Search for Dark-Matter-Nucleon Interactions via Migdal Effect with DarkSide-50.

Dark matter elastic scattering off nuclei can result in the excitation and ionization of the recoiling atom through the so-called Migdal effect. The energy deposition from the ionization electron adds to the energy deposited by the recoiling nuclear system and allows for the detection of interactions of sub-GeV/c^{2} mass dark matter. We present new constraints for sub-GeV/c^{2} dark matter using the dual-phase liquid argon time projection chamber of the DarkSide-50 experiment with an exposure of (12 306±184) kg d. The analysis is based on the ionization signal alone and significantly enhances the sensitivity of DarkSide-50, enabling sensitivity to dark matter with masses down to 40 MeV/c^{2}. Furthermore, it sets the most stringent upper limit on the spin independent dark matter nucleon cross section for masses below 3.6 GeV/c^{2}.

Search for Dark Matter Particle Interactions with Electron Final States with DarkSide-50.

We present a search for dark matter particles with sub-GeV/c^{2} masses whose interactions have final state electrons using the DarkSide-50 experiment's (12 306±184) kg d low-radioactivity liquid argon exposure. By analyzing the ionization signals, we exclude new parameter space for the dark matter-electron cross section σ[over ¯]_{e}, the axioelectric coupling constant g_{Ae}, and the dark photon kinetic mixing parameter κ. We also set the first dark matter direct-detection constraints on the mixing angle |U_{e4}|^{2} for keV/c^{2} sterile neutrinos.

Midface 3D restoration with an innovative high G' filler.

BACKGROUND: In the evaluation of the facial aging, the midface certainly represents the part that undergoes the most modifications and in which the aging process is most evident. The filling and redefinition of this part are fundamental to modify the perception of the age of the face and create a global rejuvenation effect. In general, high G' fillers with a deep implant are used to treat the midface, taking advantage of the high lifting capacity and persistence of the implant in place. METHODS: We report our experience in the treatment of 20 patients with a hyaluronic acid (HA) filler based on an innovative crosslinking technology (XTR™-eXcellent Tridimensional Reticulation) for midface treatment. GAIS (Global Aesthetic Improvement Scale) at 1 month and 3 months after treatment was evaluated as primary endpoint. Patient satisfaction with the overall appearance, repeatability of treatment, and also an instrumental evaluation of the improvement were performed. RESULTS: Global Aesthetic Improvement Scale and patient satisfaction were very good 1 month and 3 months after treatment. The majority of patients said they would undergo treatment again. Clinical results were confirmed by instrumental evaluation. CONCLUSION: The treatment of midface with this innovative HA high G' filler is really effective in restoration of the volumes and in reshaping the curves of zygomatic area.

Open-Label, Post-Marketing Study to Evaluate the Performance and Safety of Calcium Hydroxylapatite With Integral Lidocaine to Correct Facial Volume Loss

Background: Calcium hydroxylapatite (CaHA, Radiesse®) with integral 0.3% lidocaine (CaHA(+)) has recently been approved for use in aesthetic medicine. This study assessed the performance of CaHA(+) in subjects undergoing treatment for facial volume loss and evaluated subject and physician satisfaction. Methods: In a prospective, open-label, post-marketing study, 25 women seeking treatment for age-related facial volume loss received CaHA(+) injections in 1­3 facial areas including the cheeks, marionette lines, prejowl sulcus, and jawline. Subjects returned for follow-up at 14 and 120 days, with the option of touch-up injections at day 14 if required to achieve optimal correction. Filler performance was assessed using the Merz Aesthetics Scales (MAS) and subject satisfaction using the Global Impression of Change Scale (GICS). Physician satisfaction was assessed in terms of CaHA(+)-related properties (eg, ease of injection, distribution, positioning) and aesthetic outcomes. Adverse events were recorded. Results: Mean MAS scores at baseline were ~2 corresponding to moderate facial volume loss/sagging in the treated area. At day 14, the mean score had improved to ≤1.4 for all treated areas, indicating mild volume loss. At day 120, mean scores had further improved to ≤1.1. At both follow-up visits, mean GICS scores were ≥2 indicating facial appearance was 'much improved' compared with baseline. All subjects reported willingness to repeat treatment and recommend it to family/friends. Physician ratings were high for ease of CaHA(+) injection, distribution, positioning, sculpturing outcome, and effect on skin tension. Compared to CaHA without lidocaine, the physician rated CaHA(+) as better or similar in performance. Adverse events were mostly mild and expected with CaHA and filler injections in general. Conclusion: The well-established efficacy and safety profile of CaHA appears unchanged by the addition of integral lidocaine. CaHA(+) was effective for volume enhancement in a number of facial areas and associated with high subject and physician satisfaction. J Drugs Dermatol. 2019;18(1):86-91.

Treatment of Lateral Periorbital Lines with Different Dilutions of IncobotulinumtoxinA.

BACKGROUND: IncobotulinumtoxinA is a botulinum neurotoxin type A that is free from complexing proteins and is used in various therapeutic indications and aesthetic medicine. It is approved for the treatment of glabellar frown lines in the United States. In Europe, it is also approved for the treatment of lateral periorbital lines (crow's feet) and for the combined treatment of upper facial lines, including glabellar frown lines, crow's feet, and horizontal forehead lines. METHODS: In the present study, incobotulinumtoxinA was injected at two different dilutions to treat female subjects aged 40 to 50 years who had moderate-to-severe lateral periorbital lines at maximum contraction according to a score of 2 or 3 points on the 5-point Merz Aesthetics Scales (MAS). For Group 1 (n=20), 50U of incobotulinumtoxinA were reconstituted with 1.60mL of 0.9% NaCI, and for Group 2 (n=20), a reconstitution volume of 0.55mL was used. RESULTS: Merz Aesthetics Scales scores were markedly improved by at least one point in both groups at one month and three months. The mean Merz Aesthetics Scales scores at one month were 0.4 and 0.6 points for Group 1 and Group 2, respectively, corresponding to a mean improvement of 2.0 and 1.8 points compared with baseline, respectively. CONCLUSION: No significant differences in efficacy and tolerability of incobotulinumtoxinA were seen between the two dilutions at any time point.

Test of Electric Charge Conservation with Borexino.

Borexino is a liquid scintillation detector located deep underground at the Laboratori Nazionali del Gran Sasso (LNGS, Italy). Thanks to the unmatched radio purity of the scintillator, and to the well understood detector response at low energy, a new limit on the stability of the electron for decay into a neutrino and a single monoenergetic photon was obtained. This new bound, τ≥6.6×10^{28} yr at 90% C.L., is 2 orders of magnitude better than the previous limit.

Calcium Hydroxylapatite for Augmentation of Face and Hands: A Retrospective Analysis in Italian Subjects.

To assess the use and safety of calcium hydroxylapatite for volume restoration of the face and hands in clinical practice, subjects from four Italian aesthetic clinics who had received calcium hydroxylapatite augmentation treatment between January 2012 and December 2013 were recruited. Records were retrospectively reviewed for demographic characteristics, number of treatments, area treated, injection depth and volume, method of administration, and adverse events. A total of 1,783 treatments were administered to 800 subjects (female: 93.5%; mean age: 49.6 years). Overall, 620 (77.5%) subjects were treated over two sessions for a particular indication, and 243 (30.3%) treated over three sessions. The most frequently treated areas were the zygomatic area (men: 30.2%; women: 30.6% of all treatments), malar area (24.5% and 24.3%), and marionette lines (18.9% and 11.6%). A cannula was used for most treatments (86.7%). Injection volume ranged from 0.4 mL to 1.5 mL. Injection-site swelling and bruising occurred with 18.2% and 11.3% of treatments, respectively. Most cases resolved within one week and two weeks, respectively. No serious/unexpected adverse events occurred. In clinical practice, calcium hydroxylapatite is a versatile, well-tolerated treatment for filling folds and volume restoration of the face and hands.

Design and implementation of a control system reflecting the level of analgesia during general anesthesia.

