Surgical treatment of benign parapharyngeal space tumours : presentation of two clinical cases and revision of the literature

Parapharyngeal space (PPS) tumours, most of them benign, account for some 0.5% of tumours of the head and neck. The importance of these tumours lies mainly in two aspects: on the one hand, the difficulty of early diagnosis, due to the lack of symptoms in the initial stages and, on the other, the extreme complications of performing surgery in the parapharyngeal region. This article discusses two clinical cases of parapharyngeal space tumours: a 45 year old man and a 60 year old woman. We revise the scientific literature and analyse the diagnostic and therapeutic procedures used, placing special emphasis on describing the different surgical approaches to the parapharyngeal space: transcervical, transcervical-transparotid, transpalatal or transoral, transmandibular and orbitozygomatic, all of which, used alone or combined with others, allow for complete resection of these tumours with minimum morbidity

Urban wastewater disinfection for agricultural reuse: Effect of solar driven AOPs in the inactivation of a multidrug resistant E. coli strain

The occurrence of antibiotics in urban wastewater treatment plants (UWTPs) may result in the development of antibiotic resistance and subsequently in the release of multidrug resistant bacteria (MDR) and genes into the effluent. Conventional disinfection processes are only partially effective in controlling ARB spread, so advanced oxidation processes (AOPs) have been investigated as alternative option in this work. In particular, the aim of this work was to comparatively assess the efficiency of solar disinfection and solar driven AOPs (namely H2O2/sunlight, TiO2/sunlight, H2O2/TiO2/sunlight, natural photo-Fenton) for the inactivation of a multidrug (namely ampicillin, ciprofloxacin and tetracycline) resistant E. coli strain isolated from the effluent of the biological process of an UWTP. Different concentrations of H2O2 (0.588–1.470–2.205 mM), TiO2 (50–100 mg L−1), H2O2/TiO2 (0.147 mM/50 mg L−1, 0.588 mM/100 mg L−1) and Fe2+/H2O2 (0.090/0.294, 0.179/0.588, 0.358/1.176 mM) were evaluated at pilot-scale (in compound parabolic collector reactor) in real biologically treated wastewater. All investigated processes resulted in a complete inactivation (5-log decrease) of bacteria until detection limit, but the best disinfection efficiency in terms of treatment time (20 min to reach the detection limit) and required energy (0.98 kJ L−1) was observed for photo-Fenton at pH 4 (Fe2+/H2O2:0.090/0.294 mM). Antimicrobial susceptibility was tested by Kirby-Bauer disk diffusion method. Ampicillin and ciprofloxacin (to which the selected strain is resistant), cefuroxime and nitrofurantoin were chosen as tested antibiotics. None of the investigated processes affected antibiotic resistance of survived colonies

Influence of Multiple Conformations and Paths on Rate Constants and Product Branching Ratios. Thermal Decomposition of 1-Propanol Radicals

The potential energy surface involved in the thermal decomposition of 1-propanol radicals was investigated in detail using automated codes (tsscds2018 and Q2DTor). From the predicted elementary reactions, a relevant reaction network was constructed to study the decomposition at temperatures in the range 1000–2000 K. Specifically, this relevant network comprises 18 conformational reaction channels (CRCs), which in general exhibit a large wealth of conformers of reactants and transition states. Rate constants for all the CRCs were calculated using two approaches within the formulation of variational transition-state theory (VTST), as incorporated in the TheRa program. The simplest, one-well (1W) approach considers only the most stable conformer of the reactant and that of the transition state. In the second, more accurate approach, contributions from all the reactant and transition-state conformers are taken into account using the multipath (MP) formulation of VTST. In addition, kinetic Monte Carlo (KMC) simulations were performed to compute product branching ratios. The results show significant differences between the values of the rate constants calculated with the two VTST approaches. In addition, the KMC simulations carried out with the two sets of rate constants indicate that, depending on the radical considered as reactant, the 1W and the MP approaches may display different qualitative pictures of the whole decomposition processThis work was partially supported by the Consellería de Cultura, Educación e Ordenación Universitaria e da Consellería de Economía, Emprego e Industria (Axuda para Consolidación e Estructuración de unidades de investigación competitivas do Sistema Universitario de Galicia, Xunta de Galicia ED431C 2017/17 & Centro singular de investigación de Galicia acreditación 2016-2019, ED431G/09), the Ministerio de Economía y Competitividad of Spain (Research Grant No CTQ2014-58617-R), and the European Regional Development Fund (ERDF). D.F.-C. also thanks Xunta de Galicia for financial support through a postdoctoral grant. The authors thank “Centro de Supercomputación de Galicia (CESGA)” for the use of their computational facilitiesS

The role experience of advanced practice nurses in oncology: An interpretative phenomenological study.

