The quality of operation notes after trans-urethral resection of the prostate at Kilimanjaro Christian Medical University College Hospital Tanzania

Background: Operation notes are very vital in the practice of surgery. They are the only comprehensive account of what took place in theatre. Accurate and detailed documentation of surgical notes after Transurethral Resection of the Prostate (TURP) is vital. Yet it is usually forgotten in medical teaching. The Royal College of Surgeons of England (RCSE) safety standards are usually used as the benchmark for the assessment of operation notes.Patients and Methods: The study was descriptive retrospective conducted at Kilimanjaro Christian Medical Centre (KCMC). All patients who underwent TURP between January and December 2017 were enrolled. The Urology theatre register was used to trace patient identities. The Files were then extracted from the registry. Operation note sheets were analysed by the research team using a structured data collection tool. Two Independent assessors(residents) were used to assess legibility. If both agreed that the notes were decipherable, then they were deemed legible. The content of the notes was assessed for Presence or absence of recorded variables. Utmost confidentiality was kept about the surgeon and the patient.Results: A total of 251 files were assessed. Recording of date, Inpatient number, Post-Operative instructions and whether there were any intraoperative complications was at 100%. However, the time of surgery, Resection technique and Method of introduction of the resectoscope were not recorded at all. Other variables recorded were: Signature of surgeon -99.6%, Patient name-99.6%, Details of prostate chips-89%, Sheath used-81%, Circulating nurse-68%, Working element used-35%, Telescope used-12%, Type of diarthermy-7%, Loop Specifications-0.8% and type of Irrigant at 0.8%. Ninety-eight percent of the  operation notes were legible. Overall 56.6% of the operation notes had recorded variables after TURP.Conclusion: Some variables (Inpatient number, Date of operation, intraoperative complications and Postoperative instructions) were recorded at 100%. Others (Time of operation, Resection technique and method of introduction of resectoscope) were not recorded at all. Overall 56.6% of the variables were recorded and 98% of the notes were legible

The Spatial Distribution of the Young Stellar Clusters in the Star-forming Galaxy NGC 628

We present a study of the spatial distribution of the stellar cluster populations in the star-forming galaxy NGC 628. Using Hubble Space Telescope broadband WFC3/UVIS UV and optical images from the Treasury Program LEGUS (Legacy ExtraGalactic UV Survey), we have identified 1392 potential young ($\lesssim 100$ Myr) stellar clusters within the galaxy using a combination of visual inspection and automatic selection. We investigate the clustering of these young stellar clusters and quantify the strength and change of clustering strength with scale using the two-point correlation function. We also investigate how image boundary conditions and dust lanes affect the observed clustering. The distribution of the clusters is well fit by a broken power law with negative exponent α. We recover a weighted mean index of $\alpha \sim -0.8$ for all spatial scales below the break at 3farcs3 (158 pc at a distance of 9.9 Mpc) and an index of $\alpha \sim -0.18$ above 158 pc for the accumulation of all cluster types. The strength of the clustering increases with decreasing age and clusters older than 40 Myr lose their clustered structure very rapidly and tend to be randomly distributed in this galaxy, whereas the mass of the star cluster has little effect on the clustering strength. This is consistent with results from other studies that the morphological hierarchy in stellar clustering resembles the same hierarchy as the turbulent interstellar medium

Radio afterglows of very high-energy gamma-ray bursts 190829A and 180720B

We present high-cadence multifrequency radio observations of the long gamma-ray burst (GRB) 190829A, which was detected at photon energies above 100 GeV by the High Energy Stereoscopic System (H.E.S.S.). Observations with the Meer Karoo Array Telescope (MeerKAT, 1.3 GHz) and ArcminuteMicrokelvin Imager-Large Array (AMI-LA, 15.5 GHz) began one day post-burst and lasted nearly 200 d. We used complementary data from Swift X-Ray Telescope (XRT), which ran to 100 d post-burst. We detected a likely forward shock component with bothMeerKAT and XRT up to over 100 d post-burst. Conversely, the AMI-LA light curve appears to be dominated by reverse shock emission until around 70 d post-burst when the afterglow flux drops below the level of the host galaxy. We also present previously unpublished observations of the other H.E.S.S.-detected GRB, GRB 180720B from AMILA, which shows likely forward shock emission that fades in less than 10 d. We present a comparison between the radio emission from the three GRBs with detected very high energy (VHE) gamma-ray emission and a sensitivity-limited radio afterglow sample. GRB 190829A has the lowest isotropic radio luminosity of any GRB in our sample, but the distribution of luminosities is otherwise consistent, as expected, with the VHE GRBs being drawn from the same parent distribution as the other radio-detected long GRBs

