26
|
Sjue SKL, Mariam FG, Merrill FE, Morris CL, Saunders A. High order magnetic optics for high dynamic range proton radiography at a kinetic energy of 800 MeV. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2016; 87:015110. [PMID: 26827356 DOI: 10.1063/1.4939822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Flash radiography with 800 MeV kinetic energy protons at Los Alamos National Laboratory is an important experimental tool for investigations of dynamic material behavior driven by high explosives or pulsed power. The extraction of quantitative information about density fields in a dynamic experiment from proton generated images requires a high fidelity model of the proton imaging process. It is shown that accurate calculations of the transmission through the magnetic lens system require terms beyond second order for protons far from the tune energy. The approach used integrates the correlated multiple Coulomb scattering distribution simultaneously over the collimator and the image plane. Comparison with a series of static calibration images demonstrates the model's accurate reproduction of both the transmission and blur over a wide range of tune energies in an inverse identity lens that consists of four quadrupole electromagnets.
Collapse
|
27
|
Spicer J, Awada A, Brunsvig P, Saunders A, Olsen W, Nicolaisen B, Rekdal O, Laruelle M, Marjuadi F, Vakili J, Aftimos P, Barthelemy P, Deva S, Baurain J. 528 Intratumoural treatment with LTX-, an oncolytic peptide immunotherapy, in patients with advanced metastatic disease induces CD8 effector cells and regression in some injected tumours. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30329-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
28
|
Moreno PA, Garcia-Pacheco JL, Charvill J, Lofti A, Langensiepen C, Saunders A, Berckmans K, Gaspersic J, Walton L, Carmona M, Perez de la Camara S, Sanchez-de-Madariaga R, Pozo J, Muñoz A, Pascual M, Gomez EJ. iCarer: AAL for the Informal Carers of the Elderly. Stud Health Technol Inform 2015; 210:678-680. [PMID: 25991237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In the context of the long-term care for older adults, informal carers play a key role. Daily competing priorities or a care-skills deficit may lead them to stress, anxiety and/or depression. The iCarer project (AAL-2012-5-239) proposes the design and implementation of a cloud-inspired personalised and adaptive platform which will offer support to informal carers of older adults with cognitive impairment. By means of a holistic approach comprising technologies and services addressing the intelligent and interactive monitoring of activities, knowledge management for personalised guidance and orientation, virtual interaction, e-learning, care coordination facilities and social network services, iCarer aims to reduce the informal carer stress and to enhance the quality of care they provide, thus improving their quality of life. The iCarer platform will be evaluated through a multi-centre non-controlled study (4 months; 48 homes located in England and in Slovenia). Currently the iCarer project is completing the development work. The evaluation trial is expected to start in August 2015.
Collapse
|
29
|
Tjulandin S, Moiseyenko V, Semiglazov V, Manikhas G, Learoyd M, Saunders A, Stuart M, Keilholz U. Phase I, dose-finding study of AZD8931, an inhibitor of EGFR (erbB1), HER2 (erbB2) and HER3 (erbB3) signaling, in patients with advanced solid tumors. Invest New Drugs 2013; 32:145-53. [DOI: 10.1007/s10637-013-9963-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 03/31/2013] [Indexed: 11/28/2022]
|
30
|
Morris CL, King NSP, Kwiatkowski K, Mariam FG, Merrill FE, Saunders A. Charged particle radiography. REPORTS ON PROGRESS IN PHYSICS. PHYSICAL SOCIETY (GREAT BRITAIN) 2013; 76:046301. [PMID: 23481477 DOI: 10.1088/0034-4885/76/4/046301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
New applications of charged particle radiography have been developed over the past two decades that extend the range of radiographic techniques providing high-speed sequences of radiographs of thicker objects with higher effective dose than can be obtained with conventional radiographic techniques. In this paper, we review the motivation and the development of flash radiography and in particular, charged particle radiography.
