG. LOS was longer in patients with MetS (MetSG 11.4 ± 12 days vs.Impact of MetS and SIRS on elderly surgical patient outcomes has yet to be fully elucidated. The present study showed a 43.6% incidence of MetS in the elderly population. In conclusion, age per se should be not considered anymore as the main variable to estimate patient outcomes, while MetS and Frailty should have always a pivotal role.

Nuclear particle production from peripheral to central events is presented. N/Z gradient between projectile and target is studied using the fact that two reactions have the same projectile+target N/Z and so the same neutron to proton ratio for the combined system. Inclusive data study in the forward part of the center of mass indicates that N/Z equilibration between the projectile-like and the target-like is achieved for central collisions. Particles are also produced from mid-rapidity region. 3He mean pre-equilibrium character is evidenced and 6He production at mid-rapidity implies a neutron enrichment phenomenon of the projectile target interacting zone., Comment: 9 pages, 10 figures

Item does not contain fulltext OBJECTIVE: To assess the prevalence, nature, and associated phenotypes of PINK1 gene mutations in a large series of patients with early-onset (

We investigated the 238U(d,p) reaction as a surrogate for the n + 238U reaction. For this purpose we measured for the first time the γ -decay and fission probabilities of 239U∗ simultaneously and compared them to the corresponding neutron-induced data. We present the details of the procedure to infer the decay probabilities, as well as a thorough uncertainty analysis, including parameter correlations. Calculations based on the continuumdiscretized coupled-channels method and the distorted-wave Born approximation (DWBA) were used to correct our data from detected protons originating from elastic and inelastic deuteron breakup. In the region where fission and γ emission compete, the corrected fission probability is in agreement with neutron-induced data, whereas the γ -decay probability is much higher than the neutron-induced data. We have performed calculations of the decay probabilities with the statistical model and of the average angular momentum populated in the 238U(d,p) reaction with the DWBA to interpret these results Comisión Europea 269499

Mutations in the Grb10-interacting GYF protein 2 (GIGYF2) gene, within the PARK11 locus, have been nominated as a cause of Parkinson's disease in Italian and French populations. By sequencing the whole GIGYF2 coding region in forty-six probands (thirty-seven Italians) with familial Parkinson's disease compatible with an autosomal dominant inheritance, we identified no mutations. Our data add to a growing body of evidence suggesting that GIGYF2 mutations are not a frequent cause of PD. (C) 2009 Elsevier Ltd. All rights reserved.

A multiethnic series of patients with early-onset Parkinson's disease (EOP) was studied to assess the frequency and nature of parkin/PARK2 gene mutations and to investigate phenotype-genotype relationships. Forty-six EOP probands with an onset age of G, and exon 8-9-10 deletion. Homozygous mutations, two heterozygous mutations, and a single heterozygous mutation were found in 8, 6, and 1 patient, respectively. Heterozygous exon deletions represented 28% of the mutant alleles. The patients with parkin mutations showed significantly earlier onset, longer disease duration, more frequently symmetric onset, and slower disease progression than the patients without mutations, in agreement with previous studies. This study confirms the frequent involvement of parkin and the importance of genetic testing in the diagnostic work-up of EOP. © 2004 Movement Disorder Society.

Odd-even staggering effects on charge distributions are investigated for fragments produced in semiperipheral and central collisions of 112Sn+58Ni at 35 MeV/nucleon. For fragments with Z, 5 pages, 6 figures

Salvinorin A, the active component of the hallucinogenic herb Salvia divinorum, inhibits intestinal motility through activation of kappa-opioid receptors (KORs). However, this compound may have target(s) other than the KORs in the inflamed gut. Because intestinal inflammation upregulates cannabinoid receptors and endogenous cannabinoids, in the present study we investigated the possible involvement of the endogenous cannabinoid system in salvinorin A-induced delay in motility in the inflamed gut.Motility in vivo was measured by evaluating the distribution of a fluorescent marker along the small intestine; intestinal inflammation was induced by the irritant croton oil; direct or indirect activity at cannabinoid receptors was evaluated by means of binding, enzymic and cellular uptake assays.Salvinorin A as well as the KOR agonist U-50488 reduced motility in croton oil treated mice. The inhibitory effect of both salvinorin A and U-50488 was counteracted by the KOR antagonist nor-binaltorphimine and by the cannabinoid CB(1) receptor antagonist rimonabant. Rimonabant, however, did not counteract the inhibitory effect of salvinorin A on motility in control mice. Binding experiments showed very weak affinity of salvinorin A for cannabinoid CB(1) and CB(2) and no inhibitory effect on 2-arachidonoylglycerol and anandamide hydrolysis and cellular uptake.The inhibitory effect of salvinorin A on motility reveals a functional interaction between cannabinoid CB(1) receptors and KORs in the inflamed--but not in the normal--gut in vivo.

