bluuebunny/crossref_metadata_2025 huggingface dataset:
Probabilistic and multi‐objective approach for planning of microgrids under uncertainty: a distributed architecture proposal
Authors: Machado Pedro , Netto Roberto Silva , de Souza Luiz E. , Maun Jean‐Claude
Published: January 2019

This study aims to present an architecture for the planning of microgrids (MGs) in order to support system operator decision. In short, the proposed strategy is an iterative procedure that tries to find the optimal size of distributed energy resource (DER), which attends the necessities of stakeholders. The architecture has five distributed and correlated stages named MG coordination, MG operation optimisation, reliability assessment, contingency assessment, and searching mechanism. Since the DER selection involves multiple criteria and interests of different parts, it requires a multi‐attribute decision system providing a list of possible configurations based on their relative importance as denoted by the stakeholders. Owing to that, the particle swarm optimisation is used to create the multidimensional space of search in which the optimal solution will be selected by means of Pareto front decision criteria. As a result, the architecture provides a candidate solution to optimal size (optimal rated power) of each DER, that must be installed in the MG in order to have an optimal balance between technical, economical, social, and environmental aspects. To have realistic results, such a strategy is performed on a case study of a potential campus MG program.
Modelling and analysis of the distortion of strongly‐coupled wireless power transfer systems with SS and LCC–LCC compensations
Authors: Zhang Yiming , Yan Zhengchao , Kan Tianze , Liu Yanding , Mi Chunting Chris
Published: January 2019

Accurate modelling is necessary for designing a wireless power transfer (WPT) system and currently, first harmonic approximation (FHA) is widely used. However, it is not accurate for WPT systems with a strong coupling, such as fast charging of electric vehicles with a coupling coefficient of 0.80, compared to the conventional wireless charging with a coupling coefficient of 0.15–0.30. This study develops accurate models for WPT systems with series–series (SS) and LCC–LCC compensations. For the SS compensation with a strong coupling, the transmitter and receiver currents are distorted, leading to much larger values than the estimations from FHA, which determines the selection of power switches and resonant capacitors. For the LCC–LCC compensation, the transmission coil currents are only highly distorted with rich third‐order harmonics at the vicinity of the 0.889 coupling coefficient, leading to low efficiency and large coil current ratings. For the experimental prototype, the efficiency drop can be over 3%, which is significant, especially for high‐power systems. The WPT system with the LCC–LCC compensation should avoid operation in the vicinity of this particular coupling coefficient. Furthermore, experiments are conducted, and the results perfectly match the calculations, demonstrating the accuracy of the proposed models.
ZVS/ZCS Vienna rectifier topology for high power applications
Authors: Ali Abdar , Mansoor Khan Muhammad , Yuning Jiang , Ali Yaqoob , Faiz Muhammad Talib , Chuanwen Jiang
Published: January 2019

This paper focuses on the study of a soft‐switched unidirectional boost‐type rectifier employing a snubber circuit, used as a front‐end converter stage in high‐power applications. The proposed rectifier operates with soft switching which results in high efficiency and low cost. The switching losses and electromagnetic interference (EMI) result in poor efficiency, therefore, soft switching techniques need to be developed to improve the efficiency. To achieve the desired result, the snubber circuit which consists of a lossless snubber switch cell and a resonant inductor, is introduced in the above‐mentioned converter. The topology of the proposed converter is derived from the conventional T‐type three‐level boost rectifier. The circuit operation, theoretical analysis, and simulation of the converter in MATLAB/Simulink environment are carried out. Finally, a 10 kW laboratory set‐up of the proposed soft‐switched unidirectional rectifier is built. The experimental results obtained validate the theoretical analysis of the circuit.
Two‐/three‐coil hybrid topology and coil design for WPT system charging electric bicycles
Authors: Chen Yang , Yang Naijian , Yang Bin , Dai Ruimin , He Zhengyou , Mai Ruikun , Gao Shibin
Published: January 2019

Wireless power transfer (WPT) for charging electric bicycles (EBs) can save people from tiresome plugging actions and avoid electrical shock hazards, especially in adverse weather. This study proposed a two‐/three‐coil hybrid topology to achieve constant current (CC) and constant voltage (CV) for charging EBs, simplifying control schemes. The system realises CC output with two‐coil topology and operates in CV mode with three‐coil topology by turning on a switch. Besides, an inductor array is used to compensate reactive power in CV mode when massive EBs are charged by one high‐frequency inverter (HFI). The secondary side of the proposed topology is compact, and the number of components and HFI can be reduced. A coil design process based on double‐D‐type for the three‐coil system is given, with the constraint of mutual inductances among three coils and limited size. To demonstrate the validity of the proposed methods, an experimental setup is built, and the performance of the two‐/three‐coil hybrid system indicates that the fluctuations of charging current and voltage are <0.64 and 2.12% in the whole charging profile. Moreover, the performance of two WPT chargers connected with one HFI hints that massive EBs can be charged with only one HFI.
Eddington bias for cosmic neutrino sources
Authors: Strotjohann Nora Linn , Kowalski Marek , Franckowiak Anna
Published: January 2019

We describe a consequence of the Eddington bias which occurs when a single astrophysical neutrino event is used to infer the neutrino flux of the source. A trial factor is introduced by the potentially large number of similar sources that remain undetected; if this factor is not accounted for the luminosity of the observed source can be overestimated by several orders of magnitude. Based on the resulting unrealistically high neutrino fluxes, associations between high-energy neutrinos and potential counterparts or emission scenarios were rejected in the past. Correcting for the bias might justify a reevaluation of these cases.
Mass of the active galactic nucleus black hole XMMUJ134736.6+173403
Authors: Goluchová K. , Török G. , Šrámková E. , Abramowicz M. A. , Stuchlík Z. , Horák J.
Published: January 2019

