Constraints on the symmetry energy and on neutron skins from the pygmy resonances in 68Ni and 132Sn

Correlations between the behavior of the nuclear symmetry energy, the neutron skins, and the percentage of energy-weighted sum rule (EWSR) exhausted by the Pygmy Dipole Resonance (PDR) in 68Ni and 132Sn have been investigated by using different Random Phase Approximation (RPA) models for the dipole response, based on a representative set of Skyrme effective forces plus meson-exchange effective Lagrangians. A comparison with the experimental data has allowed us to constrain the value of the derivative of the symmetry energy at saturation. The neutron skin radius is deduced under this constraint.Comment: Accepted for publication in PRC Rapid Comminicatio

Effects of Spirulina and plant oil on the growth and lipid traits of white sturgeon (Acipenser transmontanus) fingerlings

The aim of this research was to evaluate the efficiency of diets with Spirulina and plant oils (POs) inclusion for white sturgeon weaning and their effects on the fatty acid (FA) composition of fish flesh. Three isoproteic (45%) and isoenergetic (21 MJ kg−1 DM) diets were formulated: one fish meal-based diet integrated with fish oil (FMO) and two 40% Spirulina meal-based diets integrated with corn (SPC) or soybean (SPS) oils respectively. One hundred and thirty-five white sturgeon fingerlings (mean weight 17.5 g) were stocked randomly in nine fibreglass tanks. At the end of the trial, which lasted 71 days, the growth performance traits and somatic indexes were determined. The chemical composition, gross energy and FA profile were determined on the fish fillets. No significant effects were observed for the growth performances or fillet chemical composition. The FA profile of the fillets reflected those of the diets. In particular, the fillets of the fish fed with the SPC and SPS diets were lower in n-3 FA, due to the substitution of fish oil (FO) with POs. It is possible to replace FO and meal in sturgeon; therefore, Spirulina meal integrated with POs could be a good alternative to sturgeon diet

Active infective endocarditis: Clinical characteristics and factors related to hospital mortality

Background: Little information exists on the clinical characteristics and factors related to hospital mortality in patients with active infective endocarditis referred for surgery. Methods: Between January 1, 2003 and December 31, 2006, 86 patients (56 males, 30 females, mean age 59.2 years) with active infective endocarditis were referred to our Department (2.8% of overall hospitalizations). The relation of several clinical, laboratory and echocardiographic findings at admission with hospital mortality was evaluated. Results: A native valve (NVE) was involved in 50/86; the other 30 had a prosthetic valve endocarditis (PVE). Six had pacemaker endocarditis. The aortic valve was involved more frequently than the mitral valve, both in NVE and PVE. The tricuspid valve was involved in four drug addicts; 51% of patients were in NYHA class III–IV. Staphylococci and streptococci were isolated in 69% of patients (39% vs 30%). Blood cultures were negative in 24%. Overall hospital mortality has been 11.6%. Two patients died before surgery, eight in the perioperative period. Hospital mortality was closely related to age, clinical and laboratory evidence of advanced septic condition (temperature > 38°C, leukocytosis and creatinine > 2.0 mg/dL) and hemodynamic impairment. Conclusions: Active infective endocarditis is a significant cause of referral to heart surgery departments and hospital mortality is still > 10%. Clinical and laboratory parameters easily available at admission suggest that severe sepsis and/or hemodynamic impairment may be helpful in predicting the clinical outcome in this group of high risk patients. (Cardiol J 2010; 17, 6: 566-573

Freestanding Cellulose Acetate/ZnO Flowers Composites for Solar Photocatalysis and Controlled Zinc Ions Release

The versatile properties of ZnO micro- and nano- structures have resulted in many applications in piezotronics, biosensors and photocatalysis. However, ZnO can easily dissolve in aqueous fluids, potentially resulting in the release of reactive oxygen species and zinc ions at toxic concentrations. Such an issue can be solved by dispersing ZnO within biocompatible polymeric matrices to reduce the direct exposure to the aqueous fluid and control the release of zinc ions. Herein, this work explores tailored ZnO flowers/cellulose acetate photocatalytic composites at different ZnO weight percentages (1-15 wt%). The photocatalytic degradation of methylene blue dye under simulated solar light is studied, finding an optimal value of ZnO filler loading in the polymer (10 wt %), resulting from a compromise between the photodegradation efficiency and the hydrophobicity induced by ZnO flowers. The reusability of the composites is investigated, finding a surprising improvement in the photodegradation efficiency after the first cycle. Simulated solar light stimulation induces the controllable release of zinc ions in aqueous solution at ppm-levels from the composites at the optimal ZnO filler loading. Finally, the release of ionic species in the absence of light stimulation is found to be directly proportional to the ZnO-loading in the composite, as a result of its degradation in aqueous environments

