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Present nuclear reaction network computations for astrophysical simulations involve many different types of rates, including neutron-capture reactions of interest for the modeling of heavy-element nucleosynthesis. While for many of them we still have to rely on theoretical calculations, an increasing number of experimentally-determined cross sections have now become available. In this contribution, we present “ASTrophysical Rate and rAw data Library” (ASTRAL), a new online database for neutron-capture cross sections based on experimental results, mainly obtained through activation and timeof-flight measurements. For the evaluation process, cross sections were re-calculated starting from raw data and by considering recent changes in physical properties of the involved isotopes (e.g., half-life and γ-ray intensities). We show the current status of the database, the techniques adopted to derive the recommended Maxwellian-averaged cross sections, and future developments.
Phase transitions in a non-perturbative regime can be studied by ab initio Lattice Field Theory methods. The status and future research directions for LFT investigations of Quantum Chromo-Dynamics under extreme conditions are reviewed, including properties of hadrons and of the hypothesized QCD axion as inferred from QCD topology in different phases. We discuss phase transitions in strong interactions in an extended parameter space, and the possibility of model building for Dark Matter and Electro-Weak Symmetry Breaking. Methodological challenges are addressed as well, including new developments in Artificial Intelligence geared towards the identification of different phases and transitions.
We study threshold testing, an elementary probing model with the goal to choose a large value out of n i.i.d. random variables. An algorithm can test each variable X_i once for some threshold t_i, and the test returns binary feedback whether X_i ≥ t_i or not. Thresholds can be chosen adaptively or non-adaptively by the algorithm. Given the results for the tests of each variable, we then select the variable with highest conditional expectation. We compare the expected value obtained by the testing algorithm with expected maximum of the variables. Threshold testing is a semi-online variant of the gambler’s problem and prophet inequalities. Indeed, the optimal performance of non-adaptive algorithms for threshold testing is governed by the standard i.i.d. prophet inequality of approximately 0.745 + o(1) as n → ∞. We show how adaptive algorithms can significantly improve upon this ratio. Our adaptive testing strategy guarantees a competitive ratio of at least 0.869 - o(1). Moreover, we show that there are distributions that admit only a constant ratio c < 1, even when n → ∞. Finally, when each box can be tested multiple times (with n tests in total), we design an algorithm that achieves a ratio of 1 - o(1).
The Ethics of Waiting lists and Rationing access to care (Ethics Parallel Session), September 26, 2023, 4:50 PM - 6:20 PM
Background: There has been a fivefold increase of neurosurgeons over the last three decades in Germany, despite a lesser increase in operations. Currently, there are approximately 1000 neurosurgical residents employed at training hospitals. Little is known about the overall training experience and career opportunities for these trainees.
Methods: In our role as resident representatives, we implemented a mailing list for interested German neurosurgical trainees. Thereafter, we created a survey including 25 items to assess the trainees’ satisfaction with their training and their perceived career prospects, which we then distributed through the mailing list. The survey was open from 1st April until 31st May 2021.
Results: 90 trainees were enrolled in the mailing list and we received 81 completed responses to our survey. Overall, 47% of trainees were very dissatisfied or dissatisfied with their training. 62% of trainees reported a lack of surgical training. 58% of trainees found it difficult to attend courses or classes and only 16% had consistent mentoring. There was an expressed desire for a more structured training programme and mentoring projects. In addition, 88% of trainees were willing to relocate for fellowships outside their current hospitals.
Conclusions: Half of the responders were dissatisfied with their neurosurgical training. There are various aspects that require improvement, such as the training curriculum, the lack of structured mentoring and the amount of administrative work. We propose the implementation of a modernized structured curriculum, which addresses the mentioned aspects, in order to improve neurosurgical training and, consecutively, patient care.
In QCD at large enough isospin chemical potential Bose-Einstein Condensation (BEC) takes place, separated from the normal phase by a phase transition. From previous studies the location of the BEC line at the physical point is known. In the chiral limit the condensation happens already at infinitesimally small isospin chemical potential for zero temperature according to chiral perturbation theory. The thermal chiral transition at zero density might then be affected, depending on the shape of the BEC boundary, by its proximity. As a first step towards the chiral limit, we perform simulations of 2+1 flavors QCD at half the physical quark masses. The position of the BEC transition is then extracted and compared with the results at physical masses.
