High-Speed, Photon Counting CCD Cameras for Astronomy

The design of electron multiplying CCD cameras require a very different approach from that appropriate for slow scan CCD operation. This paper describes the main problems in using electron multiplying CCDs for high-speed, photon counting applications in astronomy and how these may be substantially overcome. With careful design it is possible to operate the E2V Technologies L3CCDs at rates well in excess of that claimed by the manufacturer, and that levels of clock induced charge dramatically lower than those experienced with commercial cameras that need to operate at unity gain. Measurements of the performance of the E2V Technologies CCD201 operating at 26 MHz will be presented together with a guide to the effective reduction of clock induced charge levels. Examples of astronomical results obtained with our cameras are presented.Comment: 11 pages, 5 figure

High-resolution imaging and spectroscopy in the visible from large ground-based telescopes with natural guide stars

Near-diffraction limited imaging and spectroscopy in the visible on large (8-10 meter) class telescopes has proved to be beyond the capabilities of current adaptive optics technologies, even when using laser guide stars. The need for high resolution visible imaging in any part of the sky suggests that a rather different approach is needed. This paper describes the results of simulations, experiments and astronomical observations that show that a combination of low order adaptive optic correction using a 4-field curvature sensor and fast Lucky Imaging strategies with a photon counting CCD camera systems should deliver 20-25 milliarcsecond resolution in the visible with reference stars as faint as 18.5 magnitude in I band on large telescopes. Such an instrument may be used to feed an integral field spectrograph efficiently using configurations that will also be described.Comment: 8 pages, 3 figure

Photon Counting EMCCDs: New Opportunities for High Time Resolution Astrophysics

Electron Multiplying CCDs (EMCCDs) are used much less often than they might be because of the challenges they offer camera designers more comfortable with the design of slow-scan detector systems. However they offer an entirely new range of opportunities in astrophysical instrumentation. This paper will show some of the exciting new results obtained with these remarkable devices and talk about their potential in other areas of astrophysical application. We will then describe how they may be operated to give the very best performance at the lowest possible light levels. We will show that clock induced charge may be reduced to negligible levels and that, with care, devices may be clocked at significantly higher speeds than usually achieved. As an example of the advantages offered by these detectors we will show how a multi-detector EMCCD curvature wavefront sensor will revolutionise the sensitivity of adaptive optics instruments and been able to deliver the highest resolution images ever taken in the visible or the near infrared.Comment: 9 pages, 5 Figures; SPIE vol 8453, 201

The Negligible Influence of Chronic Obesity on Hospitalization, Clinical Status, and Complications in Elective Posterior Lumbar Interbody Fusion

Background. Posterior lumbar interbody fusion (PLIF) is a common surgical treatment for degenerative spinal instability, but many surgeons consider obesity a contraindication for elective spinal fusion. The aim of this study was to analyze whether obesity has any influence on hospitalization parameters, change in clinical status, or complications. Methods. In this prospective study, regression analysis was used to analyze the influence of the body mass index (BMI) on operating time, postoperative care, hospitalization time, type of postdischarge care, change in paresis or sensory deficits, pain level, wound complications, cerebrospinal fluid leakage, and implant complications. Results. Operating time increased only 2.5 minutes for each increase of BMI by 1. The probability of having a wound complication increased statistically with rising BMI. Nonetheless, BMI accounted for very little of the variation in the data, meaning that other factors or random chances play a much larger role. Conclusions. Obesity has to be considered a risk factor for wound complications in patients undergoing elective PLIF for degenerative instability. However, BMI showed no significant influence on other kinds of peri-or postoperative complications, nor clinical outcomes. So obesity cannot be considered a contraindication for elective PLIF

El Niño variability off Peru during the last 20,000 years

Here we present a high-resolution marine sediment record from the El Niño region off the coast of Peru spanning the last 20,000 years. Sea surface temperature, photosynthetic pigments, and a lithic proxy for El Niño flood events on the continent are used as paleo–El Niño–Southern Oscillation proxy data. The onset of stronger El Niño activity in Peru started around 17,000 calibrated years before the present, which is later than modeling experiments show but contemporaneous with the Heinrich event 1. Maximum El Niño activity occurred during the early and late Holocene, especially during the second and third millennium B.P. The recurrence period of very strong El Niño events is 60–80 years. El Niño events were weak before and during the beginning of the Younger Dryas, during the middle of the Holocene, and during medieval times. The strength of El Niño flood events during the last millennium has positive and negative relationships to global and Northern Hemisphere temperature reconstructions

Influenza in long-term care facilities

Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence. This article is protected by copyright. All rights reserved

Disagreement in primary study selection between systematic reviews on negative pressure wound therapy

<p>Abstract</p> <p>Background</p> <p>Primary study selection between systematic reviews is inconsistent, and reviews on the same topic may reach different conclusions. Our main objective was to compare systematic reviews on negative pressure wound therapy (NPWT) regarding their agreement in primary study selection.</p> <p>Methods</p> <p>This retrospective analysis was conducted within the framework of a systematic review (a full review and a subsequent rapid report) on NPWT prepared by the Institute for Quality and Efficiency in Health Care (IQWiG).</p> <p>For the IQWiG review and rapid report, 4 bibliographic databases (MEDLINE, EMBASE, The Cochrane Library, and CINAHL) were searched to identify systematic reviews and primary studies on NPWT versus conventional wound therapy in patients with acute or chronic wounds. All databases were searched from inception to December 2006.</p> <p>For the present analysis, reviews on NPWT were classified as eligible systematic reviews if multiple sources were systematically searched and the search strategy was documented. To ensure comparability between reviews, only reviews published in or after December 2004 and only studies published before June 2004 were considered.</p> <p>Eligible reviews were compared in respect of the methodology applied and the selection of primary studies.</p> <p>Results</p> <p>A total of 5 systematic reviews (including the IQWiG review) and 16 primary studies were analysed. The reviews included between 4 and 13 primary studies published before June 2004. Two reviews considered only randomised controlled trials (RCTs). Three reviews considered both RCTs and non-RCTs. The overall agreement in study selection between reviews was 96% for RCTs (24 of 25 options) and 57% for non-RCTs (12 of 21 options). Due to considerable disagreement in the citation and selection of non-RCTs, we contacted the review authors for clarification (this was not initially planned); all authors or institutions responded. According to published information and the additional information provided, most differences between reviews arose from variations in inclusion criteria or inter-author study classification, as well as from different reporting styles (citation or non-citation) for excluded studies.</p> <p>Conclusion</p> <p>The citation and selection of primary studies differ between systematic reviews on NPWT, particularly with regard to non-RCTs. Uniform methodological and reporting standards need to be applied to ensure comparability between reviews as well as the validity of their conclusions.</p