Resonant Absorption of Axisymmetric Modes in Twisted Magnetic Flux Tubes

It has been shown recently that magnetic twist and axisymmetric MHD modes are ubiquitous in the solar atmosphere, and therefore the study of resonant absorption for these modes has become a pressing issue because it can have important consequences for heating magnetic flux tubes in the solar atmosphere and the observed damping. In this investigation, for the first time, we calculate the damping rate for axisymmetric MHD waves in weakly twisted magnetic flux tubes. Our aim is to investigate the impact of resonant damping of these modes for solar atmospheric conditions. This analytical study is based on an idealized configuration of a straight magnetic flux tube with a weak magnetic twist inside as well as outside the tube. By implementing the conservation laws derived by Sakurai et al. and the analytic solutions for weakly twisted flux tubes obtained recently by Giagkiozis et al. we derive a dispersion relation for resonantly damped axisymmetric modes in the spectrum of the Alfvén continuum. We also obtain an insightful analytical expression for the damping rate in the long wavelength limit. Furthermore, it is shown that both the longitudinal magnetic field and the density, which are allowed to vary continuously in the inhomogeneous layer, have a significant impact on the damping time. Given the conditions in the solar atmosphere, resonantly damped axisymmetric modes are highly likely to be ubiquitous and play an important role in energy dissipation. We also suggest that, given the character of these waves, it is likely that they have already been observed in the guise of Alfvén waves

Calculation of Options of Possible Aggressive Button Between the Fans of Football Teams with the Use of Combinatory

Calculations of possible induced aggression among fans of football teams at large-capacity stadiums were carried out. For the first time, combinatorics methods have been used for these purposes. The author proposes a classification of stadiums according to the criterion of potential social aggression. "Ekaterinburg Arena" assigned to the second category of this classification. An example of organizational, planning and architectural decisions, reducing the risk of induced social aggression of fans during sporting mega-events, is given.Выполнены расчеты вариантов возможной индуцированной агрессии среди фанатов футбольных команд на стадионах большой вместимости. Впервые для этих целей использованы методы комбинаторики. Предложена авторская классификация стадионов по критерию потенциальной социальной агрессии. «Екатеринбург Арена» отнесена ко второй категории данной классификации. Приведен пример организационных, планировочных и архитектурных решений, снижающий риск индуцированной социальной агрессии фанатов во время проведения спортивных мегасобытий

A Helicity-Based Method to Infer the CME Magnetic Field Magnitude in Sun and Geospace: Generalization and Extension to Sun-Like and M-Dwarf Stars and Implications for Exoplanet Habitability

Patsourakos et al. (Astrophys. J. 817, 14, 2016) and Patsourakos and Georgoulis (Astron. Astrophys. 595, A121, 2016) introduced a method to infer the axial magnetic field in flux-rope coronal mass ejections (CMEs) in the solar corona and farther away in the interplanetary medium. The method, based on the conservation principle of magnetic helicity, uses the relative magnetic helicity of the solar source region as input estimates, along with the radius and length of the corresponding CME flux rope. The method was initially applied to cylindrical force-free flux ropes, with encouraging results. We hereby extend our framework along two distinct lines. First, we generalize our formalism to several possible flux-rope configurations (linear and nonlinear force-free, non-force-free, spheromak, and torus) to investigate the dependence of the resulting CME axial magnetic field on input parameters and the employed flux-rope configuration. Second, we generalize our framework to both Sun-like and active M-dwarf stars hosting superflares. In a qualitative sense, we find that Earth may not experience severe atmosphere-eroding magnetospheric compression even for eruptive solar superflares with energies ~ 10^4 times higher than those of the largest Geostationary Operational Environmental Satellite (GOES) X-class flares currently observed. In addition, the two recently discovered exoplanets with the highest Earth-similarity index, Kepler 438b and Proxima b, seem to lie in the prohibitive zone of atmospheric erosion due to interplanetary CMEs (ICMEs), except when they possess planetary magnetic fields that are much higher than that of Earth.Comment: http://adsabs.harvard.edu/abs/2017SoPh..292...89

