Dynamics of a solar pressure stabilized satellite

Dynamics of sun-pointing satellite in heliocentric orbit of nonzero eccentricit

Interactions of Ar(9+) and metastable Ar(8+) with a Si(100) surface at velocities near the image acceleration limit

Auger LMM spectra and preliminary model simulations of Ar(9+) and metastable Ar(8+) ions interacting with a clean monocrystalline n-doped Si(100) surface are presented. By varying the experimental parameters, several yet undiscovered spectroscopic features have been observed providing valuable hints for the development of an adequate interaction model. On our apparatus the ion beam energy can be lowered to almost mere image charge attraction. High data acquisition rates could still be maintained yielding an unprecedented statistical quality of the Auger spectra.Comment: 34 pages, 11 figures, http://pikp28.uni-muenster.de/~ducree

Increase in national intravenous thrombolysis rates for ischaemic stroke between 2005 and 2012: Is bigger better?

Background: Intravenous thrombolytic therapy after ischaemic stroke significantly reduces mortality and morbidity. Actual thrombolysis rates are disappointingly low in many western countries. It has been suggested that higher patient volume is related to shorter door-to-needle-time (DNT) and increased thrombolysis rates. We address a twofold research question: a) What are trends in national thrombolysis rates and door-to-needle times in the Netherlands between 2005-2012? and b) Is there a relationship between stroke patient volume per hospital, thrombolysis rates and DNT? Methods: We used data from the Stroke Knowledge Network Netherlands dataset. Information on volume, intravenous thrombolysis rates, and admission characteristics per hospital is acquired through yearly surveys, in up to 65 hospitals between January 2005 and December 2012. We used linear regression to determine a possible relationship between hospital stroke admission volume, hospital thrombolysis rates and mean hospital DNT, adjusted for patient characteristics. Results: Information on 121.887 stroke admissions was available, ranging from 7.393 admissions in 2005 to 24.067 admissions in 2012. Mean national thrombolysis rate increased from 6.4 % in 2005 to 14.6 % in 2012. Patient characteristics (mean age, gender, type of stroke) remained stable. Mean DNT decreased from 72.7 min in 2005 to 41.4 min in 2012. Volume of stroke admissions was not an independent predictor for mean thrombolysis rate nor for mean DNT. Conclusion: Intravenous thrombolysis rates in the Netherlands more than doubled between 2005 and 2012, in parallel with a large decline in mean DNT. We found no convincing evidence for a relationship between stroke patient volume per hospital and thrombolysis rate or DNT

Evaluation of early implementations of antibiotic stewardship program initiatives in nine Dutch hospitals

Background Antibiotic resistance is a global threat to patient safety and care. In response, hospitals start antibiotic stewardship programs to optimise antibiotic use. Expert-based guidelines recommend strategies to implement such programs, but local implementations may differ per hospital. Earlier published assessments determine maturity of antibiotic stewardship programs based on expert-based structure indicators, but they disregard that there may be valid deviations from these expert-based programs. Aim To analyse the progress and barriers of local implementations of antibiotic stewardship programs with stakeholders in nine Dutch hospitals and to develop a toolkit that guides implementing local antibiotic stewardship programs. Methods An online questionnaire based on published guidelines and recommendations, conducted with seven clinical microbiologists, seven infectious disease physicians and five clinical pharmacists at nine Dutch hospitals. Results Results show local differences in antibiotic stewardship programs and the uptake of interventions in hospitals. Antibiotic guidelines and antibiotic teams are the most extensively implemented interventions. Education, decision support and audit-feedback are deemed important interventions and they are either piloted in implementations at academic hospitals or in preparation for application in non-academic hospitals. Other interventions that are recommended in guidelines - benchmarking, restriction and antibiotic formulary - appear to have a lower priority. Automatic stop-order, pre-authorization, automatic substitution, antibiotic cycling are not deemed to be worthwhile according to respondents. Conclusion There are extensive local differences in the implementation of antibiotic stewardship interventions. These differences suggest a need to further explore the rationale behind the choice of interventions in antibiotic stewardship programs. Rather than reporting this rationale, this study reports where rationale can play a key role in the implementation of antibiotic stewardship programs. A one-size-fits-all solution is unfeasible as there may be barriers or valid reasons for local experts to deviate from expert-based guidelines. Local experts can be supported with a toolkit containing advice based on possible barriers and considerations. These parameters can be used to customise an implementation of antibiotic stewardship programs to local needs (while retaining its expert-based foundation)