The bolus (silicon + deionized water) is used in order to achieve a good electromagnetic match between the biological tissue and the applicator surface and to locally modify the skin temperature, to regulate it based on the patient's sensitivity. Therefore, it is very important to know the electromagnetic power deposition and how the bolus can induce a variation in the thermal map, both superficially and deeply. The aim of this study is to evaluate the applicator characteristics in the same conditions as those indicated by the ESHO guidelines for clinical practice and to investigate the penetration depth in the absence and in the presence of a very effective circulating bolus. The first condition is used by the manufacturer to characterize MW applicator while the second condition is used by medical equipes delivering HT treatments.The specific absorption rate (SAR) generated by a microwave planar applicator (H2, CFMA, Istok,Russia) operating at 433 MHz connected with the hyperthermic equipment ALBA (Restek, Italy) was studied in a muscle-equivalent polyacrilamide phantom. IsoSAR lines were detected on a liquid crystal sheet with a video camera. Images analysis was performed using the graphic software Paint Shop Pro 6. This method allows to evaluate PD in the phantom under the plane of MW applicator. The hyperthermic equipment ALBA is used in the Radiotherapy Unit of the Mauriziano Umberto I Hospital in Turin for both oncologic and psychiatric treatments.The actual pattern of measured SAR mainly depends on the applicator and the phantom characteristics, but also the thickness and the efficiency of the bolus inserted between the applicator and the patient's skin have been shown to affect the results. In this study the penetration depth was measured on 5 applicator sections both with non circulating bolus (static) and with circulating bolus (dynamic). The penetration depth is reduced with the dynamic bolus with respect to the static bolus in all sections, and specifically: in section I it is reduced from 19.46 +/- 1.49 mm to 17.22 +/- 0.71 mm; in section II from 38.17 +/- 4.77 mm to 26.91 +/- 1.48 mm; in section III from 39.81 +/- 3.24 mm to 30.38+/- 4.56 mm; in section IV from 42.12 +/- 1.67 mm to 33.11 +/- 1.89 mm; and finally in section V from 39.83 +/- 4.14 mm to 31.064 +/- 1.57 mm. The above reduction ranges between 11.5 and 29 % with an average value of 21.64 % Our results suggest that different conditions at the interface between bolus and phantom resulting from the use of a dynamic or static bolus produce considerable changes on the heated volume dimension and on the SAR local pattern. The effect of the convective heat losses due to the circulating bolus' assessed by our measurements is not negligible and should be taken into account when evaluating the SAR distribution before clinical treatments.To disregard the heat losses due to a circulating bolus in MW applicator characterization can severely affect the SAR estimation. This may have serious consequences on clinical applications, since the temperature in the heated lesion can be lower than expected, and the clinical effectiveness of the therapeutical session can be therefore severely reduced. Since at the moment inexpensive and accurate non-invasive temperature monitoring systems are not available, a sound knowledge of the PD of the MW applicator is of primary importance for clinical applications and for a treatment plan allowing to deliver customized treatment to each patient.

Systemic hypertension is common in patients with acute as well as with chronic renal diseases. Hypertension is an important factor that contributes to the progression of renal failure. Cardiovascular disease is the leading cause of death and disability in patients with chronic renal failure and in those receiving renal replacement therapy. The prevalence of hypertensive nephropathy remains unabated. Hypertension and chronic renal failure are closely interlinked and govern the morbidity and mortality in patients afflicted by these conditions. There is considerable hope that effective control of hypertension may retard the progression of renal disease. Although mere control of hypertension is of paramount importance, specific pharmacologic approaches may offer certain important renal advantages. Angiotensin-converting enzyme (ACE) inhibitors, by the virtue of their intrarenal effects, exert favorable consequences on the kidney function (and structure, to some extent), particularly in patients with diabetic nephropathy and hypertension. Both experimental and clinical studies have demonstrated the renoprotective effects of ACE inhibitors; these drugs slow down the progression of renal disease independent of their antihypertensive actions. More recently, angiotensin-receptor blockers have been shown to exert similar glomerular effects as ACE inhibitors. Preliminary clinical data also suggest a possible role for angiotensin-receptor blockers in the prevention of progression of renal failure. Therapeutic agents that inhibit the renin-angiotensin axis hold considerable promise in the management of patients with renal disease by slowing down the rate of decline in renal function.