In this work we study the 3+1-dimensional Nambu-Jona-Lasinio (NJL) model in the mean field-approximation. We carry out calculations using five different regularization schemes (two continuum and three lattice regularization schemes) with particular focus on inhomogeneous phases and condensates. The regularization schemes lead to drastically different inhomogeneous regions. We provide evidence that inhomogeneous condensates appear for all regularization schemes almost exclusively at values of the chemical potential and with wave numbers, which are of the order of or even larger than the corresponding regulators. This can be interpreted as indication that inhomogeneous phases in the 3+1-dimensional NJL model are rather artifacts of the regularization and not a consequence of the NJL Lagrangian and its symmetries.
In this work, inhomogeneous chiral phases are studied in a variety of Four-Fermion and Yukawa models in 2+1 dimensions at zero and non-zero temperature and chemical potentials. Employing the mean-field approximation, we do not find indications for an inhomogeneous phase in any of the studied models. We show that the homogeneous phases are stable against inhomogeneous perturbations. At zero temperature, full analytic results are presented.
Oral e-Poster Presentations - Booth 2: Spine 1 (Trauma&Misc), September 25, 2023, 10:00 AM - 10:40 AM
Background: Spondylodiscitis is a prevalent type of spinal infection, with pyogenic spondylodiscitis being the most common subtype. While antibiotic therapy is the standard treatment, some argue that early surgery can aid in infection clearance, improve survival rates, and prevent long-term complications such as deformities. However, others view early surgery as excessively risky. Due to the high mortality rate of up to 20%, it is crucial to determine the most effective treatment.
Methods: The primary objective of this study was to compare the mortality rate, relapse rate, and length of hospital stay for conservative and early surgical treatments of pyogenic spondylodiscitis, including determinants of outcomes. The study was registered on PROSPERO with the registration number CRD42022312573. The databases MEDLINE, Embase, Scopus, PubMed, and JSTOR were searched for original studies comparing conservative and early surgical treatments of pyogenic spondylodiscitis. The included studies were assessed using the ROBINS-1 tool, and eligible studies were evaluated using meta-analyses, influence, and regression analyses.
Results: The systematic review included 31 studies. The meta-analysis, which had a pooled sample size of 10,954 patients from 21 studies, found that the pooled mortality rate among patients treated with early surgery was 8%, while the rate was 13% for patients treated conservatively. The mean proportion of relapse/failure was 15% for patients treated with early surgery and 21% for those treated conservatively. Furthermore, the analysis concluded that early surgical treatment is associated with a 40% and 39% risk reduction in relapse/failure and mortality rates, respectively, when compared to conservative management. Additionally, early surgical treatment resulted in a 7.75-day reduction in length of hospital stay per patient (p<0.01). The most highly significant predictors of treatment outcome were found to be intravenous drug use, diabetes, the presence of an epidural abscess, positive cultures, location of infection, and age (p<0.001).
Conclusions: Overall, early surgical management was found to be consistently significantly more effective than conservative management in terms of relapse/failure and mortality rates when treating pyogenic spondylodiscitis, particularly for non-spinal epidural abscess spondylodiscitis.
Introduction: Spondylodiscitis is the commonest form of infectious disease of the spine and harbours a high mortality rate of up to 20%. Recent demographic trends in Germany, such as an aging population, immunosuppression, and intravenous drug use, suggest that the incidence of spondylodiscitis may be on the rise. However, the exact epidemiological development of the disease remains uncertain. This study aims to analyse the burden on the tertiary healthcare system in Germany using data from the Federal Statistical Office of Germany (FSOG) database.
Materials and Methods: All cases of spondylodiscitis diagnosed between 2005 and 2021 were identified from the FSOG database. The study characterised the mean duration of hospital stays, total and population-adjusted number of diagnoses made, age-stratified incidence, and outcomes of hospitalised patients.