A recent study of the X-ray source XMMUJ134736.6+173403 has revealed a strong quasi-periodic modulation in the X-ray flux. The observation of two quasiperiodic oscillations (QPOs) that occur on a daily timescale and exhibit a 3:1 frequency ratio strongly supports the evidence for the presence of an active galactic nucleus black hole (AGN BH). Assuming an orbital origin of QPOs, we calculated the upper and lower limit on AGN BH mass M and found M ≈ 107 − 109 M⊙. When we compare this to mass estimates of other sources, XMMUJ134736.6+173403 appears to be the most massive source with commensurable QPO frequencies, and its mass represents the current observational upper limit on AGN BH mass based on QPO observations. We note that it will be crucial for the falsification of particular resonance models of QPOs whether only a single QPO with a frequency that completes the harmonic sequence 3 : 2 : 1 is found in this source, or if a new different pair of QPOs with frequencies in the 3 : 2 ratio is found. The former case would agree with the prediction of the 3 : 2 epicyclic resonance model and BH mass M ≈ (5a2 + 8a + 8)×107 M⊙, where a is a dimensionless BH spin.
Hyperkaliämie – Ursachen, Diagnostik und Therapie
Authors: Kettritz Ralph
Published: January 2019

Was ist neu?

Bedeutung und Pathogenese Kalium spielt eine tragende Rolle bei Entstehung von Transmembranpotenzialen. Störungen des Kaliumhaushaltes können zu schweren Krankheitsbildern führen. Patienten mit Niereninsuffizienz sind besonders häufig betroffen. Kalium-Verschiebungen zwischen IZR- und EZR sowie eine verminderte renale Kaliumausscheidung aufgrund verminderter glomerulärer Filtrationsrate und/oder reduzierter Kaliumsekretion im distalen Nephron sind häufige Hyperkaliämie-Ursachen.

Diagnostik Eine Hyperkaliämie sollte mit einer sofortigen Kontrolle in der BGA-Maschine kontrolliert werden. Man erhält zusätzliche Information über eine begleitende Säure-Basen-Haushalt-Störung.

Therapie Hämodialyse ist das effektivste Nierenersatzverfahren zur Kaliumsenkung. Die medikamentösen Maßnahmen sollten bis zum Dialysebeginn allerdings nicht vergessen werden. Insulin senkt Kalium zuverlässig. Beta-Agonisten sind effektive Kaliumsenker, aber für Patienten mit hohem kardiovaskulärem Risiko nicht immer geeignet. Bikarbonat kann bei ausgeprägten metabolischen Azidosen (HCO3 < 10 mmol/l) verabreicht werden. Bei Hyperkaliämie wird in Deutschland am häufigsten Polystyrensulfonat verabreicht. Neue orale nicht-resorbierbare Kaliumsenker werden aktuell in klinischen Studien erprobt und zeigen bislang vielversprechende Resultate.
Update Morbus Basedow
Authors: Allelein Stephanie , Schott Matthias
Published: January 2019

Was ist neu?

Diagnostik Die europäischen Leitlinien von 2018 beurteilen die Messung der TRAK durch die – meistens in der Routine verwendeten – Kompetitionsassays als hochsensitiv und spezifisch. Hierdurch ist es in der Regel möglich, einen Morbus Basedow sicher zu diagnostizieren und von einer Freisetzungshyperthyreose im Rahmen einer Autoimmunthyreoiditis zu unterscheiden. Zur Unterscheidung von blockierenden und stimulierenden Antikörpern kommen unter wissenschaftlichen Aspekten Bioassays zur Anwendung.

Therapie Entsprechend der aktuellen Empfehlungen sollte wegen des etwas günstigeren Nebenwirkungsprofils – mit Ausnahme von Schwangeren – der Einsatz von Thiamazol/ Carbimazol gegenüber Propylthiouracil (PTU) vorgezogen werden. Bei einem Rezidiv oder bei fehlender Remission innerhalb von 12 bis 18 Monaten mit adäquater thyreostatischer Therapie ist eine ablative Therapie indiziert.

Prognose Zur Einschätzung des Krankheitsverlaufs ist die Bestimmung der TRAK hilfreich.

Schwangerschaft Die kürzlich erschienene Leitlinie zur Behandlung von Schwangeren mit Schilddrüsenerkrankungen gibt neue internationale Empfehlungen zur Therapie der manifesten Hyperthyreose bei Morbus Basedow. In den ersten 16 Schwangerschaftswochen (Phase der Organogenese) wird die Therapie mit PTU und im Falle einer vorbestehenden Behandlung mit Thiamazol eine zügige Umstellung auf PTU empfohlen. In der Schwangerschaft nach der 16. Woche wird nun keine klare Empfehlung bzgl. des einzusetzenden Thyreostatikums ausgesprochen. Es wird ein supprimierter TSH-Wert bei gleichzeitig (hoch-) normalem bzw. leichtgradig erhöhtem fT4-Wert angestrebt.

