Abstract Neuropsychiatric (NP) involvement in Systemic Lupus Erythematosus (SLE), can be a severe and troubling manifestation of the disease that heavily impacts patient’s health, quality of life and ...disease outcome. It is one of the most complex expressions of SLE which can affect central, peripheral and autonomous nervous system. Complex interrelated pathogenetic mechanisms, including genetic factors, vasculopathy, vascular occlusion, neuroendocrine-immune imbalance, tissue and neuronal damage mediated by autoantibodies, inflammatory mediators, blood brain barrier dysfunction and direct neuronal cell death can be all involved. About NPSLE a number of issues are still matter of debate: from classification and burden of NPSLE to attribution and diagnosis. The role of neuroimaging and new methods of investigation still remain pivotal and rapidly evolving as well as is the increasing knowledge in the pathogenesis. Overall, two main pathogenetic pathways have been recognized yielding different clinical phenotypes: a predominant ischemic-vascular one involving large and small blood vessels, mediated by aPL, immune complexes and leuko-agglutination which it is manifested with more frequent focal NP clinical pictures and a predominantly inflammatory-neurotoxic one mediated by complement activation, increased permeability of the BBB, intrathecal migration of autoantibodies, local production of immune complexes and pro-inflammatory cytokines and other inflammatory mediators usually appearing as diffuse NP manifestations. In the attempt to depict a journey throughout NPSLE from diagnosis to a reasoned therapeutic approach, classification, epidemiology, attribution, risk factors, diagnostic challenges, neuroimaging techniques and pathogenesis will be considered in this narrative review based on the most relevant and recent published data.
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The present manuscript shows the importance of studying the isovector giant dipole resonance (IVGDR) to obtain information about the isospin-symmetry breaking and the shape evolution in excited ...nuclei. The
γ
decay of the IVGDR was measured in the compound nuclei
80
Zr and
81
Rb formed at an excitation energy of
E
*
=
54
MeV and
〈
J
〉
≈
20
ℏ
. The reactions
40
Ca+
40
Ca(
E
b
e
a
m
=
136
MeV) and
37
Cl+
44
Ca(
E
b
e
a
m
=
95
MeV) were used to form the nuclei
80
Zr and
81
Rb, respectively. The experimental setup used for the
γ
-rays detection was composed by the AGATA Demonstrator array coupled with large volume LaBr
3
:Ce detectors of the HECTOR
+
array.
Significant hypotension is frequent after spinal anaesthesia and fluid administration as therapy is usually empirical. Inferior vena cava (IVC) ultrasound (US) is effective to assess fluid ...responsiveness in critical care patients. The aim of this study was to evaluate the IVCUS-guided volume optimization to prevent post-spinal hypotension.
In this prospective, randomized, cohort study, 160 patients scheduled for surgery under spinal anaesthesia were randomized into a study group (IVCUS-group), consisting of an IVCUS analysis before spinal anaesthesia with IVCUS-guided volume management and a control group (group C) with no IVCUS assessment. The primary outcome was a relative risk reduction in the incidence of hypotension between the groups; secondary outcomes were the need for vasoactive drugs and the amounts of fluids required after spinal anaesthesia. We also tested the hypothesis of a correlation between IVC collapsibility index and hypotension after spinal anaesthesia.
The relative risk reduction of hypotension between the groups was 35% (IVCUS-group 27.5%, Group C 42.5%, P=0.044, CI=95%). The need for vasoactive drugs in the IVCUS-group was significantly lower compared to the C-group (P=0.015), while the total amount of fluids was significantly superior higher in the IVCUS group (P<0.0001) compared to Group C. IVC collapsibility index was correlated with the amount of fluid administered (r2=0.32), but could not be used to predict postspinal anaesthesia hypotension.
IVCUS is an effective method to prevent postspinal anaesthesia hypotension by IVCUS-guided fluid administration before spinal anaesthesia.
www.clinicaltrials.gov - NCT02271477.
The ACtive TARget and Time Projection Chamber (ACTAR TPC) is a novel gas-filled detector that has recently been constructed at GANIL. This versatile detector is a gaseous thick target that allows the ...tracking of charged particles in three dimensions and provides a precise reaction energy reconstruction from the vertex position. A commissioning experiment using resonant scattering of a 3.2MeV/nucleon 18O beam on an isobutane gas (proton) target was performed. The beam and the heavy scattered ions were stopped in the gas volume, while the light recoil left the active volume and were stopped in auxiliary silicon detectors. A dedicated tracking algorithm was applied to determine the angle of emission and the length of the trajectory of the ions, to reconstruct the reaction kinematics used to built the excitation functions of the 1H(18O, 18O)1H and 1H(18O, 15N)4He reactions. In this article, we describe the design of the detector and the data analysis, that resulted in center of mass reaction energy resolutions of 38(4)keV FWHM and 54(9)keV FWHM for the proton and alpha channels, respectively.
