Post-Traumatic Headache in Children after Minor Head Trauma: Incidence, Phenotypes, and Risk Factors

Minor head trauma (MHT) is very frequent in children and post-traumatic headache (PTH) is one of its most common complications; however, its management is still a challenge. We aimed to assess the incidence and clinical characteristics of, and risk factors for, PTH among children referred to our pediatric emergency department (PED) for MHT. A total of 193 patients aged 3–14 years evaluated for MTH were enrolled and followed up for 6 months through phone calls and/or visits. PTH occurred in 25/193 patients (13%). PTH prevalence was significantly higher in school-aged (≥6 years) than in pre-school-aged children (21.6% vs. 4.9%, respectively, p < 0.009). Females were found to be more affected. The median time of onset was 4.6 days after MHT; resolution occurred in a median of 7 weeks. In 83.3% of patients, PTH subsided in <3 months, while in 16.7% it persisted longer. A total of 25% of children exhibited the migraine and 75% the tension-type variant. Our analysis indicates the presence of headache upon arrival in PED, isolated or associated with nausea and dizziness, as a factor predisposing the patient to the development of PTH. Our findings could be useful to identify children at risk for PTH for specific follow-up, family counseling, and treatment

Derivative expansion of quadratic operators in a general 't Hooft gauge

A derivative expansion technique is developed to compute functional determinants of quadratic operators, non diagonal in spacetime indices. This kind of operators arise in general 't Hooft gauge fixed Lagrangians. Elaborate applications of the developed derivative expansion are presented.Comment: 40 pages, to appear in Phys. Rev.

The Standard Model from a New Phase Transition on the Lattice

Several years ago it was conjectured in the so-called Roma Approach, that gauge fixing is an essential ingredient in the lattice formulation of chiral gauge theories. In this paper we discuss in detail how the gauge-fixing approach may be realized. As in the usual (gauge invariant) lattice formulation, the continuum limit corresponds to a gaussian fixed point, that now controls both the transversal and the longitudinal modes of the gauge field. A key role is played by a new phase transition separating a conventional Higgs or Higgs-confinement phase, from a phase with broken rotational invariance. In the continuum limit we expect to find a scaling region, where the lattice correlators reproduce the euclidean correlation functions of the target (chiral) gauge theory, in the corresponding continuum gauge.Comment: 16 pages, revtex, one figure. Clarifications made, mainly in sections 3 and 6 that deal with the fermion action, to appear in Phys Rev

Tyrosine hydroxylase activity in the endocrine pancreas: changes induced by short-term dietary manipulation

BACKGROUND: Tyrosine hydroxylase (TH) activity and its possible participation in the control of insulin secretion were studied in pancreatic islets of adult Wistar rats fed a standard commercial diet (SD) or carbohydrates alone (CHD) for one week. TH activity, norepinephrine (NE) content, and glucose-induced insulin secretion were assessed. Blood glucose and insulin levels were measured at the time of sacrifice. RESULTS: CHD rats had significantly higher blood glucose and lower insulin levels than SD rats (114.5 ± 6.7 vs 80.7 ± 7.25 mg/dl, p < 0.001; 20.25 ± 2.45 vs 42.5 ± 4.99 μU/ml, p < 0.01, respectively). Whereas TH activity was significantly higher in CHD isolated islets (600 ± 60 vs 330 ± 40 pmol/mg protein/h; p < 0.001), NE content was significantly lower (18 ± 1 vs 31 ± 5 pmol/mg protein), suggesting that TH activity would be inhibited by the end-products of catecholamines (CAs) biosynthetic pathway. A similar TH activity was found in control and solarectomized rats (330 ± 40 vs 300 ± 80 pmol/mg protein/h), suggesting an endogenous rather than a neural origin of TH activity. CHD islets released significantly less insulin in response to glucose than SD islets (7.4 ± 0.9 vs 11.4 ± 1.1 ng/islet/h; p < 0.02). CONCLUSIONS: TH activity is present in islet cells; dietary manipulation simultaneously induces an increase in this activity together with a decrease in glucose-induced insulin secretion in rat islets. TH activity – and the consequent endogenous CAs turnover – would participate in the paracrine control of insulin secretion

Circulating microRNAs in metastatic colorectal cancer (mCRC) patients (pts) treated with regorafenib

Abstract not availabl

Immunogenicity of viral vaccines in the italian military

Military personnel of all armed forces receive multiple vaccinations and have been doing so since long ago, but relatively few studies have investigated the possible negative or positive interference of simultaneous vaccinations. As a contribution to fill this gap, we analyzed the response to the live trivalent measles/mumps/rubella (MMR), the inactivated hepatitis A virus (HAV), the inactivated trivalent polio, and the trivalent subunits influenza vaccines in two cohorts of Italian military personnel. The first cohort was represented by 108 students from military schools and the second by 72 soldiers engaged in a nine-month mission abroad. MMR and HAV vaccines had never been administered before, whereas inactivated polio was administered to adults primed at infancy with a live trivalent oral polio vaccine. Accordingly, nearly all subjects had baseline antibodies to polio types 1 and 3, but unexpectedly, anti-measles/-mumps/-rubella antibodies were present in 82%, 82%, and 73.5% of subjects, respectively (43% for all of the antigens). Finally, anti-HAV antibodies were detectable in 14% and anti-influenza (H1/H3/B) in 18% of the study population. At mine months post-vaccination, 92% of subjects had protective antibody levels for all MMR antigens, 96% for HAV, 69% for the three influenza antigens, and 100% for polio types 1 and 3. An inverse relationship between baseline and post-vaccination antibody levels was noticed with all the vaccines. An excellent vaccine immunogenicity, a calculated long antibody persistence, and apparent lack of vaccine interference were observed