Endokrine Orbitopathie Eine aktuelle Studie zeigt eine signifikante Besserung der endokrinen Orbitopathie mit Behandlung durch den in Deutschland noch nicht zugelassenen monoklonalen IGF-1-Rezeptor-Antikörper Teprotumumab.
Management of colorectal laterally spreading tumors: a systematic review and meta-analysis
Authors: Russo Pedro , Barbeiro Sandra , Awadie Halim , Libânio Diogo , Dinis-Ribeiro Mario , Bourke Michael
Published: January 2019

Objective and study aims To evaluate the efficacy and safety of different endoscopic resection techniques for laterally spreading colorectal tumors (LST).

Methods Relevant studies were identified in three electronic databases (PubMed, ISI and Cochrane Central Register). We considered all clinical studies in which colorectal LST were treated with endoscopic resection (endoscopic mucosal resection [EMR] and/or endoscopic submucosal dissection [ESD]) and/or transanal minimally invasive surgery (TEMS). Rates of en-bloc/piecemeal resection, complete endoscopic resection, R0 resection, curative resection, adverse events (AEs) or recurrence, were extracted. Study quality was assessed with the Newcastle-Ottawa Scale and a meta-analysis was performed using a random-effects model.

Results Forty-nine studies were included. Complete resection was similar between techniques (EMR 99.5 % [95 % CI 98.6 %-100 %] vs. ESD 97.9 % [95 % CI 96.1 – 99.2 %]), being curative in 1685/1895 (13 studies, pooled curative resection 90 %, 95 % CI 86.6 – 92.9 %, I2 = 79 %) with non-significantly higher curative resection rates with ESD (93.6 %, 95 % CI 91.3 – 95.5 %, vs. 84 % 95 % CI 78.1 – 89.3 % with EMR). ESD was also associated with a significantly higher perforation risk (pooled incidence 5.9 %, 95 % CI 4.3 – 7.9 %, vs. EMR 1.2 %, 95 % CI 0.5 – 2.3 %) while bleeding was significantly more frequent with EMR (9.6 %, 95 % CI 6.5 – 13.2 %; vs. ESD 2.8 %, 95 % CI 1.9 – 4.0 %). Procedure-related mortality was 0.1 %. Recurrence occurred in 5.5 %, more often with EMR (12.6 %, 95 % CI 9.1 – 16.6 % vs. ESD 1.1 %, 95 % CI 0.3 – 2.5 %), with most amenable to successful endoscopic treatment (87.7 %, 95 % CI 81.1 – 93.1 %). Surgery was limited to 2.7 % of the lesions, 0.5 % due to AEs. No data of TEMS were available for LST.

Conclusions EMR and ESD are both effective and safe and are associated with a very low risk of procedure related mortality.
Preoperative computed tomography angiography (CTA) of the body in vascular patients: prevalence and significance of unsuspected extravascular findings
Authors: Turowski Larissa Sarah , Dollinger Marco , Wohlgemuth Walter A. , Wildgruber Moritz , Beyer Lukas Philipp , Pfister Karin , Stroszczynski Christian , Müller-Wille René
Published: January 2019

Purpose Evaluation of the prevalence and significance of unsuspected extravascular findings on computed tomography angiography (CTA) of the body before endovascular or surgical treatment in vascular patients.

Materials and Methods This study was approved by the local institutional review board. Radiology reports of 806 patients who underwent CTA of the body during January 2004 until December 2014 before endovascular or surgical treatment of vascular diseases were retrospectively reviewed. All unexpected extravascular abnormalities were classified as clinically non-significant (requiring no follow-up) or clinically significant (requiring further follow-up/immediate treatment). The course of patients with significant extravascular findings was retrospectively evaluated.

Results Overall 806 patients were included in this study (592 men; mean age: 67 years). In 778 (96.5 %) of 806 patients 3293 incidental extravascular findings were diagnosed. There were 259 suspicious findings in 205 patients (25.4 %) that required further follow-up or immediate treatment. A previously unknown malignant tumor was diagnosed in 23 (2.9 %) patients. 10 patients (1.2 %) were diagnosed with lung cancer. Malignant tumors were detected more often in men than in women (3.5 % versus 0.9 %). Patients with an incidental tumor were significantly older than patients without a tumor (mean age: 72.3 vs. 67.5 years).

Conclusion Clinically significant unexpected extravascular findings are common in vascular patients. Especially noteworthy are malignant tumors of the lung.

Key points 

Citation Format
Referring Physicians Assess the Quality of Outpatient Diagnostic Imaging Services: Development and Psychometric Evaluation of a Questionnaire
Authors: Jossen Marianne , Valeri Fabio , Heilmaier Christina , Schwappach David
Published: January 2019

Goal In order to ensure high-quality cooperation between referring physicians and imaging services, it is important to assess the quality of imaging services as perceived by referring physicians. The present study aimed to develop and validate a questionnaire for referring physicians to assess the quality of outpatient diagnostic imaging services.

Materials & Methods The questionnaire was developed by discussing and modifying an existing instrument by the German Association of Surgeons. After qualitative pretesting, the instrument was tested with physicians referring to four outpatient diagnostic imaging services in Switzerland. The results were first assessed using descriptive statistics. The final instrument was tested for validity using the concept of known-groups validity. The hypothesis underlying this procedure was that physicians referring frequently to services estimated the quality of these services to be higher than physicians who referred less often to services. The differences in ratings were assessed using a one-sided two-sample Wilcoxon test. The final questionnaire was tested for internal consistency and reliability using Cronbach’s Alpha.

Results Results show a high level of satisfaction of referring physicians with the relevant services but also potential for quality improvement initiatives. The psychometric evaluation of the final questionnaire shows that it is a valid instrument, showing significant differences between the ratings of physicians referring with high and low frequency. Furthermore, the instrument proves to be consistent and reliable.