Results: A total of 131,982 diagnoses for spondylodiscitis were identified between 2005 and 2021. The number of diagnoses for spondylodiscitis has doubled during this period, from 5.4/100,000 population in 2005 to 11/100,000 population in 2021. The highest increase in admissions was recorded for those aged 90 years and above (+1307%), 80-89 (+376%) and 70-79 (+99%). Hospital discharges to rehabilitation facilities have increased by 160%, and discharges against medical advice by 91%. On the other hand, during the analysed period, the in-hospital mortality rate has decreased by 52%.
Conclusion: The population-adjusted incidence of spondylodiscitis in Germany has more than doubled between 2005 and 2021, highlighting the clinical relevance of this disease. During the same period, in-hospital mortality dropped by half. These findings suggest the need for further investigation into optimal therapy, particularly the role and timing of surgical treatment.
Nitrogen pollution is a major constituent of global change, threatening local biodiversity, ecosystem services, and causing serious environmental damage. Specifically, in areas with heavy agricultural soil-use, excessive use of nitrogen fertilizer pollutes the groundwaters with nitrates, but also with ammonia and nitrites. Freshwater fish and other aquatic fauna are especially vulnerable to nitrites, which can cause massive mortalities at even low concentrations < 0.1 mg/l NO2- - N. Adaptation of fish to environments with relatively high concentrations of chemicals has occurred throughout the history of life, although contemporary evolution acts at a much more rapid pace. The growing use of land for mass agriculture and livestock industries in the last 50 years in the US has dramatically increased the nutrient loading into the surface and groundwaters. Nitrite poses a serious threat for freshwater fauna as it is rapidly up taken and disturbs ion homeostasis and blood gas transport in fish. In this study, we evaluated, by means of a laboratory experiment, the tolerance of fish to nitrite using six different populations of wild eastern mosquitofish (Gambusia holbrooki) from two regions, North FL and NC, and with different background nitrogen pollution histories. Mosquitofish females were exposed to nitrite in the lab, to either < 0.005 mg/l NO2- (control) or 0.3 mg/l NO2- for ten days and we assessed at the end of the exposure period their blood O2 transport capacity by measuring the concentration of four different types of hemoglobin, their total hematocrit, and their respiratory rates. Preliminary results show significant varying patterns in the response of the exposed fish, depending on the population source, as evidenced by their respiratory rates and the blood erythrocyte counts. Mortality was very low, and hemoglobin profiles indicate high tolerance of G. holbrooki to nitrite contamination – a factor supporting their invasion success in agriculturally dominated regions around the world
Insulin resistance and working memory exploring the role of blood glucose levels and lifestyle
(2023)
vIntroduction: Type 2 diabetes mellitus and dementia are among the leading causes for reduced quality of life and life expectancy worldwide and often occur comorbidly. Both diseases are linked by altered insulin signaling. Lifestyle factors and blood glucose monitoring play an essential role in the prevention and treatment of type 2 diabetes. So far, a relationship between blood glucose levels, lifestyle, and cognitive performance – a main symptom of dementia - has mainly been established in laboratory settings which reduces its ecological validity.
Objectives: This study uses ambulatory assessment and continuous glucose monitoring to explore the link between blood glucose levels, lifestyle and working memory in an ecological setting. We hypothesize that glycemic variations affect working memory performance in daily life. Second, we hypothesize that a high variance in blood glucose levels has a higher impact on working memory in insulin resistant participants. With this study, we aim to expand the knowledge on the relationship of insulin resistance and cognitive performance from the laboratory setting to everyday life.
Methods: This prospective, exploratory study will include 80 subjects with insulin resistance and 80 healthy controls. At baseline, blood indicators of insulin resistance will be measured to determine group assignment. Our ambulatory assessment includes smartphone-based sampling and sensor-based assessment. Therefore, cognitive performance will be recorded over three consecutive days using a smartphone. Four times a day, a numerical working memory task is prompted by signal-based alarms on the smartphone. Blood glucose levels are recorded in parallel by continuous glucose monitoring. In addition, lifestyle factors such as diet ad physical activity are examined. Diet is assessed by 24-h dietary protocols and movement acceleration by accelerometery.
Multilevel modelling will be used to map the relationship between blood glucose levels and working memory at the within- and between-person level. Diet and exercise are included in the analyses as additional predictors.