Rapid Assessment of Avoidable Blindness in India

BACKGROUND: Rapid assessment of avoidable blindness provides valid estimates in a short period of time to assess the magnitude and causes of avoidable blindness. The study determined magnitude and causes of avoidable blindness in India in 2007 among the 50+ population. METHODS AND FINDINGS: Sixteen randomly selected districts where blindness surveys were undertaken 7 to 10 years earlier were identified for a follow up survey. Stratified cluster sampling was used and 25 clusters (20 rural and 5 urban) were randomly picked in each district.. After a random start, 100 individuals aged 50+ were enumerated and examined sequentially in each cluster. All those with presenting vision = 50 years were enumerated, and 94.7% examined. Based on presenting vision,, 4.4% (95% Confidence Interval[CI]: 4.1,4.8) were severely visually impaired (vision<6/60 to 3/60 in the better eye) and 3.6% (95% CI: 3.3,3.9) were blind (vision<3/60 in the better eye). Prevalence of low vision (<6/18 to 6/60 in the better eye) was 16.8% (95% CI: 16.0,17.5). Prevalence of blindness and severe visual impairment (<6/60 in the better eye) was higher among rural residents (8.2%; 95% CI: 7.9,8.6) compared to urban (7.1%; 95% CI: 5.0, 9.2), among females (9.2%; 95% CI: 8.6,9.8) compared to males (6.5%; 95% CI: 6.0,7.1) and people above 70 years (20.6%; 95% CI: 19.1,22.0) compared to people aged 50-54 years (1.3%; 95% CI: 1.1,1.6). Of all blindness, 88.2% was avoidable. of which 81.9% was due to cataract and 7.1% to uncorrected refractive errors/uncorrected aphakia. CONCLUSIONS: Cataract and refractive errors are major causes of blindness and low vision and control strategies should prioritize them. Most blindness and low vision burden is avoidable

Diagnostic performance of transthyretin measurement in fat tissue of patients with ATTR amyloidosis

In this article, the diagnostic performance of a transthyretin (TTR) ELISA for detection and characterization of transthyretin-derived (ATTR) amyloid in abdominal subcutaneous fat tissue was studied. Fat tissue specimens were analyzed of 38 patients with ATTR amyloidosis, 70 controls, and 17 carriers of a TTR mutation. Amyloid amount was graded semi-quantitatively in Congo red-stained specimens (0-4+). Amyloid was extracted from tissue in guanidine, and the TTR concentration was measured using a sandwich TTR-ELISA. The TTR concentration of patients with ATTR amyloidosis (mean 0.84 ng/mg fat tissue) was significantly higher than controls (p<0.001). With a TTR concentration of 0.13 ng/mg fat tissue as cut-off value, 32 of the 38 ATTR patients were identified resulting in a sensitivity of 84%. Sixty-seven of the 70 controls had values below the cut-off value resulting in a specificity of 96%. Thus, measuring TTR in fat tissue is useful for detecting ATTR amyloidosis and for characterizing amyloid as ATTR type

Footprint and height corrections for UAV-borne gamma-ray spectrometry studies

Advancements in the development of gamma-ray spectrometers (GRS) have led to small and lightweight spectrometers that can be used under unmanned aerial vehicles (UAVs). Airborne GRS measurements are used to determine radionuclide concentrations in the ground, among which the natural occurring radionuclides K-40, U-238, and Th-232. For successful applications of these GRS sensors, it is important that absolute values of concentrations can be measured. To extract these absolute radionuclide concentrations, airborne gamma-ray data has to be corrected for measurement height. However, the current analysis models are only valid for the height range of 50-250 m. The purpose of this study is to develop a procedure that correctly predicts the true radionuclide concentration in the ground when measuring in the UAV operating range of 0-40 m. An analytical model is developed to predict the radiation footprint as a function of height. This model is used as a tool to properly determine a source-detector geometry to be used in Monte-Carlo simulations of detector response at various elevations between 0 and 40 m. The analytical model predicts that the smallest achievable footprint at 10 m height lies between 22 and 91 m and between 40 and 140 m at 20 m height. By using Monte-Carlo simulations it is shown that the analytical model correctly predicts the reduction in full energy peak gamma-rays, but does not predict the Compton continuum of a spectrum as a function of height. Therefore, Monte-Carlo simulations should be used to predict the shape and intensity of gamma-ray spectra as a function of height. A finite set of Monte-Carlo simulations at intervals of 5 m were used for the analysis of GRS measurements at heights up to 35 m. The resulting radionuclide concentrations at every height agree with the radionuclide concentration measured on the ground

Extended Classical Over-Barrier Model for Collisions of Highly Charged Ions with Conducting and Insulating Surfaces

We have extended the classical over-barrier model to simulate the neutralization dynamics of highly charged ions interacting under grazing incidence with conducting and insulating surfaces. Our calculations are based on simple model rates for resonant and Auger transitions. We include effects caused by the dielectric response of the target and, for insulators, localized surface charges. Characteristic deviations regarding the charge transfer processes from conducting and insulating targets to the ion are discussed. We find good agreement with previously published experimental data for the image energy gain of a variety of highly charged ions impinging on Au, Al, LiF and KI crystals.Comment: 32 pages http://pikp28.uni-muenster.de/~ducree