Measurement of the cosmic ray hadron spectrum up to 30 TeV at mountain altitude: the primary proton spectrum

The flux of cosmic ray hadrons at the atmospheric depth of 820 g/cm^2 has been measured by means of the EAS-TOP hadron calorimeter (Campo Imperatore, National Gran Sasso Laboratories, 2005 m a.s.l.). The hadron spectrum is well described by a single power law : S(E_h) = (2.25 +- 0.21 +- 0.34(sys)) 10^(-7)(E_h/1000)^(-2.79 +- 0.05) m^(-2) s^(-1) sr^(-1) GeV^(-1) over the energy range 30 GeV-30 TeV. The procedure and the accuracy of the measurement are discussed. The primary proton spectrum is derived from the data by using the CORSIKA/QGSJET code to compute the local hadron flux as a function of the primary proton spectrum and to calculate and subtract the heavy nuclei contribution (basing on direct measurements). Over a wide energy range E_0 = 0.5-50 TeV its best fit is given by a single power law : S(E_0) = (9.8 +- 1.1 +- 1.6(sys)) 10^(-5) (E_0/1000)^(-2.80 +- 0.06) m^(-2) s^(-1) sr^(-1) GeV^(-1). The validity of the CORSIKA/QGSJET code for such application has been checked using the EAS-TOP and KASCADE experimental data by reproducing the ratio of the measured hadron fluxes at the two experimental depths (820 and 1030 g/cm^2 respectively) at better than 10% in the considered energy range.Comment: 16 pages, 9 figures, accepted for publication in Astroparticle Physic

The Incidence Of Prescribing Errors In An Eye Hospital

BACKGROUND: Relatively little is known about the incidence of prescribing errors and there has been no work on this in a single specialty ophthalmic hospital. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors. This study is an attempt in, the setting of an eye hospital, to try to identify and attribute these medication errors. METHODS: The study setting was a single specialty eye hospital geographically separated from the main general hospital. Pharmacists prospectively recorded the number of errors of prescribing during a 4 week period at an eye hospital in UK. The errors were categorised as error of prescription writing or drug error. Potential significance of the errors was not addressed. RESULTS: Overall 144/1952 (8%)prescription sheets had errors. 7% of the total errors were errors of prescription writing while 1% were drug errors. The majority of errors were made by junior doctors and no drug errors were made by senior doctors. The outpatients department had by far the highest prevalence of errors. CONCLUSION: Certain areas within the hospital and certain grades of staff are more prone to drug errors. Further study is required to look at the reasons why this is so and what systems can be put in place to reduce these errors

Evaluation of risk of falls and orthostatic hypotension in older, long-term topical beta-blocker users

Background: Falls are a serious problem in the elderly, and have recently been described as cardiovascular-mediated side effects of beta-blocker eye drops. Therefore, we investigated the possible association between the long-term use of beta-blockers, prostaglandins and their combinations in eye drops, and falls, dizziness and orthostatic hypotension in older patients. Methods: All participants were long-term users of eye drops containing beta-blockers, prostaglandins or their combinations. They underwent a structured falls interview and blood pressure measurement for testing of orthostatic hypotension. The odds ratio for presence of orthostatic hypotension or a positive falls history according to use of beta-blocker eye drops was calculated with a binary logistic regression analysis. The main outcome measures were a positive falls history and the presence of orthostatic hypotension. Results: In total, 148 of 286 subjects participated. After adjustment for age, gender, and use of fall-risk-increasing drugs other than beta-blocker eye drops, we found no significant difference in fall risk [odds ratio (OR): 0.60; 95% confidence interval (CI): 0.268-1.327] between patients using ophthalmic beta-blockers or a combination of ophthalmic beta-blockers and prostaglandins, and patients using ophthalmic prostaglandins only. Although prevalence of orthostatic hypotension was higher in the beta-blocker group (OR: 1.67; 95% CI: 0.731-3.793) compared to the prostaglandin group, this was a non-significant difference. Conclusions: In our study, we did not find a significant association between long-term use of beta-blockers eye drops and falls, dizziness or orthostatic hypotension in older ophthalmic outpatients, compared to long-term use of prostaglandin eye drops

Secondary proton flux induced by cosmic ray interactions with the atmosphere

The atmospheric secondary proton flux is studied for altitudes extending from sea level up to the top of atmosphere by means of a 3-dimensional Monte-Carlo simulation procedure successfully used previously to account for flux measurements of protons, light nuclei, and electrons-positrons below the geomagnetic cutoff (satellite data), and of muons and antiprotons (balloon data). The calculated flux are compared with the experimental measurements from sea level uo to high float ballon altitudes. The agreement between data and simulation results are very good at all altitudes, including the lowest ones, where the calculations become extremely sensitive to the proton production cross section. The results are discussed in this context. The calculations are extended to the study of quasi trapped particles above the atmosphere to about 5 Earth radii, for prospective purpose.Comment: 7 pages, 5 figures, submitted to Phys. Rev.

Importance of factors determining the effective lifetime of a mass, long-lasting, insecticidal net distribution: a sensitivity analysis

ABSTRACT: BACKGROUND: Long-lasting insecticidal nets (LLINs) reduce malaria transmission by protecting individuals from infectious bites, and by reducing mosquito survival. In recent years, millions of LLINs have been distributed across sub-Saharan Africa (SSA). Over time, LLINs decay physically and chemically and are destroyed, making repeated interventions necessary to prevent a resurgence of malaria. Because its effects on transmission are important (more so than the effects of individual protection), estimates of the lifetime of mass distribution rounds should be based on the effective length of epidemiological protection. METHODS: Simulation models, parameterised using available field data, were used to analyse how the distribution's effective lifetime depends on the transmission setting and on LLIN characteristics. Factors considered were the pre-intervention transmission level, initial coverage, net attrition, and both physical and chemical decay. An ensemble of 14 stochastic individual-based model variants for malaria in humans was used, combined with a deterministic model for malaria in mosquitoes. RESULTS: The effective lifetime was most sensitive to the pre-intervention transmission level, with a lifetime of almost 10 years at an entomological inoculation rate of two infectious bites per adult per annum (ibpapa), but of little more than 2 years at 256 ibpapa. The LLIN attrition rate and the insecticide decay rate were the next most important parameters. The lifetime was surprisingly insensitive to physical decay parameters, but this could change as physical integrity gains importance with the emergence and spread of pyrethroid resistance. CONCLUSIONS: The strong dependency of the effective lifetime on the pre-intervention transmission level indicated that the required distribution frequency may vary more with the local entomological situation than with LLIN quality or the characteristics of the distribution system. This highlights the need for malaria monitoring both before and during intervention programmes, particularly since there are likely to be strong variations between years and over short distances. The majority of SSA's population falls into exposure categories where the lifetime is relatively long, but because exposure estimates are highly uncertain, it is necessary to consider subsequent interventions before the end of the expected effective lifetime based on an imprecise transmission measur

Ensemble Modeling of the Likely Public Health Impact of a Pre-Erythrocytic Malaria Vaccine

Using an ensemble modeling approach, Thomas Smith and colleagues find that targeted mass vaccination with a pre-erythrocytic malaria vaccine RTS,S in low-transmission settings might have better health effects than vaccination through national EPI programs