Coronary computed tomography angiography of spontaneous coronary artery dissection: A case report and review of the literature

Patient: Male, 23 Final Diagnosis: Spontaneous coronary artery dissection Symptoms: Chest discomfort • chest pain Medication: — Clinical Procedure: Coronary computed tomography angiography Specialty: Radiology OBJECTIVE: Rare disease BACKGROUND: Multidetector computed tomography (MDCT) has gained wide acceptance in the evaluation of the cardiovascular system. Of particular clinical interest is its ability to non-invasively evaluate coronary arteries in patients presenting to the emergency room. In acute coronary syndromes, myocardial ischemia is most often caused by atherosclerosis. We present a case of a rare cause of acute coronary syndrome, spontaneous coronary artery dissection (SCAD), which was initially evaluated with MDCT and followed by intravascular ultrasound (IVUS) and invasive coronary angiography (ICA). We discuss the findings and role of each modality with particular attention to coronary computed tomographic angiography (CCTA) in the diagnosis and management of SCAD. As the use of CCTA in the emergency department continues to rise, radiologists must become familiar with CT appearance of SCAD. CASE REPORT: We report the multidetector computed tomography (MDCT), intravascular ultrasound (IVUS), and invasive coronary angiography (ICA) findings in a case of spontaneous coronary artery dissection of the left anterior descending artery in a previously healthy 23-year-old man. The role of coronary computed tomographic angiography (CCTA) in diagnosis and management of this potentially life-threatening condition is discussed. CONCLUSIONS: In the clinical setting of acute coronary syndrome, SCAD must be a consideration, particularly in young patients without clear risk factors for coronary artery disease and in women in the peripartum period. CCTA is a very helpful diagnostic tool to diagnose the condition in a non-invasive manner and to follow up after treatment

On the critical end point in a two-flavor linear sigma model coupled to quarks

We use the linear sigma model coupled to quarks to explore the location of the phase transition lines in the QCD phase diagram from the point of view of chiral symmetry restoration at high temperature and baryon chemical potential. We compute analytically the effective potential in the high- and low-temperature approximations up to sixth order, including the contribution of the ring diagrams to account for the plasma screening properties. We determine the model parameters, namely, the couplings and mass-parameter, from conditions valid at the first order phase transition at vanishing temperature and, using the Hagedorn limiting temperature concept applied to finite baryon density, for a critical baryochemical potential of order of the nucleon mass. We show that when using the set of parameters thus determined, the second order phase transition line (our proxy for the crossover transition) that starts at finite temperature and zero baryon chemical potential converges to the line of first order phase transitions that starts at zero temperature and finite baryon chemical potential to determine the critical end point to lie in the region 5.02<\mu_B^{\mbox{CEP}}/T_c<5.18, 0.14, where $T_c$ is the critical transition temperature at zero baryon chemical potential.Comment: 11 pages, 3 figures, discussion extended, explicit calculations included in appendices and version accepted for publication in EPJ

Boundary and expansion effects on two-pion correlation functions in relativistic heavy-ion collisions

We examine the effects that a confining boundary together with hydrodynamical expansion play on two-pion distributions in relativistic heavy-ion collisions. We show that the effects arise from the introduction of further correlations due both to collective motion and the system's finite size. As is well known, the former leads to a reduction in the apparent source radius with increasing average pair momentum K. However, for small K, the presence of the boundary leads to a decrease of the apparent source radius with decreasing K. These two competing effects produce a maximum for the effective source radius as a function of K.Comment: 6 pages, 5 Eps figures, uses RevTeX and epsfi

Insufficiently studied factors related to burnout in nursing: Results from an e-Delphi study

Objective: This study aimed to identify potentially important factors in explaining burnout in nursing that have been insufficiently studied or ignored. Methods: A three-round Delphi study via e-mail correspondence was conducted, with a group of 40 European experts. The e-Delphi questionnaire consisted of 52 factors identified from a literature review. Experts rated and scored the importance of factors in the occurrence of burnout and the degree of attention given by researchers to each of the variables listed, on a six-point Likert scale. We used the agreement percentage (>80%) to measure the level of consensus between experts. Furthermore, to confirm the level of consensus, we also calculated mean scores and modes. Regardless of the degree of consensus reached by the experts, we have calculated the mean of the stability of the answers for each expert (individual's qualitative stability) and the mean of the stability percentages of the experts (qualitative group stability). Results: The response rate in the three rounds was 93.02% (n = 40). Eight new factors were suggested in the first round. After modified, the e-Delphi questionnaire in the second and third rounds had 60 factors. All the factors reached the third round with a consensus level above 80% in terms of the attention that researchers gave them in their studies. Moreover, the data show a total mean qualitative group stability of 96.21%. In the third round 9 factors were classified by experts as 'studied very little', 17 as 'studied little' and 34 as 'well studied' Conclusion: Findings show that not all the factors that may influence nursing burnout have received the same attention from researchers. The panel of experts has identified factors that, although important in explaining burnout, have been poorly studied or even forgotten. Our results suggest that further study into factors such as a lack of recognition of part of the tasks that nurses perform, feminine stereotype or excessive bureaucracy is needed for a better understanding of this syndrome and improve the quality of life in nurses. © 2017 Manzano-García, Ayala.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

ECONOMIA. La cabra: un animal marginat

L'explotació d'aquest animal és interessant per la ramaderia del Bergued

Density and expansion effects on pion spectra in relativistic heavy-ion collisions

We compute the pion inclusive momentum distribution in heavy-ion collisions at AGS energies, assuming thermal equilibrium and accounting for density and expansion effects at the time of decoupling. We compare to data on mid rapidity charged pions produced in central Au + Au collisions and find a very good agreement. The shape of the distribution at low $m_t-m$ is explained in part as an effect arising from the high mean pion density achieved in these reactions. The difference between the positive and negative pion distributions in the same region is attributed in part to the different average yields of each kind of charged pions.Comment: Minor changes, typo in Fig. 2b corrected, version to appear in Phys. Rev.

Relative Permeability of Homogenous-Wet and Mixed-Wet Porous Media as Determined by Pore-Scale Lattice Boltzmann Modeling

We present a pore-scale study of two-phase relative permeability in homogenous-wet porous media, and porous media altered to a mixed-wet state. A Shan-Chen type multicomponent lattice Boltzmann (LB) model is employed to determine pore-scale fluid distributions and relative permeability. Mixed-wet states are created by altering the wettability of solid surfaces in contact with the nonwetting phase at the end of steady state simulation of initially homogenous-wet porous media. To ensure accurate representation of fluid-solid interfacial areas, we compare LB simulation results to experimental measurements of interfacial fluid-fluid and fluid-solid areas determined by X-ray computed microtomography imaging of water and oil distributions in bead packs. The LB simulations are found to match experimental trends observed for fluid-fluid and fluid-solid interfacial area-saturation relationships. The relative permeability of both fluids in the homogenous-wet porous media was found to decrease with a decreasing contact angle. The relative permeability of both fluids in the altered, mixed-wet porous media was found to decrease for all mixed-wet states in comparison to the initial homogenous-wet states. The nonwetting phase relative permeability decreased significantly, while the wetting phase experienced only a minor decrease. The significance of the decrease was found to be dependent on the distribution of the unaltered solid surfaces, with less dependence on the severity of alteration. Key Points Lattice Boltzmann simulation interfacial areas match experimental trends Wetting phase relative permeability is unaffected by wettability alteration Nonwetting phase relative permeability is decreased by wettability alteration © 2014. American Geophysical Union