Results of a survey on elderly head and neck cancer patients on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Problem. Over the years, evidence-based data and technical improvements have consolidated the central role of radiation therapy (RT) in head and neck cancer (HNC) treatment, even in the elderly. This survey aimed to describe the management of the elderly HNC patients among Italian Radiation Oncology Departments (RODs) and provide possible suggestions for improvement. Method of study. An online survey based on 43 questions was sent to RODs via email. For each RODs, a radiation oncologist with expertise in HNC was invited to answer questions addressing his/her demographic data, ROD multidisciplinary unit (MU) organisation and ROD management policy in elderly HNC patients. Results. In total, 68 RODs answered, representing centres located in 16 Italian regions. MU was considered the core of HNC patient management in almost all the country. However, in many RODs, there was minimal access to a routinely comprehensive geriatric assessment at diagnosis. Most treatments were reported by respondents as curative (89% on average) and the preferred treatment technique was intensity modulated radiation therapy (IMRT). A considerable variation between RODs was found for RT target volumes. There was a relation between the specialist’s years of experience and type of concomitant systemic therapy prescribed. Conclusions. Substantial differences in elderly HNC management have been found, especially concerning patient clinical evaluation and target volume delineation. This survey shows the necessity to design a prospective national trial to provide a uniform treatment strategy and define an effective patient-centred approach

A prognostic model for use before elective surgery to estimate the risk of postoperative pulmonary complications (GSU-Pulmonary Score): a development and validation study in three international cohorts

Background: Pulmonary complications are the most common cause of death after surgery. This study aimed to derive and externally validate a novel prognostic model that can be used before elective surgery to estimate the risk of postoperative pulmonary complications and to support resource allocation and prioritisation during pandemic recovery. Methods: Data from an international, prospective cohort study were used to develop a novel prognostic risk model for pulmonary complications after elective surgery in adult patients (aged ≥18 years) across all operation and disease types. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery, which was a composite of pneumonia, acute respiratory distress syndrome, and unexpected mechanical ventilation. Model development with candidate predictor variables was done in the GlobalSurg-CovidSurg Week dataset (global; October, 2020). Two structured machine learning techniques were explored (XGBoost and the least absolute shrinkage and selection operator [LASSO]), and the model with the best performance (GSU-Pulmonary Score) underwent internal validation using bootstrap resampling. The discrimination and calibration of the score were externally validated in two further prospective cohorts: CovidSurg-Cancer (worldwide; February to August, 2020, during the COVID-19 pandemic) and RECON (UK and Australasia; January to October, 2019, before the COVID-19 pandemic). The model was deployed as an online web application. The GlobalSurg-CovidSurg Week and CovidSurg-Cancer studies were registered with ClinicalTrials.gov, NCT04509986 and NCT04384926. Findings: Prognostic models were developed from 13 candidate predictor variables in data from 86 231 patients (1158 hospitals in 114 countries). External validation included 30 492 patients from CovidSurg-Cancer (726 hospitals in 75 countries) and 6789 from RECON (150 hospitals in three countries). The overall rates of pulmonary complications were 2·0% in derivation data, and 3·9% (CovidSurg-Cancer) and 4·7% (RECON) in the validation datasets. Penalised regression using LASSO had similar discrimination to XGBoost (area under the receiver operating curve [AUROC] 0·786, 95% CI 0·774-0·798 vs 0·785, 0·772-0·797), was more explainable, and required fewer covariables. The final GSU-Pulmonary Score included ten predictor variables and showed good discrimination and calibration upon internal validation (AUROC 0·773, 95% CI 0·751-0·795; Brier score 0·020, calibration in the large [CITL] 0·034, slope 0·954). The model performance was acceptable on external validation in CovidSurg-Cancer (AUROC 0·746, 95% CI 0·733-0·760; Brier score 0·036, CITL 0·109, slope 1·056), but with some miscalibration in RECON data (AUROC 0·716, 95% CI 0·689-0·744; Brier score 0·045, CITL 1·040, slope 1·009). Interpretation: This novel prognostic risk score uses simple predictor variables available at the time of a decision for elective surgery that can accurately stratify patients' risk of postoperative pulmonary complications, including during SARS-CoV-2 outbreaks. It could inform surgical consent, resource allocation, and hospital-level prioritisation as elective surgery is upscaled to address global backlogs. Funding: National Institute for Health Research