Results: Data collection started in March 2021 and is ongoing. Up to now, 40 insulin resistant participants and 36 healthy controls have been measured. Our preliminary results indicate a positive association between blood glucose levels and working memory performance at the within-person level (estimate = .48, 95% CI [.07, .89], p =0.022). At the between-person level the analysis revealed an inverse association between blood glucose levels and working memory performance (estimate = -.45, 95 % CI [-.86 - -.05], p = 0.029).
Conclusion: Our preliminary results are in line with studies showing that an acute rise in blood glucose levels leads to short-term improvements, while stable glucose profiles are beneficial in the long term. This might expand the understanding of the impact of insulin resistance on working memory and represent a target for early interventions. Our preliminary analysis needs to be repeated in our final dataset to confirm our results.
Introduction: The optimal treatment of patients with spinal infections remains a controversial topic. Within Europe, fundamentally different therapeutic concepts are found. Therefore, the aim of this study was to compare the outcome of patients who received surgical vs. antibiotic treatment alone for primary pyogenic spondylodiscitis in an international cohort analysis.
Materials and Methods: The retrospectively compiled databases of tertiary high-volume spine centers served as the baseline for this study. All documented cases of primary spondylodiscitis treated surgically and conservatively in the period of 2017-2022 were included and grouped according to the therapeutic concept: conservative vs. surgical treatment. Independent investigators collected the relevant clinical and radiological data. The primary endpoint of this study was mortality rate; secondary endpoints were relapse rate and persisting neurological deficit.
Results: A total of 392 patients were included in the analysis (155 females with a mean age of 68 years). Of these, 95 cases were treated conservatively (CoT) and 297 cases were treated surgically (SuT). There was no significant difference (p<0.01) related to patient’s disease characteristics: Lumbar was the main location (n=240, CoT 58/ SuT 182, p=0.97) followed by thoracic (n=70, CoT 24/ SuT 46, p=0,03) and cervical (n=47, CoT 7/ SuT 40, p=0.11) region. A multilocular spinal infection was present in 32 patients (CoT 3/ SuT 29, p=0.04). 181 cases (CoT 36/ SuT 145, p=0.06) presented with an epidural abscess. Neurological deficits were recorded in 100 cases (CoT 26/ SuT 74, p=0.63), and septic conditions in 88 cases (CoT 26/ SuT 62, p=0.19). Pre-existing conditions like Diabetes (p=0.57), renal failure (p= 0.97), hepatopathy (p= 0.15), malignoma (p=0.39) or i.v. drug abuse (p=0.93) did also not differ between the groups. The mortality rate of all conservatively treated was 24.2% (23 cases) and 6.7% (20 cases) in all surgically treated patients (p<0.001). A follow-up of ≥ 6 weeks was available in 289 cases (CoT 83, SuT 206 ). In this subset of patients relapse of infection occurred in six (7.2%) and 23 (11.2%) cases in the conservative and early surgical treatment group, respectively (p=0.69). Persisting neurological deficit was recorded in 21 (25.3%) of conservatively treated and 51 (24.8%) of surgically treated cases (p=0.92).
Conclusion: Whereas relapse rates and persisting neurological deficit were not found to differ significantly, the results of this international data analyses, with their respective limitations, clearly support the growing evidence of a significantly reduced mortality rate after surgical therapy for primary pyogenic spondylodiscitis when compared to conservative treatment regimen.
Spinal Tumors / Infections (Spine Parallel Session v.3), September 27, 2023, 8:30 AM - 10:00 AM
Background: The optimal treatment of patients with spinal infections remains a controversial topic. While there is some consensus regarding the indication for surgical intervention in infections with neurologic deficit, significant deformity or progressive disease, other situations remain controversial. Within Europe, fundamentally different therapeutic concepts are found. Therefore, the aim of this study was to compare the outcome of patients who received surgical vs. antibiotic treatment alone for primary pyogenic spondylodiscitis in an international cohort analysis.
Methods: The retrospectively compiled databases of tertiary high-volume spine centers served as the baseline for this study. All documented cases of primary spondylodiscitis treated surgically and conservatively in the period of 2017-2022 were included and grouped according to the therapeutic concept: conservative vs. surgical treatment. Independent investigators collected the relevant clinical and radiological data. The primary endpoint of this study was mortality rate; secondary endpoints were relapse rate and persisting neurological deficit.