Проблема раннего восстановления удержания мочи после радикальной простатэктомии

Background. The highest rate of incontinence after radical prostatectomy (RP) is observed in the first 2–6 months after surgery. In order  to decrease the period of incontinence, virous surgical methods aimed at preservation and reconstruction of structures participating  in the mechanism of urine retention has been developed and improved.The study objective is to evaluate effectiveness of an original method of formation of an urethral anastomosis in the early continence recovery.Materials and methods. Data on 126 patients who underwent retropubic RP were analyzed. Depending on the method of urethral anastomosis formation, patients were divided into 2 groups: in the 1st group (n = 52) the patients underwent PR with urethra suspension m. levator ani, in the 2nd (n = 74) – standard RP. In the 1st group, 6 ligatures were applied to the anterior and posterior urethra walls: at the 12 and 6 hour projections through the mucosa, submucosa, and smooth muscle; at the 10, 2, 4, and 8 hour projections – more laterally with capture of the m. levator ani medial margins. Continence recovery was evaluated on days 1, 7, and 14 after urinary catheter removal and then at days 30, 90, 180, and 365 after RP. The criteria of continence were absence of urine leakage at rest and during physical activity and a necessity of using a safety liner.Results. There weren’t any significant differences at day 1 after urinary catheter removal between the two groups (р > 0.05). In the 1st group, continence values at days 30, 90, and 180 after RP were significantly higher (57.7, 69.2, and 71.1 %, respectively) compared to the 2nd group (35.1, 41.9, and 51.3 %, respectively) (р <0.05).Conclusion. Results of this work show significant benefits of RP with urethra suspension m. levator ani compared to standard RP per continence recovery criteria at days 7, 14, 30, 90, and 180 after the surgery. The technique of urethra suspension m. levator ani is easy to perform and ensures early continence recovery after RP.Введение. Часто недержание мочи после выполнения радикальной простатэктомии (РПЭ) регистрируют в первые 2–6 мес после оперативного вмешательства. В целях сокращения периода инконтиненции разработаны и усовершенствованы различные хирургические методы, направленные на сохранение и восстановление структур, участвующих в механизме удержания мочи.Цель работы – оценить эффективность применения оригинального метода формирования уретроцистоанастомоза в раннем восстановлении функции удержания мочи.Материалы и методы. Проанализированы данные 126 пациентов, подвергнутых позадилонной РПЭ. В зависимости от метода формирования уретроцистоанастомоз больные были разделены на 2 группы: пациентам 1-й группы (n = 52) выполнена РПЭ с суспензией уретры m. levator ani, 2-й (n = 74) – стандартная РПЭ. В 1-й группе на переднюю и заднюю стенки уретры накладывали 6 лигатур: в проекции 12 и 6 ч условного циферблата через слизистую, подслизистую оболочки и гладкомышечный слой; на 10, 2, 4 и 8 ч – более латерально с захватом медиальных краев m. levator ani. Восстановление функции удержания мочи оценивали через 1, 7 и 14 сут с момента удаления уретрального катетера и далее через 30, 90, 180 и 365 сут после проведения РПЭ. Критерием удержания мочи служило отсутствие подтекания мочи в покое или при физической нагрузке и необходимости использования страховочной прокладки.Результаты. Достоверных различий в показателях удержания мочи на 1-е сутки после удаления уретрального катетера в обеих группах не выявлено (р >0,05). В 1-й группе показатели континенции через 30, 90 и 180 сут после выполнения РПЭ были достоверно выше (57,7; 69,2 и 71,1 % соответственно) по сравнению со 2-й группой (35,1; 41,9 и 51,3 % соответственно) (р <0,05). Заключение. Результаты настоящей работы демонстрируют значительные преимущества РПЭ с суспензией уретры m. levator ani по сравнению со стандартной РПЭ по показателю восстановления континенции на 7, 14, 30, 90 и 180-е сутки после операции. Техника суспензии уретры m. levator ani проста в выполнении и обеспечивает восстановление функции удержания мочи в более ранние сроки после РПЭ

Improved Upper Limit on the Neutrino Mass from a Direct Kinematic Method by KATRIN.

