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The quantification of torques and moments of inertia of horizontal axis hydrokinetic turbine driveline is important to precisely predict the dynamic behavior of the complete system. Initially, this paper presents different models used in the literature for describing torques and moments of inertia of turbine components. A dynamic model of a small hydrokinetic turbine using belt transmission is developed. The model uses the Blade Element Momentum (BEM) for determining the power coefficient of the turbine rotor and considers the inertial effects and dissipative torques of whole system using some of the torque models and moments of inertia described previously. The results for the dynamical behavior of the turbine model are compared with experimental data, showing good agreement. In order to numerically analyze a more efficient drivetrain, the belt transmission is replaced by a planetary gearbox in the dynamic model, and the new results are also assessed. As a result, it was found that with planetary gears, a more compact transmission can be used, reducing the inertial effects, which brings a better efficiency in the starting of the machine and shortening the transient regime time.

Allergic rhinitis (AR) has been associated with anxiety and depression. A possible influence of frequency and intensity of the AR symptoms has remained unclear. Therefore, we evaluated the association between AR, as well as its control, seasonality and severity, and the presence of anxiety and depression.Participants were selected from a preexistent national database and consecutively contacted by phone. AR was classified according to Allergic Rhinitis and its Impact on Asthma. Presence of anxiety and depression was identified by Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). We built linear regression models assessing the association between any of the assessed anxiety or depression scores and the occurrence, degree of control, seasonality or severity of AR.We analyzed 115 participants with AR and 38 participants with no respiratory symptoms. Patients with AR presented higher scores of anxiety (HADS: 3.1; 95% confidence interval [CI] = 1.9; 4.3; p 0.001) and depression (HADS: 3.8; 95% CI = 2.5; 5.0; p 0.001). Poorer AR control was positively associated with higher prevalence and scores of anxiety (HADS: 3.0; 95% CI = 1.5; 4.5; p 0.001) and depression (HADS: 1.8; 95% CI = 0.2; 3.4; p = 0.031). Similar results were obtained with BAI and BDI-II scales. A moderate/severe presentation of AR were also related with higher scores of anxiety (HADS: 1.7; 95% CI = 0.1; 3.2; p = 0.040) and depression (HADS: 1.7; 95% CI = 0.1; 3.3; p = 0.037).The presence of AR, a poorer control, and a moderate/severe presentation of the disease were significantly associated with higher scores of anxiety and depression. Thus, it is important to alert to this association to allow a quick diagnosis of AR-associated pathologies. Laryngoscope, 2022.

BACKGROUND: Minimally invasive lateral lumbar interbody fusion is a technique that has become increasingly popular for the treatment of degenerative lumbar spine disease; however, the pertinent surgical vascular anatomy has not been examined in detail. The goal of this study is to examine the anatomy of the lower lumbar and median sacral arteries, which are important determinants of these surgical outcomes. METHODS: This is an observational, experimental study based on cadaveric models, including 20 embalmed adult human cadavers. The following measurements were made: length of the lumbar and median sacral arteries, vertical distance between the third and fourth lumbar arteries and the superior end plate of the corresponding vertebrae, anterior vertebral body height, and intervertebral disc height. RESULTS: Our sample showcased considerable variability regarding vascular anatomy around the lower lumbar spine. In 10% of specimens, the abdominal aorta bifurcated at the level of the L3-L4 intervertebral disc, and 20% showed variations in vena cava origin. Regarding the lumbar arteries, in 10% of the sample, the fourth lumbar artery was absent on the right side, and 10% presented a fifth lumbar artery. The median sacral artery was present in all cadavers; however, in 15% of specimens, it originated from a common trunk that also gave rise to the fourth pair of lumbar arteries. Anterior vertebral body height was smaller in L3 comparing with L5 (P = 0.003), and there was a significant cephalocaudal increase in the anterior intervertebral disc height in the analyzed levels (P < 0.001). Bilaterally, the distance between the fourth lumbar arteries and the superior end plate of the L4 vertebral body was shorter than this distance at the L3 vertebral body (P < 0.001 and P = 0.002 on the right and left, respectively). CONCLUSIONS AND CLINICAL RELEVANCE: These data may be useful in spine surgery planning and operative management. These anatomic variations should be identified beforehand to prevent difficulties during surgery and possible complications. LEVEL OF EVIDENCE: 4.

SETTING: Antenatal care (ANC) and postpartum care (PPC) clinic in Manhiça District, Mozambique.OBJECTIVE: To estimate the prevalence of TB among pregnant and post-partum women and describe the clinical characteristics of the disease in a rural area of Southern Mozambique.METHODS: We conducted a cross-sectional TB prevalence study among pregnant and post-partum women recruited from September 2016 to March 2018 at the Manhiça Health Care Center (MHC). We recruited two independent cohorts of women consecutively presenting for routine pregnancy or post-partum follow-up visits.RESULTS: A total of 1,980 women from the ANC clinic and 1,010 from the PPC clinic were enrolled. We found a TB prevalence of 505/100,000 (95% CI: 242–926) among pregnant women and 297/100,000 (95% CI: 61–865) among post-partum women. Among HIV-positive pregnant women, TB prevalence was 1,626/100,000 (95% CI: 782–2,970) and among postpartum HIV-positive women, TB prevalence was 984/100,000 (95% CI: 203–2,848).CONCLUSIONS: The burden of TB was not higher in postpartum women than in pregnant women. Most TB cases were detected in HIV-positive women. TB screening and diagnostic testing among pregnant and postpartum women attending ANC and PPC clinics in Manhiça District is acceptable and feasible.

