Interaction of the solar wind with them Moon: An overview on the results from the SARA experiment aboard Chandrayaan-1

The results from the Sub-keV Atom Reflecting Analyzer (SARA) experiment onboard Chandrayaan-1 have revealed several hitherto unknown and interesting aspects about the interaction of solar wind with the Moon. The SARA experiment had two sensors — CENA and SWIM. The Chandrayaan-1 energetic neutrals analyzer (CENA), detected energetic neutral atoms (ENAs), and the Solar Wind Monitor (SWIM) measured ions of solar wind origin. In this review, we summarize the observations made by the SARA experiment, which are: (1) substantial (~20%) and sustained backscattering of solar wind protons from lunar surface as energetic neutral hydrogen,1 (2) minimagnetosphere around magnetic anomalies on Moon using the backscattered ENAs,2 (3) reflection of solar wind protons from the Moon surface,3 (4) huge (~50%) deflection of solar wind protons over strong magnetic anomalies,4 and (5) presence of protons in the near-lunar plasma wake.5 These results have implications on the lunar plasma environment, implantation of solar wind hydrogen on lunar surface, and behavior of small scale magnetic anomalies on planetary bodies. The SARA observations suggest that similar processes may happen on other airless bodies covered with regolith in the solar system as well as in extra-solar system. This paper presents a review of the results obtained from the SARA observation.

Hybrid aortic arch repair

The successes of thoracic endovascular aortic repair (TEVAR) have spurned new approaches to addressing thoracic aortic pathologies. These hybrid techniques offer an alternative in patients with multi-segmental thoracic aortic pathologies which would have otherwise required a two-step arch replacement and open descending arch repair. The following article offers a clinical insight to the available hybrid approaches, such as rerouting of supra-aortic vessels. Unique complications to endovascular repairs, and technical risks and issues, are also presented along with management options and strategies to minimize such concerns.

Chlamydia prevalence in young attenders of rural and regional primary care services in Australia: a cross-sectional survey.

OBJECTIVE To estimate chlamydia prevalence among 16-29-year-olds attending general practice clinics in Australia. DESIGN, PARTICIPANTS AND SETTING A cross-sectional survey was conducted from May 2010 to December 2012. Sexually experienced 16-29-year-olds were recruited from 134 general practice clinics in 54 rural and regional towns in four states and in nine metropolitan clinics (consecutive patients were invited to participate). Participants completed a questionnaire and were tested for chlamydia. MAIN OUTCOME MEASURE Chlamydia prevalence. RESULTS Of 4284 participants, 197 tested positive for chlamydia (4.6%; 95% CI, 3.9%-5.3%). Prevalence was similar in men (5.2% [65/1257]; 95% CI, 3.9%-6.4%) and women (4.4% [132/3027]; 95% CI, 3.5%-5.2%) (P = 0.25) and high in those reporting genital symptoms or a partner with a sexually transmissible infection (STI) - 17.0% in men (8/47; 95% CI, 2.8%-31.2%); 9.5% in women (16/169; 95% CI, 5.1%-13.8%). Nearly three-quarters of cases (73.4% [130/177]) were diagnosed in asymptomatic patients attending for non-sexual health reasons, and 83.8% of all participants (3258/3890) had attended for non-sexual health reasons. Prevalence was slightly higher in participants from rural and regional areas (4.8% [179/3724]; 95% CI, 4.0%-5.6%) than those from metropolitan areas (3.1% [17/548]; 95% CI, 1.5%-4.7%) (P = 0.08). In multivariable analysis, increasing partner numbers in previous 12 months (adjusted odds ratio [AOR] for three or more partners, 5.11 [95% CI, 2.35-11.08]), chlamydia diagnosis in previous 12 months (AOR, 4.35 [95% CI, 1.52-12.41]) and inconsistent condom use with most recent partner (AOR, 2.90 [95% CI, 1.31-6.40]) were significantly associated with chlamydia in men. In women, increasing partner numbers in previous 12 months (AOR for two partners, 2.59 [95% CI, 1.59-4.23]; AOR for three or more partners, 3.58 [95% CI, 2.26-5.68]), chlamydia diagnosis in previous 12 months (AOR, 3.13 [95% CI, 1.62-6.06]) and age (AOR for 25-29-year-olds, 0.23 [95% CI, 0.12-0.44]) were associated with chlamydia. CONCLUSIONS Chlamydia prevalence is similar in young men and women attending general practice. Testing only those with genital symptoms or a partner with an STI would have missed three-quarters of cases. Most men and women are amenable to being tested in general practice, even in rural and regional areas.

