Dissociative recombination of deuterated formyl cations

In interstellar media dissociative recombination is considered the principal destruction mechanism for molecular ions. Information about this process is very important in astrophysical modeling and therefore essential for radioastronomical probes. A molecular fragmentation study on the dissociative recombination of deuterated formyl cations has been performed applying the merged-beam technique provided by the heavy-ion storage-ring TSR at the Max-Planck-Institute for Nuclear Physics in Heidelberg. Utilizing a recently developed energy-sensitive imaging detector advanced investigations of the energy dependent evolution of the branching ratios into the di erent accessible fragmentation channels and the inner excitation of the molecular recombination products have been enabled. The interpretation of the data resorts to an independently performed relaxation study which yielded the inner excitation of the initial molecular ions and the abundance ratio of the isomer. The experimental results indicate correspondence to calculations on the molecular system, which determined electronic resonant states through which the dissociative recombination is considered to proceed

Dissociative recombination of deuterated formyl cations

In interstellar media dissociative recombination is considered the principal destruction mechanism for molecular ions. Information about this process is very important in astrophysical modeling and therefore essential for radioastronomical probes. A molecular fragmentation study on the dissociative recombination of deuterated formyl cations has been performed applying the merged-beam technique provided by the heavy-ion storage-ring TSR at the Max-Planck-Institute for Nuclear Physics in Heidelberg. Utilizing a recently developed energy-sensitive imaging detector advanced investigations of the energy dependent evolution of the branching ratios into the di erent accessible fragmentation channels and the inner excitation of the molecular recombination products have been enabled. The interpretation of the data resorts to an independently performed relaxation study which yielded the inner excitation of the initial molecular ions and the abundance ratio of the isomer. The experimental results indicate correspondence to calculations on the molecular system, which determined electronic resonant states through which the dissociative recombination is considered to proceed

Astrochemistry in an Ion Storage Ring

Storage ring studies of low energy electron collisions with molecular ions have been carried out for dissociative recombination (DR) of fluorine-bearing molecules. Here we report on work aiming to improve the understanding of astrochemistry involving HF, a possible spectroscopic tracer of interstellar H2. For CF+ the rate coefficient was obtained for temperatures down to 10 K. For D2F+ the DR fragmentation branching ratios were determined to be 66(3)%, 24(2)%, and 10(2)% for the F+D+D, DF+D, and D2+F channels, respectively. The molecular DR products of this reaction, DF and D2, display an unusually high level of internal excitation, close to their dissociation limit

What do people with lung cancer and stroke expect from patient navigation?: A qualitative study in Germany

Objective This qualitative study investigated patients' needs and wishes in relation to patient navigation. Design A qualitative interview study was conducted. Participants were invited to take part in three in-depth interviews over a period of 6-12 months. Thematic analysis was used. Setting Interviewees were sought in the Berlin metropolitan area of Germany in academic university hospitals, in rehabilitation clinics and through self-help organisations. Participants The sample consisted of individuals diagnosed with lung cancer (n=20) or stroke (n=20). Results From the perspective of interviewees, patient navigators should function as consistent contact persons, present during the whole care trajectory. Their role would be to guide patients through an often confusing healthcare landscape, offering practical, advisory and emotional assistance corresponding to patients' needs. The study shows that-independent of the disease-participants had similar expectations and needs regarding support from navigators. Conclusion For chronic and complex diseases-as is the case with lung cancer and stroke-it appears less important for navigators to fulfil disease-specific tasks. Rather, they should ensure that patients' more general needs, in relation to social, practical and emotional support, are met in a way that suits their individual wishes. Following these results, patient navigation programmes might be designed to include generic elements, which should then be adapted to the infrastructure in a particular healthcare region and to the particularities of a specific healthcare system

Can routine register data be used to identify vulnerable lung cancer patients of suboptimal care in a German comprehensive cancer centre?

