Origin of the high energy neutrino flux at IceCube

We discuss the spectrum of the different components in the astrophysical neutrino flux reaching the Earth and the possible contribution of each component to the high-energy IceCube data. We show that the diffuse flux from cosmic ray interactions with gas in our galaxy implies just 2 events among the 54 event sample. We argue that the neutrino flux from cosmic ray interactions in the intergalactic (intracluster) space depends critically on the transport parameter $\delta$ describing the energy dependence in the diffusion coefficient of galactic cosmic rays. Our analysis motivates a E^{-2.1} neutrino spectrum with a drop at PeV energies that fits well the data, including the non-observation of the Glashow resonance at 6.3 PeV. We also show that a cosmic ray flux described by an unbroken power law may produce a neutrino flux with interesting spectral features (bumps and breaks) related to changes in the cosmic ray composition.Comment: 19 pages, new section about changes in CR composition, version to appear in Ap

Checklist for the Multidisciplinary Approach to United Airway in Patients with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) and asthma

Dear Editor, The united airways concept calls for a multidisciplinary approach to asthma and/or chronic rhinitis/rhinosinusitis (CRS), aimed at integral airway treatment1, 2 and better coordination among specialists.3 Failure to treat rhinitis/rhinosinusitis is associated with poor asthma control, especially of severe asthma.4, 5 Biological treatments targeting type 2 (T2) inflammatory mediators in severe respiratory diseases offer a new therapeutic option directed against the pathophysiological mechanism of these difficult-to-control united airways diseases (UAD)..

A Wideband Diplexer for Ka-Band Passive Intermodulation Measurement

In this paper we propose a novel Ka-band waveguide diplexer for passive intermodulation (PIM) measurements. Due to the higher operating frequency, this type of measurement setup usually requires wideband filters. In addition, due to the very large separation between satellite uplink and downlink bands, the PIM measurement diplexer unit must operate over a very wide frequency band. To satisfy such wide bandwidth requirements, the proposed topology is based on a band-reject filter for the downlink frequency band which is designed to provide, at the same time, the optimal passband performance for the downlink, and the optimal equiripple rejection over the PIM band. For the PIM channel, a band-pass filter combined with a high-pass section has been used. To validate the design, a prototype has been designed and manufactured. Very good agreement is shown between simulations and measurements, thereby fully validating the proposed solution.Smacchia, D.; Carceller, C.; Guglielmi, M.; Soto Pacheco, P.; Boria Esbert, VE.; Ruiz, J.; González-Santatecla, P. (2018). A Wideband Diplexer for Ka-Band Passive Intermodulation Measurement. IEEE. 1106-1109. https://doi.org/10.1109/MWSYM.2018.84391911106110

Constitutional mismatch repair deficiency (CMMRD) presenting with high-grade glioma, multiple developmental venous anomalies and malformations of cortical development-a multidisciplinary/multicentre approach and neuroimaging clues to clinching the diagnosis

Constitutional mismatch repair deficiency syndrome (CMMRD) is a rare cancer-predisposition syndrome associated with a high risk of developing a spectrum of malignancies in childhood and adolescence, including brain tumours. In this report, we present the case of an 8-year-old boy with acute headache, vomiting and an episode of unconsciousness in whom brain imaging revealed a high-grade glioma (HGG). The possibility of an underlying diagnosis of CMMRD was suspected radiologically on the basis of additional neuroimaging findings, specifically the presence of multiple supratentorial and infratentorial developmental venous anomalies (DVAs) and malformations of cortical development (MCD), namely, heterotopic grey matter. The tumour was debulked and confirmed to be a HGG on histopathology. The suspected diagnosis of CMMRD was confirmed on immunohistochemistry and genetic testing which revealed mutations in PMS2 and MSH6. The combination of a HGG, multiple DVAs and MCD in a paediatric or young adult patient should prompt the neuroradiologist to suggest an underlying diagnosis of CMMRD. A diagnosis of CMMRD has an important treatment and surveillance implications not only for the child but also the family in terms of genetic counselling

