Lumbar puncture for the generalist

The safe and successful performance of a lumbar puncture demands a working and yet specific knowledge as well as competency in performance. This review aims to aid understanding of the knowledge framework, the pitfalls and complications of lumbar puncture. It includes special reference to three dimensional relationships, functional anatomy, imaging anatomy, normal variation and living anatomy. A lumbar puncture is a commonly performed procedure for diagnostic and therapeutic purposes. Epidural and spinal anaesthesia, for example, are common in obstetric practice and involve the same technique as a lumbar puncture except for the endpoint of the needle being in the epidural space and subarachnoid space respectively. The procedure is by no means innocuous and some anatomical pitfalls include inability to find the correct entry site for placement of the lumbar puncture needle and lack of awareness of structures in relation to the advancing needle. Headache is the most common complication and it is important to avoid traumatic and dry taps, herniation syndromes and injury to the terminal end of the spinal cord. With a thorough knowledge of the contraindications, the regional anatomy and rationale of the technique and adequate prior skills practice, a lumbar puncture can be performed safely and successfully

Sustainable Soesterkwartier

The municipality of Amersfoort wants to construct an endurable and sustainable eco-town in the Soesterkwartier neighbourhood, by taking future climate change into account. The impact of climate change at the location of the proposed eco-town was studied by a literature review

Cauchy-perturbative matching and outer boundary conditions: computational studies

We present results from a new technique which allows extraction of gravitational radiation information from a generic three-dimensional numerical relativity code and provides stable outer boundary conditions. In our approach we match the solution of a Cauchy evolution of the nonlinear Einstein field equations to a set of one-dimensional linear equations obtained through perturbation techniques over a curved background. We discuss the validity of this approach in the case of linear and mildly nonlinear gravitational waves and show how a numerical module developed for this purpose is able to provide an accurate and numerically convergent description of the gravitational wave propagation and a stable numerical evolution.Comment: 20 pages, RevTe

Cauchy-perturbative matching and outer boundary conditions I: Methods and tests

We present a new method of extracting gravitational radiation from three-dimensional numerical relativity codes and providing outer boundary conditions. Our approach matches the solution of a Cauchy evolution of Einstein's equations to a set of one-dimensional linear wave equations on a curved background. We illustrate the mathematical properties of our approach and discuss a numerical module we have constructed for this purpose. This module implements the perturbative matching approach in connection with a generic three-dimensional numerical relativity simulation. Tests of its accuracy and second-order convergence are presented with analytic linear wave data.Comment: 13 pages, 6 figures, RevTe

Waveform propagation in black hole spacetimes: evaluating the quality of numerical solutions

We compute the propagation and scattering of linear gravitational waves off a Schwarzschild black hole using a numerical code which solves a generalization of the Zerilli equation to a three dimensional cartesian coordinate system. Since the solution to this problem is well understood it represents a very good testbed for evaluating our ability to perform three dimensional computations of gravitational waves in spacetimes in which a black hole event horizon is present.Comment: 13 pages, RevTeX, to appear in Phys. Rev.

Head-on collision of unequal mass black holes: close-limit predictions

The close-limit method has given approximations in excellent agreement with those of numerical relativity for collisions of equal mass black holes. We consider here colliding holes with unequal mass, for which numerical relativity results are not available. We try to ask two questions: (i) Can we get approximate answers to astrophysical questions (ideal mass ratio for energy production, maximum recoil velocity, etc.), and (ii) can we better understand the limitations of approximation methods. There is some success in answering the first type of question, but more with the second, especially in connection with the issue of measures of the intrinsic mass of the colliding holes, and of the range of validity of the method.Comment: 19 pages, RevTeX + 9 postscript figure

Hyperbolic formulations and numerical relativity II: Asymptotically constrained systems of the Einstein equations

We study asymptotically constrained systems for numerical integration of the Einstein equations, which are intended to be robust against perturbative errors for the free evolution of the initial data. First, we examine the previously proposed "$\lambda$-system", which introduces artificial flows to constraint surfaces based on the symmetric hyperbolic formulation. We show that this system works as expected for the wave propagation problem in the Maxwell system and in general relativity using Ashtekar's connection formulation. Second, we propose a new mechanism to control the stability, which we call the ``adjusted system". This is simply obtained by adding constraint terms in the dynamical equations and adjusting its multipliers. We explain why a particular choice of multiplier reduces the numerical errors from non-positive or pure-imaginary eigenvalues of the adjusted constraint propagation equations. This ``adjusted system" is also tested in the Maxwell system and in the Ashtekar's system. This mechanism affects more than the system's symmetric hyperbolicity.Comment: 16 pages, RevTeX, 9 eps figures, added Appendix B and minor changes, to appear in Class. Quant. Gra

Understanding initial data for black hole collisions

Numerical relativity, applied to collisions of black holes, starts with initial data for black holes already in each other's strong field. The initial hypersurface data typically used for computation is based on mathematical simplifying prescriptions, such as conformal flatness of the 3-geometry and longitudinality of the extrinsic curvature. In the case of head on collisions of equal mass holes, there is evidence that such prescriptions work reasonably well, but it is not clear why, or whether this success is more generally valid. Here we study these questions by considering the ``particle limit'' for head on collisions of nonspinning holes. Einstein's equations are linearized in the mass of the small hole, and described by a single gauge invariant spacetime function psi, for each multipole. The resulting equations have been solved by numerical evolution for collisions starting from various initial separations, and the evolution is studied on a sequence of hypersurfaces. In particular, we extract hypersurface data, that is psi and its time derivative, on surfaces of constant background Schwarzschild time. These evolved data can then be compared with ``prescribed'' data, evolved data can be replaced by prescribed data on any hypersurface, and evolved further forward in time, a gauge invariant measure of deviation from conformal flatness can be evaluated, etc. The main findings of this study are: (i) For holes of unequal mass the use of prescribed data on late hypersurfaces is not successful. (ii) The failure is likely due to the inability of the prescribed data to represent the near field of the smaller hole. (iii) The discrepancy in the extrinsic curvature is more important than in the 3-geometry. (iv) The use of the more general conformally flat longitudinal data does not notably improve this picture.Comment: 20 pages, REVTEX, 26 PS figures include

Nonexistence of conformally flat slices of the Kerr spacetime

Initial data for black hole collisions are commonly generated using the Bowen-York approach based on conformally flat 3-geometries. The standard (constant Boyer-Lindquist time) spatial slices of the Kerr spacetime are not conformally flat, so that use of the Bowen-York approach is limited in dealing with rotating holes. We investigate here whether there exist foliations of the Kerr spacetime that are conformally flat. We limit our considerations to foliations that are axisymmetric and that smoothly reduce in the Schwarzschild limit to slices of constant Schwarzschild time. With these restrictions, we show that no conformally flat slices can exist.Comment: 5 LaTeX pages; no figures; to be submitted to Phys. Rev.

Collisions of boosted black holes: perturbation theory prediction of gravitational radiation

We consider general relativistic Cauchy data representing two nonspinning, equal-mass black holes boosted toward each other. When the black holes are close enough to each other and their momentum is sufficiently high, an encompassing apparent horizon is present so the system can be viewed as a single, perturbed black hole. We employ gauge-invariant perturbation theory, and integrate the Zerilli equation to analyze these time-asymmetric data sets and compute gravitational wave forms and emitted energies. When coupled with a simple Newtonian analysis of the infall trajectory, we find striking agreement between the perturbation calculation of emitted energies and the results of fully general relativistic numerical simulations of time-symmetric initial data.Comment: 5 pages (RevTex 3.0 with 3 uuencoded figures), CRSR-107