The aim of this protocol is to describe the study protocol changes made and subsequently implemented to the Pediatric Guideline Adherence and Outcomes (PEGASUS) Argentina randomized controlled trial ...(RCT) for care of children with severe traumatic brain injuries (TBI) imposed by the COVID-19 pandemic. The PEGASUS study group met in spring 2020 to evaluate available literature review guidance and the study design change or pausing options due to the potential interruption of research.
As a parallel cluster RCT, pediatric patients with severe TBIs are admitted to 8 control (usual care) and 8 intervention (PEGASUS program) hospitals in Argentina, Chile, and Paraguay. PEGASUS is an intervention that aims to increase guideline adherence and best practice care for improving patient outcomes using multi-level implementation science-based approaches. Strengths and weaknesses of proposed options were assessed and resulted in a decision to revert from a stepped wedge to a parallel cluster RCT but to not delay planned implementation.
The parallel cluster design was considered more robust and flexible to secular interruptions and acceptable and feasible to the local study sites in this situation. Due to the early stage of the study, the team had flexibility to redesign and implement a design more compatible with the conditions of the research landscape in 2020 while balancing analytical methods and power, logistical and implementation feasibility, and acceptability. As of fall 2022, the PEGASUS RCT has been active for nearly 2 years of implementation and data collection, scheduled to be completed in in fall 2023. The experience of navigating research during this period will influence decisions about future research design, strategies, and contingencies.
Pediatric Guideline Adherence and Outcomes-Argentina. Registered with ClinicalTrials.gov Identifier NCT03896789 on April 1, 2019.
The potential of 1.3- mu m AlGaInAs multiple quantum-well (MQW) laser diodes for uncooled operation in high-speed optical communication systems is experimentally evaluated by characterizing the ...temperature dependence of key parameters such as the threshold current, transparency current density, optical gain and carrier lifetime. Detailed measurements performed in the 20 degree C-100 degree C temperature range indicate a localized T sub(0) value of 68 K at 98 degree C for a device with a 2.8 mu m ridge width and 700- mu m cavity length. The transparency current density is measured for temperatures from 20 degree C to 60 degree C and found to increase at a rate of 7.7 A.cm super(-2). degree C super(-1). Optical gain characterizations show that the peak modal gain at threshold is independent of temperature, whereas the differential gain decreases linearly with temperature at a rate of 310 super(-4) A super(-1). degree C super(-1). The differential carrier lifetime is determined from electrical impedance measurements and found to decrease with temperature. From the measured carrier lifetime we derive the monomolecular ( A), radiative (B), and nonradiative Auger (C) recombination coefficients and determine their temperature dependence in the 20 degree C-80 degree C range. Our study shows that A is temperature independent, B decreases with temperature, and C exhibits a less pronounced increase with temperature. The experimental observations are discussed and compared with theoretical predictions and measurements performed on other material systems.
Relativistic models for finite nuclei contain spurious center-of-mass motion in most applications for the nuclear many-body problem, where the nuclear wave function is taken as a single Slater ...determinant within a space-fixed frame description. We use the Peierls-Yoccoz projection method, previously developed for relativistic approaches together with a reparametrization of the coupling constants that fits binding energies and charge radius and apply our results to calculate elastic electron scattering monopole charge form factors for light nuclei.
A recombinant glutaryl-7-aminocephalosporanic acid acylase (GLA) from
Pseudomonas N176 has been over-expressed in BL21(DE3)pLysS
Escherichia coli cells. By alternating screenings of medium components ...and simplified factorial experimental designs, an improved microbial process was set up at shake-flask level (and then scaled up to 2L-fermentors) giving a ∼80- and 120-fold increase in specific and volumetric enzyme productivity, respectively. Under the best expression conditions, ∼1380
U/g cell and 16,100
U/L of GLA were produced versus the ∼18
U/g cell and the ∼140
U/L obtained in the initial standard conditions. Osmotic stress caused by the addition of NaCl, low cell growth rate linked to high biomass yield in the properly-designed rich medium, optimization of the time and the amount of inducer’s addition and decrease of temperature during recombinant protein production, represent the factors concurring to achieve the reported expression level. Notably, this expression level is significantly higher than any previously described production of GLAs. High volumetric production, cost reduction and the simple one-step chromatographic purification of the His-tagged recombinant enzyme, makes this GLA an economic tool to be used in the 7-ACA industrial production.