We report on the neutrino mass measurement result from the first four-week science run of the Karlsruhe Tritium Neutrino experiment KATRIN in spring 2019. Beta-decay electrons from a high-purity gaseous molecular tritium source are energy analyzed by a high-resolution MAC-E filter. A fit of the integrated electron spectrum over a narrow interval around the kinematic end point at 18.57 keV gives an effective neutrino mass square value of (-1.0_{-1.1}^{+0.9})  eV^{2}. From this, we derive an upper limit of 1.1 eV (90% confidence level) on the absolute mass scale of neutrinos. This value coincides with the KATRIN sensitivity. It improves upon previous mass limits from kinematic measurements by almost a factor of 2 and provides model-independent input to cosmological studies of structure formation

Синдром обструктивного апноэ как фактор риска развития послеоперационных осложнений у пациентов с ожирением

Introduction. Early detection of patients with obstructive sleep apnea syndrome (OSAS) using preoperative screening is necessary to reduce risks in the perioperative period.The objective was to assess the effect of OSAS on the perioperative management of patients.Methods and materials. 54 patients with a BMI of more than 30 kg/m2 were examined, for whom a bariatric operation was performed as planned. Before the operation, all patients underwent respiratory polygraph with the calculation of the apnea/ hypopnea index (AHI), mean saturation (SpO2 m) during sleep and spirometry.Results. Patients were divided into 2 groups according to AHI: gr. 1 (n=33) with AHI<15/hour, OSAS, gr. 2 (n=21) with a AHI ≥15/hour. In gr. 2 VC and FVC should be significantly lower than in gr. 1 (p<0.01). A significant decrease in SpO2 m was noted (p<0.001). On the first day after the operation, there was an increase in pCO2 of arterial blood in gr. 2, in comparison with gr. 1 (p<0.05).Conclusions. OSAS can be considered as an independent adverse risk factor for potential perioperative complications. Early detection of OSAS will reduce the risks of postoperative complications.Введение. Раннее выявление пациентов с синдромом обструктивного апноэ во сне (СОАС) с помощью предоперационного скрининга необходимо для снижения рисков в периоперационном периоде.Цель – оценить влияние СОАС на периоперационное ведение пациентов.Методы и материалы. Были обследованы 54 пациента с индексом массы тела (ИМТ) более 30 кг/м2 , направленных на бариатрическую операцию. Всем пациентам перед операцией выполнена респираторная полиграфия с расчетом индекса апноэ/гипопноэ (ИАГ), средней сатурации (SpO2 ср) во время сна и спирометрия.Результаты. Пациенты были разделены на две группы по ИАГ: гр. 1 (n=33) с ИАГ <15/ч, СОАС, гр. 2 (n=21) с ИАГ ≥15/ч. В гр. 2 жизненная емкость легких и форсированная жизненная емкость легких к должному были достоверно ниже, чем в гр. 1 (р<0,01). Отмечалось достоверно значимое снижение SpO2 ср (р<0,001). В 1-е сутки после операции отмечалось нарастание рСО2 артериальной крови в гр. 2 по сравнению с гр. 1 (р<0,05).Заключение. СОАС можно рассматривать как независимый неблагоприятный фактор риска потенциальных периоперационных осложнений. Заблаговременное выявление СОАС позволит снизить риски развития послеоперационных осложнений

STOP-BANG: инструмент для целенаправленной респираторной терапии у бариатрических пациентов

