Intense Mass Loss from C-rich AGB Stars at low Metallicity?

We argue that the energy injection of pulsations may be of greater importance to the mass-loss rate of AGB stars than metallicity, and that the mass-loss trend with metallicity is not as simple as sometimes assumed. Using our detailed radiation hydrodynamical models that include dust formation, we illustrate the effects of pulsation energy on wind properties. We find that the mass-loss rate scales with the kinetic energy input by pulsations as long as a dust-saturated wind does not occur, and all other stellar parameters are kept constant. This includes the absolute abundance of condensible carbon (not bound in CO), which is more relevant than keeping the C/O-ratio constant when comparing stars of different metallicity. The pressure and temperature gradients in the atmospheres of stars, become steeper and flatter, respectively, when the metallicity is reduced, while the radius where the atmosphere becomes opaque is typically associated with a higher gas pressure. This effect can be compensated for by adjusting the velocity amplitude of the variable inner boundary (piston), which is used to simulate the effects of pulsation, to obtain models with comparable kinetic-energy input. Hence, it is more relevant to compare models with similar energy-injections than of similar velocity amplitude. Since there is no evidence for weaker pulsations in low-metallicity AGB stars, we conclude that it is unlikely that low-metallicity C-stars have a lower mass-loss rate, than their more metal-rich counterparts with similar stellar parameters, as long as they have a comparable amount of condensible carbon.Comment: 4 pages, 3 figures. Accepted for publication in A&A. Updated after language editing. Additional typos fixe

The relation between sea ice thickness and freeboard in the Arctic

Retrieval of Arctic sea ice thickness from CryoSat-2 radar altimeter freeboard data requires observational data to verify the relation between these two variables. In this study in-situ ice and snow data from 689 observation sites, obtained during the Sever expeditions in the 1980s, have been used to establish an empirical relation between thickness and freeboard of FY ice in late winter. Estimates of mean and variability of snow depth, snow density and ice density were produced on the basis of many field observations. These estimates have been used in the hydrostatic equilibrium equation to retrieve ice thickness as a function of ice freeboard, snow depth and snow/ice density. The accuracy of the ice thickness retrieval has been calculated from the estimated variability in ice and snow parameters and error of ice freeboard measurements. It is found that uncertainties of ice density and freeboard are the major sources of error in ice thickness calculation. For FY ice, retrieval of ≈ 1.0 m (2.0 m) thickness has an uncertainty of 46% (37%), and for MY ice, retrieval of 2.4 m (3.0 m) thickness has an uncertainty of 20% (18%), assuming that the freeboard error is ± 0.03 m for both ice types. For MY ice the main uncertainty is ice density error, since the freeboard error is relatively smaller than that for FY ice. If the freeboard error can be reduced to 0.01 m by averaging measurements from CryoSat-2, the error in thickness retrieval is reduced to about 32% for a 1.0 m thick FY floe and to about 18% for a 2.4 m thick MY floe. The remaining error is dominated by uncertainty in ice density. Provision of improved ice density data is therefore important for accurate retrieval of ice thickness from CryoSat-2 data

Fetal electrocardiogram: ST waveform analysis in intrapartum surveillance

ST waveform analysis of fetal electrocardiogram (ECG) for intrapartum surveillance (STAN) is a newly introduced method for fetal surveillance. The purpose of this commentary is to assist in the proper use of fetal ECG in combination with cardiotocography (CTG) during labour. Guidelines and recommendations concerning CTG and ST waveform interpretation and classification are stated that were agreed on by the European experts on ST waveform analysis for intrapartum surveillance during a meeting in Utretcht, the Netherlands in January 2007

Do male and female trauma patients receive the same prehospital care? : An observational follow-up study

Background: Trauma-related mortality can be lowered by efficient prehospital care. Less is known about whether gender influences the prehospital trauma care provided. The aim of this study was to explore gender-related differences in prehospital trauma care of severely injured trauma patients, with a special focus on triage, transportation, and interventions. Methods: We performed a retrospective observational study based on local trauma registries and hospital and ambulance records in Stockholm County, Sweden. A total of 383 trauma patients (279 males and 104 females) > 15years of age with an Injury Severity Score (ISS) of > 15 transported to emergency care hospitals in the Stockholm area were included. Results: Male patients had a 2.75 higher odds ratio (95% CI, 1.2-6.2) for receiving the highest prehospital priority compared to females on controlling for injury mechanism and vital signs on scene. No significant difference between genders was detected regarding other aspects of the prehospital care provided. Conclusions: This study indicated that prehospital prioritization among severely injured late adolescent and adult trauma patients differs between genders. Knowledge of a more diffuse presentation of symptoms in female trauma patients despite severe injury may help to adapt and improve prehospital trauma care for this group.Peer reviewe

A simple double-focusing electrostatic ion beam deflector

We have developed an electrostatic, double-focusing 90° deflector for fast ion beams consisting of concentric cylindrical plates of differing heights. In contrast to standard cylindrical deflectors, our design allows for focusing of an incoming parallel beam not only in the plane of deflection but also in the orthogonal direction. The optical properties of our design resemble those of a spherical capacitor deflector while it is much easier and more cost effective to manufacture