Conclusion The final instrument presents a valid, consistent and reliable option for assess the quality of outpatient diagnostic imaging services as perceived by referring physicians. Results can be used as a basis for quality improvement.

Key Points: 

Citation Format
Advanced Pancreatic Cancer: High-Intensity Focused Ultrasound (HIFU) and Other Local Ablative Therapies
Authors: Marinova Milka , Wilhelm-Buchstab Timo , Strunk Holger
Published: January 2019

Background Locally advanced pancreatic cancer is a life-limiting tumor with a wide range of incapacitating symptoms such as cancer-associated pain. Several local ablative therapies with both thermal and non-thermal sources have recently received significant attention as modern treatment options for local tumor control and symptomatic improvement. The following review article provides an overview of currently available techniques and their outcomes including our own experience with high-intensity focused ultrasound (HIFU) being one of the most exciting and innovative modalities.

Method Our experiences with HIFU treatment are based on 89 pancreatic cancer patients (UICC III-IV). Outcomes such as treatment-related changes in symptoms particularly in cancer pain and quality of life as well as local tumor response, safety and survival were compared to reported studies concerning HIFU, radiofrequency and microwave ablation, cryoablation, irreversible electroporation and stereotactic body radiation therapy.

Results Even though all strategies appeared to be feasible, the unique feature of noninvasiveness represents a substantial advantage of the HIFU procedure. In 85 % of HIFU-treated patients, long-lasting pain relief was achieved. 50 % of patients did not require any analgesic treatment 6 weeks post-ablation. Unfortunately, pain palliation and quality-of-life outcomes are only rarely reported for other local treatment modalities. Tumor mass reduction could be achieved with all ablative therapies, with a mean tumor volume reduction of 60 % after 6 months in HIFU-treated pancreatic tumors. Differences in treatment-associated morbidity were reported. However, they are only partially comparable due to unbalanced study populations.

Conclusion Various local ablative treatment modalities are available and feasible for tumor mass reduction of advanced pancreatic cancer but with different symptomatic benefit for patients. An effective and long-lasting reduction of cancer-related pain was observed following HIFU without insertion of needles or electrodes. Randomized controlled studies for head-to-head comparison of these modalities are warranted in the near future.

Key points: 

Citation Format
Ein neues Konzept für die deutschsprachige Weiterbildung in
der Mikrochirurgie: Die Weiterbildungsakademie der Deutschsprachigen
Arbeitsgemeinschaft für Mikrochirurgie (DAM): Ergebnisse der
4-Jahres-Evaluierung
Authors: Bergmeister Konstantin D. , Kneser Ulrich , Kremer Thomas , Harhaus Leila , Daeschler Simeon C. , Pierer Gerhard , Schaefer Dirk J. , Hirche Christoph
Published: January 2019

Einleitung Eine aktuelle Umfrage unter Ärzten in Weiterbildung zum
Facharzt für Plastische und Ästhetische Chirurgie und Klinikleitern zeigt ein
großes Interesse an einer hochwertigen mikrochirurgischen Weiterbildung. Leider
gefährden ökonomischer Druck sowie forensische Bedenken diese Bemühungen
zunehmend und machen eine Verlagerung des Trainings außerhalb des OPs nötig. Zur
Förderung der mikrochirurgischen Weiterbildung bietet die Deutschsprachige
Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße (DAM)
eine Akademie an, um Kollegen ein breites mikrochirurgisches Spektrum zu bieten
und den fachlichen Austausch zu stärken. In dieser Arbeit stellen wir das
Kurskonzept und eine erste Evaluation vor.

Methodik Seit 2015 wurde jährlich durch die DAM eine praxisorientierte
Weiterbildungsakademie mit Gastoperateuren zu allen Schwerpunktbereichen der
Mikrochirurgie an der BG-Klinik Ludwigshafen veranstaltet. Pro Tag wurden
jeweils mindestens 3 mikrochirurgische Eingriffe in den Fachgebieten Brust-,
Nerven-, Knochen/Hand-Extremitäten- und Lymphgefäßrekonstruktion parallel
durchgeführt und begleitet von Fachvorträgen. Die Teilnehmer wurden gebeten,
anonym ihre Erwartungen zu dem Kurskonzept zu definieren sowie den Kurs und
seine Inhalte zu evaluieren.

Ergebnisse Das Format und die Ziele der Akademie werden dargestellt. Im
zweiten Schritt erfolgte die Evaluation, an der sich 79 % der Teilnehmer
beteiligten. 90 % der Teilnehmer waren aus einem Haus der Maximalversorgung oder
Universitätsklinik, wobei 57 % der Abteilungen weniger als 5 mikrochirurgische
Eingriffe pro Woche durchführten. Alle Teilnehmer sahen die Mikrochirurgie als
Teil ihres Arbeitsspektrums und das größte Interesse bestand für die
Extremitäten- (90 %) und die mikrochirurgische Rekonstruktion der Hand (80 %).
Alle Teilnehmer würden den Kurs weiterempfehlen, empfohlen wurde eine
Verbesserung der intraoperativen Video-Übertragung.

