Rethinking the neonatal transport ground ambulance

Objectives: This article describes the detailed project aimed to realize a dedicated ground ambulance for neonatal emergency transport service (NETS). To date, the European Community rules specify requirements for the design, testing, performance, and equipping of road ambulance used for transport and care of adult injured or ill patients, completely ignoring neonatal transport. Methods: The project consisted of electric and gas supply planning, interior design taking into account ergonomic and occupant protection principles, both during travel and during medical care performances. Results: A detailed project is presented. Main differences between European Type C ambulance and the new proposed Type D neonatal ground ambulance are the presence on board of air compressed cylinder, iNO cylinders and delivery system, phototheraphy, shock adsorbing stretcher support, cooling device, patient's placenta (refrigeration box), and transcutaneous gas analyzer. Conclusion: The European Community rules specify requirements for road ambulance used for transport and care of adult injured or ill patients, completely ignoring neonatal transport. This study describes the detailed project aimed to realize a dedicated ground ambulance for neonatal emergency transport service. This study demonstrated that it is not possible simply to adapt the currently dedicated ambulance for mobile intensive care and resuscitation services (actual type C European Community) in a modern dedicated NETS ambulance; it is of paramount importance suggesting to European Community to introduce a further ambulance type, to be identified type D, strictly reserved to neonatal transport activities

Terahertz Radar Cross Section Characterization using Laser Feedback Interferometry with a Quantum Cascade Laser

Radar cross section (RCS) measurements of complex, large objects are usually performed on scale models so that the measurement is carried out in a well-controlled environment. This letter explores the feasibility of RCS measurement using a terahertz quantum cascade laser via laser feedback interferometry. Numerical simulations show that the RCS information embedded in the non-linear interferometric signals obtained from simple targets can be retrieved through numerical fitting of the well-known excess phase equation. The method is validated experimentally using a terahertz quantum cascade laser and the results are well matched with those obtained from numerical simulations

Crustal structure of the propagating TAMMAR ridge segment on the Mid-Atlantic Ridge, 21.5°N

Active ridge propagation frequently occurs along spreading ridges and profoundly affects ridge crest segmentation over time. The mechanisms controlling ridge propagation, however, are poorly understood. At the slow spreading Mid-Atlantic Ridge at 21.5°N a seismic refraction and wide-angle reflection profile surveyed the crustal structure along a segment controlled by rapid ridge propagation. Tomographic traveltime inversion of seismic data suggests that the crustal structure along the ridge axis is controlled by melt supply; thus, crust is thickest, 8 km, at the domed segment center and decreases in thickness toward both segment ends. However, thicker crust is formed in the direction of ridge propagation, suggesting that melt is preferentially transferred toward the propagating ridge tip. Further, while seismic layer 2 remains constant along axis, seismic layer 3 shows profound changes in thickness, governing variations in total crustal thickness. This feature supports mantle upwelling at the segment center. Thus, fluid basaltic melt is redistributed easily laterally, while more viscose gabbroic melt tends to crystallize and accrete nearer to the locus of melt supply. The onset of propagation seems to have coincided with the formation of thicker crust, suggesting that propagation initiation might be due to changes in the melt supply. After a rapid initiation a continuous process of propagation was established. The propagation rate seems to be controlled by the amount of magma that reaches the segment ends. The strength of upwelling may govern the evolution of ridge segments and hence ultimately controls the propagation length

Die Subanalyse von Rheuma-VOR zeigt den erheblichen Bedarf der rheumatologischen Versorgung auf

Background: Early diagnosis and treatment of inflammatory rheumatic diseases can prevent consequential damage such as permanently limited mobility and joint or organ damage. Simultaneously, there is an increasing deficit in medical care owing to the lack of rheumatological capacity. Rural regions are particularly affected. Objectives: The available unconfirmed diagnoses of the study Rheuma-VOR were analysed regarding another definitive inflammatory rheumatic disease. Materials and methods: The returned questionnaires of the rheumatologists participating in Rheuma-VOR were screened for definitive inflammatory rheumatic diseases other than the required diagnosis of rheumatoid arthritis, psoriatic arthritis or spondyloarthritis. Results: Of 910 unconfirmed diagnoses, in 245 patients another definitive diagnosis could be confirmed. A total of 29.8% of the diagnoses corresponded to degenerative joint changes or chronic pain syndrome, whereas 26.1% involved different forms of inflammatory arthritis. The majority of diagnoses (40.5%) were collagenosis or vasculitis, Discussion: The available data show that a rheumatological presentation was indicated for the majority of patients. Owing to the increasing deficits in medical care a prior selection of the patients is crucial to make optimal use of restricted rheumatological capacities.Hintergrund: Eine frühe Diagnose und Behandlung entzündlich-rheumatischer Erkrankungen kann Folgeschäden wie dauerhafte Einschränkungen der Mobilität und Gelenk- oder Organschäden verhindern. Gleichzeitig besteht ein größer werdendes Versorgungsdefizit aufgrund fehlender rheumatologischer Kapazitäten. Betroffen sind besonders die ländlichen Regionen. Ziel der Arbeit: Die vorliegenden nicht bestätigten Diagnosen der Studie Rheuma-VOR wurden hinsichtlich des Vorliegens einer anderen definitiven entzündlich-rheumatischen Erkrankung analysiert. Material und Methoden: Die eingegangenen Fragebögen der an der Rheuma-VOR-Studie teilnehmenden Rheumatolog:innen wurden nach Vermerken anderer entzündlich-rheumatischer Erkrankungen als der geforderten Diagnose einer rheumatoiden Arthritis, Psoriasis-Arthritis oder Spondyloarthritis gescreent. Ergebnisse: Von 910 „nicht bestätigten“ Diagnosen waren bei 245 Patient:innen andere gestellte Diagnosen auszuwerten. Insgesamt 29,8 % der Diagnosen entsprechen degenerativen Gelenkveränderungen oder chronischen Schmerzsyndromen, bei 26,1 % lagen verschiedene Formen entzündlicher Arthritiden vor. Der Großteil der Diagnosen (40,5 %) entfiel auf Kollagenosen und Vaskulitiden, wobei die Polymyalgia rheumatica mit 20 % am häufigsten diagnostiziert wurde (49 Patient:innen). Diskussion: Die vorliegenden Daten zeigen, dass bei einem Großteil der Patient:innen die rheumatologische Vorstellung indiziert war. Aufgrund der ambulanten Versorgungsdefizite ist eine vorherige Selektion des Patientenguts essenziell, um die eingeschränkten Kapazitäten bestmöglich zu nutzen

Constructing the crust along the Galapagos Spreading Center 91.3°–95.5°W : correlation of seismic layer 2A with axial magma lens and topographic characteristics

Author Posting. © American Geophysical Union, 2004. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 109 (2004): B10310, doi:10.1029/2004JB003066.Multichannel seismic reflection data are used to infer crustal accretion processes along the intermediate spreading Galapagos Spreading Center. East of 92.5°W, we image a magma lens beneath the ridge axis that is relatively shallow (1.0–2.5 km below the seafloor) and narrow (∼0.5–1.5 km, cross-axis width). We also image a thin seismic layer 2A (0.24–0.42 km) that thickens away from the ridge axis by as much as 150%. West of 92.7°W, the magma lens is deeper (2.5–4.5 km) and wider (0.7–2.4 km), and layer 2A is thicker (0.36–0.66 km) and thickens off axis by <40%. The positive correlation between layer 2A thickness and magma lens depth supports the interpretation of layer 2A as the extrusive volcanic layer with thickness controlled by the pressure on the magma lens and its ability to push magma to the surface. Our findings also suggest that narrower magma lenses focus diking close the ridge axis such that lava flowing away from the ridge axis will blanket older flows and thicken the extrusive crust off axis. Flow of lava away from the ridge axis is probably promoted by the slope of the axial bathymetric high, which is largest east of 92.5°W. West of ∼94°W the “transitional” axial morphology lacks a prominent bathymetric high and layer 2A no longer thickens off axis. We detect no magma lens west of 94.7°W where a small axial valley appears. The above changes can be linked to the westward decrease in the magma and heat flux associated with the fading influence of the Galapagos hot spot on the Galapagos Spreading Center.This project was funded by NSF-OCE- 0002189