Detailed AGB evolutionary models and near infrared colours of intermediate-age stellar populations: Tests on star clusters

We investigate the influence of Asymptotic Giant Branch stars on integrated colours of star clusters of ages between ~100 Myr and a few gigayears, and composition typical for the Magellanic Clouds. We use state-of-the-art stellar evolution models that cover the full thermal pulse phase, and take into account the influence of dusty envelopes on the emerging spectra. We present an alternative approach to the usual isochrone method, and compute integrated fluxes and colours using a Monte Carlo technique that enables us to take into account statistical fluctuations due to the typical small number of cluster stars. We demonstrate how the statistical variations in the number of Asymptotic Giant Branch stars and the temperature and luminosity variations during thermal pulses fundamentally limit the accuracy of the comparison (and calibration, for population synthesis models that require a calibration of the Asymptotic Giant Branch contribution to the total luminosity) with star cluster integrated photometries. When compared to observed integrated colours of individual and stacked clusters in the Magellanic Clouds, our predictions match well most of the observations, when statistical fluctuations are taken into account, although there are discrepancies in narrow age ranges with some (but not all) set of observations.Comment: 12 pages, 14 figures, accepted for publication in A&

Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study

Fabrizio Cantini, Laura Niccoli, Emanuele Cassarà, Olga Kaloudi, Carlotta NanniniDivision of Rheumatology, Misericordia e Dolce Hospital, Prato, ItalyBackground: The aim of this study was to evaluate the proportion of patients with ankylosing spondylitis maintaining clinical remission after reduction of their subcutaneous etanercept dose to 50 mg every other week compared with that in patients receiving etanercept 50 mg weekly.Methods: In the first phase of this randomized, prospective, follow-up study, all biologic-naïve patients identified between January 2005 and December 2009 as satisfying the modified New York clinical criteria for ankylosing spondylitis treated with etanercept 50 mg weekly were evaluated for disease remission in January 2010. In the second phase, patients meeting the criteria for remission were randomized to receive subcutaneous etanercept as either 50 mg weekly or 50 mg every other week. The randomization allocation was 1:1. Remission was defined as Bath Ankylosing Spondylitis Disease Activity Index < 4, no extra-axial manifestations of peripheral arthritis, dactylitis, tenosynovitis, or iridocyclitis, and normal acute-phase reactants. The patients were assessed at baseline, at weeks 4 and 12, and every 12 weeks thereafter. The last visit constituted the end of the follow-up.Results: During the first phase, 78 patients with ankylosing spondylitis (57 males and 21 females, median age 38 years, median disease duration 12 years) were recruited. In January 2010, after a mean follow-up of 25 ± 11 months, 43 (55.1%) patients achieving clinical remission were randomized to one of the two treatment arms. Twenty-two patients received etanercept 50 mg every other week (group 1) and 21 received etanercept 50 mg weekly (group 2). At the end of follow-up, 19 of 22 (86.3%) subjects in group 1 and 19 of 21 (90.4%) in group 2 were still in remission, with no significant difference between the two groups. The mean follow-up duration in group 1 and group 2 was 22 ± 1 months and 21 ± 1.6 months, respectively.Conclusion: Remission of ankylosing spondylitis is possible in at least 50% of patients treated with etanercept 50 mg weekly. After halving of the etanercept dose, remission is maintained in a high percentage of patients during long-term follow-up, with important economic implications.Keywords: ankylosing spondylitis, anti-tumor necrosis factor, etanercept, remission, dose reductio

Modelling galaxy spectra in presence of interstellar dust - III. From nearby galaxies to the distant Universe

Improving upon the standard evolutionary population synthesis technique, we present spectrophotometric models of galaxies with morphology going from spherical structures to discs, properly accounting for the effect of dust in the interstellar medium (ISM). The models contain three main physical components: the diffuse ISM made of gas and dust, the complexes of molecular clouds where active star formation occurs, and stars of any age and chemical composition. These models are based on robust evolutionary chemical description providing the total amount of gas and stars present at any age, and matching the properties of galaxies of different morphological types. We have considered the results obtained by Piovan et al. for the properties of the ISM, and those by Cassarà et al. for the spectral energy distribution (SED) of single stellar populations, both in presence of dust, to model the integral SEDs of galaxies of different morphological types, going from pure bulges to discs passing through a number of composite systems with different combinations of the two components. The first part of the paper is devoted to recall the technical details of the method and the basic relations driving the interaction between the physical components of the galaxy. Then, the main parameters are examined and their effects on the SED of three prototype galaxies are highlighted. The theoretical SEDs nicely match the observational ones both for nearby galaxies and those at high redshift

From Parental Bonding to Problematic Gaming: The Mediating Role of Adult Attachment Styles

Background: Research has found that parental failures of care during childhood and insecure attachment styles are positively associated with problematic gaming. From a developmental framework, it is possible to hypothesize that attachment styles mediate the relationship between parental bonding and problematic gaming. Methods: This hypothesis was tested in a sample of 598 videogame players (410 males, 68.56%) aged between 18 and 61 years old (M = 26.68, SD = 7.23). Participants were recruited through an online survey. Self-report instruments were administered to assess problematic gaming, parental bonding, and adult attachment styles. Results: Positive paternal care was a direct and negative predictor of problematic gaming, whereas maternal overprotection indirectly predicted problematic gaming through preoccupied attachment. Conclusions: These findings suggest that positive paternal care represents a protective factor for problematic gaming; in contrast, maternal overprotection might foster a negative view of the self in the child, which increases the risk to excessively use videogames, perhaps as a maladaptive coping strategy to regulate negative feelings. Prevention programs might be aimed to improve the responsiveness of parents towards the child’s emotional needs, to prevent the development of problematic gaming. Also, clinical intervention with problematic gamers might foster their feelings of security toward relationships, to promote both a healthier use of videogames and a better quality of life