Introduction Digital Mammography (DM-2D) and more recently Digital Breast Tomosynthesis (DBT), are two of the most effective imaging modalities for breast cancer detection, often used in screening programmes. It may happen that exams using these two imaging modalities are inadvertently performed to pregnant women. The objective of this study is to assess the dose in the uterus due to DM-2D and DBT exams, according to two main irradiation scenarios: in the 1st scenario the exposure parameters were pre-selected directly by the imaging system, while in the 2nd scenario, the maximum exposure parameters were chosen. Methods The mammography equipment used was a Siemens Mammomat Inspiration. A physical anthropomorphic phantom, PMMA plates (simulating a breast thickness of 6 cm) and thermoluminescent dosimeters (TLDs) were used to measure entrance air kerma values on the phantom's breast and abdomen in order to successively estimate the mean glandular dose (MGD) and the dose in the uterus. For the two irradiation scenarios chosen, two-breast imaging modalities were selected: 1) DBT in Cranio-Caudal (CC) view (with 28 kV and 160 mAs as exposure parameters), 2) DBT and DM in Medio Lateral-Oblique (MLO) and CC views (with 34 kV and 250 mAs as exposure parameters). Results In the 1st scenario, the TLD measurements did not detect significant dose values in the abdomen whereas the MGD estimated using the D.R. Dance model was in close agreement with data available in the literature. In the 2nd scenario, there was no significant difference in MGD estimation between the different views, whereas the air kerma values in the abdomen (in DBT mode, CC and MLO) were 0.049 mGy and 0.004 mGy respectively. In CC DM-2D mode the abdomen air kerma value was 0.026 mGy, with no significant detected value in MLO view. Conclusions For the dose in the uterus, the obtained values seem to indicate that DM-2D and DBT examinations inadvertently performed during pregnancy do not pose a significant radiological risk, even considering the case of overexposure in both breasts. Implications for practice The accurate knowledge of the doses in DM-2D and DBT will contribute to raise the awareness among medical practitioners involved in breast imaging empowering them to provide accurate information about dose levels in the uterus, improving their radiation risk communication skills and consequently helping to reduce the anxiety of pregnant women undergoing this type of examinations.

Introduction Although initially believed to be less severe than heart failure with reduced ejection fraction (HFrEF), heart failure with preserved ejection fraction (HFpEF) prevalence has increased and accounts for as much as 50% of heart failure cases [1,2]. Treatment options remain limited and aim primarily for symptom relief and improvement of quality of life [2]. Urocortin-2 (Ucn-2) belongs to the corticotrophin-releasing hormone (CRH) family and has been found to have significant beneficial hemodynamic, hormonal and renoprotective effects both in both animal models and humans with HFrEF [3,4]. Objectives In this work we studied the role of the Ucn-2/CRHR2 system in the pathophysiology of HFpEF and evaluated the efficacy of Ucn-2 as a novel therapeutic strategy in this clinical syndrome. Methods 18-week-old male ZSF1-Lean (n=26) and ZSF1-Obese (n=28) rats randomly received either Ucn-2 (15 μg/kg/day, subcutaneously) or vehicle (0.9% NaCl), for 12 weeks, resulting in 4 experimental groups: ZSF1-Lean + Ucn-2; ZSF1-Lean + vehicle; ZSF1-Obese + Ucn-2; ZSF1-Obese + vehicle. During the treatment period, evolution of cardiac (dys)function was assessed by echocardiography and exercise tolerance test. After treatment, invasive hemodynamic analysis was performed, with subsequent sample collection. Histological analysis of the left ventricle (LV) was performed as well as quantitative western blotting and RT-PCR analysis for relevant molecular markers (Figure 1). Results mRNA expression of Ucn-2 and CRHR2, as well as protein levels of CRHR2, were decreased in the LV of ZSF1-Obese rats compared to ZSF1-Lean and correlated with LV structure and diastolic function. ZSF1-Obese rats showed systemic hypertension, decreased endurance capacity and impaired LV relaxation, with preserved ejection fraction and cardiac index. Chronic Ucn-2 treatment attenuated hypertension and modestly enhanced effort tolerance. In both morphometric and echocardiographic analysis we found that ZSF1-Obese rats presented significantly higher cardiac and LV weight, compared to Lean counterparts. Cardiomyocyte cross-sectional area and fibrosis were found to be increased in Obese rats, corroborating morphometric and echocardiographic measurements. Chronic Ucn-2 treatment attenuated both cardiac hypertrophy and fibrosis. Furthermore, ZSF1-Obese rats displayed increased BNP and TNF-α LV mRNA expression, both of which were decreased with Ucn-2 treatment. Interestingly, Col3A1 LV mRNA expression was found to be decreased in ZSF1-Obese rats compared to ZSF1-Lean, and Ucn-2 therapy resulted in a faint further decrease of Col3A1 expression, compared to non-treated animals. Conclusion This work suggests that Ucn-2/CRHR2 system is altered in experimental HFpEF and that chronic administration of Ucn-2 attenuates LV dysfunction and remodeling, in particular the hypertrophic changes of the cardiac muscle. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Portuguese Foundation for Science and Technology (FCT), under the auspices of the Cardiovas-cular R&D Center–UnIC [UIDB/00051/2020 and UIDP/00051/2020] and project IMPAcT [PTDC/MED-FSL/31719/2017; POCI-01–0145-FEDER-031719].

Introduction Bouveret's syndrome refers to a gastric outlet obstruction due to the impaction of a large gallstone following retrograde migration via a bilio-duodenal fistula. Although no clear management guideline has been formulated, different treatment modalities have been described, including endoscopic stone removal using classical endoscopic devices, like snares and forceps, or fragmentation of stones with new devices, such as lasers and extracorporeal shockwave lithotripsy (ESWL). Results This case series reports six patients who have been diagnosed with Bouveret's syndrome and have presented with interesting radiological and endoscopic findings. The report is followed by a literature review, including diagnostic and management options for this rare condition. Discussion Cholelithiasis is a common condition occurring in the general population and may develop rare complications such as cholecystoduodenal fistula. Bouveret's syndrome presents with a clinical picture similar to that of gastric outlet obstruction, and laboratory findings are often consistent with an obstructive jaundice picture. The use of endoscopic treatment with a range of different lithotripsy modalities has been described to manage this condition. Conclusion The diagnosis of Bouveret's syndrome is made after performing appropriate imaging studies. The first-line management option is endoscopic treatment. If this fails, surgical intervention is recommended.