INTRODUCTION: Measuring and ensuring an adequate level of analgesia in patients are of increasing interest in the area of automated drug delivery during general anesthesia. Therefore, the aim of this investigation was to develop a control system that may reflect the intraoperative analgesia value. Our hypothesis was that a feedback controller could be applied in clinical practice safely and at an adequate quality of analgesia. The purpose of this study was to evaluate the practical feasibility of such a system in a clinical setting. METHODS: The control system for the level of analgesia described in this paper relies on a parameter combination of heart rate variability (HRV), heart rate (HR), and blood pressure (mean arterial pressure, MAP), which serve as input variables for an expert system. For this fuzzy system, the experience of the participating anesthesiologists was translated into a set of fuzzy rules. In a pilot trial, the control system for automated titration of remifentanil, a short-acting opioid, was tested combined with a closed-loop propofol infusion system for hypnosis. Ten adult patients (4 women, 6 men), aged 22-52 years (median, 45 years; range, 29-49 years), with an American Society of Anesthesiologists physical status class I or II and who were scheduled for elective trauma surgery in a supine position were enrolled in this prospective trial. The precision of the system was calculated using internationally defined performance parameters. RESULTS: There was no human intervention necessary during the computer-controlled administration of propofol and remifentanil, and operating conditions were satisfactory in all patients. All patients assessed the quality of anesthesia as "good" to "very good". Median performance error, median absolute performance error, and wobble for HR and MAP during maintenance of anesthesia were -8.98 (5.32), 10.08 (4.17), and 2.68 (1.29) and -4.51 (12.73), 13.63 (2.27), and 3.90 (2.08) [mean (SD)], respectively. CONCLUSION: The control system, reflecting the level of analgesia during general anesthesia designed and evaluated in this study, allows for a clinically practical, nearly fully automated infusion of an opioid during medium-length surgical procedures with acceptable technical requirements and an adequate precision.

Anomalous spin-resolved point-contact transmission of holes due to cubic Rashba spin-orbit coupling.

Evidence is presented for the finite wave vector crossing of the two lowest one-dimensional spin-split subbands in quantum point contacts fabricated from two-dimensional hole gases with strong spin-orbit interaction. This phenomenon offers an elegant explanation for the anomalous sign of the spin polarization filtered by a point contact, as observed in magnetic focusing experiments. Anticrossing is introduced by a magnetic field parallel to the channel or an asymmetric potential transverse to it. Controlling the magnitude of the spin splitting affords a novel mechanism for inverting the sign of the spin polarization.

Impact of 17alpha-ethinylestradiol on the plankton in freshwater microcosms--II: responses of phytoplankton and the interrelation within the ecosystem.

Effects of 17alpha-ethinylestradiol (EE) on phytoplankton were investigated in a lentic freshwater microcosm study. Treatment with EE caused a shift in the species composition as shown by a principle response curve. Whereas densities of Cyanophyceae, Dinophyceae, and Chrysophyceae increased, those of Conjugatophyceae and Cryptophyceae decreased. Furthermore, relative density of Chlorophyceae declined after EE treatment. The changes showed taxa-specific time dependencies. Some species, especially the cyanobacterium Cyanobium parvum, bloomed after the treatment. EE treatment promoted total abundance and biomass of phytoplankton. Although the number of species per microcosm increased, the diversity indices (Shannon-Wiener, Simpson) tended to lower values. The ecosystem only partly recovered during the investigated post-treatment period of 6 weeks. Probably at least the main effects were caused indirectly, i.e. via decrease of grazing zooplankton (crustaceans). The relation of EE to variation of phytoplankton composition was closer than those of other abiotic factors, indicating the relevance of its impact. EE also probably affected nutrients of the phytoplankton.

Impact of 17alpha-ethinylestradiol on the plankton in freshwater microcosms--I: response of zooplankton and abiotic variables.

We investigated effects of 17alpha-ethinylestradiol (EE) in vertebrate free 230 L still water microcosms. Zooplankton composition and physico-chemical variables were observed during 4 weeks of pre-application, 6 weeks of dosing via controlled release, and a 12 weeks post-treatment period. In the treated microcosms, time-weighted averages of EE concentration ranged between 7 and 220 ng/L during the dosing period, with concentration maxima up to 724 ng/L. EE exposure resulted in a decrease of species numbers and diversity (Shannon-Wiener, Simpson). Abundances of cladocerans, copepods, and, less unambiguously, rotifers declined. Strongest affected groups were the offspring of cladocerans and copepods and, on species level, the cladoceran species Daphnia longispina and Chydorus sphaericus as well as the rotifer species Keratella quadrata and Polyarthra sp. EE apparently affected the phosphate cycle as indicated by increased phosphate concentrations in the water. During post-treatment period, the treated microcosms recovered, but especially the highest treated microcosms did not fully re-approximate to the controls. Whereas EE affected cladocerans and copepods directly, shifts of rotifers may (partly) be caused indirectly, e.g. by competition with crustaceae. Although not providing an absolute proof, the traits of direct and indirect effects on different taxonomic groups and larval stages as well as the time course of the effects indicate that effects primarily resulted from endocrine activity of EE.

