The first experimental observation of a Korteweg-de Vries-type soliton wave train in intense electron beams is reported. A narrow, large-amplitude perturbation on a long-pulse beam is observed to ...steepen and spawn a soliton wave train. The pulse width and amplitude of each peak remain unchanged over a long propagation distance, and the amplitude is inversely proportional to the square of the width. Two such pulses are seen to pass through each other, emerging from the collision unchanged. The experimental results are reproduced by particle-in-cell simulations.
The conflict in Ukraine has raised the specter of radiological and nuclear incidents, including fighting at the Zaporizhzhia nuclear plant, the largest nuclear powerplant in Europe; concerns that a ...radiological dispersion device ("dirty bomb") may be used; and threats to deploy tactical nuclear weapons. Children are more susceptible than adults to immediate and delayed radiation health effects. This article reviews the diagnosis and treatment of acute radiation syndrome. Although definitive treatment of radiation injuries should involve consultation with specialists, nonspecialists should learn to recognize the distinctive signs of radiation injury and make an initial assessment of severity of exposure.
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The association of bioimpedance phase angle (PA), as a measure of nutritional status, with muscle function, health-related quality of life (QoL) and subsequent clinical outcomes in maintenance ...hemodialysis (MHD) patients.
A 2-year prospective observational study on 250 MHD outpatients (36.8% women) with a mean age of 68.7±13.6 years. Prospective all-cause and cardiovascular (CV) hospitalization and mortality, malnutrition-inflammation score (MIS), handgrip strength (HGS), bioimpedance and short form 36 (SF-36) QoL scores were the study's measurements.
Across the three PA tertile groups, HGS was incrementally higher in the higher PA tertiles (P<0.001), maintaining this order in both male (r=0.38, P<0.001) and female patients (r=0.36, P<0.001). Better self-reported QoL was noted with higher PA values. This trend was prominent in total score (P<0.001), mental health (P=0.005) and physical health (P<0.001) dimensions, and in most of the SF-36 scales. For each 1° increase in baseline PA, the first hospitalization hazard ratio (HR) was 0.79 (95% confidence interval (CI), 0.68-0.91) and first CV event HR was 0.70 (95% CI, 0.52-0.95); all-cause death HR was 0.63 (95% CI, 0.48-0.81) and CV death HR was 0.64 (95% CI, 0.44-0.91). Associations between PA and morbidity risk continued to be significant after adjustments for various confounders, but the association between PA and mortality risk was abolished after adding MIS to the multivariable model.
For the MHD population, PA emerged as a useful predictor for impaired muscle function, health-related Qol, upcoming hospitalizations and mortality.
To compare long-term outcomes of pediatric liver transplant (LT) recipients off immunosuppression (IS) with matched controls on IS using data from the Society of Pediatric Liver Transplant (SPLIT) ...registry.
This was a retrospective case-control study. SPLIT participants <18 years of age, ≥4 years after isolated LT, and off IS for ≥1 year (cases) were age- and sex-matched 1:2 to patients with the same primary diagnosis and post-LT follow-up duration (controls). Primary outcomes included retransplantation, allograft rejection, IS comorbidities, and prevalence of SPLIT-derived composite ideal outcome (c-IO) achieved at the end of the follow-up period. Differences were compared using multiple linear regression for continuous outcomes and logistic regression for dichotomous data.
The study cohort was composed of 33 cases (42.4% male, 60.6% biliary atresia, median age at LT of 0.7 P25, P75, 0.5, 1.6 years, median IS withdrawal time of 9 P25, P75, 6, 12 years after LT) and 66 age- and sex-matched controls. No cases required retransplantation. Cases and controls had similar growth parameters, laboratory values, calculated glomerular filtration rates, rates of post-transplant lymphoproliferative disease, graft rejection, and attainment of c-IO.
No differences in allograft rejection rates, IS complications, or c-IO prevalence were seen between SPLIT patients off IS and age- and sex-matched controls remaining on IS. Discontinuation of IS most commonly occurred in the context of rigorously designed IS withdrawal trials. The available sample size was small, affecting generalizability to the broader pediatric LT population.
