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Low-energy investigations on rare ion beams are often limited by the available intensity and purity of the ion species in focus. Here, we present the first application of a technique that combines in-flight production at relativistic energies with subsequent secondary beam storage, accumulation and finally deceleration to the energy of interest. Using the FRS and ESR facilities at GSI, this scheme was pioneered to provide a secondary beam of $^{118}$Te$^{52+}$ for the measurement of nuclear proton-capture at energies of 6 and 7 MeV/u. The technique provided stored beam intensities of about $10^6$ ions at high purity and brilliance, representing a major step towards low-energy nuclear physics studies using rare ion beams.

Background Infections with S. haematobium are endemic in tropical regions and emerging in some European countries. Prolonged chronic infection with S. haematobium can cause Female Genital Schistosomiasis (FGS), which can lead to serious gynecological conditions, including infertility. However, awareness of FGS is limited, as are adequate guidelines and public health strategies to manage the disease. The aim of this study is to determine the levels and quality of FGS awareness among women and healthcare workers (HCW) in the Boeny region of Madagascar, where the disease is endemic. Methods Data collection involved a cross-sectional survey of adult women (n = 694) and HCWs (n = 93) on topics, such as respondents’ sociodemographic background characteristics, FGS awareness, and risk perceptions. Results were analyzed using descriptive statistics including proportions and 95% confidence intervals. Results Of the 694 women included in the study, 11.2% (CI [9.0-13.8%]) had heard of FGS. Among these, 34.6% (CI [24.1-46.2%]) were unaware of the gynecological symptoms signature for FGS, and 41% (CI [30.0-52.7%]) were unaware of the urological symptoms of the disease. Out of the 93 HCW surveyed, 53.2% (CI [42.6-63.6%]) had heard of FGS. Among these, 42.0% (CI [28.1-56.8%]) were unaware of the gynecological symptoms, and 52.0% (CI [37.4-66.3%]) were unaware of the urological symptoms. Conclusions Preliminary results show overall low levels of FGS awareness among the study population. While more women reported to have never heard of FGS than HCW, the proportion of HCWs who did not know the gynecological and urological symptoms of FGS was higher. Given the occurrence of FGS in Europe and the chronic character of the disease it would be crucial to conduct similar investigations in Europe. Such findings can contribute to the design of targeted local and global FGS awareness campaigns to improve the health of women affected by this disease worldwide. Key messages • Awareness of FGS among the study population in Madagascar, an endemic country, is low. • Lack of awareness can delay the identification of the disease and increase individual and community burden.

Background Prognosis in HFpEF is determined by risk factor control and treatment of comorbidities. Industrially processed TFA (IP-TFA) from partially hydrogenated oils have been linked to altered lipoprotein metabolism, endothelial dysfunction, increased biomarkers of inflammation and increased NTproBNP. In patients with heart failure with preserved ejection fraction (HFpEF), associations of TFA blood levels with patient characteristics are unknown. Purpose To evaluate associations of blood TFA with cardiovascular risk factors, aerobic capacity and cardiac function in patients with HFpEF. Methods This is a secondary analysis from the Aldo-DHF-RCT. From 422 patients, individual blood TFA were analyzed at baseline in n=404 using the HS-Omega-3-Index® methodology. Patient characteristics were; 67±8 years, 53% female, NYHA II/III (87/13%), ejection fraction ≥50%, E/e' 7.1±1.5; median NT-proBNP 158 ng/L (IQR 82–298). Multiple linear regression analyses, using sex and age as covariates, were used to describe associations of TFA with metabolic phenotype, functional capacity, echocardiographic markers for left ventricular diastolic function (LVDF), and neurohumoral activation at baseline and after 12-months-follow-up (12mFU). To account for randomization group, all analyses were repeated as sensitivity analysis with group as covariate. A significance level of α=5% was used for all tests. As all tests were hypothesis generating without confirmatory interpretation, no correction was applied to counteract the problem of multiple comparisons. Results Higher blood levels of the naturally occurring TFA C16:1n-7t were broadly associated with a more favorable lipid profile, lower body weight/central adiposity, lower white blood cell count and lower biochemical markers of non-alcoholic fatty liver disease at baseline/12mFU. Conversely, blood levels of the IP-TFA C18:1n9t were directly associated with lipid risk markers [triglycerides (β=19.7, p Conclusions In HFpEF patients, higher blood levels of industrially processed TFA, but not of the TFA C16:1n-7t in full fat dairy and meat, were associated with a higher risk phenotype and lower aerobic capacity. Our findings support efforts to remove IP-TFA from the food supply for improving risk factor control in HFpEF patients. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): German Foundation of Heart Research

