BACKGROUND:Several classification systems exist for sacral fractures; however, these systems are primarily descriptive, are not uniformly used, have not been validated, and have not been associated ...with a treatment algorithm or prognosis. The goal of the present study was to demonstrate the reliability of the AOSpine Sacral Classification System among a group of international spine and trauma surgeons.
METHODS:A total of 38 sacral fractures were reviewed independently by 18 surgeons selected from an expert panel of AOSpine and AOTrauma members. Each case was graded by each surgeon on 2 separate occasions, 4 weeks apart. Intrarater reproducibility and interrater agreement were analyzed with use of the kappa statistic (κ) for fracture severity (i.e., A, B, and C) and fracture subtype (e.g., A1, A2, and A3).
RESULTS:Seventeen reviewers were included in the final analysis, and a total of 1,292 assessments were performed (646 assessments performed twice). Overall intrarater reproducibility was excellent (κ = 0.83) for fracture severity and substantial (κ = 0.71) for all fracture subtypes. When comparing fracture severity, overall interrater agreement was substantial (κ = 0.75), with the highest agreement for type-A fractures (κ = 0.95) and the lowest for type-C fractures (κ = 0.70). Overall interrater agreement was moderate (κ = 0.58) when comparing fracture subtype, with the highest agreement seen for A2 subtypes (κ = 0.81) and the lowest for A1 subtypes (κ = 0.20).
CONCLUSIONS:To our knowledge, the present study is the first to describe the reliability of the AOSpine Sacral Classification System among a worldwide group of expert spine and trauma surgeons, with substantial to excellent intrarater reproducibility and moderate to substantial interrater agreement for the majority of fracture subtypes. These results suggest that this classification system can be reliably applied to sacral injuries, providing an important step toward standardization of treatment.
The high-frequency peaked BL Lac PKS 2155-304 at redshift z = 0.116 is a well-known VHE (>100 GeV) gamma -ray emitter. Since 2002 its VHE flux has been monitored using the H.E.S.S. stereoscopic array ...of imaging atmospheric Cerenkov telescopes in Namibia. During the 2006 July dark period, the average VHE flux was measured to be more than 10 times typical values observed from the object. This article focuses solely on an extreme gamma -ray outburst detected in the early hours of 2006 July 28 (MJD 53,944). The average flux observed during this outburst is I(>200 GeV) = (1.72 plus or minus 0.05 unk plus or minus 0.34 unk) x 10 super(-9) cm-z s-i, corresponding to similar to 7 times the flux, I(>200 GeV), observed from the Crab Nebula. Peak fluxes are measured with 1 minute timescale resolution at more than twice this average value. Variability is seen up to similar to 600 s in the Fourier power spectrum, and well-resolved bursts varying on timescales of similar to 200 s are observed. There are no strong indications for spectral variability within the data. Assuming the emission region has a size comparable to the Schwarzschild radius of a similar to 10 super(9) M unk black hole, Doppler factors greater than 100 are required to accommodate the observed variability timescales.
Detection of Gamma Rays from a Starburst Galaxy Acero, F; Akhperjanian, A.G; Anton, G ...
Science (American Association for the Advancement of Science),
11/2009, Letnik:
326, Številka:
5956
Journal Article
Recenzirano
Odprti dostop
Starburst galaxies exhibit in their central regions a highly increased rate of supernovae, the remnants of which are thought to accelerate energetic cosmic rays up to energies of approximately 10¹⁵ ...electron volts. We report the detection of gamma rays--tracers of such cosmic rays--from the starburst galaxy NGC 253 using the High Energy Stereoscopic System (H.E.S.S.) array of imaging atmospheric Cherenkov telescopes. The gamma-ray flux above 220 billion electron volts is F = (5.5 ± 1.0stat ± 2.8sys) x 10⁻¹³ cm⁻² s⁻¹, implying a cosmic-ray density about three orders of magnitude larger than that in the center of the Milky Way. The fraction of cosmic-ray energy channeled into gamma rays in this starburst environment is five times as large as that in our Galaxy.
The design and the simulated performances of a compact detector dedicated to the measurement of GRB photon polarization is presented. Such a detector would permit to answer the question “are most of ...the GRB strongly polarized?” in a mission of one year in space.
The very large collection area of ground-based gamma-ray telescopes gives them a substantial advantage over balloon or satellite based instruments in the detection of very-high-energy (>600 GeV) ...cosmic-ray electrons. Here we present the electron spectrum derived from data taken with the High Energy Stereoscopic System (H.E.S.S.) of imaging atmospheric Cherenkov telescopes. In this measurement, the first of this type, we are able to extend the measurement of the electron spectrum beyond the range accessible to direct measurements. We find evidence for a substantial steepening in the energy spectrum above 600 GeV compared to lower energies.