Results: A total of 392 patients were included in the analysis (155 females and 237 males with a mean age of 68 years). Of these, 95 cases were treated conservatively (CoT) and 297 cases were treated surgically (SuT). Most of conservatively treated patients were treated in the United Kingdom (CoT 81/ SuT 7), while most of the surgically treated cases were treated in Germany (CoT 14/ SuT 290). There was no significant difference (p<0.01) related to patient’s disease characteristics:
Lumbar was the main location (n=240, CoT 58/ SuT 182, p=0.97) followed by thoracic (n=70, CoT 24/ SuT 46, p=0,03) and cervical (n=47, CoT 7/ SuT 40, p=0.11) region. A multilocular spinal infection was present in 32 patients (CoT 3/ SuT 29, p=0.04). 181 cases (CoT 36/ SuT 145, p=0.06) presented with an epidural abscess. Neurological deficits were recorded in 100 cases (CoT 26/ SuT 74, p=0.63), and septic conditions in 88 cases (CoT 26/ SuT 62, p=0.19). Pre-existing conditions like Diabetes (CoT 20/, SuT 71, p=0.57), renal failure (CoT 19/ SuT 60, p= 0.97), hepatopathy (CoT 4/ SuT 26, p= 0.15), malignoma (CoT 9/ SuT 38, p=0.39) or i.v. drug abuse (CoT 5/, SuT 15, p=0.93) did also not differ between the groups.
The mortality rate of all conservatively treated was 24.2% (23 cases) and 6.7% (20 cases) in all surgically treated patients (p<0.001). A follow-up of ≥ 6 weeks was available in 289 cases (CoT 83, SuT 206 ). In this subset of patients relapse of infection occurred in six (7.2%) and 23 (11.2%) cases in the conservative and early surgical treatment group, respectively (p=0.69). Persisting neurological deficit was recorded in 21 (25.3%) of conservatively treated and 51 (24.8%) of surgically treated cases (p=0.92).
Conclusions: Whereas relapse rates and persisting neurological deficit were not found to differ significantly, the results of this international data analyses, with their respective limitations, clearly support the growing evidence of a significantly reduced mortality rate after surgical therapy for primary pyogenic spondylodiscitis when compared to conservative treatment regimen.
Asymptotic giant branch (AGB) stars are responsible for the production of the main component of the solar s-process distribution. Despite enormous progress in the theoretical modeling of these objects over the last few decades, many uncertainties remain. The still-unknown mechanism leading to the production of 13C neutron source is one example. The nucleosynthetic signature of AGB stars can be examined in a number of stellar sources, from spectroscopic observations of intrinsic and extrinsic stars to the heavy-element isotopic composition of presolar grains found in meteorites. The wealth of available observational data allows for constraining the processes occurring in AGB interiors. In this view, we discuss recent results from new AGB models including the effects of mixing triggered by magnetic fields, and show comparisons of the related s-process nucleosynthesis with available observations.
