Magnetic flux conservation in an imploding plasma

The theory of magnetic flux conservation is developed for a subsonic plasma implosion and used to describe the magnetic flux degradation in the MagLIF concept [S. A. Slutz et al., Phys. Plasmas 17, 056303 (2010)10.1063/1.3333505]. Depending on the initial magnetic Lewis and Péclet numbers and the electron Hall parameter, the implosion falls into either a superdiffusive regime in which the magnetization decreases or a magnetized regime in which the magnetization increases. Scaling laws for magnetic field, temperature, and magnetic flux losses in the hot spot of radius R are obtained for both regimes. The Nernst velocity convects the magnetic field outwards, pushing it against the liner and enhancing the magnetic field diffusion, thereby reducing the magnetic field compression and degrading the implosion performance. However, in the magnetized regime, the core of the hot spot becomes magnetically insulated and undergoes an ideal adiabatic compression (T∼R^{-4/3} compared to T∼R^{-2/3} without magnetic field), while the detrimental Nernst term is confined to the outer part of the hot spot. Its effect is drastically reduced, improving the magnetic flux conservation.

Developing ozone critical levels for multi-species canopies of Mediterranean annual pastures

Ozone (O₃) critical levels (CLe) are still poorly developed for herbaceous vegetation. They are currently based on single species responses which do not reflect the multi-species nature of semi-natural vegetation communities. Also, the potential effects of other factors like the nitrogen (N) input are not considered in their derivation, making their use uncertain under natural conditions. Exposure- and dose-response relationships were derived from two open-top chamber experiments exposing a mixture of 6 representative annual Mediterranean pasture species growing in natural soil to 4 O₃ fumigation levels and 3 N inputs. The Deposition of O₃ and Stomatal Exchange model (DO₃SE) was modified to account for the multi-species nature of the canopy following a big-leaf approach. This new approach was used for estimating a multi-species phytotoxic O₃ dose (POD_y-MS). Response relationships were derived based on O₃ exposure (AOT40) and flux (POD_y-MS) indices. The treatment effects were similar in the two seasons: O₃ reduced the aboveground biomass growth and N modulated this response. Gas exchange rates presented a high inter-specific variability and important inter-annual fluctuations as a result of varying growing conditions during the two years. The AOT40-based relationships were not statistically significant except when the highest N input was considered alone. In contrast, POD_y-MS relationships were all significant but for the lowest N input level. The influence of the N input on the exposure- and dose-response relationships implies that N can modify the O₃ CLe. However, this is an aspect that has not been considered so far in the methodologies for establishing O₃ CLe. Averaging across N input levels, a multi-species O₃ CLe (CLe_f-MS) is proposed POD_1-MS = 7.9 mmol m^-2, accumulated over 1.5 month with a 95% confidence interval of (5.9, 9.8). Further efforts will be needed for comparing the CLe_f-MS with current O₃ CLe_f based on single species responses.

Setting ozone critical levels for annual Mediterranean pasture species: Combined analysis of open-top chamber experiments

Annual Dehesa-type pastures comprise semi-natural vegetation communities dominated by annual species characteristic of the Mediterranean basin areas of Southern Europe. This study analyses all the datasets available on the effects of ozone (O3) on annual pasture species in order to review and propose new exposure- and flux-based O3 critical levels (CLes) following the methodology of the Convention on Long-Range Transboundary Air Pollution (CLRTAP). Based on the potential effect on pastures main ecosystem services, the availability of data and the statistical significance of the regressions, three variables have been selected for establishing CLes: total above-ground biomass, consumable food value (CFV), as a nutritional quality index, and reproductive capacity based on flower and seed production. New CLes proposed for a 10% loss (with 95% confidence intervals between brackets) of above-ground biomass and reproductive capacity were, respectively, AOT40=3.1 (2.6, 3.8) and 2.0 (1.5, 2.8) ppmh and POD1=12.2 (8.9, 15.5) and 7.2 (1.1, 13.3) mmolm(-2). The provisional AOT40- and POD1-based CLes for CFV were 2.3 (1.6, 4.0) ppmh and 4.6 (2.7, 6.5) mmolm(-2) respectively. By using only O3-sensitive species for the exposure and dose-response functions, the proposed CLes should be used for risk assessments. Their use for quantifying O3 damage may lead to an overestimation of the effects.

