Explore the vast range of titles available.

Objectives To determine the efficacy of intraoperative treatment with low dose tranexamic acid in reducing the rate of perioperative transfusions in patients undergoing radical retropubic prostatectomy.Design Double blind, parallel group, randomised, placebo controlled trial.Setting One university hospital in Milan, Italy.Participants 200 patients older than 18 years and undergoing radical retropubic prostatectomy agreed to participate in the trial. Exclusion criteria were atrial fibrillation, coronary artery disease treated with drug eluting stent, severe chronic renal failure, congenital or acquired thrombophilia, and known or suspected allergy to tranexamic acid.Interventions Intravenous infusion of tranexamic acid or equivalent volume of placebo (saline) according to the following protocol: loading dose of 500 mg tranexamic acid 20 minutes before surgery followed by continuous infusion of tranexamic acid at 250 mg/h during surgery.Main outcome measures Primary outcome: number of patients receiving blood transfusions perioperatively. Secondary outcome: intraoperative blood loss. Six month follow-up to assess long term safety in terms of mortality and thromboembolic events.Results All patients completed treatment and none was lost to follow-up. Patients transfused were 34 (34%) in the tranexamic acid group and 55 (55%) in the control group (absolute reduction in transfusion rate 21% (95% CI 7% to 34%); relative risk of receiving transfusions for patients treated with tranexamic acid 0.62 (0.45 to 0.85); number needed to treat 5 (3 to 14); P=0.004). At follow-up, no patients died and the occurrence of thromboembolic events did not differ between the two groups.Conclusions Intraoperative treatment with low dose tranexamic acid is safe and effective in reducing the rate of perioperative blood transfusions in patients undergoing radical retropubic prostatectomy. Trial registration ClinicalTrials.gov identifier NCT00670345.

Background Effective emotional regulation is recognized as essential to a good mental health of people with chronic diseases, and Mind–body and Art Therapies (MBATs) could have a positive effect on emotional regulation skills in this population. Thus, we aimed to evaluate the effect of MBATs on emotional regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) questionnaire. Methods A convergent mixed approach nested in a pragmatic superiority two arms parallel randomized controlled trial was conducted. French speaking adults with one or more chronic somatic illnesses and not suffering from a chronic psychiatric disorder unrelated to one of their chronic somatic illness were included. At inclusion, non-directive interviews were conducted, followed by an initial DERS assessment. The same combination of evaluation was implemented after 6 months of activity (T1). After inclusion, each participant was randomized within either the intervention group (G1) or the control group (G2) following a controlled wait-list design by use of a pregenerated randomization list. Staff and patient were blinded to this list until the initial evaluation was completed, after which the trial was conducted in an open-label fashion. Participants chose 2 mediations: one creativity-focused (art-therapy, writing workshop, theatre of life, vocal workshop) and one mind–body-focused (mindfulness meditation, Pilates, shiatsu, ayurvedic massages). G1 started their mediations immediately after inclusion, while G2 started 6 months later. Primary outcome was the change in means at 6 months in the overall DERS score compared between each group. Non-directive interviews were carried out at the inclusion and after 6 months of MBATs. A continuous inductive analysis was carried out on gathered material in G1 to explore the participants' experiences regarding their disease and their perceived changes associated to the intervention. Results A total of 150 patients was randomized (75 per groups) at the end of the study. At T1, 133 patients filled out the final questionnaire (67 in G1 vs 66 in G2) and 112 interviews were analysed (54 in G1 vs 58 in G2). All 150 patients were analysed (intention to treat) using a multiple imputation approach. The mean DERS score at T0 was equal to 82.8 ± 21.1 and 85.0 ± 20.2 in G1 and G2 respectively. On average, at T1, the score decreased in the G1 (Δ = -4.8, SD = 21.3) and in G2 (Δ = -0.11, SD = 17.8). The difference in decrease, however, was not statistically significant ( p  = 0.13). Qualitative analysis underlined some MBATs benefits on emotional regulation, especially on regulation strategies. No harms related to the intervention has been observed. Conclusions This study only partially supports benefits on MBAT on emotional regulation skills enhancement in patients with chronic disease receiving MBATs, as measured by the DERS scale. Trial registration The protocol was registered on Clinical Trials (NCT02911207).

