Bestimmung der Analysierstärke des A4-Compton-Rückstreupolarimeters zur Messung der longitudinalen Spinpolarisation des MAMI-Elektronenstrahls

Das A4-Experiment bestimmt den Beitrag der Strangequarks zu den elektromagnetischen Formfaktoren des Nukleons durch Messung der Paritätsverletzung in der elastischen Elektron-Nukleon-Streuung. Diese Messungen werden mit dem spinpolarisierten Elektronenstrahl des Mainzer Mikrotrons (MAMI) bei Strahlenergien zwischen 315 und 1508 MeV ndurchgeführt. Die Bestimmung des Strahlpolarisationsgrades ist für die Analyse der Daten unerläßlich, um die physikalische Asymmetrie aus der gemessenen paritätsverletzenden Asymmetrie extrahieren zu können. Aus diesem Grund wird von der A4-Kollaboration ein neuartiges Compton-Laserrückstreupolarimeter entwickelt, das eine zerstörungsfreie Messung der Strahlpolarisation, parallel zum laufenden Paritätsexperiment erlaubt. Um den zuverlässigen Dauerbetrieb des Polarimeters zu ermöglichen, wurde das Polarimeter im Rahmen dieser Arbeit weiterentwickelt. Das Datenerfassungssystem für Photonen- und Elektronendetektor wurde neu aufgebaut und im Hinblick auf die Verarbeitung hoher Raten optimiert. Zum Nachweis der rückgestreuten Photonen wurde ein neuartiger Detektor (LYSO) in Betrieb genommen. Darüber hinaus wurden GEANT4-Simulationen der Detektoren durchgeführt und eine Analyseumgebung für die Extraktion von Comptonasymmetrien aus den Rückstreudaten entwickelt. Das Analyseverfahren nutzt die Möglichkeit, die rückgestreuten Photonen durch koinzidente Detektion der gestreuten Elektronen energiemarkiert nachzuweisen (Tagging). Durch die von der Energiemarkierung eingeführte differentielle Energieskala wird somit eine präzise Bestimmung der Analysierstärke möglich. In der vorliegenden Arbeit wurde die Analysierstärke des Polarimeters bestimmt, so daß nun das Produkt von Elektronen- und Laserstrahlpolarisation bei einem Strahlstrom von 20 muA, parallel zum laufenden Paritätsexperiment, mit einer statistischen Genauigkeit von 1% in 24 Stunden bei 855 MeV bzw. <1% in 12 Stunden bei 1508 MeV gemessen werden kann. In Kombination mit der Bestimmung der Laserpolarisation in einer parallelen Arbeit (Y. Imai) auf 1% kann die statistische Unsicherheit der Strahlpolarisation im A4-Experiment von zuvor 5% auf nun 1,5% bei 1508MeV verringert werden. Für die Daten zur Messung der paritätsverletzenden Elektronenstreuung bei einem Viererimpulsübertrag von $Q^2=0,6 (GeV/c)^2$ beträgt die Rohasymmetrie beim derzeitigen Stand der Analyse $A_{PV}^{Roh} = ( -20,0 pm 0,9_{stat} ) cdot 10^{-6}$. Für eine Strahlpolarisation von 80% erhält man einen Gesamtfehler von $1,68 cdot 10^{-6}$ für $Delta P_e/P_e = 5 %$. Als Ergebnis dieser Arbeit wird sich dieser Fehler durch Analyse der Daten des Compton-Laserrückstreupolarimeters um 29% auf $1,19 cdot 10^{-6}$ ($Delta P_e/P_e = 1,5 %$) verringern lassen.

Experimental Analysis and Numerical Simulation of Quench in Superconducting HTS Tapes and Coils