Identification of patients with obstructive sleep apnea syndrome and high respiratory risk, optimization of the screening algorithm for these patients and administration of preventive non-invasive lung ventilation, makes it possible to prevent the development of perioperative complications, reduce duration of hospital stay and reduce mortality in patients undergoing surgery and bariatric surgery specifically.The objective: to evaluate the effectiveness of STOP-BANG questionnaire for preventive targeted respiratory therapy to reduce the risk of complications in bariatric patients. Subjects and Methods. We examined 60 patients with BMI above 30 kg/m2 referred to elective secondary surgery, the age made 44.2 ± 10.1 years, 23 men and 37 women. Before the operation, patients underwent STOP-BANG questionnaire survey, night respiratory monitoring with the calculation of the apnea/hypopnea index (AHI) and/or saturation during sleep. The standard preoperative examination included clinical and biochemical analyzes.Results. Based on results of STOP-BANG survey, a correlation was revealed between the score and AHI as well as the score and average saturation. The higher score the patients had according to the STOP-BANG questionnaire, the higher AHI was (r = 0.4748, p = 0.002), and the lower mean SpO2 was (r = -0.6958, p < 0.001). Using the ROC analysis, we chose the optimal threshold value - 4 points according to STOP-BANG questionnaire, where the sensitivity of the method was 93% for the AHI, the specificity was 56%, and for the average saturation it was 100% and 63%, respectively. Of the total number of bariatric patients included in the study, 30% required preventive ventilation. In the high respiratory risk group, no significant intraoperative incidents and deaths were reported by the surgical and anesthetic teams. All patients were discharged on time (5‒7 days). Based on the results, a screening procedure has been offered for bariatric patients with high respiratory risk associated with obstructive sleep apnea syndrome.Conclusion. The STOP-BANG questionnaire is a reliable screening tool for high respiratory risk in morbid obese patients. Early diagnosis of high respiratory risk and implementation of preventive ventilation reduces the incidence of perioperative respiratory and cardiovascular complications.Выявление пациентов с синдромом обструктивного апноэ сна (СОАС) и высоким респираторным риском дает возможности для своевременного предупреждения периоперационных осложнений. Одним из важных мероприятий представляется назначение превентивной неинвазивной вентиляции легких, которая может уменьшить сроки госпитализации и снизить уровень летальности у пациентов хирургического профиля, в частности у бариатрических пациентов. Цель: оценить эффективность применения опросника STOP-BANG при назначении превентивной целенаправленной респираторной терапии для снижения риска развития осложнений у бариатрических пациентов.Материал и методы. Обследовано 60 пациентов с индексом массы тела более 30 кг/м2, направленных на бариатрическую операцию в плановом порядке, средний возраст 44,2 ± 10,1 года, мужчин 23 и женщин 37. Пациенты перед операцией прошли анкетирование по опроснику STOP-BANG, полисомнографию с расчетом индекса апноэ/гипопноэ (ИАГ) и/или сатурации во время сна. Стандартное предоперационное обследование включало клинический и биохимический анализы.Результаты. На основании результатов опроса по методике STOP-BANG выявлена корреляционная взаимосвязь между количеством баллов и ИАГ, а также количеством баллов и средней сатурацией. Чем больше баллов было у пациентов по опроснику STOP-BANG, тем выше был ИАГ (r = 0,4748, p = 0,002) и тем ниже SpO2ср (r = -0,6958, p < 0,001). С помощью ROC-анализа мы выбрали оптимальные пороговые значения – 4 балла по опроснику STOP-BANG, где для ИАГ чувствительность метода для диагностики тяжелого обструктивного апноэ сна составила 93%, специфичность – 56%, а для средней сатурации – 100 и 63% соответственно. Из общего числа включенных в исследование бариатрических пациентов 30% потребовали превентивной вентиляции. Значимых интраоперационных инцидентов, осложнений и летальных исходов у пациентов группы высокого респираторного риска не было. Все пациенты были выписаны в установленные сроки (на 5‒7-е сут). По итогам предложен алгоритм скрининга бариатрических пациентов с высоким респираторным риском, ассоциированным с СОАС.Заключение. Опросник STOP-BANG является надежным инструментом скрининга для выявления высокого респираторного риска у пациентов с морбидным ожирением. Ранняя диагностика высокого респираторного риска и выполнение превентивной неинвазивной вентиляции легких позволяют снизить частоту развития периоперационных респираторных и сердечно-сосудистых осложнений

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic