An Empirical Analysis of the Current Need for Teleneuromedical Care in German Hospitals without Neurology Departments

Indroduction. At present, modern telemedicine methods are being introduced, that may contribute to reducing lack of qualified stroke patient care, particularly in less populated regions. With the help of video conferencing systems, a so-called neuromedical teleconsultation is carried out. Methods. The study included a multicentered, completely standardized survey of physicians in hospitals by means of a computerized on-line questionnaire. Descriptive statistical methods were used for data analysis. Results. 119 acute hospitals without neurology departments were included in the study. The most important reasons for participating in a teleneuromedical network is seen as the improvement in the quality of treatment (82%), the ability to avoid unnecessary patient transport (76%), easier and faster access to stroke expertise (72%) as well as better competitiveness among medical services (67%). The most significant problem areas are the financing system of teleneuromedicine with regard to the acquisition costs of the technical equipment (43%) and the compensation for the stroke-unit center with the specialists' consultation service (31%) as well as legal aspects of teleneuromedicine (27%). Conclusions. This investigation showed that there is a high acceptance for teleneuromedicine among co-operating hospitals. However these facilities have goals in addition to improved quality in stroke treatment. Therefore the use of teleneuromedicine must be also associated with long term incentives for the overall health care system, particularly since the implementation of a teleneuromedicine network system is time consuming and associated with high implementation costs

Excitation and relaxation in atom-cluster collisions

Electronic and vibrational degrees of freedom in atom-cluster collisions are treated simultaneously and self-consistently by combining time-dependent density functional theory with classical molecular dynamics. The gradual change of the excitation mechanisms (electronic and vibrational) as well as the related relaxation phenomena (phase transitions and fragmentation) are studied in a common framework as a function of the impact energy (eV...MeV). Cluster "transparency" characterized by practically undisturbed atom-cluster penetration is predicted to be an important reaction mechanism within a particular window of impact energies.Comment: RevTeX (4 pages, 4 figures included with epsf

Self-consistent Coulomb picture of an electron-electron bilayer system

In this work we implement the self-consistent Thomas-Fermi approach and a local conductivity model to an electron-electron bilayer system. The presence of an incompressible strip, originating from screening calculations at the top (or bottom) layer is considered as a source of an external potential fluctuation to the bottom (or top) layer. This essentially yields modifications to both screening properties and the magneto-transport quantities. The effect of the temperature, inter-layer distance and density mismatch on the density and the potential fluctuations are investigated. It is observed that the existence of the incompressible strips plays an important role simply due to their poor screening properties on both screening and the magneto-resistance (MR) properties. Here we also report and interpret the observed MR Hysteresis within our model.Comment: 12 pages, 12 figures, submitted to PR

Detection of anti-Toxoplasma gondii antibodies in human sera using synthetic glycosylphosphatidylinositol glycans on a bead-based multiplex assay

Toxoplasmosis, while often an asymptomatic parasitic disease in healthy individuals, can cause severe complications in immunocompromised persons and during pregnancy. The most common method to diagnose Toxoplasma gondii infections is the serological determination of antibodies directed against parasite protein antigens. Here we report the use of a bead-based multiplex assay containing a synthetic phosphoglycan portion of the Toxoplasma gondii glycosylphosphatidylinositol (GPI1) for the detection of GPI1-specific antibodies in human sera. The glycan was conjugated to beads at the lipid site to retain its natural orientation and its immunogenic groups. We compared the response against GPI1 with that against the protein antigen SAG1, a common component of commercial serological assays, via the detection of parasite-specific human IgG and IgM antibodies, respectively. The GPI1-based test is in excellent agreement with the results for the commercial ELISA, as the ROC analysis of the GPI1 test shows 97% specificity and 98% sensitivity for the assay. GPI1 was a more reliable predictor for a parasite-specific IgM response compared to SAG1, indicating that a bead-based multiplex assay using GPI1 in combination with SAG1 may strengthen Toxoplasma gondii serology, in particular in seroepidemiological studies.Peer Reviewe

Neutralization of SARS-CoV-2 by highly potent, hyperthermostable, and mutation-tolerant nanobodies

Monoclonal anti-SARS-CoV-2 immunoglobulins represent a treatment option for COVID-19. However, their production in mammalian cells is not scalable to meet the global demand. Single-domain (VHH) antibodies (also called nanobodies) provide an alternative suitable for microbial production. Using alpaca immune libraries against the receptor-binding domain (RBD) of the SARS-CoV-2 Spike protein, we isolated 45 infection-blocking VHH antibodies. These include nanobodies that can withstand 95°C. The most effective VHH antibody neutralizes SARS-CoV-2 at 17–50 pM concentration (0.2–0.7 µg per liter), binds the open and closed states of the Spike, and shows a tight RBD interaction in the X-ray and cryo-EM structures. The best VHH trimers neutralize even at 40 ng per liter. We constructed nanobody tandems and identified nanobody monomers that tolerate the K417N/T, E484K, N501Y, and L452R immune-escape mutations found in the Alpha, Beta, Gamma, Epsilon, Iota, and Delta/Kappa lineages. We also demonstrate neutralization of the Beta strain at low-picomolar VHH concentrations. We further discovered VHH antibodies that enforce native folding of the RBD in the E. coli cytosol, where its folding normally fails. Such “fold-promoting” nanobodies may allow for simplified production of vaccines and their adaptation to viral escape-mutations

Time Scales in Spectator Fragmentation

Proton-proton correlations and correlations of p-alpha, d-alpha, and t-alpha from spectator decays following Au + Au collisions at 1000 AMeV have been measured with an highly efficient detector hodoscope. The constructed correlation functions indicate a moderate expansion and low breakup densities similar to assumptions made in statistical multifragmentation models. In agreement with a volume breakup rather short time scales were deduced employing directional cuts in proton-proton correlations. PACS numbers: 25.70.Pq, 21.65.+f, 25.70.MnComment: 8 pages, with 5 included figures; To appear in the proceedings of the CRIS 2000 conference; Also available from http://www-kp3.gsi.de/www/kp3/aladin_publications.htm

Breakup Density in Spectator Fragmentation

Proton-proton correlations and correlations of protons, deuterons and tritons with alpha particles from spectator decays following 197Au + 197Au collisions at 1000 MeV per nucleon have been measured with two highly efficient detector hodoscopes. The constructed correlation functions, interpreted within the approximation of a simultaneous volume decay, indicate a moderate expansion and low breakup densities, similar to assumptions made in statistical multifragmentation models. PACS numbers: 25.70.Pq, 21.65.+f, 25.70.Mn, 25.75.GzComment: 11 pages, LaTeX with 3 included figures; Also available from http://www-kp3.gsi.de/www/kp3/aladin_publications.htm

Thermal and Chemical Freeze-out in Spectator Fragmentation

Isotope temperatures from double ratios of hydrogen, helium, lithium, beryllium, and carbon isotopic yields, and excited-state temperatures from yield ratios of particle-unstable resonances in 4He, 5Li, and 8Be, were determined for spectator fragmentation, following collisions of 197Au with targets ranging from C to Au at incident energies of 600 and 1000 MeV per nucleon. A deviation of the isotopic from the excited-state temperatures is observed which coincides with the transition from residue formation to multi-fragment production, suggesting a chemical freeze-out prior to thermal freeze-out in bulk disintegrations.Comment: 14 pages, 10 figures, submitted to Phys. Rev. C, small changes as suggested by the editors and referee

Penning-trap mass spectrometry of highly charged, neutron-rich Rb and Sr isotopes in the vicinity of A≈100A\approx100

The neutron-rich mass region around $A\approx100$ presents challenges for modeling the astrophysical $r$-process because of rapid shape transitions. We report on mass measurements using the TITAN Penning trap at TRIUMF-ISAC to attain more reliable theoretical predictions of $r$-process nucleosynthesis paths in this region. A new approach using highly charged ($q=15+$) ions has been applied which considerably saves measurement time and preserves accuracy. New mass measurements of neutron-rich $^{94,97,98}$Rb and $^{94,97-99}$Sr have uncertainties of less than 4 keV and show deviations of up to 11$\sigma$ to previous measurements. An analysis using a parameterized $r$-process model is performed and shows that mass uncertainties for the A=90 abundance region are eliminated