Integrated optics prototype beam combiner for long baseline interferometry in the L and M bands

In the last few years, integrated optics (IO) beam combiners have facilitated the emergence of 4-telescope interferometers such as PIONIER or GRAVITY, boosting the imaging capabilities of the VLTI. However, the spectral range beyond 2.2microns is not ideally covered by the conventional silica based IO. Here, we propose to consider new laser-written IO prototypes made of GLS glasses, a material that permits access to the mid-infrared spectral regime. Our goal is to conduct a full characterization of our mid-IR IO 2-telescope coupler in order to measure the performance levels directly relevant for long-baseline interferometry. We focus in particular on the exploitation of the L and M astronomical bands. We use a dedicated Michelson-interferometer setup to perform Fourier Transform spectroscopy on the coupler and measure its broadband interferometric performance. We also analyze the polarization properties of the coupler, the differential dispersion and phase degradation as well as the modal behavior and the total throughput. We measure broadband interferometric contrasts of 94.9% and 92.1% for unpolarized light in the L and M bands. Spectrally integrated splitting ratios are close to 50% but show chromatic dependence over the considered bandwidths. Additionally, the phase variation due to the combiner is measured and does not exceed 0.04rad and 0.07rad across the band L and M band, respectively. The total throughput of the coupler including Fresnel and injection losses from free-space is 25.4%. The laser-written IO GLS prototype combiners prove to be a reliable technological solution with promising performance for mid-infrared long-baseline interferometry. In the next steps, we will consider more advanced optical functions as well as a fiber-fed input and revise the optical design parameters in order the further enhance the total throughput and achromatic behavior

Intravenous versus epidural analgesia to reduce the incidence of gastrointestinal complications after elective pancreatoduodenectomy (the PAKMAN trial, DRKS 00007784): study protocol for a randomized controlled trial

Background: Despite substantial improvements in surgical and anesthesiological practices leading to decreased mortality of less than 5 % at high-volume centers, pancreatic surgery is still associated with high morbidity rates of up to 50 %. Attention is increasingly directed toward the optimization of perioperative management to reduce complications and enhance postoperative recovery. Currently, two different strategies for postoperative pain management after pancreatoduodenectomy are being routinely used: patient-controlled intravenous analgesia and thoracic epidural analgesia. Evidence is lacking to assess which strategy entails fewer postoperative complications. Methods/design: The PAKMAN trial is designed as an adaptive, pragmatic, randomized, controlled, multicenter, open-label, superiority trial with two parallel study groups. A total of 370 patients scheduled for elective pancreatoduodenectomy will be randomized after giving written informed consent, and 278 patients are needed for analysis. Patients with chronic pancreatitis, severe chronic obstructive pulmonary disease (COPD), American Society of Anesthesiologists (ASA) physical status classification ≥ IV, or chronic pain syndrome will be excluded. The group A intervention includes intraoperative general anesthesia and postoperative patient-controlled intravenous analgesia; the group B intervention comprises combined intraoperative general anesthesia and epidural analgesia with postoperative epidural analgesia. The primary endpoint of this trial is a composite of the gastrointestinal complications (delayed gastric emptying, pancreatic fistula, biliary leak, gastrointestinal bleeding, and postoperative ileus) up to postoperative day 30. The aim is to investigate whether the frequency of gastrointestinal complications following pancreatoduodenectomy can be reduced by 15 % using postoperative, patient-controlled intravenous analgesia compared with epidural analgesia. Discussion: Several previous studies investigating the two different strategies for postoperative pain management have mainly focused on their effectiveness in pain control. However, the PAKMAN trial is the first to compare them with regard to their impact on the surgical endpoint “postoperative gastrointestinal complications” after pancreatoduodenectomy. Trial registration: German Clinical Trials Register, DRKS0000778

Management of medication overuse (MO) and medication overuse headache (MOH) S1 guideline.

INTRODUCTION Chronic headache due to the overuse of medication for the treatment of migraine attacks has a prevalence of 0.5-2.0%. This guideline provides guidance for the management of medication overuse (MO) and medication overuse headache (MOH). RECOMMENDATIONS Treatment of headache due to overuse of analgesics or specific migraine medications involves several stages. Patients with medication overuse (MO) or medication overuse headache (MOH) should be educated about the relationship between frequent use of symptomatic headache medication and the transition from episodic to chronic migraine (chronification), with the aim of reducing and limiting the use of acute medication. In a second step, migraine prophylaxis should be initiated in patients with migraine and overuse of analgesics or specific migraine drugs. Topiramate, onabotulinumtoxinA and the monoclonal antibodies against CGRP or the CGRP-receptor are effective in patients with chronic migraine and medication overuse. In patients with tension-type headache, prophylaxis is performed with amitriptyline. Drug prophylaxis should be supplemented by non-drug interventions. For patients in whom education and prophylactic medication are not effective, pausing acute medication is recommended. This treatment can be performed in an outpatient, day hospital or inpatient setting. Patients with headache due to overuse of opioids should undergo inpatient withdrawal. The success rate of the stepped treatment approach is 50-70% after 6 to 12 months. A high relapse rate is observed in patients with opioid overuse. Tricyclic antidepressants, neuroleptics (antiemetics) and the administration of steroids are recommended for the treatment of withdrawal symptoms or headaches during the medication pause. Consistent patient education and further close monitoring reduce the risk of relapse

