FLUKA Simulations of Pion Decay Gamma-radiation from Energetic Flare Ions

Gamma-ray continuum at > 10 MeV photon energy yields information on > 0.2 - 0.3 GeV/nucleon ions at the Sun. We use the general-purpose Monte Carlo code FLUKA (FLUktuierende KAskade) to model the transport of ions injected into thick and thin target sources, the nuclear processes that give rise to pions and other secondaries and the escape of the resulting photons from the atmosphere. We give examples of photon spectra calculated with a range of different assumptions about the primary ion velocity distribution and the source region. We show that FLUKA gives results for pion decay photon emissivity in agreement with previous treatments. Through the directionality of secondary products, as well as Compton scattering and pair production of photons prior to escaping the Sun, the predicted spectrum depends significantly on the viewing angle. Details of the photon spectrum in the 100 MeV range may constrain the angular distribution of primary ions and the depths at which they interact. We display a set of thick-target spectra produced making various assumptions about the incident ion energy and angular distribution and the viewing angle. If ions are very strongly beamed downward, or ion energies do not extend much above 1 GeV/nucleon, the photon spectrum is highly insensitive to details of the ion distribution. Under the simplest assumptions, flares observed near disc centre should not display significant radiation above 1 GeV photon energy. We give an example application to Fermi Large Area Telescope data from the flare of 12 June 2010.Comment: 25 pages, 13 figures, to be published in Solar Physic

Anterior cruciate ligament reconstruction: A multicenter prospective cohort study evaluating 3 different grafts using same bone drilling method

To compare the clinical outcomes after anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone autograft (BPTBAu), BPTB allograft (BPTBAll), or hamstring (semitendinosus-gracilis) tendon autograft (HTAu), performing bone drilling with same methods in terms of transtibial drilling, orientation, positioning, and width of femoral and tibial tunnels. DESIGN: Multicenter prospective cohort study (level of evidence II). SETTING: Departments of Orthopedic Surgery of Centro Medico Teknon (Barcelona, Spain) Clinica Universitaria de Navarra (Navarra, Spain), and Clinica FREMAP (Gijon, Spain). PATIENTS: All patients with ACL tears attending 3 different institutions between January 2004 and June 2006 were approached for eligibility and those meeting inclusion criteria finally participated in this study. INTERVENTION: Each institution was assigned to perform a specific surgical technique. Patients were prospectively followed after undergoing ACL reconstruction with BPTBAu, BPTBAll, or HTAu, with a minimum follow-up of 24 months. MAIN OUTCOME MEASURES: Included knee laxity and International Knee Documentation Committee (IKDC) score. Knee laxity was assessed with the KT-1000 arthrometer (evaluated with neutral and external rotation positions) and both Lachman and pivot shift tests. Additional outcomes included main symptoms (anterior knee pain, swelling, crepitation, and instability), disturbance in knee sensation, visual analogue scale (VAS) for satisfaction with surgery, range of motion (ROM), and isokinetic knee strength. RESULTS: There were no significant differences among the 3 groups for any of the clinical outcomes, except for a slightly greater KT-1000-measured knee laxity in external rotation in the BPTBAu compared with the other groups. All patients demonstrated grade A or B of the IKDC. The mean VAS for satisfaction with surgery in all patients was 8.5. CONCLUSIONS: The selection of the surgical technique for ACL reconstruction may be based on the surgeon's preference

Pilot study to introduce a notification card for partner notification of sexually transmitted infections in Catalonia, Spain, June 2010 to June 2011

We conducted a cross-sectional study in 10 primary care centres in Catalonia, to determine applicability, acceptability and effectiveness of partner notification cards used by patients diagnosed of a sexually transmitted infection (STI) and to characterise these and their sexual partners. Statutorily notifiable STIs included Chlamydia infection, gonorrhoea, syphilis, human immunodeficiency virus (HIV) infection or other STIs as deemed necessary by the treating physician. Between June 2010 and June 2011, 219 index cases were enrolled, of whom 130 were men (59.4%), 71 of them men who have sex with men (54.6%). Chlamydia infection (41.1%), gonorrhoea (17.8%) and syphilis (16.0%) were the STIs most frequently diagnosed. HIV infection accounted for 4% of cases. A total of 687 sexual partners were reported, and 300 of these were traceable through the notification card (45.7%). Those who did not report traceable contacts were older (mean age: 34 years versus 31 years, p=0.03). The main reason for not distributing the card was anonymous sexual intercourse (38%). Patient referral notification cards can reach a high percentage of sexual partners at risk. However, only few notified sexual partners attended participating health centres. Internet-based partner notification may be considered in order to reach those partners not otherwise traceable

Social and emotional loneliness among older people living in nursing homes in Spain: a cross-sectional study