Harnessing the remaining energy downstream of dams has recently gained significant attention as the kinetic energy available in the water current is considerable. This work developed a novel study to quantify the energy gain downstream of dams using a horizontal-axis hydrokinetic turbine with a diffuser. The present assessment uses field data from the Tucuruí Dam, where a stream velocity of 2.35 m/s is the velocity at which the highest energy extraction can occur. In this case, a 3-bladed hydrokinetic turbine with a 10 m diameter, shrouded by a flanged conical diffuser, was simulated. Numerical modeling using computational fluid dynamics was carried out using the Reynolds averaged Navier–Stokes formulation with the κ – ω shear stress transport as the turbulence model. The results yield good agreement with experimental and theoretical data available in the literature. Moreover, the turbine power coefficient under the diffuser effect could increase by about 55% for a tip speed ratio of 5.4, and the power output increased by about 1.5 times when compared to the same turbine without a diffuser. Additionally, as there are no hydrokinetic turbines installed downstream of dams in the Amazon region, the present study is relevant as it explores the use of hydrokinetic turbines as an alternative for harnessing the turbined and verted flow from dams. This alternative may help avoid further environmental impacts caused by the need for structural extensions.

The neutron fluence spectrum used in the analysis to determine absolute cross section values was found to be erroneous. A correction is reported herein.

Human brain activity during memory Animal studies suggest that sequence replay of neuronal activity may underlie memory retrieval and consolidation. However, there is no direct evidence that the replay of spiking activity sequences is important for these processes in the human brain. Vaz et al. simultaneously recorded single-unit spikes, local field potential, and intracranial electroencephalography signals in the brain while participants performed a memory task. Sharp wave ripple oscillations in the temporal lobe cortex reflected bursts of neural spiking, and these bursts of spikes organized into sequences during memory formation. These sequences were replayed during successful memory retrieval. The extent of sequence replay during correct recall was related to the extent to which cortical spiking activity was coupled with ripples in the medial temporal lobe. Science , this issue p. 1131

Accurate neutron capture cross section data for minor actinides (MAs) are required to estimate the production and transmutation rates of MAs in light water reactors, critical fast reactors like Gen-IV systems, and other innovative reactor systems such as accelerator driven systems (ADS). In particular, 244Cm, 246Cm and 248Cm play a role in the transport, storage and transmutation of the nuclear waste of the current nuclear reactors, due to the contribution of these isotopes to the radiotoxicity, neutron emission, and decay heat in the spent nuclear fuel. Also, capture reactions in these Cm isotopes open the path for the formation of heavier elements. In this work, the results of the capture cross section measurement on 244Cm, 246Cm and 248Cm performed at the CERN n_TOF facility are presented. It is important to notice that the Cm samples used in the experiment at n_TOF have been used previously in an experiment at J-PARC, this experiment and the previous one done in the 70s with a nuclear explosion were the only previous capture experiments for these isotopes. At n_TOF, the capture cross section measurements of 244Cm, 246Cm and 248Cm were performed at the 20 m vertical flight path (EAR2) with three C6D6 total energy detectors. In addition, the cross section of 244Cm was measured at the 185 m flight path (EAR1) with a Total Absorption Calorimeter (TAC). The combination of measurements in EAR1 and EAR2 has contributed to controlling and reducing the systematic uncertainties in the results. The compatibility of the different measurements performed and the techniques to obtain the results are presented in this paper as well as the procedure to obtain the resonance parameters.

The n_TOF neutron time-of-flight facility at CERN is used for nuclear data measurements. The n_TOF Collaboration works closely with the Nuclear Reaction Data Centres (NRDC) network to disseminate the experimental data through the international EXFOR library. In addition, the Collaboration helps integrate the results in the evaluated library projects. The present contribution describes the dissemination status of n_TOF results, their impact on evaluated libraries and ongoing efforts to provide n_TOF resonance parameters in ENDF-6 format for further use by evaluation projects.

The neutron capture cross section of 241Am is an important quantity for nuclear energy production and fuel cycle scenarios. Several measurements have been performed in recent years with the aim to reduce existing uncertainties in evaluated data. Two previous measurements, performed at the 185 m flight-path station EAR1 of the neutron time-of-flight facility n_TOF at CERN, have permitted to substantially extend the resolved resonance region, but suffered in the near-thermal energy range from the unfavorable signal-to-background ratio resulting from the combination of the high radioactivity of 241Am and the rather low thermal neutron flux. The here presented 241Am(n,γ) measurement, performed with C6D6 liquid scintillator gamma detectors at the 20 m flight-path station EAR2 of the n_TOF facility, took advantage of the much higher neutron flux. The current status of the analysis of the data, focussed on the low-energy region, will be described here.

The slow neutron capture process (s-process) is responsible for producing about half of the elemental abundances heavier than iron in the universe. Neutron capture cross sections on stable isotopes are a key nuclear physics input for s-process studies. The 72Ge(n, γ) Maxwellian-Averaged Cross Section (MACS) has an important influence on the production of isotopes between Ge and Zr in the weak s-process in massive stars and so far only theoretical estimations are available. An experiment was carried out at the neutron time-of-flight facility n_TOF at CERN to measure the 72Ge(n, γ) reaction for the first time at stellar neutron energies. The capture measurement was performed using an enriched 72GeO2 sample at a flight path length of 184 m, which provided high neutron energy resolution. The prompt gamma rays produced after neutron capture were detected with a set of liquid scintillation detectors (C6D6). The neutron capture yield is derived from the counting spectra taking into account the neutron flux and the gamma-ray detection efficiency using the Pulse Height Weighting Technique. Over 70 new neutron resonances were identified, providing an improved resolved reaction cross section to calculate experimental MACS values for the first time. The experiment, data analysis and the new MACS results will be presented including their impact on stellar nucleosynthesis, which was investigated using the post-processing nucleosynthesis code mppnp for a 25 solar mass model.

A new measurement of the 235U(n,f) fission cross section was carried out at n_TOF. The experiment covered the neutron energy range from 10 MeV up to 500 MeV, and it used the 1H(n,n) cross section as normalization for the neutron fluence measurement. In this contribution, the measurements and the characterization of the detectors covering the incident energy range up to 150 MeV are discussed.

The measurement of the 235U(n,f) reaction cross section in the neutron energy region 10 MeV to 500 MeV was carried out at the CERN n_TOF facility. The experimental campaign, completed in 2018, provided precise and accurate data on the fission reaction relative to neutron-proton elastic scattering. A description and characterization of the used setup for the simultaneous measurement of fission fragments and neutron flux is reported here.