Ozone levels in the Spanish Sierra de Guadarrama mountain range are above the thresholds for plant protection: analysis at 2262, 1850, and 995 m a.s.l

The Sierra de Guadarrama mountain range, located at 60 km from Madrid City (Spain), includes high valuable ecosystems following an altitude gradient, some of them protected under the Sierra de Guadarrama National Park. The characteristic Mediterranean climatic conditions and the precursors emitted from Madrid favor a high photochemical production of ozone (O₃) in the region. However, very little information is available about the patterns and levels of O₃ and other air pollutants in the high elevation areas and their potential effects on vegetation. Ozone levels were monitored at three altitudes (2262, 1850, and 995 m a.s.l.) for at least 3 years within the 2005-2011 period. NO _x and SO₂ were also recorded at the highest and lowest altitude sites. Despite the inter-annual and seasonal variations detected in the O₃ concentrations, the study revealed that SG is exposed to a chronic O₃ pollution. The two high elevation sites showed high O₃ levels even in winter and at nighttime, having low correlation with local meteorological variables. At the lower elevation site, O₃ levels were more related with local meteorological and pollution conditions. Ozone concentrations at the three sites exceeded the thresholds for the protection of human health and vegetation according to the European Air Quality Directive (EU/50/2008) and the thresholds for vegetation protection of the CLRTAP. Ozone should be considered as a stress factor for the health of the Sierra de Guadarrama mountain ecosystems. Furthermore, since O₃ levels at foothills differ from concentration in high elevation, monitoring stations in mountain ranges should be incorporated in regional air quality monitoring networks.

Postoperative Changes of Carpal Canal Pressure in Carpal Tunnel Syndrome: A Prospective Study with Follow-Up of 1 Year

Carpal canal pressures were measured in 103 patients with idiopathic carpal tunnel syndrome, before and after open release, with a postoperative follow-up of 1 year. Twenty-five normal subjects were used as controls. Pressures were measured with the wrists in three positions: neutral, full passive flexion and full passive extension. At each wrist position, the mean pre-operative pressures in the study group were significantly higher than in the control group. In both groups, the pressures were maximal with full passive extension and minimal in the neutral wrist position. Immediately after surgical release, there was a marked decrease of the carpal canal pressures. However, during the second postoperative month, there was a significant increase of the pressures at each wrist position, although these were still within the normal control range. This rise in pressures persisted to 12 months. These findings suggest that the carpal ligament reconstitutes by normal scar formation, but with lengthening such that the volume of the carpal canal is enlarged, so preventing a rise in pressure with return of the pre-operative problem.

Aberrant gene methylation and bronchial dysplasia in high risk lung cancer patients

INTRODUCTION

The risk for lung cancer is incremented in high degree dysplasia (HGD) and in subjects with hypermethylation of multiple genes. We sought to establish the association between them, as well as to analyze the DNA aberrant methylation in sputum and in bronchial washings (BW).

METHODS

Cross sectional study of high risk patients for lung cancer in whom induced sputum and autofluorescence bronchoscopy were performed. The molecular analysis was determined on DAPK1, RASSF1A and p16 genes using Methylation-specific PCR.

RESULTS

A total of 128 patients were enrolled in the study. Dysplasia lesions were found in 79 patients (61.7%) and high grade dysplasia in 20 (15.6%). Ninety eight patients out of 128 underwent molecular analysis. Methylation was observed in bronchial secretions (sputum or BW) in 60 patients (61.2%), 51 of them (52%) for DAPK1, in 20 (20.4%) for p16 and in three (3.1%) for RASSF1A. Methylated genes only found in sputum accounted for 38.3% and only in BW in 41.7%, and in both 20.0%. In the 11.2% of the patients studied, HGD and a hypermethylated gene were present, while for the 55.1% of the sample only one of both was detected and for the rest of the subjects (33.6%), none of the risk factors were observed.