We report on extreme UV (EUV) photodetectors based on CVD single crystal diamond in a p-type/intrinsic/metal configuration fabricated and tested at Roma “Tor Vergata” University laboratory, operating ...in a sandwich geometry. Particular care has been devoted to the design of the device geometry in order to take advantage of the internal junction electric field and to minimize the signal contribution arising from secondary electron emission, which is known to strongly affect the detection properties in the UV and EUV regions. The device has been characterized in the EUV spectral region by using both He and He–Ne DC gas discharge radiation sources and a toroidal grating vacuum monochromator, with 5 Å wavelength resolution. The reproducibility test has been performed on several photodetectors showing a high uniformity of the device performances. The devices showed negligible undesired effects such as persistent photocurrent and memory effects, resulting in extremely promising stability features of the p-type/intrinsic/metal structured device. The devices have been tested at different bias voltages between 0 and 15 V, showing the best performances at 0 bias voltage. Finally, the external quantum efficiency (EQE), as well as the responsivity have been measured in the range 20 to 100 nm.
Abstract
Background
Chronic medical conditions, such as inflammatory bowel diseases(IBD),have been associated with impaired quality of life (QoL) and the presence of mood disorders compared with the ...general population. The aim of this observational study was to evaluate in a single-centre cohort of IBD patients: QoL, state and trait anxiety, depression and alexithymia.
Methods
Consecutive adult IBD outpatients from January to March 2018 were enrolled in the study. Main inclusion criteria were: confirmed diagnosis of Crohn’s disease (CD) or ulcerative colitis (UC) from at least 1 year and age between 18 and 70 years. Disease activity was evaluated by the Harvey–Bradshaw Index (HBI) for CD and the partial Mayo Score (pMS) for UC. Quality of life was evaluated with the SF36 and the results summarised in the physical and mental component scales (PCS and MCS). The PCS and MCS composite means and standard deviations (SD) are 50 ± 10 for the U.S. general population. Anxiety was evaluated with the State-Trait Anxiety Inventory which consists of two axes (Year 1 for state anxiety and Year 2 for trait anxiety; STAI scores >40: clinically significant symptoms of anxiety); depression was measured with the Beck Depression Inventory-II; alexithymia was investigated through the TAS-20.
Results
48 patients were enrolled (M/F 26/22, mean age at test 39 (SD 13.6) years; mean time from diagnosis 11.5 (SD 8.2), CD/UC 32/16). Thirteen of our patients had active disease at the time of the study and 20 was on biologic therapy. The mean PCS value was 50.3 (SD 11.9) and the mean MCS value was 40.15 (SD 7.60). Twenty patients (41.7%) had a pathological STAI1 (existing anxiety) and 25 (52.1%) a pathological STAI 2 (a predisposition to anxious reactions as a personality characteristic). Thirty-three (68.7%) had minimal depression while only one (2.1%) was severely depressed. Six patients (12.5%) reported borderline alexithymia and four clear alexithymia (8.3%). PCS and MCS scores were negatively correlated with depression and anxiety scores (worse quality of life in term of physical and mental aspects, worse depression and anxiety) while they were not related to alexithymia. No correlation was found between scales used and age at test, time from diagnosis and pMS. Instead, we found a relationship between HBI and all scales: presence of depression (r = 0.57, p = 0.0007), state anxiety (r = 0.4, p = 0.02), trait anxiety (r = 0.5, p = 0.003), alexithymia (r = 0.34, p = 0.05), mental scale (r = −0.54, p = 0.004) and physical scale (r = −0.5, p = 0.004). QoL and mood disorders were not influenced by the use of biologics or disease type(CD or UC.
Conclusions
Mood disorders affect IBD patients at any age and independently from the therapy used or the time from diagnosis. More attention should be given to the psychological aspects of IBD patients to improve their QoL.