Diskussion Diese Arbeit zeigt, dass praxisorientierte Akademien am
Beispiel der Mikrochirurgie ein hochaktuelles Lernformat sind, um den
Limitationen der chirurgischen Aus- und Weiterbildung erfolgreich
entgegenzutreten. Insbesondere der enge Austausch mit den Experten wurde als
wertvoll erachtet, um ein Netzwerk innerhalb der deutschsprachigen
Mikrochirurgie aufzubauen. Die Akademie verfolgt das Ziel, eine junge Generation
von Mikrochirurgen dauerhaft und nachhaltig zu begeistern und ein
professionelles Netzwerk aufzubauen und weiterzuentwickeln.
Angehörigenbefragung zum Sterben im Krankenhaus: Ein Vergleich zwischen Abteilungen für innere Medizin und Palliativstationen in der Steiermark (Österreich)
Authors: Stolz Erwin , Mayerl Hannes , Baumgartner Johann , Steinkellner Karin , Freidl Wolfgang
Published: January 2019

Hintergrund 49% der Verstorbenen in Österreich sterben gegenwärtig im Krankenhaus, wodurch der Versorgungsqualität am Ende des Lebens sowie der Sterbensqualität im stationären Bereich eine zentrale Bedeutung zukommt. Ziel dieses Kurzbeitrages ist ein Vergleich der Wahrnehmung der Betreuung und des Sterbens im Krankenhaus zwischen Abteilungen für innere Medizin und Palliativstationen aus dem Blickwinkel Angehöriger.

Methode Im Rahmen einer Pilotstudie wurden 2015–2017 210 Angehörige von Patienten die auf 4 Abteilungen für innere Medizin und 2 Palliativstationen im Bundesland Steiermark verstorben waren hinsichtlich ihrer Wahrnehmung der Kommunikation durch die Betreuer, der Betreuungssituation sowie der Zeit des Sterbens des Patienten mittels Fragebogen befragt.

Ergebnisse Es zeigte sich, dass hinsichtlich der Betreuung der Patienten und bezüglich der Zeit des Sterbens (d. h. rechtzeitige Verständigung bei Zustandsverschlechterung des Patienten, beim unmittelbaren Sterben anwesend sein, Vorbereitung auf das Sterben sowie Qualität des Sterbens) die beiden Palliativstationen von den Angehörigen jeweils deutlich besser bewertet wurden als die Abteilungen für innere Medizin.

Schlussfolgerungen Vor dem Hintergrund der großen Anzahl an Menschen die in Österreich im Krankenhaus versterben, wurde im Rahmen dieser explorativen Studie gezeigt, dass die Betreuungs- und Sterbensqualität auf palliativmedizinischen Stationen im Vergleich zu Stationen für innere Medizin von Angehörigen Verstorbener als besser eingeschätzt wurde. Daher wird eine umfassendere und systematischere Evaluation des möglichen Mehrwerts palliativmedizinischer Einrichtungen in Krankenhäusern in Österreich empfohlen.
Kinetic Gait Analysis of Agility Dogs Entering the A-Frame
Authors: Glyde Mark , Hosgood Giselle , Dempsey Alasdair , Wickham Sarah , Appelgrein Carla
Published: January 2019

Objective The main purpose of this study was to investigate the effect of a decrease in the A-frame angle of incline on the vertical and cranio-caudal ground reaction forces observed in a homogeneous cohort of agility dogs during entrance and contact with the A-frame.

Materials and Methods A crossover study design was applied to eight large breed dogs to compare the vertical and cranio-caudal ground reaction forces entering the A-frame at three angles of incline: 40° (standard), 35° and 30°. The peak vertical force, passive impact peak, peak propulsive force, peak braking force, the time point (percentile) in the stance phase at which these events occurred and the proportion of time for limb contact spent in braking (% braking) and propulsion (% propulsion) were examined.

The variables measured from three trials at each incline were evaluated for a significant effect of A-frame angle with height and velocity included as covariates.

Results The peak propulsive force and the % propulsion were significantly higher at the 40° angle of incline compared with 30° (p = 0.013, p = 0.0165 respectively) and the % braking was significantly lower at the 40° angle of incline compared with 30° (p = 0.0165). There was no significant effect of A-frame angle on the vertical ground reaction forces measured.

Clinical Significance Compared with 30° incline, ascent up the A-frame at a 40° incline requires a higher propulsive force and extended time in propulsion to maintain forward movement and convert potential energy into forward kinetic energy.
Anatomical Study of a Chimeric Fascio-Osteomyocutaneous Fibula Flap for Free Microvascular Tissue Transfer
Authors: Hamscha Ulrike Maria , Weninger Wolfgang Josef , Freystätter Christian , Tzou Chieh-Han , Radtke Christine
Published: January 2019

Background Functional restoration in reconstructive surgery can require complex and adaptable approaches. In this anatomical study, the combined angiosome of the septofasciomyocutaneous vessels originating from the fibular artery was defined as basis for a chimeric flap of the lateral lower leg.

Methods Methylene blue injection into the fibular artery was performed in 10 legs of fresh cadavers for visualization of the angiosome on the skin, fibula, and adjacent muscles as the lateral hemisoleus (HS) muscle. With regards to clinical specifications a maximum-size flap containing cutaneous, osseous, and muscular elements was raised. During dissection, the distribution pattern, number and size of stained septofasciomyocutaneous vessels at the lateral border of the proximal, middle, and distal thirds of the fibula length, as well as the flap dimensions were evaluated.

