Hyperonic mixing in five-baryon double-strangeness hypernuclei in a two-channel treatment

Properties of hypernuclei $_{\Lambda \Lambda}^5$H and $_{\Lambda \Lambda }^5$He are studied in a two-channel approach with explicit treatment of coupling of channels ^3\text{Z}+\Lambda+\Lambda and \alpha+\Xi. Diagonal \Lambda\Lambda and coupling \Lambda\Lambda-\Xi N interactions are derived within G-matrix procedure from Nijmegen meson-exchange models. Bond energy \Delta B_{\Lambda\Lambda} in $_{\Lambda \Lambda}^5$He exceeds significantly that in $_{\Lambda \Lambda}^5$H due to the channel coupling. Diagonal \Xi\alpha attraction amplifies the effect, which is sensitive also to \Lambda-core interaction. The difference of the \Delta B_{\Lambda\Lambda} values can be an unambiguous signature of the \Lambda\Lambda-\Xi N coupling in \Lambda\Lambda hypernuclei. However, improved knowledge of the hyperon-nucleus potentials is needed for quantitative extraction of the coupling strength from future data on the \Lambda\Lambda hypernuclear binding energies.Comment: 11 pages with 3 figures; Phys. Rev. C, accepte

ΛΛ\Lambda\Lambda-ΞN\Xi N-ΣΣ\Sigma\Sigma coupling in ΛΛ 6^{~6}_{\Lambda\Lambda}He with the Nijmegen soft-core potentials

The $\Lambda\Lambda$-$\Xi N$-$\Sigma\Sigma$ coupling in $^{~6}_{\Lambda\Lambda}$He is studied with the [$\alpha$ + $\Lambda$ + $\Lambda$] + [$\alpha$ + $\Xi$ + $N$] + [$\alpha$ + $\Sigma$ + $\Sigma$] model, where the $\alpha$ particle is assumed as a frozen core. We use the Nijmegen soft-core potentials, NSC97e and NSC97f, for the valence baryon-baryon part, and the phenomenological potentials for the $\alpha-B$ parts ($B$=$N$, $\Lambda$, $\Xi$ and $\Sigma$). We find that the calculated $\Delta B_{\Lambda\Lambda}$ of $^{~6}_{\Lambda\Lambda}$He for NSC97e and NSC97f are, respectively, 0.6 and 0.4 MeV in the full coupled-channel calculation, the results of which are about half in comparison with the experimental data, $\Delta B^{exp}_{\Lambda\Lambda}=1.01\pm0.20^{+0.18}_{-0.11}$ MeV. Characteristics of the $S=-2$ sector in the NSC97 potentials are discussed in detail.Comment: 18 pages, 4 figure

Does anticholinergics drug burden relate to global neuro-disability outcome measures and length of hospital stay?

Primary objective: To assess the relationship between disability, length of stay (LOS) and anticholinergic burden (ACB) with people following acquired brain or spinal cord injury. Research design: A retrospective case note review assessed total rehabilitation unit admission. Methods and procedures: Assessment of 52 consecutive patients with acquired brain/spinal injury and neuropathy in an in-patient neuro-rehabilitation unit of a UK university hospital. Data analysed included: Northwick Park Dependency Score (NPDS), Rehabilitation complexity Scale (RCS), Functional Independence Measure and Functional Assessment Measure FIM-FAM (UK version 2.2), LOS and ACB. Outcome was different in RCS, NPDS and FIM-FAM between admission and discharge. Main outcomes and results: A positive change was reported in ACB results in a positive change in NPDS, with no significant effect on FIM-FAM, either Motor or Cognitive, or on the RCS. Change in ACB correlated to the length of hospital stay (regression correlation = −6.64; SE = 3.89). There was a significant harmful impact of increase in ACB score during hospital stay, from low to high ACB on NPDS (OR = 9.65; 95% CI = 1.36–68.64) and FIM-FAM Total scores (OR = 0.03; 95% CI = 0.002–0.35). Conclusions: There was a statistically significant correlation of ACB and neuro-disability measures and LOS amongst this patient cohort

Chiral perturbation theory at O(a^2) for lattice QCD

We construct the chiral effective Lagrangian for two lattice theories: one with Wilson fermions and the other with Wilson sea fermions and Ginsparg-Wilson valence fermions. For each of these theories we construct the Symanzik action through order $a^2$. The chiral Lagrangian is then derived, including terms of order $a^2$, which have not been calculated before. We find that there are only few new terms at this order. Corrections to existing coefficients in the continuum chiral Lagrangian are proportional to $a^2$, and appear in the Lagrangian at order $a^2 p^2$ or higher. Similarly, O(4) symmetry breaking terms enter the Symanzik action at order $a^2$, but contribute to the chiral Lagrangian at order $a^2 p^4$ or higher. We calculate the light meson masses in chiral perturbation theory for both lattice theories. At next-to-leading order, we find that there are no order $a^2$ corrections to the valence-valence meson mass in the mixed theory due to the enhanced chiral symmetry of the valence sector.Comment: 25 pages, LaTeX2e; references adde

Reduced level of arousal and increased mortality in adult acute medical admissions: a systematic review and meta-analysis