Aufbau eines strukturierten Auswahlverfahrens für Schauspielpatienten

Einleitung In unserer Institution sind die Anforderungen an Schauspielpatienten (SPs) seit 2010 stetig angestiegen(Guttormsen et al., 2013). Zudem stieg auch die Zahl der benötigten SPs insgesamt, so dass wir uns entschieden ein effektives Aufnahmeverfahren gemäss professioneller Qualitätskriterien (Wallace, 2007) zu gestalten. Methoden Seit 2012 organisieren wir 2 x jährlich eine Informations-Veranstaltung für interessierte Bewerber. In einem ersten Teil wird über die Einsätze von SPs informiert und die Rahmenbedingungen dargelegt. In einem zweiten Teil werden Improvisationsübungen in Gruppen, zu zweit oder einzeln durchgeführt. Die SP-Trainer beobachten das Spiel. Zusätzlich wird die Performance gefilmt. Alle Interessierten müssen sich nach dieser 2-stündigen Veranstaltung für 2 weitere Einzeltermine einschreiben: 1. Spielen eines OSCE-Falles (mit SP-Trainer) 2. Körperliche Untersuchung (mit Arzt). Anschliessend wird im Team entschieden, ob alle Voraussetzungen in Bezug auf Teamfähigkeit/Zuverlässigkeit, schauspielerische Fertigkeiten, körperliche Merkmale für eine Anstellung erfüllt sind. Ergebnisse Mit der Einführung dieses strukturierten Auswahlverfahrens haben wir folgendes erreicht: die ausgewählten SPs passen sehr gut in das Team und erfordern weniger organisatorischen Aufwand. Die Rollen können exakter auf das Profil der jeweiligen SPs abgestimmt werden (insbes. durch die körperliche Untersuchung).  Mit der Informationsveranstaltung für die Gruppe wird der zeitliche Aufwand für die Information der SPs gegenüber reinen Einzelinterviews gesenkt (50%), trotzdem können durch die Einzeltermine detaillierte Informationen erhoben werden. Diskussion Seit der Neustrukturierung des Auswahlverfahrens entsprechen die gewählten SPs deutlich besser unserem Anforderungsprofil. In Zukunft planen wir das Anforderungsprofil schriftlich zu dokumentieren und zu veröffentlichen, um das Verfahren transparent zu machen. Literatur: [1] Guttormsen, S., C. Beyeler, R. Bonvin, S. Feller, C. Schirlo, K. Schnabel, T. Schurter, and C. Berendonk. 2013. The new licencing examination for human medicine: from concept to implementation. Swiss Med Wkly 143:w13897. [2] Wallace, P. 2007. Coaching Standardized Patients for Use in the Assessment of Clinical Competence. Springer Publishing Company, New York

Noninvasive pressure difference mapping derived from 4D flow MRI in patients with unrepaired and repaired aortic coarctation.

