First charge breeding of a rare-isotope beam with the electron-beam ion trap of the ReA post-accelerator at the National Superconducting Cyclotron Laboratory

An electron-beam ion trap (EBIT) charge breeder is being brought into operation at the National Superconducting Cyclotron Laboratory at Michigan State University. The EBIT is part of the ReA post-accelerator for reacceleration of rare isotopes, which are thermalized in a gas "stopping" cell after being produced at high energy by projectile fragmentation. The ReA EBIT has a distinctive design; it is characterized by a high-current electron gun and a two-field superconducting magnet to optimize the capture and charge-breeding efficiency of continuously injected singly charged ion beams. Following a brief overview of the reaccelerator system and the ReA EBIT, this paper presents the latest commissioning results, particularly, charge breeding and reacceleration of the highly charged rare isotopes, (76)Ga(24 +, 25 +).

Cost-effectiveness of automated external defibrillators on airlines

CONTEXT

Installation of automated external defibrillators (AEDs) on passenger aircraft has been shown to improve survival of cardiac arrest in that setting, but the cost-effectiveness of such measures has not been proven.

OBJECTIVE

To examine the costs and effectiveness of several different options for AED deployment in the US commercial air transportation system.

DESIGN, SETTING, AND SUBJECTS

Decision and cost-effectiveness analysis of a strategy of full deployment on all aircraft as well as several strategies of partial deployment only on larger aircraft, compared with a baseline strategy of no AEDs on aircraft (but training flight attendants in basic life support) for a hypothetical cohort of persons experiencing cardiac arrest aboard US commercial aircraft. Estimates for costs and outcomes were obtained from the medical literature, the Federal Aviation Administration, the Air Transport Association of America, a population-based cohort of Medicare patients, AED manufacturers, and the Bureau of Labor Statistics.

MAIN OUTCOME MEASURES

Quality-adjusted survival after cardiac arrest; costs of AED deployment on aircraft and of medical care for cardiac arrest survivors.

RESULTS

Adding AEDs on passenger aircraft with more than 200 passengers would cost $35 300 per quality-adjusted life-year (QALY) gained. Additional AEDs on aircraft with capacities between 100 and 200 persons would cost an additional $40 800 per added QALY compared with deployment on large-capacity aircraft only, and full deployment on all passenger aircraft would cost an additional $94 700 per QALY gained compared with limited deployment on aircraft with capacity greater than 100. Sensitivity analyses indicated that the quality of life, annual mortality rate, and the effectiveness of AEDs in improving survival were the most influential factors in the model. In 85% of Monte Carlo simulations, AED placement on large-capacity aircraft produced cost-effectiveness ratios of less than $50 000 per QALY.

CONCLUSION

The cost-effectiveness of placing AEDs on commercial aircraft compares favorably with the cost-effectiveness of widely accepted medical interventions and health policy regulations, but is critically dependent on the passenger capacity of the aircraft. Placing AEDs on most US commercial aircraft would meet conventional standards of cost-effectiveness.

Treatment of the femoral and tibial fractures with Grosse and Kempf locking nails

In a series of 104 femoral and 50 tibioendomedullary nailings using Grosse-Kempf (G-F) locking nails, 24% of femoral fractures and 12% of tibial fractures were comminuted; 48% of the patients had multiple injuries. The nail was locked at proximal and distal levels in 54% of the cases for the femur. Dynamization of the nail was carried out at an average of 12 weeks. Nonweight-bearing was imposed for both series from three weeks to three months. Bone healing was achieved before six months in 100% of tibial fractures. Following Thoressen criteria, the results of femoral cases were all excellent and good; the percentage reached 96% for tibial cases. The G-F nail is suitable for high-energy, comminuted fractures.

The role of the fornix/fimbria and some related subcortical structures in place learning and memory

Place learning and memory were assessed in rats with selective damage to the fornix/fimbria or to subcortical structures which have a major connection with the hippocampal formation via the fornix/fimbria. Navigation to a hidden or visible platform in a fixed location was studied in the Morris water task in rats who were preoperatively trained in the task or who were preoperatively naive. All rats learned to navigate accurately to a visible platform. Only complete transection of the fornix/fimbria abolished both acquisition and retention of navigation to a hidden platform. Severe impairment of postoperative acquisition was produced by bilateral damage to the medial nucleus accumbens or bilateral damage to the anterior thalamic area. Nucleus accumbens or anterior thalamic damage produced little effect on retention of preoperatively acquired place navigation. Damage to medial septum or mammillary complex produced modest impairments evident only in postoperative acquisition.