Detection of virial shocks in stacked Fermi-LAT clusters

In the hierarchical paradigm of structure formation, galaxy clusters are the largest objects ever to virialize. They are thought to grow by accreting mass through large scale, strong virial shocks. Such a collisionless shock is expected to accelerate relativistic electrons, thus generating a spectrally flat leptonic virial ring. However attempts to detect virial rings have all failed, leaving the shock paradigm unconfirmed. Here we identify a virial $\gamma$-ray signal by stacking Fermi-LAT data for 112 clusters, enhancing the ring sensitivity by rescaling clusters to their virial radii and utilizing the anticipated spectrum. In addition to a central unresolved, hard signal (detected at the nominal $5.8\sigma$ confidence level), probably dominated by active galactic nuclei, we identify ($5.9\sigma$) a bright, spectrally flat $\gamma$-ray ring at the expected shock position. It corresponds to $\sim 0.6\%$ (with an uncertainty factor $\sim2$) thermal energy deposition in relativistic electrons over a Hubble time. This result validates the shock paradigm, calibrates its parameters, and indicates that the cumulative emission from such shocks significantly contributes to the diffuse extragalactic $\gamma$-ray and radio backgrounds.Comment: Proceedings of the 7th International Fermi Symposium, Garmisch, Oct 15-20 201

The quality of women\u27s intelligence : female humanists in Renaissance Italy.

This thesis examines how the advent of humanism in Renaissance Italy impacted women, namely those who were raised within intellectual families and granted educational opportunities not before afforded to members of their sex. In quattrocento Italy, learned women began to circulate their writings and participate in the humanist milieu, and the intellectual lives and published works of these female humanists all in some manner contested Renaissance patriarchy and gender perceptions. As such, this thesis challenges the conception that the Renaissance further disenfranchised women and offers a framework for analyzing and appreciating the ways in which women participated in the academic dialogue of their time once past the age of sexual maturity. I argue that to fully analyze the myriad of ways in which learned adult women participated in humanism more narrowly, and in the Renaissance more broadly, their engagement with paternal figures, patrons, and patriarchal institutions must be appreciated on an individual basis. The investigation of Renaissance humanism and the educational opportunities the movement provided for women in Part I contextualizes the social and academic milieu of the four notable learned women presented in the microhistorical, biographical case studies. Furthermore, the case studies support my larger argument that a sexually mature female humanist’s public reception and career longevity were dependent upon her willingness to adhere to patriarchal ideology and conform to traditional prescriptions of femininity. This thesis, therefore, suggests that historians continue to ask how adult women’s experiences were determined by their sexual maturity, marital choices, and relationship with paternal figures, and even more importantly, how adult women continued to meaningfully participate in society in spite of socially mandated limitations on their gender

Surgical treatment of spondylitis and diaphragm relaxation in patient less than 1 year old

Design Case report. Introduction The combination of severe post-infectious kyphosis and diaphragm relaxation is extremely rare in patient early than 1 year old. Its no publications concerning their simultaneous surgical treatment. Case description 7-Month-old girl had simultaneous spinal reconstruction with anterior and posterior instrumentation and plastic of diaphragm because of sequelae of non-granulenatous spondylitis complicated by severe kyphosis (54°) and diaphragm relaxation. Between 1.5 and 3 months of live she had several infections incl. pneumonia, enterocolitis, ENT infection. Anterior fusion was done by titanium mesh with auto-rib, posterior – by compressive rods based on low-profile hooks. The deformity was reduced till 20°. 2.5 years after initial surgery and 1 year after removal of posterior instrumentation the adequate level of diaphragm and minimal (4°) loss of kyphosis correction were identified. Conclusions The combination of spondylitis and diaphragm relaxation in early aged patient could be explained but it could not be confirmed as a sequelae of late-onset neonatal sepsis with a multi-focal lesions. The simultaneous surgery provided on the combined approaches (trans-thoracic and posterior) looks as optimal options in such combination of pathologies. In remains controversial how will the spine develop after so early reconstructive surgery, including in situ stable anterior fusion carried out by titanium mesh with auto-rib

Хирургическое лечение последствий вертебральных поражений при сепсисе новорожденных (анализ серии клинических наблюдений)

