Coherent neutrino radiation in supernovae at two loops

We develop a neutrino transport theory, in terms of the real-time non-equilibrium Green's functions, which is applicable to physical conditions arbitrary far from thermal equilibrium. We compute the coherent neutrino radiation in cores of supernovae by evaluating the two-particle-two-hole (2p-2h) polarization function with dressed propagators. The propagator dressing is carried out in the particle-particle channel to all orders in the interaction. We show that at two loops there are two distinct sources of coherence effects in the bremsstrahlung. One is the generically off-shell intermediate state propagation, which leads to the Landau-Pomeranchuk-Migdal type suppression of radiation. We extend previous perturbative results, obtained in the leading order in quasiparticle width, by deriving the exact non-perturbative expression. A new contribution due to off-shell finial/initial baryon states is treated in the leading order in the quasiparticle width. The latter contribution corresponds to processes of higher order than second order in the virial expansion in the number of quasiparticles. At 2p-2h level, the time component of the polarization tensor for the vector transitions vanishes identically in the soft neutrino limit. Vector current thereby is conserved. The contraction of the neutral axial vector current with tensor interaction among the baryons leads to a non-vanishing contribution to the bremsstrahlung rate. These rates are evaluated numerically for finite temperature pure neutron matter at and above the nuclear saturation density.Comment: 26 pages, 5 figures, uses Revte

Photodisintegration of the deuteron in the few GeV region using asymptotic amplitudes

Exclusive photodisintegration of the deuteron in the 1-4GeV range is described in terms of a simple covariant and gauge invariant approach using an effective counting rule as the hard part of the d-np vertex. At a scattering angle of theta_cm=90 degrees a prescaling behavior of the differential cross section proportional to 1/s^(n-2) with n ~ 12 is obtained; going away from 90 degrees the value of n decreases slowly, in qualitative agreement with the recent data.Comment: 10 pages, 3 figures, to appear in Physics Letters

Pions in isospin asymmetric matter and nuclear Drell-Yan scattering

Using a self-consistent delta-hole model the pion propagation in isospin asymmetric nuclear matter is studied. In neutron-rich matter, corresponding to heavy nuclei, a significant difference in positive and negative pion light-cone distributions is obtained leading to a nuclear enhancement of up antiquark distribution compared to the down antiquark one. This means that the sea-quark asymmetry in the free nucleon cannot be extracted model independently from an experiment on a neutron-rich nucleus.Comment: 10 pages, 3 figures (included), Latex 2.09, uses elsart.sty, epsf.st

Die rol wat 'n medikus buite sy beroep in sy gemeenskap vervul

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The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs:the VIP2 study

Purpose: Premorbid conditions affect prognosis of acutely-ill aged patients. Several lines of evidence suggest geriatric syndromes need to be assessed but little is known on their relative effect on the 30-day survival after ICU admission. The primary aim of this study was to describe the prevalence of frailty, cognition decline and activity of daily life in addition to the presence of comorbidity and polypharmacy and to assess their influence on 30-day survival. Methods: Prospective cohort study with 242 ICUs from 22 countries. Patients 80 years or above acutely admitted over a six months period to an ICU between May 2018 and May 2019 were included. In addition to common patients’ characteristics and disease severity, we collected information on specific geriatric syndromes as potential predictive factors for 30-day survival, frailty (Clinical Frailty scale) with a CFS &gt; 4 defining frail patients, cognitive impairment (informant questionnaire on cognitive decline in the elderly (IQCODE) with IQCODE ≥ 3.5 defining cognitive decline, and disability (measured the activity of daily life with the Katz index) with ADL ≤ 4 defining disability. A Principal Component Analysis to identify co-linearity between geriatric syndromes was performed and from this a multivariable model was built with all geriatric information or only one: CFS, IQCODE or ADL. Akaike’s information criterion across imputations was used to evaluate the goodness of fit of our models. Results: We included 3920 patients with a median age of 84 years (IQR: 81–87), 53.3% males). 80% received at least one organ support. The median ICU length of stay was 3.88 days (IQR: 1.83–8). The ICU and 30-day survival were 72.5% and 61.2% respectively. The geriatric conditions were median (IQR): CFS: 4 (3–6); IQCODE: 3.19 (3–3.69); ADL: 6 (4–6); Comorbidity and Polypharmacy score (CPS): 10 (7–14). CFS, ADL and IQCODE were closely correlated. The multivariable analysis identified predictors of 1-month mortality (HR; 95% CI): Age (per 1 year increase): 1.02 (1.–1.03, p = 0.01), ICU admission diagnosis, sequential organ failure assessment score (SOFA) (per point): 1.15 (1.14–1.17, p &lt; 0.0001) and CFS (per point): 1.1 (1.05–1.15, p &lt; 0.001). CFS remained an independent factor after inclusion of life-sustaining treatment limitation in the model. Conclusion: We confirm that frailty assessment using the CFS is able to predict short-term mortality in elderly patients admitted to ICU. Other geriatric syndromes do not add improvement to the prediction model. Since CFS is easy to measure, it should be routinely collected for all elderly ICU patients in particular in connection to advance care plans, and should be used in decision making.</p