The main objective of the study was to analyze the influence of text characteristics, namely the integration of images and schemas, in interest and understanding perceived by students. Three types of different expository texts (simple expository text, expository text with schema and expository text with image) were elaborated. Participants were 69 students of classes of the 2nd cycle of basic education and were asked to read the text and answer to a survey that included questions about their interest and comprehension. The results showed that the expository text with image is what obtains higher levels of interest and understanding.

This work was supported by the Austrian Science Fund FWF (J3503), the Adolf Messer Foundation (Germany), the UK Science and Facilities Council (ST/M006085/1), and the European Research Council ERC-2015-StG No. 677497. We also acknowledge support of Narodowe Centrum Nauki (NCN) under the grant (UMO-2016/22/M/ST2/00183) and University of Lodz under the grant (9/IDUB/MLOD/2021), MEYS of the Czech Republic, the Charles University project UNCE/SCI/013, and the Croatian Science Foundation under the project IP-2018-01-8570.

We thank P. Black (University of Edinburgh) for support in design and construction of the detection system and P. Morrall (Daresbury Laboratory) for production of the B and LiF reference samples. This Letter was supported by the Austrian Science Fund (FWF), Project No. J3503, by JRCIRMM through the EUFRAT Program, by the U.K. Science and Technologies Facilities Council (STFC), Projects No. ST/L005824/1 and No. ST/M006085/1, the European Research Council ERC-2015-STG Grant No. 677497, and the Cost Action "ChETEC" (Grant No. CA16117).

The hydrokinetic turbine is used worldwide for electrical generation purposes, as such a technology may strongly reduce environmental impact. Turbines designed using backward swept blades can significantly reduce the axial load, being relevant for hydro turbines. However, few works have been conducted in the literature in this regard. For the case of hydrokinetic rotors, backward swept blades are still a challenge, as the authors are unaware of any optimization procedures available, making this paper relevant for the current state of the art. Thus, the present work develops a new optimization procedure applied to hydrokinetic turbine swept blades, with the main objective being the design of blades with reduced axial load on the rotor and possibly a reduction in the cavitation. The proposed method consists of an extension of the blade element momentum theory (BEMT) to the case of backward swept blades through a radial transformation function. The method has low computational cost and easy implementation. Once it is based on the BEMT, it presents good agreement when compared to experimental data. As a result, the sweep heavily affects the chord and twist angle distributions along the blade, increasing the turbine torque and power coefficient. In the case of the torque, it can be increased by about 18%. Additionally, even though the bound circulation demonstrates a strong change for swept rotors, Prandtl’s tip loss seems to be not sensitive to the sweep effect, and alternative models are needed.

In X-ray breast imaging, Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT), are the standard and largely used techniques, both for diagnostic and screening purposes. Other techniques, such as dedicated Breast Computed Tomography (BCT) and Contrast Enhanced Mammography (CEM) have been developed as an alternative or a complementary technique to the established ones. The performance of these imaging techniques is being continuously assessed to improve the image quality and to reduce the radiation dose. These imaging modalities are predominantly used in the diagnostic setting to resolve incomplete or indeterminate findings detected with conventional screening examinations and could potentially be used either as an adjunct or as a primary screening tool in select populations, such as for women with dense breasts. The aim of this review is to describe the radiation dosimetry for these imaging techniques, and to compare the mean glandular dose with standard breast imaging modalities, such as DM and DBT.

Purpose Given the large use of computed tomography (CT) worldwide, the potential harmful effects and the radiation dose delivered to the patient have become high-interest topics among the scientific community. The main objective of this work was to modify existing three-dimensional (3D) voxel phantom models to resemble real patients as much as possible, thus trying to give a contribute towards the concept of a more personalized patient dosimetry. Moreover, comparisons were made of organ dose computed in the standard reference phantom and phantoms modified to match patient body size and organ size. This study focused essentially on one of the biggest and most radiosensitive organs in the thorax, the lungs. Methods In order to accomplish this objective a FORTRAN-based program was developed, which is able to semi-automatically modify the volumetric information of organs of interest in a standard voxel phantom (Female ICRP Adult Reference). Monte Carlo (MC) PENELOPE simulation code was used to mimic CT previews and, therefore, generate 2D projections, used for visual organ matching with clinical patient CT images, and calculate organ dose in both phantoms (ICRP standard and ICRP modified). Two CT scan irradiation setups were considered, namely Fan Beam CT (FBCT) and Cone Beam CT (CBCT) geometries. Validation of the implemented MC model (voxel phantom plus X-ray sources in diagnostic energy range) was accomplished through the calculation of lung-absorbed dose per fluence conversion coefficients for the Anterior-Posterior (AP) geometry setup with subsequent comparison with ICRP 116 tabulated values. Results The main results reported that matching the voxel phantom's size and lungs provides organ dose values substantially different from the ones calculated in the ICRP reference phantom. According to the data presented in this study, organ dose can be up to 20% underestimated and 40% overestimated when compared to organ dose in the reference phantom, considering both irradiation setups. Conclusions This study demonstrates that voxel phantoms developed using single patient data could provide a better and more precise organ dose assessment by MC methods with respect to a standard phantom.

Coupled ripples in memory Short-lived, high-frequency oscillations in the brain called ripples have been implicated as substrates for memory formation. There is, however, little evidence linking ripple activity with awake memory retrieval in humans. Vaz et al. analyzed intracranial recordings in human subjects (see the Perspective by Gelinas). They found that ripple oscillations in the brain's medial temporal lobe were coupled with ripple oscillations in the temporal cortex. This coupling was enhanced just before successful memory retrieval. During successful retrievals with ripples, patterns of oscillations were recapitulated across multiple electrodes, consistent with the initial encoding. The observation that ripple oscillations occur before successful memory retrieval suggests that they may play a mechanistic role in the retrieval process. Science , this issue p. 975 ; see also p. 927

According to the World Health Organization (WHO), at the end of 2020, 7.8 million women alive were diagnosed with breast cancer in the past 5 years, making it the world's most prevalent cancer. It is largely recognized and demonstrated that early detection represents the first strategy to follow in the fight against cancer. The effectiveness of mammography screening for early breast cancer detection has been proven in several surveys and studies over the last three decades. The estimation of the Mean Glandular Dose (MGD) is important to understand the radiation-associated risk from breast x-ray imaging exams. It continues to be the subject of numerous studies and debates, since its accuracy is directly related to risk estimation and for optimizing breast cancer screening programs. This manuscript reviews the main dosimetry formalisms used to estimate the MGD in mammography and to understand the continuing efforts to reduce the absorbed dose over the last forty years. The dosimetry protocols were formulated initially for mammography. Digital breast tomosynthesis (DBT) either in conjunction with synthesized digital mammogram (SDM) or with digital mammography (DM), is routinely used in many breast cancer screening programs and consequently the dosimetry protocols were extended for these techniques.

