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BACKGROUND/AIMS: Ketogenic diet therapies (KDTs) offer a needed therapeutic option for patients with drug-resistant epilepsy. The current study investigated biochemical and anthropometric indices of cardiovascular disease (CVD) risk in adults with epilepsy treated with KDT over 6 months. METHOD: 65 adults with epilepsy naïve to diet therapy were enrolled in a prospective longitudinal study and instructed on modified Atkins diet (MAD) use. Seizure frequency, anthropometric measures, blood levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoproteins A1 and B, and lipoprotein sub-fractions were assessed at baseline, 3 months, and 6 months. RESULTS: Subsequent to study enrollment, 34 participants were lost to follow-up, elected not to start, or stopped MAD prior to study completion, leaving a total of 31 participants in the study at 6 months. Compared to baseline, participants on MAD showed significant reductions in median seizure frequency/week, weight, body mass index, waist and hip circumference, and percent body fat at 3 and 6 months. Compared to baseline, participants on MAD for 3 months showed significantly increased levels of total, small and medium LDL particles, ApoB and ApoB/A1 ratio. At 6 months, only small LDL particles and ApoB levels remained elevated and levels of ApoA1 had risen, suggesting possible compensatory adaptation over time. CONCLUSIONS: This study provides evidence demonstrating the efficacy and cardiovascular safety of 6 months of MAD use by adults with epilepsy. It also highlights an index of CVD risk – small LDL particles - that should be closely monitored.. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02694094.

Objectives Patients with epilepsy are known to exhibit high rates of comorbid psychiatric disorders such as depression, anxiety, and other mood disorders. Little is known about the psychiatric effects of a ketogenic diet therapy (KDT) on adults with epilepsy. The objective of this study was to better understand the relationship between KDT and psychological state based on depressive and anxiety symptoms in adults with chronic epilepsy. Methods Adults at the Johns Hopkins Adult Epilepsy Diet Center on a modified Atkins diet (MAD) for at least one month were surveyed retrospectively. Adults who were diet naive were given a baseline survey and an additional survey after 3 months or more on MAD. Surveys included validated measures of depressive and anxiety symptoms as well as their severity. Participant demographics, seizure frequency, and use of concomitant antiseizure drugs (ASDs), chronic anxiolytics (excluding as-needed benzodiazepines for seizure rescue only), and/or antidepressant drugs were extracted from electronic medical records. Results One-hundred participants aged 19–75 enrolled in the study. Sixty participants filled out a single retrospective survey. Of 40 diet naive participants who filled out a baseline prospective survey, 19 completed a follow-up survey while on MAD and 21 participants were lost to follow-up. Longer diet duration was significantly associated with fewer anxiety and depressive symptoms, based on psychiatric measure scores, in retrospective study participants. Lower seizure frequency was also significantly associated with less anxiety symptoms in the retrospective cohort. Prospective study participants did not experience significant change in anxiety or depressive symptoms on the diet. There was a significant correlation between higher ketone level and responder rate (≥50% seizure reduction) in the prospective cohort, although no correlation between ketone level and change in psychiatric symptoms was seen. Significance Psychiatric comorbidity among patients with epilepsy is quite common and can be influenced by multiple factors such as seizure frequency, the use of various ASDs, social factors, and underlying etiology. Although ketogenic diet therapies have been in clinical use for one century, the psychiatric impacts have been insufficiently explored. This study provides preliminary evidence that KDT may have a positive impact on psychological state independent of seizure reduction or ketone body production and may be influenced by longer duration of diet therapy. These results support further investigation into specific effects and potential therapeutic benefits on various psychiatric disorders.

Ketogenic diet therapies are high-fat, low-carbohydrate diets designed to mimic a fasting state. Although initially developed nearly one century ago for seizure management, most clinical trials for the management of drug-resistant epilepsy in children as well as adults have been conducted over the last 3 decades. Moreover, ketogenic diets offer promising new adjunctive strategies in the critical care setting for the resolution of acute status epilepticus when traditional antiseizure drugs and anesthetic agents fail. Here, we review the history of ketogenic diet development, the clinical evidence supporting its use for the treatment of drug-resistant epilepsy in children and adults, and the early evidence supporting ketogenic diet feasibility, safety, and potential efficacy in the management of status epilepticus.

The current coronavirus-19 pandemic has changed dramatically how neurologists care for children and adults with epilepsy. Stay-at-home orders and resistance to hospitalizations by patients have led epileptologists to engage in telemedicine and re-evaluate how to provide elective services. Ketogenic diet therapy is often started in the hospital, with families educated in hospital-based classes, but this is difficult to do in this current pandemic. At our two academic centers, both our pediatric and adult epilepsy diet centers have had to quickly consider alternative methods to both start and maintain ketogenic diet therapy. This paper provides several examples of how ketogenic diet therapy can be provided to patients in unique ways, along with recommendations from other experts and patients learned over the past few months., Highlights • Ketogenic diet therapy can be successfully initiated in the hospital with shorter, focused admissions to minimize exposure. • Similarly, the classic ketogenic diet can be started as an outpatient with telemedicine visits for education and monitoring, a non-fasting approach, and close follow-up. • In adults, starting the modified Atkins diet has been successfully accomplished with live or pre-recording educational sessions and telemedicine as well. • Patients on ketogenic diets in this pandemic should ensure adequate high fat food supplies, medications, a scale for checking their weight, and telemedicine capability.