Collapse
|
31
|
Morris CL, Bourke M, Byler DD, Chen CF, Hogan G, Hunter JF, Kwiatkowski K, Mariam FG, McClellan KJ, Merrill F, Morley DJ, Saunders A. Qualitative comparison of bremsstrahlung X-rays and 800 MeV protons for tomography of urania fuel pellets. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2013; 84:023902. [PMID: 23464222 DOI: 10.1063/1.4789947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We present an assessment of x-rays and proton tomography as tools for studying the time dependence of the development of damage in fuel rods. We also show data taken with existing facilities at Los Alamos National Laboratory that support this assessment. Data on surrogate fuel rods have been taken using the 800 MeV proton radiography (pRad) facility at the Los Alamos Neutron Science Center (LANSCE), and with a 450 keV bremsstrahlung X-ray tomography facility. The proton radiography pRad facility at LANSCE can provide good position resolution (<70 μm has been demonstrate, 20 μm seems feasible with minor changes) for tomography on activated fuel rods. Bremsstrahlung x-rays may be able to provide better than 100 μm resolution but further development of sources, collimation, and detectors is necessary for x-rays to deal with the background radiation for tomography of activated fuel rods.
Collapse
|
32
|
Saunders A, Makela M, Bagdasarova Y, Back HO, Boissevain J, Broussard LJ, Bowles TJ, Carr R, Currie SA, Filippone B, García A, Geltenbort P, Hickerson KP, Hill RE, Hoagland J, Hoedl S, Holley AT, Hogan G, Ito TM, Lamoreaux S, Liu CY, Liu J, Mammei RR, Martin J, Melconian D, Mendenhall MP, Morris CL, Mortensen RN, Pattie RW, Pitt M, Plaster B, Ramsey J, Rios R, Sallaska A, Seestrom SJ, Sharapov EI, Sjue S, Sondheim WE, Teasdale W, Young AR, VornDick B, Vogelaar RB, Wang Z, Xu Y. Performance of the Los Alamos National Laboratory spallation-driven solid-deuterium ultra-cold neutron source. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2013; 84:013304. [PMID: 23387639 DOI: 10.1063/1.4770063] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In this paper, we describe the performance of the Los Alamos spallation-driven solid-deuterium ultra-cold neutron (UCN) source. Measurements of the cold neutron flux, the very low energy neutron production rate, and the UCN rates and density at the exit from the biological shield are presented and compared to Monte Carlo predictions. The cold neutron rates compare well with predictions from the Monte Carlo code MCNPX and the UCN rates agree with our custom UCN Monte Carlo code. The source is shown to perform as modeled. The maximum delivered UCN density at the exit from the biological shield is 52(9) UCN/cc with a solid deuterium volume of ~1500 cm(3).
Collapse
|
33
|
Holley AT, Broussard LJ, Davis JL, Hickerson K, Ito TM, Liu CY, Lyles JTM, Makela M, Mammei RR, Mendenhall MP, Morris CL, Mortensen R, Pattie RW, Rios R, Saunders A, Young AR. A high-field adiabatic fast passage ultracold neutron spin flipper for the UCNA experiment. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2012; 83:073505. [PMID: 22852693 DOI: 10.1063/1.4732822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The UCNA collaboration is making a precision measurement of the β asymmetry (A) in free neutron decay using polarized ultracold neutrons (UCN). A critical component of this experiment is an adiabatic fast passage neutron spin flipper capable of efficient operation in ambient magnetic fields on the order of 1 T. The requirement that it operate in a high field necessitated the construction of a free neutron spin flipper based, for the first time, on a birdcage resonator. The design, construction, and initial testing of this spin flipper prior to its use in the first measurement of A with UCN during the 2007 run cycle of the Los Alamos Neutron Science Center's 800 MeV proton accelerator is detailed. These studies determined the flipping efficiency of the device, averaged over the UCN spectrum present at the location of the spin flipper, to be ̅ε=0.9985(4).
