The ion channel free-electron laser with varying betatron amplitude

The ion-channel laser (ICL) is an ultra-compact version of the free-electron laser (FEL), with the undulator replaced by an ion channel. Previous studies of the ICL assumed transverse momentum amplitudes which were unrealistically small for experiments. Here we show that this restriction can be removed by correctly taking into account the dependence of the resonance between oscillations and emitted field on the betatron amplitude, which must be treated as variable. The ICL model with this essential addition is described using the well-known formalism for the FEL. Analysis of the resulting scaled equations shows a realistic prospect of building a compact ICL source for fundamental wavelengths down to UV, and harmonics potentially extending to x-rays. The gain parameter ρ can attain values as high as 0.03, which permits driving an ICL with electron bunches with realistic emittance

The SURgical PAtient Safety System (SURPASS) checklist optimizes timing of antibiotic prophylaxis

Background: Surgical site infection (SSI) is an adverse event in which a close relation between process of care and outcome has been demonstrated: administration of antibiotic prophylaxis decreases the risk of SSI. In our tertiary referral centre, a SURgical PAtient Safety System (SURPASS) checklist was developed and implemented. This multidisciplinary checklist covers the entire surgical pathway and includes, among other items, administration of antibiotic prophylaxis before induction of anaesthesia. The aim of this study was to determine the effect of SURPASS implementation on timing of antibiotic prophylaxis. Methods: A retrospective analysis was performed on two cohorts of patients: one cohort of surgical patients that underwent surgery before implementation of the checklist and a comparable cohort after implementation. The interval between administration of antibiotic prophylaxis and incision was compared between the two cohorts. Results: A total of 772 surgical procedures were included. More than half of procedures were gastro-intestinal; others were vascular, trauma and hernia repair procedures. After implementation, the checklist was used in 81.4 % of procedures. The interval between administration of antibiotic prophylaxis and incision increased from 23.9 minutes before implementation of SURPASS to 29.9 minutes after implementation (p = 0.047). In procedures where the checklist was used, the interval increased to 32.9 minutes (p = 0.004). The proportion of patients that did not receive antibiotics until after the incision decreased significantly. Conclusion: The use of the SURPASS checklist leads to better compliance with regard to the timing of antibiotic prophylaxis administration

Spatio-temporal coupling of attosecond pulses

The shortest light pulses produced to date are of the order of a few tens of attoseconds, with central frequencies in the extreme ultraviolet range and bandwidths exceeding tens of eV. They are often produced as a train of pulses separated by half the driving laser period, leading in the frequency domain to a spectrum of high, odd-order harmonics. As light pulses become shorter and more spectrally wide, the widely-used approximation consisting in writing the optical waveform as a product of temporal and spatial amplitudes does not apply anymore. Here, we investigate the interplay of temporal and spatial properties of attosecond pulses. We show that the divergence and focus position of the generated harmonics often strongly depend on their frequency, leading to strong chromatic aberrations of the broadband attosecond pulses. Our argumentation uses a simple analytical model based on Gaussian optics, numerical propagation calculations and experimental harmonic divergence measurements. This effect needs to be considered for future applications requiring high quality focusing while retaining the broadband/ultrashort characteristics of the radiation

Spatial aberrations in high-order harmonic generation

We investigate the spatial characteristics of high-order harmonic radiation generated in argon, and observe cross-like patterns in the far field. An analytical model describing harmonics from an astigmatic driving beam reveals that these patterns result from the order and generation position dependent divergence of harmonics. Even small amounts of driving field astigmatism may result in cross-like patterns, coming from the superposition of individual harmonics with spatial profiles elongated in different directions. By correcting the aberrations using a deformable mirror, we show that fine-tuning the driving wavefront is essential for optimal spatial quality of the harmonics

Continuous ambulatory peritoneal dialysis: pharmacokinetics and clinical outcome of paclitaxel and carboplatin treatment