We present new \(\nu_\mu\rightarrow\nu_e\), \(\nu_\mu\rightarrow\nu_\mu\), \(\overline{\nu}_\mu\rightarrow\overline{\nu}_e\), and \(\overline{\nu}_\mu\rightarrow\overline{\nu}_\mu\) oscillation ...measurements by the NOvA experiment, with a 50% increase in neutrino-mode beam exposure over the previously reported results. The additional data, combined with previously published neutrino and antineutrino data, are all analyzed using improved techniques and simulations. A joint fit to the \(\nu_e\), \(\nu_\mu\), \(\overline{\nu}_e\), and \(\overline{\nu}_\mu\) candidate samples within the 3-flavor neutrino oscillation framework continues to yield a best-fit point in the normal mass ordering and the upper octant of the \(\theta_{23}\) mixing angle, with \(\Delta m^{2}_{32} = (2.41\pm0.07)\times 10^{-3}\) eV\(^2\) and \(\sin^2\theta_{23} = 0.57^{+0.03}_{-0.04}\). The data disfavor combinations of oscillation parameters that give rise to a large asymmetry in the rates of \(\nu_e\) and \(\overline{\nu}_e\) appearance. This includes values of the CP-violating phase in the vicinity of \(\delta_\text{CP} = \pi/2\) which are excluded by \(>3\sigma\) for the inverted mass ordering, and values around \(\delta_\text{CP} = 3\pi/2\) in the normal ordering which are disfavored at 2\(\sigma\) confidence.
LRO-LAMP Observations of the LCROSS Impact Plume Gladstone, G. Randall; Hurley, Dana M; Retherford, Kurt D ...
Science (American Association for the Advancement of Science),
10/2010, Letnik:
330, Številka:
6003
Journal Article
Recenzirano
On 9 October 2009, the Lunar Crater Observation and Sensing Satellite (LCROSS) sent a kinetic impactor to strike Cabeus crater, on a mission to search for water ice and other volatiles expected to be ...trapped in lunar polar soils. The Lyman Alpha Mapping Project (LAMP) ultraviolet spectrograph onboard the Lunar Reconnaissance Orbiter (LRO) observed the plume generated by the LCROSS impact as far-ultraviolet emissions from the fluorescence of sunlight by molecular hydrogen and carbon monoxide, plus resonantly scattered sunlight from atomic mercury, with contributions from calcium and magnesium. The observed light curve is well simulated by the expansion of a vapor cloud at a temperature of approximately 1000 kelvin, containing approximately 570 kilograms (kg) of carbon monoxide, approximately 140 kg of molecular hydrogen, approximately 160 kg of calcium, approximately 120 kg of mercury, and approximately 40 kg of magnesium.
Background
The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement ...enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery.
Methods
An online survey designed by SMART committee members to define SAGES member’s awareness and use of enhanced recovery principles and practice was emailed to all SAGES members. Reminders were sent 2 and 3 weeks later, encouraging completion of the survey. The web-based survey included 48 questions and took an estimated 20 min to complete.
Results
A total of 229 members completed the survey. Respondents were primarily general/MIS surgeons (82.6%) working in an urban location (85.5%), with a bell-shaped age distribution (median 35–44). Almost half regularly used some elements of ERPs (48.7%), but 30% were unfamiliar with the concept. Wide variety in the specific ERP elements used and discharge criteria were reported. The majority had to create and implement their own plan (70.4%). Roadblocks to implementation were inconsistencies with partners/covering physicians (56.3%), nursing education (46.6%), and resources (34.7%). When implemented, members saw improvements in length of stay (88%), patient satisfaction (54.7%), postoperative pain (53.3%), time to return of bowel function (52.7%), and readmissions (16.7%). A need for education and standardization was especially seen in preoperative care, with 74.4% fasting patients from midnight the night before surgery. Wide variations were also reported in pain management practices. An overwhelming majority (89%) reported that having a protocol endorsed by a national organization, such as SAGES, would help with implementation.
Conclusions
From this survey of SAGES members, there is a need for education, tools, and standardized protocols to increase awareness, support implementation, and encourage wider utilization of ERP. The overwhelming majority stated having a protocol endorsed by a national organization, such as SAGES, would facilitate implementation.