Results In all specimens, vessels originating from the fibular artery and supplying the resected fibular bone, the fasciocutaneous flap and dorsally located muscles were found. The mean number of vessels to the skin was 4.2 per leg with a mean diameter of 1.1 ± 0.5 mm (range: 0.4–2.5 mm) and to the HS muscle 3.4 vessels with a mean diameter of 1.2 ± 0.7 mm (range: 0.3–3.0 mm). A total of 88.4% vessels occurred in the proximal and middle thirds of the legs. The resected fibula graft had a mean length of 23.8 ± 3.9 cm (range: 19.9–31.0 cm) and the skin paddle had a mean size of 23.8 ± 3.9 cm (range: 19.9–31.0 cm) × 7.0 cm. The flexor hallucis longus (FHL) muscle had a mean volume of 37.2 ± 15.8 cm3 (range: 18–58 cm3) and the lateral HS muscle 77.1 ± 23.3 cm3 (range: 48–105 cm3).

Conclusion Our results and anatomical descriptions indicate that chimeric fibula flaps can meet the specific reconstructional requirements of complex and large sized defects representing a promising basis for further studies.
Low-Molecular-Weight Heparin in Cancer Patients: Overview and Indications
Authors: Voigtlaender Minna , Langer Florian
Published: January 2019

Although venous thromboembolism (VTE) is a well-known cause of death in patients with cancer, both its treatment and prevention remain a challenge in daily practice. Direct oral anticoagulants have emerged as safe and efficacious alternatives to vitamin K antagonists in the general population, and recent clinical trials also support their use in select patients with cancer-associated VTE. Despite this, low-molecular-weight heparins (LMWHs), a comparatively ancient class of antithrombotic drugs, remain the anticoagulants of choice in many indications relevant to modern haematology and oncology. In addition to the treatment of established VTE, these indications include VTE prophylaxis in surgical or acutely ill, hospitalized medical cancer patients as well as the prevention of VTE in high-risk patients undergoing ambulatory chemotherapy. In a constantly changing landscape of approved anticancer agents, this review article summarizes pivotal clinical trial data and guideline recommendations regarding the use of LMWH in haematological and oncological patients, who constitute a highly vulnerable patient population due to their increased risk for both bleeding and VTE recurrence.
Trauma-Induced Coagulopathy
Authors: Petros Sirak
Published: January 2019

Trauma-induced coagulopathy (TIC) is a heterogeneous entity that contributes to a significant morbidity and mortality following trauma. The activated protein C system, endotheliopathy and platelet dysfunction have been implicated in the pathogenesis of TIC, although there are still controversies on the exact pathogenesis. TIC can be modified by hypoperfusion, acidosis, hypothermia, haemodilution, underlying disease conditions, pre-injury medications as well as genetic predispositions. Current definition of this syndrome is based on laboratory abnormalities that do not easily allow a distinction between adaptive and maladaptive changes of the haemostatic system. The management of the coagulopathy in the early phase of trauma focuses on the treatment of bleeding. The improving quality in the early damage control following trauma has led to a marked reduction in morbidity and mortality. In the later phase, hypercoagulopathy and inflammation contribute to organ dysfunction, venous thromboembolism and poor outcome. Despite considerable advances in trauma management, TIC remains a diagnostic and therapeutic challenge both in the early and late phases of trauma. This review mainly focuses on the pathogenesis of TIC, with a very short discussion on diagnostic and therapeutic principles.
Magneto-hydrodynamical nonlinear simulations of magnetically confined plasmas using smooth particle hydrodynamics (SPH)
Authors: Vela Vela L. , Sánchez R. , Reynolds-Barredo J. M. , Geiger J.
Published: January 2019

The successful application of techniques inspired in Smoothed Particle Hydrodynamics (SPH) to magnetohydrodynamical (MHD) nonlinear simulations of magnetically confined plasmas requires the previous solution to a number of challenging issues that are still not fully resolved, namely, the construction of precise, arbitrary initial conditions in complicated geometries, the formulation of adequate boundary conditions for the magnetic field, and the correct treatment of three-dimensional toroidal boundaries of the arbitrary shape. In this paper, we present an SPH implementation of the nonlinear MHD equations that include our proposed solution to these issues and test its performance on a broad selection of nonlinear MHD problems: (1) the propagation of circularly polarized Alfvén waves, (2) the occurrence of magnetic reconnection for a Harris current-sheet, and (3) the nonlinear MHD stability properties of various cylindrical pinches.
Effect of dietary probiotics and stocking density on carcass traits, meat quality, microbial populations and ileal histomorphology in broilers under hot-climate conditions
Authors: Ebeid T. A. , Fathi M. M. , Al-Homidan I. , Ibrahim Z. H. , Al-Sagan A. A.
Published: January 2019

The objective of the present study was to investigate the potential effects associated with dietary probiotic inclusion and the stocking density on carcass traits, meat chemical composition, meat sensory quality, microbial populations and ileal histomorphology in broiler chickens raised under hot climate conditions. In total, 1800 1-day-old unsexed broiler chicks (Ross 308) were randomly allocated in a completely randomised design according to a 3 × 2 factorial arrangement, with three concentrations of a dietary probiotic (0, 200 and 400 mg/kg) containing 4 × 109 cfu/g of Bacillus subtilis and two stocking densities (12 or 18 birds/m2), forming six treatments, with three pens (replicates) each. The probiotic concentration had no significant (P > 0.05) effect on bodyweight gain, feed consumption, feed conversion ratio, carcass percentage and meat chemical composition. Dietary probiotic inclusion significantly (P = 0.02) increased the scores of meat colour and odour. The acceptability score was significantly (P < 0.03) affected by the stocking density. Dietary supplementation of the probiotic at both 200 and 400 mg/kg significantly (P = 0.05) reduced the counts of Escherichia coli and Salmonella in the gut and litter. In meat, dietary supplementation of the probiotic at 200 and 400 mg/kg significantly (P = 0.03) reduced the counts of E. coli, compared with those of the control group. Moreover, Salmonella was not detected in meat. Regarding the ileal villi and crypt morphology, dietary probiotic supplementation significantly (P = 0.05) increased the height of the villus. There were no significant probiotic concentration × stocking density interactions for any of the investigated parameters, except for the gizzard percentage. Thus, dietary probiotic supplementation in broilers raised under a high ambient temperature had a significantly positive effect on the ileal villus height and a significantly negative effect on the counts of E. coli and Salmonella in the gut and litter. No negative effects on growth performance, carcass parts and meat quality were detected.
Flow interactions between uncoordinated flapping swimmers give rise to group cohesion
Authors: Newbolt Joel W. , Zhang Jun , Ristroph Leif
Published: January 2019