The Ge72(n,γ) cross section was measured for neutron energies up to 300keV at the neutron time-of-flight facility n_TOF (CERN), Geneva, for the first time covering energies relevant to heavy-element synthesis in stars. The measurement was performed at the high-resolution beamline EAR-1, using an isotopically enriched GeO272 sample. The prompt capture γ rays were detected with four liquid scintillation detectors, optimized for low neutron sensitivity. We determined resonance capture kernels up to a neutron energy of 43keV, and averaged cross sections from 43 to 300keV. Maxwellian-averaged cross section values were calculated from kT=5 to 100keV, with uncertainties between 3.2% and 7.1%. The new results significantly reduce uncertainties of abundances produced in the slow neutron capture process in massive stars.

Direct brain recordings have provided important insights into how persistent oscillatory activity support human memory retrieval, but the extent to which transient fluctuations in intracranial EEG (iEEG) captures the dynamic coordination of underlying neurons involved in memory processing remains unclear. Here, we simultaneously record iEEG, local field potential (LFP), and single unit activity in the human temporal cortex. We demonstrate that cortical ripples contribute to broadband high frequency activity and exhibit a spectrum of amplitudes and durations related to the amount of underlying neuronal spiking. Ripples in the macro-scale iEEG are related to the number and synchrony of ripples in the micro-scale LFP, which in turn are related to the synchrony of neuronal spiking. Our data suggest that neural activity in the human cortex is organized into dynamic, discrete packets of information.

We measured the neutron capture-to-fission cross-section ratio (α ratio) and the capture cross section of $^{235}$U between 0.2 and 200 eV at the n_TOF facility at CERN. The simultaneous measurement of neutron-induced capture and fission rates was performed by means of the n_TOF BaF$_{2}$ Total Absorption Calorimeter (TAC), used for detection of γ rays, in combination with a set of micromegas detectors used as fission tagging detectors. The energy dependence of the capture cross section was obtained with help of the $^{6}$Li(n,t) standard reaction determining the n_TOF neutron fluence; the well-known integral of the $^{235}$U(n,f) cross section between 7.8 and 11 eV was then used for its absolute normalization. The α ratio, obtained with slightly higher statistical fluctuations, was determined directly, without need for any reference cross section. To perform the analysis of this measurement we developed a new methodology to correct the experimentally observed effect that the probabilities of detecting a fission reaction in the TAC and the micromegas detectors are not independent. The results of this work have been used in a new evaluation of $^{235}$U performed within the scope of the Collaborative International Evaluated Library Organisation (CIELO) Project, and are consistent with the ENDF/B-VIII.0 and JEFF-3.3 capture cross sections below 4 eV and above 100 eV. However, the measured capture cross section is on average 10% larger between 4 and 100 eV.

The neutron capture cross sections of several unstable nuclides acting as branching points in the s process are crucial for stellar nucleosynthesis studies. The unstable $^{171}$Tm(t$_{1/2}$=1.92 yr) is part of the branching around mass A∼170 but its neutron capture cross section as a function of the neutron energy is not known to date. In this work, following the production for the first time of more than 5 mg of $^{171}$Tm at the high-flux reactor Institut Laue-Langevin in France, a sample was produced at the Paul Scherrer Institute in Switzerland. Two complementary experiments were carried out at the neutron time-of-flight facility (n_TOF) at CERN in Switzerland and at the SARAF liquid lithium target facility at Soreq Nuclear Research Center in Israel by time of flight and activation, respectively. The result of the time-of-flight experiment consists of the first ever set of resonance parameters and the corresponding average resonance parameters, allowing us to make an estimation of the Maxwellian-averaged cross sections (MACS) by extrapolation. The activation measurement provides a direct and more precise measurement of the MACS at 30 keV: 384(40) mb, with which the estimation from the n_TOF data agree at the limit of 1 standard deviation. This value is 2.6 times lower than the JEFF-3.3 and ENDF/B-VIII evaluations, 25% lower than that of the Bao et al. compilation, and 1.6 times larger than the value recommended in the KADoNiS (v1) database, based on the only previous experiment. Our result affects the nucleosynthesis at the A∼170 branching, namely, the $^{171}$Yb abundance increases in the material lost by asymptotic giant branch stars, providing a better match to the available pre-solar SiC grain measurements compared to the calculations based on the current JEFF-3.3 model-based evaluation.

Background: Nuclear waste management is considered amongst the major challenges in the field of nuclear energy. A possible means of addressing this issue is waste transmutation in advanced nuclear systems, whose operation requires a fast neutron spectrum. In this regard, the accurate knowledge of neutron-induced reaction cross sections of several (minor) actinide isotopes is essential for design optimization and improvement of safety margins of such systems. One such case is Pu240, due to its accumulation in spent nuclear fuel of thermal reactors and its usage in fast reactor fuel. The measurement of the Pu240(n,f) cross section was previously attempted at the CERN n_TOF facility EAR1 measuring station using the time-of-flight technique. Due to the low amount of available material and the given flux at EAR1, the measurement had to last several months to achieve a sufficient statistical accuracy. This long duration led to detector deterioration due to the prolonged exposure to the high α activity of the fission foils, therefore the measurement could not be successfully completed. Purpose: It is aimed to determine whether it is feasible to study neutron-induced fission at n_TOF/EAR2 and provide data on the Pu240(n,f) reaction in energy regions requested for applications. Methods: The study of the Pu240(n,f) reaction was made at a new experimental area (EAR2) with a shorter flight path which delivered on average 30 times higher flux at fast neutron energies. This enabled the measurement to be performed much faster, thus limiting the exposure of the detectors to the intrinsic activity of the fission foils. The experimental setup was based on microbulk Micromegas detectors and the time-of-flight data were analyzed with an optimized pulse-shape analysis algorithm. Special attention was dedicated to the estimation of the non-negligible counting loss corrections with the development of a new methodology, and other corrections were estimated via Monte Carlo simulations of the experimental setup. Results: This new measurement of the Pu240(n,f) cross section yielded data from 9meV up to 6MeV incident neutron energy and fission resonance kernels were extracted up to 10keV. Conclusions: Neutron-induced fission of high activity samples can be successfully studied at the n_TOF/EAR2 facility at CERN covering a wide range of neutron energies, from thermal to a few MeV.

