The 3-D ionization structure and evolution of NGC 7009 (Saturn Nebula)

Tomographic and 3-D analyses for extended, emission-line objects are applied to long-slit ESO NTT + EMMI high-resolution spectra of the intriguing planetary nebula NGC 7009, covered at twelve position angles. We derive the gas expansion law, the diagnostics and ionic radial profiles, the distance and the central star parameters, the nebular photo-ionization model and the spatial recovery of the plasma structure and evolution. The Saturn Nebula (distance~1.4 kpc, age~6000 yr, ionized mass~0.18 Mo) consists of several interconnected components, characterized by different morphology, physical conditions, excitation and kinematics. The internal shell, the main shell, the streams and the ansae expand at V(exp)~4.0xR" km/s, the outer shell, the caps and the equatorial pseudo-ring at V(exp)~3.15xR" km/s, and the halo at V(exp)~10 km/s. We compare the radial distribution of the physical conditions and the line fluxes observed in the eight sub-systems with the theoretical profiles coming from the photo-ionization code CLOUDY, inferring that all the spectral characteristics of NGC 7009 are explainable in terms of photo-ionization by the central star, a hot (logT*~4.95) and luminous (log L*/Lo~3.70) 0.60--0.61 Mo post--AGB star in the hydrogen-shell nuclear burning phase. The 3--D shaping of the Saturn Nebula is discussed within an evolutionary scenario dominated by photo-ionization and supported by the fast stellar wind: it begins with the superwind ejection, passes through the neutral, transition phase (lasting ~ 3000 yr), the ionization start (occurred ~2000 yr ago), and the full ionization of the main shell (~1000 yr ago), at last reaching the present days: the whole nebula is optically thin to the UV stellar flux, except the caps and the ansae.Comment: accepted for pub. in A&A, 28 pages, 14 figures, full text with figures available at http://web.pd.astro.it/supern/ps/h4665.ps, movies on the 3D structure available at http://web.pd.astro.it/sabbadin

Sports cardiology: A glorious past, a well-defined present, a bright future

The attention towards sports cardiology has dramatically grown after the introduction of preparticipation screening and the need for specific education on electrocardiogram interpretation in athletes, given the differences between athletes and the general population. The present article stresses the need for specific skills, knowledge, and clinical expertise in sports cardiology, which are essential for appropriately screening competitive athletes to prevent sudden cardiac death and avoid overdiagnosis. However, disqualification from sports competitions may lead to sports inactivity, and athletes may enter a gray zone where little or no information is provided about what they can or cannot do to stay active. However, modern sports cardiology cannot neglect the patient's needs and the importance of the safe practice of regular exercise. In this context, the personalized exercise prescription plays a crucial role in the core curriculum and the clinical activity of professionals involved in sports cardiology programs. Given its specificities, sports cardiology requires a formal education plan for medical school students and all residents. Additional education and practice are required for young colleagues who want to focus their professional lives on sports cardiology. The future directions of emerging modern sports cardiology should not neglect the importance of a scientific community that works together, designing multicenter international outcomes-based research to address the many remaining areas of uncertainty

Atmospheric Turbulence Compensation with Laser Phase Shifting Interferometry

Laser guide stars with adaptive optics allow astronomical image correction in the absence of a natural guide star. Single guide star systems with a star created in the earth's sodium layer can be used to correct the wavefront in the near infrared spectral regime for 8-m class telescopes. For possible future telescopes of larger sizes, or for correction at shorter wavelengths, the use of a single guide star is ultimately limited by focal anisoplanatism that arises from the finite height of the guide star. To overcome this limitation we propose to overlap coherently pulsed laser beams that are expanded over the full aperture of the telescope, traveling upwards along the same path which light from the astronomical object travels downwards. Imaging the scattered light from the resultant interference pattern with a camera gated to a certain height above the telescope, and using phase shifting interferometry we have found a method to retrieve the local wavefront gradients. By sensing the backscattered light from two different heights, one can fully remove the cone effect, which can otherwise be a serious handicap to the use of laser guide stars at shorter wavelengths or on larger telescopes. Using two laser beams multiconjugate correction is possible, resulting in larger corrected fields. With a proper choice of laser, wavefront correction could be expanded to the visible regime and, due to the lack of a cone effect, the method is applicable to any size of telescope. Finally the position of the laser spot could be imaged from the side of the main telescope against a bright background star to retrieve tip-tilt information, which would greatly improve the sky coverage of the system.Comment: 11 pages, 10 figure