A surgical technique for catheterization of the sagittal sinus in pigs.

The purpose of our study was to describe an efficient, reliable and inexpensive surgical method for cerebral venous blood gas sampling in acutely instrumented pigs in a research setting. Parameters from the blood samples are used to monitor brain perfusion and oxygenation in different animal models. To the authors' knowledge, this is the first detailed description of an accurate surgical technique for catheterization of the sagittal sinus in pigs.

Non-sequential fractional ultrapulsed CO2 resurfacing of photoaged facial skin: preliminary clinical report.

This study evaluates results, adverse side effects and downtime of the protocol 'ActiveFX' for photodamaged facial skin. A non-sequential fractional ultrapulsed CO2 laser with specific settings is used in addition to a new computer pattern generator (CPG). From September 2006 to March 2007, 55 patients underwent this new 'soft' single-session, single-pass and full-face ablative fractional treatment. The patients were evaluated at baseline and 1 and 3 months after the treatment using a five-point scale. Seven aspects of photodamaged skin were recorded: global score, fine lines, mottled pigmentation, sallow complexion, tactile roughness, coarse wrinkles and telangiectasias. The results were compared with a non-parametric statistical test, the Wilcoxon's exact test. Eight patients received a double-pass treatment on the crow's feet regions and the improvement of the coarse wrinkles was analyzed with a quartile grading scale. Significant differences (p<0.05) between baseline and 1 and 3 months post-treatment were observed for all features except telangiectasias. Coarse wrinkles presented a good improvement only in the regions submitted to a double-pass. Minimal and isolated adverse side effects were noted and the downtime was very low. Non-sequential fractional ultrapulsed CO2 light treatment ('ActiveFX') can be considered an excellent alternative for photodamaged facial skin.

Management of pulmonary aspiration.

Pulmonary aspiration of gastric contents in the perioperative phase is associated with increased postoperative morbidity and mortality. For the management of aspiration, differentiation between acid-associated aspiration pneumonitis and aspiration pneumonia as a consequence of a secondary bacterial contamination is of crucial importance. The incidence of aspiration in elective surgery is 1 per 2000-3000 anaesthesias in adults. In children, it is slightly more common with 1 per 1200-2600 anaesthesias. In the context of emergency anaesthesias the incidence of aspiration is three to four times higher. The risk particularly increases with recent ingestion of solid food or fluids, with older patients, with pregnant women, and with consciousness-reduced patients. Besides giving a review of the pathophysiology, incidence, and the risk factors of aspiration, this article places emphasis on the practical management of this anaesthesia-associated complication. Cricoid pressure, as a non-evidence-based but clinically wide-spread method in the context of the prophylaxis of aspiration, is discussed critically. The main part deals with strategies to structure the management of aspiration by use of scientific concepts based on medical crisis management. For this, an algorithm based on current scientific investigations is presented.

Intense pulsed light treatment of 1,000 consecutive patients with facial vascular marks.

BACKGROUND: Facial teleangectasias or vascular marks often represent a very cosmetically detracting problem for the affected patient, who tries to cover the lesions by camouflage strategies. This study describes the response of these vascular lesions after an intense pulsed light source was used on 1,000 consecutive patients. METHODS: Between October 1998 and April 2005, 1,000 consecutive patients with various skin types (Fitzpatrick I to IV) were treated with Photoderm VL. The average age of the patients was 47.1 years. These patients were subjected to a mean of 2.16 treatments (range, 1-9), then followed up 48 h, 72 h, 1 week, 3 weeks, and 1 month after each treatment. All the patients were followed up 2 months after the last treatment, and the percentage of clearance was assessed by comparison of pre- and posttreatment photographs. The patients also answered a questionnaire in which they expressed personal satisfaction. The final physicians-nurse evaluation also was recorded on the same form. RESULTS: Most of the patients (89.70%) experienced a clearance of 75% to 100%. The results appear to be correlated with operator experience, but not with lesion size, age, or skin type. Minimal adverse side effects occurred for 14.6% of the patients, but only for 6.76% of the treatments. CONCLUSION: The intense pulsed light source Photoderm VL can be considered a fast, safe, and effective treatment for facial teleangectasias or vascular marks.

