Hemolysis and methemoglobinemia due to hepatitis E virus infection in patient with G6PD deficiency

published_or_final_versionSpringer Open Choice, 21 Feb 201

Magnetic increases with central current sheets: Observations with Parker Solar Probe

Aims. We report the observation by Parker Solar Probe (PSP) of magnetic structures in the solar wind that present a strong peak in their magnetic field magnitude with an embedded central current sheet. Similar structures have been observed, either at the Earth’s magnetopause and called interlinked flux tubes, or in the solar wind and called interplanetary field enhancements. Methods. In this work, we first investigate two striking events in detail; one occurred in the regular slow solar wind on November 2, 2018 and the other was observed during a heliospheric current sheet crossing on November 13, 2018. They both show the presence of a central current sheet with a visible ion jet and general characteristics consistent with the occurrence of magnetic reconnection. We then performed a survey of PSP data from encounters 1 to 4 and find 18 additional events presenting an increase in the magnetic field magnitude of over 30% and a central current sheet. We performed a statistical study on the 20 "magnetic increases with central current sheet" (MICCS), with 13 observed in the regular slow solar wind with a constant polarity (i.e., identical strahl direction), and 7 which were specifically observed near a heliospheric current sheet (HCS) crossing. Results. We analyze and discuss the general properties of the structures, including the duration, location, amplitude, and magnetic topology, as well as the characteristics of their central current sheet. We find that the latter has a preferential orientation in the TN plane of the RTN frame. We also find no significant change in the dust impact rate in the vicinity of the MICCS under study, leading us to conclude that dust probably plays no role in the MICCS formation and evolution. Our findings are overall consistent with a double flux tube-configuration that would result from initially distinct flux tubes which interact during solar wind propagation

Whistler wave occurrence and the interaction with strahl electrons during the first encounter of Parker Solar Probe

Aims. We studied the properties and occurrence of narrowband whistler waves and their interaction with strahl electrons observed between 0.17 and 0.26 au during the first encounter of Parker Solar Probe. Methods. We used Digital Fields Board band-pass filtered (BPF) data from FIELDS to detect the signatures of whistler waves. Additionally parameters derived from the particle distribution functions measured by the Solar Wind Electrons Alphas and Protons (SWEAP) instrument suite were used to investigate the plasma properties, and FIELDS suite measurements were used to investigate the electromagnetic (EM) fields properties corresponding to the observed whistler signatures. Results. We observe that the occurrence of whistler waves is low, nearly ~1.5% and less than 0.5% in the analyzed peak and average BPF data, respectively. Whistlers occur highly intermittently and 80% of the whistlers appear continuously for less than 3 s. The spacecraft frequencies of the analyzed waves are less than 0.2 electron cyclotron frequency (fce). The occurrence rate of whistler waves was found to be anticorrelated with the solar wind bulk velocity. The study of the duration of the whistler intervals revealed an anticorrelation between the duration and the solar wind velocity, as well as between the duration and the normalized amplitude of magnetic field variations. The pitch-angle widths (PAWs) of the field-aligned electron population referred to as the strahl are broader by at least 12 degrees during the presence of large amplitude narrowband whistler waves. This observation points toward an EM wave electron interaction, resulting in pitch-angle scattering. PAWs of strahl electrons corresponding to the short duration whistlers are higher compared to the long duration whistlers, indicating short duration whistlers scatter the strahl electrons better than the long duration ones. Parallel cuts through the strahl electron velocity distribution function (VDF) observed during the whistler intervals appear to depart from the Maxwellian shape typically found in the near-Sun strahl VDFs. The relative decrease in the parallel electron temperature and the increase in PAW for the electrons in the strahl energy range suggests that the interaction with whistler waves results in a transfer of electron momentum from the parallel to the perpendicular direction

Ambipolar Electric Field and Potential in the Solar Wind Estimated from Electron Velocity Distribution Functions

The solar wind escapes from the solar corona and is accelerated, over a short distance, to its terminal velocity. The energy balance associated with this acceleration remains poorly understood. To quantify the global electrostatic contribution to the solar wind dynamics, we empirically estimate the ambipolar electric field (E∥) and potential (Φr,∞). We analyze electron velocity distribution functions (VDFs) measured in the near-Sun solar wind between 20.3 RS and 85.3 RS by the Parker Solar Probe. We test the predictions of two different solar wind models. Close to the Sun, the VDFs exhibit a suprathermal electron deficit in the sunward, magnetic-field-aligned part of phase space. We argue that the sunward deficit is a remnant of the electron cutoff predicted by collisionless exospheric models. This cutoff energy is directly linked to Φr,∞. Competing effects of E∥ and Coulomb collisions in the solar wind are addressed by the Steady Electron Runaway Model (SERM). In this model, electron phase space is separated into collisionally overdamped and underdamped regions. We assume that this boundary velocity at small pitch angles coincides with the strahl break-point energy, which allows us to calculate E∥. The obtained Φr,∞ and E∥ agree well with theoretical expectations. They decrease with radial distance as power-law functions with indices αΦ = −0.66 and αE = −1.69. We finally estimate the velocity gained by protons from electrostatic acceleration, which equals 77% calculated from the exospheric models, and 44% from the SERM model

Kinetic-scale Spectral Features of Cross Helicity and Residual Energy in the Inner Heliosphere

In this work, we present the first results from the flux angle (FA) operation mode of the Faraday Cup instrument on board the Parker Solar Probe (PSP). The FA mode allows rapid measurements of phase space density fluctuations close to the peak of the proton velocity distribution function with a cadence of 293 Hz. This approach provides an invaluable tool for understanding kinetic-scale turbulence in the solar wind and solar corona. We describe a technique to convert the phase space density fluctuations into vector velocity components and compute several turbulence parameters, such as spectral index, residual energy, and cross helicity during two intervals when the FA mode was used in PSP's first encounter at 0.174 au distance from the Sun