Proton pump inhibitors and serum magnesium levels in patients with Torsades de Pointes

Background: Torsades de pointes (TdP) is a life-threatening ventricular tachycardia occurring in long QT-syndrome patients. It usually develops when multiple QT-prolonging factors are concomitantly present, more frequently drugs and electrolyte imbalances. Since proton-pump inhibitors (PPIs)-associated hypomagnesemia is an increasingly recognized adverse event, PPIs were recently included in the list of drugs with conditional risk of TdP, despite only few cases of TdP in PPI users have been reported so far. Objectives: Aim of the present study is to evaluate whether PPI-induced hypomagnesemia actually has a significant clinical impact on the risk of TdP in the general population. Methods: Forty-eight unselected patients who experienced TdP were consecutively enrolled (2008-2017). Shortly after the first TdP episode, in those patients who did not receive magnesium sulfate and/or potassium or calcium replacement therapy, serum electrolytes were measured and their relationship with PPI usage analyzed. Results: Many patients (28/48, 58%) were under current PPI treatment when TdP occurred. Among TdP patients in whom serum electrolyte determinations were obtained before replacement therapy (27/48), those taking PPIs had significantly lower serum magnesium levels than those who did not. Hypomagnesemia occurred in ~40% of patients receiving PPIs (6/14), in all cases after an extended treatment (> 2 weeks). In patients taking PPIs the mean QT-prolonging risk factor number was significantly higher than in those who did not, a difference which was mainly driven by lower magnesium levels. Conclusions: In unselected TdP patients, PPI-induced hypomagnesemia was common and significantly contributed to their cumulative arrhythmic risk. By providing clinical support to current recommendations, our data confirm that more awareness is needed when a PPI is prescribed, specifically as regards the risk of life-threatening arrhythmias

Utility of baseline 18FDG-PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma

The International Extranodal Lymphoma Study Group (IELSG) 26 study was designed to evaluate the role of (18)F-fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) in the management of primary mediastinal (thymic) large B-cell lymphoma (PMBCL). We examined the prognostic impact of functional PET parameters at diagnosis. Metabolic activity defined by the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) was measured on baseline 18FDG PET/CT following a standard protocol in a prospectively enrolled cohort of 103 PMBCL patients. All received combination chemoimmunotherapy with doxorubicin- and rituximab-based regimens; 93 had consolidation radiotherapy. Cutoff values were determined using the receiver-operating characteristic curve. At a median follow-up of 36 months, progression-free survival (PFS) and overall survival (OS) were 87% and 94%, respectively. In univariate analysis, elevated MTV and TLG were significantly associated with worse PFS and OS. Only TLG retained statistical significance for both OS (P = .001) and PFS (P < .001) in multivariate analysis. At 5 years, OS was 100% for patients with low TLG vs 80% for those with high TLG (P = .0001), whereas PFS was 99% vs 64%, respectively (P < .0001). TLG on baseline PET appeared to be a powerful predictor of PMBCL outcomes and warrants further validation as a biomarker. The IELSG 26 study was registered at www.clinicaltrials.gov as #NCT00944567

Francesco Ferrara, il primo degli economisti cafoscarini

The paper presents the important personality of the great Italian economist Francesco Ferrara who has been the first Director of the new School of Commerce founded in Venice in 1868. The paper is divided in two parts: the first part presents the main features of Francesco Ferrara as an economist, showing how he was clearly a supporter of a free-market oriented vision of the economic analysis and of the economic policy, not liking at all a vision of the economic analysis separated from the political implications, but definitely favouring a political economy vision. He was a sharp opponent of socialism, although admiring the logical power of Marx's thought, but not Marxian ideas. But he was also an opponent of intermediate visions leading to mediations in the field of economic policy. His rather radical positions led him to resign from the role of minister of Finance. In the second part the paper shows how Ferrara accepted the proposal of Luigi Luzzatti to be appointed as director of new School of Commerce of Ca' Foscari in summer 1868; the paper shows how the relations between Ferrara and Luzzatti were characterized by polemical moments, both because of the lines followed by Ferrara in appointing the professors of the new school and because of the openness shown by Luzzatti, and not liked at all by Ferrara, towards policies showing a favorable attitude towards social interventions. Eventually the disagreements were solved. Finally, the paper shows how Ferrara succeeded in appointing at Ca' Foscari some of the most important Italian economists of his time, such as Maffeo Pantaleoni

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or >= 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care