Background Schistosomiasis is a high-burden parasitic disease and endemic in tropical climates, such as Madagascar. Recently it is emerging in Europe. Chronic infections lead to disabilities including loss in work productivity. Current control strategies focus on school-aged children, thereby systematically excluding adults. The goal to eliminate the disease as a public health problem is aligned with the Sustainable Development Goals agenda, including Universal Health Coverage (UHC). We aim at assessing the distribution of schistosomiasis among adults in Madagascar, in order to promote more targeted public health initiatives against the disease. Methods In a cross-sectional study, 1477 blood samples were collected at three primary health-care centers in Madagascar from 03.21 to 01.22. A semi quantitative PCR assay was used to assess the presence of Schistosoma. Positivity rates with 95% Confidence Intervals (CI) were reported by gender and age groups. Results Our study population had a balanced gender distribution with 54.2% [CI: 51.7;56.8] of females and a median age of 37 years (IQR: 24-48). Preliminary results show an overall Schistosome positivity rate of 59.5% [CI: 57.0;62.0]. Positivity was higher in males 62.4% [CI: 58.7;66.1], than in females 57.1% [CI: 53.5;60.5]. Highest positivity was seen in the 18-34 year age group with 66.2% [CI: 62.7;69.6]. Lowest positivity of 46.2% [CI: 39.2;53.2] was observed in adults aged over 55 years. Conclusions Our preliminary results provide evidence of high positivity rates of schistosomiasis among adults in a highly endemic country. Differently from many studies, males seem more affected than females. The youngest age group, representing the more active workforce of a population, shows a higher positivity rate. Our data suggests that, in the logic of UHC and health as a human right, public health strategies for schistosomiasis need to be re-addressed towards a universal coverage of affected individuals. Key messages

Background and objectives Malaria remains a major global public health concern and a leading cause of morbidity and mortality especially among children Methods Using data of 3,004 children from the Malaria Indicator Survey of the Demographic and Health Surveys Program conducted in Ghana in 2019, a household wealth index (quintiles) was derived using principal component analysis based on household assets. Causal multiple mediation analyses investigated mediating effects of treatment-seeking, bed net (LLIN) use, educational attainment, and housing conditions on the association between socioeconomic position and children's malaria fever events. Results Higher maternal educational attainment and housing conditions jointly mediate 18% of the association between socioeconomic position and malaria fever events (OR = 0.98; 95%CI = 0.96-0.99). Maternal educational attainment and seeking formal prenatal health care jointly mediate 20% of the total effect (OR = 0.98; 95%CI = 0.95-1.00), in presence of a lower socioeconomic position. No strong mediation was found for educational attainment jointly with the use of LLINs between malaria and socioeconomic position in this study (OR = 0.99; 95%CI = 0.97-1.01). Conclusions As shown by the proportions mediated between malaria and socioeconomic position, findings suggest that current malaria control efforts could be strengthened by investments at the structural levels, such as increased (female) education, targeted improvements in housing, and stronger integration of informal health care. Key messages

This paper examines two CDC data sets in order to provide a comprehensive overview and social implications of COVID-19 related deaths within the United States over the first eight months of 2020. By analyzing the first data set during this eight-month period with the variables of age, race, and individual states in the United States, we found correlations between COVID-19 deaths and these three variables. Overall, our multivariable regression model was found to be statistically significant. When analyzing the second CDC data set, we used the same variables with one exception; gender was used in place of race. From this analysis, it was found that trends in age and individual states were significant. However, since gender was not found to be significant in predicting deaths, we concluded that, gender does not play a significant role in the prognosis of COVID-19 induced deaths. However, the age of an individual and his/her state of residence potentially play a significant role in determining life or death. Socio-economic analysis of the US population confirms Qualitative socio-economic Logic based Cascade Hypotheses (QLCH) of education, occupation, and income affecting race/ethnicity differently. For a given race/ethnicity, education drives occupation then income, where a person lives, and in turn his/her access to healthcare coverage. Considering socio-economic data based QLCH framework, we conclude that different races are poised for differing effects of COVID-19 and that Asians and Whites are in a stronger position to combat COVID-19 than Hispanics and Blacks.

The prediction of microclimate effects within an urban context through simulations has previously been done through elaborate software packages that offer accurate results but require extensive domain knowledge and time for the preparation of a model. In day-to-day policymaking, however, these efforts may turn out to be a major limiting factor: Policymakers and city administrators need a quick tool that can predict the effects of urban interventions in a variety of possible scenarios rather than a full-fledged simulation study for a limited set of specific interventions. In our work, we have been seeking to address this mismatch in expectations by using the best of both worlds: We have approximated results from a full-fledged simulation that uses a Cellular Automaton running within a 3D city visualization. Policymakers can edit the urban context by changing cell types (placement of greenery, etc.), thus leading to scenarios that can be compared to the status quo. As a matter of fact, policymakers can use these comparisons to argue for measures that mitigate the effects of heat islands, without requiring extensive domain knowledge or the effort to prepare a simulation model.

