Surgical fidelity: comparing the microscope and the endoscope

pre-printBackground: Both the microscope and the endoscope are widely used as visualization tools in neurosurgery; however, surgical dexterity when operating with endoscopic visual control may differ. The aim of this study was to compare the surgical fidelity when using each of these visualization tools. Methods: Junior residents and expert surgeons performed standardized motor tasks under microscopic and endoscopic visualization. Demerits for inaccuracy and time needed to complete the tasks were used to compare the surgeons' performance with the microscope and the endoscope. The participants also performed a motor task under direct vision using different instruments to evaluate whether the shape of the instrument had any impact on the surgical fidelity. Results: For the junior residents, the number of demerits accrued was lower with the microscope than with the endoscope, and the time needed to complete the tasks was also lower with the microscope. There was no difference in the number of demerits between the microscopic and the endoscopic experts, but the microscopic expert completed the task in a shorter time. There was no difference in demerits or performance time when comparing a short, straight instrument and a longer, bayoneted one. Conclusion: For junior residents, surgical fidelity is higher with the microscope than with the endoscope. This difference vanishes with experience, but a slower speed of execution is observed with endoscopic visualization, both in junior and expert surgeons

The Low Velocity Wind from the Circumstellar Matter Around the B9V Star sigma Herculis

We have obtained FUSE spectra of sigma Her, a nearby binary system, with a main sequence primary, that has a Vega-like infrared excess. We observe absorption in the excited fine structure lines C II* at 1037 A, N II* at 1085 A, and N II** at 1086 A that are blueshifted by as much as ~30 km/sec with respect to the star. Since these features are considerably narrower than the stellar lines and broader than interstellar features, the C II and N II are circumstellar. We suggest that there is a radiatively driven wind, arising from the circumstellar matter, rather than accretion as occurs around beta Pic, because of sigma Her's high luminosity. Assuming that the gas is liberated by collisions between parent bodies at 20 AU, the approximate distance at which blackbody grains are in radiative equilibrium with the star and at which 3-body orbits become unstable, we infer dM/dt ~ 6 * 10^-12 M_{sun}/yr. This wind depletes the minimum mass of parent bodies in less than the estimated age of the system.Comment: 6 pages, 3 figures, ApJ in pres

The outer halo globular cluster system of M31 - II. Kinematics

We present a detailed kinematic analysis of the outer halo globular cluster (GC) system of M31. Our basis for this is a set of new spectroscopic observations for 78 clusters lying at projected distances between Rproj ~20-140 kpc from the M31 centre. These are largely drawn from the recent PAndAS globular cluster catalogue; 63 of our targets have no previous velocity data. Via a Bayesian maximum likelihood analysis we find that GCs with Rproj > 30 kpc exhibit coherent rotation around the minor optical axis of M31, in the same direction as more centrally- located GCs, but with a smaller amplitude of 86+/-17 km s-1. There is also evidence that the velocity dispersion of the outer halo GC system decreases as a function of projected distance from the M31 centre, and that this relation can be well described by a power law of index ~ -0.5. The velocity dispersion profile of the outer halo GCs is quite similar to that of the halo stars, at least out to the radius up to which there is available information on the stellar kinematics. We detect and discuss various velocity correlations amongst subgroups of GCs that lie on stellar debris streams in the M31 halo. Many of these subgroups are dynamically cold, exhibiting internal velocity dispersions consistent with zero. Simple Monte Carlo experiments imply that such configurations are unlikely to form by chance, adding weight to the notion that a significant fraction of the outer halo GCs in M31 have been accreted alongside their parent dwarf galaxies. We also estimate the M31 mass within 200 kpc via the Tracer Mass Estimator, finding (1.2 - 1.6) +/- 0.2 10^{12}M_sun. This quantity is subject to additional systematic effects due to various limitations of the data, and assumptions built in into the TME. Finally, we discuss our results in the context of formation scenarios for the M31 halo.Comment: 24 pages, 12 figures, 7 tables; Accepted for publication in MNRA

From Cooper Pairs to Composite Bosons: A Generalized RPA Analysis of Collective Excitations

The evolution of the ground state and the excitation spectrum of the two and three dimensional attractive Hubbard model is studied as the system evolves from a Cooper pair regime for weak attraction to a composite boson regime for a strong attraction.Comment: 20 pages RevTex, 7 figures on reques

New polymorphic microsatellite markers for California sea lions (Zalophus californianus)

Nine microsatellite loci were isolated and characterized from California sea lions (Zalophus californianus). In addition, two of five loci tested from harbour seal (Phoca vitulina) produced a single, clear band in Z. californianus, as did one out of five loci from grey seal (Halichoerus grypus) and one out of two loci from elephant seal (Mirounga sp.). No locus tested from South American fur seal (Arctocephalus australis) amplified in Z. californianus. Locus variability was assessed in California sea lions from Los Islotes rookery, Baja California Sur, Mexico. All loci were variable, with allele numbers ranging from three to 12. © 2005 Blackwell Publishing Ltd.Peer Reviewe

El principio de transparencia en el contrato de prestación de servicios en las entidades estatales

El presente artículo busca hacer un análisis de la aplicación que se le da al principio de transparencia dentro de la contratación estatal, específicamente en el contrato de prestación de servicios celebrado bajo la modalidad de contratación directa, de este modo se podrá examinar la importancia y alcance que tiene el principio de transparencia con relación a las diferentes etapas del proceso de contratación; por otra parte se hará un estudio de los actos y procedimientos que realiza la administración pública para la celebración y escogencia del contratista de prestación de servicios profesionales y de apoyo a la gestión; de igual manera se analizara la postura que han asumido las altas cortes colombianas con respecto al principio de transparencia y la celebración de contratos de prestación de servicios por parte de las entidades estatales

Managing Injuries of the Neck Trial (MINT) : design of a randomised controlled trial of treatments for whiplash associated disorders

Background: A substantial proportion of patients with whiplash injuries develop chronic symptoms. However, the best treatment of acute injuries to prevent long-term problems is uncertain. A stepped care treatment pathway has been proposed, in which patients are given advice and education at their initial visit to the emergency department (ED), followed by review at three weeks and physiotherapy for those with persisting symptoms. MINT is a two-stage randomised controlled trial to evaluate two components of such a pathway: 1. use of The Whiplash Book versus usual advice when patients first attend the emergency department; 2. referral to physiotherapy versus reinforcement of advice for patients with continuing symptoms at three weeks. Methods: Evaluation of the Whiplash Book versus usual advice uses a cluster randomised design in emergency departments of eight NHS Trusts. Eligible patients are identified by clinicians in participating emergency departments and are sent a study questionnaire within a week of their ED attendance. Three thousand participants will be included. Patients with persisting symptoms three weeks after their ED attendance are eligible to join an individually randomised study of physiotherapy versus reinforcement of the advice given in ED. Six hundred participants will be randomised. Follow-up is at 4, 8 and 12 months after their ED attendance. Primary outcome is the Neck Disability Index (NDI), and secondary outcomes include quality of life and time to return to work and normal activities. An economic evaluation is being carried out. Conclusion: This paper describes the protocol and operational aspects of a complex intervention trial based in NHS emergency and physiotherapy departments, evaluating two components of a stepped-care approach to the treatment of whiplash injuries. The trial uses two randomisations, with the first stage being cluster randomised and the second individually randomised