Necrotizing soft tissue infections - a multicentre, prospective observational study (INFECT) : Protocol and statistical analysis plan

Background: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating these to patient-important outcomes. With this protocol and statistical analysis plan we describe the methods used to obtain data and the details of the planned analyses. Methods: The INFECT study is a multicentre, prospective observational cohort study. Patients with NSTIs are enrolled in five Scandinavian hospitals, which are all referral centres for NSTIs. The primary outcomes are the descriptive variables of the patients. Secondary outcomes include identification of factors associated with 90-day mortality and amputation; associations between affected body part, maximum skin defect and Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and 90-day mortality; 90-day mortality in patients with and without acute kidney injury (AKI) and LRINEC score of six and above or below six; and association between affected body part at arrival and microbiological findings. Exploratory outcomes include univariate analyses of baseline characteristics associations with 90-day mortality. The statistical analyses will be conducted in accordance with the predefined statistical analysis plan. Conclusion: Necrotizing soft tissue infections result in severe morbidity and mortality. The INFECT study will be the largest prospective study in patients with NSTIs to date and will provide important data for clinicians, researchers and policy makers on the characteristics and outcomes of these patients.</p

"Tomography" of the cluster structure of light nuclei via relativistic dissociation

These lecture notes present the capabilities of relativistic nuclear physics for the development of the physics of nuclear clusters. Nuclear track emulsion continues to be an effective technique for pilot studies that allows one, in particular, to study the cluster dissociation of a wide variety of light relativistic nuclei within a common approach. Despite the fact that the capabilities of the relativistic fragmentation for the study of nuclear clustering were recognized quite a long time ago, electronic experiments have not been able to come closer to an integrated analysis of ensembles of relativistic fragments. The continued pause in the investigation of the "fine" structure of relativistic fragmentation has led to resumption of regular exposures of nuclear emulsions in beams of light nuclei produced for the first time at the Nuclotron of the Joint Institute for Nuclear Research (JINR, Dubna). To date, an analysis of the peripheral interactions of relativistic isotopes of beryllium, boron, carbon and nitrogen, including radioactive ones, with nuclei of the emulsion composition, has been performed, which allows the clustering pattern to be presented for a whole family of light nuclei.Comment: ISBN 978-3-319-01076-2. 55 pages, 28 figure

Efectos y beneficios del entrenamiento de fuerza en pacientes con cáncer: revisión sistemática de la literatura

Introduction: cancer is among the diseases having the greatest mortality rates and the cause of many disabilities worldwide. The practice of exercise is developed as an adjuvant therapy along with the cancer treatment to reduce mortality and disability in the different types of cancer.Objective: to identify the effects of strength training on cancer patients.Methods: a complete review of the medical literature was conducted until December 2018, scientific articles published in indexed bases from 2015 to 2018. The studies included were in population over 18 years old with cancer diagnosis regardless of sociodemographic characteristics, type or stage of cancer. The data extracted were on the population, intervention and control groups, type of cancer, period, frequency of intervention and results.Results: during the first search 36071 titles of clinical study were found in specialized journals. 10 experimental studies were chosen. Multiple positive effects were found, as well as components that should be taken into account when performing strength training on cancer patients or cancer survivors.Conclusions: strength training in patients with cancer or survivors of this disease, helps them to improve their symptoms as well as their quality of life, strength, improved mobility and pain, among others. Also, strength training is beneficial to patients without causing adverse effects or long-term complications.Introducción: El cáncer se encuentra entre las enfermedades con mayor mortalidad y causante de un gran número de discapacidades a nivel mundial. El ejercicio surge como un coadyuvante del tratamiento oncológico para disminuir la mortalidad y discapacidad en los diferentes tipos de cáncer.Objetivo: Identificar los efectos del entrenamiento de fuerza en pacientes con cáncer.Método:  Se realizó una revisión de la literatura hasta diciembre del 2018, de artículos científicos publicados en bases de indexadas desde 2015 y hasta 2018. Los estudios incluidos fueron en población mayor a 18 años con diagnóstico de cáncer sin importar características sociodemográficas, tipo o estadio del cáncer. Los datos extraídos fueron sobre la población, grupos de intervención y control, tipo de cáncer, periodo, frecuencia de la intervención y resultados.Resultados: Durante la primera búsqueda 36071 títulos de estudios clínicos fueron encontrados en revistas especializadas. Al final 10 estudios de carácter experimental fueron seleccionados. En dichos estudios, múltiples efectos fueron encontrados, así como componentes que se deben tener en cuenta a realizar un entrenamiento de fuerza en pacientes con cáncer o sobrevivientes del mismo.Conclusiones: El entrenamiento de fuerza en pacientes con cáncer o sobrevivientes de esta enfermedad, les ayuda a mejorar su sintomatología al igual que su calidad de vida, fatiga, fuerza, mejoría en la movilidad y el dolor, entre otros. Así mismo, el entrenamiento de fuerza es beneficioso para los pacientes sin causar efectos adversos o complicaciones a largo plazo

Diabetes and necrotizing soft tissue infections—A prospective observational cohort study : Statistical analysis plan