Background. Neonatal sepsis presents one of the current issues in modern pediatrics. The orthopedic outcomes of such a state and the possibility of treatment, in particular by surgical spinal reconstruction, are rarely analyzed. Objective. To analyze pathology features and treatment outcomes in infants with vertebral complications resulted from neonatal sepsis.Material and Methods. The analysis of observation and treatment of 15 infants, who have undergone neonatal sepsis which led to vertebral lesion with subsequent gross kyphotic deformity formation, is presented.Results. Average age of infants was 2.5 months when spinal pathology was diagnosed. In 7 of the 15 observations, a local angular kyphosis was revealed when the acute phase of disease was already passed („cured“). The thoracic vertebrae were most often affected, mainly Th 7-8 vertebral bodies. Average kyphosis was 53°. All infants were operated on during the period from 2006 to 2017. Each had two-stage spinal reconstruction including the anterior spinal fusion using a titanium mesh cage filled with bone autografts, or an autogenous bone graft only. At the second stage, the instrumental correction and fixation of the spine with a multi-support laminar structure were performed. Average age of patients at the time of surgery was 14 months. Average value of kyphosis correction was 27°. Further correction and anterior spinal fusion were achieved when performing the incorporation of a titanium mesh cage with bone autografts. The histological and bacteriological examination of the surgical material did not reveal any signs of infection or inflammation. Correction of deformity and restoration of the supporting strength of anterior vertebral column as a result of surgery were achieved in all cases. Various complications in the early and late followup period were reported in a total of 7 cases. Repeated interventions were required in two patients: in one case in the early period (dislocation of the structure supporting hook) and in one case in the long-term period (graft resorption and kyphotic deformity relapse).Conclusion. One of the complications of neonatal sepsis is severe multilevel thoracic spondylitis, the outcome of which is the formation of severe kyphosis against the background of subtotal bone vertebral destruction. The principal possibility of radical spine reconstruction in infants with achievement of good anatomical and functional results is shown. Актуальность. Неонатальный сепсис является одной из актуальных проблем современной педиатрии. Ортопедические исходы таких состояний и возможности лечения, в частности, хирургической реконструкции позвоночника, анализируются крайне редко.Цель исследования — выявление особенностей патологии и оценка результатов лечения детей с вертебральными осложнениями перенесенного сепсиса новорожденных. Материал и методы. Представлен ретроспективный анализ наблюдения и лечения 15 детей, перенесших сепсис новорожденных с поражением позвоночника и последующим формированием грубой кифотической деформации.Результаты. Средний возраст детей на момент диагностики патологии позвоночника составил 2,5 мес. В 7 из 15 наблюдений локальный угловой кифоз выявлен после купирования острого состояния. Наиболее часто поражались грудные позвонки, преимущественно на уровне Th7-8. Средняя величина кифоза составила 53°. Все дети оперированы в период с 2006 по2017 г. в объеме расширенной реконструкции позвоночника с проведением переднего спондилодеза титановой блок-решеткой с аутокостью либо только аутокостью. Вторым этапом проводились задняя инструментальная коррекция и фиксация позвоночника многоопорной ламинарной конструкцией. Средний возраст детей на момент операции составил 14 мес. Средняя величина коррекции кифоза — 27°. Результаты коррекции и переднего спондилодеза были лучше при имплантации титановой блок-решётки с аутокостью. Проведенные гистологическое и бактериологическое исследования операционного материала ни в одном случае не выявили признаков активности инфекционно-воспалительного процесса. Коррекция деформации и восстановление опорности передней колонны позвоночника при операции достигнуты во всех случаях. Различные осложнения в раннем и позднем периодах наблюдения суммарно отмечены в 7 случаях. Повторные вмешательства потребовались у двоих пациентов: в одном случае в раннем периоде (вывих опорного крюка конструкции) и в одном случае — в отдаленном периоде (резорбция трансплантата и рецидив кифотической деформации).Заключение. Одно из осложнений сепсиса новорожденных — тяжелый многоуровневый спондилит грудного отдела позвоночника, исходом которого является формирование грубого кифоза на фоне субтотальной деструкции позвонков. Показана принципиальная возможность радикальной реконструкции позвоночника у детей раннего возраста с достижением хорошего анатомо-функционального результата.

Экстирпация грудных и поясничных полупозвонков из дорсального доступа с применением ультразвукового костного скальпеля у детей: результат проспективного многоцентрового исследования

