Probing pre-formed alpha particles in the ground state of nuclei

In this Letter, we report on alpha particle emission through the nuclear break-up in the reaction 40Ca on a 40Ca target at 50A MeV. It is observed that, similarly to nucleons, alpha particles can be emitted to the continuum with very specific angular distribution during the reaction. The alpha particle properties can be understood as resulting from an alpha cluster in the daughter nucleus that is perturbed by the short range nuclear attraction of the collision partner and emitted. A time-dependent theory that describe the alpha particle wave-function evolution is able to reproduce qualitatively the observed angular distribution. This mechanism offers new possibilities to study alpha particle properties in the nuclear medium.Comment: 4 pages, 3 figure

Effect of ondansetron on the analgesic efficacy of tramadol used for postoperative analgesia: a randomised controlled study

Background: Ondansetron is used to reduce tramadol induced postoperative nausea and vomiting  (PONV). Studies on patient-controlled analgesia (PCA) found that ondansetron reduces the analgesic  efficacy of tramadol. Drug requirement in PCA and in conventional intravenous analgesia without PCA  device may differ. This study evaluated the effect of ondansetron on analgesic efficacy of tramadol for postoperative analgesia without a PCA device.Methods: A prospective, randomised, placebo-controlled, double-blind parallel group study was  conducted on 126 euthyroid patients of ASA I and II, aged between 30 and 65 years undergoing  hemithyroidectomy under general anaesthesia. Patients were divided into group O and group C. At the time of closure of strap muscles, patients in group O received tramadol 1.5 mg/kg IV and ondansetron 0.1 mg/kg (diluted to 4 ml) IV and those in group C received tramadol 1.5 mg/kg IV and normal saline 4 ml IV. Duration of analgesia, pain score (VAS), PONV and sedation scores were analysed.Results: Duration of analgesia was longer in group C compared with group O (164.1 min vs. 76.3 min, p < 0.05). Postoperative VAS score was higher in group O (p < 0.001). Group C showed higher PONV and sedation score.Conclusion: Ondansetron reduces the duration and quality of analgesia of tramadol administered  conventionally without a PCA device.Keywords: ondansetron, pain, postoperative nausea and vomiting, sedation, tramado

Dynamic Conduction and Repolarisation Changes in Early Arrhythmogenic Right Ventricular Cardiomyopathy versus Benign Outflow Tract Ectopy Demonstrated by High Density Mapping and Paced Surface ECG Analysis

Aims: The concealed phase of arrhythmogenic right ventricular cardiomyopathy (ARVC) may initially manifest electrophysiologically. No studies have examined dynamic conduction/repolarization kinetics to distinguish benign right ventricular outflow tract ectopy (RVOT ectopy) from ARVC's early phase. We investigated dynamic endocardial electrophysiological changes that differentiate early ARVC disease expression from RVOT ectopy. Methods: 22 ARVC (12 definite based upon family history and mutation carrier status, 10 probable) patients without right ventricular structural anomalies underwent high-density non-contact mapping of the right ventricle. These were compared to data from 14 RVOT ectopy and 12 patients with supraventricular tachycardias and normal hearts. Endocardial & surface ECG conduction and repolarization parameters were assessed during a standard S1-S2 restitution protocol. Results: Definite ARVC without RV structural disease could not be clearly distinguished from RVOT ectopy during sinus rhythm or during steady state pacing. Delay in Activation Times at coupling intervals just above the ventricular effective refractory period (VERP) increased in definite ARVC (43±20 ms) more than RVOT ectopy patients (36±14 ms, p = 0.03) or Normals (25±16 ms, p = 0.008) and a progressive separation of the repolarisation time curves between groups existed. Repolarization time increases in the RVOT were also greatest in ARVC (definite ARVC: 18±20 ms; RVOT ectopy: 5±14, Normal: 1±18, p<0.05). Surface ECG correlates of these intracardiac measurements demonstrated an increase of greater than 48 ms in stimulus to surface ECG J-point pre-ERP versus steady state, with an 88% specificity and 68% sensitivity in distinguishing definite ARVC from the other groups. This technique could not distinguish patients with genetic predisposition to ARVC only (probable ARVC) from controls. Conclusions: Significant changes in dynamic conduction and repolarization are apparent in early ARVC before detectable RV structural abnormalities, and were present to a lesser degree in probable ARVC patients. Investigation of dynamic electrophysiological parameters may be useful to identify concealed ARVC in patients without disease pedigrees by using endocardial electrogram or paced ECG parameters