Integration of the atmospheric fluctuations in a dual-field optical interferometer: the short exposure regime

Spatial phase-referencing in dual-field optical interferometry is reconsidered. Our analysis is based on the 2-sample variance of the differential phase between target and reference star. We show that averaging over time of the atmospheric effects depends on this 2-sample phase variance (Allan variance) rather than on the true variance. The proper expression for fringe smearing beyond the isoplanatic angle is derived. With simulations of atmospheric effects, based on a Paranal turbulence model, we show how the performances of a dual-field optical interferometer can be evaluated in a diagram 'separation angle' versus 'magnitude of faint object'. In this diagram, a domain with short exposure is found to be most useful for interferometry, with about the same magnitude limits in the H and K bands. With star counts from a Galaxy model, we evaluate the sky coverage for differential astrometry and detection of exoplanets, i.e. likelihood of faint reference stars in the vicinity of a bright target. With the 2mass survey, we evaluate sky coverage for phase-referencing, i.e. avaibility of a bright enough star for main delay tracking in the vicinity of any target direction.Comment: 9 pages, 8 figures, accepted for publication in A&

The gas turbulence in planetary nebulae: quantification and multi-D maps from long-slit, wide-spectral range echellogram

This methodological paper is part of a short series dedicated to the long-standing astronomical problem of de-projecting the bi-dimensional, apparent morphology of a three-dimensional distribution of gas. We focus on the quantification and spatial recovery of turbulent motions in planetary nebulae (and other classes of expanding nebulae) by means of long-slit echellograms over a wide spectral range. We introduce some basic theoretical notions, discuss the observational methodology, and develop an accurate procedure disentangling all broadening components of the velocity profile in all spatial positions of each spectral image. This allows us to extract random, non-thermal motions at unprecedented accuracy, and to map them in 1-, 2- and 3-dimensions. We present the solution to practical problems in the multi-dimensional turbulence-analysis of a testing-planetary nebula (NGC 7009), using the three-step procedure (spatio-kinematics, tomography, and 3-D rendering) developed at the Astronomical Observatory of Padua. In addition, we introduce an observational paradigm valid for all spectroscopic parameters in all classes of expanding nebulae. Unsteady, chaotic motions at a local scale constitute a fundamental (although elusive) kinematical parameter of each planetary nebula, providing deep insights on its different shaping agents and mechanisms, and on their mutual interaction. The detailed study of turbulence, its stratification within a target and (possible) systematic variation among different sub-classes of planetary nebulae deserve long-slit, multi-position angle, wide-spectral range echellograms containing emissions at low-, medium-, and high-ionization, to be analyzed pixel-to-pixel with a straightforward and versatile methodology, extracting all the physical information stored in each frame at best.Comment: 11 page, 10 figures, A&A in pres

Mental health services utilization after Mariana dam burst

Abstract Background The global burden of mental health conditions is increasing, especially in middle- and low-income countries and frequently the quality of mental health services is lower than the quality of services for other conditions. Disasters may increase this burden through their direct impact or due to secondary stressors, such as the preclusion of access to essential services. The aim of this study is to assess the impact of Mariana dam burst (Brazil) in November 2015, in the utilization of public mental health services by the population that experienced an interruption of water supply after the event. Methods We used data from DATASUS, the database of the Brazilian public health system, analyzing data from 34 months before to 36 months after the event. We defined as affected the population living in the municipalities of Minas Gerais state that had an interruption of water supply after the event and the rest of the state population as the comparison group. We designed an Interrupted time-series analysis to evaluate both immediate and gradual changes in use of mental health services after the accident. Results The affected population included 381,749 inhabitants and the comparison group 20,487,352 inhabitants. The monthly rate of mental health visits in the affected population in the beginning of the series was 296 (CI 182 to 409, p < 0.001) per 100.000 person-month. Comparing the groups after the event, we observed a non-statistically significant higher increase in the rate of visits immediately after the event of 115.96 (CI -30.00 to 261.92, p = 0.118) and a significant increase in the monthly rate of visits (change in slope) of 15.55 (CI 8.19 to 22.92, p < 0.001) in the affected group. Discussion The results suggest that the event translated in a long-term increase in mental health services utilization. We believe that this study presents an innovative methodology on the assessment of mental health services after disasters and that it could be adapted to other contexts. Key messages Indirect impacts of disasters may be associated with long-term changes in the utilization of mental health services. Interrupted time series using routine data are useful tools for the assessment of health services utilization following disasters