The quench characteristics of second generation (2 G) YBCO Coated Conductor (CC) tapes are of fundamental importance for the design and safe operation of superconducting cables and magnets based on this material. Their ability to transport high current densities at high temperature, up to 77 K, and at very high fields, over 20 T, together with the increasing knowledge in their manufacturing, which is reducing their cost, are pushing the use of this innovative material in numerous system applications, from high field magnets for research to motors and generators as well as for cables. The aim of this Ph. D. thesis is the experimental analysis and numerical simulations of quench in superconducting HTS tapes and coils. A measurements facility for the characterization of superconducting tapes and coils was designed, assembled and tested. The facility consist of a cryostat, a cryocooler, a vacuum system, resistive and superconducting current leads and signal feedthrough. Moreover, the data acquisition system and the software for critical current and quench measurements were developed. A 2D model was developed using the finite element code COMSOL Multiphysics R . The problem of modeling the high aspect ratio of the tape is tackled by multiplying the tape thickness by a constant factor, compensating the heat and electrical balance equations by introducing a material anisotropy. The model was then validated both with the results of a 1D quench model based on a non-linear electric circuit coupled to a thermal model of the tape, to literature measurements and to critical current and quench measurements made in the cryogenic facility. Finally the model was extended to the study of coils and windings with the definition of the tape and stack homogenized properties. The procedure allows the definition of a multi-scale hierarchical model, able to simulate the windings with different degrees of detail.

SMARTDIAB: a communication and information technology approach for the intelligent monitoring, management and follow-up of type 1 diabetes patients

SMARTDIAB is a platform designed to support the monitoring, management, and treatment of patients with type 1 diabetes mellitus (T1DM), by combining state-of-the-art approaches in the fields of database (DB) technologies, communications, simulation algorithms, and data mining. SMARTDIAB consists mainly of two units: 1) the patient unit (PU); and 2) the patient management unit (PMU), which communicate with each other for data exchange. The PMU can be accessed by the PU through the internet using devices, such as PCs/laptops with direct internet access or mobile phones via a Wi-Fi/General Packet Radio Service access network. The PU consists of an insulin pump for subcutaneous insulin infusion to the patient and a continuous glucose measurement system. The aforementioned devices running a user-friendly application gather patient's related information and transmit it to the PMU. The PMU consists of a diabetes data management system (DDMS), a decision support system (DSS) that provides risk assessment for long-term diabetes complications, and an insulin infusion advisory system (IIAS), which reside on a Web server. The DDMS can be accessed from both medical personnel and patients, with appropriate security access rights and front-end interfaces. The DDMS, apart from being used for data storage/retrieval, provides also advanced tools for the intelligent processing of the patient's data, supporting the physician in decision making, regarding the patient's treatment. The IIAS is used to close the loop between the insulin pump and the continuous glucose monitoring system, by providing the pump with the appropriate insulin infusion rate in order to keep the patient's glucose levels within predefined limits. The pilot version of the SMARTDIAB has already been implemented, while the platform's evaluation in clinical environment is being in progress.

Webinar Training: an acceptable, feasible and effective approach for multi-site medical record abstraction: the BOWII experience

Background Abstractor training is a key element in creating valid and reliable data collection procedures. The choice between in-person vs. remote or simultaneous vs. sequential abstractor training has considerable consequences for time and resource utilization. We conducted a web-based (webinar) abstractor training session to standardize training across six individual Cancer Research Network (CRN) sites for a study of breast cancer treatment effects in older women (BOWII). The goals of this manuscript are to describe the training session, its participants and participants' evaluation of webinar technology for abstraction training. Findings A webinar was held for all six sites with the primary purpose of simultaneously training staff and ensuring consistent abstraction across sites. The training session involved sequential review of over 600 data elements outlined in the coding manual in conjunction with the display of data entry fields in the study's electronic data collection system. Post-training evaluation was conducted via Survey Monkey©. Inter-rater reliability measures for abstractors within each site were conducted three months after the commencement of data collection. Ten of the 16 people who participated in the training completed the online survey. Almost all (90%) of the 10 trainees had previous medical record abstraction experience and nearly two-thirds reported over 10 years of experience. Half of the respondents had previously participated in a webinar, among which three had participated in a webinar for training purposes. All rated the knowledge and information delivered through the webinar as useful and reported it adequately prepared them for data collection. Moreover, all participants would recommend this platform for multi-site abstraction training. Consistent with participant-reported training effectiveness, results of data collection inter-rater agreement within sites ranged from 89 to 98%, with a weighted average of 95% agreement across sites. Conclusions Conducting training via web-based technology was an acceptable and effective approach to standardizing medical record review across multiple sites for this group of experienced abstractors. Given the substantial time and cost savings achieved with the webinar, coupled with participants' positive evaluation of the training session, researchers should consider this instructional method as part of training efforts to ensure high quality data collection in multi-site studies.