Electroweak corrections to Neutralino and Chargino decays into a W-boson in the (N)MSSM

We present the complete electroweak one-loop corrections to the partial widths for two-body decays of a chargino (neutralino) into a W-boson and a neutralino (chargino). We perform the calculation for the minimal and the next-to-minimal supersymmetric standard model using an on-shell renormalization scheme. Particular attention is paid to the question of gauge invariance which is achieved using the so-called pinch technique. Furthermore we show that these corrections show a strong parameter dependence and usually are in the range of 1-10 percent if the neutralino involved is a higgsino or wino like state. However, in case of a bino-like or a singlino-like neutralino the corrections can go up to 50% and more. Moreover we present the public program CNNDecays performing these calculations.Comment: 42 pages, 15 figures; discussion of on-shell masses added, renormalization of the electric charge and Bremsstrahlung integrals corrected, published in Nuclear Physics

Cloud observations in Switzerland using hemispherical sky cameras

We present observations of total cloud cover and cloud type classification results from a sky camera network comprising four stations in Switzerland. In a comprehensive intercomparison study, records of total cloud cover from the sky camera, long-wave radiation observations, Meteosat, ceilometer, and visual observations were compared. Total cloud cover from the sky camera was in 65–85% of cases within ±1 okta with respect to the other methods. The sky camera overestimates cloudiness with respect to the other automatic techniques on average by up to 1.1 ± 2.8 oktas but underestimates it by 0.8 ± 1.9 oktas compared to the human observer. However, the bias depends on the cloudiness and therefore needs to be considered when records from various observational techniques are being homogenized. Cloud type classification was conducted using the k-Nearest Neighbor classifier in combination with a set of color and textural features. In addition, a radiative feature was introduced which improved the discrimination by up to 10%. The performance of the algorithm mainly depends on the atmospheric conditions, site-specific characteristics, the randomness of the selected images, and possible visual misclassifications: The mean success rate was 80–90% when the image only contained a single cloud class but dropped to 50–70% if the test images were completely randomly selected and multiple cloud classes occurred in the images

A Time Projection Chamber with GEM-Based Readout

For the International Large Detector concept at the planned International Linear Collider, the use of time projection chambers (TPC) with micro-pattern gas detector readout as the main tracking detector is investigated. In this paper, results from a prototype TPC, placed in a 1 T solenoidal field and read out with three independent GEM-based readout modules, are reported. The TPC was exposed to a 6 GeV electron beam at the DESY II synchrotron. The efficiency for reconstructing hits, the measurement of the drift velocity, the space point resolution and the control of field inhomogeneities are presented.Comment: 22 pages, 19 figure

Self-medication of migraine and tension-type headache: summary of the evidence-based recommendations of the Deutsche Migräne und Kopfschmerzgesellschaft (DMKG), the Deutsche Gesellschaft für Neurologie (DGN), the Österreichische Kopfschmerzgesellschaft (ÖKSG) and the Schweizerische Kopfwehgesellschaft (SKG)

The current evidence-based guideline on self-medication in migraine and tension-type headache of the German, Austrian and Swiss headache societies and the German Society of Neurology is addressed to physicians engaged in primary care as well as pharmacists and patients. The guideline is especially concerned with the description of the methodology used, the selection process of the literature used and which evidence the recommendations are based upon. The following recommendations about self-medication in migraine attacks can be made: The efficacy of the fixed-dose combination of acetaminophen, acetylsalicylic acid and caffeine and the monotherapies with ibuprofen or naratriptan or acetaminophen or phenazone are scientifically proven and recommended as first-line therapy. None of the substances used in self-medication in migraine prophylaxis can be seen as effective. Concerning the self-medication in tension-type headache, the following therapies can be recommended as first-line therapy: the fixed-dose combination of acetaminophen, acetylsalicylic acid and caffeine as well as the fixed combination of acetaminophen and caffeine as well as the monotherapies with ibuprofen or acetylsalicylic acid or diclofenac. The four scientific societies hope that this guideline will help to improve the treatment of headaches which largely is initiated by the patients themselves without any consultation with their physicians

Polarized QED splittings of massive fermions and dipole subtraction for non-collinear-safe observables

Building on earlier work, the dipole subtraction formalism for photonic corrections is extended to various photon--fermion splittings where the resulting collinear singularities lead to corrections that are enhanced by logarithms of small fermion masses. The difference to the earlier treatment of photon radiation is that now no cancellation of final-state singularities is assumed, i.e. we allow for non-collinear-safe final-state radiation. Moreover, we consider collinear fermion production from incoming photons, forward-scattering of incoming fermions, and collinearly produced fermion-antifermion pairs. For all cases we also provide the corresponding formulas for the phase-space slicing approach, and particle polarization is supported for all relevant situations. A comparison of numerical results obtained with the proposed subtraction procedure and the slicing method is explicitly performed for the sample process e- gamma -> e- mu- mu+.Comment: 44 pages, late