A randomised controlled trial of prehabilitation in patients undergoing elective cardiac surgery

The feasibility, safety and efficacy of prehabilitation in adult patients awaiting elective cardiac surgery are unknown. A total of 180 participants undergoing elective cardiac surgery were allocated randomly to receive either standard pre-operative care or prehabilitation, consisting of pre-operative exercise and inspiratory muscle training. The primary outcome was change in six-minute walk test distance from baseline to pre-operative assessment. Secondary outcomes included change in inspiratory muscle strength (maximal inspiratory pressure); sarcopenia (handgrip strength); quality of life and compliance. Safety outcomes were pre-specified surgical and pulmonary complications and adverse events. All outcomes were assessed at baseline; at pre-operative assessment; and 6 and 12 weeks following surgery. Mean (SD) age was 64.7 (10.2) years; 33/180 (18%) were women. In total, 65/91 (71.4%) participants who were allocated to prehabilitation attended at least four of eight supervised in-hospital exercise classes; participants aged > 50 years were more likely than younger participants to attend (odds ratio (95%CI) of 4.6 (1.0–25.1)). Six-minute walk test was not significantly different between groups (mean difference (95%CI) -7.8 m (-30.6–15.0), p = 0.503) in the intention-to-treat analysis. Subgroup analyses based on tests for interaction indicated improvements in six-minute walk test distance were larger amongst sarcopenic patients in the prehabilitation group (p = 0.004). Change in maximal inspiratory pressure from baseline to all time-points was significantly greater in the prehabilitation group, with the greatest mean difference (95%CI) observed 12 weeks after surgery (10.6 cmH2O (4.6–16.6) cmH2O, p < 0.001). There were no differences in handgrip strength or quality of life up to 12 weeks after surgery. There was no significant difference in postoperative mortality (one death in each group), surgical or pulmonary complications. Of 71 pre-operative adverse events, six (8.5%) were related to prehabilitation. The combination of exercise and inspiratory muscle training in a prehabilitation intervention before cardiac surgery was not superior to standard care in improving functional exercise capacity measured by six-minute walk test distance pre-operatively. Future trials should target patients living with sarcopenia and include inspiratory muscle strength training

Thermally assisted magnetization reversal in the presence of a spin-transfer torque

We propose a generalized stochastic Landau-Lifshitz equation and its corresponding Fokker-Planck equation for the magnetization dynamics in the presence of spin transfer torques. Since the spin transfer torque can pump a magnetic energy into the magnetic system, the equilibrium temperature of the magnetic system is ill-defined. We introduce an effective temperature based on a stationary solution of the Fokker-Planck equation. In the limit of high energy barriers, the law of thermal agitation is derived. We find that the N\'{e}el-Brown relaxation formula remains valid as long as we replace the temperature by an effective one that is linearly dependent of the spin torque. We carry out the numerical integration of the stochastic Landau-Lifshitz equation to support our theory. Our results agree with existing experimental data.Comment: 5 figure

Electromotive forces and the Meissner effect puzzle

In a voltaic cell, positive (negative) ions flow from the low (high) potential electrode to the high (low) potential electrode, driven by an `electromotive force' which points in opposite direction and overcomes the electric force. Similarly in a superconductor charge flows in direction opposite to that dictated by the Faraday electric field as the magnetic field is expelled in the Meissner effect. The puzzle is the same in both cases: what drives electric charges against electromagnetic forces? I propose that the answer is also the same in both cases: kinetic energy lowering, or `quantum pressure'

Petrogenesis and Ni-Cu sulphide potential of mafic-ultramafic rocks in the Mesoproterozoic Fraser Zone within the Albany-Fraser Orogen, Western Australia