Experimental determination of the cross sections of proton capture on radioactive nuclei is extremely difficult. Therefore, it is of substantial interest for the understanding of the production of the p-nuclei. For the first time, a direct measurement of proton-capture cross sections on stored, radioactive ions became possible in an energy range of interest for nuclear astrophysics. The experiment was performed at the Experimental Storage Ring (ESR) at GSI by making use of a sensitive method to measure (p,γ) and (p,n) reactions in inverse kinematics. These reaction channels are of high relevance for the nucleosyn-thesis processes in supernovae, which are among the most violent explosions in the universe and are not yet well understood. The cross section of the 118Te(p,γ) reaction has been measured at energies of 6 MeV/u and 7 MeV/u. The heavy ions interacted with a hydrogen gas jet target. The radiative recombination process of the fully stripped 118Te ions and electrons from the hydrogen target was used as a luminosity monitor. An overview of the experimental method and preliminary results from the ongoing analysis will be presented.

Background: Professional identity formation (PIF) is considered a key process in the development of healthcare providers. In medical education, PIF literature has historically centered on cognitive processes and medicine’s socialization practices that help to transform trainees to clinicians. Recent work has begun to unravel how larger socio-historical contexts and identity intersectionality influence PIF in ethnically/racially minoritized physicians,1-2 but has not yet been explored in physician assistant (PA) students and PAs considered underrepresented minorities (URM). Methods: In this qualitative study, 44 URM PA students and practicing PAs were recruited and interviewed from three southern universities/colleges. Participants included three Native Americans, 23 Black/African Americans, 12 Hispanic/Latinos, and six of mixed races/ethnicities. Using constructive grounded theory, the authors analyzed interview data for how the participants construct their professional identity and how factors like ethnicity, race, and gender influence PIF. Constant comparative analysis among the researchers was used to identify themes and discuss differences. Results: The results indicated that minoritized PAs identify their diverse background and experiences as assets to their professional identity and leverage these assets in their interactions with underserved patients. Participants described how their personal identities and socio-historical contexts informed their clinical thinking and practice, especially in instances of racial/ethnic concordance. Conclusions: Race, ethnicity, gender, and socio-historical contexts influence the PIF of minoritized PAs in ways that have been largely ignored in medical literature and PAs leverage these qualities to improve patient interactions., Background: The early months of 2020 strained US health systems, prompting abrupt, unprecedented alteration to medical curricula. We found medical students, from first years to near-graduates, described themselves as ill-equipped sentient “fomites,” unpaid “meat shields,” “wastes of masks,” and impediments to the “real” work of responding to COVID-19. They fell back on well-established student identities and activities, retreating into Anki decks and QBanks, as much a symptom of underpreparedness to support the pandemic response as a remedy. Methods: We collected 5,460 COVID-related r/medicalschool Reddit posts made from 3/12/2020-4/16/2020 and selected those commenting on professional role, identity, or preparation. We then applied Critical Incident Analysis—a method for unpacking “underlying trends, motives and structures”1(p23-24) that “trigger insights about some aspect of teaching and learning.”2(p13) In accordance with Columbia University IRB and the medical school subreddit rules for research studies, this study does not involve the recruitment of participants and falls outside the scope of Human Subjects Research under 45 CFR 46 (Columbia University protocol: AAAS6866(M00Y01)). Results: We offer the analysis of these critical incidents to open discussion of how curricula can support students from day one to step up, rather than step back, from opportunities to provide care in the face of novel challenges to public health. We invite conversation about how medical schools can foster the professional identity formation in today’s students necessary for tomorrow’s physicians to feel as well-equipped to handle unforeseen medical crises as to crush upcoming exams., Summary of Innovation: The attitude medical students have toward disabled persons is mixed: some studies reported students had a worse perception of disabled persons, while in others they were more empathetic.1 One reason why medical students may see disabled persons as deficient is rooted in the medical model of disability, where the problem is a result of an individual’s physiology and/or biology.2 This is contrasted with the human rights model of disability, which stresses that all disabled persons should have both legal and human rights, and that society should have an understanding of the role impairment plays in both their and our lives.3 Disabled persons need and deserve quality and empathetic medical care so that they and we can live our best possible lives. Updating medical school curricula to include perspectives from disabled persons in addition to the reality impairments play in our lives from a rights-based perspective may improve the medical care disabled persons receive. Utilizing an autoethnographic perspective,4,5,6 I reflect on and analyze two specific comments repeated by medical professionals some of the comments made to me that characterize the tone of the medical model of disability. Recognizing that an autoethnographic account is not meant to be generalizable, this commentary on medical education stresses the need to include (a) disability framed using the human rights model, and (b) disabled people in revising medical school curricula., Summary of Innovation: Interprofessional collaboration provides unique opportunities for improving patient care in pediatric hospital medicine. This study used Tajfel and Turner’s Social Identity Theory as a conceptual framework to characterize the relationships between the social identities of pediatric hospitalists and their perceptions of interprofessional collaboration and teamwork. This theory was chosen given its ability to study interpersonal dynamics within complex systems, including healthcare. We used qualitative methods including free-listing and semi-structured interviews to explore these phenomena and examine the relationships among identity, collaboration, and teams. Thirteen pediatric hospitalists were recruited for participation over the course of three months. We identified five key themes: (1) Pediatric hospitalists fall along a spectrum ranging from profession-centered to team-centered, (2) Familiarity is conducive to formation of team identity, (3) Co-creation of a shared vision and practice of creating shared mental models strengthens sense of team, (4) Workplace culture, which includes workflows and reporting hierarchies among others, acts as both a facilitator for and barrier to formation of team identity, and (5) Although most participants identified themselves as the leaders of the team, the concept of “flexible leadership“, or identifying the team member with the appropriate expertise and skillset as the leader for a given problem, was prominent in high-functioning teams. We conclude that Social Identity Theory can be a useful theoretical lens for examining interprofessional collaboration and teamwork in healthcare settings, including among pediatric hospitalists. Moving forward, it will be critical to explore the link between social identity and patient-centered outcomes as well as to evaluate the development of profession-based and team-based identities., Background: The literature describes the crucial role of Professional Identity Formation (PIF) in medical students’ transition to physicians. Little is known about how medical students are developing their sense of professional identity during these early months of the COVID-19 pandemic. In this initial study, we explored perceptions and experiences of undergraduate medical students whose training and education have been dramatically affected to better understand how these widespread disruptions have influenced their professional identity formation. Methods: We conducted a conventional content analysis1 of published medical student blogs, commentaries, and perspectives. Inclusion criteria were: (1) the publication highlighted medical students’ experiences; (2) the writer identified as an undergraduate medical student, or the writer stated direct quotations from undergraduate medical students; (3) U.S. and Canada based (4) posted since 17/ Mar/2020. We identified twenty blogs and commentaries that fit inclusion criteria. We, the four authors, independently performed a straightforward content analysis of medical students’ written public statements to identify emerging themes. To ensure validity of the analysis, we then compared and discussed our separate findings to arrive at a consensus position. Findings: We found three major themes: identity dissonance; questioning and asserting the legitimacy of medical students as physicians; and renewed values, commitment, and virtues of a physician. The findings showed that the major disruptions of COVID-19 to medical education and health care can impact PIF in both negative and positive ways. This study will further inform the design and components of future projects on medical students’ PIF amid COVID-19.