Facial teleangectasias: our experience in treatment with IPL.

BACKGROUND AND OBJECTIVES: Facial teleangectasias can be a relevant cosmetic problem, which the patient usually hides with a thick layer of makeup. This study will describe the response on these vascular lesions using the intense pulsed light (IPL) source. METHODS: Five hundred eighteen consecutive patients were treated with Photoderm VL (Lumenis Ltd.). The average age of patients of various skin types (Fitzpatrick I to IV) was 48.5 years. They were subjected to a mean of 1.69 treatments (range 1-9) followed up 48 hours, 72 hours, 1 week, 3 weeks, and 1 month after each treatment. All patients were followed up after 2 months from the last treatment and the percentage of clearance was assessed by comparing pre- and post-treatment photographs. The patients also answered a questionnaire in which they expressed personal satisfaction. The physicians evaluation was also recorded on the same form. RESULTS: Patients (87.64%) presented a clearance of 75%-100%. The results appear not correlated with lesions size, age, skin type but with operator experience. Minimal side adverse effects occurred in 20% of the patients. CONCLUSION: The IPL source, Photoderm VL, can be considered an alternative or a supplement to the existing laser devices for facial teleangectasias treatment.

Nonylphenol induced changes in trophic web structure of plankton analysed by multivariate statistical approaches.

Microcosm studies unveil relevant information in ecotoxicology. However, statistical evaluation of data gained from the different parts of the ecosystem often remain on unsatisfying, discretely level, e.g. separately for different species communities. A combination of different multivariate statistical methods enables an ecological interpretation of the found changes in zoo- and phytoplankton abundances in connection with the physico-chemical variables. To investigate the effects of nonylphenol (NP) on plankton communities, NP was continuously applicated in microcosms by controlled release. Plankton taxa were identified and quantified, various physico-chemical variables were measured. Maximum NP concentration ranged between 29 and 129 microg/L. The most important abiotic variable explaining both zoo- and phytoplankton abundances was NP concentration. NP primarily inhibited Crustaceae, especially juveniles. Cladocera and Copepoda abundances decreased. Rotatoria tend to increase, probably due to a decline of competition and predator pressure. Shifts in phytoplankton structure occurred with a time lag. Aggregating phytoplankton on class level did not show NP effects, whereas aggregating them according to feeding protection strategies did. Thus NP influences phytoplankton at least prevailingly indirectly via zooplankton. Zooplankton shifts led to species composition with different feeding preferences and strategies. Thereby the feeding pressure on phytoplankton changed. NP reorganized the plankton interrelation. Whereas without NP phytoplankton composition was dominated by Rotatoria, in the NP treated microcosms the Crustaceae unveiled highest explanatory power. The found effects were reversible in all but the highest treated microcosm. There are indications that the found effects were caused by endocrine activity of the chemical. Iteratively combining multivariate statistical methods with ecological and toxicological knowledge proved to provide a deeper insight into the mode of ecosystem disturbance by toxic substances.

Breath analysis in critically ill patients: potential and limitations.

Breath tests are attractive since they are noninvasive and can be repeated frequently in the dynamically changing state of critically ill patients. Volatile organic compounds can be produced anywhere in the body and are transported via the bloodstream and exhaled through the lung. They can reflect physiologic or pathologic biochemical processes such as lipid peroxidation, liver disease, renal failure, allograft rejection, and dextrose or cholesterol metabolism. This review describes the diagnostic potential of endogenous organic volatile substances in the breath of critically ill patients. Since many of these patients require ventilatory support, aspects of breath analysis under mechanical ventilation will be addressed. Analytical procedures, problems concerning the physiologic meaning of breath markers and future developments will be discussed.