We study here an optimized geometry for an X-ray detector with hole in the center, as key component for ASCANIO: an innovative 16-channels SDD based spectrometer specifically designed for X-ray fluorescence microscopy (XFM) imaging in synchrotron beamlines. The detector will feature a backscattering geometry with a tilted SDD layout achieving 1 sr solid angle at 8 mm sample distance and a potential Output Count Rate higher than 20 Mcps . The 1 mm thick SDD provides 65 % absorption efficiency at 20 keV while preserving a good energy resolution better than 150 eV thanks to a dedicated cooling system and a low noise front-end electronics. In this paper, the optimization of the detector geometry, in terms of solid angle vs sample distance and maximization of the Output Count Rate introducing a tilting of the SDD units, is discussed.

This paper presents the measurements on first very thin Ultra-Fast Silicon Detectors (UFSDs) produced by Fondazione Bruno Kessler; the data have been collected in a beam test setup at the CERN PS, using beam with a momentum of 12 GeV/c. UFSDs with a nominal thickness of 25 and 35 μ m and an area of 1 × 1 mm 2 have been considered, together with an additional HPK 50- μ m thick sensor, taken as reference. Their timing performances have been studied as a function of the applied voltage and gain. A time resolution of about 25 ps and of 22 ps at a voltage of 120 and 240 V has been obtained for the 25 and 35 μ m thick UFSDs, respectively.

The results of a collaborative development activity aimed to the realization of multi-cell detectors based on monolithic SDD pixel technology will be described. Two kind of detection systems, skilled for the light lines at synchrotrons, have been brought to high levels of finalization and integration; a 64 cells detection system dedicated to absorption spectroscopy (XAFS) and a 32 cells detector for the X-ray microscopy (TwinMic). The main targets of this effort, led in a tight collaboration with the beam lines scientists, were large sensitive area, high rate capabilities, state of the art efficiency and energy resolution. The aim is to reduce the beam time demand for each single measurement while delivering a cutting edge analytical power. All basic elements of those detection systems, from the detector’s design and production to the front-end and read-out electronics including the final engineering of the integrated system were customized to the specific use addressed.

Boron Neutron Capture Therapy (BNCT) is a targeted radiotherapy that requires precise dose monitoring to ensure effective treatment. We initially report experimental measurements performed with the BeNEdiCTE detector, designed for SPECT-based dose monitoring in BNCT. The detector is based on a co-doped LaBr 3 (Ce, Sr) monolithic crystal read out by Silicon Photomultipliers and compact electronics. Tomographic measurements were performed at the Laboratorio di Energia Nucleare Applicata in Pavia (Italy). Then, measurements with neutron conditions similar to those expected in clinical treatments were performed at the Nagoya University Acceleratordriven Neutron Source (Japan). The detector demonstrated the ability to detect the 478 keV gamma rays emitted during boron neutron capture reactions. Additionally, the detector successfully reconstructed 2D and 3D images of the boron distribution with sub-centimeter resolution. The measurements highlighted key areas for improvement to make the detector suitable for clinical use with patients, which will be presented in detail in this work. The boron present in the FR4 material used in the electronics boards was identified as a significant source of 478-keV gamma rays uncorrelated with the imaged object. To mitigate this, a new substrate material, RO3003, was tested, showing a substantial reduction in gamma rays emitted at 478 keV. Furthermore, the detector’s electronics were optimized to improve count-rate capability. This involved reducing the dead time from 5.4 µs to 2.1 µs and refining an energy thresholding mechanism to process only events around 478 keV. These improvements will enhance the detector’s performance, bringing it closer to clinical use with patients.

