Three dimensional fluid-kinetic model of a magnetically guided plasma jet

A fluid-kinetic model of the collisionless plasma row in a convergent-divergent magnetic nozzle is presented. The model combines the leading-order Vlasov equation and the fluid continuity and perpendicular momentum equation for magnetized electrons, and the fluid equations for cold ions, which must be solved iteratively to determine the self-consistent plasma response in a three-dimensional magnetic field. The kinetic electron solution identifies three electron populations and provides the plasma density and pressure tensor. The far downstream asymptotic behavior shows the anisotropic cooling of the electron populations. The fluid equations determine the electric potential and the fluid velocities. In the small ion-sound gyroradius case the solution is constructed one magnetic line at a time. In the large ion-sound gyroradius case, ion detachment from magnetic lines makes the problem fully three-dimensional.This work was supported by National R&D Plan (Grant ESP2016-75887) from the Gobierno de España. Jesús Ramos thanks the financial sponsorship of the Chair of Excellence award granted by UC3M and Banco de Santander

Prognostic Role of Bacterial and Fungal Infections in Patients with Liver Cirrhosis with and without Acute-on-Chronic Liver Failure: A Prospective 2-Center Study

Background. Bacterial and fungal infections (BFIs) are frequent in patients with cirrhosis and often trigger acute-on-chronic liver failure (ACLF). This prospective observational study aims to describe the interactions between BFI and ACLF in terms of mortality and related risk factors. Methods. We performed a 2-center prospective observational study enrolling hospitalized patients with cirrhosis admitted for acute decompensation. Data were recorded at admission and during hospitalization. Survival was recorded up to 1 year. Results. Among the 516 patients enrolled, 108 (21%) were infected at admission, while an additional 61 patients (12%) developed an infection during hospital stay. In the absence of ACLF, the 1-year mortality rate of patients with BFI did not differ from that of patients without BFI (33% vs 31%; P = .553). In contrast, those with ACLF triggered or complicated by BFI had a significantly higher mortality rate than those who remained free from BFI (75% vs 54%; P = .011). Competing risk analysis showed that the negative impact of ACLF-related BFI on long-term prognosis was independent from Model for End-stage Liver Disease (MELD) incorporating serum sodium concentration score, comorbidity, and basal C-reactive protein level. Finally, multivariable logistic regression showed that higher MELD score (P < .001), QuickSOFA score ≥2 points (P = .007), and secondary bloodstream (P = .022) and multidrug-resistant pathogen isolation (P = .030) were independently associated with ACLF in patients with BFI. Conclusions. This large prospective study indicated that the adverse impact of BFI on long-term survival in decompensated cirrhosis is not universal but is limited to those patients who also develop ACLF. Both disease severity and microbiological factors predispose infected decompensated patients to ACLF

Inductive Plasma Thruster (IPT) design for an Atmosphere-Breathing Electric Propulsion System (ABEP)

Challenging space missions include those at very low altitudes, where the atmosphere is source of aerodynamic drag on the spacecraft, therefore an efficient propulsion system is required to extend the mission lifetime. One solution is Atmosphere-Breathing Electric Propulsion (ABEP). It collects atmospheric particles to use as propellant for an electric thruster. This would minimize the requirement of limited propellant availability. The system could be applied to any planet with atmosphere, enabling new mission at these altitude ranges for continuous orbiting. Challenging is also the presence of reactive chemical species, such as atomic oxygen in Earth orbit. Such components are erosion source of (not only) propulsion system components, i.e. acceleration grids, electrodes, and discharge channels of conventional EP systems (RIT and HET). IRS is developing within the DISCOVERER project an intake and a thruster for an ABEP system. This paper deals with the design and first operation of the inductive plasma thruster (IPT) developed at IRS. The paper describes its design aided by numerical tools such as HELIC and ADAMANT. Such a device is based on RF electrodeless discharge aided by externally applied static magnetic field. The IPT is composed by a movable injector, to variate the discharge channel length, and a movable electromagnet to variate position and intensity of the magnetic field. By changing these parameters along with a novel antenna design for electric propulsion, the aim is to achieve the highest efficiency for the ionization stage by enabling the formation of helicon-based discharge. Finally, the designed IPT is presented and the feature of the birdcage antenna highlighted

Mortality risk in a population of patients treated for gambling disorders: results of a follow-up study

Aims. To examine mortality risk and causes of death in a cohort of a population of patients treated for gambling disorders in northern Italy from 1992 to 2019. Methods. Cohort study. Results. Half of the patients were diagnosed with psychiatric disorders, substance use disorder or alcohol dependence. The excess mortality compared to the general population (SMR) was 1.16 (0.85-1.58), more elevated among females aged 40 to 59 and males aged 20 to 29. Females had higher SMRs for all cancers and suicide; males for malignant neoplasm of liver, of lung, of prostate, and of bladder. Conclusions. Despite patients increasing, subjects who most turn to the services are the most serious ones, in older age, with comorbid mental disorders and with a compromised health status. This is reflected in the high risk of death for all cancers