The level structures of 70Co and 70Ni, populated from the β decay of 70Fe, have been investigated using β-delayed γ-ray spectroscopy following in-flight fission of a 238U beam. The experimental ...results are compared to Monte-Carlo Shell-Model calculations including the pf+g9/2+d5/2 orbitals. The strong population of a (1+) state at 274 keV in 70Co is at variance with the expected excitation energy of ∼1 MeV from near spherical single-particle estimates. This observation indicates a dominance of prolate-deformed intruder configurations in the low-lying levels, which coexist with the normal near spherical states. It is shown that the β decay of the neutron-rich A=70 isobars from the new island of inversion to the Z=28 closed-shell regime progresses in accordance with a newly reported type of shell evolution, the so-called Type II, which involves many particle-hole excitations across energy gaps.
Nuclei in the vicinity of 78Ni are important benchmarks for nuclear structure, which can reveal changes in the shell structure far from stability. Spectroscopy of the odd-odd isotope 78Cu was ...performed for the first time in an experiment with the EURICA setup at the Radioactive Isotope Beam Factory at RIKEN Nishina Center. Excited states in the neutron-rich isotope were populated following the β decay of 78Ni produced by in-flight fission and separated by the BigRIPS separator. A level scheme based on the analysis of γ−γ coincidences is presented. Tentative spin and parity assignments were made when possible based on the β-decay feeding intensities and γ-decay properties of the excited states. Time correlations between β and γ decay show clear indications of an isomeric state with a half-life of 3.8(4) ms. Large-scale Monte Carlo shell-model calculations were performed using the A3DA-m interaction and a valence space comprising the full fp shell and the 1g9/2 and 2d5/2 orbitals for both protons and neutrons. The comparison of the experimental results with the shell-model calculations allows interpreting the excited states in terms of spin multiplets arising from the proton-neutron interaction. The results provide further insight into the evolution of the proton single-particle orbitals as a function of neutron number, and quantitative information about the proton-neutron interaction outside the doubly magic 78Ni core.
Enlarged Vestibular Aqueduct (EVA) is one of the most common congenital malformations associated with sensorineural or mixed hearing loss. The association between hearing loss and EVA is described in ...syndromic (i.e. Pendred Syndrome, BOR, Waardenburg) and non-syndromic disorders, as isolate or familiar mutations of the SLC26A4 gene. The audiological phenotype of the EVA syndrome is heterogeneous, the type and entity of hearing loss may vary and vertigo episodes might also be present.
The aim of this retrospective study was to describe the clinical and genetic features of a group of adolescent subjects presenting an EVA clinical profile, considering the presence of SLC26A4 gene mutations.
14 Caucasian patients were assessed (24 ears in total; 4 patients presented a monolateral EVA), 10 females and 4 males. Their age at the time of diagnosis was between 1 and 6 years (mean age 2.5 years). Subjects were assessed by an ENT microscopy evaluation with a complete audiometric assessment, CT & MRI scans and genetic tests for the evaluation of the pendrin gene mutations (SLC26A4).
Considering the presence of SLC26A4 mutations and thyroid function, we could identify three sub-groups of patients: group 1, non syndromic EVA (ns EVA, no SLC26A4 mutation and no thyroid dysfunction); group 2, EVA with DFNB4 (single SLC26A4 gene mutation and no thyroid dysfunction); group 3, EVA with Pendred Syndrome (two pathological mutation of SLC26A4 and thyromegaly with thyroid dysfunction).
Patients of group 1 (ns-EVA) showed various degrees of hearing loss from mild (55%) to severe-profound (45%). In groups 2 (DFNB4) and 3 (PDS), the degree of hearing loss is severe to profound in 70–75% of the cases; middle and high frequencies are mainly involved.
The phenotypic expressions associated with the EVA clinical profile are heterogeneous. From the available data, it was not possible to identify a representative audiological profile, in any of the three sub-groups. The data suggest that: (i) a later onset of hearing loss is usually related to EVA, in absence of SLC26A4 gene mutations; and (ii) hearing loss is more severe in patients with SLC26A4 gene mutations (groups 2 and 3 of this study).
The isospin mixing was deduced in the compound nucleus Zr80 at an excitation energy of E*=54 MeV from the gamma decay of the giant dipole resonance. The reaction Ca40+Ca40 at Ebeam=136 MeV was used ...to form the compound nucleus in the isospin I=0 channel, while the reaction CI37+Ca44 at Ebeam=95 MeV was used as the reference reaction. The gamma rays were detected with the AGATA demonstrator array coupled with LaBr3:Ce detectors. The temperature dependence of the isospin mixing was obtained and the zero-temperature value deduced. The isospin-symmetry-breaking correction delta C used for the Fermi superallowed transitions was extracted and found to be consistent with beta -decay data.
Neutron-rich Ba isotopes are expected to exhibit octupolar correlations, reaching their maximum in isotopes around mass A = 146. The odd-A neutron-rich members of this isotopic chain show typical ...patterns related to non-axially symmetric shapes, which are however less marked compared to even-A ones, pointing to a major contribution from vibrations. In the present paper we present results from a recent study focused on 148-150Cs β-decay performed at the ISOLDE Decay Station equipped with fast-timing detectors. A detailed analysis of the measured decay half-lives and decay scheme of 149Ba is presented, giving a first insight in the structure of this neutron-rich nucleus.
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