UK experience of liver transplantation for erythropoietic protoporphyria

Erythropoietic protoporphyria (EPP) is characterised by excess production of free protoporphyrin from the bone marrow, most commonly due to deficiency of the enzyme ferrochelatase. Excess protoporphyrin gives rise to the cutaneous photosensitivity characteristic of the disease, and in a minority of patients leads to end-stage liver disease necessitating liver transplantation (LT). There is limited information regarding the timing, impact and long-term outcome of LT in such patients, thus we aimed to identify the indications and outcomes of all transplants performed for EPP in the UK using data from the UK Transplant Registry. Between 1987 and 2009, five patients underwent LT for EPP liver disease. Median follow-up was 60 months, and there were two deaths at 44 and 95 months from causes unrelated to liver disease. The remaining recipients are alive at 22.4 years, 61 months and 55 months after transplant. A high rate of postoperative biliary stricturing requiring multiple biliary interventions was observed. Recurrent EPP-liver disease occurred in 4/5 (80%) of patients but graft failure has not been observed. Given the role of biliary obstruction in inducing EPP-mediated liver damage, we suggest that consideration should be given for construction of a Roux loop at the time of transplant. Thus we demonstrate that although EPP liver transplant recipients have a good long-term survival, comparable to patients undergoing LT for other indications, biliary complications and disease recurrence are almost universal, and bone marrow transplantation should be considered where possible

Fluorine in AGB Carbon Stars Revisited

A reanalysis of the fluorine abundance in three Galactic AGB carbon stars (TX Psc, AQ Sgr and R Scl) has been performed from the molecular HF (1-0) R9 line at 2.3358 $\mu$m. High-resolution (R$\sim 50000$) and high signal to noise spectra obtained with the CRIRES spectrograph and the VLT telescope or from the NOAO archive (for TX Psc) have been used. Our abundance analysis uses the latest generation of MARCS model atmospheres for cool carbon rich stars. Using spectral synthesis in LTE we derive for these stars fluorine abundances that are systematically lower by $\sim 0.8$ dex in average with respect to the sole previous estimates by Jorissen, Smith & Lambert (1992). The possible reasons of this discrepancy are explored. We conclude that the difference may rely on the blending with C-bearing molecules (CN and C$_2$) that were not properly taken into account in the former study. The new F abundances are in better agreement with the prediction of full network stellar models of low mass AGB stars. These models also reproduce the $s$-process elements distribution in the sampled stars. This result, if confirmed in a larger sample of AGB stars, might alleviate the current difficulty to explain the largest [F/O] ratios found by Jorissen et al. In particular, it may not be necessary to search for alternative nuclear chains affecting the production of F in AGB stars.Comment: 25 pages, 3 figures. to be appear in The Astrophysical Journal (Jan 2009 issue

Individual quality assessment of autografting by probability estimation for clinical endpoints: a prospective validation study from the European group for blood and marrow transplantation.

The aim of supportive autografting is to reduce the side effects from stem cell transplantation and avoid procedure-related health disadvantages for patients at the lowest possible cost and resource expenditure. Economic evaluation of health care is becoming increasingly important. We report clinical and laboratory data collected from 397 consecutive adult patients (173 non-Hodgkin lymphoma, 30 Hodgkin lymphoma, 160 multiple myeloma, 7 autoimmune diseases, and 28 acute leukemia) who underwent their first autologous peripheral blood stem cell transplantation (PBSCT). We considered primary endpoints evaluating health economic efficacy (eg, antibiotic administration, transfusion of blood components, and time in hospital), secondary endpoints evaluating toxicity (in accordance with Common Toxicity Criteria), and tertiary endpoints evaluating safety (ie, the risk of regimen-related death or disease progression within the first year after PBSCT). A time-dependent grading of efficacy is proposed with day 21 for multiple myeloma and day 25 for the other disease categories (depending on the length of the conditioning regimen) as the acceptable maximum time in hospital, which together with antibiotics, antifungal, or transfusion therapy delineates four groups: favorable (≤7 days on antibiotics and no transfusions; ≤21 [25] days in hospital), intermediate (from 7 to 10 days on antibiotics and 7 days on antibiotics, >3 but 30/34 days in hospital after transplantation), and very unfavorable (>10 days on antibiotics, >6 transfusions; >30 to 34 days in hospital). The multivariate analysis showed that (1) PBSC harvests of ≥4 × 106/kg CD34 + cells in 1 apheresis procedure were associated with a favorable outcome in all patient categories except acute myelogenous leukemia and acute lymphoblastic leukemia (P = .001), (2) ≥5 × 106/kg CD34 + cells infused predicted better transplantation outcome in all patient categories (P 500 mL) (P = .002), and (5) patients with a central venous catheter during both collection and infusion of PBSC had a more favorable outcome post-PBSCT than peripheral access (P = .007). The type of mobilization regimen did not affect the outcome of auto-PBSCT. The present study identified predictive variables, which may be useful in future individual pretransplantation probability evaluations with the goal to improve supportive care

Sutureless prepuceplasty with wound healing by second intention: An alternative surgical approach in children's phimosis treatment

Abstract Background A new technique for the treatment of children's phimosis is presented that minimizes the repairing time, the postoperative complications and maintains the physical foreskin appearance intact. Methods Eightyseven children with phimosis were treated with this new developed technique, between 2003 and 2005. Sutureless prepuceplasty creates a permanent surgical extension of the close prepuce. Stretching and retraction of phimotic foreskin reveals a tight prepuce ring that is cutting in its dorsal surface longitudinally. Rarely triple symmetric incisions in the preputial outlet are necessary. The foreskin is loose and moves absolutely free in bilateral courses. The wounds are healing by second intention. Antisepsis, steroids and Elicina cream, (which contains allantoin, collagen, elastin, glycolic acid and vitamins A, D, and E) should apply daily, for twenty to thirty days. Results The foreskin is moving in centripetal or efferent courses absolutely loosely, painlessly and bloodlessly. The mean time of follow-up was 27 months (one to four years). No complications were observed. Conclusion Sutureless prepuceplasty may present an acceptable alternative in children's phimosis reconstruction.</p