The current review highlights the evidence supporting the use of ketogenic diets in the management of drug-resistant epilepsy and status epilepticus in adults. Ketogenic diet variants are compared and advantages and potential side effects of diet therapy are discussed.

The current review highlights the evidence supporting the use of ketogenic diet therapies in the management of a growing number of neurological disorders in adults. An overview of the scientific literature supporting posited mechanisms of therapeutic efficacy is presented including effects on neurotransmission, oxidative stress, and neuro-inflammation. The clinical evidence supporting ketogenic diet use in the management of adult epilepsy, malignant glioma, Alzheimer’s disease, migraine headache, motor neuron disease, and other neurologic disorders is highlighted and reviewed. Lastly, common adverse effects of ketogenic therapy in adults, including gastrointestinal symptoms, weight loss, and transient dyslipidemia are discussed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13311-018-0666-8) contains supplementary material, which is available to authorized users.

Purpose To determine whether use of a ketogenic formula during the first month of the modified Atkins diet (MAD) in adults with drug-resistant epilepsy (DRE) improves seizure reduction and compliance compared to MAD alone. Methods Eighty adults (age ≥18 years) with DRE and ≥4 reliably quantifiable seizures/month were enrolled. All participants were trained to follow a 20 g/day net carbohydrate limit MAD. Patients were randomized to receive one 8-ounce (237 mL) tetrapak of KetoCal®, a 4:1 ketogenic ratio formula, daily in combination with MAD during the first month (treatment arm) or second month (control/cross-over arm). Patients recorded urine ketones, weight, and seizure frequency and followed up at 1 and 2 months. Results By 1 month, 84% of patients achieved ketosis (median of 4–4.5 days). At 1 month, the treatment arm had a significantly higher ketogenic ratio and more patients with a ≥1:1 ketogenic ratio compared to the control arm. There was no difference in median seizure frequency, proportion of responders (≥50% seizure reduction), or median seizure reduction from baseline between groups. However, patients treated with KetoCal® during the first month were significantly more likely to continue MAD for 6 months or more. Conclusion Although supplementing MAD with a ketogenic formula in the first month did not increase the likelihood of reducing seizures compared to MAD alone, significantly more adults remained on MAD long-term with this approach. This suggests a potential strategy for encouraging compliance with MAD in adults with DRE.

Aim The current study investigated biochemical and vascular markers of cardiovascular health in adult patients with epilepsy treated with long-term (greater than 1 year) ketogenic diet therapy compared with controls. Method Anthropometric measures, serum fasting lipid panel, apolipoproteins A-1 and B, lipoprotein sub-fractions as well as common carotid intima-media thickness (cIMT), and plaque presence were assessed in 20 adult patients with epilepsy on a modified Atkins diet (MAD) for > 1 year started as an adult compared with 21 adult patients with epilepsy naive to diet therapy. Results Patients treated with MAD had significantly lower weight, body mass index, waist and hip circumference, percent body fat, and serum triglyceride levels when compared with control patients. In contrast, they had significantly higher serum levels of small low-density-lipoprotein (LDL) particles and were significantly more likely to have LDL pattern B in which small LDL particles predominate when compared with controls. However, there was no significant difference in cIMT or plaque presence between groups. Conclusion Our results provide clinical evidence demonstrating the cardiovascular safety of a high-fat, low-carbohydrate diet used in adults with epilepsy for at least 12 months. It also highlights potential markers of cardiovascular risk – small dense LDL particles – that should be closely monitored in adults treated with diet therapy long-term.

The paper describes a novel application of an electron beam ion trap as a plasma target facility for intense laser-plasma interaction studies. The low density plasma target (~;1013/cm3) is confined in a mobile cryogenic electromagnetic charged particle trap, with the magnetic confinement field of 1-3 T maintained by a superconducting magnet. Ion plasmas for a large variety of ion species and charge states are produced and maintained within the magnetic field and the space-charge of an energetic electron beam in the "electron beam ion trap" (EBIT) geometry. Intense laser beams (optical lasers, X-ray lasers and upcoming "X-ray free electron lasers" (XFEL)) provide strong time varying electromagnetic fields (>1012 V/cm in femto- to nano-second pulses) for interactions with electromagnetically confined neutral/non-neutral plasmas. Experimental scenarios with intense photon fields on ionization/excitation processes, the ionization balance, as well as photon polarization effects and tests with intense lasers that utilize the ion plasma target are outlined. A first test of the plasma target with the PHELIX high intensity laser at GSI is described.

The total electron emission yields following the interaction of “Slow (⩽2 keV/a.u.) Highly Charged Ions” (SHCI) (O 3+⋯7+ , Xe 12+⋯52+ , Au 54+⋯69+ ) with different target surfaces (highly-oriented pyrolytic graphite (HOPG), Au and SiO2) have been measured. The emission yields increase with charge state, and is found to be highest for carbon, the HOPG target, and lowest for the SiO 2 target. An empirical formula for the electron emission is including recent results from investigations of plasmon excitation following SHCI impact are used to interpret the results.