Background: Necrotizing soft tissue infections (NSTIs) are rare but carry a high morbidity and mortality. The multicenter INFECT project aims to improve the understanding of the pathogenesis, clinical characteristics, diagnosis, and prognosis of NSTIs. This article describes the study outline and statistical analyses that will be used. Methods: Within the framework of INFECT project, patients with NSTI at 5 Scandinavian hospitals are enrolled in a prospective observational cohort study. The goal is to evaluate outcome and characteristics for patients with NSTI and diabetes compared to patients with NSTI without diabetes. The primary outcome is mortality at 90 days after inclusion. Secondary outcomes include days alive and out of ICU and hospital, SAPS II, SOFA score, infectious etiology, amputation, affected body area, and renal replacement therapy. Comparison in mortality between patients with diabetes type 1 and 2 as well as between insulin-treated and non-insulin–treated diabetes patients will be made. Clinical data for diabetic patients with NSTI will be reported. Conclusion: The study will provide important data on patients with NSTI and diabetes.</p

Observation of γ-delayed 3α breakup of the 15.11 and 12.71 MeV states in 12C

6 pags., 4 figs., 2 tabs. -- PACS:27.20.+n25.55.Hp23.20.-g29.85.-cThe reactions 10B (3He, p α α α) at 4.9 MeV and 11B (3He, d α α α) at 8.5 MeV have been used to investigate the γ decay of states in 12C. By measuring the four-body final state in complete kinematics we are able to detect γ transitions indirectly. We find γ transitions from the 15.11 MeV state in 12C to the 12.71, 11.83, 10.3 and 7.65 MeV states followed by their breakup into three α particles. The relative γ-ray branching ratios obtained are (1.2 ± 0.3), (0.32 ± 0.12), (1.4 ± 0.2) and (4.4 ± 0.8) %, respectively, with the remaining (92.7 ± 1.0) % of the γ decays going to the bound states. We obtain Γα / Γ = (2.8 ± 1.2) % for the isospin-forbidden α decay of the 15.11 MeV state. From the 12.71 MeV state we find γ transitions to the 10.3 and 7.65 MeV states. The relative γ-ray branching ratios are (0.9- 0.5 + 0.6) and (2.6- 1.2 + 1.6) %, respectively, with the remaining (96.6- 1.3 + 1.7) % of the γ decays going to the bound states. Finally, we discuss the relation between the β decay of 12N and 12B to states in 12C and the γ decay of the 15.11 MeV analog in 12C to the same states. © 2009 Elsevier B.V.We would like to acknowledge the support of the Spanish CICYT research grant FPA2007-62170 and the MICINN Consolider Project CSD 2007-00042 as well as the support of the European Union VI Framework through RII3-EURONS/JRA4-DLEP (contract number 506065). D.G. is a Juan de la Cierva fellow

The β-decay approach for studying 12C

6 pags., 3 figs. -- 9th International Conference on Clustering Aspects of Nuclear Structure and Dynamics (CLUSTERS'07) 3–7 September 2007, Stratford upon Avon, UKThe β-decays of the mirror nuclei 12B and 12N both populate states in 12C and they are therefore a precious source of information about this nucleus. Due to the selection rules of β-decay only 0+, 1+ and 2+ states are populated. This allows a very clean study of unbound states just above the 3α-threshold with those spin and parities. This probe has been applied in two experiments using two complementary experimental techniques: in the first the three α-particles emitted after β-decay are measured in coincidence in separate detectors using the ISOL method, while in the second method 12B and 12N are implanted in a detector and the summed energy of the three α-particles is measured directly. Preliminary results from the two approaches are presented. © 2008 IOP Publishing Ltd

High-sensitivity study of levels in Al-30 following beta decay of Mg-30

gamma-ray and fast-timing spectroscopy were used to study levels in Al-30 populated following the beta(-) decay of Mg-30. Five new transitions and three new levels were located in Al-30. A search was made to identify the third 1(+) state expected at an excitation energy of similar to 2.5 MeV. Two new levels were found, at 3163.9 and 3362.5 keV, that are firm candidates for this state. Using the advanced time-delayed (ATD) beta gamma gamma (t) method we have measured the lifetime of the 243.8-keV state to be T-1/2 = 15(4) ps, which implies that the 243.8-keV transition is mainly of M1 character. Its fast B(M1; 2(+) -> 3(+)) value of 0.10(3) W.u. is in very good agreement with the USD shell-model prediction of 0.090 W.u. The 1801.5-keV level is the only level observed in this study that could be a candidate for the second excited 2(+) state.Peer reviewe

Branching ratios in the β decays of N12 and B12

Absolute branching ratios to unbound states in C12 populated in the β decays of N12 and B12 are reported. Clean sources of N12 and B12 were obtained using the isotope separation on-line (ISOL) method. The relative branching ratios to the different populated states were extracted using single-alpha as well as complete kinematics triple-alpha spectra. These two largely independent methods give consistent results. Absolute normalization is achieved via the precisely known absolute branching ratio to the bound 4.44 MeV state in C12. The extracted branching ratios to the unbound states are a factor of three more precise than previous measurements. Branching ratios in the decay of Na20 are also extracted and used to check the results. © 2009 The American Physical Society.Supported by the Academy of Finland (Project No. 44875), by the Spanish Agency CICYT (Nos. FPA2007–62170 and FPA2007–62216), by the European Union Sixth Framework Programme “EURONS” (No. 506065), by the Swedish Research Council, and the Knut and Alice Wallenberg foundation.Peer Reviewe