Management of acute non-specific low back pain in the emergency department: do emergency physicians follow the guidelines? Results of a cross-sectional survey.

Objectives: Clinical guidelines for acute non-specific low back pain (LBP) recommend avoiding imaging studies or invasive treatments and to advise patients to stay active. The aim of this study was to evaluate the management of acute non-specific LBP in the emergency departments (ED).

Setting: We invited all department chiefs of Swiss EDs and their physician staff to participate in a web-based survey using two clinical case vignettes of patients with acute non-specific LBP presenting to an ED.

Pulmonary Histoplasmosis Mimicking Metastatic Lung Cancer: A Case Report.

Histoplasmosis is a well-known endemic fungal infection but experience in non-endemic regions is often limited, which may lead to delayed diagnosis and extensive testing. The diagnosis can be especially challenging, typically when the disease first presents with pulmonary nodules accompanied by hilar and mediastinal lymphadenopathy, suggesting a much more common malignant disease. In this situation, a greater FDG uptake in draining lymph nodes in comparison with the associated lung nodule seen in [F]FDG-PET/CT, the so-called "flip-flop fungus" sign, can help to orientate further diagnostic measures.

The European Joint Research Project UHDpulse - Metrology for advanced radiotherapy using particle beams with ultra-high pulse dose rates.

UHDpulse - Metrology for advanced radiotherapy using particle beams with ultra-high pulse dose rates is a recently started European Joint Research Project with the aim to develop and improve dosimetry standards for FLASH radiotherapy, very high energy electron (VHEE) radiotherapy and laser-driven medical accelerators. This paper gives a short overview about the current state of developments of radiotherapy with FLASH electrons and protons, very high energy electrons as well as laser-driven particles and the related challenges in dosimetry due to the ultra-high dose rate during the short radiation pulses. We summarize the objectives and plans of the UHDpulse project and present the 16 participating partners.

Locating Cytosine Conical Intersections by Laser Experiments and Calculations.

The decay mechanism of S → S excited cytosine (Cyt) and the effect of substitution are studied combining jet-cooled spectroscopy (nanosecond resonant two-photon ionization (R2PI) and picosecond lifetime measurements) with CASPT2//CASSCF computations for eight derivatives. For Cyt and five derivatives substituted at N1, C5, and C6, rapid internal conversion sets in at 250-1200 cm above the 0 bands. The break-off in the spectra correlates with the calculated barriers toward the "C5-C6 twist" conical intersection, which unambiguously establishes the decay mechanism at low S state vibrational energies.

Chemical radiation dosimetry in magnetic fields: characterization of a Fricke-type chemical detector in 6 MV photon beams and magnetic fields up to 1.42 T.

In magnetic resonance guided radiotherapy (MRgRT) radiation dose measurements needs to be performed in the presence of a magnetic field. In this study, the influence of magnetic fields on the readings of a Fricke detector, a chemical dosimeter, have been investigated in 6 MV photon beams. This type of detector has been chosen, as the Federal Office of Metrology (METAS, Switzerland) has great experience with Fricke dosimetry and since it is not expected that this detector is greatly affected by the presence of a magnetic field.

Excited-state vibrations, lifetimes, and nonradiative dynamics of jet-cooled 1-ethylcytosine.

The S excited-state lifetime of jet-cooled 1-ethylcytosine (1ECyt) is ∼1 ns, one of the longest lifetimes for cytosine derivatives to date. Here, we analyze its S → S vibronic spectrum using two-color resonant two-photon ionization and UV/UV holeburning spectroscopy. Compared to cytosine and 1-methylcytosine, the S → S spectrum of 1ECyt shows a progression in the out-of-plane "butterfly" mode ν , identified by spin-component scaled-second-order coupled-cluster method ab initio calculations.

Planarizing cytosine: The S state structure, vibrations, and nonradiative dynamics of jet-cooled 5,6-trimethylenecytosine.

We measure the S → S spectrum and time-resolved S state nonradiative dynamics of the "clamped" cytosine derivative 5,6-trimethylenecytosine (TMCyt) in a supersonic jet, using two-color resonant two-photon ionization (R2PI), UV/UV holeburning, and ns time-resolved pump/delayed ionization. The experiments are complemented with spin-component scaled second-order approximate coupled cluster (SCS-CC2), time-dependent density functional theory, and multi-state second-order perturbation-theory (MS-CASPT2) ab initio calculations. While the R2PI spectrum of cytosine breaks off ∼500 cm above its 0 band, that of TMCyt extends up to +4400 cm higher, with over a hundred resolved vibronic bands.

The excited-state structure, vibrations, lifetimes, and nonradiative dynamics of jet-cooled 1-methylcytosine.

We have investigated the S → S UV vibronic spectrum and time-resolved S state dynamics of jet-cooled amino-keto 1-methylcytosine (1MCyt) using two-color resonant two-photon ionization, UV/UV holeburning and depletion spectroscopies, as well as nanosecond and picosecond time-resolved pump/delayed ionization measurements. The experimental study is complemented with spin-component-scaled second-order coupled-cluster and multistate complete active space second order perturbation ab initio calculations. Above the weak electronic origin of 1MCyt at 31 852 cm about 20 intense vibronic bands are observed.

