Resonance-enhanced multi-octave supercontinuum generation in antiresonant hollow-core fibers.

Ultrafast supercontinuum generation in gas-filled waveguides is an enabling technology for many intriguing applications ranging from attosecond metrology towards biophotonics, with the amount of spectral broadening crucially depending on the pulse dispersion of the propagating mode. In this study, we show that structural resonances in a gas-filled antiresonant hollow core optical fiber provide an additional degree of freedom in dispersion engineering, which enables the generation of more than three octaves of broadband light that ranges from deep UV wavelengths to near infrared. Our observation relies on the introduction of a geometric-induced resonance in the spectral vicinity of the ultrafast pump laser, outperforming gas dispersion and yielding a unique dispersion profile independent of core size, which is highly relevant for scaling input powers. Using a krypton-filled fiber, we observe spectral broadening from 200 nm to 1.7 µm at an output energy of ∼ 23 µJ within a single optical mode across the entire spectral bandwidth. Simulations show that the frequency generation results from an accelerated fission process of soliton-like waveforms in a non-adiabatic dispersion regime associated with the emission of multiple phase-matched Cherenkov radiations on both sides of the resonance. This effect, along with the dispersion tuning and scaling capabilities of the fiber geometry, enables coherent ultra-broadband and high-energy sources, which range from the UV to the mid-infrared spectral range.

[Rehabilitation 2008: when to use outpatient and inpatient rehabilitation?]. / Reha 2008: Wann ambulant, wann stationär?

Due to illnesses of the cardiovascular system, costs of approximately 35 billion Euros arise in Germany per annum. This corresponds to around 15% of all costs arising in public-health service. Because of a positive influence of high-risk factors, high-risk illnesses, training condition, and lifestyle it is possible to improve the prognosis of the concerned patient within the scope of a training-based cardiac rehabilitation program. Altogether, the final costs of each case will be lowered by a cardiac rehabilitation. A proven advantage of an inpatient rehabilitation program over an outpatient rehabilitation program is not given. As the costs of outpatient measures are less than the costs of inpatient rehabilitation, outpatient measures usually should be preferred. Inpatient rehabilitation should only be carried out with patients who cannot take part in outpatient cardiac rehabilitation programs on account of attendant circumstances (e.g., age, comorbidities, immobility). As there is no adequate overall medical care with outpatient rehabilitation centers in Germany, around 90% of all cardiac rehabilitations usually takes place under inpatient conditions far away from home. In almost every case, however, the realization of close-to-home rehabilitation is to the best advantage. Regardless whether this is realized on an inpatient or outpatient basis, close-to-home rehabilitation also allows the social environment of the patient to be included into the care. Due to being close to home, also long term-based and everyday-attendant rehabilitation types would be possible in future.

[Effects of a phase II cardiac rehabilitation program performed on an outpatient basis]. / Die effektivität einer ambulanten kardiogischen Rehabilitation der Phase II. Modellprojekt der LVA-Rheinprovinz und der rheinschen Krankenhassen zur ambulanten/teilstationären kardiologischen Rehabilitation.

BACKGROUND AND OBJECTIVE: In Germany, phase II cardiac rehabilitation has always been carried out on an inpatient basis. Meanwhile, the governmental health authorities are demanding more flexible solutions for cardiac rehabilitation. The objective of this study is to examine the effects of phase II cardiac rehabilitation performed on an outpatient basis (OCR) in a larger patient cohort. These are the first results of patients before and directly after the OCR performed at six different rehabilitation centers. PATIENTS AND METHODS: The study group consisted of 479 men and 74 women, 56.1 +/- 11.5 years. Cardiovascular indications for the OCR were myocardial infarction in 219 cases, coronary artery disease (CAD) in 92, in 84 cases with invasive procedures, coronary artery bypass graft in 185, cardiac valve surgery in 26, and other cardiac diseases in 29. 70% of the patients were worker, 25% without professional training. Staying with the family (42%) and aversion to stationary programs (61%)were the main reasons for the choice of OCR. Without OCR,27.4% would have refused any rehabilitation program. RESULTS: Maximal physical performance increased from 97.8 + - 31.4 to 120.4 +/- 37.3 W (p < 0.001). LDL cholesterol was reduced from 145.9 +/- 42.7 to 117.5 +/- 34.7 mg% (p < 0.001), triglycerides from 203.3 +/- 136.0 to 161.9 +/- 91.6 mg% (p < ).010), HDL cholesterol increased from 39.8 + 11.2 to 41.0 +/- 11.3 mg% (p = 0.003). The use of lipid-lowering therapy in CAD patients increased from 63.1% to 80.7%. A reduction in body mass index from 27.1 +/- 3.6 to 26.9 +/- 3.5 kg/m2 (p = 0.010) was demonstrated. The number of active smokers decreased from 53.8% to 25.6%. CONCLUSION: The results obtained are interesting with respect to the patients' social status. With 70% general laborers, our cohort is in contrast to previously published OCR data. On the whole, these results demonstrate that rehabilitative measures can also be implemented on an outpatient basis, without a decrease in the quality of treatment. This also applies to patients who represent lower socioeconomic levels. The results should motivate to work harder and more sufficiently on the development of more flexible cardiac rehabilitation programs.

[4th report of German Association of Cardiologists in private practice (BNK) on quality assurance in cardiac catheterization and coronary intervention 1999-2002]. / 4. Bericht des Bundesverbandes Niederglassener Kardiologen zur Qualitätssicherung in der diagnostischen und therapeutischen Invasivkardiologie 1999-2002.

The Society of German Cardiologists in private practice (BNK) reports about its project on quality assurance in invasive cardiology (QuIK). Results of a computerized data collection and analysis of cardiac catheterizations and interventions in the years 1999-2002 are presented. These results are compared with other registries. The QuIK-project is done voluntarily by 70% of the society's cardiologists who perform invasive methods. A total of 225,562 diagnostic and 64,895 interventional procedures are documented over the 4 years. Patient characteristics and procedural data kept unchanged. Complication rates were low (< 2%), MACE < 0.5%. There was a rising number of patients referred with acute myocardial infarction. Less time was used to complete procedures from 1 year to another. Two out of three of the centers underwent a monitoring/auditing process in 2002. The desirable post-interventional follow-up after discharge in all cases appears to be impossible to fulfill under the given economical circumstances.