Stellar Wind Accretion in GX301-2: Evidence for a High-density Stream

The X-ray binary system GX301-2 consists of a neutron star in an eccentric orbit accreting from the massive early-type star WRAY 977. It has previously been shown that the X-ray orbital light curve is consistent with existence of a gas stream flowing out from Wray 977 in addition to its strong stellar wind. Here, X-ray monitoring observations by the Rossi X-ray Timing Explorer (RXTE)/ All-Sky-Monitor (ASM) and pointed observations by the RXTE/ Proportional Counter Array (PCA) over the past decade are analyzed. We analyze both the flux and column density dependence on orbital phase. The wind and stream dynamics are calculated for various system inclinations, companion rotation rates and wind velocities, as well as parametrized by the stream width and density. These calculations are used as inputs to determine both the expected accretion luminosity and the column density along the line-of-sight to the neutron star. The model luminosity and column density are compared to observed flux and column density vs. orbital phase, to constrain the properties of the stellar wind and the gas stream. We find that the change between bright and medium intensity levels is primarily due to decreased mass loss in the stellar wind, but the change between medium and dim intensity levels is primarily due to decreased stream density. The mass-loss rate in the stream exceeds that in the stellar wind by a factor of 2.5. The quality of the model fits is significantly better for lower inclinations, favoring a mass for WRAY 977 of 53 to 62 Msun.Comment: 19 pages, 6 figure

The extreme mobility of debris avalanches: A new model of transport mechanism

International audienceLarge rockslide-debris avalanches, resulting from flank collapses that shape volcanoes and mountains on Earth and other object of the solar system, are rapid and dangerous gravity-driven granular flows that travel abnormal distances. During the last 50 years, numerous physical models have been put forward to explain their extreme mobility. The principal models are based on fluidization, lubrication, or dynamic disintegration. However, these processes remain poorly constrained. To identify precisely the transport mechanisms during debris avalanches, we examined morphometric (fractal dimension and circularity), grain size, and exoscopic characteristics of the various types of particles (clasts and matrix) from volcanic debris avalanche deposits of La Réunion Island (Indian Ocean). From these data we demonstrate for the first time that syn-transport dynamic disintegration continuously operates with the increasing runout distance from the source down to a grinding limit of 500 μm. Below this limit, the particle size reduction exclusively results from their attrition by frictional interactions. Consequently, the exceptional mobility of debris avalanches may be explained by the combined effect of elastic energy release during the dynamic disintegration of the larger clasts and frictional reduction within the matrix due to interactions between the finer particles

Ultrafast supercontinuum spectroscopy of carrier multiplication and biexcitonic effects in excited states of PbS quantum dots

We examine the multiple exciton population dynamics in PbS quantum dots by ultrafast spectrally-resolved supercontinuum transient absorption (SC-TA). We simultaneously probe the first three excitonic transitions over a broad spectral range. Transient spectra show the presence of first order bleach of absorption for the 1S_h-1S_e transition and second order bleach along with photoinduced absorption band for 1P_h-1P_e transition. We also report evidence of the one-photon forbidden 1S_{h,e}-1P_{h,e} transition. We examine signatures of carrier multiplication (multiexcitons for the single absorbed photon) from analysis of the first and second order bleaches, in the limit of low absorbed photon numbers (~ 10^-2), at pump energies from two to four times the semiconductor band gap. The multiexciton generation efficiency is discussed both in terms of a broadband global fit and the ratio between early- to long-time transient absorption signals.. Analysis of population dynamics shows that the bleach peak due to the biexciton population is red-shifted respect the single exciton one, indicating a positive binding energy.Comment: 16 pages, 5 figure

Factors affecting the use of patient survey data for quality improvement in the Veterans Health Administration

<p>Abstract</p> <p>Background</p> <p>Little is known about how to use patient feedback to improve experiences of health care. The Veterans Health Administration (VA) conducts regular patient surveys that have indicated improved care experiences over the past decade. The goal of this study was to assess factors that were barriers to, or promoters of, efforts to improve care experiences in VA facilities.</p> <p>Methods</p> <p>We conducted case studies at two VA facilities, one with stable high scores on inpatient reports of emotional support between 2002 and 2006, and one with stable low scores over the same period. A semi-structured interview was used to gather information from staff who worked with patient survey data at the study facilities. Data were analyzed using a previously developed qualitative framework describing organizational, professional and data-related barriers and promoters to data use.</p> <p>Results</p> <p>Respondents reported more promoters than barriers to using survey data, and particularly support for improvement efforts. Themes included developing patient-centered cultures, quality improvement structures such as regular data review, and training staff in patient-centered behaviors. The influence of incentives, the role of nursing leadership, and triangulating survey data with other data on patients' views also emerged as important. It was easier to collect data on current organization and practice than those in the past and this made it difficult to deduce which factors might influence differing facility performance.</p> <p>Conclusions</p> <p>Interviews with VA staff provided promising examples of how systematic processes for using survey data can be implemented as part of wider quality improvement efforts. However, prospective studies are needed to identify the most effective strategies for using patient feedback to improve specific aspects of patient-centered care.</p