Alterations of the retinoic acid receptor (RAR)alpha locus are found in 100% of acute promyelocytic leukemia patients, where chromosomal translocations generate the promyelocytic leukemia ...(PML)-RARalpha chimeric protein. Here, we have investigated the biological properties of the other RAR isoforms (RARbeta and RARgamma), through the generation and characterization of artificial PML-RAR'x' fusion proteins. Surprisingly, we found that all of the RAR isoforms share an identical oncogenic potential in vitro, thus implying that the selection of the RARalpha locus in leukemia patients must occur--rather than through functional differences among the various RAR isoforms-as the consequence of the nuclear architecture of the different RAR loci.
Recent initiatives in ultra-short, GeV electron beam generation have been aimed at achieving sub-femtosecond (fs) pulses capable of driving X-ray free-electron lasers (FELs) in single-spike mode. ...This scheme foresees the use of very low charge beams, which may allow existing FEL injectors to produce few-100 as pulses, with very high brightness. Towards this end, recent experiments at SLAC have produced ∼2
fs rms, low transverse emittance, 20
pC electron pulses. Here we examine the use of such pulses to excite plasma wakefields exceeding 1
TV/m, permitting a table-top TeV accelerator. We present a scheme for focusing the beam to very small dimensions, where the surface Coulomb fields are also at the TV/m level. These conditions access a new regime for high field for atomic physics, allowing frontier atomic physics experiments such as barrier suppression regime ionization. They also, critically, permit well-sub-fs plasma formation for subsequent wake excitation. We examine the use of such ultra-short beams for creating coherent sub-cycle IR radiation at unprecedented high power levels.
Non-invasive ventilation (NIV) is an effective treatment in patients with acute exacerbation of COPD (AECOPD). However, it may induce post-hypercapnic metabolic alkalosis (MA). This study aims to ...evaluate the effect of acetazolamide (ACET) in AECOPD patients treated with NIV.
Eleven AECOPD patients, with hypercapnic respiratory failure and MA following NIV, were treated with ACET 500 mg for two consecutive days and compared to a matched control group. Patients and controls were non invasively ventilated in a bilevel positive airway pressure (BiPAP) mode to a standard maximal pressure target of 15-20 cmH2O.
ACET intra-group analysis showed a significant improvement for PaCO2 (63.9 ± 9.8 vs. 54.9 ± 8.3 mmHg), HCO3- (43.5 ± 5.9 vs. 36.1 ± 5.4 mmol/L) and both arterial pH (7.46 ± 0.06 vs. 7.41 ± 0.06) and urinary pH (6.94 ± 0.77 vs 5.80 ± 0.82), already at day 1. No significant changes in endpoints considered were observed in the control group at any time-point. Inter-group analysis showed significant differences between changes in PaCO2 and HCO3- (delta), both at day 1 and 2. Furthermore, the length of NIV treatment was significantly reduced in the ACET group compared to controls (6 ± 8 vs. 19 ± 19 days). No adverse events were recorded in the ACET and control groups.
ACET appears to be effective and safe in AECOPD patients with post-NIV MA.
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•Occurrence of somatic mutations may generate clonal polymorphisms in cv. Italy.•Clonal polymorphism in vineyards of cv. Italy was investigated by molecular markers.•Screening of ...microsatellite loci and ISSR marker showed a low clonal polymorphism.•Moderate genetic divergence among four clones of cv. Italy was evident.•How vegetative propagation of clonal material may generate genetic divergence.
The genetic structure of vineyards with cv. Italy grapes, multiplied and maintained by vegetative propagation for more than fifty years in the region of Marialva, Brazil, was analyzed. Polymorphisms in 13 microsatellite loci and 14 ISSR markers were analyzed to estimate the genetic diversity indices of 57 plants obtained from four vineyards (V1 – V4). Higher genetic uniformity was detected by microsatellite and ISSR markers in V1 than in V2, V3, and V4 vineyards. Polymorphisms in microsatellite loci revealed only one somatic mutation at the molecular level. However, beyond the casual selection of samples for the establishment of new vineyards, propagation of this somatic mutation caused genetic divergence between the vineyards. Two molecular markers indicated moderate genetic divergence among the four vineyards with cv. Italy grapes. Polymorphisms in SSR loci and ISSR markers showed that clonal propagation of cv. Italy grapes may generate genetic divergence among vineyards.
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