Approximately 4% of pregnant patients with COVID-19 infection require intensive care unit admission. Given the practical implications of advanced ventilatory and circulatory support techniques, urgent or emergent delivery for non-reassuring fetal status frequently represents a logistical impossibility. This manuscript proposes a protocol for obstetrical management of patients in these situations, emphasizing coordinated preparation between obstetric, anesthesiology, and intensivist teams, with planned preterm delivery at gestational ages when neonatal outcomes are likely to be favorable.

Whether sealing the hepatic resection surface after liver surgery decreases morbidity is still unclear. Nevertheless, various methods and materials are currently in use for this procedure. Here, we describe our experience with a simple technique using a mobilized falciform ligament flap in minimally invasive liver surgery (MILS). We retrospectively analyzed the charts from 46 patients who received minor MILS between 2011 and 2019 from the same surgical team in a university hospital setting in Germany. Twenty-four patients underwent laparoscopic liver resection, and 22 patients received robotic-assisted liver resection. Sixteen patients in the laparoscopic group and fourteen in the robotic group received a falciform ligament flap (FLF) to cover the resection surface after liver surgery. Our cohort was thus divided into two groups: laparoscopic and robotic patients with (MILS + FLF) and without an FLF (MILS−FLF). Twenty-eight patients (60.9%) in our cohort were male. The overall mean age was 56.8 years (SD 16.8). The mean operating time was 249 min in the MILS + FLF group vs. 235 min in the MILS−FLF group (p = 0.682). The mean blood loss was 301 ml in the MILS + FLF group vs. 318 ml in the MILS−FLF group (p = 0.859). Overall morbidity was 3.3% in the MILS + FLF group vs. 18.8% in the MILS−FLF group (p = 0.114). One patient in the MILS−FLF group (overall 2.2%), who underwent robotic liver surgery, developed bile leakage, but this did not occur in the MILS + FLF group. Covering the resection surface of the liver after minor minimally invasive liver resection with an FLF is a simple and cost-effective technique that does not prolong surgical time or negatively affect other perioperative parameters. In fact, it is a safe add-on step during MILS that may reduce postoperative morbidity. Further studies with larger cohorts will be needed to substantiate our proof of concept and results.