Objective: Patients submitted to carotid artery endarterectomy (CEA) have a long-term risk of major adverse cardiovascular events (MACE) of 6–9% at 2 years. Hematological parameters have been shown to have a predictive function in atherosclerotic diseases, namely the red blood cell distribution width-coefficient of variation (RDW-CV). This parameter has been associated with worse outcomes such as myocardial infarction (MI), stroke, and all-cause mortality. This study aims to evaluate the potential role of preoperative hematologic parameters such as RDW-CV in predicting perioperative and long-term cardiovascular adverse events and mortality in patients submitted to CEA. Methods: From January 2012 to January 2019, 180 patients who underwent CEA with regional anesthesia in a tertiary care and referral center were selected from a prospective cohort database. Blood samples were collected preoperatively 2 weeks before admission, including a full blood count. The primary outcome included long-term MACE. Secondary outcomes included all-cause mortality, stroke, MI, acute heart failure, and major adverse limb events (MALE). Results: At baseline, 27.2% of patients had increased RDW-CV. Increased RDW-CV was independently associated with baseline hemoglobin (adjusted odds ratio [aOR] 0.715, 95% CI 0.588–0.869, p = 0.001) and atrial fibrillation (aOR 4.028, 95% CI 1.037–15.639, p = 0.001). After a median follow-up of 50 months, log-rank univariate analysis of RDW-CV demonstrated a significant association between increased RDW-CV and long-term all-cause mortality (log-rank p = 0.011) and MACE (aHR 2.047, 95% CI 1.202–3.487, p = 0.008). A decreased hemoglobin to platelet ratio (aHR 2.650e–8, 95% CI 9.049e–15 to 0.078, p = 0.019) was also associated with all-cause mortality. Conclusion: RDW is a widely available and low-cost marker that independently predicts long-term mortality, MACE, and MI after CEA. This biomarker could prove useful in assessing which patients would likely benefit from CEA in the long term.

Summary: Background: Patients undergoing carotid endarterectomy (CEA) may suffer from cerebral hypoperfusion during the carotid cross-clamping. Near-infrared spectroscopy cerebral oximetry (NIRS) is a non-invasive method of regional cerebral oxygen saturation measurement reflecting changes in cerebral blood flow during CEA. The main goal of the study was to evaluate the accuracy of the NIRS in detecting cerebral hypoperfusion during CEA under regional anesthesia (RA) and compare it with awake neurological testing. Patients and methods: A prospective observational study of 28 patients that underwent CEA in RA and manifested neurologic deficits, and 28 consecutive controls from a tertiary and referral center, was performed. All patients were monitored with NIRS cerebral oximetry and awake testing as the control technique. Subsequently, operating characteristic curve and Cohen’s kappa coefficient were determined to evaluate the reliability of the monitoring test. Results: NIRS presented a sensitivity of 27.3% and a specificity of 89.3% in comparison to awake testing. Receiver operating characteristic (ROC) curve analysis demonstrated that a decrease of at least 20% in cerebral oxygen saturation is the best threshold to infer cerebral hypoperfusion. However, the respective area under the curve (AUROC) was 0.606 (95% CI: 0.456–0.756, P = 0.178) with a calculated Cohen’s kappa of 0.179, P = 0.093. Regarding 30-days outcomes, only awake testing has shown significant associations with stroke and postoperative complications ( P = 0.043 and P = 0.05), which were higher in patients with post-clamping neurologic deficits. Conclusions: NIRS demonstrated a reduced discriminative capacity for critical cerebral hypoperfusion, and does not seem to add substantial clinical benefits to the awake test.

The isotope used in this research was supplied by the United States Department of Energy Office of Science by the Isotope Program in the Office of Nuclear Physics., The neutron capture cross section of 154Gd was measured from 1 eV to 300 keV in the experimental area located 185 m from the CERN n_TOF neutron spallation source, using a metallic sample of gadolinium, enriched to 67% in 154Gd. The capture measurement, performed with four C6D6 scintillation detectors, has been complemented by a transmission measurement performed at the GELINA time-of-flight facility (JRC-Geel), thus minimising the uncertainty related to sample composition. An accurate Maxwellian averaged capture cross section (MACS) was deduced over the temperature range of interest for s process nucleosynthesis modelling. We report a value of 880(50) mb for the MACS at kT = 30 keV, significantly lower compared to values available in literature. The new adopted 154Gd(n,γ ) cross section reduces the discrepancy between observed and calculated solar s-only isotopic abundances predicted by s-process nucleosynthesis models., EUFRAT open access programme of the Joint Research Centre at Geel

Smile harmony consists on the aesthetics of gingival and dental aspects. When gingival aesthetics are not in harmony with the whole, gingivectomy, considered a simple and safe procedure with satisfactory results by patients, presents the solution to the disharmony of this factor in some cases. The present study aims to demonstrate the clinical case of a patient who presented necrosis after a gingivectomy and gingival surgery in the 21 tooth. The case led to the search for a solution to the necrosis where the treatment was conservative without exposing the patient to gingival esthetical defect and involved in the elaboration of a clinical protocol, emphasizing measures to be taken in case of complications after gingivectomy.

