MAYA: An active-target detector for binary reactions with exotic beams

International audienceWith recent improvements in the production of radioactive beams in facilities such as SPIRAL at GANIL, a larger area of the nuclear chart is now accessible for experimentation. For these usually low-intensity and low-energy secondary beams, we have developed the new MAYA detector based on the active-target concept. This device allows to use a relatively thick target without loss of resolution by using the detection gas as target material. Dedicated 3D tracking, particle identification, energy loss and range measurements allow complete kinematic reconstruction of reactions taking place inside MAYA

Mass Measurements near N=Z

Abstract After an outline of the physics motivations, that illustrate why we think it is important to measure masses in the region N≈Z, we report on on experiments performed at Ganil. An experiment aimed at measuring the masses of proton-rich nuclei in the mass region A ≈ 60–80 has been performed, using a direct time-of-flight technique in conjunction with SISSI and the SPEG spectrometer at GANIL. The nuclei were produced via the fragmentation of a 78 Kr beam (73 meV/nucleon). A novel technique for the purification of the secondary beams, based on the stripping of the ions and using the α and the SPEG spectrometers, was succesfully checked. It allows for good selectivity without altering the beam quality. Secondary ions of 100 Ag, 100 Cd, 100 In and 100 Sn were produced via the fusion-evaporation reaction 50 Cr + 58 Ni at an energy of 5.1 MeV/nucleon, and were accelerated simultaneously in the second cyclotron of GANIL (CSS2). About 10 counts were observed from the production and acceleration of 100 Sn 22+ . The masses of 100 Cd, 100 In and 100 Sn were measured with respect to 100 Ag using the CSS2 cyclotron, with precisions of 2 × 10 −6 , 3 × 10 −6 and 10 −5 respectively

A misleading urethral smear with polymorphonuclear leucocytes and intracellular diplococci; case report of urethritis caused by Neisseria meningitidis

Dermatology and Venereolog

Quality of Care for Knee Osteoarthritis in Primary Care: A Patient's Perspective

OBJECTIVE: To describe the quality of osteoarthritis care in general practice from a patient's perspective and to identify novel associations between process quality indicators and patient-reported outcome and experience measures. METHODS: For this study, 235 individuals with knee osteoarthritis completed a survey based on both process and outcome indicators. Process indicators were extracted from international guidelines and included the domains: diagnosis, self-management, treatment, and follow-up. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and RAND 36-item Short Form health survey (SF-36) were used to assess patient-reported outcomes. Patient-reported experience with care was evaluated with the European Task Force on Patient Evaluations of General Practice Care (EUROPEP) instrument. A series of multilevel regression analyses were then performed to analyze determinants at the patient level (i.e., age, sex, body mass index, and education) and associations between process and outcome indicators. RESULTS: Overall, low adherence to the process indicators was observed (38%), particularly on informing patients about the importance of weight loss (24% [95% confidence interval (95% CI) 19-31]) or referring them for physical therapy (41% [95% CI 33-49]). Patients described their quality of life as moderate, with an overall score of 63% and 35% on the SF-36 and WOMAC surveys, respectively. Regarding the determinants, patients with a higher education level were better informed (odds ratio [OR] 3.4; P = 0.0003). Associations between process and outcome indicators were scarce, with the exception of patient satisfaction with care and use of nonsteroidal antiinflammatory drugs (NSAIDs) (OR 2.9; P = 0.0014). CONCLUSION: Patients with knee osteoarthritis receive suboptimal conservative management. They report a moderate quality of life. This study confirms the evidence suggesting that NSAIDs are the backbone of osteoarthritis pain management but also adds evidence from a patient's perspective

Educational outreach visits to improve knee osteoarthritis management in primary care

Contains fulltext : 201795.pdf (publisher's version ) (Open Access

Epidemiology of knee osteoarthritis in general practice: a registry-based study

OBJECTIVES: The present study investigated (1) trends in the prevalence and incidence of knee osteoarthritis over a 20-year period (1996-2015); (2) trends in multimorbidity and (3) trends in drug prescriptions. DESIGN: Registry-based study. SETTING: Primary healthcare, Flanders, Belgium. PARTICIPANTS: Data were collected from Intego, a general practice-based morbidity registration network. In the study period between 1996 and 2015, data from 440 140 unique patients were available. OUTCOME MEASURES: Trends in prevalence and incidence rate of knee osteoarthritis were computed using joinpoint regression analysis. The mean disease count was calculated to assess trends in multimorbidity. In addition, the number of drug prescriptions was identified by the Anatomical Therapeutic Chemical Classification code and trends were equally recorded with joinpoint regression. RESULTS: The total age-standardised prevalence of knee osteoarthritis increased from 2.0% in 1996 to 3.6% in 2015. An upward trend was observed with an average annual percentage change (AAPC) of 2.5 (95% CI 2.2 to 2.9). In 2015, the prevalence rates in the 10 year age groups from the 45-54 years age group onwards were 3.1%, 5.6%, 9.0% and 13.9%, to reach 15.0% in people aged 85 years and older. The incidence remained stable with 3.75 per thousand in 2015 (AAPC=-0.5, 95% CI -1.4 to 0.5). The mean disease count significantly increased from 1.63 to 2.34 (p<0.001) for incident cases with knee osteoarthritis. Finally, we observed a significantly positive trend in the overall prescription of acetaminophen (AAPC=6.7, 95% CI 5.6 to 7.7), weak opioids (AAPC=4.0, 95% CI 0.9 to 7.3) and glucosamine (AAPC=8.6, 95% CI 2.4 to 15.1). Oral non-steroidal anti-inflammatory drugs were most prescribed, with a prevalence rate of 29.8% in 2015, but remained stable during the study period (AAPC=0.0, 95% CI -1.1 to 1.1). CONCLUSIONS: Increased prevalence, multimorbidity, and number of drug prescriptions confirm an increased burden of knee osteoarthritis. In future, these trends can be used to prioritise initiatives for improvement in care