Mechanical concept of the neurosurgical robot ‘Minerva'

We describe a robot capable of performing all procedures necessary to carry out a complete stereotactic neurosurgical operation under the control and supervision of a surgeon. The operation consists of the introduction of a small probe with diameter 2-3 mm through a hole without trepanation. The robot has been built and is now being tested and evaluated. The accompanying control software as well as various medical probes are either in development or partially tested. The installation will be able to carry out a complete intervention under the surveillance of a computed tomography scanner. In this article we emphasize the design choices required to eliminate gearing backlash in a crucial degree of freedo

The effect of communication between the right and left liver on the outcome of surgical drainage for jaundice due to malignant obstruction at the hilus of the liver

Debate continues regarding the optimal management of irresectable malignant proximal biliary obstruction. Controversy exists concerning the ability of unilateral drainage to provide adequate biliary decompression with tumors that have occluded the communication between the right and left hepatic ductal systems. Between October 1986 and October 1989, 18 patients with malignant proximal biliary obstruction were treated by an intrahepatic biliary enteric bypass. Patients were divided into two groups based on the presence or absence of a communication between the right and left biliary systems. In Group I (n = 9), there was free communication; and in Group II (n = 9) there was no communication. There were two perioperative deaths (11%) one due to persistent cholangitis and the other to myocardial insufficiency both with one death in each group. The median survival (excluding perioperative deaths) was 5.6 months. Comparison of pre- and postoperative serum levels of bilirubin and alkaline phosphatase showed a significant decrease in each group, but no difference between the groups in the size of the reduction. Sixteen patients survived at least three months and the palliation was judged as excellent in eight, fair in five, and unchanged in three. These results demonstrate the effectiveness of biliary enteric bypass regardless of communication between the left and right biliary ductal systems.H. U. Baer, M. Rhyner, S. C. Stain, P. W. Glauser, A. R. Dennison, G. J. Maddern, and L. H. Blumgar

Continuum and line modeling of disks around young stars II. Line diagnostics for GASPS from the DENT grid

Aims. We want to understand the chemistry and physics of disks on the basis of a large unbiased and statistically relevant grid of disk models. One of the main goals is to explore the diagnostic power of various gas emission lines and line ratios for deriving main disk parameters such as the gas mass. Methods. We explore the results of the DENT grid (Disk Evolution with Neat Theory) that consists of 300 000 disk models with 11 free parameters. Through a statistical analysis, we search for correlations and trends in an effort to find tools for disk diagnostic. Results. All calculated quantities like species masses, temperatures, continuum and line fluxes differ by several orders of magnitude across the entire parameter space. The broad distribution of these quantities as a function of input parameters shows the limitation of using a prototype T Tauri or Herbig Ae/Be disk model. The statistical analysis of the DENT grid shows that CO gas is rarely the dominant carbon reservoir in disks. Models with large inner radii (10 times the dust condensation radius) and/or shallow surface density gradients lack massive gas phase water reservoirs. Also, 60% of the disks have gas temperatures averaged over the oxygen mass in the range between 15 and 70 K; the average gas temperatures for CO and O differ by less than a factor two. Studying the observational diagnostics, the [CII] 158 \mum fine structure line flux is very sensitive to the stellar UV flux and presence of a UV excess and it traces the outer disk radius (Rout). In the submm, the CO low J rotational lines also trace Rout. Low [OI] 63/145 line ratios (< a few) can be explained with cool atomic O gas in the uppermost surface layers leading to self-absorption in the 63 \mum line; this occurs mostly for massive non-flaring, settled disk models without UV excess. ... abbreviatedComment: 15 pages, 25 figures, accepted for publication in A&

