GIS-gestützte Modellierung der Erreichbarkeiten ambulanter Pflegedienste nach SGB V und SGB XI in Unterfranken unter Berücksichtigung demographischer Entwicklungen

Ziel des Beitrags ist die Untersuchung und Bewertung der Erreichbarkeit der Bevölkerung durch ambulante Pflegedienste in Unterfranken unter Einbeziehung der räumlich differenzierten Bevölkerungsstruktur für das Jahr 2017 sowie der voraussichtlichen demographischen Entwicklung bis 2025. Die Erreichbarkeiten werden sowohl rasterbasiert als auch vektorbasiert in einer GIS-Software modelliert. Darüber hinaus werden demographische Entwicklungen in der Altersgruppe "80 Jahre und älter" eingebunden. Die Ergebnisse der rasterbasierten Fahrzeitenmodellierung zeigen flächenhaft relativ gute Erreichbarkeiten, mit Ausnahme weniger peripherer Gebiete. Mittels vektorbasierter Fahrzeitenmodellierung werden Einzugsgebiete, welche auf Personalkosten und Anfahrtspauschalen nach SGB V und SGB XI als Berechnungsgrundlagen basieren, für ambulante Pflegedienste berechnet. Es zeigt sich, dass in Teilen Unterfrankens keine ausreichende Kostendeckung gegeben ist. Hinsichtlich der skizzierten Bevölkerungsentwicklung sowie unzureichender Fahrtkostendeckung im Bereich der Mittelgebirge und abseits der Verdichtungsräume wird eine Flexibilisierung der Anfahrtsvergütung sowie eine Aufstockung des Pflegepersonals empfohlen.The aim of this paper is to analyse the accessibility of outpatient care services in Lower Franconia, Germany, taking into account the spatially differentiated population structure for the year 2017 as well as the expected demographic development until 2025. The accessibility was modelled both raster-based and vector-based in a GIS software. Moreover, demographic developments in the age group "80 years and older" are also incorporated. The results of the raster-based travel time modelling show relatively good accessibility in the study area except from a few peripheral areas. Catchment areas for outpatient care services were calculated using vector-based travel time modelling, drawing on travel flat rates according to SGB V and SGB XI as well as staff costs as calculation bases for threshold values. In parts of Lower Franconia there is no sufficient cost coverage. With regard to the population development outlined above and insufficient coverage of travel costs by flat-rate travel allowances in low mountain ranges and away from urban agglomerations, a transition to a flexible travel compensation for nursing services and an increase in nursing staff is recommended

Demonstrating grating-based phase-contrast imaging of laser-driven shock waves

Single-shot X-ray phase-contrast imaging is used to take high-resolution images of laser-driven strong shock waves. Employing a two-grating Talbot interferometer, we successfully acquire standard absorption, differential phase-contrast, and dark-field images of the shocked target. Good agreement is demonstrated between experimental data and the results of two-dimensional radiation hydrodynamics simulations of the laser–plasma interaction. The main sources of image noise are identified through a thorough assessment of the interferometer’s performance. The acquired images demonstrate that grating-based phase-contrast imaging is a powerful diagnostic tool for high-energy-density science. In addition, we make a novel attempt at using the dark-field image as a signal modality of Talbot interferometry to identify the microstructure of a foam target

Metal Absorption Systems in Spectra of Pairs of QSOs

We present the first large sample of absorption systems in paired QSOs consisting of 691 absorption systems in the spectra of 310 QSOs including 170 pairings. All these absorption systems have metal lines, usually C IV or Mg II. We see 17 cases of absorption in one line-of-sight within 200 km/s (1 Mpc) of absorption in the paired line-of-sight with the probability at least approx 50% at 100kpc, declining rapidly to 23% at 100 - 200 kpc. We detect clustering on 0.5Mpc scales and see a hint of the "fingers of God" redshift-space distortion. The distribution matches absorbers arising in galaxies at z=2 with a normal correlation function and systematic infall velocities but unusually low random pair-wise velocity differences. Absorption in gas flowing out from galaxies at a mean velocity of 250 km/s would produce vastly more elongation than we see. The UV absorption from fast winds that Adelberger et al. 2005 see in spectra of LBGs is not representative of the absorption that we see. Either the winds are confined to LBGs, or they can not extend to 40 kpc with large velocities, while continuing to make UV absorption we see, implying most metals were in place in the IGM long before z=2. Separately, when we examine the absorption seen when a sight line passes a second QSO, we see 19 absorbers within 400 km/s of the partner QSO. The probability of seeing absorption is approximately constant for impact parameters 0.1 - 1.5 Mpc. Perhaps we do not see a rapid rise in the probability at small impact parameters because the UV from QSOs destroys some absorbers near to the QSOs. The 3D distribution of 64 absorbers around 313 QSOs is to first order isotropic, with just a hint of the anisotropy expected if the QSO UV emission is beamed, or alternatively QSOs might emit UV isotropically but for a surprisingly short time of only 0.3Myr.Comment: 36 pages with 25 figures and 10 Tables Submited to MNRA

Multidimensional Conservation Laws: Overview, Problems, and Perspective

Some of recent important developments are overviewed, several longstanding open problems are discussed, and a perspective is presented for the mathematical theory of multidimensional conservation laws. Some basic features and phenomena of multidimensional hyperbolic conservation laws are revealed, and some samples of multidimensional systems/models and related important problems are presented and analyzed with emphasis on the prototypes that have been solved or may be expected to be solved rigorously at least for some cases. In particular, multidimensional steady supersonic problems and transonic problems, shock reflection-diffraction problems, and related effective nonlinear approaches are analyzed. A theory of divergence-measure vector fields and related analytical frameworks for the analysis of entropy solutions are discussed.Comment: 43 pages, 3 figure

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| < 0.03 at 95% confidence level. [Figure not available: see fulltext.

An embedding technique to determine ττ backgrounds in proton-proton collision data

An embedding technique is presented to estimate standard model tau tau backgrounds from data with minimal simulation input. In the data, the muons are removed from reconstructed mu mu events and replaced with simulated tau leptons with the same kinematic properties. In this way, a set of hybrid events is obtained that does not rely on simulation except for the decay of the tau leptons. The challenges in describing the underlying event or the production of associated jets in the simulation are avoided. The technique described in this paper was developed for CMS. Its validation and the inherent uncertainties are also discussed. The demonstration of the performance of the technique is based on a sample of proton-proton collisions collected by CMS in 2017 at root s = 13 TeV corresponding to an integrated luminosity of 41.5 fb(-1).Peer reviewe