Magnetic connectivity of the ecliptic plane within 0.5 AU : PFSS modeling of the first PSP encounter

We compare magnetic field measurements taken by the FIELDS instrument on Parker Solar Probe (PSP) during its first solar encounter to predictions obtained by Potential Field Source Surface (PFSS) modeling. Ballistic propagation is used to connect the spacecraft to the source surface. Despite the simplicity of the model, our results show striking agreement with PSPs first observations of the heliospheric magnetic field from 0.5 AU (107.5 Rs) down to 0.16 AU (35.7 Rs). Further, we show the robustness of the agreement is improved both by allowing the photospheric input to the model to vary in time, and by advecting the field from PSP down to the PFSS model domain using in situ PSP/SWEAP measurements of the solar wind speed instead of assuming it to be constant with longitude and latitude. We also explore the source surface height parameter (RSS) to the PFSS model finding that an extraordinarily low source surface height (1.3-1.5Rs) predicts observed small scale polarity inversions which are otherwise washed out with regular modeling parameters. Finally, we extract field line traces from these models. By overlaying these on EUV images we observe magnetic connectivity to various equatorial and mid-latitude coronal holes indicating plausible magnetic footpoints and offering context for future discussions of sources of the solar wind measured by PSP

Sharp Alfvenic impulses in the near-Sun solar wind

Measurements of the near-Sun solar wind by Parker Solar Probe have revealed the presence of largenumbers of discrete Alfv ́enic impulses with an anti-Sunward sense of propagation. These are similarto those previously observed near 1 AU, in high speed streams over the Sun’s poles and at 60 solarradii. At 35 solar radii, however, they are typically shorter and sharper than seen elsewhere. Inaddition, these spikes occur in “patches” and there are also clear periods within the same stream whenthey do not occur; the timescale of these patches might be related to the rate at which the spacecraftmagnetic footpoint tracks across the coronal hole from which the plasma originated. While the velocityfluctuations associated with these spikes are typically under 100 km/s, due to the rather low Alfv ́enspeeds in the streams observed by the spacecraft to date, these are still associated with large angulardeflections of the magnetic field - and these deflections are not isotropic. These deflections do notappear to be related to the recently reported large scale, pro-rotation solar wind flow. Estimates ofthe size and shape of the spikes reveal high aspect ratio flow-aligned structures with a transverse scaleof≈104km. These events might be signatures of near-Sun impulsive reconnection events

Ankles back in randomized controlled trial (ABrCt): braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training) against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care.</p> <p>Methods/Design</p> <p>This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention.</p> <p>Discussion</p> <p>The ABrCt is the first randomized controlled trial to directly compare the secondary preventive effect of the combined use of braces and neuromuscular training, against the use of either braces or neuromuscular training as separate secondary preventive measures. This study expects to identify the most effective and cost-efficient secondary preventive measure for ankle sprains. The study results could lead to changes in the clinical guidelines on the prevention of ankle sprains, and they will become available in 2012.</p> <p>Trial registration</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2157">NTR2157</a></p

Kinetic‐Scale Turbulence in the Venusian Magnetosheath

While not specifically designed as a planetary mission, NASA's Parker Solar Probe (PSP) mission uses a series of Venus gravity assists (VGAs) in order to reduce its perihelion distance. These orbital maneuvers provide the opportunity for direct measurements of the Venus plasma environment at high cadence. We present first observations of kinetic scale turbulence in the Venus magnetosheath from the first two VGAs. In VGA1, PSP observed a quasi‐parallel shock, β ∼ 1 magnetosheath plasma, and a kinetic range scaling of k−2.9. VGA2 was characterized by a quasi‐perpendicular shock with β ∼ 10, and a steep k−3.4 spectral scaling. Temperature anisotropy measurements from VGA2 suggest an active mirror mode instability. Significant coherent waves are present in both encounters at sub‐ion and electron scales. Using conditioning techniques to exclude these electromagnetic wave events suggests the presence of developed sub‐ion kinetic turbulence in both magnetosheath encounters

Payment for performance (P4P): any future in Italy?

<p>Abstract</p> <p>Background</p> <p>Pay for Performance (P4P) programs, based on provision of financial incentives for service quality, have been widely adopted to enhance quality of care and to promote a more efficient use of health care resources whilst improving patient outcomes. In Italy, as in other countries, the growing concern over the quality of health services provided and the scarcity of resources would make P4P programs a useful means of improving their performance. The aim of this paper is to evaluate whether it is possible to implement P4P programs in the Lombardy Region, in Italy, based on the existing data set.</p> <p>Methods</p> <p>Thirteen quality measures were identified regarding four clinical conditions (acute myocardial infarction (AMI), heart failure (HF), ischemic stroke and hip and knee replacement) on the basis of an international literature review. Data was collected using the database of three institutions, which included hospital discharge records (Scheda di Dimissione ospedaliera-SDO-) and letters of discharge. The study population was identified using both the Principal ICD-9-CM diagnosis codes and the discharge date. A Statistical Analysis System (SAS) program was used for the text analysis.</p> <p>Results</p> <p>It was possible to calculate almost all the parameters pertaining to the three hospitals as all the data required was available with the exception of inpatient mortality in two hospitals and smoking cessation advice/counseling in one hospital.</p> <p>Conclusions</p> <p>On the ground of this analysis, we believe that it is possible to implement a P4P program in the Lombardy Region. However, for this program to be initiated, all necessary data must be available in electronic format and uniformly collected. Moreover, several other factors must be assessed: which clinical conditions should be included, the threshold for each quality parameter, the amount of financial incentives offered and how they will be provided.</p