Practical considerations in the management of proton-pump inhibitors

Proton-pump inhibitors (PPIs) are one of the most active ingredients prescribed in Spain. In recent decades there has been an overuse of these drugs in both outpatient clinics and hospitals that has lead to a significant increase in healthcare spending and to an increase in the risk of possible side effects. It is important for health professionals to know the accepted indications and the correct doses for the use of these drugs. On the market there are different types of PPI: omeprazole, pantoprazole, lansoprazole, rabeprazole and esomeprazole. Omeprazole is the oldest and most used PPI, being also the cheapest. Although there are no important differences between PPIs in curing diseases, esomeprazole, a new-generation PPI, has proved to be more effective in eradicating H. pylori and in healing severe esophagitis compared to other PPIs. In recent years the use of generic drugs has spread; these drugs have the same bioavailability than the original drugs. In the case of PPIs, the few comparative studies available in the literature between original and generic drugs have shown no significant differences in clinical efficacy.

Ammonia effects on proton conductivity properties of coordination polymers

Crystalline metal phosphonates are referred to as a type of structurally versatile coordination polymers [1]. Many of them contain guest molecules (H2O, heterocyclics, etc.), acidic sites and, furthermore, their structure can be also amenable for post‐synthesis modifications in order to enhance desired properties [2]. In the present work, we examine the relationships between crystal structure and proton conductivity for several metal phosphonates derive from multifunctional ligands, such as 5-(dihydroxyphosphoryl)isophthalic acid (PiPhtA) [3] and 2-hydroxyphosphonoacetic acid (H3HPAA). Crystalline divalent metal derivatives show a great structural diversity, from 1D to 3D open-frameworks, possessing hydrogen-bonded water molecules and acid groups. These solids present a proton conductivity range between 7.2·10-6 and 1.3·10−3 S·cm-1. Upon exposure to ammonia vapor, from an aqueous solution, solid state transformations are observed accompanied of enhance proton conductivities. The stability of these solids under different environment conditions (temperature and relative humidities) as well as the influence of the ammonia adsorption on the proton conduction properties of the resulting solids will be discussed.

WATER TRANSPORT THROUGH POROUS MEDIA AND IN FLOW CHANNELS OF PROTON EXCHANGE MEMBRANE FUEL CELL

Proton exchange membrane (PEM) fuel cell has been known as a promising power source for different applications such as automotive, residential and stationary. During the operation of a PEM fuel cell, hydrogen is oxidized in anode and oxygen is reduced in the cathode to produce the intended power. Water and heat are inevitable byproducts of these reactions. The water produced in the cathode should be properly removed from inside the cell. Otherwise, it may block the path of reactants passing through the gas channels and/or gas diffusion layer (GDL). This deteriorates the performance of the cell and eventually can cease the operation of the cell. Water transport in PEM fuel cell has been the subject of this PhD study. Water transport on the surface of the GDL, through the gas flow channels, and through GDL has been studied in details. For water transport on the surface of the GDL, droplet detachment has been measured for different GDL conditions and for anode and cathode gas flow channels. Water transport through gas flow channels has been investigated by measuring the two-phase flow pressure drop along the gas flow channels. As accumulated liquid water within gas flow channels resists the gas flow, the pressure drop increases along the flow channels. The two-phase flow pressure drop can reveal useful information about the amount of liquid water accumulated within gas flow channels. Liquid water transport though GDL has also been investigated by measuring the liquid water breakthrough pressure for the region between the capillary fingering and the stable displacement on the drainage phase diagram. The breakthrough pressure has been measured for different variables such as GDL thickness, PTFE/Nafion content within the GDL, GDL compression, the inclusion of a micro-porous layer (MPL), and different water flow rates through the GDL. Prior to all these studies, GDL microstructural properties have been studied. GDL microstructural properties such as mean pore diameter, pore diameter distribution, and pore roundness distribution have been investigated by analyzing SEM images of GDL samples.

