Mechanisms Suppressing Superheavy Element Yields in Cold Fusion Reactions

Superheavy elements are formed in fusion reactions which are hindered by fast nonequilibrium processes. To quantify these, mass-angle distributions and cross sections have been measured, at beam energies from below-barrier to 25% above, for the reactions of 48Ca,50Ti, and 54Cr with 208 Pb. Moving from 48Ca to 54Cr leads to a drastic fall in the symmetric fission yield, which is reflected in the measured mass-angle distribution by the presence of competing fast nonequilibrium deep inelastic and quasifission processes. These are responsible for reduction of the compound nucleus formation probablity PCN (as measured by the symmetric-peaked fission cross section), by a factor of 2.5 for 50Ti and 15 for 54Cr in comparison to 48 Ca. The energy dependence of PCN indicates that cold fusion reactions (involving 208Pb) are not driven by a diffusion process.The authors acknowledge the Australian Research Council for support through Discovery Grants No. DP140101337, No. DP160101254, No. DP170102318, No. FL110100098, and No. DE140100784. Financial support from the NCRIS HIA capability for operation of the Heavy Ion Accelerator Facility is acknowledged. The authors acknowledge the support of the German Academic Exchange Service (DAAD) via funds of the German Federal Ministry of Education and Research (BMBF)

Interplay of charge clustering and weak binding in reactions of ⁸Li

In collisions of light, stable, weakly bound nuclides, complete fusion (capture of all of the projectile charge) has been found to be suppressed by ∼30% at above-barrier energies. This is thought to be related to their low thresholds for breakup into charged clusters. The observation of fusion suppression in the neutron-rich radioactive nucleus Li8 is therefore puzzling: the lowest breakup threshold yields Li7+n which cannot contribute to fusion suppression because Li7 retains all the projectile charge. In this work, the full characteristics of Li8 breakup in reactions with Bi209 are presented, including, for the first time, coincidence measurements of breakup into charged clusters. Correlations of cluster fragments show that most breakup occurs too slowly to significantly suppress fusion. However, a large cross section for unaccompanied α particles was found, suggesting that charge clustering, facilitating partial charge capture, rather than weak binding is the crucial factor in fusion suppression, which may therefore persist in exotic nuclides

Is standard breast-conserving therapy (BCT) in elderly breast cancer patients justified? A prospective measurement of acute toxicity according CTC-classification

<p>Abstract</p> <p>Background</p> <p>Breast conserving therapy (BCT) is an accepted treatment for early-stage breast cancer. This study aimed to measure prospectively acute radiation-related toxicity and to create a comprehensive data base for long-term temporal analyses of 3D conformal adjuvant radiotherapy. The specific aspect of age has been neglected by traditional research. Therefore, the impact of age on acute BCT toxicity should be also specifically adressed.</p> <p>Methods</p> <p>Toxicity was measured in 109 patients at initiation (t1), during radiotherapy (t2-t7), and 6 weeks after treatment completion (t8) using a new topographic module. Organ systems were recorded in 15 scales and scored according to symptom intensity (grade 0-5) based on CTC (Common Toxicity Criteria) -classification. Radiotherapy was virtually CT-based planned and applied with 6-MeV-photons. Mean total dose was 60.1 Gy. Patients were stratified by age in 3 Groups: <50, 50-60, and >60 years.</p> <p>Results</p> <p>Registered toxicity was generally low. Mean overall-grade climbed from 0.29-0.40 (t1-t7), and dropped to 0.23 (t8). Univariate analyses revealed slightly higher toxicity in older (> 60 years) versus young patients (< 50 years) in 2 scales only: breast-symmetry (p = 0.033), and arm function (p = 0.007). However, in the scale "appetite" toxicity was higher in younger (< 50 years) versus older (> 60 years) patients (p = 0.039). Toxicity differences in all other scales were not significant. Between older (> 60 years) and midaged patients (50-60 years) no significant differences in toxicity were found. This was also true for the comparison between young (< 50 years) versus midaged patient groups (50-60 years).</p> <p>Conclusion</p> <p>The treatment concept of BCT for breast cancer is generally well tolerated. The toxicity-measurement with the new topographic module is feasible. Not modified standard treatment for BC should be performed in elderly women.</p