The emergence of a new source of X-rays from the binary neutron star merger GW170817

The binary neutron-star (BNS) merger GW170817 is the first celestial object from which both gravitational waves (GWs) and light have been detected enabling critical insight on the pre-merger (GWs) and post-merger (light) physical properties of these phenomena. For the first $\sim 3$ years after the merger the detected radio and X-ray radiation has been dominated by emission from a structured relativistic jet initially pointing $\sim 15-25$ degrees away from our line of sight and propagating into a low-density medium. Here we report on observational evidence for the emergence of a new X-ray emission component at $\delta t>900$ days after the merger. The new component has luminosity $L_x \approx 5\times 10^{38}\rm{erg s^{-1}}$ at 1234 days, and represents a $\sim 3.5\sigma$ - $4.3\sigma$ excess compared to the expectations from the off-axis jet model that best fits the multi-wavelength afterglow of GW170817 at earlier times. A lack of detectable radio emission at 3 GHz around the same time suggests a harder broadband spectrum than the jet afterglow. These properties are consistent with synchrotron emission from a mildly relativistic shock generated by the expanding merger ejecta, i.e. a kilonova afterglow. In this context our simulations show that the X-ray excess supports the presence of a high-velocity tail in the merger ejecta, and argues against the prompt collapse of the merger remnant into a black hole. However, radiation from accretion processes on the compact-object remnant represents a viable alternative to the kilonova afterglow. Neither a kilonova afterglow nor accretion-powered emission have been observed before.Comment: 66 pages, 12 figures, Submitte

A measurement of the tau mass and the first CPT test with tau leptons

We measure the mass of the tau lepton to be 1775.1+-1.6(stat)+-1.0(syst.) MeV using tau pairs from Z0 decays. To test CPT invariance we compare the masses of the positively and negatively charged tau leptons. The relative mass difference is found to be smaller than 3.0 10^-3 at the 90% confidence level.Comment: 10 pages, 4 figures, Submitted to Phys. Letts.

Measurement of the B0 Lifetime and Oscillation Frequency using B0->D*+l-v decays

The lifetime and oscillation frequency of the B0 meson has been measured using B0->D*+l-v decays recorded on the Z0 peak with the OPAL detector at LEP. The D*+ -> D0pi+ decays were reconstructed using an inclusive technique and the production flavour of the B0 mesons was determined using a combination of tags from the rest of the event. The results t_B0 = 1.541 +- 0.028 +- 0.023 ps, Dm_d = 0.497 +- 0.024 +- 0.025 ps-1 were obtained, where in each case the first error is statistical and the second systematic.Comment: 17 pages, 4 figures, submitted to Phys. Lett.

First Measurement of Z/gamma* Production in Compton Scattering of Quasi-real Photons

We report the first observation of Z/gamma* production in Compton scattering of quasi-real photons. This is a subprocess of the reaction e+e- to e+e-Z/gamma*, where one of the final state electrons is undetected. Approximately 55 pb-1 of data collected in the year 1997 at an e+e- centre-of-mass energy of 183 GeV with the OPAL detector at LEP have been analysed. The Z/gamma* from Compton scattering has been detected in the hadronic decay channel. Within well defined kinematic bounds, we measure the product of cross-section and Z/gamma* branching ratio to hadrons to be (0.9+-0.3+-0.1) pb for events with a hadronic mass larger than 60 GeV, dominated by (e)eZ production. In the hadronic mass region between 5 GeV and 60 GeV, dominated by (e)egamma* production, this product is found to be (4.1+-1.6+-0.6) pb. Our results agree with the predictions of two Monte Carlo event generators, grc4f and PYTHIA.Comment: 18 pages, LaTeX, 5 eps figures included, submitted to Physics Letters