Significance

Fish and birds moving in groups are thought to benefit from hydrodynamic or aerodynamic interactions between individuals. To better understand these effects, we devise a robotic “school” of flapping swimmers whose formations and motions come about from flow interactions. Surprisingly, we find that the flows naturally generated during swimming can also prevent collisions and separations, allowing even uncoordinated individuals with different flapping motions to travel together. Other benefits include freeloading by a “lazy” follower who keeps up with a faster-flapping leader by surfing on its wake. More generally, our study provides complete maps linking flapping motions to group locomotion, which is needed to test whether flow interactions are also exploited by animals.
Effect of individualized resistance training prescription with heart rate variability on individual muscle hypertrophy and strength responses
Authors: De Oliveira Ramon Martins , Ugrinowitsch Carlos , Kingsley James Derek , Da Silva Deivid Gomes , Bittencourt Diego , Caruso Flávia Rossi , Borghi‐Silva Audrey , Libardi Cleiton Augusto
Published: January 2019

The aim of the present study was to investigate if resistance training (RT), performed with individualized recovery between sessions (RT‐IND), promotes greater gains in strength and muscle mass and reduces the variability on adaptations compared to RT with fixed recovery intervals (RT‐FIX). Twenty young men (age 21.9 ± 3.3 years) were randomized in the RT‐IND and RT‐FIX groups. Five days before the beginning of the training, measurements of the root mean square of successive R‐R intervals differences (RMSSD) values of each individual were performed to establish the baseline values. Before each RT session, the RMSSD values determined whether the participants from RT‐IND protocol were recovered from the previous session. Participants performed the RT session only if RMSSD values had returned to the baseline, otherwise they had to wait for an additional 24 h. RT‐FIX performed an RT session every 48 h. Muscle strength was measured by one‐maximal repetition (1‐RM) test and muscle cross‐section area (CSA) of the vastus laterals by ultrasonography were assessed pre‐ and post‐training. 1‐RM values increased significantly from pre to post‐training for both groups (RT‐IND: 30% and RT‐FIX: 42%, main time effect, P < 0001), with no significant difference between groups. Muscle CSA increased significantly from pre to post‐training (RT‐IND: 15.7% and RT‐FIX: 15.8%, main time effect, P < 0001), with no significant difference between groups. In conclusion, RT‐IND did not increase the gains in muscle strength and mass neither reduce the variability in muscle adaptations when compared to the RT‐FIX.
Final report on APMP.QM-S10: elements in food supplement
Authors: Hatamleh N , Puelles M , Lozano H , Khan M , Yang L , Pihillagawa I G , Nadeau K , Mester Z , Wei C , Li X , Sin D W M , Fung W H , Tsoi Y T , Bergamaschi L , Okumu T O , Uribe C , Stakheev A , Shin R , Jaćimović R , Thiengmanee U , Klich H , Raouf J , Chaabene N , Chaieb S , Ngô H T
Published: January 2019

APMP.QM-S10 was coordinated by Government Laboratory, Hong Kong SAR (GLHK) under the auspices of the Inorganic Analysis Working Group (IAWG) of the Comité Consultatif pour la Quantité de Matière (CCQM). Fourteen national metrology institutes (NMIs) or designated institutes (DIs) registered for the examination of zinc, manganese, calcium and magnesium. All institutes submitted the results for zinc and manganese, and twelve institutes submitted the results for calcium and magnesium. The supplementary comparison was designed to enable participating institutes to demonstrate their measurement capabilities in measuring the mass fractions of the analytes at mg/kg levels in a test sample of food supplement by various analytical techniques.

For examination of zinc, manganese, calcium and magnesium, most of the participants used microwave-assisted acid digestion methods for sample dissolution. A variety of instrumental techniques including inductively coupled plasmas mass spectrometry (ICP-MS), isotope dilution inductively coupled plasmas mass spectrometry (ID-ICP-MS), inductively coupled plasmas optical emission spectrometry (ICP-OES), flame atomic absorption spectrometry (FAAS), and instrumental neutron action analysis (INAA) were employed by the participants for determination. For this supplementary comparison, inorganic core capabilities have been demonstrated by the concerned participants with respect to methods including ICP-MS (without isotope dilution), ID-ICP-MS, ICP-OES, FAAS and INAA on the determination of elements (zinc, manganese, calcium and magnesium) in a food matrix of food supplement.

