1,400 research outputs found

    Facets of radio-loud AGN evolution : a LOFAR surveys perspective

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    Radio observations provide a unique view of black holes in the Universe. This thesis presents low frequency radio images and uses the radio sources in those images to study the evolution of black holes and galaxies through the age of the Universe.Galaxie

    Influence of enrollment sequence effect on observed outcomes in the ADDRESS and PROWESS studies of drotrecogin alfa (activated) in patients with severe sepsis

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    INTRODUCTION: We performed a study to determine whether an enrollment sequence effect noted in the PROWESS (recombinant human activated Protein C Worldwide Evaluation in Severe Sepsis) trial exists in the ADDRESS (Administration of Drotrecogin Alfa [Activated] [DrotAA] in Early Stage Severe Sepsis) trial. METHODS: We evaluated prospectively defined subgroups from two large phase 3 clinical trials: ADDRESS, which included 516 sites in 34 countries, and PROWESS, which included 164 sites in 11 countries. ADDRESS consisted of patients with severe sepsis at low risk of death not indicated for treatment with DrotAA. PROWESS consisted of patients with severe sepsis with one or more organ dysfunctions. DrotAA (24 microg/kg per hour) or placebo was infused for 96 hours. RESULTS: In ADDRESS and PROWESS, there was a statistically significant interaction between the DrotAA treatment effect and the sequence in which patients were enrolled. In both trials, higher mortality was associated with DrotAA use in the subgroup of patients enrolled first at study sites. Compared with placebo, PROWESS mortality was lower with DrotAA treatment for the second and subsequent patients enrolled, whereas in ADDRESS, mortality remained higher for the second patient enrolled but thereafter was lower for DrotAA-treated patients. Comparison of patients enrolled first with subsequent patients enrolled indicated that the characteristics of patients changed. Subsequently enrolled patients were treated earlier, were less likely to suffer nonserious bleeds (ADDRESS), and experienced fewer protocol violations (PROWESS). CONCLUSIONS: Analyses suggest that an enrollment sequence effect was present in the ADDRESS and PROWESS trials. Analysis of this effect on outcomes suggests that it is most apparent in patients at lower risk of death. In PROWESS, this effect appeared to be associated with a reduction of the DrotAA treatment effect for the first patients enrolled at each site. In ADDRESS, this effect may have contributed to early termination of the study. The finding of an enrollment sequence effect in two separate trials suggests that trial designs, site selection and training, data collection and monitoring, and statistical analysis plans may need to be adjusted for these potentially confounding events. TRIAL REGISTRATION: ADDRESS trial registration number: NCT00568737. PROWESS was completed before trial registration was required

    The Role of the Pediatric Nurse Practitioner in the Comprehensive Management of Pediatric Oncology Patients in the Inpatient Setting

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    The role of the pediatric nurse practitioner (PNP) in the comprehensive management of pediatric oncology patients in the inpatient setting was examined at a large tertiary teaching hospital. This article shows role responsibilities including new diagnosis teaching, procedures, routine chemotherapy, patients' comprehensive medical management, coordination of nursing care across settings, phone triage, and professional development. A PNP's typical day is highlighted to illustrate the innovative merging of traditional ambulatory care roles with that of the PNP as a comprehensive manager of pediatric oncology patients in the inpatient setting. This role provides a more seamless care experience and provides critical links in the delivery of health care to pediatric oncology patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68349/2/10.1177_104345429901600202.pd

    Unified dark energy models : a phenomenological approach

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    A phenomenological approach is proposed to the problem of universe accelerated expansion and of the dark energy nature. A general class of models is introduced whose energy density depends on the redshift zz in such a way that a smooth transition among the three main phases of the universe evolution (radiation era, matter domination, asymptotical de Sitter state) is naturally achieved. We use the estimated age of the universe, the Hubble diagram of Type Ia Supernovae and the angular size - redshift relation for compact and ultracompact radio structures to test whether the model is in agreement with astrophysical observation and to constrain its main parameters. Although phenomenologically motivated, the model may be straightforwardly interpreted as a two fluids scenario in which the quintessence is generated by a suitably chosen scalar field potential. On the other hand, the same model may also be read in the context of unified dark energy models or in the framework of modified Friedmann equation theories.Comment: 12 pages, 10 figures, accepted for publication on Physical Review

    Multi-gap superconductivity in a BaFe1.84Co0.16As2 film from optical measurements at terahertz frequencies

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    We measured the THz reflectance properties of a high quality epitaxial thin film of the Fe-based superconductor BaFe1.84_{1.84}Co0.16_{0.16}As2_2 with Tc_c=22.5 K. The film was grown by pulsed laser deposition on a DyScO3_3 substrate with an epitaxial SrTiO3_3 intermediate layer. The measured RS/RNR_S/R_N spectrum, i.e. the reflectivity ratio between the superconducting and normal state reflectance, provides clear evidence of a superconducting gap ΔA\Delta_A close to 15 cm1^{-1}. A detailed data analysis shows that a two-band, two-gap model is absolutely necessary to obtain a good description of the measured RS/RNR_S/R_N spectrum. The low-energy ΔA\Delta_A gap results to be well determined (ΔA\Delta_A=15.5±\pm0.5 cm1^{-1}), while the value of the high-energy gap ΔB\Delta_B is more uncertain (ΔB\Delta_B=55±\pm7 cm1^{-1}). Our results provide evidence of a nodeless isotropic double-gap scenario, with the presence of two optical gaps corresponding to 2Δ/kTc\Delta/kT_c values close to 2 and 7.Comment: Published Versio

    Anthropogenic Space Weather

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    Anthropogenic effects on the space environment started in the late 19th century and reached their peak in the 1960s when high-altitude nuclear explosions were carried out by the USA and the Soviet Union. These explosions created artificial radiation belts near Earth that resulted in major damages to several satellites. Another, unexpected impact of the high-altitude nuclear tests was the electromagnetic pulse (EMP) that can have devastating effects over a large geographic area (as large as the continental United States). Other anthropogenic impacts on the space environment include chemical release ex- periments, high-frequency wave heating of the ionosphere and the interaction of VLF waves with the radiation belts. This paper reviews the fundamental physical process behind these phenomena and discusses the observations of their impacts.Comment: 71 pages, 35 figure
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