Shell evolution approaching the N=20 island of inversion : Structure of 26Na

The levels in 26Na with single particle character have been observed for the first time using the d(25Na, pγ) reaction at 5 MeV/nucleon. The measured excitation energies and the deduced spectroscopic factors are in good overall agreement with (0+1)hω shell model calculations performed in a complete spsdfp basis and incorporating a reduction in the N=20 gap. Notably, the 1p3/2 neutron configuration was found to play an enhanced role in the structure of the low-lying negative parity states in 26Na, compared to the isotone 28Al. Thus, the lowering of the 1p3/2 orbital relative to the 0f7/2 occurring in the neighbouring Z=10 and 12 nuclei - 25,27Ne and 27,29Mg - is seen also to occur at Z=11 and further strengthens the constraints on the modelling of the transition into the island of inversion

Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19.

BACKGROUND: The efficacy of interleukin-6 receptor antagonists in critically ill patients with coronavirus disease 2019 (Covid-19) is unclear. METHODS: We evaluated tocilizumab and sarilumab in an ongoing international, multifactorial, adaptive platform trial. Adult patients with Covid-19, within 24 hours after starting organ support in the intensive care unit (ICU), were randomly assigned to receive tocilizumab (8 mg per kilogram of body weight), sarilumab (400 mg), or standard care (control). The primary outcome was respiratory and cardiovascular organ support-free days, on an ordinal scale combining in-hospital death (assigned a value of -1) and days free of organ support to day 21. The trial uses a Bayesian statistical model with predefined criteria for superiority, efficacy, equivalence, or futility. An odds ratio greater than 1 represented improved survival, more organ support-free days, or both. RESULTS: Both tocilizumab and sarilumab met the predefined criteria for efficacy. At that time, 353 patients had been assigned to tocilizumab, 48 to sarilumab, and 402 to control. The median number of organ support-free days was 10 (interquartile range, -1 to 16) in the tocilizumab group, 11 (interquartile range, 0 to 16) in the sarilumab group, and 0 (interquartile range, -1 to 15) in the control group. The median adjusted cumulative odds ratios were 1.64 (95% credible interval, 1.25 to 2.14) for tocilizumab and 1.76 (95% credible interval, 1.17 to 2.91) for sarilumab as compared with control, yielding posterior probabilities of superiority to control of more than 99.9% and of 99.5%, respectively. An analysis of 90-day survival showed improved survival in the pooled interleukin-6 receptor antagonist groups, yielding a hazard ratio for the comparison with the control group of 1.61 (95% credible interval, 1.25 to 2.08) and a posterior probability of superiority of more than 99.9%. All secondary analyses supported efficacy of these interleukin-6 receptor antagonists. CONCLUSIONS: In critically ill patients with Covid-19 receiving organ support in ICUs, treatment with the interleukin-6 receptor antagonists tocilizumab and sarilumab improved outcomes, including survival. (REMAP-CAP ClinicalTrials.gov number, NCT02735707.)

Three-dimensional measurement of cemented femoral stem stability: An in vitro cadaver study

Objective. To compare the in vitro stability of two cemented hip stem designs: Stem I was a collarless, double-tapered, highly polished implant; Stem II had a collar and matt finish. Background. Stability of the femoral component of a hip implant is important for its long-term clinical success. Excessive migration or cyclic motion can increase the risk of early implant failure. Methods. The stems were implanted in paired human cadaver femurs, and custom-designed micromotion sensors were used to measure three- dimensional motions of the stems at proximal, middle and distal locations during simulated in vivo loading cycles. Results. This study found that despite 'rigid' fixation, cemented stems exhibit detectable motions under a limited number of cycles of simulated physiologic loads. At four times the donor body weight, Stem I showed a subsidence of 90 μm, compared to 25 μm of Stem II (P<0.05). In contrast, the proximal end of Stem II exhibited greater cyclic motions in the medial-lateral direction (P<0.05). Conclusions. The different mot

Le isole Baleari e Canarie : due diversi tipi di insularit\ue0 nell'Estado auton\uf3mico spagnolo

Analisi delle caratteristiche peculiari degli arcipelaghi spagnol

Scaling Methods in Regional Integrated Assessments: From Points Upward and from Global Models Downwards

Scaling methods in regional integrated assessments are often adopted as givens, when in fact there are a range of methods that each have their strengths and weaknesses. Methods such as a site within a polygon, spatially uniform grids, grids with relational data on polygons, interpolation and stochastic spatial models are reviewed for crop-climate modeling of climate change impacts developed in the European Union’s Clivara project. A similar suite of methods for downscaling from global climate models to local conditions exists, and is reviewed. Up- and down-scaling issues relate to availability of data, the level of technical expertise in the project team, validation, uncertainty and risk, stakeholder participation, and modeling of actor-agents. Given the many aims of integrated assessments, no one approach is best