151 research outputs found

    Raman microscopy to characterize plasma-wall interaction materials: from carbon era to metallic walls

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    Plasma-wall interaction in magnetic fusion devices is responsible for wall changes and plasma pollution with major safety issues. It is investigated both in situ and ex situ, especially by realizing large scale dedicated post-mortem campaigns. Selected parts of the walls are extracted and characterized by several techniques. It is important to extract hydrogen isotopes, oxygen or other element content. This is classically done by ion beam analysis and thermal desorption spectroscopy. Raman microscopy is an alternative and complementary technique. The aim of this work is to demonstrate that Raman microscopy is a very sensitive tool. Moreover, if coupled to other techniques and tested on well-controlled reference samples, Raman microscopy can be used efficiently for characterization of wall samples. Present work reviews long experience gained on carbon-based materials demonstrating how Raman microscopy can be related to structural disorder and hydrogen retention, as it is a direct probe of chemical bonds and atomic structure. In particular, we highlight the fact that Raman microscopy can be used to estimate the hydrogen content and bonds to other elements as well as how it evolves under heating. We also present state-of-the-art Raman analyses of beryllium- and tungsten-based materials, and finally, we draw some perspectives regarding boron-based deposits.</p

    Questionnaire of chronic illness care in primary care-psychometric properties and test-retest reliability

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    <p>Abstract</p> <p>Background</p> <p>The Chronic Care Model (CCM) is an evidence-based approach to improving the structure of care for chronically ill patients with multimorbidity. The Assessment of Chronic Illness Care (ACIC), an instrument commonly used in international research, includes all aspects of the CCM, but cannot be easily extended to the German context. A new instrument called the "Questionnaire of Chronic Illness Care in Primary Care" (QCPC) was developed for use in Germany for this reason. Here, we present the results of the psychometric properties and test-retest reliability of QCPC.</p> <p>Methods</p> <p>A total of 109 family doctors from different German states participated in the validation study. Participating physicians completed the QCPC, which includes items concerning the CCM and practice structure, at baseline (T0) and 3 weeks later (T1). Internal consistency reliability and test-retest reliability were evaluated using Cronbach's alpha and Pearson's r, respectively.</p> <p>Results</p> <p>The QCPC contains five elements of the CCM (decision support, delivery system design, self-management support, clinical information systems, and community linkages). All subscales demonstrated moderate internal consistency and moderate test-retest reliability over a three-week interval.</p> <p>Conclusions</p> <p>The QCPC is an appropriate instrument to assess the structure of chronic illness care. Unlike the ACIC, the QCPC can be used by health care providers without CCM training. The QCPC can detect the actual state of care as well as areas for improvement of care according to the CCM.</p

    Surgery for anomalous aortic origin of coronary arteries : a multicentre study from the European Congenital Heart Surgeons Association

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    OBJECTIVES: We sought to describe early and late outcomes in a large surgical series of patients with anomalous aortic origin of coronary arteries. METHODS: We performed a retrospective multicentre study including surgical patients with anomalous aortic origin of coronary arteries since 1991. Patients with isolated high coronary takeoff and associated major congenital heart disease were excluded. RESULTS: We collected 156 surgical patients (median age 39.5 years, interquartile range 15-53) affected by anomalous right (67.9%), anomalous left (22.4%) and other anatomical abnormalities (9.6%). An interarterial course occurred in 86.5%, an intramural course in 62.8% and symptoms in 85.9%. The operations included coronary unroofing (56.4%), reimplantation (19.2%), coronary bypass graft (15.4%) and other (9.0%). Two patients with preoperative cardiac failure died postoperatively (1.3%). All survivors were discharged home in good clinical condition. At a median follow-up of 2 years (interquartile range 1-5, 88.5% complete), there were 3 deaths (2.2%), 9 reinterventions in 8 patients (5 interventional, 3 surgical); 91.2% are in New York Heart Association functional class <= II, but symptoms persisted in 14.2%; 48.1% of them returned to sport activity. On Kaplan-Meier analysis, event-free survival at follow-up was 74.6%. Morbidity was not significantly different among age classes, anatomical variants and types of surgical procedures. Furthermore, return to sport activity was significantly higher in younger patients who participated in sports preoperatively. CONCLUSIONS: Surgical repair of anomalous aortic origin of coronary arteries is effective and has few complications. Unroofing and coronary reimplantation are safe and are the most common procedures. The occurrence of late adverse events is not negligible, and long-term surveillance is mandatory. Most young athletes can return to an unrestrained lifestyle