LBT/ARGOS adaptive optics observations of z∼2\sim 2 lensed galaxies

Gravitationally lensed systems allow a detailed view of galaxies at high redshift. High spatial- and spectral-resolution measurements of arc-like structures can offer unique constraints on the physical and dynamical properties of high-z systems. We present near-infrared spectra centred on the gravitational arcs of six known z ~ 2 lensed star-forming galaxies of stellar masses of 10^9-10^11 Msun and star formation rate (SFR) in the range between 10 and 400 Msun/yr. Ground layer adaptive optics (AO)-assisted observations are obtained at the Large Binocular Telescope (LBT) with the LUCI spectrographs during the commissioning of the ARGOS facility. We used MOS masks with curved slits to follow the extended arched structures and study the diagnostic emission lines. Combining spatially resolved kinematic properties across the arc-like morphologies, emission line diagnostics and archival information, we distinguish between merging and rotationally supported systems, and reveal the possible presence of ejected gas. For galaxies that have evidence for outflows, we derive outflow energetics and mass-loading factors compatible with those observed for stellar winds in local and high-z galaxies. We also use flux ratio diagnostics to derive gas-phase metallicities. The low signal-to-noise ratio in the faint H$\beta$ and nitrogen lines allows us to derive an upper limit of ~ 0.15 dex for the spatial variations in metallicity along the slit for the lensed galaxy J1038. Analysed near-infrared spectra presented here represent the first scientific demonstration of performing AO-assisted multi-object spectroscopy with narrow curved-shape slits. The increased angular and spectral resolution, combined with the binocular operation mode with the 8.4-m-wide eyes of LBT, will allow the characterisation of kinematic and chemical properties of a large sample of galaxies at high-z in the near future.Comment: 18 pages, 13 figures, accepted for publication in A&

Perceptions of Death Among Patients with Advanced Cancer Receiving Early Palliative Care and Their Caregivers: Results from a Mixed-Method Analysis

BACKGROUND: Oncologists are often concerned that talking about death with patients may hinder their relationship. However, the views of death held by patients have not been thoroughly investigated. This study aimed to describe the perception of death among patients with advanced cancer receiving early palliative care (EPC) and their caregivers. MATERIAL AND METHODS: Qualitative and quantitative analyses were performed on 2 databases: (a) transcripts of open-ended questionnaires administered to 130 cancer patients receiving EPC with a mean age of 68.4 years and to 115 primary caregivers of patients on EPC with a mean age of 56.8; (b) texts collected from an Italian forum, containing instances of web-mediated interactions between patients and their caregivers. RESULTS: Quantitative analysis shows that: (a) patients and caregivers are not afraid of speaking about death; (b) patients and caregivers on EPC use the word "death" significantly more than patients on standard oncology care (SOC) and their caregivers (P &lt; .0001). For both participants on EPC and SOC, the adjectives and verbs associated with the word "death" have positive connotations; however, these associations are significantly more frequent for participants on EPC (verbs, Ps &lt; .0001; adjectives, Ps &lt; .003). Qualitative analysis reveals that these positive connotations refer to an actual, positive experience of the end of life in the EPC group and a wish or a negated event in the SOC group. CONCLUSIONS: EPC interventions, along with proper physician-patient communication, may be associated with an increased acceptance of death in patients with advanced cancer and their caregivers

VIPERdb2: an enhanced and web API enabled relational database for structural virology

VIPERdb (http://viperdb.scripps.edu) is a relational database and a web portal for icosahedral virus capsid structures. Our aim is to provide a comprehensive resource specific to the needs of the virology community, with an emphasis on the description and comparison of derived data from structural and computational analyses of the virus capsids. In the current release, VIPERdb2, we implemented a useful and novel method to represent capsid protein residues in the icosahedral asymmetric unit (IAU) using azimuthal polar orthographic projections, otherwise known as Φ–Ψ (Phi–Psi) diagrams. In conjunction with a new Application Programming Interface (API), these diagrams can be used as a dynamic interface to the database to map residues (categorized as surface, interface and core residues) and identify family wide conserved residues including hotspots at the interfaces. Additionally, we enhanced the interactivity with the database by interfacing with web-based tools. In particular, the applications Jmol and STRAP were implemented to visualize and interact with the virus molecular structures and provide sequence–structure alignment capabilities. Together with extended curation practices that maintain data uniformity, a relational database implementation based on a schema for macromolecular structures and the APIs provided will greatly enhance the ability to do structural bioinformatics analysis of virus capsids

Early palliative care versus usual haematological care in multiple myeloma: retrospective cohort study

Objectives Although early palliative care (EPC) is beneficial in acute myeloid leukaemia, little is known about EPC value in multiple myeloma (MM). We compared quality indicators for palliative and end of life (EOL) care in patients with MM receiving EPC with those of patients who received usual haematological care (UHC).Methods This observational, retrospective study was based on 290 consecutive patients with MM. The following indicators were abstracted: providing psychological support, assessing/managing pain, discussing goals of care, promoting advance care plan, accessing home care services; no anti MM treatment within 14 and 30 days and hospice length of stay &gt;7 days before death; no cardiopulmonary resuscitation, no intubation, &lt;2 hospitalisations and emergency department visits within 30 days before death. Comparisons were performed using unadjusted and confounder adjusted regression models.Results 55 patients received EPC and 231 UHC. Compared with UHC patients, EPC patients had a significantly higher number of quality indicators of care (mean 2.62 +/- 1.25 vs 1.12 +/- 0.95; p&lt;0.0001)); a significant reduction of pain intensity over time (p&lt;0.01) and a trend towards reduced aggressiveness at EOL, with the same survival (5.3 vs 5.46 years; p=0.74)).Conclusions Our data support the value of integrating EPC into MM routine practice and lay the groundwork for future prospective comparative studies