Recently the first laser–plasma interaction and hohlraum experiments have been performed at the National Ignition Facility (NIF) in support of indirect drive inertial confinement fusion designs. The effects of laser beam smoothing by spectral dispersion and polarization smoothing on the intense (2 × 1015 W cm−2) beam propagation in gas-filled tubes has been studied at up to 7 mm plasma scales as found in indirect drive gas filled ignition hohlraum designs. These experiments have shown the expected full propagation without filamentation and beam break up when using full laser smoothing. In addition, vacuum hohlraums have been irradiated with laser powers up to 6 TW, 1–9 ns pulse lengths and energies up to 17 kJ to activate several diagnostics, to study the hohlraum radiation temperature scaling with the laser power and hohlraum size, and to make contact with hohlraum experiments performed at the Nova and Omega laser facilities. Subsequently, novel long laser pulse hohlraum experiments have tested models of hohlraum plasma filling and long pulse hohlraum radiation production. The validity of the plasma filling assessment using in analytical models and radiation hydrodynamics calculations with the code LASNEX has been proven in these studies. The comparison of these results with modelling will be discussed.

The intense, ultra-fast electronic excitation of clean silicon (100)–(2×1) surfaces leads to the formation of silicon nanostructures embedded in silicon, which photoluminesce in the yellow-green (∼2-eV band gap). The silicon surfaces were irradiated with slow, highly charged ions (e.g. Xe44+ and Au53+) to produce the ultra-fast electronic excitation. The observation of excitonic features in the luminescence from these nanostructures has recently been reported. In this paper we report the dispersion of the excitonic features with laser excitation energy. A phonon-scattering process is proposed to explain the observed dispersion.

New emission-based MeV nuclear microscopies have been in the process of development for the past four years. These techniques all fall under the heading of ion-induced emission microscopy (I-IEM), and the first to be developed was ion-electron emission microscopy (IEEM). With I-IEM the ion beam is not focused, but instead, secondary particles emitted when a single-ion strikes the sample are projected at great magnification onto a high efficiency single particle detector generating position signals. These X and Y signals are then put into coincidence with other signals made by this same ion in a fashion completely analogous to traditional nuclear microprobe analysis. In this paper, we update the current state of I-IEMs, which currently includes IEEM and highly charged ion-secondary ion mass spectroscopy (HCI-SIMS or IIEM) and ion-photon emission microscopy. At the present time none of these microscopies have atomic resolution, but the potential exists for resolution adequate for many scientific and nanotechnology applications.

The extraction of high-Z high-charge-state ions up to U90+ from a high-energy electron-beam ion trap, the SuperEBIT at Lawrence Livermore National Laboratory, is reported. The SuperEBIT provides a 240 mA electron beam with up to 200 keV of energy. Depending on the operating conditions (pulsed, continuous) and charge state, the number of ions extracted from the SuperEBIT varies between 102 and 105 ions per second under the tested conditions. The ions produced in SuperEBIT are extracted at potentials ranging from 0.5 to 20 keV (continuously variable) to provide highly charged low-emittance ion beams with energies between a few keV and several MeV. The performance of the SuperEBIT as an ion source is described and aspects for future developments and potential applications are discussed.

Highly Charged Ion (HCI) Time-of-Flight (TOF) Secondary Ion Mass Spectrometry (SIMS) has been employed to analyze the changes in the surface composition of TATB caused by low energy electron, ultraviolet, and Gamma ray irradiation. Comparisons are made between canary yellow (not irradiated) TATB and TATB that has been “greened” by exposure to radiation. We ascribe the color change from yellow to green to a loss of oxygen. Another striking aspect of this study is the presence of a feature at m/z = 30 (NO+) for highly charged ion SIMS, which does not occur in singly charged ion TOF SIMS.

The emission of small (hydrogenated) carbon cluster ions CnHm + (n =2-22) upon highly charged Xeq+ (q =20-44) impact on C84 surfaces is studied by means of time-of-flight secondary ion mass spectrometry. The respective stage of hydrogenation/protonation of a certain carbon cluster ion Cn + is a strong indication for its geometrical structure. From the cluster ion yield as a function of cluster size it can be concluded, that the hydrogenation takes place after the initial carbon cluster formation. The carbon clusters seem to be emitted as an entity in agreement with “equilibrium” and “shock wave” models.

Electronic sputtering in the interaction of slow (v < vBohr), highly charged ions (SHCI) with solid surfaces has been subject of controversial discussions for almost 20 years. We review results from recent studies of total sputtering yields and discuss distinct microscopic mechanisms (such as defect mediated desorption, Coulomb explosions and eAects of intense electronic excitation) in the response of insulators and semiconductors to the impact of SHCI. We then describe an application of ions like Xe 44a and Au 69a as projectiles in time-of-flight secondary ion mass spectrometry for surface characterization of semiconductors. ” 2000 Elsevier Science B.V. All rights reserved.