Virtual reality and live scenario simulation: options for training medical students in mass casualty incident triage

Introduction Multicasualty triage is the process of establishing the priority of care among casualties in disaster management. Recent mass casualty incidents (MCI) revealed that health personnel are unfamiliar with the triage protocols. The objective of this study is to compare the relative impact of two simulation-based methods for training medical students in mass casualty triage using the Simple Triage and Rapid Treatment (START) algorithm. Methods A prospective randomized controlled longitudinal study. Medical students enrolled in the emergency medicine course were randomized into two groups (A and B). On day 1, group A students were exposed to a virtual reality (VR) scenario and group B students were exposed to a live scenario (LS), both exercises aiming at triaging 10 victims in a limited period of time (30 seconds/victim). On day 2 all students attended a 2-hour lecture about medical disaster management and START. On day 3 group A and B students were exposed to a LS and to a VR scenario respectively. The vital signs and clinical condition of the 10 victims were identical in the two scenarios. Ability of the groups to manage a simulated triage scenario was then compared (times and triage accuracy). Results Groups A and B were composed of 25 and 28 students respectively. During day 1 group A LS triage accuracy was 58%, while the average time to assess all patients was 4 minutes 28 seconds. The group B VR scenario triage accuracy was 52%, while the average time to complete the assessment was 5 minutes 18 seconds. During day 3 the triage accuracy for group A VR simulation was 92%, while the average time was 3 minutes 53 seconds. Group B triage accuracy during the LS was 84%, with an average time of 3 minutes 25 seconds. Triage scores improved significantly during day 3 (P < 0.001) in the two groups. The time to complete each scenario decreased significantly from day 1 to day 3. Conclusions The study demonstrates that the training course generates significant improvement in triage accuracy and speed. It also reveals that VR simulation compared to live exercises has equivalent results in prompting critical decisions in mass casualty drills. In the beginning the average time to complete the VR scenario was higher than the LS. This could be due to the fact that on day 1 very detailed VR victims created a higher challenge for untaught students. However, the higher triage accuracy recorded at the end of day 3 in VR could be explained by a lower stress level compared to the LS, which could be creating a more stressful environment in taught students

Alignment and preliminary outcomes of an ELT-size instrument to a very large telescope: LINC-NIRVANA at LBT

LINC-NIRVANA (LN) is a high resolution, near infrared imager that uses a multiple field-of-view, layer-oriented, multi-conjugate AO system, consisting of four multi-pyramid wavefront sensors (two for each arm of the Large Binocular Telescope, each conjugated to a different altitude). The system employs up to 40 star probes, looking at up to 20 natural guide stars simultaneously. Its final goal is to perform Fizeau interferometric imaging, thereby achieving ELT-like spatial resolution (22.8 m baseline resolution). For this reason, LN is also equipped with a fringe tracker, a beam combiner and a NIR science camera, for a total of more than 250 optical components and an overall size of approximately 6x4x4.5 meters. This paper describes the tradeoffs evaluated in order to achieve the alignment of the system to the telescope. We note that LN is comparable in size to planned ELT instrumentation. The impact of such alignment strategies will be compared and the selected procedure, where the LBT telescope is, in fact, aligned to the instrument, will be described. Furthermore, results coming from early night-time commissioning of the system will be presented.Comment: 8 pages, 6 pages, AO4ELT5 Proceedings, 201