Supplemental material, sj-pdf-2-asp-10.1177_0003702820930292 for Reporting Guidelines to Increase the Reproducibility and Comparability of Research on Microplastics by Win Cowger, Andy M. Booth, Bonnie M. Hamilton, Clara Thaysen, Sebastian Primpke, Keenan Munno, Amy L. Lusher, Alexandre Dehaut, Vitor P. Vaz, Max Liboiron, Lisa I. Devriese, Ludovic Hermabessiere, Chelsea Rochman, Samantha N. Athey, Jennifer M. Lynch, Hannah De Frond, Andrew Gray, Oliver A.H. Jones, Susanne Brander, Clare Steele, Shelly Moore, Alterra Sanchez and Holly Nel in Applied Spectroscopy

Supplemental material, sj-pdf-1-asp-10.1177_0003702820930292 for Reporting Guidelines to Increase the Reproducibility and Comparability of Research on Microplastics by Win Cowger, Andy M. Booth, Bonnie M. Hamilton, Clara Thaysen, Sebastian Primpke, Keenan Munno, Amy L. Lusher, Alexandre Dehaut, Vitor P. Vaz, Max Liboiron, Lisa I. Devriese, Ludovic Hermabessiere, Chelsea Rochman, Samantha N. Athey, Jennifer M. Lynch, Hannah De Frond, Andrew Gray, Oliver A.H. Jones, Susanne Brander, Clare Steele, Shelly Moore, Alterra Sanchez and Holly Nel in Applied Spectroscopy

Biokinetic data from the administration of radiopharmaceuticals is essential in nuclear medicine dosimetry. It has particular significance in children, as their metabolism is very different from adults. Biokinetic models for paediatric patients could therefore need to be adapted to better reflect their absorption, retention and excretion functions, when compared to adults. Obtaining quality in vivo infant or paediatric biokinetic data is then essential to improve the available reference models, which in turn can lead to the optimization of paediatric procedures and protocols in clinical practice. This study analyses the biokinetic behaviour of 99mTc-dimercaptosuccinic acid (DMSA), in 8 infants aged 4 months to 2 years old, through an imaging study using a gamma camera, and compares the obtained values with those obtained with the reference ICRP biokinetic model. The in vivo data was treated using an adapted methodology from the MIRD 16 pamphlet. Activity curves for the liver, the kidney and the whole body, were built, and new effective absorption, retention and excretion half-lives were estimated, and compared with the reference biokinetic parameters of ICRP 128. The obtained residence time in the kidneys of 2.56 h, has a deviation of 30.8% to the ICRP 128 value of 3.70 h. The obtained maximum uptake in the kidneys was of 0.22/A0, which compares to the value of 0.31/A0 for ICRP. The obtained biokinetic parameters were used to estimate the absorbed dose. The obtained dose values are smaller than the reference ICRP 128 ones by 32.1% in the kidneys, and 18.4% in the liver.

The distribution of radiopharmaceuticals in tumor cells represents a fundamental aspect for a successful molecular targeted radiotherapy. It was largely demonstrated at microscopic level that only a fraction of cells in tumoral tissues incorporate the radiolabel. In addition, the distribution of the radionuclides at sub-cellular level, namely inside each nucleus, should also be investigated for accurate dosimetry estimation. The most used method to perform cellular dosimetry is the MIRD one, where S-values are able to estimate cellular absorbed doses for several electron energies, nucleus diameters, and considering homogeneous source distributions. However the radionuclide distribution inside nuclei can be also highly non-homogeneous. The aim of this study is to show in what extent a non-accurate cellular dosimetry could lead to misinterpretations of surviving cell fraction vs dose relationship; in this context, a dosimetric case study with 99mTc is also presented. Methods The state-of-art MCNP6 Monte Carlo simulation was used in order to model cell structures both in MIRD geometry (MG) and MIRD modified geometries (MMG), where also entire mitotic chromosome volumes were considered (each structure was modeled as liquid water material). In order to simulate a wide energy range of Auger emitting radionuclides, four mono energetic electron emissions were considered, namely 213 eV, 6 keV, 11 keV and 20 keV. A dosimetric calculation for 99mTc undergoing inhomogeneous nuclear internalization was also performed. Results After a successful validation step between MIRD and our computed S-values for three Auger-emitting radionuclides (99mTc, 125I and 64Cu), absorbed dose results showed that the standard MG could differ from the MMG from one to three orders of magnitude. These results were also confirmed by considering the 99mTc spectrum emission (Auger and internal conversion electrons). Moreover, considering an inhomogeneous radionuclide distribution, the average electron energy that maximizes the absorbed dose was found to be different for MG and MMG. Conclusions The modeling of realistic radionuclide localization inside cells, including a inhomogeneous nuclear distribution, revealed that i) a strong bias in surviving cell fraction vs dose relationships (taking to different radiobiological models) can arise; ii) the alternative models might contribute to a more accurate prediction of the radiobiological effects inherent to more specific molecular targeted radiotherapy strategies.

Thin 33S samples for the study of the 33S(n, α)30Si cross-section at the n_TOF facility at CERN were made by thermal evaporation of 33S powder onto a dedicated substrate made of kapton covered with thin layers of copper, chromium and titanium. This method has provided for the first time bare sulfur samples a few centimeters in diameter. The samples have shown an excellent adherence with no mass loss after few years and no sublimation in vacuum at room temperature. The determination of the mass thickness of 33S has been performed by means of Rutherford backscattering spectrometry. The samples have been successfully tested under neutron irradiation.

BACKGROUND Congenital diaphragmatic hernia (CDH) has a high mortality rate, representing a therapeutic challenge. Prenatal diagnosis (PND) is essential in defining optimal perinatal strategy, particularly delivery planning. Hospital Pediatrico de Coimbra is the referral centre for all neonatal surgery, particularly CDH, for the central region of Portugal. The aim was to evaluate clinical management and outcome of newborns with CDH. METHODS An exploratory retrospective study made up of newborns admitted to PICU with CDH was undertaken between January 1995 and December 2014. Two groups were formed based on their year of admission: group A (1995- 2004) and group B (2005- 2014) and were compared. RESULTS The mean birth weight of the 69 newborns admitted was 2.762 ± 696 g; the median of the gestational age was 38 weeks. Associated malformations were observed in 28 (40.5%) and 15 (21.7%) had a right-sided diaphragm defect. The global mortality was 13.0%; in group A was significantly higher than in group B (22.2 vs 3.0%; p = 0.029). A reduction in mortality throughout the years was confirmed after adjusting for POS score (OR = 0.77; 95% CI: 0.62- 0.96, p = 0.021). PND was made in 30.6% of cases in the group A and 66.7% in the group B (p = 0.03). Tertiary perinatal hospital birth was achieved in 60% of newborns in the group A versus 84.8% in group B (p = 0.022). Maximum fraction of inspired oxygen showed a statistically significant difference between the two study groups (60% vs 40%; p = 0.009). CONCLUSIONS A significant decrease in mortality was observed throughout the study. The authors highlight the increase in prenatal diagnosis and an improvement in perinatal care with planning delivery as important contributors to these results.