Internet based multicenter study for thoracolumbar injuries: a new concept and preliminary results

This article reports about the internet based, second multicenter study (MCS II) of the spine study group (AG WS) of the German trauma association (DGU). It represents a continuation of the first study conducted between the years 1994 and 1996 (MCS I). For the purpose of one common, centralised data capture methodology, a newly developed internet-based data collection system ( http://www.memdoc.org ) of the Institute for Evaluative Research in Orthopaedic Surgery of the University of Bern was used. The aim of this first publication on the MCS II was to describe in detail the new method of data collection and the structure of the developed data base system, via internet. The goal of the study was the assessment of the current state of treatment for fresh traumatic injuries of the thoracolumbar spine in the German speaking part of Europe. For that reason, we intended to collect large number of cases and representative, valid information about the radiographic, clinical and subjective treatment outcomes. Thanks to the new study design of MCS II, not only the common surgical treatment concepts, but also the new and constantly broadening spectrum of spine surgery, i.e. vertebro-/kyphoplasty, computer assisted surgery and navigation, minimal-invasive, and endoscopic techniques, documented and evaluated. We present a first statistical overview and preliminary analysis of 18 centers from Germany and Austria that participated in MCS II. A real time data capture at source was made possible by the constant availability of the data collection system via internet access. Following the principle of an application service provider, software, questionnaires and validation routines are located on a central server, which is accessed from the periphery (hospitals) by means of standard Internet browsers. By that, costly and time consuming software installation and maintenance of local data repositories are avoided and, more importantly, cumbersome migration of data into one integrated database becomes obsolete. Finally, this set-up also replaces traditional systems wherein paper questionnaires were mailed to the central study office and entered by hand whereby incomplete or incorrect forms always represent a resource consuming problem and source of error. With the new study concept and the expanded inclusion criteria of MCS II 1, 251 case histories with admission and surgical data were collected. This remarkable number of interventions documented during 24 months represents an increase of 183% compared to the previously conducted MCS I. The concept and technical feasibility of the MEMdoc data collection system was proven, as the participants of the MCS II succeeded in collecting data ever published on the largest series of patients with spinal injuries treated within a 2 year period.

Pharmacovigilance of drug allergy and hypersensitivity using the ENDA-DAHD database and the GALEN platform. The Galenda project

Nonallergic hypersensitivity and allergic reactions are part of the many different types of adverse drug reactions (ADRs). Databases exist for the collection of ADRs. Spontaneous reporting makes up the core data-generating system of pharmacovigilance, but there is a large under-estimation of allergy/hypersensitivity drug reactions. A specific database is therefore required for drug allergy and hypersensitivity using standard operating procedures (SOPs), as the diagnosis of drug allergy/hypersensitivity is difficult and current pharmacovigilance algorithms are insufficient. Although difficult, the diagnosis of drug allergy/hypersensitivity has been standardized by the European Network for Drug Allergy (ENDA) under the aegis of the European Academy of Allergology and Clinical Immunology and SOPs have been published. Based on ENDA and Global Allergy and Asthma European Network (GA(2)LEN, EU Framework Programme 6) SOPs, a Drug Allergy and Hypersensitivity Database (DAHD((R))) has been established under FileMaker((R)) Pro 9. It is already available online in many different languages and can be accessed using a personal login. GA(2)LEN is a European network of 27 partners (16 countries) and 59 collaborating centres (26 countries), which can coordinate and implement the DAHD across Europe. The GA(2)LEN-ENDA-DAHD platform interacting with a pharmacovigilance network appears to be of great interest for the reporting of allergy/hypersensitivity ADRs in conjunction with other pharmacovigilance instruments.

[A mortality databank for international comparison and background information]

This article describes the structure and utilization of a computerized databank system for WHO mortality data. This system makes available "at finger-tips" data which previously were published by WHO in its blue volumes. The data can be handled much more flexible. At the moment the system provides information on age-standardized rates (direct standardization), total number of cases, as well as cover per age-group and year for about a hundred countries. The time period covered is 1950-1985, with exceptions for data which are not available to WHO.