The Albany Fraser Orogen is located along the southern and southeastern margins of the Archean Yilgarn Craton. The orogen formed during reworking of the Yilgarn Craton, along with variable additions of juvenile mantle material, from at least 1810 Ma to 1140 Ma. The Fraser Zone is a 425 km long and 50 km wide geophysically distinct belt near the northwestern edge of the orogen, hosting abundant sills of predominantly metagabbroic non-cumulate rocks, but including larger cumulate bodies, all emplaced at c. 1300 Ma. The gabbroic rocks are interpreted to have crystallised from a basaltic magma that had ∼8.8% MgO, 185 ppm Ni, 51 ppm Cu, and extremely low contents of platinum-group elements (PGE, <1 ppb). Levels of high field-strength elements (HFSE) in the least enriched rocks indicate that the magma was derived from a mantle source more depleted than a MORB source. Isotope and trace element systematics suggest that the magma was contaminated (εNd 0 to −2 throughout, La/Nb around 3) with small (<10%) amounts of crust before and during ascent and emplacement. Larger bodies of cumulate rocks show evidence for additional contamination, at the emplacement level, with country-rock metasedimentary rocks or their anatectic melts. The area has been the focus of considerable exploration for Ni–Cu sulphides following the discovery of the Nova deposit in 2012 in an intrusion consisting of olivine gabbronoritic, noritic and peridotitic cumulates, interlayered with metasedimentary rocks belonging to the Snowys Dam Formation of the Arid Basin. Disseminated sulphides from a drillcore intersecting the structurally upper portion of the intrusion, above the main ore zone, have tenors of ∼3–6.3% Ni, 1.8–6% Cu and mostly <500 ppb PGE, suggesting derivation from magma with the same composition as the regional Fraser Zone metagabbroic sills, at R factors of ∼1500. However, the Nova rocks tend to have higher εSr (38–52) and more variable δ34S (−2 to +4) than the regional metagabbros (εSr 17–32, δ34S around 0), consistent with the geochemical evidence for enhanced crustal assimilation of the metasedimentary country-rock in a relatively large magma staging chamber from which pulses of sulphide bearing, crystal-charged magmas were emplaced at slightly different crustal levels. Preliminary investigations suggest that the critical factors determining whether or not Fraser Zone mafic magmas are mineralised probably relate to local geodynamic conditions that allow large magma chambers to endure long enough to sequester country-rock sulphur

Magnetic Field Amplification in Galaxy Clusters and its Simulation

We review the present theoretical and numerical understanding of magnetic field amplification in cosmic large-scale structure, on length scales of galaxy clusters and beyond. Structure formation drives compression and turbulence, which amplify tiny magnetic seed fields to the microGauss values that are observed in the intracluster medium. This process is intimately connected to the properties of turbulence and the microphysics of the intra-cluster medium. Additional roles are played by merger induced shocks that sweep through the intra-cluster medium and motions induced by sloshing cool cores. The accurate simulation of magnetic field amplification in clusters still poses a serious challenge for simulations of cosmological structure formation. We review the current literature on cosmological simulations that include magnetic fields and outline theoretical as well as numerical challenges.Comment: 60 pages, 19 Figure

Heavy quarkonium: progress, puzzles, and opportunities

A golden age for heavy quarkonium physics dawned a decade ago, initiated by the confluence of exciting advances in quantum chromodynamics (QCD) and an explosion of related experimental activity. The early years of this period were chronicled in the Quarkonium Working Group (QWG) CERN Yellow Report (YR) in 2004, which presented a comprehensive review of the status of the field at that time and provided specific recommendations for further progress. However, the broad spectrum of subsequent breakthroughs, surprises, and continuing puzzles could only be partially anticipated. Since the release of the YR, the BESII program concluded only to give birth to BESIII; the $B$-factories and CLEO-c flourished; quarkonium production and polarization measurements at HERA and the Tevatron matured; and heavy-ion collisions at RHIC have opened a window on the deconfinement regime. All these experiments leave legacies of quality, precision, and unsolved mysteries for quarkonium physics, and therefore beg for continuing investigations. The plethora of newly-found quarkonium-like states unleashed a flood of theoretical investigations into new forms of matter such as quark-gluon hybrids, mesonic molecules, and tetraquarks. Measurements of the spectroscopy, decays, production, and in-medium behavior of c\bar{c}, b\bar{b}, and b\bar{c} bound states have been shown to validate some theoretical approaches to QCD and highlight lack of quantitative success for others. The intriguing details of quarkonium suppression in heavy-ion collisions that have emerged from RHIC have elevated the importance of separating hot- and cold-nuclear-matter effects in quark-gluon plasma studies. This review systematically addresses all these matters and concludes by prioritizing directions for ongoing and future efforts.Comment: 182 pages, 112 figures. Editors: N. Brambilla, S. Eidelman, B. K. Heltsley, R. Vogt. Section Coordinators: G. T. Bodwin, E. Eichten, A. D. Frawley, A. B. Meyer, R. E. Mitchell, V. Papadimitriou, P. Petreczky, A. A. Petrov, P. Robbe, A. Vair