Digital breast tomosynthesis (DBT) is a quasi-three-dimensional imaging technique that was developed to solve the principal limitation of mammography, namely the overlapping tissue effect. This issue in standard mammography (SM) leads to two main problems: low sensitivity (difficulty to detect lesions) and low specificity (non-negligible percentage of false positives). Although DBT is now being introduced in clinical practice the features of this technique have not yet been fully and accurately assessed. Consequently, optimization studies in terms of choosing the most suitable parameters which maximize image quality according to the known limits of breast dosimetry are currently performing. In DBT, scatter radiation can lead to a loss of contrast and to an increase of image noise by reducing the signal-to-difference-noise ratio (SDNR) of a lesion. Moreover the use of an anti-scatter grid is a concern due to the low exposure of the photon flux available per projection. For this reason the main aim of this study was to analyze the influence of the scatter radiation on image quality and the dose delivered to the breast. In particular a detailed analysis of the scatter radiation on the optimal energy that maximizes the SDNR was performed for different monochromatic energies and voltages. To reach this objective the PenEasy Monte Carlo (MC) simulation tool imbedded in the general-purpose main program PENELOPE, was used. After a successful validation of the MC model with measurements, 2D projection images of primary, coherent and incoherent photons were obtained. For that, a homogeneous breast phantom (2, 4, 6, 8 cm) with 25%, 50% and 75% glandular compositions was used, including a 5 mm thick tumor. The images were generated for each monochromatic X-ray energies in the range from 16 keV to 32 keV. For each angular projection considered (25 angular projections covering an arc of 50°) the scatter-to-primary ratio (SPR), the mean glandular dose (MGD) and the signal difference to noise ratio (SDNR) were calculated with the aim to assess/determine in which conditions (i.e. energy, angular projection, breast thickness) the scatter radiation affects the image quality. The obtained results on the aforementioned quantities and topics will be reported.

Cone-Beam Computed Tomography (CBCT) enables high-resolution volumetric scanning of the bone and soft tissue anatomy under investigation at the treatment accelerator. This technique is extensively used in Image Guided Radiation Therapy (IGRT) for pre-treatment verification of patient position and target volume localization. When employed daily and several times per patient, CBCT imaging may lead to high cumulative imaging doses to the healthy tissues surrounding the exposed organs. This work aims at (1) evaluating the dose distribution during a CBCT scan and (2) calculating the organ doses involved in this image guiding procedure for clinically available scanning protocols. Both Monte Carlo (MC) simulations and measurements were performed. To model and simulate the kV imaging system mounted on a linear accelerator (Edge™, Varian Medical Systems) the state-of-the-art MC radiation transport program MCNPX 2.7.0 was used. In order to validate the simulation results, measurements of the Computed Tomography Dose Index (CTDI) were performed, using standard PMMA head and body phantoms, with 150 mm length and a standard pencil ionizing chamber (IC) 100 mm long. Measurements for head and pelvis scanning protocols, usually adopted in clinical environment were acquired, using two acquisition modes (full-fan and half fan). To calculate the organ doses, the implemented MC model of the CBCT scanner together with a male voxel phantom (“Golem”) was used. The good agreement between the MCNPX simulations and the CTDI w measurements (differences up to 17%) presented in this work reveals that the CBCT MC model was successfully validated, taking into account the several uncertainties. The adequacy of the computational model to map dose distributions during a CBCT scan is discussed in order to identify ways to reduce the total CBCT imaging dose. The organ dose assessment highlights the need to evaluate the therapeutic and the CBCT imaging doses, in a more balanced approach, and the importance of improving awareness regarding the increased risk, arising from repeated exposures.

Recently there has been considerable effort to investigate the potential use and efficacy of Auger-electron emitters in targeted radiotherapy. Auger electrons travel a short distance within human tissues (at nano-scale level) and, therefore, if an Auger-emitting radionuclide is transported to the cell nucleus it will cause enhanced DNA damage. Among the Auger-emitting radionuclides, 125I is of particular interest, as it emits about 25 electrons per decay. 99mTc only emits 5 electrons per decay, but presents some attractive characteristics such as a short half-life, easy procurement and availability and ideal imaging properties for therapy monitoring. In order to study the dosimetric behavior of these two radionuclides (125I and 99mTc) at nano-scale sizes and given the DNA-intercalation properties of Acridine Orange (AO), we have designed 99mTc (I)-tricarbonyl complexes and 125I-heteroaromatic compounds that contain AO derivatives, in order to promote a closer proximity between the radionuclides and the DNA structure. With the aim to have an insight on the relevance of these radiolabelled compounds for DNA-targeted Auger therapy, different aspects were investigated: i) their ability to cause DNA strand breaks; ii) the influence of the two different radionuclides in DNA damage; iii) the effect of the distance between the AO intercalating unit and the radioactive atom (99mTc or 125I). To address these issues several studies were carried out encompassing the evaluation of plasmid DNA damage, molecular docking and nanodosimetric Monte Carlo modelling and calculations. Results show that the two classes of compounds are able to induce DNA double strand breaks (dsb), but the number of DNA damages (e.g. dsb yield) is strongly dependent on the linker used to attach the Auger emitting radionuclide (125I or 99mTc) to the AO moiety. In addition, nanodosimetric calculations confirm a strong gradient of the absorbed energy with the DNA-radionuclide distance for the two radionuclides studied. Finally these results show the existence of a critical distance (of about 11 A) beyond which it is probable that the direct effects start to be ineffective in DNA damage induction.