Suicide mortality risk in a cohort of individuals treated for alcohol, heroin or cocaine abuse: Results of a follow-up study

Cohort study. This follow-up study (from 1975 to 2016) was aimed to estimate the mortality risk for suicide in a cohort of patients presenting to a public treatment centre for addiction (SERD) with Alcohol Use Disorder (AUD), Heroin Use Disorder - HUD or Cocaine Use Disorder (CUD), also relating to their access to a Mental Heath Service. Crude Mortality Rates for suicide were higher for patients with AUDs, for men and subjects 45–64 years old. Hanging was the main cause of suicide death. We highlight an increase in mortality in the period 2009–2012, which coincides with the economic recession, and in the year of first contact with a SERD. The Standardized Mortality Ratios (SMRs) were 4.9, higher among females than males. From the multivariate analysis, a higher risk for patients that were separated or divorced was observed. The results of our study provide some guidance on the features of subjects at greatest risk of death from suicide, which may be useful in reducing and preventing suicide and gaining a better clinical management of patients with SUDs

Risky consumption, reasons for use, migratory status and normalization: the results of an Italian study on minors aged between 13 and 16

Aims \u2013 To describe the relationship between migratory status, the use of substance and psychological disorders perceived in a sample of minors. Design/methodology/approach Transversal multicentre study with interviews with young people aged 13 to 16 recruited from middle and high schools in Italy. Findings The results show the implementation of a process of normalization in terms of the presence of legal and illegal psychoactive substances in the living contexts of the minors, of their widespread early use and of a substantial indifferentiation in the reasons for use (e.g. pleasure, curiosity, fun). Youths born in Italy with at least one non-native parent are noteworthy for an elevated prevalence of perceived psychological disorders and for particular lifestyles linked to the use of marijuana, alcohol abuse and the intensive consumption of tobacco. Second generation minors show symptoms of psychological malaise, anxiety and depression before which the use of substances appears to realize a particular form of self-cure. Research limitations/implications This study presents some objective limits that indicate prudence in generalizing the results: only subjects who obtained consent from their parents were interviewed and the information communicated in the interviews could have been influenced by various factors, including the situation and the location. We used a standard definition of binge-drinking (Valencia-Mart\uedn et al., 2008). Actually, different criteria (i.e. number of drinks, time of consumption, etc.) and formulations of the question are used in different surveys, showing that there is as yet no consensus definition of binge-drinking. Nevertheless, the term has become somewhat confusing, as it is often used as a synonym of drunkenness, making cross-cultural comparisons difficult (Beccaria et al., 2014). These are aspects that limit the generalizability of the results to the interviews alone and do not allow for prevalence estimates. Nevertheless, the results offer useful indications for future prevention projects specifically oriented to early adolescence. Practical implications The results of the study, on the one hand, document the growing use of legal and illegal proactive substances among minors and the relative cultural trend in this particular age band, testified to by the high number of those who have been present in situations of consumption to whom the substances were offered; on the other, they evidence a subpopulation of youths born in Italy with at least one non-native parent (i.e. second generation of immigrants). These youths stand out for an elevated prevalence of perceived psychological disorders and for their particular lifestyles connected to the use of marijuana, to alcohol abuse and the intensive consumption of alcohol. This is also the group with the highest percentage of mothers alone in the family. Originality/value The results of the study show new and little known aspects of the multicultural Italian society that is changing profoundly, to be deepened by means of targeted research, which also focus on structural factors relatable to specific social positions. In this framework, a particular subgroup, i.e. the second generation minors, shows symptoms of psychic malaise, anxiety and depression in regard to which substance use seems to realize a form of self-cure

Identification of harmful drinking in subjects who have had their driving license suspended due to alcohol use: a retrospective Italian study

OBJECTIVE: Early identification of Harmful Drinking (HD) is difficult, and underestimated. The aim of our retrospective study was to investigate the presence of HD in a population of subjects who had their driving license suspended due to driving under the influence of alcohol. MATERIALS AND METHODS: We retrospectively recruited 979 subjects. During the first appointment (T0), clinical and laboratory characteristics of patients were evaluated, and the AUDIT questionnaire was administered. Two groups were then defined: Harmful Drinking (HD) and non-HD, and all subjects underwent a brief interview for 5-10 minutes before being assigned to a group. RESULTS: 95.9% of our sample were identified as non-HD, whereas 4.1% of them were HD; twenty-one (2.1%) of the HD underwent a control appointment (T1), and 17 (1.7%) of them were diagnosed with alcohol use disorder (AUD); there was a statistically significant reduction in mean daily alcohol intake (p<0.009), and in the mean values of the blood markers of HD between T0 and T1 in HD. CONCLUSIONS: The present study shows that 4.1%, and 1.7% of subjects presented a diagnosis of HD and AUD, respectively, and their entry in a protocol of drinking monitoring proved beneficial in reducing alcohol intake. Thus, the implementation of strict surveillance of subjects found driving under the influence of alcohol involving a network of professional figures (from police forces to specialists in alcohol addiction treatment) may help to detect and to treat subjects with HD and AUD, and to monitor their alcohol use over time