The investigation of highly charged ion Coulomb crystallization in mixed strongly coupled plasmas is of interest in many areas: white dwarf astrophysical plasmas are believed to have very similar thermodynamic properties, cold highly charged ions can be used as an object for high precision laser spectroscopy of fine and hyperfine transitions in the visible due to the absence of Doppler broadening and, an entirely new area of research is the potential application to highly charged ion based quantum computing schemes.

We have measured the deposition of potential energy of slow $(\ensuremath{\sim}6\ifmmode\times\else\texttimes\fi{}{10}^{5}\mathrm{m}/\mathrm{s})$, highly charged ions in solids with an ion implanted silicon detector. A large fraction (about $35%$ or 60 keV) of the potential energy dissipated by ${\mathrm{Au}}^{69+}$ ions can be traced in electronic excitations deep $(g50\mathrm{nm})$ inside the solid. In contrast, only about $10%$ of the potential energy has been accounted for in measurements of emitted secondary particles.

We report observations of nonequilibrium charge state distributions of slow, highly charged (33+{le} q{le}75+) ions after transmission of thin carbon foils. Charge equilibration times are determined directly from the dependencies of exit charge states on projectile velocity (0.5{times}10{sup 6}{lt}v{lt}10{sup 6} m/s) and foil thickness (5{endash}10thinspthinspnm). Ions like Xe{sup 44+} and Au{sup 68+} are found to equilibrate inside of solid matter in a time of only 7thinspthinspfs. {copyright} {ital 1999} {ital The American Physical Society}

Aims The objectives of this study were: (1) to determine, using immunohistochemistry, the level of expression of the cell cycle factors p53, p21 and cyclin D1 in a group of bronchioloalveolar carcinomas (BACs), and to compare these data to relevant published data for lung carcinoma; (2) to determine if higher expression rates for these factors in BAC were associated statistically with advanced clinical stage, greater tumour size, tobacco abuse, and/or BAC subtype; (3) to seek, using Fisher's exact t-test and paired data groups, any significant associations within the expression data for p53, p21 and cyclin D1. Methods and results A panel of monoclonal antibodies against p53, p21 and cyclin D1 was applied to 19 bronchioloalveolar carcinomas (17 surgical pathology cases and two autopsies) from the tissue archives of St. Louis University. These immunohistochemical stains were graded on a semiquantitative scale according to the prevalence of nuclear staining within the tumour (

Ions with charge states as high as 80+, produced in the Lawrence Livermore National Laboratory electron beam ion trap were extracted and transferred to a Penning ion trap (RETRAP). RETRAP was operated at cryogenic temperature in the field of a superconducting magnet. The stored low-energy ions collided occasionally with H{sub 2} molecules in the ultrahigh-vacuum environment of the trap, capturing one or two electrons and reducing the charge state of the ions. The number of ions was monitored nondestructively by ramping the axial oscillation frequencies of the ions through resonance with a tuned circuit composed in part of trap capacitance and an external inductor. This produced resonance signals whose square is proportional to the number of ions in each charge state. These signals were recorded vs storage time to determine the electron-capture rates. From these rates the relative electron-capture cross sections were obtained using estimates of the mean ion energies based on modeling the ion storage, and with the aid of a density calibration measurement using Ar{sup 11+}. The measured total electron-capture cross sections are consistent with a linear increase with charge state q. The cross-section data for the highest charge states lie above the predictions of the absorbing spheremore » model, but agree within uncertainties in both experiment and theory. The true double-capture cross-section fraction for q{gt}35 is near 25{percent}. The results are discussed with relation to measurements on lower charge states, and with theory. {copyright} {ital 1998} {ital The American Physical Society}« less

Recombination of slow highly charged ions at the surface of a target foil can be used as a source of x rays for a projection x-ray microscope. In a first test of this concept, a low emittance beam of Ar18+ and Ar17+ ions from an electron beam ion trap was focused with einzel lenses to a 20 μm full width at half maximum spot on a beryllium target foil. The 3 keV x rays from radiative deexcitation of the ions were used to obtain a magnified image of an electroformed nickel mesh with 20 μm resolution by projection onto a CCD camera. Prospects for substantial improvements in resolution and intensity are discussed.

Time resolved hard x-ray images (hv > 9 keV) and time integrated hard x-ray spectra (hv = 18-150 keV from vacuum hohlraums irradiated with four 351 nm wavelength NIF laser beams are presented as a function of hohlraum size and laser power and duration. The hard x-ray images and spectra provide insight into the time evolution of the hohlraum plasma filling and the production of hot electrons. The fraction of laser energy detected as hot electrons (f hot ) shows correlation with both laser intensity and with an analytic plasma filling model.

Recent experimental results from the RETRAP apparatus, including electron capture measurements on highly charged high-Z ions and laser cooling of a mixed cloud of Be+ and Be2+ ions, are briefly described. These results are used as a basis for discussion of planned spectroscopy measurements on hydrogen-like and beryllium-like high-Z highly charged ions. Experimental parameters for potential measurements of the ground state hyperfine structure of a hydrogen-like high-Z ion, and the g-factor of the electron bound in that ion, are emphasized.