Loneliness, little studied in Nursing Homes (NHs), can affect physical and mental health. We aimed to analyze the factors associated with overall, social, and emotional loneliness in 65 residents of 5 NHs from Central Catalonia (Spain), and to verify its prevalence. The sample consisted of 81.5% women with a mean age of 84±7.13 years. The cross-sectional study included older adults aged 65 or over and with preserved cognitive status. De Jong Gierveld Loneliness Scale was used to assess overall loneliness and its subtypes; and sociodemographic and health-related variables were collected. The chi-square (or Fisher’s) test and logistic regression were used for bivariate and multivariate analysis respectively. Prevalence of overall loneliness was 70.7% (95%CI:58.2-81.4), social loneliness 44.6% (95% CI: 33.1-56.6) and emotional loneliness 46.2% (95% CI: 34.5–58.1). Overall loneliness was associated with lower perceived quality of life (Odds Ratio-OR = 5.52, 95% CI:1.25-24.38) and NHs with state subsidized places (OR = 0.19, 95% CI: .05-.74); social loneliness with having 0-1 children (OR = .25, 95% CI: .08-.77), and emotional loneliness with depression (OR = 4.54, 95% CI: 1.28-16.08) and urinary incontinence (UI) (OR = 4.65, 95% CI: 1.23-17.52). Loneliness was present in almost 71% of residents and was associated with type of NH and poorer quality of life, the emotional with depression and UI and the social one with having less than 2 children.La soledad, poco estudiada en las residencias de ancianos, puede afectar a la salud física y mental. Nuestro objetivo es analizar los factores asociados a la soledad global, social y emocional de un total de 65 residentes de 5 residencias de la Cataluña Central (España), y comprobar su prevalencia. La muestra estuvo formada por 81.5% mujeres con una edad media de 84±7.13 años. El estudio transversal incluyó a adultos mayores de 65 años y con estado cognitivo preservado. Se utilizó la Escala de Soledad de De Jong Gierveld para evaluar la soledad general y sus subtipos; y se recogieron variables sociodemográficas y relacionadas con la salud. Se utilizó la prueba de chi-cuadrado (o de Fisher) y la regresión logística para el análisis bivariante y multivariante, respectivamente. La prevalencia de la soledad global fue del 70.7% (IC 95%: 58.2-81.4), la soledad social del 44.6% (IC 95%: 33.1-56.6) y la soledad emocional del 46.2% (IC 95%: 34.5-58.1). La soledad global se asoció con una menor calidad de vida percibida (Odds Ratio-OR = 5.52, IC 95%: 1.25-24.38) y las residencias concertadas (OR = 0.19, IC 95%: 0.05-0. 74); la soledad social con tener 0-1 hijos (OR = 0.25, IC 95%: 0.08-0.77), y la soledad emocional con la depresión (OR = 4.54, IC 95%: 1.28-16.08) y la incontinencia urinaria (UI) (OR = 4.65, IC 95%: 1.23-17.52). La soledad estuvo presente en casi el 71% de los residentes y se asoció con el tipo de residencia y la peor calidad de vida, la emocional con la depresión y la IU y la social con tener menos de 2 hijos

Sarcopenia and associated factors according to the EWGSOP2 criteria in older people living in nursing homes: a cross-sectional study

BACKGROUND: In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. Early diagnosis of sarcopenia in nursing home residents and the identification of contributing factors would target interventions to reduce the incidence of malnutrition, social isolation, functional decline, hospitalization and mortality. AIM: Verify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes in Central Catalonia (Spain). DESIGN: A cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia. RESULTS: Among the total sample of 104 nursing home residents (mean age 84.6, ± 7.8; median 86, IQR 110), 84.6% were women and 85 (81.7%) (95% confidence interval [CI] 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) had confirmed sarcopenia and 7 (6.7%) had severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition and urinary continence were positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associated factor: OR = 0.13 (0.03 - 0.57), p = 0.007 and OR = 0.14 (0.03 - 0.60), p = 0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence status. For confirmed sarcopenia, obesity also represented a negative associated factor OR = 0.06 (0.01 - 0.99), p = 0.049 and the total time in sedentary behavior a positive associated factor OR = 1.10 (1.00- 1.20), p = 0.040. CONCLUSIONS: According the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7 to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia, whilst obesity represented a protective factor in this population

Soledad social y emocional en personas mayores que viven en residencias geriátricas de España: un estudio transversal