Herschel detects oxygen in the β Pictoris debris disk

The young star beta Pictoris is well known for its dusty debris disk, produced through the grinding down by collisions of planetesimals, kilometre-sized bodies in orbit around the star. In addition to dust, small amounts of gas are also known to orbit the star, likely the result from vaporisation of violently colliding dust grains. The disk is seen edge on and from previous absorption spectroscopy we know that the gas is very rich in carbon relative to other elements. The oxygen content has been more difficult to assess, however, with early estimates finding very little oxygen in the gas at a C/O ratio 20x higher than the cosmic value. A C/O ratio that high is difficult to explain and would have far-reaching consequences for planet formation. Here we report on observations by the far-infrared space telescope Herschel, using PACS, of emission lines from ionised carbon and neutral oxygen. The detected emission from C+ is consistent with that previously reported being observed by the HIFI instrument on Herschel, while the emission from O is hard to explain without assuming a higher-density region in the disk, perhaps in the shape of a clump or a dense torus, required to sufficiently excite the O atoms. A possible scenario is that the C/O gas is produced by the same process responsible for the CO clump recently observed by ALMA in the disk, and that the re-distribution of the gas takes longer than previously assumed. A more detailed estimate of the C/O ratio and the mass of O will have to await better constraints on the C/O gas spatial distribution.Comment: Accepted by A&A; 6 pages including 3 figure

International Veterinary Epilepsy Task Force consensus proposal: Medical treatment of canine epilepsy in Europe

In Europe, the number of antiepileptic drugs (AEDs) licensed for dogs has grown considerably over the last years. Nevertheless, the same questions remain, which include, 1) when to start treatment, 2) which drug is best used initially, 3) which adjunctive AED can be advised if treatment with the initial drug is unsatisfactory, and 4) when treatment changes should be considered. In this consensus proposal, an overview is given on the aim of AED treatment, when to start long-term treatment in canine epilepsy and which veterinary AEDs are currently in use for dogs. The consensus proposal for drug treatment protocols, 1) is based on current published evidence-based literature, 2) considers the current legal framework of the cascade regulation for the prescription of veterinary drugs in Europe, and 3) reflects the authors’ experience. With this paper it is aimed to provide a consensus for the management of canine idiopathic epilepsy. Furthermore, for the management of structural epilepsy AEDs are inevitable in addition to treating the underlying cause, if possible

The Taurus Spitzer Survey: New Candidate Taurus Members Selected Using Sensitive Mid-Infrared Photometry

We report on the properties of pre-main-sequence objects in the Taurus molecular clouds as observed in 7 mid- and far-infrared bands with the Spitzer Space Telescope. There are 215 previously-identified members of the Taurus star-forming region in our ~44 square degree map; these members exhibit a range of Spitzer colors that we take to define young stars still surrounded by circumstellar dust (noting that ~20% of the bonafide Taurus members exhibit no detectable dust excesses). We looked for new objects in the survey field with similar Spitzer properties, aided by extensive optical, X-ray, and ultraviolet imaging, and found 148 candidate new members of Taurus. We have obtained follow-up spectroscopy for about half the candidate sample, thus far confirming 34 new members, 3 probable new members, and 10 possible new members, an increase of 15-20% in Taurus members. Of the objects for which we have spectroscopy, 7 are now confirmed extragalactic objects, and one is a background Be star. The remaining 93 candidate objects await additional analysis and/or data to be confirmed or rejected as Taurus members. Most of the new members are Class II M stars and are located along the same cloud filaments as the previously-identified Taurus members. Among non-members with Spitzer colors similar to young, dusty stars are evolved Be stars, planetary nebulae, carbon stars, galaxies, and AGN.Comment: Accepted to ApJS. Two large online-only figures available with the preprint here: http://web.ipac.caltech.edu/staff/rebull/research.htm

Signatures of warm carbon monoxide in protoplanetary discs observed with Herschel SPIRE