It is common to have knowledge about the unknown parameters of a demographic model which restricts the values of the parameters. With such knowledge, it is reasonable to require that our parameter estimates satisfy the parameter constraints and one should use a constrained estimation procedure. We briefly review existing approaches to fitting parameter-constrained models. We describe a Bayesian approach for the fitting of parameter-constrained demographic models, which is the main focus of the paper. We illustrate the Bayesian approach by fitting a parameter-constrained proportional hazards model based on current-status data and a parameter-constrained log-linear regression model for standardized mortality ratios.

Charge-exchange cross sections for collisions between ${\mathrm{H}}_{2}$ and ions with unusually low center-of-mass energies (\ensuremath{\approx}6 eV) and high-charge states (${\mathrm{Xe}}^{q+}:35, 43\ensuremath{\le}q\ensuremath{\le}46$, ${\mathrm{Th}}^{q+}:73\ensuremath{\le}q\ensuremath{\le}80$) have been measured using a Penning ion trap. A nondestructive measurement technique permitted both primary and product ion analysis. The data, averaged over the charge states indicated above, are consistent with a total cross section that scales linearly with ion charge $q$. The true double-capture cross section is found to be about 25% of the total cross section at high $q$. The results are compared to predictions of the absorbing-sphere model.

We evaluated the use of utility measurements to assess the quality of life of patients with Crohn's disease. Utility scores were obtained using the Time Trade-Off (TTO), Standard Gamble, and Visual Analog Scale (VAS) methods in 180 consecutive patients with Crohn's disease. The mean utility scores of patients with a spectrum of disease severity were compared with other measures of disease activity to assess the operating properties of these instruments. All methods of utility estimation yielded lower mean scores in patients with more severe disease. (Remission versus chronically active, therapy resistant disease: TTO 0.96 versus 0.88; Standard Gamble 0.88 versus 0.74; VAS 0.84 versus 0.61). TTO scores were consistently higher than those derived by the other methods (p = 0.001). The utility scores were reliable in patients who were stable (intraclass correlation coefficient 0.55-0.84), but were less responsive than the Crohn's Disease Activity Index (responsiveness ratio 0.97-1.3 versus 2.10) to changes in disease severity. Patients with active Crohn's disease have decreased quality of life as measured by utility scores. Although utilities are valid and reliable quality of life assessments, they are less responsive than other measures of outcome used for clinical trials.

To investigate the origin of discrete shadowing from uterine leiomyomas at ultrasound (US) that does not progress from an echogenic origin.Seven hysterectomy specimens with leiomyomas were scanned in a water bath. With US guidance, 13 self-retaining needles were placed at the origin of shadows that did not (12 cases) or did (one case) arise from an echogenic focus. The localized tissues were inspected for gross pathologic features and microanatomic detail.In the 12 cases, the shadow originated from transitional zones: the margins of the fibroid with adjacent myometrium (three needles), the edges of nodular whorls of smooth muscle (four needles), and the margin between smooth muscle bundles and hyalinized connective tissue (five needles). There was no evidence of calcification, hemorrhage, or necrosis. In the other case, microcalcifications were found.Discrete shadowing not arising from echogenic foci resulted from the structural features of the leiomyomas and occurred at transitional boundaries between juxtaposed tissue types or at the curved margins of organized anatomic structures.

Extracted Xe 44+ ions from an electron beam ion trap (EBIT) have been decelerated and captured in a cylindrical Penning trap. The voltage induced between the compensation electrodes by the axial ion oscillation is used to measure charge exchange rate coefficients from H 2 to Xe 44+ at low energies and the resistive cooling time constant as well. The experimentally determined reaction rates are found to be in reasonable agreement with the Langevin model for charge exchange.

A single-detector technique for the measurement of negative ion time-of-flight spectra is introduced in this work. Spectra are presented for 390 keV Xe 44f ions at normal incidence on different samples. Mass distributions for C, and Si,O, clusters indicate that highly charged ions lead to a statistical off-surface formation of heavy clusters, whereas low-energy singly-charged ions may directly produce heavy carbon clusters. The detection technique has proven to be very efficient and might even be used as a nearly non-destructive surface-analysis method for investigations of time dependent surface modifications.

We present total yields for emission of slow (${\mathit{E}}_{\mathit{e}}$\ensuremath{\le}50 eV) electrons due to the impact of slow (${\mathit{v}}_{\mathit{p}}$\ensuremath{\le}5\ifmmode\times\else\texttimes\fi{}${10}^{5}$ m/s) highly charged ions [${\mathrm{Ar}}^{\mathit{q}+}$ (q\ensuremath{\le}18), ${\mathrm{Xe}}^{\mathit{q}+}$ (q\ensuremath{\le}51), and ${\mathrm{Th}}^{\mathit{q}+}$ (q\ensuremath{\le}80)] on clean polycrystalline gold. The highly charged ions were produced in the Lawrence Livermore National Laboratory electron-beam ion trap; electron yields have been derived from the respective measured electron emission statistics. The experimental data support a currently accepted scenario for multicharged ion-induced electron emission, which is largely based on a classical over-barrier model. In particular, we are able to distinguish different processes contributing to the total above-surface electron emission. In addition, an ultimate low-impact-energy limit due to projectile self-acceleration toward the metal surface, as a result of the projectile image charge, has been demonstrated and evaluated.