Loneliness, little studied in Nursing Homes (NHs), can affect physical and mental health. We aimed to analyze the factors associated with overall, social, and emotional loneliness in 65 residents of 5 NHs from Central Catalonia (Spain), and to verify its prevalence. The sample consisted of 81.5% women with a mean age of 84±7.13 years. The crosssectional study included older adults aged 65 or over and with preserved cognitive status. De Jong Gierveld Loneliness Scale was used to assess overall loneliness and itssubtypes; and sociodemographic and health-related variables were collected. The chi-square (or Fisher’s) test and logistic regression were used for bivariate and multivariate analysis respectively. Prevalence of overall loneliness was 70.7% (95%CI:58.2-81.4), social loneliness 44.6% (95% CI: 33.1-56.6) and emotional loneliness 46.2% (95% CI: 34.5–58.1). Overall loneliness was associated with lower per-ceived quality of life (Odds Ratio-OR = 5.52, 95% CI:1.25-24.38) and NHswith state subsidized places (OR =0.19, 95% CI: .05-.74); social loneliness with having 0-1 children (OR = .25, 95% CI: .08-.77), and emotional loneliness with depression (OR = 4.54, 95% CI: 1.28-16.08) and urinary incontinence (UI) (OR = 4.65, 95% CI: 1.23-17.52). Loneliness was present in almost 71% of residents and was associated with type of NH and poorer quality of life, the emotional with depression and UI and the social one with having less than 2 children.La soledad, poco estudiada en las residencias de ancianos, puede afectar a la salud física y mental. Nuestro objetivo es analizar los factores asociados a la soledad global, social y emocional de un total de 65 residentes de 5 residencias de la Cataluña Central (España), y comprobar su prevalencia. La muestra estuvo formada por 81.5% mujeres con una edad media de 84±7.13 años. El estudio transversal incluyó a adultos mayores de 65 años y con estado cognitivo preservado. Se utilizó la Escala de Soledad de De Jong Gierveld para evaluar la soledad general y sus subtipos; y se recogieron variables sociodemográficas y relacionadas con la salud. Se utilizó la prueba de chi-cuadrado (o de Fisher) y la regresión logística para el análisis bivariante y multivariante, respectivamente. La prevalencia de la soledad global fue del 70.7% (IC 95%: 58.2-81.4), la soledad social del 44.6% (IC 95%: 33.1-56.6) y la soledad emocional del 46.2% (IC 95%: 34.5-58.1). La soledad global se asoció con una menor calidad de vida percibida (Odds Ratio-OR = 5.52, IC 95%: 1.25-24.38) y las residencias concertadas (OR = 0.19, IC 95%: 0.05-0. 74); la soledad social con tener 0-1 hijos (OR =0.25, IC 95%: 0.08-0.77), y la soledad emocional con la depresión (OR = 4.54, IC 95%: 1.28-16.08) y la incontinencia urinaria (UI) (OR = 4.65, IC 95%: 1.23-17.52). La soledad estuvo presente en casi el 71% de los residentes y se asoció con el tipo de residencia y la peor calidad de vida, la emocional con la depresión y la IU y la social con tener menos de 2 hijo

Urinary incontinence and sedentary behaviour in nursing home residents in Osona, Catalonia: protocol for the OsoNaH project, a multicentre observational study

Introduction Several studies have shown that physical activity (PA) levels and sedentary behaviour (SB) are independent risk factors for many health-related issues. However, there is scarce evidence supporting the relationship between SB and urinary incontinence (UI) in community-dwelling older adults, and no information on any possible association in institutionalised older adults. Stage I of this project has the main objective of determining the prevalence of UI and its associated factors in nursing home (NH) residents, as well as analysing the association between UI (and its types) and SB. Stage II aims to investigate the incidence and predictive factors of functional and continence decline, falls, hospitalisations, mortality and the impact of the COVID-19 pandemic among NH residents.Methods and analysis Stage I is an observational, multicentre, cross-sectional study with mixed methodology that aims to explore the current status of several health-related outcomes in NH residents of Osona (Barcelona, Spain). The prevalence ratio will be used as an association measure and multivariate analysis will be undertaken using Poisson regression with robust variance. Stage II is a 2-year longitudinal study that aims to analyse functional and continence decline, incidence of falls, hospitalisations, mortality and the impact of the COVID-19 pandemic on these outcomes. A survival analysis using the actuarial method for functional decline and continence, evaluated every 6 months, and the Kaplan-Meier method for falls, hospitalisations and deaths, and Cox regression for multivariate analysis will be undertaken.Ethics and dissemination The study received the following approvals: University of Vic - Central University of Catalonia Ethics and Research Committee (92/2019 and 109/2020), Clinical Research Ethics Committee of the Osona Foundation for Health Research and Education (FORES) (code 2020118/PR249). Study results will be disseminated at conferences, meetings and through peer-reviewed journals.Trial registration number NCT04297904

Modelling magnetised medium particle transport in the guiding centre limit with GEANT4

Monte Carlo codes are a standard tool for studying energetic particle propagation, secondary production, and radiation in astrophysical settings. In magnetised plasmas such as those found in solar active regions, the enormous disparity between particle gyroradii and system scales proves to be a major computational obstacle. To address this problem we have written a new module in Geant4 using the guiding centre (GC) approach in which the particle motion is averaged over a gyrofrequency. We describe the formulation and implementation of this method in particular dealing with the uncertainty in gyrophase so that particle velocities are well-defined for input to the modules handling reactions. As far as feasible, we compare the propagation and slowing down of primary protons, secondary particle production, and run times in the GC limit with the Newton–Lorentz approach, finding very good agreement between the two methods and orders of magnitude improvement in run times in the GC case. Finally, we present an illustrative solar physics application involving two interacting dipoles, which is only achievable using the GC approach