Purpose: Administration of chemotherapy in patients with renal failure, treated with hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) is still a challenge and literature data is scarce. Here we present a case study of a patient on CAPD, treated with weekly and three-weekly paclitaxel/ carboplatin for recurrent ovarian cancer. Experimental: During the first, second and ninth cycle of treatment, blood, urine and CAPD samples were collected for pharmacokinetic analysis of paclitaxel and total and unbound carboplatin-derived platinum. Results: Treatment was well tolerated by the patient. No excessive toxicity was observed and at the e

The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors)

<p>Abstract</p> <p>Background</p> <p>The potential of clinical interventions, aiming at reduction of preventable Adverse Drug Events (preventable ADEs) during hospital stay, have been studied extensively. Clinical Pharmacy is a well-established and effective service, usually consisting of full-time on-ward participation of clinical pharmacists in medical teams. Within the current Hospital Pharmacy organisation in the Netherlands, such on-ward service is less feasible and therefore not yet established. However, given the substantial incidence of preventable ADEs in Dutch hospitals found in recent studies, appears warranted. Therefore, "Ward-Oriented Pharmacy", an on-ward service tailored to the Dutch hospital setting, will be developed. This service will consist of multifaceted interventions implemented in the Internal Medicine wards by hospital pharmacists. The effect of this service on preventable ADEs in elderly inpatients will be measured. Elderly patients are at high risk for ADEs due to multi-morbidity, concomitant disabilities and polypharmacy. Most studies on the incidence and preventability of ADEs in elderly patients have been conducted in the outpatient setting or on admission to a hospital, and fewer in the inpatient setting. Moreover, recognition of ADEs by the treating physicians is challenging in elderly patients because their disease presentation is often atypical and complex. Detailed information about the performance of the treating physicians in ADE recognition is scarce.</p> <p>Methods/Design</p> <p>The design is a multi-centre, interrupted time series study. Patients of 65 years or older, consecutively admitted to Internal Medicine wards will be included. After a pre-measurement, a Ward-Oriented Pharmacy service will be introduced and the effect of this service will be assessed during a post-measurement. The primary outcome measures are the ADE prevalence on admission and ADE incidence during hospital stay. These outcomes will be assessed using structured retrospective chart review by an independent expert panel. This assessment will include determination of causality, severity and preventability of ADEs. In addition, the extent to which ADEs are recognised and managed by the treating physicians will be considered.</p> <p>Discussion</p> <p>The primary goal of the WINGS study is to assess whether a significant reduction in preventable ADEs in elderly inpatients can be achieved by a Ward-Oriented Pharmacy service offered. A comprehensive ADE detection method will be used based on expert opinion and retrospective, trigger-tool enhanced, chart review.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN64974377">ISRCTN64974377</a></p

Heating and expansion of radio frequency driven ultracold plasmas

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Divergence and efficiency optimization in polarization-controlled two-color high-harmonic generation

Improving the brightness of high-harmonic generation (HHG) sources is one of the major goals for next-generation ultrafast, imaging and metrology applications in the extreme-ultraviolet spectrum. Previous research efforts have demonstrated a plethora of techniques to increase the conversion efficiency of HHG. However, few studies so far have addressed how to simultaneously minimize the divergence and improve focusability, which all contribute to an increased brightness of the source. Here, we investigate how to improve both photon yield and divergence, which is directly linked to focusability, when adding the second harmonic to the fundamental driving field. We study the effects of the relative polarization in two-color HHG and compare the results to a one-color configuration. In a perpendicular two-color field, the relative phase between the two colors can be used to suppress or enhance recombination of either the long or the short trajectories. This allows to exert control over the divergence of the harmonics. In a parallel two-color field, the ionization rate is modified through the two-color phase, which selects trajectories during the ionization step. This enhances the total yield. We elaborate on the underlying mechanisms for parallel, perpendicular, and intermediate polarization angles, and confirm our experimental observations with simulations