Collapse
|
34
|
Merrill FE, Campos E, Espinoza C, Hogan G, Hollander B, Lopez J, Mariam FG, Morley D, Morris CL, Murray M, Saunders A, Schwartz C, Thompson TN. Magnifying lens for 800 MeV proton radiography. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2011; 82:103709. [PMID: 22047305 DOI: 10.1063/1.3652974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article describes the design and performance of a magnifying magnetic-lens system designed, built, and commissioned at the Los Alamos National Laboratory (LANL) for 800 MeV flash proton radiography. The technique of flash proton radiography has been developed at LANL to study material properties under dynamic loading conditions through the analysis of time sequences of proton radiographs. The requirements of this growing experimental program have resulted in the need for improvements in spatial radiographic resolution. To meet these needs, a new magnetic lens system, consisting of four permanent magnet quadrupoles, has been developed. This new lens system was designed to reduce the second order chromatic aberrations, the dominant source of image blur in 800 MeV proton radiography, as well as magnifying the image to reduce the blur contribution from the detector and camera systems. The recently commissioned lens system performed as designed, providing nearly a factor of three improvement in radiographic resolution.
Collapse
|
35
|
Keilholz U, Moiseyenko V, Makhson A, Semiglazov V, Learoyd M, Saunders A, Stuart M, Tjulandin S. Phase I, dose-finding study of monotherapy with AZD8931, an inhibitor of ErbB1, 2, and 3 signaling, in patients (pts) with advanced solid tumors. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
36
|
Lopez-Martin JA, Vidal Losada M, Cortes J, Bermejo B, Lluch Fernandez A, Learoyd M, Saunders A, Stuart M, Baselga J. Phase I, dose-finding study of AZD8931, an inhibitor of ErbB1, 2, and 3 receptor signaling, in combination with paclitaxel (P). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
37
|
Liu J, Mendenhall MP, Holley AT, Back HO, Bowles TJ, Broussard LJ, Carr R, Clayton S, Currie S, Filippone BW, García A, Geltenbort P, Hickerson KP, Hoagland J, Hogan GE, Hona B, Ito TM, Liu CY, Makela M, Mammei RR, Martin JW, Melconian D, Morris CL, Pattie RW, Pérez Galván A, Pitt ML, Plaster B, Ramsey JC, Rios R, Russell R, Saunders A, Seestrom SJ, Sondheim WE, Tatar E, Vogelaar RB, VornDick B, Wrede C, Yan H, Young AR. Determination of the axial-vector weak coupling constant with ultracold neutrons. PHYSICAL REVIEW LETTERS 2010; 105:181803. [PMID: 21231098 DOI: 10.1103/physrevlett.105.181803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Indexed: 05/30/2023]
Abstract
A precise measurement of the neutron decay β asymmetry A₀ has been carried out using polarized ultracold neutrons from the pulsed spallation ultracold neutron source at the Los Alamos Neutron Science Center. Combining data obtained in 2008 and 2009, we report A₀ = -0.119 66±0.000 89{-0.001 40}{+0.001 23}, from which we determine the ratio of the axial-vector to vector weak coupling of the nucleon g{A}/g{V}=-1.275 90{-0.004 45}{+0.004 09}.
Collapse
|
38
|
Blumenthal P, Eber M, Cooley T, Saunders A, Bixiones C, Clemente C. Revitalizing long-acting reversible contraceptives in settings with high unmet need: a multi-country experience matching demand creation and service delivery. Contraception 2010. [DOI: 10.1016/j.contraception.2010.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
39
|
Scholten D, Saunders A, Dawson K, Wong T, Ellis E. Air travel by individuals with active tuberculosis: Reporting patterns and epidemiologic characteristics, Canada 2006–2008. Travel Med Infect Dis 2010; 8:113-9. [DOI: 10.1016/j.tmaid.2010.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 02/04/2010] [Indexed: 10/19/2022]
|
40
|
Pattie RW, Anaya J, Back HO, Boissevain JG, Bowles TJ, Broussard LJ, Carr R, Clark DJ, Currie S, Du S, Filippone BW, Geltenbort P, García A, Hawari A, Hickerson KP, Hill R, Hino M, Hoedl SA, Hogan GE, Holley AT, Ito TM, Kawai T, Kirch K, Kitagaki S, Lamoreaux SK, Liu CY, Liu J, Makela M, Mammei RR, Martin JW, Melconian D, Meier N, Mendenhall MP, Morris CL, Mortensen R, Pichlmaier A, Pitt ML, Plaster B, Ramsey JC, Rios R, Sabourov K, Sallaska AL, Saunders A, Schmid R, Seestrom S, Servicky C, Sjue SKL, Smith D, Sondheim WE, Tatar E, Teasdale W, Terai C, Tipton B, Utsuro M, Vogelaar RB, Wehring BW, Xu YP, Young AR, Yuan J. First measurement of the neutron beta asymmetry with ultracold neutrons. PHYSICAL REVIEW LETTERS 2009; 102:012301. [PMID: 19257182 DOI: 10.1103/physrevlett.102.012301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Indexed: 05/27/2023]