Fecal incontinence refers to the inability to pass stool in a localized and timely manner resulting in the involuntary loss of intestinal contents such as air, intestinal mucus or stool. The prevalence of fecal incontinence in the general population is approximately 2-21%. Women are more frequently affected than men. Physiotherapeutically guided pelvic floor training, otherwise known as Kegel exercise, is the mainstay of treatment for fecal incontinence. The objective of this study was to evaluate the feasibility and potential benefits of a new biofeedback training, which uses a non-insertable pelvic floor sensor with digital interface, called ACTICORE1.From January 2020 to April 2021, we conducted a prospective non-randomized multicentric clinical pilot study at the Alexianer St. Hedwig Hospital Berlin (Germany), private clinic Strack (Germany) and the University Hospital Magdeburg (Germany). Patients with fecal incontinence, defined as a Wexner score2, were recruited and asked to either perform biofeedback training with ACTICORE1 (6 min daily for 16 weeks) or daily Kegel exercise (Physiotherapeutic guidance weekly for the first 6 weeks; biweekly for the remaining 10 weeks). The primary outcome was severity of fecal incontinence after 16 weeks of training assessed using the Wexner score. Secondary outcomes were severity of fecal incontinence after 12 weeks and patients' quality of life assessed using the EQ-5D-3L questionnaire after 16 weeks of training. The two-one-sided t-tests (TOST) procedure was used to determine if training with ACTICORE1 has equivalent or noninferior efficacies compared to Kegel exercise.A total of 40 individuals were included. Dropout occurred in 4 cases. The final sample included 19 patients who performed the ACTICORE1 training (ACTICORE-group) and 17 patients who performed guideline-based physiotherapy (PHYSIO-group). Univariate analysis of biometric parameters showed no statistically significant differences. Individuals in the ACTICORE-group were younger (M=46,6 (SD=18,9) years vs. M=57,1 (SD=17,3) years, p=0.093). In terms of endpoint evaluation, a non-inferiority of ACTICORE1 compared to the therapy standard (Kegel exercise) was detected. Both groups showed a statistically significant intraindividual improvement in fecal incontinence as measured by Wexner scoring after 16 weeks. The TOST detected a non-inferiority of ACTICORE1 training (98% confidence interval with equivalence bounds 5 for low and high; Results: 1.36, upper 6.75).Pelvic floor training with ACTICORE1 may enable sufficient pelvic floor training as a digital health application. The study at hand revealed a non-inferiority of ACTICORE1 training compared to Kegel exercise.

This paper is based on the assumption that a key challenge of good design is spatial organization as a result of functional requirements. The authors present a new NetLogo application that assists designers in understanding proposed functional relationships (of spaces) by visualizing them graphically. In more detail, the tool translates adjacency matrices (as representation of functional relationships) into a graph (in architecture known as bubble diagram). The latter can be considered as a pre-step of the actual design, by which the information about functional interrelations becomes more readable and understandable for the designer.

Perovskite silicon tandem solar cells combine potentially low production costs with the ability to surpass the efficiency limit of silicon single junction solar cells. Optical modeling and optimization are crucial to achieve this ambitious goal in the near future. The optimization should seek to maximize the energy yield based on realistic environmental conditions. This work analyzes the energy yield of perovskite silicon tandem solar cells and modules based on realistic experimental data, with a special focus on the investigation of surface textures at the front and rear side of the solar cell and its implication for reflection as well as parasitic absorption properties. The investigation reveals a 7.3%

Indications of a GeV component in the emission from GRBs are known since the EGRET observations during the 1990's and they have been confirmed by the data of the Fermi satellite. These results have, however, shown that our understanding of GRB physics is still unsatisfactory. The new generation of Cherenkov observatories and in particular the MAGIC telescope, allow for the first time the possibility to extend the measurement of GRBs from several tens up to hundreds of GeV energy range. Both leptonic and hadronic processes have been suggested to explain the possible GeV/TeV counterpart of GRBs. Observations with ground-based telescopes of very high energy photons (E>30 GeV) from these sources are going to play a key role in discriminating among the different proposed emission mechanisms, which are barely distinguishable at lower energies. MAGIC telescope observations of the GRB 090102 (z=1.547) field and Fermi Large Area Telescope (LAT) data in the same time interval are analysed to derive upper limits of the GeV/TeV emission. We compare these results to the expected emissions evaluated for different processes in the framework of a relativistic blast wave model for the afterglow. Simultaneous upper limits with Fermi and a Cherenkov telescope have been derived for this GRB observation. The results we obtained are compatible with the expected emission although the difficulties in predicting the HE and VHE emission for the afterglow of this event makes it difficult to draw firmer conclusions. Nonetheless, MAGIC sensitivity in the energy range of overlap with space-based instruments (above about 40 GeV) is about one order of magnitude better with respect to Fermi. This makes evident the constraining power of ground-based observations and shows that the MAGIC telescope has reached the required performance to make possible GRB multiwavelength studies in the very high energy range., 8 pages, 5 figures, 2 tables. Submitted to MNRAS

Discrete-event simulation of hospitals typically specifies flow by means of a process graph through which patients are routed. While this is generally fine for models in which processes are clearly defined, e.g. smaller units such as emergency departments, it falls short of capturing the fact that a patient can in principle go from one unit to any other unit if medical procedure requires it. This problem becomes even more evident when modeling a whole hospital, at which level specifying each individual treatment through directed edges and nodes becomes unviably complex. In the past three years, we have been developing a combined hospital simulation/space design tool in which processes are defined individually by patient, as sequence of visited units imported from the Hospital Information System (treatment chains). The major advantage of this approach lies in the fact that we can now design a future space layout in which assumed capacities (staffing, equipment, required space) can be tested against the recorded patient volume, using an Agent-Based Simulation to re-enact each treatment chain. In contrast to other hospital simulations, this approach targets early stages of architectural conception, during which the actual building structure is elaborated. Using the method, we can compare and contrast different layouts during that stage, making simulation a driver for design rather than a tool for late optimization within the final floor plan.