CONCLUSIONS

Our data determines DNA aberrant methylation panel in bronchial secretions is present in a 61.2% and HGD is found in 15.6%. Although both parameters have previously been identified as risk factors for lung cancer, the current study does not find a significative association between them. The study also highlights the importance of BW as a complementary sample to induced sputum when analyzing gene aberrant methylation.

Toxicity and efficacy of busulfan and fludarabine myeloablative conditioning for HLA-identical sibling allogeneic hematopoietic cell transplantation in AML and MDS

The safety and efficacy of a 4-day myeloablative conditioning (MAC) regimen consisting of Bu 3.2 mg/kg and fludarabine 40 mg/m(2)/day for HLA-identical sibling allogeneic hematopoietic cell transplantation (HCT) in myeloid malignancies was investigated in 133 patients (median age, 47 years; range 19-74 years) with de novo AML (60%), secondary AML (20%) or myelodysplastic syndrome (20%). All patients engrafted. Hepatic veno-occlusive disease occurred in five patients (4%), and severe toxicities, mostly mucositis, occurred in twenty-three (17%) patients. The non-relapse mortality (NRM) at 100 days was 1.5%. The incidences of acute GVHD grade 2-4 and grade 3-4 were 32 and 13%, respectively. At a median follow-up of 38 months, the cumulative incidence of chronic GVHD was 67%. The relapse incidence was 30% (27 and 31%, respectively, in patients with early- and late-stage disease), and the overall NRM was 15%. The actuarial 4-year disease-free survival (DFS) and overall survival (OS) were 54 and 62%, respectively. Patients aged <50 years had better outcomes compared with older patients (DFS 64 vs 42%, P=0.006; OS 73 vs 47%, P<0.001, respectively).

Self-consistent theory of high-order harmonic generation by relativistic plasma mirror

We present a self-consistent semianalytical model of the relativistic plasma mirror, based on the exact computation of the laser-driven electron surface oscillations within the cold-fluid approximation. Valid for arbitrary solid densities, laser incidence angle, and a large set of laser intensities (10(18)-10(21) W/cm(2)), the model unravels different regimes of harmonic generation. In particular, it is found that efficient conversion of p-polarized laser pulses into high-order harmonics well above the plasma frequency requires either high laser intensities, low plasma densities, or incidence angles larger than a threshold value. This critical angle corresponds to a transition between a regime where the electron surface dynamics is mostly governed by the laser J×B force and a "cyclotron Brunel" regime, where electrons perform many cyclotron gyrations when moving into the vacuum. Under conditions relevant to current laser experiments, the latter regime gives rise to nonmonotonic variations of the harmonic yield with the laser field. Our predictions are supported by an extensive parametric study performed with highly resolved one-dimensional particle-in-cell simulations.

Incidence and risk factors of post-engraftment invasive fungal disease in adult allogeneic hematopoietic stem cell transplant recipients receiving oral azoles prophylaxis

Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving >40 days who engrafted and were discharged without prior IFD. All patients who received ⩾20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria. The independent prognostic factors after multivariate analyses were used to construct a post-engraftment IFD risk score. The 1-year CI of IFD was 11%. The non-relapse mortality was 40% in those developing IFD and 16% in those who did not. The intent-to-treat analysis showed that 17% of patients abandoned the assigned prophylaxis. Age >40 years, ⩾1 previous SCT, pre-engraftment neutropenia >15 days, extensive chronic GVHD and CMV reactivation were independent risk factors. The post-engraftment IFD score stratified patients into low risk (0-1 factor, CI 0.7%), intermediate risk (2 factors, CI 9.9%) and high risk (3-5 factors, CI 24.7%) (P<0.0001). The antifungal prophylaxis strategy failed to prevent post-engraftment IFD in 11% of alloSCT. Our risk score could be useful to implement risk-adapted strategies using antifungal prophylaxis after engraftment.

Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia

Outcomes after unmanipulated haploidentical stem cell transplantation (Haplo) and after unrelated cord blood transplantation (UCBT) are encouraging and have become alternative options to treat patients with high-risk acute leukemia without human leukocyte antigen (HLA) matched donor. We compared outcomes after UCBT and Haplo in adults with de novo acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Median follow-up was 24 months. Analysis was performed separately for patients with AML, n=918 (Haplo=360, UCBT=558) and ALL, n=528 (Haplo=158 and UCBT=370). UCBT was associated with delayed engraftment and higher graft failure in both AML and ALL recipients. In multivariate analysis, UCBT was associated with lower incidence of chronic graft-vs-host disease both in the AML group (hazard ratio (HR)=0.63, P=0.008) and in the ALL group (HR=0.58, P=0.01). Not statistically significant differences were observed between Haplo and UCBT for relapse incidence (HR=0.95, P=0.76 for AML and HR=0.82, P=0.31 for ALL), non-relapse mortality (HR=1.16, P=0.47 for AML and HR=1.23, P=0.23 for ALL) and leukemia-free survival (HR 0.78, P=0.78 for AML and HR=1.00, P=0.84 for ALL). There were no statistically differences on main outcomes after unmanipulated Haplo and UCBT, and both approaches are valid for acute leukemia patients lacking a HLA matched donor. Both strategies expand the donor pool for patients in need.

A modified commercial gas chromatograph for the continuous monitoring of the thermal degradation of sunflower oil and off-line solid phase extraction gas-chromatography-mass spectrometry characterization of released volatiles

A homemade flow cell attached to a commercial Gas Chromatograph equipped with a Flame Ionization Detector (FID) has been designed for the continuous monitoring of volatile compounds released during heating edible oils. Analytical parameters such as mass of sample, temperature and flow rates have been optimized and the obtained results have been compared with the corresponding thermographs from standard TG systems. Results show that under optimum conditions, the profiles of volatiles released upon heating are comparable to the profiles of TG curves, suggesting that the FID based system could be an alternative to TGA. Additionally, volatiles have been retained in a Lichrolut EN(®) resin, eluted and analyzed by Gas Chromatography-Mass Spectrometry. In this case, forty five compounds have been identified (acids, alcohols, alkanes, aldehydes, ketones and furans) and compared with the FID signals, working both in air or nitrogen atmosphere. It has been concluded that the oxidative thermal degradation is prevented in the presence of a nitrogen atmosphere.

Switching from zidovudine/lamivudine to tenofovir/emtricitabine improves fat distribution as measured by fat mass ratio

OBJECTIVES

Fat mass ratio (FMR) has been suggested as an objective indicator of abnormal body fat distribution in HIV infection. Although it could provide more comprehensive information on body fat changes than limb fat mass, FMR has scarcely been used in clinical trials examining body fat distribution in HIV-infected patients.

METHODS

A subanalysis of a controlled, randomized clinical trial in virologically suppressed HIV-1-infected men switching from zidovudine (ZDV)/lamivudine (3TC) to emtricitabine (FTC)/tenofovir (TDF) versus continuing on ZDV/3TC was carried out. FMR was assessed by dual X-ray absorptiometry (DEXA) for a period of 72 weeks. Lipoatrophy was defined as FMR ≥ 1.5. Multivariate linear regression models for the change in FMR from baseline were fitted.

RESULTS

Sixty-five men were randomized and treated (28 in the FTC/TDF arm and 37 in the ZDV/3TC arm), and 57 completed the study (25 and 32 in each arm, respectively). In the FTC/TDF arm, adjusted mean FMR decreased by 0.52 at week 72 (P = 0.014), and in the ZDV/3TC arm it increased by 0.13 (P = 0.491; P between arms = 0.023). Among subjects with lipoatrophy (baseline FMR ≥ 1.5), adjusted FMR decreased by 0.76 (P = 0.003) in the FTC/TDF arm and increased by 0.21 (P = 0.411; P between arms = 0.009) in the ZDV/3TC arm. Baseline FMR and treatment group were significant predictors (P < 0.05) of post-baseline changes in FMR.

CONCLUSIONS

Switching from ZDV/3TC to FTC/TDF led to an improvement in FMR, compared with progressive worsening of FMR in subjects receiving ZDV/3TC, showing that fat mass not only increased but was also distributed in a healthier way after the switch.