Applications of advanced and dual energy computed tomography in proton therapy

This thesis focuses on advanced reconstruction methods and Dual Energy (DE) Computed Tomography (CT) applications for proton therapy, aiming at improving patient positioning and investigating approaches to deal with metal artifacts. To tackle the first goal, an algorithm for post-processing input DE images has been developed. The outputs are tumor- and bone-canceled images, which help in recognising structures in patient body. We proved that positioning error is substantially reduced using contrast enhanced images, thus suggesting the potential of such application. If positioning plays a key role in the delivery, even more important is the quality of planning CT. For that, modern CT scanners offer possibility to tackle challenging cases, like treatment of tumors close to metal implants. Possible approaches for dealing with artifacts introduced by such rods have been investigated experimentally at Paul Scherrer Institut (Switzerland), simulating several treatment plans on an anthropomorphic phantom. In particular, we examined the cases in which none, manual or Iterative Metal Artifact Reduction (iMAR) algorithm were used to correct the artifacts, using both Filtered Back Projection and Sinogram Affirmed Iterative Reconstruction as image reconstruction techniques. Moreover, direct stopping power calculation from DE images with iMAR has also been considered as alternative approach. Delivered dose measured with Gafchromic EBT3 films was compared with the one calculated in Treatment Planning System. Residual positioning errors, daily machine dependent uncertainties and film quenching have been taken into account in the analyses. Although plans with multiple fields seemed more robust than single field, results showed in general better agreement between prescribed and delivered dose when using iMAR, especially if combined with DE approach. Thus, we proved the potential of these advanced algorithms in improving dosimetry for plans in presence of metal implants.

Proton radiotherapy: a therapeutic opportunity for pediatric brain tumor patients

Proton radiation therapy is a form of external radiation that uses charged particles which have distinct physical advantages to deliver the majority of its dose in the target while minimizing the dose of radiation to normal tissues. In children who are particularly susceptible even at low and medium doses of radiation, the significant reduction of integral dose can potentially mitigate the incidence of side effects and improve quality of life. The aim of the first part of the thesis is to describe the physical and radiobiological properties of protons, the Proton Therapy Center of Trento (TCPT) active for clinical purpose since 2014, which use the most recent technique called active pencil beam scanning. The second part of the thesis describes the preliminary clinical results of 23 pediatric patients with central nervous system tumors as well as of two aggressive pediatric meningiomas treated with pencil beam scanning. All the patients were particularly well-suited candidates for proton therapy (PT) for possible benefits in terms of survival and incidence of acute and late side effects. We reported also a multicentric experience of 27 medulloblastoma patients (median age 6 years, M/F ratio 13/14) treated between 2015 and 2020 at TPTC coming from three Pediatric oncology centers: Bologna, Florence, and Ljubljana, with a focus on clinical results and toxicities related to radiotherapy (RT). Proton therapy was associated with mostly mild acute and late adverse effects and no cases of CNS necrosis or high grade of neuroradiological abnormailities. Comparable rates of survival and local control were obtained to those achievable with conventional RT. Finally, we performed a systematic review to specifically address the safety of PT for pediatric CNS patients, late side effects and clinical effectiveness after PT in this patient group.

Forward Neutral-Pion Transverse Single-Spin Asymmetries in p plus p Collisions at s=200 GeV

We report precision measurements of the Feynman x (x(F)) dependence, and first measurements of the transverse momentum (p(T)) dependence, of transverse single-spin asymmetries for the production of pi(0) mesons from polarized proton collisions at s=200 GeV. The x(F) dependence of the results is in fair agreement with perturbative QCD model calculations that identify orbital motion of quarks and gluons within the proton as the origin of the spin effects. Results for the p(T) dependence at fixed x(F) are not consistent with these same perturbative QCD-based calculations.

Cross Section and Parity-Violating Spin Asymmetries of W(+/-) Boson Production in Polarized p plus p Collisions at root s=500 Gev

Large parity-violating longitudinal single-spin asymmetries A(L)(e+) = 0.86(-0.14)(+0.30) and Ae(L)(e-) = 0.88(-0.71)(+0.12) are observed for inclusive high transverse momentum electrons and positrons in polarized p + p collisions at a center-of-mass energy of root s = 500 GeV with the PHENIX detector at RHIC. These e(+/-) come mainly from the decay of W(+/-) and Z(0) bosons, and their asymmetries directly demonstrate parity violation in the couplings of the W(+/-) to the light quarks. The observed electron and positron yields were used to estimate W(+/-) boson production cross sections for the e(+/-) channels of sigma(pp -> W(+)X) X BR(W(+) -> e(+) nu(e)) = 144.1 +/- 21.2(stat)(-10.3)(+3.4)(syst) +/- 21.6(norm) pb, and sigma(pp -> W(-)X) X BR(W(-) -> e(-) (nu) over bar (e)) = 3.17 +/- 12.1(stat)(-8.2)(+10.1)(syst) +/- 4.8(norm) pb.