A summary of the present status of the LLNL EBIT based research program on highly charged ion-solid surface interaction is presented. New results for coincidence measurements of K”-KP X-ray emission for Fe 26f incident on Al, using two Ge detectors are presented. It is shown that excellent resolution of the satellite and hypersatellite lines are achieved, in excess of what is possible with single Ge detector measurements. Recent results from ongoing investigations on electron emission, sputtered ion and energy loss phenomena are presented. Results from charge-state analysis of grazing incidence specular scattering of highly charged ions off atomically flat surfaces of gold, carbon and mica indicate that the incident ion essentially reaches ground state of its electronic distribution within the ion-surface interaction time of - 100 fs. Atomic force microscopy is used to investigate the formation of a new type of ion induced surface defect, peculiar to highly charged ion-surface interactions. A linear correlation, between the defect volume and the incident ion charge, supports a mechanism of defect formation due to potential energy induced electron emission and subsequent collective displacement due to local charge imbalance.

We found unambiguous evidence of a new radiation effect from the occurrence of single ion defects which are created through the interaction of the Coulombic potential of slow highly charged ions (e.g. Xe 44+ and U 70+ ) and the surface of solid insulating materials (i.e. mica). In the cases studied, the kinetic energy of the ions is some 300–500 keV (ca. 2.2 keV/u), while the energy associated with the electrostatic potential of the incident ions approaches 200 keV. Defect production in mica has been investigated as a function of incident ion charge using an atomic force microscope. The volume of “blister-like” defects has been found to be proportional to the incident ion charge.

We have determined exit charge states and energy losses of slow, highly charged gold ions after transmission of thin (7 ± 3 nm) diamond like carbon foils. Average charge states of up to 37+ were observed for Th80+ at 8.2 keV/u (0.57 vBohr). The final charge state is populated through re-arrangement processes after the projectile has left the foil. High final charge states indicate that none of the M-shell vacancies in Th80+ could be filled inside the foil. The increase of the average exit charge state as a function of M-shell vacancies is a sign of strongly enhanced X-ray fluorescent yields for hollow atom decay in vacuum.

Regional gravity and aeromagnetic data of Wales have been processed using a variety of techniques. Image processing has greatly assisted qualitative interpretation, whilst automated procedures have provided additional quantitative information. The shaded relief images emphasize gradients in the potential fields, and are useful for displaying strong linear features. The Euler deconvolution method produces plotted solution maps, which define the position of the source of the gravity and magnetic anomalies. Euler solution maps of Wales and the adjacent continental shelf are presented for the first time. These maps are interpreted in relation to the known geology, with special emphasis on the Lower Palaeozoic Welsh Basin. It is proposed that the Euler solutions define a network of fault-bounded blocks within the Precambrian basement.

Gravity and aeromagnetic data sets provide systematic coverage over the whole of the Welsh Basin. Physical property information shows considerable overlap in densities within the Lower Palaeozoic and Precambrian formations, with relatively few units of the exposed succession being strongly magnetic. While the geophysical anomalies cannot be interpreted unambiguously in terms of these sources, the data can still be used to test different geological models and to indicate the range of possible solutions. The major fault zones are seen to influence the anomaly patterns in a variety of ways, reflecting a combination of differing near-surface contrasts and effects within the underlying basement. The general increase in gravity values towards Cardigan Bay may originate from the lower crust, and the large amplitude aeromagnetic low seen over Cardigan Bay indicates that a distinctive change in the character of the crust occurs here. Two-dimensional modelling in central Wales shows that a westward thickening of the Welsh Basin, to a maximum of about 10 km, may also be significant. It is necessary to postulate a separation of the base of denser, Lower Palaeozoic rocks from the underlying, more magnetic basement in order to account for offsets in anomaly source locations. This implies the presence of less dense Cambrian sediments and/or non-magnetic components of the Precambrian basement.

Inclusive and exclusive spectra of the {sup 4}He({pi},{pi}{prime},{ital p}) reaction were measured with {pi}{sup +} and {pi}{sup {minus}} at {ital T}{sub {pi}}=140 MeV and {theta}{sub {pi}}=40{degree}, and at 180 MeV and 30{degree}, 40{degree}, 60{degree}, and 80{degree} using the EPICS system at LAMPF in coincidence with elastic plastic scintillators. The inclusive spectra yield cross section ratios {ital R}{sub {pi}}={sigma}({pi}{sup +})/{sigma}({pi}{sup {minus}})=1.1{plus minus}0.1 at both {ital T}{sub {pi}} and all {theta}{sub {pi}}. Exclusive spectra were obtained between {sup 4}He{sup *} excitation energies {ital E}{sub {ital x}}=21.5 and 45.0 MeV. Angular correlation functions for ({pi},{pi}{prime},{ital p}) were extracted at {ital T}{sub {pi}}=180 MeV at the four pion angles for selected regions of {ital E}{sub {ital x}}. The ({pi}{sup +},{pi}{sup +{prime}}{ital p}) angular correlations show a distinct peak near the free proton knockout angle; however, the ({pi}{sup {minus}},{pi}{sup {minus}{prime}}{ital p}) data show either a flat distribution or a mininum near that angle. Calculations, using a distorted wave impulse approximation (DWIA) code which models the ({pi},{pi}{prime}{ital p}) reaction as a pion-induced proton knockout, predict peaks in the angular correlation functions in the quasifree knockout direction and reproduce quite well the ({pi}{sup +},{pi}{sup +{prime}}{ital p}) data above {ital E}{sub {ital x}}=30 MeV. However, these calculations domore » not resemble the ({pi}{sup {minus}},{pi}{sup {minus}{prime}}{ital p}) data at any excitation energy.« less