Monthly notices of the Royal Astronomical Society 451(1), 739 - 750 (2015). doi:10.1093/mnras/stv895, The high-frequency-peaked BL Lac (HBL) 1ES 0806+524 (z = 0.138) was discovered in very high energy (VHE) γ-rays in 2008. Until now, the broad-band spectrum of 1ES 0806+524 has been only poorly characterized, in particular at high energies. We analysed multiwavelength observations from γ-rays to radio performed from 2011 January to March, which were triggered by the high activity detected at optical frequencies. These observations constitute the most precise determination of the broad-band emission of 1ES 0806+524 to date. The stereoscopic Major Atmospheric Gamma-Ray Imaging Cherenkov (MAGIC) observations yielded a γ-ray signal above 250 GeV of (3.7 ± 0.7) per cent of the Crab Nebula flux with a statistical significance of 9.9σ. The multiwavelength observations showed significant variability in essentially all energy bands, including a VHE γ-ray flare that lasted less than one night, which provided unprecedented evidence for short-term variability in 1ES 0806+524. The spectrum of this flare is well described by a power law with a photon index of 2.97 ± 0.29 between ∼150 GeV and 1 TeV and an integral flux of (9.3 ± 1.9) per cent of the Crab nebula flux above 250 GeV. The spectrum during the non-flaring VHE activity is compatible with the only available VHE observation performed in 2008 with VERITAS when the source was in a low optical state. The broad-band spectral energy distribution can be described with a one-zone synchrotron self-Compton model with parameters typical for HBLs, indicating that 1ES 0806+524 is not substantially different from the HBLs previously detected., Published by Oxford Univ. Press, Oxford

Adjacencies stand at the beginning of a multitude of planning tasks. Especially in hospital planning they are essential for describing relationships between different organizational units - e.g. ‘close’, ‘distant’ or ‘neutral’. Mathematically, these terms map to relative weights between each pair of units in the range [-1, 1] which are put into a (symmetric) adjacency matrix. This matrix subsequently determines relative locations of individual spaces (preliminary space layout). The paper deals with the effective definition of this adjacency matrix in the context of early-stage architectural planning. In contrast to current planning practice, which looks at each adjacency relation in isolation, our approach uses a Newtonian gravitation model to propagate changes to a single relationship immediately to the whole space layout. As a result, we are able to supply architects with a design tool that accelerates the definition of adjacencies and lets them preview the preliminary space layout at the same time.

Background: Phosphodiesterase 2A (PDE2A) is an evolutionarily conserved enzyme that catalyzes the degradation of the cyclic nucleotides, cyclic adenosine monophosphate, and/or cyclic guanosine monophosphate. Recent studies reported the expression of PDE2A in the dorsal horn of the spinal cord, pointing to a potential contribution to the processing of pain. However, the functions of PDE2A in spinal pain processing in vivo remained elusive. Methods: Immunohistochemistry, laser microdissection, and quantitative real-time reverse transcription polymerase chain reaction experiments were performed to characterize the localization and regulation of PDE2A protein and messenger RNA in the mouse spinal cord. Effects of the selective PDE2A inhibitor, BAY 60–7550 (Cayman Chemical, Ann Arbor, MI), in animal models of inflammatory pain (n = 6 to 10), neuropathic pain (n = 5 to 6), and after intrathecal injection of cyclic nucleotides (n = 6 to 8) were examined. Also, cyclic adenosine monophosphate and cyclic guanosine monophosphate levels in spinal cord tissues were measured by liquid chromatography tandem mass spectrometry. Results: The authors here demonstrate that PDE2A is distinctly expressed in neurons of the superficial dorsal horn of the spinal cord, and that its spinal expression is upregulated in response to hind paw inflammation. Administration of the selective PDE2A inhibitor, BAY 60–7550, increased the nociceptive behavior of mice in animal models of inflammatory pain. Moreover, BAY 60–7550 increased the pain hypersensitivity induced by intrathecal delivery of cyclic adenosine monophosphate, but not of cyclic guanosine monophosphate, and it increased the cyclic adenosine monophosphate levels in spinal cord tissues. Conclusion: Our findings indicate that PDE2A contributes to the processing of inflammatory pain in the spinal cord.