Conductance and application of organic molecule pairs as nanofuses

We propose that a pair of organic molecules can mimic the behavior of a macroscopic fuse at nanoscale, one component of the pair being the on state and the other the off state. For this task wemake use of density-functional theory to calculate the physical properties of selected molecules, which have also been synthesized by our team. By this means we obtain the transmission spectra and the current of the proposed devices, which allows us to compare the behavior of the on and off states.Of particular interest is the on/off switch ratios, defined as the current ratios of the on and off structures at the corresponding bias voltage. In a first stage, we examine the best linker between the device and the electrode for high on/off switch ratios. Once this is determined, we test the influence of the electron richness of the system to provide a high on/off switch ratio. The entire analysis is also supported by the molecular projected self-consistent Hamiltonian, which provides a good way of understanding the molecular behavior. All the calculations support that interesting on/off switch ratios of two orders of magnitude could be obtained with these prototypical nanofusesWe thank the Regional Government of Andalucía for financial support (Projects No. P06-FQM-01726 and No. P09-FQM-04571), the “Centro de Supercomputación de la Universidad de Granada,” and the “Centro de Computación Científica-UAM” for computation time. The authors are also grateful to the Spanish Secretaría de Estado de Universidades e Investigación, Ministerio de Educación y Ciencia, for financial support within research projects TEC2007-66812 and TEC2010-16211. N.F. thanks the Regional Government of Andalucía for her research contract, and LAC thanks the University of Granada for his research contrac

New considerations for PM, black carbon and particle number concentration for air quality monitoring across different European cities

In many large cities of Europe standard air quality limit values of particulate matter (PM) are exceeded. Emissions from road traffic and biomass burning are frequently reported to be the major causes. As a consequence of these exceedances a large number of air quality plans, most of them focusing on traffic emissions reductions, have been implemented in the last decade. In spite of this implementation, a number of cities did not record a decrease of PM levels. Thus, is the efficiency of air quality plans overestimated? Do the road traffic emissions contribute less than expected to ambient air PM levels in urban areas? Or do we need a more specific metric to evaluate the impact of the above emissions on the levels of urban aerosols? This study shows the results of the interpretation of the variability of levels of PM, Black Carbon (BC), aerosol number concentration (N) and a number of gaseous pollutants in seven selected urban areas covering road traffic, urban background, urban-industrial, and urban-shipping environments from southern, central and northern Europe. The results showed that variations of PM and N levels do not always reflect the variation of the impact of road traffic emissions on urban aerosols. However, BC levels vary proportionally with those of traffic related gaseous pollutants, such as CO, NO₂ and NO. Due to this high correlation, one may suppose that monitoring the levels of these gaseous pollutants would be enough to extrapolate exposure to traffic-derived BC levels. However, the BC/CO, BC/NO₂ and BC/NO ratios vary widely among the cities studied, as a function of distance to traffic emissions, vehicle fleet composition and the influence of other emission sources such as biomass burning. Thus, levels of BC should be measured at air quality monitoring sites. During morning traffic rush hours, a narrow variation in the N/BC ratio was evidenced, but a wide variation of this ratio was determined for the noon period. Although in central and northern Europe N and BC levels tend to vary simultaneously, not only during the traffic rush hours but also during the whole day, in urban background stations in southern Europe maximum N levels coinciding with minimum BC levels are recorded at midday in all seasons. These N maxima recorded in southern European urban background environments are attributed to midday nucleation episodes occurring when gaseous pollutants are diluted and maximum insolation and O₃ levels occur. The occurrence of SO₂ peaks may also contribute to the occurrence of midday nucleation bursts in specific industrial or shipping-influenced areas, although at several central European sites similar levels of SO₂ are recorded without yielding nucleation episodes. Accordingly, it is clearly evidenced that N variability in different European urban environments is not equally influenced by the same emission sources and atmospheric processes. We conclude that N variability does not always reflect the impact of road traffic on air quality, whereas BC is a more consistent tracer of such an influence. However, N should be measured since ultrafine particles (<100 nm) may have large impacts on human health. The combination of PM₁₀ and BC monitoring in urban areas potentially constitutes a useful approach for air quality monitoring. BC is mostly governed by vehicle exhaust emissions, while PM₁₀ concentrations at these sites are also governed by non-exhaust particulate emissions resuspended by traffic, by midday atmospheric dilution and by other nontraffic emissions