Objectives Several patient factors have been described to influence access to optimal cancer care like socioeconomic factors or place of residence. In this study, we investigate whether data routinely collected in a clinical cancer registry can be used to identify populations of lung cancer patients with increased risk of not receiving optimal cancer care.Methods We analysed data of 837 lung cancer patients extracted from the clinical cancer registry of a German university hospital. We compared patient populations by two indicators of optimal care, namely implementation of tumour board meeting recommendations as well as the timeliness of care.Results There was a high rate of implementation of tumour board meeting recommendations of 94.4%. Reasons for non-implementation were mainly a patient's own wish or a worsening of the health situation. Of all patient parameters, only tumour stage was associated with the two optimal care indicators.Conclusion Using routine data from a clinical cancer registry, we were not able to identify patient populations at risk of not getting optimal care and the implementation of guideline-conform care appeared to be very high in this setting. However, limitations were the ambiguity of optimal care indicators and availability of parameters predictive for patients' vulnerability.Clinical epidemiolog

Dissociative recombination measurements of NH+ using an ion storage ring

We have investigated dissociative recombination (DR) of NH+ with electrons using a merged beams configuration at the TSR heavy-ion storage ring located at the Max Planck Institute for Nuclear Physics in Heidelberg, Germany. We present our measured absolute merged-beams recombination rate coefficient for collision energies from 0 to 12 eV. From these data, we have extracted a cross section, which we have transformed to a plasma rate coefficient for the collisional plasma temperature range from T pl = 10 to 18,000 K. We show that the NH+ DR rate coefficient data in current astrochemical models are underestimated by up to a factor of approximately nine. Our new data will result in predicted NH+ abundances lower than those calculated by present models. This is in agreement with the sensitivity limits of all observations attempting to detect NH+ in interstellar clouds

Dacron® vs. PTFE as bypass materials in peripheral vascular surgery – systematic review and meta-analysis

Roll S, Müller-Nordhorn J, Keil T, et al. Dacron® vs. PTFE as bypass materials in peripheral vascular surgery – systematic review and meta-analysis. BMC Surgery. 2008;8(1): 22.Background: In peripheral vascular bypass surgery different synthetic materials are available for bypass grafting. It is unclear which of the two commonly used materials, polytetrafluoroethylene (PTFE) or polyester (Dacron®) grafts, is to be preferred. Thus, the aim of this meta-analysis and systematic review was to compare the effectiveness of these two prosthetic bypass materials (Dacron® and PTFE). Methods: We performed a systematic literature search in MEDLINE, Cochrane-Library – CENTRAL, EMBASE and other databases for relevant publications in English and German published between 1999 and 2008. Only randomized controlled trials were considered for inclusion. We assessed the methodological quality by means of standardized checklists. Primary patency was used as the main endpoint. Random-effect meta-analysis as well as pooling data in life table format was performed to combine study results. Results: Nine randomized controlled trials (RCT) were included. Two trials showed statistically significant differences in primary patency, one favouring Dacron® and one favouring PTFE grafts, while 7 trials did not show statistically significant differences between the two materials. Meta-analysis on the comparison of PTFE vs. Dacron® grafts yielded no differences with regard to primary patency rates (hazard ratio 1.04 (95% confidence interval [0.85;1.28]), no significant heterogeneity (p = 0.32, I2 = 14%)). Similarly, there were no significant differences with regard to secondary patency rates. Conclusion: Systematic evaluation and meta-analysis of randomized controlled trials comparing Dacron® and PTFE as bypass materials for peripheral vascular surgery showed no evidence of an advantage of one synthetic material over the other

Exploring high-energy doubly excited states of NH by dissociative recombination of NH+

