Training primary care physicians to offer their patients faecal occult blood testing and colonoscopy for colorectal cancer screening on an equal basis: a pilot intervention with before-after and parallel group surveys.

Primary care physicians (PCPs) should prescribe faecal immunochemical testing (FIT) or colonoscopy for colorectal cancer screening based on their patient's values and preferences. However, there are wide variations between PCPs in the screening method prescribed. The objective was to assess the impact of an educational intervention on PCPs' intent to offer FIT or colonoscopy on an equal basis. Survey before and after training seminars, with a parallel comparison through a mailed survey to PCPs not attending the training seminars. All PCPs in the canton of Vaud, Switzerland. Of 592 eligible PCPs, 133 (22%) attended a seminar and 106 (80%) filled both surveys. 109 (24%) PCPs who did not attend the seminars returned the mailed survey. A 2 h-long interactive seminar targeting PCP knowledge, skills and attitudes regarding offering a choice of colorectal cancer (CRC) screening options. The primary outcome was PCP intention of having their patients screened with FIT and colonoscopy in equal proportions (between 40% and 60% each). Secondary outcomes were the perceived role of PCPs in screening decisions (from paternalistic to informed decision-making) and correct answer to a clinical vignette. Before the seminars, 8% of PCPs reported that they had equal proportions of their patients screened for CRC by FIT and colonoscopy; after the seminar, 33% foresaw having their patients screened in equal proportions (p<0.001). Among those not attending, there was no change (13% vs 14%, p=0.8). Of those attending, there was no change in their perceived role in screening decisions, while the proportion responding correctly to a clinical vignette increased (88-99%, p<0.001). An interactive training seminar increased the proportion of physicians with the intention to prescribe FIT and colonoscopy in equal proportions

Structure of the quartetting ground state of N=ZN=Z nuclei

The formal equivalence between the quartetting picture and the symmetry restored BCS picture is established for the ground state correlations induced by the general isovector-isoscalar pairing interaction. Multiple ground state structures compatible with the particle number and isospin symmetries are evaluated. The competition of isovector and isoscalar correlations is discussed for the $N=Z$ nuclei above $^{100}$Sn.Comment: 5 pages, 1 figur

The cryogenic stopping cell of the IGISOL facility at ELI-NP

An IGISOL beamline that produces neutron-rich nuclei via photofission induced by a high-brilliance gamma beam is being developed at the Extreme Light Infrastructure - Nuclear Physics (ELI-NP) facility. The core device will be a cryogenic stopping cell with an actinide target system in its center. We report on some of the latest simulation results for an optimal design of this gas cell

Electromagnetic character of the competitive γγ/γ\gamma\gamma/\gamma-decay from 137m^{137\mathrm{m}}Ba

Second-order processes in physics is a research topic focusing attention from several fields worldwide including, for example, non-linear quantum electrodynamics with high-power lasers, neutrinoless double-$\beta$ decay, and stimulated atomic two-photon transitions. For the electromagnetic nuclear interaction, the observation of the competitive double-$\gamma$ decay from $^{137\mathrm{m}}$Ba has opened up the nuclear structure field for detailed investigation of second-order processes through the manifestation of off-diagonal nuclear polarizability. Here we confirm this observation with an $8.7\sigma$ significance, and an improved value on the double-photon versus single-photon branching ratio as $2.62\times10^{-6}(30)$. Our results, however, contradict the conclusions from the original experiment, where the decay was interpreted to be dominated by a quadrupole-quadrupole component. Here, we find a substantial enhancement in the energy distribution consistent with a dominating octupole-dipole character and a rather small quadrupole-quadrupole element in the decay, hindered due to an evolution of the internal nuclear structure. The implied strongly hindered double-photon branching in $^{137\mathrm{m}}$Ba opens up the possibility of the double-photon branching as a feasible tool for nuclear-structure studies on off-diagonal polarizability in nuclei where this hindrance is not present.Comment: 12 pages, 5 figures, 2 tabel

Training primary care physicians in shared decision making for colorectal cancer screening : insights from a statewide organized Colorectal Cancer Screening Program in Switzerland

An organized screening program in Vaud, Switzerland aims to offer the choice of fecal-immunological testing (FIT) and colonoscopy for colorectal cancer (CRC) screening -At baseline, wide variations between primary care physicians (PCPs) in prescription of FIT and colonoscopy. -Shared decision making (SDM) might reduce variations in care. AIM : Increase the proportion of PCPs who intend to offer their patients FIT and colonoscopy on an equal basis Methods : Training program in 2015 with before and after survey ; Parallel comparison through mailed survey to PCPs not attending ; Training program: 2 hour seminar with interactive quizzes, 8-minute video of SDM consultation, and distribution a decision aid and evidence synopsis

Recent Upgrades of the Gas Handling System for the Cryogenic Stopping Cell of the FRS Ion Catcher