Double differential electron emission yields following the impact of fast (3.95\ifmmode\times\else\texttimes\fi{}${10}^{7}$cm/sec)${\mathrm{Ar}}^{9,12,18+}$, ${\mathrm{Ne}}^{9+}$, ${\mathrm{Xe}}^{30,44+}$, and ${\mathrm{Th}}^{70,75+}$ ions on Cu and Au targets have been measured. The electron emission is dominated by low-energy electrons (50 eV). It is found that the total yield, which rises to about 100 electrons per ion, is a nonlinear function of the total potential energy of the incident ion (up to about 200 keV).

New data for elastic and inelastic ${\mathrm{\ensuremath{\pi}}}^{+}$ and ${\mathrm{\ensuremath{\pi}}}^{\mathrm{\ensuremath{-}}}$ scattering by $^{208}\mathrm{Pb}$ at 180 MeV are presented. The elastic scattering data were analyzed with a standard Kisslinger potential in a coordinate space (r space) calculation using the free \ensuremath{\pi}-N amplitudes to calculate the potential coefficients. Momentum-space (p-space) calculations were also performed using the free \ensuremath{\pi}-N amplitudes to calculate on-shell matrix elements and the Landau-Tabakin model for the off-shell. The same ground-state proton and neutron densities were used in these two spaces and the fits are good. The distorted-wave impulse approximation calculations in both spaces, with the same collective model transition densities, reproduce the inelastic differential cross sections quite well. The proton and neutron transition multipole matrix elements and their ratios were calculated from the deformation parameters extracted from fits to inelastic scattering data. It is found that the ratios calculated in these two spaces are quite close to each other and close to those found in a comparison of (e,e') and (p,p') experiments, while the absolute value of matrix elements found in the p-space calculations are \ensuremath{\sim}15--20 % smaller than those from the r-space calculations. The r-space proton matrix elements are generally in good agreement with those obtained from electron scattering. The effects of the pion-nucleon interactions and form factors used in these calculations were investigated.

Differential cross sections were measured for pion elastic and inelastic scattering from {sup 208}Pb at {ital T}{sub {pi}}=120 and 250 MeV. Energy-dependent neutron- and proton-transition matrix elements for a range of excited states were extracted and tested for consistency, using several structure models.

Images of geophysical potential field data are becoming more common as a result of the increased availability of image analysis systems. These data are processed using techniques originally developed for remotely sensed satellite imagery. In general, geophysicists are not familiar with such techniques and may apply them without due consideration. This can lead to abuses of the geophysical data and reduce the validity of the interpretation. This paper describes some critical processes which can introduce errors to the data. The production of a regular grid from scattered data is fundamental to image processing. The choice of cell size is paramount and must balance the spatial distribution of the data. The necessary scaling of data from real values into a byte format for display purposes can result in small anomalies being masked. Contrast stretching of grey level images is often applied but can alter the shape of anomalies by varying degrees and should be avoided. Filters are often used to produce shaded relief images but without due regard to their frequency response and the effect on images expanded to fill the display space. The generation of spurious numerical artefacts can be reduced by ensuring that the filter is applied at real precision to the original data grid. The resultant images can then be processed for display. The use of image analysis systems for data integration requires careful consideration of the sampling strategy and information content of each dataset. It is proposed that such procedures are more appropriately conducted on a geographic information system.

The double isobaric analog state \ensuremath{\Vert}IAS\ensuremath{\bigotimes}\ensuremath{\bigotimes}IAS〉 and a new resonance below the \ensuremath{\Vert}IAS\ensuremath{\bigotimes}IAS〉 have been observed in pion-induced double-charge-exchange reactions on $^{93}\mathrm{Nb}$. Angular distributions have been measured for both transitions. The cross section observed in the ${\mathit{T}}_{l}$ resonance is 21% of that for the \ensuremath{\Vert}IAS\ensuremath{\bigotimes}IAS〉 in $^{93}\mathrm{Tc}$. We mention various possibilities for the nature of the observed resonance but have no unique explanation for its large cross section.

The Euler 3-D deconvolution technique uses potential field data to calculate the position of discontinuities in physical properties without the need of any prior local geological information. Initial difficulties in presenting the Euler solutions in a manner which facilitated interpretation have been overcome using new techniques of image analysis, colour graphics and with real-time rotation of 3-D models. This has provided additional insight into the structure and tectonic history of part of eastern England.