Hemodynamic variables and mortality in cardiogenic shock: a retrospective cohort study

INTRODUCTION: Despite the key role of hemodynamic goals, there are few data addressing the question as to which hemodynamic variables are associated with outcome or should be targeted in cardiogenic shock patients. The aim of this study was to investigate the association between hemodynamic variables and cardiogenic shock mortality. METHODS: Medical records and the patient data management system of a multidisciplinary intensive care unit (ICU) were reviewed for patients admitted because of cardiogenic shock. In all patients, the hourly variable time integral of hemodynamic variables during the first 24 hours after ICU admission was calculated. If hemodynamic variables were associated with 28-day mortality, the hourly variable time integral of drops below clinically relevant threshold levels was computed. Regression models and receiver operator characteristic analyses were calculated. All statistical models were adjusted for age, admission year, mean catecholamine doses and the Simplified Acute Physiology Score II (excluding hemodynamic counts) in order to account for the influence of age, changes in therapies during the observation period, the severity of cardiovascular failure and the severity of the underlying disease on 28-day mortality. RESULTS: One-hundred and nineteen patients were included. Cardiac index (CI) (P = 0.01) and cardiac power index (CPI) (P = 0.03) were the only hemodynamic variables separately associated with mortality. The hourly time integral of CI drops <3, 2.75 (both P = 0.02) and 2.5 (P = 0.03) L/min/m2 was associated with death but not that of CI drops <2 L/min/m2 or lower thresholds (all P > 0.05). The hourly time integral of CPI drops <0.5-0.8 W/m2 (all P = 0.04) was associated with 28-day mortality but not that of CPI drops <0.4 W/m2 or lower thresholds (all P > 0.05). CONCLUSIONS: During the first 24 hours after intensive care unit admission, CI and CPI are the most important hemodynamic variables separately associated with 28-day mortality in patients with cardiogenic shock. A CI of 3 L/min/m2 and a CPI of 0.8 W/m2 were most predictive of 28-day mortality. Since our results must be considered hypothesis-generating, randomized controlled trials are required to evaluate whether targeting these levels as early resuscitation endpoints can improve mortality in cardiogenic shock.

Automatische visuelle Datensammlung aus Materialflusssystemen und ihre Anwendung in Simulationsmodellen

Simulation ist heute eine unentbehrliche Komponente bei der Planung und Analyse von modernen Materialflusssystemen. Ihr Nutzen hängt in hohem Maße davon ab, wie akkurat sie das physikalische System modellieren kann. In diesem Artikel wird ein Kamera-basiertes System vorgestellt, welches in bestimmten Einsatzfällen bei der Datensammlung behilflich sein kann. Vor- und Nachteile des Systems werden diskutiert und die Einsatzfälle abgegrenzt. Am Ende des Artikels wird das Kamera-basierte Datensammlungssystem an Beispielen verdeutlicht und es wird gezeigt, wie die Ergebnisse in Simulationsmodellen angewendet werden können.

Evaluating atmospheric methane inversion model results for Pallas, northern Finland

A state-of-the-art inverse model, CarbonTracker Data Assimilation Shell (CTDAS), was used to optimize estimates of methane (CH4) surface fluxes using atmospheric observations of CH4 as a constraint. The model consists of the latest version of the TM5 atmospheric chemistry-transport model and an ensemble Kalman filter based data assimilation system. The model was constrained by atmospheric methane surface concentrations, obtained from the World Data Centre for Greenhouse Gases (WDCGG). Prior methane emissions were specified for five sources: biosphere, anthropogenic, fire, termites and ocean, of which bio-sphere and anthropogenic emissions were optimized. Atmospheric CH 4 mole fractions for 2007 from northern Finland calculated from prior and optimized emissions were compared with observations. It was found that the root mean squared errors of the posterior esti - mates were more than halved. Furthermore, inclusion of NOAA observations of CH 4 from weekly discrete air samples collected at Pallas improved agreement between posterior CH 4 mole fraction estimates and continuous observations, and resulted in reducing optimized biosphere emissions and their uncertainties in northern Finland.

Patient-Rated Outcomes of Lumbar Fusion in Patients with Degenerative Disease of the Lumbar Spine: Does Age Matter?