Aim(s): To understand the experiences of advanced practice nurses working in cancer care. Design: Phenomenological qualitative study. Methods: Three focus groups were held to collect qualitative data. Participants were recruited through theoretical non-probabilistic sampling of maximum variation, based on 12 profiles. Data saturation was achieved with a final sample of 21 oncology advanced practice nurses who were performing advanced clinical practice roles in the four centers from December 2021 to March 2022. An interpretative phenomenological analysis was performed following Guba and Lincoln's criteria of trustworthiness. The centers' ethics committee approved the study, and all participants gave written informed consent. Data analysis was undertaken with NVivo 12 software. Results: Three broad themes emerged from the data analysis: the role performed, facilitators and barriers in the development of the role and nurses' lived experience of the role. Conclusion: Advanced practice nurses are aware that they do not perform their role to its full potential, and they describe different facilitators and barriers. Despite the difficulties, they present a positive attitude as well as a capacity for leadership, which has allowed them to consolidate the advanced practice nursing role in unfavourable environments. Implications for the profession: These results will enable institutions to establish strategies at different levels in the implementation and development of advanced practice nursing roles. Reporting method: Reporting complied with COREQ criteria for qualitative research. Patient or public contributions: No patient or public contribution

A long-period Cepheid variable in the starburst cluster VdBH222

Galactic starburst clusters play a twin role in astrophysics, serving as laboratories for the study of stellar physics and also delineating the structure and recent star formation history of the Milky Way. In order to exploit these opportunities we have undertaken a multi-epoch spectroscopic survey of the red supergiant dominated young massive clusters thought to be present at both near and far ends of the Galactic Bar. Significant spectroscopic variability suggestive of radial pulsations was found for the yellow supergiant VdBH 222 #505. Follow-up photometric investigations revealed modulation with a period of ~23.325d; both timescale and pulsational profile are consistent with a Cepheid classification. As a consequence #505 may be recognised as one of the longest period Galactic cluster Cepheids identified to date and hence of considerable use in constraining the bright end of the period/luminosity relation at solar metallicities. In conjunction with extant photometry we infer a distance of ~6kpc for VdBH222 and an age of ~20Myr. This results in a moderate reduction in both integrated cluster mass (~2x10^4Msun) and the initial stellar masses of the evolved cluster members (~10Msun). As such, VdBH222 becomes an excellent test-bed for studying the properties of some of the lowest mass stars observed to undergo type-II supernovae. Moreover, the distance is in tension with a location of VdBH 222 at the far end of the Galactic Bar. Instead a birthsite in the near 3kpc arm is suggested; providing compelling evidence of extensive recent star formation in a region of the inner Milky Way which has hitherto been thought to be devoid of such activity

The effect of a live music therapy intervention on critically ill paediatric patients in the intensive care unit: A quasi-experimental pretest-posttest study

Background: Music therapy as a nonpharmacological means of managing patient pain, anxiety, and discomfort is a recognised technique, although it is not widely used in the paediatric intensive care unit (PICU). Aim: The aim of this study was to assess the clinical effect of a live music therapy intervention on vital signs and levels of discomfort and pain for paediatric patients in the PICU. Methods: This was a quasi-experimental pretesteposttest study. The music therapy intervention was carried out by two music therapists who were specifically trained, each possessing a master's degree in the field of hospital music therapy. Ten minutes before the start of the music therapy session, the investigators recorded the vital signs of the patients and assessed their levels of discomfort and pain. The procedure was repeated at the start of the intervention; at 2, 5, and 10 min during the intervention; and at 10 min following the conclusion of the intervention. Results: Two hundred fifty-nine patients were included; 55.2% were male, with a median age of 1 year (0 e21). A total of 96 (37.1%) patients suffered a chronic illness. The main reason for PICU admission was respiratory illness, at 50.2% (n ¼ 130). Significantly lower values were observed for heart rate (p ¼ 0.002), breathing rate (p < 0.001), and degree of discomfort (p < 0.001) during the music therapy session. Conclusions: Live music therapy results in reduced heart rates, breathing rates, and paediatric patient discomfort levels. Although music therapy is not widely used in the PICU, our results suggest that using interventions such as that used in this study could help reduce patient discomfor

Measurement of the Ge 70 (n,γ) cross section up to 300 keV at the CERN n-TOF facility

©2019 American Physical Society.Neutron capture data on intermediate mass nuclei are of key importance to nucleosynthesis in the weak component of the slow neutron capture processes, which occurs in massive stars. The (n,γ) cross section on Ge70, which is mainly produced in the s process, was measured at the neutron time-of-flight facility n-TOF at CERN. Resonance capture kernels were determined up to 40 keV neutron energy and average cross sections up to 300 keV. Stellar cross sections were calculated from kT=5 keV to kT=100 keV and are in very good agreement with a previous measurement by Walter and Beer (1985) and recent evaluations. Average cross sections are in agreement with Walter and Beer (1985) over most of the neutron energy range covered, while they are systematically smaller for neutron energies above 150 keV. We have calculated isotopic abundances produced in s-process environments in a 25 solar mass star for two initial metallicities (below solar and close to solar). While the low metallicity model reproduces best the solar system germanium isotopic abundances, the close to solar model shows a good global match to solar system abundances in the range of mass numbers A=60-80.Peer reviewedFinal Published versio

Search for the standard model Higgs boson in the H to ZZ to 2l 2nu channel in pp collisions at sqrt(s) = 7 TeV

A search for the standard model Higgs boson in the H to ZZ to 2l 2nu decay channel, where l = e or mu, in pp collisions at a center-of-mass energy of 7 TeV is presented. The data were collected at the LHC, with the CMS detector, and correspond to an integrated luminosity of 4.6 inverse femtobarns. No significant excess is observed above the background expectation, and upper limits are set on the Higgs boson production cross section. The presence of the standard model Higgs boson with a mass in the 270-440 GeV range is excluded at 95% confidence level.Comment: Submitted to JHE