New-onset myasthenia gravis after mRNA SARS-CoV-2 vaccination: a case series

Background Myasthenia gravis (MG) is an autoimmune disease that targets acetylcholine receptor (AChR) of the neuromuscular junction. New-onset MG after SARS-CoV-2 vaccination has rarely been reported. Case presentation We report about three patients who presented new-onset myasthenia gravis after receiving mRNA SARSCoV-2 vaccination. The patients were all males and older than 55 years. All the patients presented with ocular and bulbar symptoms. The interval between vaccine administration and MG onset ranged from 3 days after the frst dose to 10 days after the second dose. All the patients had elevated serum AChR antibodies and responded to pyridostigmine. Two out of three patients were successfully treated with IVIG or plasma exchange and with long-term immunosuppression. Conclusions MG is a rare disease; clinicians should be aware of possible new-onset MG after SARS-CoV-2 vaccination, especially with the current recommendation of booster doses. The hyperstimulation of the innate immune system or the exacerbation of a subclinical pre-existing MG could be possible explanations

Improved astrophysical rate for the 18O(p,α)15N reaction by underground measurements

The 18O(p,\u3b1)15N reaction affects the synthesis of 15N, 18O and 19F isotopes, whose abundances can be used to probe the nucleosynthesis and mixing processes occurring deep inside asymptotic giant branch (AGB) stars. We performed a low-background direct measurement of the 18O(p,\u3b1)15N reaction cross-section at the Laboratory for Underground Nuclear Astrophysics (LUNA) from center of mass energy Ec.m.=340keV down to Ec.m.=55keV, the lowest energy measured to date corresponding to a cross-section of less than 1 picobarn/sr. The strength of a key resonance at center of mass energy Er=90keV was found to be a factor of 10 higher than previously reported. A multi-channel R-matrix analysis of our and other data available in the literature was performed. Over a wide temperature range, T=0.01\u20131.00GK, our new astrophysical rate is both more accurate and precise than recent evaluations. Stronger constraints can now be placed on the physical processes controlling nucleosynthesis in AGB stars with interesting consequences on the abundance of 18O in these stars and in stardust grains, specifically on the production sites of oxygen-rich Group II grains

Direct measurements of low-energy resonance strengths of the 23Na(p,γ)24Mg reaction for astrophysics

The NeNa and the MgAl cycles play a fundamental role in the nucleosynthesis of asymptotic giant branch stars undergoing hot bottom burning. The 23Na(p, \u3b3)24Mgreaction links these two cycles and a precise determination of its rate is required to correctly estimate the contribution of these stars to the chemical evolution of various isotopes of Na, Mg and Al. At temperatures of 50 <110 MK, narrow resonances at Ep=140and 251 keVare the main contributors to the reaction rate, in addition to the direct capture that dominates in the lower part of the temperature range. We present new measurements of the strengths of these resonances at the Laboratory for Underground Nuclear Astrophysics (LUNA). We have used two complementary detection approaches: high efficiency with a 4\u3c0BGO detector for the 140keV resonance, and high resolution with a HPGe detector for the 251keV resonance. Thanks to the reduced cosmic ray background of LUNA, we were able to determine the resonance strength of the 251keV resonance as \u3c9\u3b3=482(82)\u3bceVand observed new gamma ray transitions for the decay of the corresponding state in 24Mgat Ex=11931 keV. With the highly efficient BGO detector, we observed a signal for the 140keV resonance for the first time in a direct measurement, resulting in a strength of \u3c9\u3b3140=1.46+0.58 120.53neV(68% CL). Our measurement reduces the uncertainty of the 23Na(p, \u3b3)24Mgreaction rate in the temperature range from 0.05 to 0.1GK to at most +50% 1235%at 0.07GK. Accordingly, our results imply a significant reduction of the uncertainties in the nucleosynthesis calculations

Advances in radiative capture studies at LUNA with a segmented BGO detector

Studies of charged-particle reactions for low-energy nuclear astrophysics require high sensitivity, which can be achieved by means of detection setups with high efficiency and low backgrounds, to obtain precise measurements in the energy region of interest for stellar scenarios. High-efficiency total absorption spectroscopy is an established and powerful tool for studying radiative capture reactions, particularly if combined with the cosmic background reduction by several orders of magnitude obtained at the Laboratory for Underground Nuclear Astrophysics (LUNA). We present recent improvements in the detection setup with the Bismuth GermaniumOxide (BGO) detector at LUNA, aiming to reduce high-energy backgrounds and to increase the summing detection efficiency. The new design results in enhanced sensitivity of the BGO setup, as we demonstrate and discuss in the context of the first direct measurement of the 65 keV resonance (Ex = 5672 keV) of the 17O(p, γ)18F reaction. Moreover, we show two applications of the BGO detector, which exploit its segmentation. In case of complex γ-ray cascades, e. g. the de-excitation of Ex = 5672 keV in 18F, the BGO segmentation allows to identify and suppress the beam induced background signals that mimic the sum peak of interest. We demonstrate another new application for such a detector in form of in-situ activation measurementsof a reaction with β+ unstable product nuclei, e. g., the 14N(p, γ)15O reactio