The oxidation state of sulfur in slab fluids is controversial, with both dominantly oxidized and reduced species proposed. Here we use in situ X-ray absorption spectroscopy analysis of sulfur-in-apatite to monitor changes in the oxidation state of sulfur during high-P metasomatism by slab fluids in the subduction channel. Our samples include a 73 cm continuous transect of reaction zones between a metagabbroic eclogite block and serpentinite matrix from a mélange zone on the island of Syros, Greece. The block core consists of garnet, omphacite, phengite, paragonite, epidote-clinozoisite, and rutile. In this region, apatite is only observed as elongate inclusions in omphacite cores. From the core outwards micas are increasingly replaced by epidote-clinozoisite, garnets are smaller and more frequent, pyrite + bornite is observed as inclusions in recrystallized omphacite, and apatite is increasingly abundant in the matrix and inclusions in garnet. A major transition at 48 cm separates an assemblage of Ca-Na amphibole, omphacite, chlorite, pyrite, and apatite from the inner garnet-bearing eclogite assemblages. Omphacite disappears from the assemblage at ~56 cm and amphibole compositions sharply transition to tremolite at 59 cm. Finally, the assemblage tremolite + talc + pyrite is observed after ~70 cm.Apatites in the eclogite assemblages exclusively display S6+ peaks in their absorption spectra. This includes apatite inclusions in omphacite in the least altered lithology, as well as matrix apatite and isolated apatite inclusions in garnet in the outermost metasomatized eclogite zone. In the intermediate pyrite-rich (~1-5 vol %) amphibole + omphacite + chlorite zone, apatite displays a strong S1- absorption peak in most grains, with rare analyses showing mixed S1- and S6+. Finally, apatite in the outermost tremolite-bearing assemblages only displays a S6+ peak. The pyrite-rich zone at 48 cm occurs at the initial interface between the serpentinite matrix and eclogite block, characterized by a dramatic decrease in Na content and Mg#. Our data suggest that reduction of S6+ in infiltrating fluids to S1- in pyrite became focused as Fe diffused across the steep Mg# gradient, resulting in pyrite precipitation. In contrast, S reduction in the Mg-rich tremolite-dominant portions of the transect was limited by a lack of Fe, resulting in low modes of pyrite and fluid buffered S6+ in apatite. Finally, S6+-bearing apatite is also observed in reaction zone lithologies from elsewhere on Syros, suggesting our observations are not isolated.Two important conclusions are drawn from these data and observations: (1) In the case of Syros, slab fluids at eclogite-facies conditions carried oxidized S6+, and (2) The interaction of these fluids with eclogites composed of ferrous-Fe silicates resulted in extensive sulfide precipitation.
The Heidelberg Ion-Beam Therapy Centre (HIT) provides proton, helium, and carbon-ion beams with different energies and intensities for cancer treatment and oxygen-ion beams for experiments. For several experiments and possible future applications, such as helium ion beam radiography, a low-intensity ion beam monitor integrated into the dose delivery feedback system for the accelerator control is a necessary pre-requisite. The updated 2D prototype for this purpose consists of scintillating fibres with enhanced radiation hardness, silicon photomultipliers (SiPMs) to amplify the emitted light, and a dedicated front-end readout system (FERS) to process and record the generated signals. This setup was tested successfully on monitoring ion-beam position and profile horizontally and vertically, as well as the beam intensity, for all four ion types with energies from 50 to 430 MeV/u and intensities from 1E2 to 1E7 ions/s. Additionally, time-of-arrival (ToA) measurements on single ions have been successfully performed for a limited intensity range, allowing for ion tracking in a further update. This will reduce noise, and will also improve the accuracy and usability of ion radiography.
In the culture history of ancient Europe questions pertaining to its diverse relationships to advanced civilisations in the Mediterranean sphere look back upon a long tradition. Varyingly different single finds and groups of finds have repeatedly provided the prospect and scope for investigating the character and extent of contacts and influences as well as the consequences for cultural developments north of the Alps. In discussions on the genesis and significance of the Bronze Age in central and northern Europe, the perceived linkages between the eastern Mediterranean and the Carpathian Basin and via the Danube River as far as areas north of the Alps have played an important role. Without question, the Danube River represented a crucial axis of communication ever since the Neolithic period and in following times. Recent interdisciplinary studies, however, have broadened the scope and shown that further important communication routes existed along the Ionian-Adriatic Sea to Upper Italy and beyond the Alps, and via the Rhône valley and the West Alps to the North. Thereby, impulses of varying economic nature could be discerned, which were consequential for many aspects of the cultural development of the Early and Middle Bronze Age in Central Europe.
How can older adults participate equally in digitisation processes across Europe, and what inclusive research strategies are needed? This Zine summarizes findings from a “Research Innovation Lab on Ageing in a Digital Age”, funded by the VolkswagenStiftung, aiming to bring together 29 docs and postdocs anchored in 26 different disciplines coming from 11 countries, at all stages of their work, to address cutting edge questions relating to ageing in a digital age. Five groups worked together over five days in Frankfurt, Germany, in July 2023 in a creative and interactive hackathon, specific to developing non-technical solutions to social issues of this topic. Moreover, four distinguished experts presented keynote speeches and proposals from various conceptual, methodological and empirical perspectives.