Cross section and double helicity asymmetry for eta mesons and their comparison to pi(0) production in p plus p collisions at root s=200 GeV

Measurements of double-helicity asymmetries in inclusive hadron production in polarized p + p collisions are sensitive to helicity-dependent parton distribution functions, in particular, to the gluon helicity distribution, Delta g. This study focuses on the extraction of the double-helicity asymmetry in eta production ((p) over right arrow + (p) over right arrow -> eta + X), the eta cross section, and the eta/pi(0) cross section ratio. The cross section and ratio measurements provide essential input for the extraction of fragmentation functions that are needed to access the helicity-dependent parton distribution functions.

Double-helicity dependence of jet properties from dihadrons in longitudinally polarized p plus p collisions at root s=200 GeV

It has been postulated that partonic orbital angular momentum can lead to a significant double-helicity dependence in the net transverse momentum of Drell-Yan dileptons produced in longitudinally polarized p + p collisions. Analogous effects are also expected for dijet production. If confirmed by experiment, this hypothesis, which is based on semiclassical arguments, could lead to a new approach for studying the contributions of orbital angular momentum to the proton spin. We report the first measurement of the double-helicity dependence of the dijet transverse momentum in longitudinally polarized p + p collisions at root s = 200 GeV from data taken by the PHENIX experiment in 2005 and 2006. The analysis deduces the transverse momentum of the dijet from the widths of the near-and far-side peaks in the azimuthal correlation of the dihadrons. When averaged over the transverse momentum of the triggered particle, the difference of the root mean square of the dijet transverse momentum between like-and unlike-helicity collisions is found to be -37 +/- 88(stat) +/- 14(sys)t MeV/c.

Inclusive cross section and double helicity asymmetry for pi(0) production in p plus p collisions at root s=62.4 GeV

The PHENIX experiment presents results from the RHIC 2006 run with polarized p + p collisions at root s = 62.4 GeV, for inclusive pi(0) production at midrapidity. Unpolarized cross section results are measured for transverse momenta p(T) = 0.5 to 7 GeV/c. Next-to-leading order perturbative quantum chromodynamics calculations are compared with the data, and while the calculations are consistent with the measurements, next-to-leading logarithmic corrections improve the agreement. Double helicity asymmetries A(LL) are presented for p(T) = 1 to 4 GeV/c and probe the higher range of Bjorken x of the gluon (x(g)) with better statistical precision than our previous measurements at root s = 200 GeV. These measurements are sensitive to the gluon polarization in the proton for 0.06 < x(g) < 0.4.

Event structure and double helicity asymmetry in jet production from polarized p plus p collisions at root s=200 GeV

We report on the event structure and double helicity asymmetry (A(LL)) of jet production in longitudinally polarized p + p collisions at root s = 200 GeV. Photons and charged particles were measured by the PHENIX experiment at midrapidity vertical bar eta vertical bar < 0.35 with the requirement of a high-momentum (> 2 GeV/c) photon in the event. Event structure, such as multiplicity, p(T) density and thrust in the PHENIX acceptance, were measured and compared with the results from the PYTHIA event generator and the GEANT detector simulation. The shape of jets and the underlying event were well reproduced at this collision energy. For the measurement of jet A(LL), photons and charged particles were clustered with a seed-cone algorithm to obtain the cluster pT sum (p(T)(reco)). The effect of detector response and the underlying events on p(T)(reco) was evaluated with the simulation. The production rate of reconstructed jets is satisfactorily reproduced with the next-to-leading-order and perturbative quantum chromodynamics jet production cross section. For 4< p(T)(reco) < 12 GeV/c with an average beam polarization of < P > = 49% we measured Lambda(LL) = -0.0014 +/- 0.0037(stat) at the lowest p(T)(reco) bin (4-5 GeV= c) and -0.0181 +/- 0.0282(stat) at the highest p(T)(reco) bin (10-12 GeV= c) with a beam polarization scale error of 9.4% and a pT scale error of 10%. Jets in the measured p(T)(reco) range arise primarily from hard-scattered gluons with momentum fraction 0: 02 < x < 0: 3 according to PYTHIA. The measured A(LL) is compared with predictions that assume various Delta G(x) distributions based on the Gluck-Reya-Stratmann-Vogelsang parameterization. The present result imposes the limit -a.1 < integral(0.3)(0.02) dx Delta G(x, mu(2) = GeV2) < 0.4 at 95% confidence level or integral(0.3)(0.002) dx Delta G(x, mu(2) = 1 GeV2) < 0.5 at 99% confidence level.