Gas-Phase Cytosine and Cytosine-N1-Derivatives Have 0.1-1 ns Lifetimes Near the S1 State Minimum.

Ultraviolet radiative damage to DNA is inefficient because of the ultrafast S1 ⇝ S0 internal conversion of its nucleobases. Using picosecond pump-ionization delay measurements, we find that the S1((1)ππ*) state vibrationless lifetime of gas-phase keto-amino cytosine (Cyt) is τ = 730 ps or ∼ 700 times longer than that measured by femtosecond pump-probe ionization at higher vibrational excess energy, Eexc. N1-Alkylation increases the S1 lifetime up to τ = 1030 ps for N1-ethyl-Cyt but decreases it to 100 ps for N1-isopropyl-Cyt.

The elusive S2 state, the S1/S2 splitting, and the excimer states of the benzene dimer.

We observe the weak S0 → S2 transitions of the T-shaped benzene dimers (Bz)2 and (Bz-d6)2 about 250 cm(-1) and 220 cm(-1) above their respective S0 → S1 electronic origins using two-color resonant two-photon ionization spectroscopy. Spin-component scaled (SCS) second-order approximate coupled-cluster (CC2) calculations predict that for the tipped T-shaped geometry, the S0 → S2 electronic oscillator strength fel(S2) is ∼10 times smaller than fel(S1) and the S2 state lies ∼240 cm(-1) above S1, in excellent agreement with experiment. The S0 → S1 (ππ(∗)) transition is mainly localized on the "stem" benzene, with a minor stem → cap charge-transfer contribution; the S0 → S2 transition is mainly localized on the "cap" benzene.

Modeling the Histidine-Phenylalanine Interaction: The NH···π Hydrogen Bond of Imidazole·Benzene.

NH···π hydrogen bonds occur frequently between the amino acid side groups in proteins and peptides. Data-mining studies of protein crystals find that ∼80% of the T-shaped histidine···aromatic contacts are CH···π, and only ∼20% are NH···π interactions. We investigated the infrared (IR) and ultraviolet (UV) spectra of the supersonic-jet-cooled imidazole·benzene (Im·Bz) complex as a model for the NH···π interaction between histidine and phenylalanine.

Low-lying excited states and nonradiative processes of 9-methyl-2-aminopurine.

The UV spectrum of the adenine analogue 9-methyl-2-aminopurine (9M-2AP) is investigated with one- and two-color resonant two-photon ionization spectroscopy at 0.3 and 0.05 cm(-1) resolution in a supersonic jet.

Excited-state structure, vibrations, and nonradiative relaxation of jet-cooled 5-fluorocytosine.

The S0 → S1 vibronic spectrum and S1 state nonradiative relaxation of jet-cooled keto-amino 5-fluorocytosine (5FCyt) are investigated by two-color resonant two-photon ionization spectroscopy at 0.3 and 0.05 cm(–1) resolution.

Excited-state structure and dynamics of keto-amino cytosine: the 1ππ* state is nonplanar and its radiationless decay is not ultrafast.

We have measured the mass- and tautomer-specific S0 → S1 vibronic spectra and S1 state lifetimes of the keto–amino tautomer of cytosine cooled in supersonic jets, using two-color resonant two-photon ionization (R2PI) spectroscopy at 0.05 cm(–1) resolution. The rotational contours of the 0(0)(0) band and nine vibronic bands up to +437 cm(–1) are polarized in the pyrimidinone plane, proving that the electronic excitation is to a 1ππ* state.

Out-of-plane low-frequency vibrations and nonradiative decay in the 1ππ* state of jet-cooled 5-methylcytosine.

We investigate the UV vibronic spectrum and excited-state nonradiative processes of jet-cooled 5-methylcytosine (5MCyt) using two-color resonant two-photon ionization spectroscopy at 0.3 and 0.05 cm(–1) resolution.

Low-lying excited states and nonradiative processes of the adenine analogues 7H- and 9H-2-aminopurine.

We have investigated the UV vibronic spectra and excited-state nonradiative processes of the 7H- and 9H-tautomers of jet-cooled 2-aminopurine (2AP) and of the 9H-2AP-d(4) and -d(5) isotopomers, using two-color resonant two-photon ionization spectroscopy at 0.3 and 0.045  cm(-1) resolution.

Vibronic spectra of jet-cooled 2-aminopurine·H2O clusters studied by UV resonant two-photon ionization spectroscopy and quantum chemical calculations.

For understanding the major- and minor-groove hydration patterns of DNAs and RNAs, it is important to understand the local solvation of individual nucleobases at the molecular level. We have investigated the 2-aminopurine·H(2)O monohydrate by two-color resonant two-photon ionization and UV/UV hole-burning spectroscopies, which reveal two isomers, denoted A and B. The electronic spectral shift δν of the S(1) ← S(0) transition relative to bare 9H-2-aminopurine (9H-2AP) is small for isomer A (-70 cm(-1)), while that of isomer B is much larger (δν = -889 cm(-1)).