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Intranasal oxytocin therapy has been used to improve various aspects of autism spectrum disorder on the basis of tenuous results from small studies. In a randomized trial involving 290 participants 3 to 17 years of age with autism spectrum disorder, daily use of oxytocin did not improve measures of social interaction as compared with placebo over a period of 24 weeks.

Laser-accelerated protons, generated by irradiating a solid target with a short, energetic laser pulse at high intensity ( I  > 10 18   W · cm −2 ), represent a complementary if not outperforming source compared to conventional accelerators, due  to their intrinsic features, such as high beam charge and short bunch duration. However, the broadband energy spectrum of these proton sources is a bottleneck that precludes their use in applications requiring a more reduced energy spread. Consequently, in recent times strong effort has been put to overcome these limits and to develop laser-driven proton beamlines with low energy spread. In this paper, we report on beam dynamics simulations aiming at optimizing a laser-driven beamline - i.e. a laser-based proton source coupled to conventional magnetic beam manipulation devices - producing protons with a reduced energy spread, usable for applications. The energy range of investigation goes from 2 to 20 MeV, i.e. the typical proton energies that can be routinely obtained using commercial TW-power class laser systems. Our beamline design is capable of reducing the energy spread below 20%, still keeping the overall transmission efficiency around 1% and producing a proton spot-size in the range of 10 mm 2 . We briefly discuss the results in the context of applications in the domain of Cultural Heritage.

Laser-based electron sources are attracting strong interest from the conventional accelerator community due to their unique characteristics in terms of high initial energy, low emittance, and significant beam current. Extremely strong electric fields (up to hundreds of GV/m ) generated in the plasma allow accelerating gradients much higher than in conventional accelerators and set the basis for achieving very high final energies in a compact space. Generating laser-driven high-energy electron beam lines therefore represents an attractive challenge for novel particle accelerators. In this paper we show that laser-driven electrons generated by the nowadays consolidated TW laser systems, when leaving the interaction region, are subject to a very strong, normalized emittance worsening which makes them quickly unusable for any beam transport. Furthermore, due to their intrinsic beam characteristics, controlling and capturing the full beam current can only be achieved improving the source parameters.

Background The prevalence of autism spectrum disorder (ASD) has surged, with an estimated 1 in 36 eight-year-olds in the United States meeting criteria for ASD in 2020. Autistic individuals face elevated rates of co-occurring medical, psychiatric, and behavioral conditions compared to non-autistic individuals. The rising ASD-patient demand is increasingly outpacing the capacity of ASD-specialty clinics, resulting in urgent need for autism-competent providers in general practice settings. This work aims to empower healthcare providers, especially primary care providers (PCPs), with guidelines for the recognition and safe pharmacologic management of common co-occurring psychiatric and behavioral conditions in ASD. Methods Lurie Center for Autism medical providers, who have extensive experience in ASD care, delineated approaches for recognition and pharmacological treatment of sleep disturbances, attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, and irritability tailored to ASD patients. Pharmacological guidelines were iteratively refined until consensus was reached. Treatment differences relative to standard of care (SOC) of non-autistic individuals are noted. Key literature and clinical trial results were reviewed to supplement clinical experience. Results The pharmacological treatment pathways reflect how appropriate medication options for ASD patients can depend on many factors unique to the patient and can differ from established non-autistic SOC. Key takeaways include: For sleep disturbances in ASD, initial strategies align with non-autistic SOC, emphasizing sleep hygiene and melatonin use. First-line recommendations for treating ADHD, anxiety, and depression in ASD differ from non-autistic SOC; α 2 -adrenergic agonists are more suitable than stimulants for some ASD-ADHD patients, buspirone and mirtazapine are preferred to selective serotonin reuptake inhibitors (SSRIs) for anxiety, and duloxetine, mirtazapine, bupropion, and vortioxetine are recommended ahead of SSRIs for depression. Addressing irritability in ASD requires interdisciplinary evaluation of contributing factors, and guanfacine, risperidone, or aripiprazole may be appropriate, depending on severity. Conclusions Recognition and treatment of co-occurring psychiatric and behavioral conditions in autistic patients must account for differences in clinical presentation and medication effectiveness and tolerability. Drawing on evidence-based clinical insights, these guidelines seek to support PCPs in making informed decisions when prescribing medications for ASD patients with co-occurring psychiatric and behavioral conditions, ultimately enhancing access to timely, comprehensive care for all individuals with ASD.