Abstract
We report the first measurement of an angular correlation parameter in neutron beta decay using polarized ultracold neutrons (UCN). We utilize UCN with energies below about 200 neV, which we guide and store for approximately 30 s in a Cu decay volume. The interaction of the neutron magnetic dipole moment with a static 7 T field external to the decay volume provides a 420 neV potential energy barrier to the spin state parallel to the field, polarizing the UCN before they pass through an adiabatic fast passage spin flipper and enter a decay volume, situated within a 1 T field in a 2x2pi solenoidal spectrometer. We determine a value for the beta-asymmetry parameter A_{0}=-0.1138+/-0.0046+/-0.0021.
Collapse
|
41
|
Gu AZ, Saunders A, Neethling JB, Stensel HD, Blackall LL. Functionally relevant microorganisms to enhanced biological phosphorus removal performance at full-scale wastewater treatment plants in the United States. WATER ENVIRONMENT RESEARCH : A RESEARCH PUBLICATION OF THE WATER ENVIRONMENT FEDERATION 2008; 80:688-698. [PMID: 18751532 DOI: 10.2175/106143008x276741] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The abundance and relevance ofAccumulibacter phosphatis (presumed to be polyphosphate-accumulating organisms [PAOs]), Competibacter phosphatis (presumed to be glycogen-accumulating organisms [GAOs]), and tetrad-forming organisms (TFOs) to phosphorus removal performance at six full-scale enhanced biological phosphorus removal (EBPR) wastewater treatment plants were investigated. Coexistence of various levels of candidate PAOs and GAOs were found at these facilities. Accumulibacter were found to be 5 to 20% of the total bacterial population, and Competibacter were 0 to 20% of the total bacteria population. The TFO abundance varied from nondetectable to dominant. Anaerobic phosphorus (P) release to acetate uptake ratios (P(rel)/HAc(up)) obtained from bench tests were correlated positively with the abundance ratio of Accumulibacter/(Competibacter +TFOs) and negatively with the abundance of (Competibacter +TFOs) for all plants except one, suggesting the relevance of these candidate organisms to EBPR processes. However, effluent phosphorus concentration, amount of phosphorus removed, and process stability in an EBPR system were not directly related to high PAO abundance or mutually exclusive with a high GAO fraction. The plant that had the lowest average effluent phosphorus and highest stability rating had the lowest P(rel)/HAc(up) and the most TFOs. Evaluation of full-scale EBPR performance data indicated that low effluent phosphorus concentration and high process stability are positively correlated with the influent readily biodegradable chemical oxygen demand-to-phosphorus ratio. A system-level carbon-distribution-based conceptual model is proposed for capturing the dynamic competition between PAOs and GAOs and their effect on an EBPR process, and the results from this study seem to support the model hypothesis.
Collapse
|
42
|
Smilowitz L, Henson BF, Romero JJ, Asay BW, Schwartz CL, Saunders A, Merrill FE, Morris CL, Kwiatkowski K, Hogan G, Nedrow P, Murray MM, Thompson TN, McNeil W, Rightley P, Marr-Lyon M. Direct observation of the phenomenology of a solid thermal explosion using time-resolved proton radiography. PHYSICAL REVIEW LETTERS 2008; 100:228301. [PMID: 18643466 DOI: 10.1103/physrevlett.100.228301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Indexed: 05/26/2023]
Abstract
We present a new phenomenology for burn propagation inside a thermal explosion based on dynamic radiography. Radiographic images were obtained of an aluminum cased solid cylindrical sample of a plastic bonded formulation of octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine. The phenomenology observed is ignition followed by cracking in the solid accompanied by the propagation of a radially symmetric front of increasing proton transmission. This is followed by a further increase in transmission through the sample, ending after approximately 100 micros. We show that these processes are consistent with the propagation of a convective burn front followed by consumption of the remaining solid by conductive particle burning.