Performance reporting for consumers: issues for the Australian private hospital sector

A group of consumers of private hospital services and their carers collaborated with staff of a Melbourne private hospital and with industry representatives to develop a consumer-driven performance report on cardiac services. During the development process participating consumers identified situational and structural barriers to their right to be informed of costs, to choice and to quality care. Their growing appreciation of these barriers led them to a different perspective on performance reporting, which resulted in their redirecting the project. The consumer participants no longer wanted a performance report that provided comparative quantitative data. Instead they designed a report that outlined the structures, systems and processes the hospital had in place to address the quality and safety of services provided. In addition, consumer participants developed a decision support tool for consumers to use in navigating the private health care sector. The journey of these consumers in creating a consumer driven performance report for a private hospital service may assist those responsible for governance of Australia's health system in choosing appropriate strategies and mechanisms to enhance private hospital accountability. The situational and institutional industry barriers to choice, information and quality identified by these consumers need to be addressed before public performance reporting for private hospitals is introduced in Australia

Targeting ErbB2 and ErbB3 with a bispecific single-chain Fv enhances targeting selectivity and induces a therapeutic effect in vitro

Inappropriate signalling through the EGFR and ErbB2/HER2 members of the epidermal growth factor family of receptor tyrosine kinases is well recognised as being causally linked to a variety of cancers. Consequently, monoclonal antibodies specific for these receptors have become increasingly important components of effective treatment strategies for cancer. Increasing evidence suggests that ErbB3 plays a critical role in cancer progression and resistance to therapy. We hypothesised that co-targeting the preferred ErbB2/ErbB3 heterodimer with a bispecific single-chain Fv (bs-scFv) antibody would promote increased targeting selectivity over antibodies specific for a single tumour-associated antigen (TAA). In addition, we hypothesised that targeting this important heterodimer could induce a therapeutic effect. Here, we describe the construction and evaluation of the A5-linker-ML3.9 bs-scFv (ALM), an anti-ErbB3/ErbB2 bs-scFv. The A5-linker-ML3.9 bs-scFv exhibits selective targeting of tumour cells in vitro and in vivo that co-express the two target antigens over tumour cells that express only one target antigen or normal cells that express low levels of both antigens. The A5-linker-ML3.9 bs-scFv also exhibits significantly greater in vivo targeting of ErbB2‘+'/ErbB3‘+' tumours than derivative molecules that contain only one functional arm targeting ErbB2 or ErbB3. Binding of ALM to ErbB2‘+'/ErbB3‘+' cells mediates inhibition of tumour cell growth in vitro by effectively targeting the therapeutic anti-ErbB3 A5 scFv. This suggests both that ALM could provide the basis for an effective therapeutic agent and that engineered antibodies selected to co-target critical functional pairs of TAAs can enhance the targeting specificity and efficacy of antibody-based cancer therapeutics

A proposed systems approach to the evaluation of integrated palliative care

<p>Abstract</p> <p>Background</p> <p>There is increasing global interest in regional palliative care networks (PCN) to integrate care, creating systems that are more cost-effective and responsive in multi-agency settings. Networks are particularly relevant where different professional skill sets are required to serve the broad spectrum of end-of-life needs. We propose a comprehensive framework for evaluating PCNs, focusing on the nature and extent of inter-professional collaboration, community readiness, and client-centred care.</p> <p>Methods</p> <p>In the absence of an overarching structure for examining PCNs, a framework was developed based on previous models of health system evaluation, explicit theory, and the research literature relevant to PCN functioning. This research evidence was used to substantiate the choice of model factors.</p> <p>Results</p> <p>The proposed framework takes a systems approach with system structure, process of care, and patient outcomes levels of consideration. Each factor represented makes an independent contribution to the description and assessment of the network.</p> <p>Conclusions</p> <p>Realizing palliative patients' needs for complex packages of treatment and social support, in a seamless, cost-effective manner, are major drivers of the impetus for network-integrated care. The framework proposed is a first step to guide evaluation to inform the development of appropriate strategies to further promote collaboration within the PCN and, ultimately, optimal palliative care that meets patients' needs and expectations.</p