[Comprehensive care program for the mentally ill in Spanish prisons (PAIEM): assessment after four years operation]

OBJECTIVE

To assess the comprehensive care program for the mentally ill in prison (PAIEM), which has been implemented for 3 years in Spanish prisons with the aim of improving processes and results.

METHODS

Descriptive study of the data gathered from an anonymous questionnaire completed by members of the PAIEM team in prisons. Frequency distributions were obtained of all the variables relating to facts, attitudes, opinions, experiences, situations and processes of the PAIEM.

RESULTS

91.2% of the PAIEM teams responded. Psychologists, educators, doctors and social workers were the professionals that collaborated most actively in the PAIEM (73%-84%) and were the ones to act most frequently as tutors. The mentally ill are usually located in ordinary modules (80%). The most commonly used activities for their psycho-social rehabilitation are self care (73%), education for health, preparation for daily life and social skills (more than 60%). Interventions with families are basically by telephone (79%). Bivariate analysis showed that the PAIEMs that operate most effectively are those that coordinate well with other technical teams, that prepare referral more than six months prior to release and ones where the NGOs process the referrals. Over 71% of the professionals observed improvements of disabilities and needs in over half the patients more than half of the professionals involved are satisfied (3.4/5) with their participation, although they acknowledge that there is a greater work load.

CONCLUSIONS

The activities of the PAIEM are adequate, especially in the phases of early detection, stabilisation and rehabilitation and less so in the social incorporation phase, which improves when the third sector intervenes in referrals of patients to the social health care network outside prison.

Cardiac output monitoring with pulmonary versus transpulmonary thermodilution during liver transplantation: interchangeable methods?

BACKGROUND

Liver transplantation (LT) implies hemodynamic instability, making invasive monitoring of cardiac output (CO) mandatory. Intermittent thermodilution with pulmonary artery catheter (PAC) remains the clinical gold standard to measure CO. The agreement between PAC and new monitoring methods in LT needs to be further investigated. Our aim is to clarify whether cardiac index (CI) measurements with transpulmonary intermittent thermodilution, and continuous pulmonary thermodilution methods agree sufficiently with those performed intermittently with PAC to be considered interchangeable during LT.

METHODS

We studied prospectively hemodynamic parameters of 72 consecutive patients undergoing LT. Each CI was obtained simultaneously with three different techniques: intermittent (PACi) and continuous (CCI) pulmonary artery thermodilution with PAC, and intermittent transpulmonary thermodilution (TPTD) with PiCCO2 in 8 time points of the procedure, obtaining 1350 paired measurements. Exclusion criteria was retransplantation. The statistical Bland Altman method for repeated measures was used to assess agreement, and polar plot methodology to evaluate trending ability.

RESULTS

Analysis of agreement between PACi and TPTD measurements (N.=474 paired measurements) showed a bias of -0.42 L/min/m2, 95% limits of agreement (95%LoA) of ±1.5 L/min/m2 and percentage error of 45%. PACi-CCI comparisons (N.=431) showed bias of -0.02 L/min/m2, 95%LoA of ±1.96 L/min/m2, and percentage error of 64%. These results demonstrated questionable clinical agreement between PACi and TPTD, and no agreement between PACi and CCI. TPTD and CCI showed poor CO trending ability.

CONCLUSION

Continuous pulmonary thermodilution with PAC is not an alternative monitoring method of CO. Transpulmonary thermodilution CO monitoring with PiCCO2 shows too questionable agreement with the clinical gold standard (PACi) being in the limit of acceptance to be considered interchangeable during liver transplantation.

Biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

In 2011, the Spanish Society of Medical Oncology and the Spanish Society of Pathology started a joint project to establish recommendations on biomarker testing in patients with advanced non-small-cell lung cancer based on the current evidence. Most of these recommendations are still valid, but new evidence requires some aspects to be updated. Specifically, the recommendation about which biomarkers to test in which patients is being amended, and the best way to manage tumour samples and minimum requirements for biomarker test material are defined. Suitable techniques for testing for epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangement are also reviewed, and a consensus is reached on which situations warrant re-biopsy.