Failure to keep initial appointments at a community mental health center results in a burden on the staff and the center's financial resources. The authors studied referrals to an outpatient program ...and found that delay in scheduling appointments had a significant impact on rate of kept appointments. The impact was significant during the first week of delay and appeared to stabilize after day seven. Age influenced the rate but differed in influence between the adult and child programs. Changes aimed at reducing wait time for initial appointments may favorably affect rate of kept appointments and ultimately preserve staff and financial resources.
The 50 mK cryogenic focal plane anti-coincidence detector of the Athena X-ray observatory (CryoAC) is a silicon suspended absorber sensed by a network of about 400 Ir/Au Transition Edge Sensors (TES) ...and connected through silicon bridges to a surrounding silicon frame plated with gold (rim). The device is shaped by Deep Reactive Ion Etching (DRIE) from a single silicon wafer of 500μm. There are two different possible geometries: a single Monolithic absorber and a Segmented one with 4 distinct absorber structures. As part of the payload of space mission the detector must resist to several mechanical excitation. We have tested a set of structural prototypes of the CryoAC vibrating several hexagonal silicon samples by using the vibrational mask provided by SRON which is responsible for FPA design. The aim is to have a first information on the mechanical response of the silicon bridges that connect the absorber to the rim, to start a trade-off over the two geometries and to validate the elastic-mechanical response.
The HOLMES experiment aims to directly measure the ν mass studying the 163Ho electron capture decay spectrum, using arrays of TES-based micro-calorimeters implanted with O(102 Bq/detector) 163Ho ...atoms. The neutron irradiation of 162Er enriched samples, used for the production of 163Ho, also generates radioactive contaminants. Chemical processes have been developed to extract the Ho fraction with high efficiency. The radioactive Ho isotope 166mHo is also present in the final sample and could significantly contribute to background events in the final spectrum. For this reason a dedicated implantation/mass separator has been set up and commissioned. It is designed to achieve more than 5 σ separation 163/166 u simultaneously allowing an efficient 163Ho atoms embedding inside micro-calorimeter absorbers. Its main components are a 50 kV sputter-based ion source, a magnetic dipole and a target chamber. A specially designed co-evaporation system has been implemented to deposit gold on the detector absorbers during implantation to overcome the 163Ho source saturation problem. The system performances in terms of achievable beam current, profile and mass separation have been evaluated by means of calibration runs using Cu, Mo, Au and 165Ho beams. An intensive study was done to optimize the target containing 163Ho in order to achieve a large fraction of ionized Ho in the beam. In this work, the machine development and commissioning will be described.
Anthracycline-containing chemotherapy (A-CHT) can induce late cardiotoxicity adding a considerable burden to cardiovascular risk. Irradiation of left breast cancer has also been associated to an ...increased risk of cardiovascular disease. The aim of this observational study is to prove the usefulness of an accurate cardiovascular evaluation in left breast cancer survivors treated with radiotherapy (RT) and A-CHT. Patients with left breast cancer, on follow-up after treatment with A-CHT plus RT in an adjuvant setting, were eligible for this observational study. Patients underwent cardiovascular assessment with myocardial perfusion imaging. Thirty patients were enrolled in the study: mean age at diagnosis 55.8 years; stage: I/III; Er and/or pgR status: positive in 24/30 pts; 3 patients in pre-menopausal status. Twenty-two patients (73.3%) had normal perfusion imaging, 1 patient (3.3%) had a fixed myocardial perfusion defect, 7 patients (23.3%) had reversible myocardial perfusion defects; 1 patient (3%) with normal perfusion scan showed depressed rest and stress LVEF. Only 1 patient had a large defect and underwent coronary angiography and percutaneous coronary intervention. Five patients with small defect showed normal coronary arteries at Multislice Computed Tomography. Cardiovascular follow-up may reveal signs of A-CHT or RT-induced cardiotoxicity. A stress test combined with MPI- and GATED-derived data of ventricular systolic performance after stress can give information on the coronary reserve and the contractile reserve and allow early appropriate treatment.
In the most recent development in cosmic microwave detection there is great interest for planar antenna coupled Transition Edge Sensor (TES) which allow performance that meet requirements of future ...cosmology mission. In particular we are developing such kind of bolometers with a planar sinuous antenna that are well suited for dense arrays for both imaging and polarization measurement, for CMB, earth observation and security, In this framework we are selecting two different TES platform (Ti/Au and Ir/Au) options suitable for high performance bolometer to be operated in space applications. We present here a preliminary bolometer design and first studies for the realization of Ti/Au and Ir/Au TESs, with particular regard to the dependence of the transition temperature T c on the thermal profile and oxygen contamination during the production or annealing process.