Character of superposed states under deterministic LOCC

In this paper we investigate the effect of superposition of states on local conversion of pure bipartite states under deterministic LOCC. We are able to form a bridge between comparable and incomparable classes of states through the linear superposition of states. For example, if we consider two pairs of incomparable states, then their superposition may result into a comparable pair of states. We investigate many such cases and provide some of the results in tabular form. We also investigate the entanglement behavior of such classes of states, specifically their monotone nature. Finally we provide some bounds of different measures of entanglement based on the idea of comparability and incomparability under deterministic LOCC.Comment: 9 pages, pdflatex, no figure, to appear in the journal Quantum Information Processin

BEFRIENding for Depression, Anxiety and Social support in older adults living in Australian residential aged care facilities (BEFRIENDAS): randomised controlled trial protocol.

BACKGROUND: This protocol describes an ongoing study of the impact of befriending on depression, anxiety and loneliness in older people living in residential aged care facilities in Australia. While systematic reviews of befriending have indicated positive benefits of befriending for people in a range of ages and settings, there have been no randomised controlled trials (RCTs) of befriending for older people living in residential aged care with depression and no studies of the cost effectiveness of befriending in residential aged care facilities (RACFs) in Australia. METHODS AND ANALYSIS: We are conducting a single blind pragmatic RCT comparing two groups of older people living in RACFs, one receiving an intervention consisting of weekly befriending for 4 months from a trained volunteer and the other receiving treatment as usual. Participants undergo eligibility screening for depression (GDS-15 ≥ 4) and cognitive impairment (GPCog ≥ 4) and assessments at three measurement time points: baseline prior to randomisation, 2 months post-baseline and 4 months post-baseline. The primary outcome measure is depression, and secondary outcome measures are anxiety, loneliness, social isolation and quality of life. The economic evaluation will take the form of a cost-utility analysis based on the outcome of quality of life. The primary and secondary outcomes will be analysed using negative binomial and logistic regressions utilizing the Generalised Estimating Equations approach. DISCUSSION: To our knowledge, this is the first RCT evaluating the effectiveness of befriending on older people with depression living in residential aged care. It is expected that the befriending intervention will reduce the severity of depression symptoms experienced by older people living in residential aged care. If the intervention proves effective it may be incorporated into volunteer training programs and adopted as a way of supporting older people's mental health. TRIAL REGISTRATION: Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number: ACTRN12619000676112 , registered 06/05/2019 - retrospectively registered

Befriending older adults in nursing homes: volunteer perceptions of switching to remote befriending in the COVID-19 era

Objectives: Residents in nursing homes are being isolated to prevent exposure to COVID-19. Many are prone to depression, anxiety and loneliness, and extra isolation leaves them vulnerable to compromised mental health. In this study, trained volunteers providing befriending for residents with symptoms of depression, anxiety and loneliness switched to remote befriending during COVID-19. The purpose of this study was to gauge volunteer perceptions of the switch. Methods: A qualitative phenomenological approach was used to understand how switching to remote befriending impacted on volunteers and residents. A convenience sample of 18 participants responded to questions either in individual or group interviews. Results: Volunteers adapted their befriending visits, switching from face to face visits to remote options. The format was decided collaboratively. Hearing impairments hindered phone calls. Residents sometimes felt uncomfortable with digital technology but on the whole, the change to remote ‘visiting’ was accepted. Conclusions: Further research is being conducted to gauge mental health outcomes for residents. Most volunteers and residents accepted the switch to remote befriending as better than no contact. Clinical implications: Volunteers can provide valuable support for residents living with social isolation during COVID-19. The format for social support needs to be decided collaboratively between volunteer and resident

Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder

Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Simpson, 2013). However, these treatments are not accessible to many sufferers around the world. Currently available guidelines for care are deemed to be essential but insufficient because of highly variable clinician knowledge and competencies specific to OCD. The phase two mandate of the 14 nation International OCD Accreditation Task Force (ATF) created by the Canadian Institute for Obsessive Compulsive Disorders is development of knowledge and competency standards for specialized treatments for OCD through the lifespan deemed by experts to be foundational to transformative change in this field. This paper presents knowledge and competency standards for specialized CBT for adult OCD developed to inform, advance, and offer a model for clinical practice and training for OCD. During upcoming ATF phases three and four criteria and processes for training in specialized treatments for OCD through the lifespan for certification (individuals) and accreditation (sites) will be developed based on the ATF standards