Abstract Background Reduced level of arousal is commonly observed in medical admissions and may predict in-hospital mortality. Delirium and reduced level of arousal are closely related. We systematically reviewed and conducted a meta-analysis of studies in adult acute medical patients of the relationship between reduced level of arousal on admission and in-hospital mortality. Methods We conducted a systematic review (PROSPERO: CRD42016022048), searching MEDLINE and EMBASE. We included studies of adult patients admitted with acute medical illness with level of arousal assessed on admission and mortality rates reported. We performed meta-analysis using a random effects model. Results From 23,941 studies we included 21 with 14 included in the meta-analysis. Mean age range was 33.4 - 83.8 years. Studies considered unselected general medical admissions (8 studies, n=13,039) or specific medical conditions (13 studies, n=38,882). Methods of evaluating level of arousal varied. The prevalence of reduced level of arousal was 3.1%-76.9% (median 13.5%). Mortality rates were 1.7%-58% (median 15.9%). Reduced level of arousal was associated with higher in-hospital mortality (pooled OR 5.71; 95% CI 4.21-7.74; low quality evidence: high risk of bias, clinical heterogeneity and possible publication bias). Conclusions Reduced level of arousal on hospital admission may be a strong predictor of in-hospital mortality. Most evidence was of low quality. Reduced level of arousal is highly specific to delirium, better formal detection of hypoactive delirium and implementation of care pathways may improve outcomes. Future studies to assess the impact of interventions on in-hospital mortality should use validated assessments of both level of arousal and delirium

Effective Lagrangian for strongly coupled domain wall fermions

We derive the effective Lagrangian for mesons in lattice gauge theory with domain-wall fermions in the strong-coupling and large-N_c limits. We use the formalism of supergroups to deal with the Pauli-Villars fields, needed to regulate the contributions of the heavy fermions. We calculate the spectrum of pseudo-Goldstone bosons and show that domain wall fermions are doubled and massive in this regime. Since we take the extent and lattice spacing of the fifth dimension to infinity and zero respectively, our conclusions apply also to overlap fermions.Comment: 26 pp. RevTeX and 3 figures; corrected error in symmetry breaking scheme and added comments to discussio

Population density, water supply, and the risk of dengue fever in Vietnam: cohort study and spatial analysis.

BACKGROUND: Aedes aegypti, the major vector of dengue viruses, often breeds in water storage containers used by households without tap water supply, and occurs in high numbers even in dense urban areas. We analysed the interaction between human population density and lack of tap water as a cause of dengue fever outbreaks with the aim of identifying geographic areas at highest risk. METHODS AND FINDINGS: We conducted an individual-level cohort study in a population of 75,000 geo-referenced households in Vietnam over the course of two epidemics, on the basis of dengue hospital admissions (n = 3,013). We applied space-time scan statistics and mathematical models to confirm the findings. We identified a surprisingly narrow range of critical human population densities between around 3,000 to 7,000 people/km² prone to dengue outbreaks. In the study area, this population density was typical of villages and some peri-urban areas. Scan statistics showed that areas with a high population density or adequate water supply did not experience severe outbreaks. The risk of dengue was higher in rural than in urban areas, largely explained by lack of piped water supply, and in human population densities more often falling within the critical range. Mathematical modeling suggests that simple assumptions regarding area-level vector/host ratios may explain the occurrence of outbreaks. CONCLUSIONS: Rural areas may contribute at least as much to the dissemination of dengue fever as cities. Improving water supply and vector control in areas with a human population density critical for dengue transmission could increase the efficiency of control efforts. Please see later in the article for the Editors' Summary

Depression and sickness behavior are Janus-faced responses to shared inflammatory pathways

It is of considerable translational importance whether depression is a form or a consequence of sickness behavior. Sickness behavior is a behavioral complex induced by infections and immune trauma and mediated by pro-inflammatory cytokines. It is an adaptive response that enhances recovery by conserving energy to combat acute inflammation. There are considerable phenomenological similarities between sickness behavior and depression, for example, behavioral inhibition, anorexia and weight loss, and melancholic (anhedonia), physio-somatic (fatigue, hyperalgesia, malaise), anxiety and neurocognitive symptoms. In clinical depression, however, a transition occurs to sensitization of immuno-inflammatory pathways, progressive damage by oxidative and nitrosative stress to lipids, proteins, and DNA, and autoimmune responses directed against self-epitopes. The latter mechanisms are the substrate of a neuroprogressive process, whereby multiple depressive episodes cause neural tissue damage and consequent functional and cognitive sequelae. Thus, shared immuno-inflammatory pathways underpin the physiology of sickness behavior and the pathophysiology of clinical depression explaining their partially overlapping phenomenology. Inflammation may provoke a Janus-faced response with a good, acute side, generating protective inflammation through sickness behavior and a bad, chronic side, for example, clinical depression, a lifelong disorder with positive feedback loops between (neuro)inflammation and (neuro)degenerative processes following less well defined triggers

Aneurysm of antecubital vein: an unusual complication of peripheral intravenous cannulation

<p>Abstract</p> <p>Background</p> <p>Intravenous cannulation is a very common procedure. Venous aneurysm secondary to peripheral intravenous cannulation is extremely rare. Moreover, venous aneurysm can mimic other conditions and may confuse the issue.</p> <p>Case presentation</p> <p>We describe a case of a 45-year-old woman who was referred with the diagnosis of varicose vein of right arm. A history of intravenous cannulation at the same site was noted that raised suspicion. The swelling was compressible and turned out to be a venous aneurysm. The lesion was completely excised. Postoperative recovery was uneventful. Histology findings were in conformity with the preoperative diagnosis.</p> <p>Conclusion</p> <p>Caution should be exercised in diagnosing varicose vein at a site that bears a history of intravenous cannulation. The case also raises an important issue regarding consent. Should patients undergoing peripheral intravenous cannulation be warned of this rare complication?</p