New considerations for PM, Black Carbon and particle number concentration for air quality monitoring across different European cities

In many large cities of Europe standard air quality limit values of particulate matter (PM) are exceeded. Emissions from road traffic and biomass burning are frequently reported to be the major causes. As a consequence of these exceedances a large number of air quality plans, most of them focusing on traffic emissions reductions, have been implemented in the last decade. In spite of this implementation, a number of cities did not record a decrease of PM levels. Thus, is the efficiency of air quality plans overestimated? Do the road traffic emissions contribute less than expected to ambient air PM levels in urban areas? Or do we need a more specific metric to evaluate the impact of the above emissions on the levels of urban aerosols? This study shows the results of the interpretation of the 2009 variability of levels of PM, Black Carbon (BC), aerosol number concentration (N) and a number of gaseous pollutants in seven selected urban areas covering road traffic, urban background, urban-industrial, and urban-shipping environments from southern, central and northern Europe. The results showed that variations of PM and N levels do not always reflect the variation of the impact of road traffic emissions on urban aerosols. However, BC levels vary proportionally with those of traffic related gaseous pollutants, such as CO, NO2 and NO. Due to this high correlation, one may suppose that monitoring the levels of these gaseous pollutants would be enough to extrapolate exposure to traffic-derived BC levels. However, the BC/CO, BC/NO2 and BC/NO ratios vary widely among the cities studied, as a function of distance to traffic emissions, vehicle fleet composition and the influence of other emission sources such as biomass burning. Thus, levels of BC should be measured at air quality monitoring sites. During morning traffic rush hours, a narrow variation in the N/BC ratio was evidenced, but a wide variation of this ratio was determined for the noon period. Although in central and northern Europe N and BC levels tend to vary simultaneously, not only during the traffic rush hours but also during the whole day, in urban background stations in southern Europe maximum N levels coinciding with minimum BC levels are recorded at midday in all seasons. These N maxima recorded in southern European urban background environments are attributed to midday nucleation episodes occurring when gaseous pollutants are diluted and maximum insolation and O3 levels occur. The occurrence of SO2 peaks may also contribute to the occurrence of midday nucleation bursts in specific industrial or shipping-influenced areas, although at several central European sites similar levels of SO2 are recorded without yielding nucleation episodes. Accordingly, it is clearly evidenced that N variability in different European urban environments is not equally influenced by the same emission sources and atmospheric processes. We conclude that N variability does not always reflect the impact of road traffic on air quality, whereas BC is a more consistent tracer of such an influence. However, N should be measured since ultrafine particles (<100 nm) may have large impacts on human health. The combination of PM10 and BC monitoring in urban areas potentially constitutes a useful approach for air quality monitoring. BC is mostly governed by vehicle exhaust emissions, while PM10 concentrations at these sites are also governed by non-exhaust particulate emissions resuspended by traffic, by midday atmospheric dilution and by other non-traffic emissions

Gut microbiota, innate immune pathways, and inflammatory control mechanisms in patients with major depressive disorder

Although alterations in the gut microbiota have been linked to the pathophysiology of major depressive disorder (MDD), including through effects on the immune response, our understanding is deficient about the straight connection patterns among microbiota and MDD in patients. Male and female MDD patients were recruited: 46 patients with a current active MDD (a-MDD) and 22 in remission or with only mild symptoms (r-MDD). Forty-five healthy controls (HC) were also recruited. Psychopathological states were assessed, and fecal and blood samples were collected. Results indicated that the inducible nitric oxide synthase expression was higher in MDD patients compared with HC and the oxidative stress levels were greater in the a-MDD group. Furthermore, the lipopolysaccharide (an indirect marker of bacterial translocation) was higher in a-MDD patients compared with the other groups. Fecal samples did not cluster according to the presence or the absence of MDD. There were bacterial genera whose relative abundance was altered in MDD: Bilophila (2-fold) and Alistipes (1.5-fold) were higher, while Anaerostipes (1.5-fold) and Dialister (15-fold) were lower in MDD patients compared with HC. Patients with a-MDD presented higher relative abundance of Alistipes and Anaerostipes (1.5-fold) and a complete depletion of Dialister compared with HC. Patients with r-MDD presented higher abundance of Bilophila (2.5-fold) compared with HC. Thus, the abundance of bacterial genera and some immune pathways, both with potential implications in the pathophysiology of depression, appear to be altered in MDD, with the most noticeable changes occurring in patients with the worse clinical condition, the a-MDD group. © 2021, The Author(s)