Determination of Superconducting Gap of SmFeAsFxO1-x Superconductors by Andreev Reflection Spectroscopy

The superconducting gap in FeAs-based superconductor SmFeAs(O1-xFx) (x = 0.15 and 0.30) and the temperature dependence of the sample with x = 0.15 have been measured by Andreev reflection spectroscopy. The intrinsic superconducting gap is independent of contacts while many other "gap-like" features vary appreciably for different contacts. The determined gap value of 2D = 13.34 +/-0.47 meV for SmFeAs(O0.85F0.15) gives 2D/kBTC = 3.68, close to the BCS prediction of 3.53. The superconducting gap decreases with temperature and vanishes at TC, in a manner similar to the BCS behavior but dramatically different from that of the nodal pseudogap behavior in cuprate superconductors.Comment: 13 pages, 9 figures, Special Issue of Physica C on Superconducting Pnictide

Genome-wide association for major depressive disorder: a possible role for the presynaptic protein piccolo

Major depressive disorder (MDD) is a common complex trait with enormous public health significance. As part of the Genetic Association Information Network initiative of the US Foundation for the National Institutes of Health, we conducted a genome-wide association study of 435 291 single nucleotide polymorphisms (SNPs) genotyped in 1738 MDD cases and 1802 controls selected to be at low liability for MDD. Of the top 200, 11 signals localized to a 167 kb region overlapping the gene piccolo (PCLO, whose protein product localizes to the cytomatrix of the presynaptic active zone and is important in monoaminergic neurotransmission in the brain) with P-values of 7.7 × 1

Characteristics of contralateral carcinomas in patients with differentiated thyroid cancer larger than 1 cm

Purpose: Traditionally, total thyroidectomy has been advocated for patients with tumors larger than 1 cm. However, according to the ATA and NCCN guidelines (2015, USA), patients with tumors up to 4 cm are now eligible for lobectomy. A rationale for adhering to total thyroidectomy might be the presence of contralateral carcinomas. The purpose of this study was to describe the characteristics of contralateral carcinomas in patients with differentiated thyroid cancer (DTC) larger than 1 cm. Methods: A retrospective study was performed including patients from 17 centers in 5 countries. Adults diagnosed with DTC stage T1b-T3 N0-1a M0 who all underwent a total thyroidectomy were included. The primary endpoint was the presence of a contralateral carcinoma. Results: A total of 1

The product of a Petrine circle? A reassessment of the origin and character of 1 Peter

© 2002 SAGE PublicationsRecent studies of 1 Peter, especially by John Elliott, have sought to rescue the letter from its assimilation to the Pauline tradition and to establish the view, now widely held, that 1 Peter is the distinctive product of a Petrine circle. After examining the traditions in 1 Peter, both Pauline and non-Pauline, and the names in the letter (Silvanus, Mark and Peter), this essay argues that there is no substantial evidence, either inside or outside the letter, to support the view of 1 Peter as originating from a specifically Petrine group. It is much more plausibly seen as reflecting the consolidation of early Christian traditions in Roman Christianity. Despite the scholarly majority currently in its favour, the view of 1 Peter as the distinctive product of a Petrine tradition from a Petrine circle should therefore be rejected