Response of the Compton polarimeter POLAR to polarized hard X-rays Orsi, S.; Haas, D.; Hajdas, W. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
08/2011, Letnik:
648, Številka:
1
Journal Article
Recenzirano
POLAR is a novel compact space-borne Compton polarimeter conceived for a precise measurement of hard X-ray polarization and optimized for the detection of Gamma-Ray Burst (GRB) photons in the energy ...range 50–500keV. In December 2009 we have performed a systematic calibration of one modular unit of POLAR at four energy levels (200, 288, 356 and 511keV) with a 100% polarized synchrotron radiation source at the beam line ID15A at ESRF. The detector was displaced several times on the beam line in order to achieve a uniform illumination, which mimics the flux from a GRB placed on the zenith of the experiment. Several rotations of the detector on the beam axis allowed us to test the response of POLAR to several polarization angles. Two different analysis methods to reconstruct the polarization angle of the beam and the modulation factor μ100 are presented; the first relies on the existence of a unpolarized sample, produced by merging two data sets with orthogonal polarization directions, and is less dependent on systematic effects due to asymmetries in the detector; the second is independent from unpolarized measurements, and will likely be used to analyze the polarization of GRB during the flight. Both methods reconstruct the input polarization angle within 2° and produce modulation factors μ100 between 30% and 50% depending on the beam energy. Monte Carlo simulations performed with GEANT4 confirm the experimental results.
A method to localize gamma-ray bursts using POLAR Suarez-Garcia, E.; Haas, D.; Hajdas, W. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
12/2010, Letnik:
624, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The hard X-ray polarimeter POLAR aims to measure the linear polarization of the 50–500
keV photons arriving from the prompt emission of
γ
-ray
bursts (GRBs). The position in the sky of the detected ...GRBs is needed to determine their level of polarization. We present here a method by which, despite of the polarimeter incapability of taking images, GRBs can be roughly localized using POLAR alone. For this purpose scalers are attached to the output of the 25 multi-anode photomultipliers (MAPMs) that collect the light from the POLAR scintillator target. Each scaler measures how many GRB photons produce at least one energy deposition above 50
keV in the corresponding MAPM. Simulations show that the relative outputs of the 25 scalers depend on the GRB position. A database of very strong GRBs simulated at 10
201 positions has been produced. When a GRB is detected, its location is calculated searching the minimum of the
χ
2
obtained in the comparison between the measured scaler pattern and the database. This GRB localization technique brings enough accuracy so that the error transmitted to the 100% modulation factor is kept below 10% for GRBs with fluence
F
tot
≥
10
−
5
erg
cm
−
2
. The POLAR localization capability will be useful for those cases where no other instruments are simultaneously observing the same field of view.
Purpose
To report on the development of AOSpine CROST (Clinician Reported Outcome Spine Trauma) and results of an initial reliability study.
Methods
The AOSpine CROST was developed using an iterative ...approach of multiple cycles of development, review, and revision including an expert clinician panel. Subsequently, a reliability study was performed among an expert panel who were provided with 20 spine trauma cases, administered twice with 4-week interval. The results of the developmental process were analyzed using descriptive statistics, the reliability per parameter using Kappa statistics, inter-rater rater agreement using intraclass correlation coefficient (ICC), and internal consistency using Cronbach’s
α
.
Results
The AOSpine CROST was developed and consisted of 10 parameters, 2 of which are only applicable for surgically treated patents (‘Wound healing’ and ‘Implants’). A dichotomous scoring system (‘yes’ or ‘no’ response) was incorporated to express expected problems for the short term and long term. In the reliability study, 16 (84.2%) participated in the first round and 14 (73.7%) in the second. Intra-rater reliability was fair to good for both time points (
κ
= 0.40–0.80 and
κ
= 0.31–0.67). Results of inter-rater reliability were lower (
κ
= 0.18–0.60 and
κ
= 0.16–0.46). Inter-rater agreement for total scores showed moderate results (ICC = 0.52–0.60), and the internal consistency was acceptable (
α
= 0.76–0.82).
Conclusions
The AOSpine CROST, an outcome tool for the surgeons, was developed using an iterative process. An initial reliability analysis showed fair to moderate results and acceptable internal consistency. Further clinical validation studies will be performed to further validate the tool.
Knowledge of the rigidity dependence of the boron to carbon flux ratio (B/C) is important in understanding the propagation of cosmic rays. The precise measurement of the B/C ratio from 1.9 GV to 2.6 ...TV, based on 2.3 million boron and 8.3 million carbon nuclei collected by AMS during the first 5 years of operation, is presented. The detailed variation with rigidity of the B/C spectral index is reported for the first time. The B/C ratio does not show any significant structures in contrast to many cosmic ray models that require such structures at high rigidities. Remarkably, above 65 GV, the B/C ratio is well described by a single power law R^{Δ} with index Δ=-0.333±0.014(fit)±0.005(syst), in good agreement with the Kolmogorov theory of turbulence which predicts Δ=-1/3 asymptotically.
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