Atypical clinical presentation and long-term survival in a patient with optic nerve medulloepithelioma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Medulloepithelioma is a rare congenital tumor of the primitive medullary neuroepithelium. A significant proportion of patients with medulloepithelioma arising from the optic nerve die from intracranial spread or cerebral metastasis. Because it has no known distinct clinical features and because of its low frequency, this tumor presents within the first two to six years of life and is usually misdiagnosed clinically as a different type of optic nerve tumor. Here, we describe a new and atypical case of medulloepithelioma of the optic nerve in a 12-year-old boy. To the best of our knowledge, he is the oldest reported patient to present with this disease and, now as an adult, has the longest documented period of disease-free survival.</p> <p>Case presentation</p> <p>A 12-year-old Caucasian boy with headache and unilateral amaurosis was referred for a presumed optic nerve glioma to our hospital. A computed tomography scan showed optic nerve enlargement, and fundoscopy showed a whitish mass at the optic disc. Our patient had been followed at his local hospital for four years for an 'optic disc cyst' with no change or progression. He experienced mild progressive visual impairment during that period. He was admitted for resection, and a histopathological analysis revealed a medulloepithelioma of the optic nerve. Supplemental orbital radiotherapy was performed. He remained disease-free for 25 years.</p> <p>Conclusions</p> <p>Medulloepithelioma of the optic nerve can clinically mimic more common pediatric tumors, such as optic glioma, meningioma, or retinoblastoma. Thus, medulloepithelioma should be included in the differential diagnoses of pediatric optic nerve lesions. Fundoscopy in these patients may provide relevant information for diagnosis. Anterior optic nerve medulloepitheliomas may behave differently from and have a better prognosis than medulloepitheliomas that have a more posterior location. Our case report illustrates that long-term survival can be achieved in patients with this malignant tumor.</p

Hughes Abdominal Repair Trial (HART) – Abdominal wall closure techniques to reduce the incidence of incisional hernias: study protocol for a randomised controlled trial

Background Incisional hernias are common complications of midline closure following abdominal surgery and cause significant morbidity, impaired quality of life and increased health care costs. The ‘Hughes Repair’ combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. This theoretically distributes the load along the incision length as well as across it. There is evidence to suggest that this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared the Hughes Repair with standard mass closure for the prevention of incisional hernia formation following a midline incision. Methods/design This is a 1:1 randomised controlled trial comparing two suture techniques for the closure of the midline abdominal wound following surgery for colorectal cancer. Full ethical approval has been gained (Wales REC 3, MREC 12/WA/0374). Eight hundred patients will be randomised from approximately 20 general surgical units within the United Kingdom. Patients undergoing open or laparoscopic (more than a 5-cm midline incision) surgery for colorectal cancer, elective or emergency, are eligible. Patients under the age of 18 years, those having mesh inserted or undergoing musculofascial flap closure of the perineal defect in abdominoperineal wound closure, and those unable to give informed consent will be excluded. Patients will be randomised intraoperatively to either the Hughes Repair or standard mass closure. The primary outcome measure is the incidence of incisional hernias at 1 year as assessed by standardised clinical examination. The secondary outcomes include quality of life patient-reported outcome measures, cost-utility analysis, incidence of complete abdominal wound dehiscence and C-POSSUM scores. The incidence of incisional hernia at 1 year, assessed by computerised tomography, will form a tertiary outcome. Discussion A feasibility phase has been completed. The results of the study will be used to inform current and future practice and potentially reduce the risk of incisional hernia formation following midline incisions