Collapse
|
43
|
Atchison F, Blau B, Bodek K, van den Brandt B, Bryś T, Daum M, Fierlinger P, Frei A, Geltenbort P, Hautle P, Henneck R, Heule S, Holley A, Kasprzak M, Kirch K, Knecht A, Konter JA, Kuźniak M, Liu CY, Morris CL, Pichlmaier A, Plonka C, Pokotilovski Y, Saunders A, Shin Y, Tortorella D, Wohlmuther M, Young AR, Zejma J, Zsigmond G. Cold neutron energy dependent production of ultracold neutrons in solid deuterium. PHYSICAL REVIEW LETTERS 2007; 99:262502. [PMID: 18233572 DOI: 10.1103/physrevlett.99.262502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Indexed: 05/25/2023]
Abstract
A measurement of the production of ultracold neutrons from velocity-selected cold neutrons on gaseous and solid deuterium targets is reported. The expected energy dependence for two-particle collisions with well defined neutron and Maxwell-Boltzmann distributed molecular velocities is found for the gas target. The solid target data agree in shape with the phonon density-of-states curve and provide strong evidence for the phonon model including multiphonon excitations.
Collapse
|
44
|
Currie A, Akwar H, MacDonald W, Saunders A, Baikie M, Sweet L, Landry L, Demczuk W, Panaro L. Home or away? Investigation of Salmonella enteritidis PFGE pattern SENXAI.0003 and SENBNI.0003, phage type 8, the in the Maritimes, 2005. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2006; 32:231-9. [PMID: 17076033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
|
45
|
Watson-Creed G, Saunders A, Scott J, Lowe L, Pettipas J, Hatchette TF. Two successive outbreaks of mumps in Nova Scotia among vaccinated adolescents and young adults. CMAJ 2006; 175:483-8. [PMID: 16940266 PMCID: PMC1550754 DOI: 10.1503/cmaj.060660] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Before the widespread use of vaccine, mumps was the most common cause of viral meningitis (up to 10% of mumps infections). Vaccination programs have resulted in a drop of more than 99% in the number of reported mumps cases in the United States and Canada. Although rare in Canada, outbreaks have recently occurred throughout the world, including a large outbreak in the United Kingdom, where more than 56,000 cases were reported in 2004-2005. METHODS Two recent outbreaks in Nova Scotia were investigated by public health officials. Cases were defined by laboratory confirmation of infection (i.e., isolation of mumps virus by culture) or clinical diagnosis in people epidemiologically linked to a laboratory-confirmed case. The people infected were interviewed to determine possible links and to identify contacts. Mumps virus was cultured from urine and throat specimens, identified via reverse-transcriptase polymerase chain reaction (RT-PCR) and subjected to phylogenetic analysis to identify the origin of the strain. RESULTS The first outbreak involved 13 high-school students (median age 14 yr): 9 who had previously received 2 doses of measles-mumps-rubella vaccine (MMR) and 4 who received a single dose. The second outbreak comprised 19 cases of mumps among students and some staff at a local university (median age 23 yr), of whom 18 had received only 1 dose of MMR (the other received a second dose). The viruses identified in the outbreaks were phylogenetically similar and belonged to a genotype commonly reported in the UK. The virus from the second outbreak is identical to the strain currently circulating in the UK and United States. INTERPRETATION The predominance in these outbreaks of infected people of university age not only highlights an environment with potential for increased transmission but also raises questions about the efficacy of the MMR vaccine. The people affected may represent a "lost cohort" who do not have immunity from natural mumps infection and were not offered a 2-dose schedule. Given the current level of mumps activity around the world, clinicians should remain vigilant for symptoms of mumps.