We have investigated electron capture by NH+ resulting in dissociative recombination (DR). The impact energies studied of ~4–12 eV extend over the range below the two lowest predicted NH+ dissociative states in the Franck–Condon (FC) region of the ion. Our focus has been on the final state populations of the resulting N and H atoms. The neutral DR fragments are detected downstream of a merged electron and ion beam interaction zone in the TSR storage ring, which is located at the Max Planck Institute for Nuclear Physics in Heidelberg, Germany. Transverse fragment distances were measured on a recently developed high count-rate imaging detector. The distance distributions enabled a detailed tracking of the final state populations as a function of the electron collision energy. These can be correlated with doubly excited neutral states in the FC region of the ion. At low electron energy of ~5 eV, the atomic product final levels are nitrogen Rydberg states together with ground-state hydrogen. In a small electron energy interval near 7 eV, a significant part of the final state population forms hydrogen Rydberg atoms with nitrogen atoms in the first excited ($\rm ^2D$) term, showing the effect of Rydberg doubly excited states below the predicted 2 2Π ionic potential. The distance distributions above ~10 eV are compatible with nitrogen Rydberg states correlating to the doubly excited Rydberg state manifold below the ionic 2 4Σ− level

Geographical variation in cardiovascular incidence: results from the British Women's Heart and Health Study

BACKGROUND: Prevalence of cardiovascular disease (CVD) in women shows regional variations not explained by common risk factors. Analysis of CVD incidence will provide insight into whether there is further divergence between regions with increasing age. METHODS: Seven-year follow-up data on 2685 women aged 59-80 (mean 69) at baseline from 23 towns in the UK were available from the British Women's Heart and Health Study. Time to fatal or non-fatal CVD was analyzed using Cox regression with adjustment for risk factors, using multiple imputation for missing values. RESULTS: Compared to South England, CVD incidence is similar in North England (HR 1.05 (95% CI 0.84, 1.31)) and Scotland (0.93 (0.68, 1.27)), but lower in Midlands/Wales (0.85 (0.64, 1.12)). Event severity influenced regional variation, with South England showing lower fatal incident CVD than other regions, but higher non-fatal incident CVD. Kaplan-Meier plots suggested that regional divergence in CVD occurred before baseline (before mean baseline age of 69). CONCLUSIONS: In women, regional differences in CVD early in adult life do not further diverge in later life. This may be due to regional differences in early detection, survivorship of women entering the study, or event severity. Targeting health care resources for CVD by geographic variation may not be appropriate for older age-groups

Prevalence of Symptomatic Heart Failure with Reduced and with Normal Ejection Fraction in an Elderly General Population-The CARLA Study

Background/Objectives: Chronic heart failure (CHF) is one of the most important public health concerns in the industrialized world having increasing incidence and prevalence. Although there are several studies describing the prevalence of heart failure with reduced ejection fraction (HFREF) and heart failure with normal ejection fraction (HFNEF) in selected populations, there are few data regarding the prevalence and the determinants of symptomatic heart failure in the general population. Methods: Cross-sectional data of a population-based German sample (1,779 subjects aged 45-83 years) were analyzed to determine the prevalence and determinants of chronic SHF and HFNEF defined according to the European Society of Cardiology using symptoms, echocardiography and serum NT-proBNP. Prevalence was age-standardized to the German population as of December 31st, 2005. Results: The overall age-standardized prevalence of symptomatic CHF was 7.7% (95%CI 6.0-9.8) for men and 9.0% (95%CI 7.0-11.5) for women. The prevalence of CHF strongly increased with age from 3.0% among 45-54- year-old subjects to 22.0% among 75-83- year-old subjects. Symptomatic HFREF could be shown in 48% (n = 78), symptomatic HFNEF in 52% (n = 85) of subjects with CHF. The age-standardized prevalence of HFREF was 3.8 % (95%CI 2.4-5.8) for women and 4.6 % (95%CI 3.6-6.3) for men. The age-standardized prevalence of HFNEF for women and men was 5.1 % (95%CI 3.8-7.0) and 3.0 % (95%CI 2.1-4.5), respectively. Persons with CHF were more likely to have hypertension (PR = 3.4; 95%CI 1.6-7.3) or to have had a previous myocardial infarction (PR = 2.5, 95%CI 1.8-3.5). Conclusion: The prevalence of symptomatic CHF appears high in this population compared with other studies. While more women were affected by HFNEF than men, more male subjects suffered from HFREF. The high prevalence of symptomatic CHF seems likely to be mainly due to the high prevalence of cardiovascular risk factors in this population