STUDY DESIGN Single centre retrospective study of prospectively collected data, nested within the Eurospine Spine Tango data acquisition system. OBJECTIVE The aim of this study was to assess the patient-rated outcome and complication rates associated with lumbar fusion procedures in three different age groups. SUMMARY OF BACKGROUND DATA There is a general reluctance to consider spinal fusion procedures in elderly patients due to the increased likelihood of complications. METHODS Before and at 3, 12, and 24 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI). At the 3-, 12-, and 24-month follow-ups they also rated the Global Treatment Outcome (GTO) and their satisfaction with care. Patients were divided into three age groups: younger (≥50y < 65y; n = 317), older (≥65y < 80y; n = 350), and geriatric (≥ 80y; n = 40). RESULTS 707 consecutive patients were included. The preoperative comorbidity status differed significantly (p < 0.0001) between the age groups, with the highest scores in the geriatric group. Medical complications during surgery were lower in the younger age group (7%) than in the older (13.4%; p = 0.006) and geriatric groups (17.5%; p = 0.007); surgical complications tended to be higher in the elderly group (younger, 6.3%; older, 6.0%; geriatric, 15.0%; p = 0.09). There were no significant group differences (p > 0.05) for the scores on any of the COMI domains, GTO, or patient-rated satisfaction at either 3-, 12-, and 24-months follow-up. CONCLUSIONS Despite greater comorbidity and complication rates in geriatric patients, the patient-rated outcome was as good in the elderly as it was in younger age groups up to two years after surgery. These data indicate that geriatric age needs careful consideration of associated risks but is not per se a contraindication for fusion for lumbar degenerative disease. LEVEL OF EVIDENCE 4.

The movement toward patient safety: State action related to reporting and disclosure of healthcare-associated infections

Increasing attention has been given to the problem of medical errors over the past decade. Included within that focused attention has been a strong interest in reducing the occurrence of healthcare-associated infections (HAIs). Acting concurrently with federal initiatives, the majority of U.S. states have statutorily required reporting and public disclosure of HAI data. Although the occurrence of these state statutory enactments and other state initiatives represent a recognition of the strong concern pertaining to HAIs, vast differences in each state’s HAI reporting and public disclosure requirements creates a varied and unequal response to what has become a national problem.^ The purpose of this research was to explore the variations in state HAI legal requirements and other state mandates. State actions, including statutory enactments, regulations, and other initiatives related to state reporting and public disclosure mechanisms were compared, discussed, and analyzed in an effort to illustrate the impact of the lack of uniformity as a public health concern.^ The HAI statutes, administrative requirements, and other mandates of each state and two U.S. territories were reviewed to answer the following seven research questions: How far has the state progressed in its HAI initiative? If the state has a HAI reporting requirement, is it mandatory or voluntary? What healthcare entities are subject to the reporting requirements? What data collection system is utilized? What measures are required to be reported? What is the public disclosure mechanism? How is the underlying reported information protected from public disclosure or other legal release?^ Secondary publicly available data, including state statutes, administrative rules, and other initiatives, were utilized to examine the current HAI-related legislative and administrative activity of the study subjects. The information was reviewed and analyzed to determine variations in HAI reporting and public disclosure laws. Particular attention was given to the seven key research questions.^ The research revealed that considerable progress has been achieved in state HAI initiatives since 2004. Despite this progress, however, when reviewing the state laws and HAI programs comparatively, considerable variations were found to exist with regards to the type of reporting requirements, healthcare facilities subject to the reporting laws, data collection systems utilized, reportable measures, public disclosure requirements, and confidentiality and privilege provisions. The wide variations in state statutes, administrative rules, and other agency directives create a fragmented and inconsistent approach to addressing the nationwide occurrence of HAIs in the U.S. healthcare system. ^

The CMCC Eddy-permitting Global Ocean Physical Reanalysis (C-GLORS v5, 1980-2014), links to NetCDF files

The CMCC Global Ocean Physical Reanalysis System (C-GLORS) is used to simulate the state of the ocean in the last decades. It consists of a variational data assimilation system (OceanVar), capable of assimilating all in-situ observations along with altimetry data, and a forecast step performed by the ocean model NEMO coupled with the LIM2 sea-ice model. KEY STRENGTHS: - Data are available for a large number of ocean parameters - An extensive validation has been conducted and is freely available - The reanalysis is performed at high resolution (1/4 degree) and spans the last 30 years KEY LIMITATIONS: - Quality may be discontinuos and depend on observation coverage - Uncertainty estimates are simply derived through verification skill scores