There are a limited number of treatment options for patients with ulcerative colitis (UC). An increased risk of thrombosis in UC coupled with an observation that UC patients being treated with anticoagulant therapy for thrombotic events had an improvement in their bowel symptoms led to trials examining the use of unfractionated heparin (UFH) and low molecular weight heparins (LMWH) in patients with active UC.To review randomized trials examining the efficacy of unfractionated heparin (UFH) or low molecular weight heparins (LMWH) for remission induction in patients with ulcerative colitis.The MEDLINE (PUBMED), and EMBASE databases, The Cochrane Central Register of Controlled Trials, the Cochrane IBD/FBD group specialized trials register, review papers on ulcerative colitis, and references from identified papers were searched in an effort to identify all randomized trials studying UFH or LMWH use in patients with ulcerative colitis. Abstracts from major gastroenterological meetings were searched to identify research published in abstract form only.Each author independently reviewed potentially relevant trials to determine their eligibility for inclusion based on the criteria identified above. The Jadad scale was used to assess study quality. Studies published in abstract form only were included if the authors could be contacted for further information.A data extraction form was developed and used to extract data from included studies. At least 2 authors independently extracted data. Any disagreements were resolved by consensus. Data were analyzed using Review Manager (RevMan 4.2.9). Data were analyzed on an intention-to-treat basis, and treated dichotomously. In cross-over studies, only data from the first arm were included. The primary endpoint was induction of remission, as defined by the studies. Data were combined for analysis if they assessed the same treatments (UFH or LMWH versus placebo or other therapy). If a comparison was only assessed in a single trial, P-values were derived using the chi-square test. If the comparison was assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals (95% CI). The presence of heterogeneity among studies was assessed using the chi-square test (a P value of 0.10 was regarded as statistically significant). If statistically significant heterogeneity was identified the odds ratio and 95% CI were calculated using a random effects model.There were 2 randomized, double-blind studies assessing LMWH versus placebo for the treatment of mild-moderate active UC. Various outcomes were assessed in the 2 studies. LMWH showed no benefit over placebo in any outcome, including clinical remission (OR 1.09; 95% CI 0.26 to 4.63; P = 0.91), clinical improvement (OR 0.73; 95% CI 0.32 to 1.66; P = 0.45 and OR 1.09; 95% CI 0.18 to 6.58; P = 0.92 in the two studies, respectively), endoscopic improvement (OR 1.35; 95% CI 0.29 to 6.18; P = 0.70), or histological improvement (OR 2.00; 95% CI 0.45 to 8.96; P = 0.37). LMWH was also not beneficial when added to standard therapy in a randomized open-label trial in which the outcome measures included clinical remission (OR 0.71; 95% CI 0.17 to 2.95; P = 0.64), clinical improvement (OR 2.00; 95% CI 0.31 to 12.75; P = 0.46), endoscopic remission (OR 0.71; 95% CI 0.17 to 2.95; P = 0.64), or endoscopic improvement (OR 1.40; 95% CI 0.34 to 5.79; P = 0.64). LMWH was well-tolerated and provided no significant benefit for quality of life. One study examining UFH versus corticosteroids in the treatment of severe UC demonstrated inferiority of UFH in clinical improvement as an outcome measure (OR 0.02; 95% CI 0 to 0.40; P = 0.01). Patients assigned to UFH did not improve clinically. More patients assigned to UFH had rectal hemorrhage as an adverse event.There is no evidence to support the use of UFH or LMWH for the treatment of active UC. No further trials examining these drugs for patients with UC are warranted, except perhaps a trial of UFH in patients with mild disease. Any benefit found would need to be weighed against a possible increased risk of rectal bleeding in patients with active UC.

Exclusive $^{4}\mathrm{He}$(${\mathrm{\ensuremath{\pi}}}^{\ifmmode\pm\else\textpm\fi{}}$,${\mathrm{\ensuremath{\pi}}}^{\ifmmode\pm\else\textpm\fi{}}$'p${)}^{3}$H spectra in the excitation energy range between 21.5 and 44 MeV in $^{4}\mathrm{He}$ were measured at ${\mathit{T}}_{\mathrm{\ensuremath{\pi}}}$=180 MeV at several pion and proton angles. The cross section ratio ${\mathit{R}}_{\mathrm{\ensuremath{\pi}}\mathit{p}}$=\ensuremath{\sigma}(${\mathrm{\ensuremath{\pi}}}^{+}$,${\mathrm{\ensuremath{\pi}}}^{+}$'p)/\ensuremath{\sigma}(${\mathrm{\ensuremath{\pi}}}^{\mathrm{\ensuremath{-}}}$,${\mathrm{\ensuremath{\pi}}}^{\mathrm{\ensuremath{-}}}$'p) was found to be between 1 and 2 near 22 MeV which is in the region of the ${\mathit{J}}^{\mathrm{\ensuremath{\pi}}}$=${2}^{\mathrm{\ensuremath{-}}}$, T=0 state. Between 25 and 40 MeV in the continuum, which comprises the giant dipole resonance and broad ${2}^{\mathrm{\ensuremath{-}}}$ and ${2}^{+}$ states, ${\mathit{R}}_{\mathrm{\ensuremath{\pi}}\mathit{p}}$ ranges from 0.22 to 45 in sharp contrast to the predicted values of \ensuremath{\approxeq}1 from a model assuming the entire yield is due to the sequential decay of a state of good isospin, and 6 to 9 from a distorted-wave impulse approximation calculation assuming quasifree proton knockout.