In this paper, the major upgrades and technical improvements of the buffer gas handling system for the cryogenic stopping cell of the FRS Ion Catcher at GSI/FAIR (in Darmstadt, Germany) are described. The upgrades include implementation of new gas lines and gas purifiers to achieve a higher buffer gas cleanliness for a more efficient extraction of reactive ions as well as suppression of the molecular background ionized in the stopping cell. Furthermore, additional techniques have been implemented for improved monitoring and quantification of the purity of the helium buffer gas

Activation of ERAD Pathway by Human Hepatitis B Virus Modulates Viral and Subviral Particle Production

Hepatitis B virus (HBV) belongs to the Hepadnaviridae family of enveloped DNA viruses. It was previously shown that HBV can induce endoplasmic reticulum (ER) stress and activate the IRE1-XBP1 pathway of the unfolded protein response (UPR), through the expression of the viral regulatory protein X (HBx). However, it remained obscure whether or not this activation had any functional consequences on the target genes of the UPR pathway. Of these targets, the ER degradation-enhancing, mannosidase-like proteins (EDEMs) are thought to play an important role in relieving the ER stress during UPR, by recognizing terminally misfolded glycoproteins and delivering them to the ER-associated degradation (ERAD). In this study, we investigated the role of EDEMs in the HBV life-cycle. We found that synthesis of EDEMs (EDEM1 and its homologues, EDEM2 and EDEM3) is significantly up-regulated in cells with persistent or transient HBV replication. Co-expression of the wild-type HBV envelope proteins with EDEM1 resulted in their massive degradation, a process reversed by EDEM1 silencing. Surprisingly, the autophagy/lysosomes, rather than the proteasome were involved in disposal of the HBV envelope proteins. Importantly, inhibition of the endogenous EDEM1 expression in HBV replicating cells significantly increased secretion of both, enveloped virus and subviral particles. This is the first report showing that HBV activates the ERAD pathway, which, in turn, reduces the amount of envelope proteins, possibly as a mechanism to control the level of virus particles in infected cells and facilitate the establishment of chronic infections

First investigation on the isomeric ratio in multinucleon transfer reactions: Entrance channel effects on the spin distribution

The multinucleon transfer (MNT) reaction approach was successfully employed for the first time to measure the isomeric ratios (IRs) of $^{211}$Po (25/2$^+$) isomer and its (9/2$^+$) ground state at the IGISOL facility using a 945 MeV $^{136}$Xe beam impinged on $^{209}$Bi and $^{\rm nat}$Pb targets. The dominant production of isomers compared to the corresponding ground states was consistently revealed in the $\alpha$-decay spectra. Deduced IR of $^{211}$Po populated through the $^{136}$Xe+$^{\rm nat}$Pb reaction was found to enhance $\approx$1.8-times than observed for $^{136}$Xe+$^{209}$Bi. State-of-the-art Langevin-type model calculations have been utilized to estimate the spin distribution of an MNT residue. The computations qualitatively corroborate with the considerable increase in IRs of $^{211}$Po produced from $^{136}$Xe+$^{\rm nat}$Pb compared to $^{136}$Xe+$^{209}$Bi. Theoretical investigations indicate a weak influence of target spin on IRs. The enhancement of the $^{211}$Po isomer in the $^{136}$Xe+$^{\rm nat}$Pb over $^{136}$Xe+$^{209}$Bi can be attributed to the different proton ($p$)-transfer production routes. Estimations demonstrate an increment in the angular momentum transfer, favorable for isomer production, with increasing projectile energy. Comparative analysis indicates the two entrance channel parameters, projectile mass and $p$-transfer channels, strongly influencing the population of the high-spin isomer of $^{211}$Po (25/2$^+$). This is the first experimental and theoretical investigation on the IRs of nuclei produced via different channels of MNT reactions, with the latter quantitatively underestimating the former by a factor of two.Comment: 5 figure

From implementation to operation and the first measurements with the ELIGANT detectors from ELI-NP

The ELIGANT set of instruments is a dedicated tool being developed at ELI-NP for studying high-energy collective nuclear excitations using gamma beams. The topics of interest in these studies range from fundamental nuclear structure properties of the Giant Dipole Resonance and the low-energy strength enhancement in the Pygmy Dipole Resonance region, to applications in p-process nucleosynthesis and propagation of Ultra-High Energy Cosmic Rays. The equipment consists of large-volume LaBr3:Ce and CeBr3 detectors for high-energy gamma-rays, liquid scintillators and lithium glass scintillators for high-and low-energy neutron time-of-flight, and a proportional counter system of 3He tubes for cross-section measurements. These instruments have been installed and commissioned with sources and via in beam measurements, in different configurations, at the IFIN-HH Tandem/Tandetron accelerators with terminal voltages of 3 MV and 9 MV. This contribution gives an overview of the present and future activities with ELIGANT