The launch of the Far Ultraviolet Spectroscopic Explorer (FUSE) has been followed by an extensive period of calibration and characterization as part of the preparation for normal satellite ...operations. Major tasks carried out during this period include the initial coalignment, focusing, and characterization of the four instrument channels and a preliminary measurement of the resolution and throughput performance of the instrument. We describe the results from this test program and present preliminary estimates of the on-orbit performance of the FUSE satellite based on a combination of these data and prelaunch laboratory measurements.
Abstract
On 2016 July 03, several instruments onboard ESA's Rosetta spacecraft detected signs of an outburst event on comet 67P, at a heliocentric distance of 3.32 au from the Sun, outbound from ...perihelion. We here report on the inferred properties of the ejected dust and the surface change at the site of the outburst. The activity coincided with the local sunrise and continued over a time interval of 14–68 min. It left a 10-m-sized icy patch on the surface. The ejected material comprised refractory grains of several hundred microns in size, and sub-micron-sized water ice grains. The high dust mass production rate is incompatible with the free sublimation of crystalline water ice under solar illumination as the only acceleration process. Additional energy stored near the surface must have increased the gas density. We suggest a pressurized sub-surface gas reservoir, or the crystallization of amorphous water ice as possible causes.
Psoriasis relapse may involve compensatory T-cell activation pathways in the presence of CD28-CD80/CD86 blockade with abatacept.
To determine whether costimulatory signaling blockade with abatacept ...prevents psoriasis relapse after ustekinumab withdrawal.
Psoriasis Treatment with Abatacept and Ustekinumab: a Study of Efficacy (PAUSE), a parallel-design, double-blind, placebo-controlled randomized clinical trial, was conducted at 10 sites in the US and Canada. Participant enrollment opened on March 19, 2014, and concluded on April 11, 2016. Participants were adults with moderate to severe plaque psoriasis and received ustekinumab in a lead-in phase. Those who responded to ustekinumab at week 12 were randomized 1:1 to either the continued with ustekinumab group (ustekinumab group) or the switched to abatacept group (abatacept group). Treatment was discontinued at week 39, and participants were followed up for psoriasis relapse until week 88. Statistical analyses were performed in the intention-to-treat (ITT) and safety samples from May 3, 2018, to July 6, 2021.
Participants received subcutaneous ustekinumab at weeks 0 and 4 (45 mg per dose for those ≤100 kg; 90 mg per dose for those >100 kg). Participants randomized to the abatacept group at week 12 received subcutaneous abatacept, 125 mg weekly, from weeks 12 to 39 and ustekinumab placebo at weeks 16 and 28. Participants randomized to the ustekinumab group received ustekinumab at weeks 16 and 28 and abatacept placebo weekly from weeks 12 to 39.
The primary end point was the proportion of participants with psoriasis relapse (loss of ≥50% of the initial Psoriasis Area and Severity Index improvement) between weeks 12 and 88. Secondary end points included time to psoriasis relapse, proportion of participants with psoriasis relapse between weeks 12 and 40, and adverse events. The psoriasis transcriptome and serum cytokines were evaluated.
A total of 108 participants (mean SD age, 46.1 12.1 years; 73 67.6% men) were treated with open-label ustekinumab; 91 were randomized to blinded treatment. Similar proportions of participants in the abatacept group and the ustekinumab group relapsed between weeks 12 and 88 (41 of 45 91.1% vs 40 of 46 87.0%; P = .41). Median time to relapse from the last dose of ustekinumab was similar between groups as well: 36 weeks (95% CI, 36-48 weeks) in the abatacept group vs 32 weeks (95% CI, 28-40 weeks) in the ustekinumab group. Similar numbers and rates of adverse events occurred. Abatacept did not maintain suppression of the pathogenic IL-23-mediated psoriasis molecular signature in lesions after ustekinumab withdrawal, and serum IL-19 levels increased.
This parallel-design, double-blind randomized clinical trial found that abatacept did not prevent psoriasis relapse that occurred after ustekinumab withdrawal because it did not completely block the pathogenic psoriasis molecular pathways that led to relapse.
ClinicalTrials.gov Identifier: NCT01999868.
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