Kaonic atoms, formed when a negatively charged kaon replaces an electron, provide a unique laboratory to test fundamental interactions at low energies. EXKALIBUR (EXtensive Kaonic Atoms research: from LIthium and Beryllium to URanium) is a program to perform systematic, high-precision X-ray spectroscopy of selected kaonic atoms across the periodic table at the DA NE accelerator at the National Laboratory of Frascati. Here, we outline its detector-driven strategy: silicon drift detectors for 1040 keV transitions in light targets (Li, Be, B, O), CdZnTe detectors for 40300 keV lines in intermediate-Z systems (Mg, Al, Si, S), and a high-purity germanium detector for high-Z atoms (Se, Zr, Ta, Mo, W, Pb), complemented by VOXES, a high-resolution crystal spectrometer for sub-eV studies. EXKALIBUR plans to (i) reduce the charged-kaon mass uncertainty below 10 keV, (ii) produce a database of nuclear shifts and widths to constrain multi-nucleon K--nucleus interactions models, and (iii) provide precision data for testing bound-state quantum electrodynamics in strong elds. We summarize the planned measurements and expected sensitivities within DA NE luminosities.

The SIDDHARTA-2 experiment aiming at measuring for the first time the X-ray transitions in kaonic deuterium, has successfully completed its 2024 physics run at the DA NE collider of the INFN Laboratori Nazionali di Frascati. This work presents an overview of the scientific and technical achievements of SIDDHARTA-2 so far, including the most precise measurement of kaonic helium-4 La transitions and yields in gas, the observation of the kaonic helium-4 M-series transitions, and the measurement of high-n transitions in kaonic carbon, oxygen, nitrogen, and aluminium. The results of these measurements are discussed in the context of the kaonic atoms physics program at DA NE, including future prospects within the EXKALIBUR proposal.

Background Propofol is one of the most widely used hypnotic agents in the world. Nonetheless, propofol might have detrimental effects on clinically relevant outcomes, possibly due to inhibition of other interventions' organ protective properties. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate if propofol reduced survival compared to any other hypnotic agent in any clinical setting. Methods We searched eligible studies in PubMed, Google Scholar, and the Cochrane Register of Clinical Trials. The following inclusion criteria were used: random treatment allocation and comparison between propofol and any comparator in any clinical setting. The primary outcome was mortality at the longest follow-up available. We conducted a fixed-effects meta-analysis for the risk ratio (RR). Using this RR and 95% confidence interval, we estimated the probability of any harm (RR > 1) through Bayesian statistics. We registered this systematic review and meta-analysis in PROSPERO International Prospective Register of Systematic Reviews (CRD42022323143). Results We identified 252 randomized trials comprising 30,757 patients. Mortality was higher in the propofol group than in the comparator group (760/14,754 [5.2%] vs. 682/16,003 [4.3%]; RR = 1.10; 95% confidence interval, 1.01–1.20; p = 0.03; I 2  = 0%; number needed to harm = 235), corresponding to a 98.4% probability of any increase in mortality. A statistically significant mortality increase in the propofol group was confirmed in subgroups of cardiac surgery, adult patients, volatile agent as comparator, large studies, and studies with low mortality in the comparator arm. Conclusions Propofol may reduce survival in perioperative and critically ill patients. This needs careful assessment of the risk versus benefit of propofol compared to other agents while planning for large, pragmatic multicentric randomized controlled trials to provide a definitive answer. Graphical Abstract

KAMEO (Kaonic Atoms Measuring Nuclear Resonance Effects Ob-servables) is a proposal for an experiment aiming to perform the first consistent measurement of the E2 nuclear resonance effects in kaonic molybdenum A=94,96,98,100 isotopes. The E2 nuclear resonance mixes atomic states, due to the electrical quadrupole excitation of nuclear rotational states. It occurs in atoms having the energy of a nuclear excitation state closely matching an atomic de-excitation state energy, and affects the rates of X-ray atomic transitions matching the energy of the resonance. The measurement E2 nuclear resonance effect in KMO isotopes allows the study of the strong kaon-nucleus interaction in a rotational excited nuclear state. Moreover, the effect enables the K - to access an inner atomic level not easily reachable by the kaon normal cascade, due to the nuclear absorption. The KAMEO proposed apparatus consists of 4 enriched Mo A=94,96,98,100 isotope strips, exposed to the kaons produced by the DAφNE collider, for kaonic atoms formation, with a high-purity germanium detector, cooled with liquid nitrogen, used to measure the X-ray atomic transitions. The DAφNE collider is located at the National Laboratories of Frascati (LNF-INFN), in Italy. It is already suited for kaonic atoms measurement by the SIDDHARTA-2 collaboration.