Until April 2007 the MAGIC telescope used a 300 MSamples/s FADC system to sample the shaped PMT signals produced by the captured Cherenkov photons of air showers. Different algorithms to reconstruct the signal from the read-out samples (extractors) have been implemented and are described and compared. Criteria based on the obtained charge and time resolution/bias are defined and used to judge the different extractors, by applying them to calibration, cosmic and pedestal signals. The achievable charge and time resolution have been derived as functions of the incident number of photo-electrons., Accepted for publication in NIM A

The paper describes the different methods, used in the MAGIC experiment, to unfold experimental energy distributions of cosmic ray particles (gamma-rays). Questions and problems related to the unfolding are discussed. Various procedures are proposed which can help to make the unfolding robust and reliable. The different methods and procedures are implemented in the MAGIC software and are used in most of the analyses., Comment: Submitted to NIM A

The blazar Markarian 501 (Mrk 501) was observed at energies above 0.10 TeV with the MAGIC telescope from May through July 2005. The high sensitivity of the instrument enabled the determination of the flux and spectrum of the source on a night-by-night basis. Throughout our observational campaign, the flux from Mrk 501 was found to vary by an order of magnitude. Intra-night flux variability with flux-doubling times down to 2 minutes was observed during the two most active nights, namely June 30 and July 9. These are the fastest flux variations ever observed in Mrk 501. The ~20-minute long flare of July 9 showed an indication of a 4 +/- 1 min time delay between the peaks of F(1.2 TeV), which may indicate a progressive acceleration of electrons in the emitting plasma blob. The flux variability was quantified for several energy ranges, and found to increase with the energy of the gamma-ray photons. The spectra hardened significantly with increasing flux, and during the two most active nights, a spectral peak was clearly detected at 0.43 +/- 0.06 TeV and 0.25 +/- 0.07 TeV, respectively for June 30 and July 9. There is no evidence of such spectral feature for the other nights at energies down to 0.10 TeV, thus suggesting that the spectral peak is correlated with the source luminosity. These observed characteristics could be accommodated in a Synchrotron-Self-Compton (SSC) framework in which the increase in gamma-ray flux is produced by a freshly injected (high energy) electron population.

During its first data cycle, between 2005 and the beginning of 2006, the fast repositioning system of the MAGIC telescope allowed the observation of nine different gamma-ray bursts as possible sources of very high energy gamma-rays. These observations were triggered by alerts from Swift, HETE-2, and INTEGRAL; they started as quickly as possible after the alerts and lasted for several minutes, with an energy threshold varying between 80 and 200 GeV, depending on the zenith angle of the burst. No evidence for gamma signals was found, and upper limits for the flux were derived for all events using the standard analysis chain of MAGIC. For the bursts with measured redshifts, the upper limits are compatible with a power-law extrapolation, when the intrinsic fluxes are evaluated taking into account the attenuation due to the scattering in the metagalactic radiation field.

Very-high energy (VHE) gamma quanta contribute only a minuscule fraction - below one per million - to the flux of cosmic rays. Nevertheless, being neutral particles they are currently the best "messengers" of processes from the relativistic/ultra-relativistic Universe because they can be extrapolated back to their origin. The window of VHE gamma rays was opened only in 1989 by the Whipple collaboration, reporting the observation of TeV gamma rays from the Crab nebula. After a slow start, this new field of research is now rapidly expanding with the discovery of more than 150 VHE gamma-ray emitting sources. Progress is intimately related with the steady improvement of detectors and rapidly increasing computing power. We give an overview of the early attempts before and around 1989 and the progress after the pioneering work of the Whipple collaboration. The main focus of this article is on the development of experimental techniques for Earth-bound gamma-ray detectors; consequently, more emphasis is given to those experiments that made an initial breakthrough rather than to the successors which often had and have a similar (sometimes even higher) scientific output as the pioneering experiments. The considered energy threshold is about 30 GeV. At lower energies, observations can presently only be performed with balloon or satellite-borne detectors. Irrespective of the stormy experimental progress, the success story could not have been called a success story without a broad scientific output. Therefore we conclude this article with a summary of the scientific rationales and main results achieved over the last two decades., 45 pages, 38 figures, review prepared for EPJ-H special issue "Cosmic rays, gamma rays and neutrinos: A survey of 100 years of research"

Introduction\ud Current methods of identifying axillary node metastases in breast cancer patients are highly accurate, but are associated with several adverse events. This review evaluates the diagnostic accuracy of magnetic resonance imaging (MRI) techniques for identification of axillary metastases in early stage newly diagnosed breast cancer patients.\ud \ud Methods\ud Comprehensive searches were conducted in April 2009. Study quality was assessed. Sensitivity and specificity were meta-analysed using a bivariate random effects approach, utilising pathological diagnosis via node biopsy as the comparative gold standard.\ud \ud Results\ud Based on the highest sensitivity and specificity reported in each of the nine studies evaluating MRI (n = 307 patients), mean sensitivity was 90% (95% CI: 78–96%; range 65–100%) and mean specificity 90% (95% CI: 75–96%; range 54–100%). Across five studies evaluating ultrasmall super-paramagnetic iron oxide (USPIO)-enhanced MRI (n = 93), mean sensitivity was 98% (95% CI: 61–100%) and mean specificity 96% (95% CI: 72–100%). Across three studies of gadolinium-enhanced MRI (n = 187), mean sensitivity was 88% (95% CI: 78–94%) and mean specificity 73% (95% CI: 63–81%). In the single study of in-vivo proton MR spectroscopy (n = 27), sensitivity was 65% (95% CI: 38–86%) and specificity 100% (95% CI: 69–100%).\ud \ud Conclusions\ud USPIO-enhanced MRI showed a trend towards higher sensitivity and specificity and may make a useful addition to the current diagnostic pathway. Additional larger studies with standardised methods and standardised criteria for classifying a node as positive are needed. Current estimates of sensitivity and specificity do not support replacement of SLNB with any current MRI technology in this patient group.