The goal of this study was the evaluation of cardiac arrhythmias in an unselected population of elderly patients by 24-hour Holter electrocardiography. An elevated incidence of hyperkinetic (62%) and hypokinetic arrhythmias (22.7%) were detected. Following a critical review of the literature, the Authors conclude that even in hyperkinetic arrhythmias a conservative approach is advisable without indiscriminate therapeutic treatment. This review also confirmed the clinical utility of ambulatory monitoring in the detection of arrhythmias, otherwise underestimated, mainly in asymptomatic patients.

A serum bank maintained for renal transplant recipients allowed for a longitudinal study of antibody responses before and after herpes zoster. Renal transplant recipients without herpes zoster served as controls. Antibody responses to varicella-zoster virus, herpes simplex virus type 1, and cytomegalovirus were measured. The serological responses following herpes zoster were prompt and sustained (in the majority of cases), transient, or not present at all. Zoster without an eruption occurred (apparent only on retrospective chart review) and furnished an explanation for unexplained unilateral pain syndromes in these patients. Asymptomatic rises in titer of antibody to varicella-zoster virus not explained by rises in antibody to herpes simplex virus occurred in both groups. This latter finding points to an unstable relation between virus and host and supports and hypothesis of Hope-Simpson that subclinical release of virus with resulting antigenic stimulation may maintain immunity to varicella-zoster virus. Patients with herpes zoster and controls did not differ in several humoral immune parameters that might have explained the occurrence of herpes zoster. There was no evidence that herpes zoster precipitated renal graft rejection.

Enhanced Recovery After Surgery (ERAS) pathway is a multi-disciplinary, patient-centered protocol relying on the implementation of the best evidence-based perioperative practice. In the field of colorectal surgery, the application of ERAS programs is associated with up to 50% reduction of morbidity rates and up to 2.5 days reduction of postoperative hospital stay. However, widespread adoption of ERAS pathways is still yet to come, mainly because of the lack of proper information and communication. Purpose of this paper is to support the diffusion of ERAS pathways through a critical review of the existing evidence by members of the two national societies dealing with ERAS pathways in Italy, the PeriOperative Italian Society (POIS) and the Associazione Italiana Chirurghi Ospedalieri (ACOI), showing the results of a consensus development conference held at Matera, Italy, during the national ACOI Congress on June 10, 2019.

Introduction In vitro hemolysis is the primary cause of sample/test rejection by the laboratory. Case report A 10-year-old, admitted with an asthma attack in the emergency-room, medicated with albuterol sulphate (intravenous bronchodilator that could induce hypokalemia), needed laboratory test monitoring. The physician prescribed the technical-nurse to perform blood sampling for: complete blood count, electrolytes, glucose, and blood gas analysis–within 30min after therapy. Samples were delivered to laboratory with a note “I had difficult to locate an appropriate access to perform the blood collection”. Laboratory results Glucose: 4.77 mmol/L. Complete blood count revealed discreet eosinophilia 0.13x109/L, and thrombocytopenia 18x109/L. However, platelet clumps were observed in peripheral blood smear. Blood gas analysis was unreported, laboratory informed that sample had micro clots. Electrolytes: laboratory did not report the results; sample hemolyzed. 0.9 g/L of free hemoglobin is the cut-off defined by the laboratory; the sample presented 2.3 g/L of free hemoglobin. 3.9 mmol/L of potassium was the unreported result vs 2.1 mmol/L in the new sample. Briefly, the laboratory technician was trained to hide potassium results on hemolyzed sample due to the potential overestimation. Even if the hemolyzed sample presented a potassium value close to the lower reference range value (3.5-5.1 mmol/L), reporting the potassium result could allow the physician starting proper therapy to revert the hypokalemia by albuterol sulfate. Conclusion The laboratory should be aware of the clinical patient conditions and of the related physician needs, before hiding results. Therefore, both the laboratory and the clinic personnel should communicate in order to guarantee the patient safety.