Simulation for Operational Readiness in a New Freestanding Emergency Department: Strategy and Tactics

© 2016 by the Society for Simulation in Healthcare. Statement Simulation in multiple contexts over the course of a 10-week period served as a core learning strategy to orient experienced clinicians before opening a large new urban freestanding emergency department. To ensure technical and procedural skills of all team members, who would provide care without on-site recourse to specialty backup, we designed a comprehensive interprofessional curriculum to verify and regularize a wide range of competencies and best practices for all clinicians. Formulated under the rubric of systems integration, simulation activities aimed to instill a shared culture of patient safety among the entire cohort of 43 experienced emergency physicians, physician assistants, nurses, and patient technicians, most newly hired to the health system, who had never before worked together. Methods throughout the preoperational term included predominantly hands-on skills review, high-fidelity simulation, and simulation with standardized patients. We also used simulation during instruction in disaster preparedness, sexual assault forensics, and community outreach. Our program culminated with 2 days of in-situ simulation deployed in simultaneous and overlapping timeframes to challenge system response capabilities, resilience, and flexibility; this work revealed latent safety threats, lapses in communication, issues of intake procedure and patient flow, and the persistence of inapt or inapplicable mental models in responding to clinical emergencies

An innovative technique to improve safety of volatile anesthetics suction from the cardiopulmonary bypass circuit

Context: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB. Aims: The aim of this study is to improve the safe administration of volatile anesthesia during CPB. Settings and Design: Tertiary teaching hospital. Subjects and Methods: We describe an original device that collects and disposes of any volatile anesthetic vapors present in the exit stream of the oxygenator, hence preventing its dispersal into the operating theatre environment and adaptively regulates pressure of oxygenator chamber in the CPB circuit. Results: We have so far applied a prototype of this device in more than 1300 adult cardiac surgery patients who received volatile anesthetics during the CPB phase. Conclusions: Widespread implementation of scavenging system like the one we designed may facilitate the perfusionist and the anesthesiologist in delivering these cardioprotective drugs with beneficial impact on patients' outcome without compromising on safety

Local multi-channel RF surface coil versus body RF coil transmission for cardiac magnetic resonance at 3 Tesla: which configuration is winning the game?

INTRODUCTION: The purpose of this study was to demonstrate the feasibility and efficiency of cardiac MR at 3 Tesla using local four-channel RF coil transmission and benchmark it against large volume body RF coil excitation. METHODS: Electromagnetic field simulations are conducted to detail RF power deposition, transmission field uniformity and efficiency for local and body RF coil transmission. For both excitation regimes transmission field maps are acquired in a human torso phantom. For each transmission regime flip angle distributions and blood-myocardium contrast are examined in a volunteer study of 12 subjects. The feasibility of the local transceiver RF coil array for cardiac chamber quantification at 3 Tesla is demonstrated. RESULTS: Our simulations and experiments demonstrate that cardiac MR at 3 Tesla using four-channel surface RF coil transmission is competitive versus current clinical CMR practice of large volume body RF coil transmission. The efficiency advantage of the 4TX/4RX setup facilitates shorter repetition times governed by local SAR limits versus body RF coil transmission at whole-body SAR limit. No statistically significant difference was found for cardiac chamber quantification derived with body RF coil versus four-channel surface RF coil transmission. Our simulation also show that the body RF coil exceeds local SAR limits by a factor of ~2 when driven at maximum applicable input power to reach the whole-body SAR limit. CONCLUSION: Pursuing local surface RF coil arrays for transmission in cardiac MR is a conceptually appealing alternative to body RF coil transmission, especially for patients with implants

Discovery of a rich proto-cluster at z=2.9 and associated diffuse cold gas in the VIMOS Ultra-Deep Survey (VUDS)

[Abridged] We characterise a massive proto-cluster at z=2.895 that we found in the COSMOS field using the spectroscopic sample of the VIMOS Ultra-Deep Survey (VUDS). This is one of the rare structures at z~3 not identified around AGNs or radio galaxies, so it is an ideal laboratory to study galaxy formation in dense environments. The structure comprises 12 galaxies with secure spectroscopic redshift in an area of 7'x8', in a z bin of Dz=0.016. The measured galaxy number overdensity is delta_g=12+/-2. This overdensity has total mass of M~8.1x10^(14)M_sun in a volume of 13x15x17 Mpc^3. Simulations indicate that such an overdensity at z~2.9 is a proto-cluster that will collapse in a cluster of total mass M~2.5x10^(15)M_sun at z=0. We compare the properties of the galaxies within the overdensity with a control sample at the same z but outside the overdensity. We did not find any statistically significant difference between the properties (stellar mass, SFR, sSFR, NUV-r, r-K) of the galaxies inside and outside the overdensity. The stacked spectrum of galaxies in the overdensity background shows a significant absorption feature at the wavelength of Lya redshifted at z=2.895 (lambda=4736 A), with a rest frame EW = 4+/- 1.4 A. Stacking only background galaxies without intervening sources at z~2.9 along their line of sight, we find that this absorption feature has a rest frame EW of 10.8+/-3.7 A, with a detection S/N of ~4. These EW values imply a high column density (N(HI)~3-20x10^(19)cm^(-2)), consistent with a scenario where such absorption is due to intervening cold gas streams, falling into the halo potential wells of the proto-cluster galaxies. However, we cannot exclude the hypothesis that this absorption is due to the diffuse gas within the overdensity.Comment: 15 pages, 9 figures, accepted for publication in A&A (revised version after referee's comments and language editing