Collapse
|
46
|
Gu AZ, Saunders A, Neethling J, Stensel HD, Blackall LL. INVESTIGATION OF PAOs AND GAOs AND THEIR EFFECTS ON EBPR PERFORMANCE AT FULL-SCALE WASTEWATER TREATMENT PLANTS IN U.S. ACTA ACUST UNITED AC 2005. [DOI: 10.2175/193864705783867116] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
47
|
Valach F, Saunders A, Cowley A, Watkin DJ. Crystal structure of bis(2-chloro-6-fluorobenzoato)bis(pyridine)copper(II), CU(C7H3ClFO2)2(C5NH5)2. Z KRIST-NEW CRYST ST 2003. [DOI: 10.1524/ncrs.2003.218.jg.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
48
|
Abstract
OBJECTIVE To assess the significance of ultrasonographically detected hypoechoic lesions of the testis when the clinical examination is normal, and to highlight the management difficulties thereafter. PATIENTS AND METHODS Over a 2-year period four patients underwent radical orchidectomy where the sole indication for surgery was a hypoechoic lesion detected on ultrasonography (US). The indications for US were persistent scrotal discomfort in two men, contralateral orchitis, and the follow-up of testicular microlithiasis. The lesions were 4-11 mm in size and one man had several. None of the lesions were palpable; the tumour markers were normal in all patients. RESULTS Three of the testes contained seminoma; in one there were two foci of seminoma and in all intratubular germ cell neoplasia was also identified. The remaining case was a Leydig-cell tumour. All tumours were staged as pT1 after radical inguinal orchidectomy. CONCLUSION Impalpable lesions of the testis are likely to be malignant if they are hypoechoic on US and should be considered as seminoma until proved otherwise. The management thereafter is not straightforward, but must ensure an adequate histological diagnosis if the US appearances do not resolve.
Collapse
|
49
|
Valach F, Saunders A, Cowley A, Watkin DJ. Crystal structure of bis(2-chloro-6-fluorobenzoato)bis(pyridine)copper(II), Cu(C7H3ClFO2)2(C5NH5)2. Z KRIST-NEW CRYST ST 2003. [DOI: 10.1524/ncrs.2003.218.1.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
50
|
Sakr M, Kendall R, Angus J, Sanders A, Nicholl J, Wardrope J, Saunders A. Emergency nurse practitioners: a three part study in clinical and cost effectiveness. Emerg Med J 2003; 20:158-63. [PMID: 12642530 PMCID: PMC1726060 DOI: 10.1136/emj.20.2.158] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To compare the clinical effectiveness and costs of minor injury services provided by nurse practitioners with minor injury care provided by an accident and emergency (A&E) department. METHODS A three part prospective study in a city where an A&E department was closing and being replaced by a nurse led minor injury unit (MIU). The first part of the study took a sample of patients attending the A&E department. The second part of the study was a sample of patients from a nurse led MIU that had replaced the A&E department. In each of these samples the clinical effectiveness was judged by comparing the "gold standard" of a research assessment with the clinical assessment. Primary outcome measures were the number of errors in clinical assessment, treatment, and disposal. The third part of the study used routine data whose collection had been prospectively configured to assess the costs and cost consequences of both models of care. RESULTS The minor injury unit produced a safe service where the total package of care was equal to or in some cases better than the A&E care. Significant process errors were made in 191 of 1447 (13.2%) patients treated by medical staff in the A&E department and 126 of 1313 (9.6%) of patients treated by nurse practitioners in the MIU. Very significant errors were rare (one error). Waiting times were much better at the MIU (mean MIU 19 minutes, A&E department 56.4 minutes). The revenue costs were greater in the MIU (MIU pound 41.1, A&E department pound 40.01) and there was a great difference in the rates of follow up and with the nurses referring 47% of patients for follow up and the A&E department referring only 27%. Thus the costs and cost consequences were greater for MIU care compared with A&E care (MIU pound 12.7 per minor injury case, A&E department pound 9.66 per minor injury case). CONCLUSION A nurse practitioner minor injury service can provide a safe and effective service for the treatment of minor injury. However, the costs of such a service are greater and there seems to be an increased use of outpatient services.
Collapse
|