The (9)Be((8)Li, (9)Be)(8)Li elastic-transfer reaction

Angular distributions for the (9)Be((8)Li, (9)Be) (8)Li elastic-transfer reaction have been measured with a 27-MeV (8)Li radioactive nuclear beam. Spectroscopic factors for the <(9)Be vertical bar(8)Li + p > bound system were obtained from the comparison between the experimental differential cross sections and finite-range distorted-wave Born approximation calculations made with the code FRESCO. The spectroscopic factors so obtained are compared with shell-model calculations and other experimental values. Using the present value for the spectroscopic factors, cross sections and reaction rates for the (8)Li(p,gamma) (9)Be direct proton-capture reaction of astrophysical interest were calculated in the framework of the potential model.

Integrability and exact spectrum of a pairing model for nucleons

A pairing model for nucleons, introduced by Richardson in 1966, which describes proton-neutron pairing as well as proton-proton and neutron-neutron pairing, is re-examined in the context of the quantum inverse scattering method. Specifically, this shows that the model is integrable by enabling the explicit construction of the conserved operators. We determine the eigenvalues of these operators in terms of the Bethe ansatz, which in turn leads to an expression for the energy eigenvalues of the Hamiltonian.

Observation and measurements of the production of prompt and non-prompt J/ψ mesons in association with a Z boson in pp collisions at s√ = 8 TeV with the ATLAS detector

The production of a Z boson in association with a J/ψ meson in proton--proton collisions probes the production mechanisms of quarkonium and heavy flavour in association with vector bosons, and allows studies of multiple parton scattering. Using 20.3fb−1 of data collected with the ATLAS experiment at the LHC, in pp collisions at s√=8 TeV, the first measurement of associated Z+J/ψ production is presented for both prompt and non-prompt J/ψ production, with both signatures having a significance in excess of 5σ. The inclusive production cross-sections for Z boson production (in μ+μ− or e+e− decay modes) in association with prompt and non-prompt J/ψ(→μ+μ−) are measured relative to the inclusive production rate of Z bosons in the same fiducial volume to be (88±16±6)×10−8 and (157±22±10)×10−8 respectively. Normalised differential production cross-sections are also determined as a function of the J/ψ transverse momentum. The fraction of signal events arising from single and double parton scattering is estimated, and a lower limit of 5.3 (3.7)mb at 68 (95) confidence level is placed on the effective cross-section regulating double parton interactions.

Origin of the neutron skin thickness of 208Pb in nuclear mean-field models

We study whether the neutron skin thickness Δrnp of 208Pb originates from the bulk or from the surface of the nucleon density distributions, according to the mean-field models of nuclear structure, and find that it depends on the stiffness of the nuclear symmetry energy. The bulk contribution to Δrnp arises from an extended sharp radius of neutrons, whereas the surface contribution arises from different widths of the neutron and proton surfaces. Nuclear models where the symmetry energy is stiff, as typical of relativistic models, predict a bulk contribution in Δrnp of 208Pb about twice as large as the surface contribution. In contrast, models with a soft symmetry energy like common nonrelativistic models predict that Δrnp of 208Pb is divided similarly into bulk and surface parts. Indeed, if the symmetry energy is supersoft, the surface contribution becomes dominant. We note that the linear correlation of Δrnp of 208Pb with the density derivative of the nuclear symmetry energy arises from the bulk part of Δrnp. We also note that most models predict a mixed-type (between halo and skin) neutron distribution for 208Pb. Although the halo-type limit is actually found in the models with a supersoft symmetry energy, the skin-type limit is not supported by any mean-field model. Finally, we compute parity-violating electron scattering in the conditions of the 208Pb parity radius experiment (PREX) and obtain a pocket formula for the parity-violating asymmetry in terms of the parameters that characterize the shape of the 208Pb nucleon densities.