Background. The surgical treatment of congenital spinal deformity caused by hemivertebra is associated with high rate of complications. A research of a new surgery technique for operation time and blood loss decrease could potentially improve outcomes. The purpose — to evaluate the efficacy of ultrasonic bone scalpel in surgical treatment of pediatric congenital spinal deformities caused by monosegmental hemivertebra. Patients and Methods. Level of Evidence III. The study based on the data of 55 consecutively operated pediatric patients who underwent 59 posterior hemivertebra resection provided by ultrasonic bone scalpel from January 2015 to December 2019. The average age was 4 years and 4 months. 36 hemivertebra were located in thoracic spine and 23 were located in lumbar spine. Total duration of surgery, estimated blood loss (ml and % of circulated blood volume, CBV), complications rate and deformity correction were noted. The influence of posterior instrumentation length and patients age at time of surgery on evaluation parameters was analyzed. 5-year (2015–2019) systematic literature review was performed for compare with obtain results. Results. Total operation time was 131 min ± 33 min for thoracic spine and 165 min ± 50 min for lumbar spine (p = 0,005). Estimated blood loss was 105 ml ± 74 ml (Me 80 ml) for thoracic resection and 123 ml ± 59 ml (Me 120 ml) — for lumbar (p = 0,178). The length of posterior instrumentation were not influence on operation time and total blood loss (p = 0,957; p = 0,967), patients age at time of surgery were not influence on operation time (p = 0,458), but correlate with total blood loss (p = 0,023). Intraoperative complications was not observed. Four cases of transpedicular screw malposition without neurological deficit were noted (type C acc. Gertzbein-Robbins). Conclusions. Posterior hemivertebra resection with ultrasonic bone scalpel is safe and effective procedure provides decrease of operation time and estimated blood loss.Актуальность. Хирургическое лечение врожденных деформаций позвоночника у детей на фоне полупозвонков сопряжено с высоким уровнем осложнений. Поиск путей снижения травматичности операции позволит улучшить отдаленные результаты. Цель — оценить эффективность применения ультразвукового костного скальпеля в хирургическом лечении врожденных деформаций позвоночника у детей на фоне моносегментарных полупозвонков. Материал и методы. Дизайн исследования — трехцентровое проспективное. Последовательно оперированы 55 пациентов в возрасте от 10 мес. до 13 лет (M = 4 года 4 мес., Me — 3 года 8 мес.), выполнены 59 экстирпаций полупозвонков (грудных — 36, поясничных — 23) с применением ультразвукового костного скальпеля из одного дорсального доступа. Оцениваемые параметры: длительность операции, объем кровопотери (абсолютный и относительный), частота и характер осложнений, величина коррекции деформации и ее динамика в послеоперационном периоде. Проведен систематический обзор литературы (период поиска публикаций 2015–2019 гг.) по дорсальным экстирпациям полупозвонков у детей, выполненных с применением стандартной техники с использованием высокоскоростного бура. Результаты. Длительность операции в серии составила 131±33 мин. для грудных экстирпаций и 165±50 мин. для поясничных (p = 0,005). Объем абсолютной кровопотери: 105±74 мл (Me 80 мл) для грудных экстирпаций и 123±59 мл (Me 120 мл) для поясничных (p = 0,178). Объем относительной кровопотери: 6,8±3,1% от ОЦК для грудных и 11,5±5,5% от ОЦК для поясничных экстирпаций (p = 0,002). Протяженность задней инструментальной фиксации не оказывает значимого влияния на длительность операции и объем абсолютной кровопотери (p = 0,957; p = 0,967). Возраст пациентов на момент операции не оказывает влияния на длительность операции (p = 0,458), при этом влияет на объем абсолютной кровопотери (p = 0,023). Интраоперационных осложнений не выявлено, за исключением 4 случаев мальпозиции ТПФ, не потребовавших ревизии. Заключение. Применение ультразвукового костного скальпеля при дорсальных экстирпациях полупозвонков у детей обеспечивает безопасность операции, снижает ее длительность и операционную кровопотерю

Calculation of nuclear magnetic shielding constants using variation-perturbation method with moderate size basis sets

Within a framework of variation-perturbation formalism of Karplus-Kolker, an algorithm and a program for the nuclear magnetic shielding calculations with ground-state wave functions were developed. The calculations of nuclear magnetic shielding σ in some diatomic molecules and also in methane, water and CH3F molecules with 6-311G ab initio wave functions were carried out. The results were compared with the experimental data and the results obtained by other theoretical methods. This method can be considered as an alternative approach for the calculations of the magnetic anisotropic effects on chemical shifts and can be used for predicting the tendencies in magnetic shielding alteration due to the different fragments in a big molecular systems. © 2001 Elsevier Science B.V. All rights reserved

MANAGEMENT OF INTENSIVE THERAPY OF GENERAL PERITONITIS IN CHILDREN

In the presented work the results of treatment of 161 children at the age from

Quantum-Chemical Model for Description of Solvation Effect in Proton-Transfer Reactions. Prediction of Gas-Phase Acidities of Organic Compounds

Electrostatic solvation effects in proton-transfer reactions were described in terms of the AM1 and MNDO energies of electrostatic interaction between a unit positive charge with organic anions. These values were then used to estimate the gas-phase acidities of organic compounds from the ionic acidities in dimethyl sulfoxide. For 35 CH, NH, OH, and SH acids, the difference between the calculated and experimental gas-phase acidities does not exceed 15 kJ/mol (standard deviation 8.3 kJ/mol)