Flash Therapy is a revolution in cancer cure since it spares healthy tissue from the damage of ionization radiations without decreasing its effectiveness in tumor control. To allow the implementation of the FLASH therapy concept into actual clinical use and treat deep tumors, Very High Electron Energy (VHEE) should be achieved in a range of 50-150 MeV. In the framework of the VHEE project carried out at Sapienza University, in collaboration with INFN, we investigate the main issues in designing a compact C band (5.712 GHz) electron linacs for FLASH Radiotherapy. In this paper, we describe the design strategy, the electromagnetic properties, and the first prototypes of the RF structures to be tested at Sapienza University.

Adults with autism spectrum disorder (ASD) are at risk for excess bodyweight and hypertension, yet the prevalence of and clinical predictors for these health conditions remain unknown. The objective of this study was to assess the prevalence of overweight, obesity, and hypertension in a large clinical sample of adults with a confirmed diagnosis of ASD and to examine potential clinical predictors. This retrospective chart review study included adult subjects (≥ 20 years) with ASD who had been seen within the past 5 years at a multidisciplinary developmental disorders clinic. Data collected from the electronic health record included age, sex, race and ethnicity, cognitive ability, language ability, body mass index (BMI), hypertension, and use of second generation antipsychotic medications (SGAs). Of 622 adults with a confirmed diagnosis of ASD potentially eligible for the study, 483 (78%) had one or more notes in their records from the past 5 years. Those with recent notes were 23% female, 89% White, and had a mean (SD) age of 28.1 (7.1) years. Overall prevalence estimates for adults represented by this predominantly male, White, and young clinical sample were 28% (95% CI 24%, 32%) for overweight (BMI 25–29.9 kg/m 2 ), 35% (95% CI 31%, 40%) for obesity (≥ 30 kg/m 2 ), and 11% (95% CI 9%, 15%) for hypertension. Controlling for age and sex, intellectual disability (ID) was significantly associated with BMI (p = 0.003) but not hypertension (p = 0.69); those with moderate or more severe ID had a mean BMI that was 2.26 kg/m 2 (95% CI 0.96, 3.57) lower than those with no ID. Controlling for age and sex, neither language ability, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) subtype of autism, nor past or current use of SGAs were significantly associated with BMI or hypertension. The study identified a high prevalence of overweight and obesity in adults with ASD consistent with the prevalence of these medical comorbidities in the U.S. population.

This study was a 10-week double-blind, placebo-controlled pilot trial of mirtazapine for anxiety in youth with autism spectrum disorder (ASD). Participants were ages 5 to 17 years with ASD and clinically significant anxiety (Pediatric Anxiety Rating Scale [PARS] score ≥10). Thirty participants were randomized to mirtazapine (7.5–45 mg/day) or placebo in a 2:1 ratio. The co-primary outcome measures were the PARS and the Clinical Global Impressions-Improvement subscale (CGI-I). Mirtazapine resulted in a statistically significant within group decrease in anxiety on the PARS (ES 1.76, p < 0.001). The improvement in PARS score for mirtazapine versus placebo was clinically meaningful but not statistically significant (ES = 0.63, p = 0.64). Forty-seven percent of participants assigned to mirtazapine (95% CI 22%: 74%) and 20% assigned to placebo (95% CI 2%: 60%) were rated “much improved” (CGI-I = 2) or “very much improved” (CGI-I = 1) for anxiety, p = 0.46. No statistically significant differences in mean 10-week changes between mirtazapine and placebo occurred on any outcome measure. There were no statistically significant differences in adverse effect frequency between mirtazapine and placebo. The results are consistent with mirtazapine’s safety and tolerability and meet three of four pre-specified indicators of efficacy (statistically significant change in total PARS score for mirtazapine, numerically greater reduction in total PARS score for mirtazapine than placebo, numerically higher number of responders to mirtazapine than placebo, but not greater than 50% of participants receiving mirtazapine rated as responders). Implementation of a larger randomized controlled trial of mirtazapine for the treatment of anxiety in this population is supported.Clinical trial registration information: Mirtazapine Treatment of Anxiety in Children and Adolescents with Pervasive Developmental Disorders; https://clinicaltrials.gov; NCT01302964.