Molecular gas constitutes the dominant mass component of protoplanetary discs. To date, these sources have not been studied comprehensively at the longest far-infrared and shortest submillimetre wavelengths. This paper presents Herschel SPIRE FTS spectroscopic observations towards 18 protoplanetary discs, covering the entire 450-1540 GHz (666-195 μm) range at ν/Δν ≈ 400-1300. The spectra reveal clear detections of the dust continuum and, in six targets, a significant amount of spectral line emission primarily attributable to 12CO rotational lines. Other targets exhibit little to no detectable spectral lines. Low signal-to-noise detections also include signatures from 13CO, [C i] and HCN. For completeness, we present upper limits of non-detected lines in all targets, including low-energy transitions of H2O and CH+ molecules. The 10 12CO lines that fall within the SPIRE FTS bands trace energy levels of∼50-500 K. Combined with lower and higher energy lines from the literature, we compare the CO rotational line energy distribution with detailed physical-chemical models, for sources where these are available and published. Our 13CO line detections in the disc around Herbig Be star HD 100546 exceed, by factors of∼10-30, the values predicted by a model that matches a wealth of other observational constraints, including the SPIRE 12CO ladder. To explain the observed 12CO/13CO ratio, it may be necessary to consider the combined effects of optical depth and isotope selective (photo)chemical processes. Considering the full sample of 18 objects, we find that the strongest line emission is observed in discs around Herbig Ae/Be stars, although not all show line emission. In addition, two of the six T Tauri objects exhibit detectable 12CO lines in the SPIRE rang

Vancomycin versus Placebo for Treating Persistent Fever in Patients with Neutropenic Cancer Receiving Piperacillin-Tazobactam Monotherapy

This prospective, double-blind trial assessed whether the addition of a glycopeptide would be able to reduce the time to defervescence in neutropenic patients with cancer who had persistent fever 48-60 h after the initiation of empirical piperacillin-tazobactam monotherapy. Of 763 eligible patients, 165 with persistent fever were randomized to receive piperacillin-tazobactam therapy plus either vancomycin therapy or placebo. Defervescence was observed in 82 (95%) of 86 patients in the vancomycin group and in 73 (92%) of 79 patients in the placebo group (P = .52). The distributions of the time to defervescence were not statistically significant between the 2 groups (estimated hazard ratio, 1.03; 95% confidence interval, 0.75-1.43; P = .75). The number of additional episodes of gram-positive bacteremia and the percentage of patients for whom amphotericin B was empirically added to their therapy regimen were also similar in both groups. This study failed to demonstrate that the empirical addition of vancomycin therapy to the treatment regimen is of benefit to persistently febrile neutropenic patients with cance

International Veterinary Epilepsy Task Force Consensus Proposal: Outcome of therapeutic interventions in canine and feline epilepsy

Common criteria for the diagnosis of drug resistance and the assessment of outcome are needed urgently as a prerequisite for standardized evaluation and reporting of individual therapeutic responses in canine epilepsy. Thus, we provide a proposal for the definition of drug resistance and partial therapeutic success in canine patients with epilepsy. This consensus statement also suggests a list of factors and aspects of outcome, which should be considered in addition to the impact on seizures. Moreover, these expert recommendations discuss criteria which determine the validity and informative value of a therapeutic trial in an individual patient and also suggest the application of individual outcome criteria. Agreement on common guidelines does not only render a basis for future optimization of individual patient management, but is also a presupposition for the design and implementation of clinical studies with highly standardized inclusion and exclusion criteria. Respective standardization will improve the comparability of findings from different studies and renders an improved basis for multicenter studies. Therefore, this proposal provides an in-depth discussion of the implications of outcome criteria for clinical studies. In particular ethical aspects and the different options for study design and application of individual patient-centered outcome criteria are considered

Circumstellar disks and planets. Science cases for next-generation optical/infrared long-baseline interferometers

We present a review of the interplay between the evolution of circumstellar disks and the formation of planets, both from the perspective of theoretical models and dedicated observations. Based on this, we identify and discuss fundamental questions concerning the formation and evolution of circumstellar disks and planets which can be addressed in the near future with optical and infrared long-baseline interferometers. Furthermore, the importance of complementary observations with long-baseline (sub)millimeter interferometers and high-sensitivity infrared observatories is outlined.Comment: 83 pages; Accepted for publication in "Astronomy and Astrophysics Review"; The final publication is available at http://www.springerlink.co