Sample size considerations for trials using cerebral white matter hyperintensity progression as an intermediate outcome at 1 year after mild stroke: Results of a prospective cohort study

Background: White matter hyperintensities (WMHs) are commonly seen on in brain imaging and are associated with stroke and cognitive decline. Therefore, they may provide a relevant intermediate outcome in clinical trials. WMH can be measured as a volume or visually on the Fazekas scale. We investigated predictors of WMH progression and design of efficient studies using WMH volume and Fazekas score as an intermediate outcome. Methods: We prospectively recruited 264 patients with mild ischaemic stroke and measured WMH volume, Fazekas score, age and cardiovascular risk factors at baseline and 1 year. We modelled predictors of WMH burden at 1 year and used the results in sample size calculations for hypothetical randomised controlled trials with different analysis plans and lengths of follow-up. Results: Follow-up WMH volume was predicted by baseline WMH: a 0.73-ml (95% CI 0.65-0.80, p < 0.0001) increase per 1-ml baseline volume increment, and a 2.93-ml increase (95% CI 1.76-4.10, p < 0.0001) per point on the Fazekas scale. Using a mean difference of 1 ml in WMH volume between treatment groups, 80% power and 5% alpha, adjusting for all predictors and 2-year follow-up produced the smallest sample size (n = 642). Other study designs produced samples sizes from 2054 to 21,270. Sample size calculations using Fazekas score as an outcome with the same power and alpha, as well as an OR corresponding to a 1-ml difference, were sensitive to assumptions and ranged from 2504 to 18,886. Conclusions: Baseline WMH volume and Fazekas score predicted follow-up WMH volume. Study size was smallest using volumes and longer-term follow-up, but this must be balanced against resources required to measure volumes versus Fazekas scores, bias due to dropout and scanner drift. Samples sizes based on Fazekas scores may be best estimated with simulation studies

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Evaluation of the community based group parenting intervention ‘Getting through the day’

Childhood behavioural disorders affect up to 9% of UK children under the age of ten (Meltzer et al.,2000). The consequences of these difficulties are widespread, placing the dchild at greater risk for later psychopathology, unemployment, relatioship problems and criminal activity. The trajectory towards the development of behavioural difficulties presents a complex milieu of potential risk and protective factors. Individual risk factors includes cognitive deficits, premature birth and childhood physical illness, although these are tempered by interactions with environmental risk factors such as low socioeconomic status and parental factors such as parental self-efficacy and mental health. Parenting skills are consistently highlighted as a key factor for the mediation of behavioral difficulties, and consequently lend themselves to the most influential intervention approach - the group parenting programme. Despite a wealth of programmes available, strenth of content and supporting evidence base vary widely. Current approaches are outlined and critiqued. 'Getting throught the day' is a manualised group parenting programme developed to impact upon child behaviour, parental self-efficacy and parental wellbeing. The aim of the current study was to evaluate this resource in the community setting within which it is delivered. Following longitudinal design, group participants and parents of 'healthy controls' from local schools and nurseries completed the standarised assessment questionnaires Strenght and Difficulties Questionnaire (corroborated by teacher version), Parenting Stress Index-Short Form, Hospital Anxiety and Depression Scale and the non-standardised Tool to Measure Parenting Self-Efficacy. statistical analyses of Analysis of Variance and Analysis of Covariance were conducted as appropriate, Results indicate positive change for intervention group participants as compared to healthy controls across domains of parent self-efficacy and parent mental health. Results and clinical implications are discussed in the context of this valuable resource and the existing evidence base for group parenting interventions

Evaluation of the community based group parenting intervention 'Getting through the day'