PURPOSE To develop a method for computing and visualizing pressure differences derived from time-resolved velocity-encoded three-dimensional phase-contrast magnetic resonance imaging (4D flow MRI) and to compare pressure difference maps of patients with unrepaired and repaired aortic coarctation to young healthy volunteers. METHODS 4D flow MRI data of four patients with aortic coarctation either before or after repair (mean age 17 years, age range 3-28, one female, three males) and four young healthy volunteers without history of cardiovascular disease (mean age 24 years, age range 20-27, one female, three males) was acquired using a 1.5-T clinical MR scanner. Image analysis was performed with in-house developed image processing software. Relative pressures were computed based on the Navier-Stokes equation. RESULTS A standardized method for intuitive visualization of pressure difference maps was developed and successfully applied to all included patients and volunteers. Young healthy volunteers exhibited smooth and regular distribution of relative pressures in the thoracic aorta at mid systole with very similar distribution in all analyzed volunteers. Patients demonstrated disturbed pressures compared to volunteers. Changes included a pressure drop at the aortic isthmus in all patients, increased relative pressures in the aortic arch in patients with residual narrowing after repair, and increased relative pressures in the descending aorta in a patient after patch aortoplasty. CONCLUSIONS Pressure difference maps derived from 4D flow MRI can depict alterations of spatial pressure distribution in patients with repaired and unrepaired aortic coarctation. The technique might allow identifying pathophysiological conditions underlying complications after aortic coarctation repair.

3D morphometry using automated aortic segmentation in native MR angiography: an alternative to contrast enhanced MRA?

INTRODUCTION Native-MR angiography (N-MRA) is considered an imaging alternative to contrast enhanced MR angiography (CE-MRA) for patients with renal insufficiency. Lower intraluminal contrast in N-MRA often leads to failure of the segmentation process in commercial algorithms. This study introduces an in-house 3D model-based segmentation approach used to compare both sequences by automatic 3D lumen segmentation, allowing for evaluation of differences of aortic lumen diameters as well as differences in length comparing both acquisition techniques at every possible location. METHODS AND MATERIALS Sixteen healthy volunteers underwent 1.5-T-MR Angiography (MRA). For each volunteer, two different MR sequences were performed, CE-MRA: gradient echo Turbo FLASH sequence and N-MRA: respiratory-and-cardiac-gated, T2-weighted 3D SSFP. Datasets were segmented using a 3D model-based ellipse-fitting approach with a single seed point placed manually above the celiac trunk. The segmented volumes were manually cropped from left subclavian artery to celiac trunk to avoid error due to side branches. Diameters, volumes and centerline length were computed for intraindividual comparison. For statistical analysis the Wilcoxon-Signed-Ranked-Test was used. RESULTS Average centerline length obtained based on N-MRA was 239.0±23.4 mm compared to 238.6±23.5 mm for CE-MRA without significant difference (P=0.877). Average maximum diameter obtained based on N-MRA was 25.7±3.3 mm compared to 24.1±3.2 mm for CE-MRA (P<0.001). In agreement with the difference in diameters, volumes obtained based on N-MRA (100.1±35.4 cm(3)) were consistently and significantly larger compared to CE-MRA (89.2±30.0 cm(3)) (P<0.001). CONCLUSIONS 3D morphometry shows highly similar centerline lengths for N-MRA and CE-MRA, but systematically higher diameters and volumes for N-MRA.

Sutureless Aortic Valve Replacement International Registry (SU-AVR-IR): design and rationale from the International Valvular Surgery Study Group (IVSSG).

BACKGROUND Sutureless aortic valve replacement (SU-AVR) is an innovative approach which shortens cardiopulmonary bypass and cross-clamp durations and may facilitate minimally invasive approach. Evidence outlining its safety, efficacy, hemodynamic profile and potential complications is replete with small-volume observational studies and few comparative publications. METHODS Minimally invasive aortic valve surgery and high-volume SU-AVR replacement centers were contacted for recruitment into a global collaborative coalition dedicated to sutureless valve research. A Research Steering Committee was formulated to direct research and support the mission of providing registry evidence warranted for SU-AVR. RESULTS The International Valvular Surgery Study Group (IVSSG) was formed under the auspices of the Research Steering Committee, comprised of 36 expert valvular surgeons from 27 major centers across the globe. IVSSG Sutureless Projects currently proceeding include the Retrospective and Prospective Phases of the SU-AVR International Registry (SU-AVR-IR). CONCLUSIONS The global pooling of data by the IVSSG Sutureless Projects will provide required robust clinical evidence on the safety, efficacy and hemodynamic outcomes of SU-AVR.