C31 NEXT GENERATION MYOCARDITIS Mistrulli, R; Cartoni, D; Andreoli, F ...
European heart journal supplements,
05/2023, Letnik:
25, Številka:
Supplement_D
Journal Article
Recenzirano
Odprti dostop
Abstract
A 75–year–old overweight man, affected by hypertension, diabetes mellitus and atrial fibrillation since 2020. After 3 unsuccessful attempts of electrical cardioversion it was opted for a ...strategy of rate control with beta blocker and anticoagulant therapy with Rivaroxaban 20 mg. Following episodes of rectal bleeding; adenocarcinoma of the colon was diagnosed. The patient underwent hemicolectomy and started therapy with Pembrolizumab. The anticoagulant was replaced with Edoxaban 60 mg. In August 2022, he was admitted to the emergency department for severe signs and symptoms of heart failure. On ECG, atrial fibrillation with a heart rate of 90 bpm and non–specific changes in ventricular repolarization. The echocardiogram showed a severe reduction of the ejection fraction (FE 30%), which was not present at previous controls. On blood tests, troponins were negative and BNP increased. The patient underwent coronarography which was negative for significant lesions, and heart failure therapy was prescribed. Three months later the patient came to our cardio–oncology outpatient clinic; we repeated the echocardiogram which showed a recovery of the ejection fraction to 45% and planned a cardiac MRI. Cardiac MRI (CMR) showed global left ventricular hypokinesia (FE 42%) and late subepicardial gadoline enhancement in the basal segment of the inferior wall and transmural in the basal segment of the lateral wall without signs of oedema. Report described as compatible with myocarditis. The case was discussed collegially with radiologists and oncologists, and it was decided to discontinue immunotherapy (ICI). Myocarditis is the most common cardiovascular adverse events of ICI therapy, although it has a very low incidence. Generally, myocarditis related to ICI therapy has a high mortality rate and requires discontinuation of ICI. In addition, CMR may have a lower sensitivity in this setting. There is also a possibility of developing left ventricular dysfunction without associated myocarditis in the absence of increase in cardiac troponin and active myocardial inflammation at CMR. Although our case has been defined as myocarditis, it presents some unclear aspects due in part to the early non–diagnosis as a complication of ICI therapy. Although cancer patients taking ICI has expanded considerably in recent years, the evidence on cardiovascular complications is scarce and unknown to the clinical cardiologist.
The MEG II experiment, based at the Paul Scherrer Institut in Switzerland, reports the result of a search for the decay
μ
+
→
e
+
γ
from data taken in the first physics run in 2021. No excess of ...events over the expected background is observed, yielding an upper limit on the branching ratio of
B
(
μ
+
→
e
+
γ
)
<
7.5
×
10
-
13
(90% CL). The combination of this result and the limit obtained by MEG gives
B
(
μ
+
→
e
+
γ
)
<
3.1
×
10
-
13
(90% CL), which is the most stringent limit to date. A ten-fold larger sample of data is being collected during the years 2022–2023, and data-taking will continue in the coming years.
Posterior MIPO approach in the humerus has been described by using a 4.5mm LCP plate. Although straight plates have shown good results, they have not been designed to adapt to the distal humeral ...metaphysis. The goal of the study was to test the null hypothesis that there is no difference in hardware removal after posterior MIPO with either a straight or a pre-contoured plate.
Patients older than 18 years, who had suffered mid-distal humeral shaft fracture, were treated by a posterior MIPO technique with a locking plate and had a minimum of 12-month follow-up were retrospectively included. Patients were separated into: group 1 (LCP 4.5mm straight plate); and group 2 (3.5mm anatomically shaped plate). Clinical and radiological evaluations were performed in the postoperative period. Patient-reported outcomes and the need of hardware removal because of pain were assessed.
Sixty-seven patients fulfilled the inclusion criteria. Twenty-seven patients in group 1 and 40 in group 2. No patient was lost to follow-up. There were no statistical differences between in patient reported outcomes measures. All the fractures healed. Within group 1, 18% (95%CI: 6–38%) of the patients required implant removal while in group 2 this incidence was 0% (95%CI: 0–9%) (P 0.009).
These results suggest that the use of a 4.5mm LCP compared to an anatomical 3.5mm LCP in posterior MIPO of the humerus generates greater discomfort and therefore leads to a 18% increase in the risk of implant removal.
El abordaje posterior percutáneo del húmero se ha descrito utilizando una placa LCP de 4,5mm. A pesar de que las placas rectas han demostrado buenos resultados, estas no han sido diseñadas para adaptarse a la metáfisis del húmero distal. El objetivo de este estudio es probar la hipótesis nula de que no existen diferencias en la extracción de la osteosíntesis después de una MIPO posterior utilizando una placa recta comparado a una placa anatómica.