Childhood behavioural disorders affect up to 9% of UK children under the age of ten (Meltzer et al.,2000). The consequences of these difficulties are widespread, placing the dchild at greater risk for later psychopathology, unemployment, relatioship problems and criminal activity. The trajectory towards the development of behavioural difficulties presents a complex milieu of potential risk and protective factors. Individual risk factors includes cognitive deficits, premature birth and childhood physical illness, although these are tempered by interactions with environmental risk factors such as low socioeconomic status and parental factors such as parental self-efficacy and mental health. Parenting skills are consistently highlighted as a key factor for the mediation of behavioral difficulties, and consequently lend themselves to the most influential intervention approach - the group parenting programme. Despite a wealth of programmes available, strenth of content and supporting evidence base vary widely. Current approaches are outlined and critiqued. 'Getting throught the day' is a manualised group parenting programme developed to impact upon child behaviour, parental self-efficacy and parental wellbeing. The aim of the current study was to evaluate this resource in the community setting within which it is delivered. Following longitudinal design, group participants and parents of 'healthy controls' from local schools and nurseries completed the standarised assessment questionnaires Strenght and Difficulties Questionnaire (corroborated by teacher version), Parenting Stress Index-Short Form, Hospital Anxiety and Depression Scale and the non-standardised Tool to Measure Parenting Self-Efficacy. statistical analyses of Analysis of Variance and Analysis of Covariance were conducted as appropriate, Results indicate positive change for intervention group participants as compared to healthy controls across domains of parent self-efficacy and parent mental health. Results and clinical implications are discussed in the context of this valuable resource and the existing evidence base for group parenting interventions.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Evaluation of the community based group parenting intervention 'Getting through the day'

Childhood behavioural disorders affect up to 9% of UK children under the age of ten (Meltzer et al.,2000). The consequences of these difficulties are widespread, placing the dchild at greater risk for later psychopathology, unemployment, relatioship problems and criminal activity. The trajectory towards the development of behavioural difficulties presents a complex milieu of potential risk and protective factors. Individual risk factors includes cognitive deficits, premature birth and childhood physical illness, although these are tempered by interactions with environmental risk factors such as low socioeconomic status and parental factors such as parental self-efficacy and mental health. Parenting skills are consistently highlighted as a key factor for the mediation of behavioral difficulties, and consequently lend themselves to the most influential intervention approach - the group parenting programme. Despite a wealth of programmes available, strenth of content and supporting evidence base vary widely. Current approaches are outlined and critiqued. 'Getting throught the day' is a manualised group parenting programme developed to impact upon child behaviour, parental self-efficacy and parental wellbeing. The aim of the current study was to evaluate this resource in the community setting within which it is delivered. Following longitudinal design, group participants and parents of 'healthy controls' from local schools and nurseries completed the standarised assessment questionnaires Strenght and Difficulties Questionnaire (corroborated by teacher version), Parenting Stress Index-Short Form, Hospital Anxiety and Depression Scale and the non-standardised Tool to Measure Parenting Self-Efficacy. statistical analyses of Analysis of Variance and Analysis of Covariance were conducted as appropriate, Results indicate positive change for intervention group participants as compared to healthy controls across domains of parent self-efficacy and parent mental health. Results and clinical implications are discussed in the context of this valuable resource and the existing evidence base for group parenting interventions.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Data from: Correlates of extinction risk in squamate reptiles: the relative importance of biology, geography, threat and range size

Aim Evaluating the relative roles of biological traits and environmental factors that predispose species to an elevated risk of extinction is of fundamental importance to macroecology. Identifying species that possess extinction-promoting traits allows targeted conservation action before precipitous declines occur. Such analyses have been carried out for several vertebrate groups, with the notable exception of reptiles. We identify traits correlating with high extinction risk in squamate reptiles, assess whether these differ with geography, taxonomy and threats, and make recommendations for future Red List assessments. Location Global. Methods We collected data on biological traits and environmental factors for a representative sample of 1139 species of squamate reptiles. We used phylogenetically controlled regression models to identify general correlates of extinction risk, threat-specific correlates of risk and realm-specific correlates of risk. We also assessed the relative importance of range size versus other factors through multiplicative bivariate models, partial regressions and variance partitioning. Results Range size was the most important predictor of extinction risk, reflecting the high frequency of reptiles assessed under range-based IUCN criteria. Habitat specialists occupying accessible ranges were at a greater risk of extinction: although these factors never contributed more than 10% to the variance in extinction risk, they showed significant interactions with range size. The predictive power of our global models ranged from 23% to 29%. The general overall pattern remained the same among geographical, taxonomic and threat-specific data subsets. Main conclusions Proactive conservation requires shortcuts to identify species at high risk of extinction. Regardless of location, squamate reptiles that are range-restricted habitat specialists living in areas highly accessible to humans are likely to become extinct first. Prioritizing species that exhibit such traits could forestall extinction. Integration of data sources on human pressures, such as accessibility of species ranges, may aid robust and time-efficient assessments of species extinction risk