A study of the decay of 187W using a 2 m curved-crystal spectrometer

The gamma rays in the decay of 187W have been studied using the University of Michigan 2 m curved-crystal spectrometer and a lithium-drifted germanium diode spectrometer. One previously unreported transition has been observed and the energies of all observed transitions have been determined with the curved-crystal spectrometer. Upper limits have been determined for the intensities of possible unobserved gamma rays in the 160-1200 keV region. The relative merits and complementarity of the curved crystal spectrometer and the Ge(Li) spectrometer are discussed. In addition, data are presented concerning the reflectivity of the curved crystal using the germanium planes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/33458/1/0000862.pd

Precision measurements of gamma-ray energies up to 2 MeV using a 2 m curved-crystal monochromator

Precision measurements of gamma-ray energies up to 2 MeV were performed using a 2m curved-crystal monochromator. Effective source activities of less than 40 mCur were used for the measurements of the transitions in the 2 MeV region. In the 150 keV region, effective source activities of less than 200 [mu]Cur may be used. Measurements have been performed on the transitions of energies less than 2150 keV which follow the decay of In116(54 min), Mn56 (2.6 h) and Sc46 (85 d). In addition, results are presented which indicate that the reflection coefficient is approximately linear with respect to wavelength for the second order reflection from the germanium (02) planes in the region of 6-90 mA (2000-135 keV).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31997/1/0000039.pd

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)