Geiger-mode Avalanche Photodiodes (G-APD) bear the potential to significantly improve the sensitivity of Imaging Air Cherenkov Telescopes (IACT). We are currently building the First G-APD Cherenkov Telescope (FACT) by refurbishing an old IACT with a mirror area of 9.5 square meters and are constructing a new, fine-pixelized camera using novel G-APDs. The main goal is to evaluate the performance of a complete system by observing very high energy gamma-rays from the Crab Nebula. This is an important field test to check the feasibility of G-APD-based cameras to replace at some time the PMT-based cameras of planned future IACTs like AGE and CTA. In this article, we present the basic design of such a camera as well as some important details. (C) 2010 Elsevier B.V. All rights reserved.

Hybrid photon detectors are one of the few low light level sensors that can provide an excellent single and multiple photoelectron amplitude resolution. The recently developed hybrid photon detectors for the Major Atmospheric Gamma-Imaging Cherenkov (MAGIC) telescope project with an 18-mm-diameter GaAsP photocathode (the Hamamatsu R9792U-40) have a peak quantum efficiency of more than 50% and a pulse width of ∼ 2.3 ns . In addition, the afterpulsing rate of these tubes is ∼ 300 times lower compared to that of conventional photomultiplier tubes. Photocathode aging measurements showed lifetimes of more than 10 years under standard operating conditions of Cherenkov Telescopes. The temperature dependence of the avalanche gain can be reduced to the same level of a photomultiplier by a simple compensation circuit. Here we report on the recent progress with the above-mentioned hybrid photon detectors.

The MAGIC telescopes are two Imaging Atmospheric Cherenkov Telescopes (IACTs) located on the Canary island of La Palma. The telescopes are designed to measure Cherenkov light from air showers initiated by gamma rays in the energy regime from around 50 GeV to more than 50 TeV. The two telescopes were built in 2004 and 2009, respectively, with different cameras, triggers and readout systems. In the years 2011-2012 the MAGIC collaboration undertook a major upgrade to make the stereoscopic system uniform, improving its overall performance and easing its maintenance. In particular, the camera, the receivers and the trigger of the first telescope were replaced and the readout of the two telescopes was upgraded. This paper (Part I) describes the details of the upgrade as well as the basic performance parameters of MAGIC such as raw data treatment, dead time of the system, linearity in the electronic chain and sources of noise. In Part II, we describe the physics performance of the upgraded system., 19 pages, 18 figures, accepted by Astroparticle Physics

The BL Lac object 1ES 1011+496 was discovered at Very High Energy gamma-rays by MAGIC in spring 2007. Before that the source was little studied in different wavelengths. Therefore a multi-wavelength (MWL) campaign was organized in spring 2008. Along MAGIC, the MWL campaign included the Metsahovi radio observatory, Bell and KVA optical telescopes and the Swift and AGILE satellites. MAGIC observations span from March to May, 2008 for a total of 27.9 hours, of which 19.4 hours remained after quality cuts. The light curve showed no significant variability. The differential VHE spectrum could be described with a power-law function. Both results were similar to those obtained during the discovery. Swift XRT observations revealed an X-ray flare, characterized by a harder when brighter trend, as is typical for high synchrotron peak BL Lac objects (HBL). Strong optical variability was found during the campaign, but no conclusion on the connection between the optical and VHE gamma-ray bands could be drawn. The contemporaneous SED shows a synchrotron dominated source, unlike concluded in previous work based on nonsimultaneous data, and is well described by a standard one zone synchrotron self Compton model. We also performed a study on the source classification. While the optical and X-ray data taken during our campaign show typical characteristics of an HBL, we suggest, based on archival data, that 1ES 1011+496 is actually a borderline case between intermediate and high synchrotron peak frequency BL Lac objects., 13 pages, accepted for publication in MNRAS

We report on very high energy gamma-observations with the MAGIC Telescope of the pulsar PSR B1951+32 and its associated nebula, CTB 80. Our data constrain the cutoff energy of the pulsar to be less than 32 GeV, assuming the pulsed gamma-ray emission to be exponentially cut off. The upper limit on the flux of pulsed gamma-ray emission above 75 GeV is 4.3*10^-11 photons cm^-2 sec^-1, and the upper limit on the flux of steady emission above 140 GeV is 1.5*10^-11 photons cm^-2 sec^-1. We discuss our results in the framework of recent model predictions and other studies.

The basic concept and the status of currently operating ground-based array detectors for VHE gamma-ray astronomy will be presented and compared with imaging air Cherenkov telescopes. Also an outlook of future prospects will be given.