    CC9 Livestock-Associated Staphylococcus aureus Emerges in Bloodstream Infections in French Patients Unconnected With Animal Farming

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    We report 4 bloodstream infections associated with CC9 agr type II Staphylococcus aureus in individuals without animal exposure. We demonstrate, by microarray analysis, the presence of egc cluster, fnbA, cap operon, lukS, set2, set12, splE, splD, sak, epiD, and can, genomic features associated with a high virulence potential in human

    What is new in pediatric cardiac imaging?

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    Cardiac imaging has had significant influence on the science and practice of pediatric cardiology. Especially the development and improvements made in noninasive imaging techniques, like echocardiography and cardiac magnetic resonance imaging (MRI), have been extremely important. Technical advancements in the field of medical imaging are quickly being made. This review will focus on some of the important evolutions in pediatric cardiac imaging. Techniques such as intracardiac echocardiography, 3D echocardiography, and tissue Doppler imaging are relatively new echocardiographic techniques, which further optimize the anatomical and functional aspects of congenital heart disease. Also, the current standing of cardiac MRI and cardiac computerized tomography will be discussed. Finally, the recent European efforts to organize training and accreditation in pediatric echocardiography are highlighted

    A Comparative Exploration of Community Pharmacists' Views on the Nature and Management of Over-the-Counter (OTC) and Prescription Codeine Misuse in Three Regulatory Regimes: Ireland, South Africa and the United Kingdom

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    Misuse of codeine containing preparations is a public health concern given the potential for associated harms and dependence. This study explores the perspectives of community pharmacists in three regulatory regimes on issues of customer misuse of over-the-counter (OTC) and prescribed codeine. A qualitative design comprising six focus groups (n = 45) was conducted in Ireland, United Kingdom, South Africa. Transcripts were analysed using the constant comparative method of content analysis. Pharmacists described popular codeine-containing products and the need for improved medicine information and warning labels. Issues around legitimate availability of codeine and regulatory status; presence of therapeutic need; difficulties in customer–pharmacist communication; business environments and retail focus were raised. Participants also discussed how they identified customers potentially misusing codeine and difficulties in relationships between pharmacists and prescribers. A number of recommendations were put forward as ways to manage the issues. The study highlights the difficulties encountered by community pharmacists operating under various regulatory regimes when supplying codeine containing preparations in negotiating patient awareness and compliance and potential ways to deal with misuse and dependence

    Children living with HIV in Europe: do migrants have worse treatment outcomes?

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    Super 301 and the Trade Deficit

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    The thesis considers the issues associated with one of the amendments of section 301 of the Trade Act of 1974 - the so-called Super 301. It was included in the Omnibus Trade and Competitiveness Act of 1988. This measure was passed to solve problems with the U.S. bilateral trade deficits, which were considered to be a consequence of trade barriers to U.S. exports in foreign countries Under Super 301 the United States presses foreign countries to eliminate unfair trade practices under threat of unilateral retaliation. The paper explores the history of Super 301, the cases of its application, the extent to which it achieved its purpose, and its implications for the international multilateral trade agreements. The paper concludes that the Super 301 has failed to eliminate the problem of the U.S. bilateral trade deficit with Japan, and has inspired resentment on the part of U.S. trading partners to negotiate under threat of punishment.http://archive.org/details/superndtradedefi1094513563Bulgarian Air Force author.Approved for public release; distribution is unlimited
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