The simulation of beam dynamics in the presence of collective effects requires a strong computational effort to take into account, in a self-consistent way, the wakefield acting on a given charge and produced by all the others. Generally this is done by means of a convolution integral or sum. Moreover, if the electromagnetic fields consist of resonant modes with high quality factors, responsible, for example, for coupled bunch instabilities, a charge is also affected by itself in previous turns, and a very long record of wakefield must be properly taken into account. In this paper we present a new simulation code for the longitudinal beam dynamics in a circular accelerator, which exploits an alternative approach to the currently used convolution sum, reducing the computing time and avoiding the issues related to the length of wakefield for coupled bunch instabilities. With this approach it is possible to simulate, without the need for large computing power, simultaneously, the single and multibunch beam dynamics including intrabunch motion. Moreover, for a given machine, generally both the coupling impedance and the wake potential of a short Gaussian bunch are known. However, a classical simulation code needs in input the so-called “Green” function, that is the wakefield produced by a point charge, making necessary some manipulations to use the wake potential instead of the Green function. The method that we propose does not need the wakefield as input, but a particular fitting of the coupling impedance requiring the use of the resonator impedance model, thus avoiding issues related to the knowledge of the Green function. The same approach can also be applied to the transverse case and to linear accelerators as well.

Radiation therapy is currently the most utilized technique for the treatment of tumors by means of ionizing radiation, such as electrons, protons and x/gamma rays, depending on the type, size and depth of the cancer mass. Radiation therapy has in general fulfilled the main requirement of targeting thus damaging the malignant cells and sparing the healthy tissues as best as possible. In this scenario, electron linear accelerators have been operated as viable tools for the delivery of both high-energetic electrons and x-ray beams, which are obtained via the bremsstrahlung process of the electrons hitting on a high-Z material. Recently, it has been experimentally demonstrated that ultrahigh dose-rate bursts of electrons and x-ray beams increase the differential response between healthy and tumor tissues. This beneficial response is referred to as the FLASH effect. For this purpose, we have developed the first dedicated compactS-band linear accelerator for FLASH radiotherapy. This linac is optimized for a nominal energy of 7 MeV and a pulsed electron beam current of 100 mA and above. The accelerator is mounted on a remote-controlled system for preclinical research studies in the FLASH regime. We will show the rf and beam dynamics design of theS-band linac as well as the commissioning and high-power rf tests. Furthermore, the results of the dosimetric measurements will be illustrated.

Space charge forces represent main induced effects in an RF-injector that degrade the beam quality. In this scenario the laser distribution sent on the photocathode acquires an important role in the emittance compensation process, as the slice analysis shows. Starting from the preliminary studies performed on [1], a novel semi-analytical model of space charge forces is proposed in detail for bunch with arbitrary charge distribution to derive expressions of self-induced forces. The performance of the fields at low energy regime (as the field has not expired RF forces) is under present analysis, we can investigate use of this model in low charge regime. Further, the model has been bench-marked with the behavior of the distributions present in the literature and studied for new ones. It has also been applied for the study of the optimization of a C-band hybrid photoinjector now being commissioned, thus explaining the factor two reduction of the emittance observed at the exit of the gun by changing the initial distribution at the cathode.