Se incluyó retrospectivamente en 2 instituciones a pacientes mayores de 18 años que habían sufrido una fractura diafisaria de húmero distal tratados mediante técnica percutánea posterior con una placa bloqueada y con un seguimiento mínimo de 12 meses. Los pacientes se dividieron en: grupo 1 (placa recta LCP de 4,5mm) y grupo 2 (placa de forma anatómica de 3,5mm). Durante el postoperatorio se reportó la evaluación clínica y radiológica, así como la necesidad de retirar el implante debido al dolor.
Sesenta y siete pacientes cumplieron los criterios de inclusión. Veintisiete pacientes en el grupo 1 y 40 en el grupo 2. No se perdió ningún paciente durante el seguimiento. Dentro del grupo 1, el 18% (IC del 95%: 6-38%) de los pacientes requirieron extracción del implante, mientras que en el grupo 2 esta incidencia fue del 0% (IC del 95%: 0-9%) (p = 0,009). No hubo diferencias estadísticas entre las medidas de resultado informadas por los pacientes; todas las fracturas consolidaron.
Los resultados de nuestro estudio demostrarían que el uso de placas LCP rectas de 4,5mm comparado a las placas anatómicas LCP de 3,5mm en MIPO posterior de húmero genera mayores molestias y, por lo tanto, conllevan un incremento en el riesgo de extracción del implante de un 18%.
The MEG detector for μ+→e+γ decay search Adam, J.; Bai, X.; Baldini, A. M. ...
The European physical journal. C, Particles and fields,
04/2013, Letnik:
73, Številka:
4
Journal Article
Recenzirano
Odprti dostop
The MEG (Mu to Electron Gamma) experiment has been running at the Paul Scherrer Institut (PSI), Switzerland since 2008 to search for the decay
μ
+
→e
+
γ
by using one of the most intense continuous
μ
...+
beams in the world. This paper presents the MEG components: the positron spectrometer, including a thin target, a superconducting magnet, a set of drift chambers for measuring the muon decay vertex and the positron momentum, a timing counter for measuring the positron time, and a liquid xenon detector for measuring the photon energy, position and time. The trigger system, the read-out electronics and the data acquisition system are also presented in detail. The paper is completed with a description of the equipment and techniques developed for the calibration in time and energy and the simulation of the whole apparatus.
Abstract
Background
Fluoropirimidine represents one of the staple treatment of metastatic colorectal cancer; chemoterapy–based cardiotoxicity is unfortunately habitual in clinical practice. ...Raltitrexed could represent a valid alterantive to 5–FU in patients with cardiovascular comorbidities or in which 5–FU Has not been tolerated.
Case Report
Our patient is a 73 years–old woman, who underwent left colon surgical resection due to subocclusion; a whola body staging was not performed. After surgery, patient underwent CT scan,i n which multiple liver, lung and peritoneal metastases were identified. Biomolecular profiling assessment was perfomed (RAS, BRAF Wild type, DPYD*6 heterozigosis mutation). On January 2020, patient began FOLFIRI + PANITUMUMAB scheme as first line treatment (total cycles perfomed: 15). On January 2021, PD was detected though restaging imaging, and patient was subsequently treated with FOLFOX + BEvacizumab as second line. After 5 cycles, patient developed dyspnoea and palpitation; EKG was performed depicting Atrial fibrillation with heart rate: 73bpm, preserved biventricular systolic function and increased BNP and NT–pro–BNP serum concentration. According to patient’s high thromboembolic risk, oral anticoagulation (NOAC) was administered and multidisciplinary discussion was scheduled. NAO were preferred to Vitamin K antagonists due to drug–drug interactions; the treatment–of–choice was Apixaban 2.5 mg bis in die. Given the fact that aforementioned condition could have been attributed to 5–FU cardiologic toxicity, Raltitrexed was administered in lieu thereof 5–FU once synusal rythm was restored (TOMOX scheme). Bevacizumab administration was restored after a longer waiting (ca 2 months); the patient uderwent systematic and serial cardiologic assessment through clinical and EKG consults.
Conclusion
Our case report depicts the undelayable necessity of a Multidisciplinar collaboration in which oncologists and cardiologists could propose personalized treatment strategies which ensure correct antitumoral activities without significant and life–threatening toxicities.
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![[Translated article] The us...](http://api.summon.serialssolutions.com/2.0.0/image/issn/XR4PS5YY4K/1888-4415/small "[Translated article] The use of an anatomical implant compared to a straight LCP decreases extraction in posterior humeral MIPO")