Generally, the participants' results of APMP.QM-S10 were found to be consistent for all measurands according to their equivalence statements. Except with some extreme values, most of the participants obtained the values of d
i/U(d
i) within ± 1 for the measurands.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Dissolved methane in the residual basins of the Aral Sea
Authors: Izhitskaya E S , Egorov A V , Zavialov P O , Yakushev E V , Izhitskiy A S
Published: January 2019

Due to catastrophic desiccation, today’s Aral Sea consists of a few separate residual basins, characterized by different ecological conditions (the Large Aral, Lake Tshchebas, the Small Aral). This study is the first report on dissolved methane concentrations in these basins. Overall, 48 water samples were obtained and analyzed for methane content. High values of dissolved methane in the anaerobic layer of the Large Aral Sea, including the Chernyshev Bay, are apparently caused by damping of vertical mixing and decomposition of abundant organic matter in anoxic conditions. The estimated methane flux from the surface of the Large Aral Sea is actually higher than that from many other lakes in the world. For the anoxic layer of the Large Aral, certain relations between distributions of methane and other hydrochemical parameters, including dissolved oxygen and hydrogen sulfide, were found. In the brackish Small Aral Sea, methane content was moderate. Lake Tshchebas exhibits intermediate conditions between the Large and the Small Aral seas in terms of salinity and methane concentration. The observed differences of methane content and distributions in separate residual basins are linked with the differences of their mixing and oxygenation regimes.
Cartan subalgebras for quantum symmetric pair coideals
Authors: Letzter Gail
Published: January 2019

There is renewed interest in the coideal subalgebras used to form quantum symmetric pairs because of recent discoveries showing that they play a fundamental role in the representation theory of quantized enveloping algebras. However, there is still no general theory of finite-dimensional modules for these coideals. In this paper, we establish an important step in this direction: we show that every quantum symmetric pair coideal subalgebra admits a quantum Cartan subalgebra which is a polynomial ring that specializes to its classical counterpart. The construction builds on Kostant and Sugiura’s classification of Cartan subalgebras for real semisimple Lie algebras via strongly orthogonal systems of positive roots. We show that these quantum Cartan subalgebras act semisimply on finite-dimensional unitary modules and identify particularly nice generators of the quantum Cartan subalgebra for a family of examples.
Planned Risk Information Avoidance: A Proposed Theoretical Model
Authors: Deline Mary Beth , Kahlor Lee Ann
Published: January 2019

Risk information avoidance is widespread, and happens in contexts ranging from the personal to civic spheres. Disciplines from communication to psychology have been exploring the avoidance phenomena for decades, yet we lack a unifying theoretical model to understand it. To develop such a model, we start with the planned risk information-seeking model (PRISM) and explore its tenets, and related research, as they apply to information avoidance. We end with a theoretically sound planned risk information avoidance (PRIA) model and accompanying propositions in three overarching areas: cognitive, affective and socio-cultural. This model shows promise in advancing our collective understanding of the PRIA phenomenon.
Discriminatory power of scoring systems for outcome prediction in patients with extracorporeal membrane oxygenation following cardiovascular surgery†
Authors: Schrutka Lore , Rohmann Felix , Binder Christina , Haberl Thomas , Dreyfuss Ben , Heinz Gottfried , Lang Irene M , Felli Alessia , Steinlechner Barbara , Niessner Alexander , Laufer Günther , Goliasch Georg , Wiedemann Dominik , Distelmaier Klaus
Published: January 2019

OBJECTIVES

Although extracorporeal membrane oxygenation (ECMO) represents a rapidly evolving treatment option in patients with refractory heart or lung failure, survival remains poor and appropriate risk stratification challenging because established risk prediction models have not been validated for this specific population.

METHODS

This observational single-centre registry included a total of 240 patients treated with venoarterial ECMO therapy following cardiovascular surgery and analysed the discriminatory power of the European System of Cardiac Operative Risk Evaluation (EuroSCORE) additive, the EuroSCORE II, the Sequential Organ Failure Assessment (SOFA) score, the Simplified Acute Physiology Score (SAPS) II, the SAPS III, the Acute Physiology and Chronic Health Evaluation (APACHE) II, the Risk of renal failure, Injury to the kidney, Failure of kidney function, Loss of kidney function and End-stage renal failure (RIFLE) classification, the survival after venoarterial ECMO (SAVE) score, the prEdictioN of Cardiogenic shock OUtcome foR AMI patients salvaGed by VA-ECMO (ENCOURAGE) score and the Society of Thoracic Surgeons (STS) risk model for outcome prediction.

RESULTS

During a median follow-up time of 37 months (interquartile range 19–67), 65% of the patients died. Only the SAVE score and the SAPS II were significantly associated with the 30-day mortality rate with a hazard ratio (HR) of 1.06 [95% confidence interval (CI) 1.02–1.11; P = 0.002] for the SAVE score and an HR of 1.02 (95% CI 1.01–1.03; P = 0.004) for the SAPS II with a modest discriminatory power displayed by a C-index of 0.61 and 0.57, respectively. Seven out of 10 scoring systems revealed significant association with long-term mortality, with the SAVE score and the SAPS II remaining the strongest predictors of long-term mortality with an HR of 1.06 (95% CI 1.03–1.09; P < 0.001, C-index 0.61) for the SAVE score and an HR of 1.02 (95% CI 1.01–1.03; P < 0.001, C-index 0.58) for the SAPS II.

CONCLUSIONS

Risk assessment based on established risk models in patients with ECMO remains difficult. Only the SAPS II and the SAVE score were exclusively found to be suitable for short- and long-term outcome prediction in this specific vulnerable patient population.
Furstenberg Systems of Bounded Multiplicative Functions and Applications
Authors: Frantzikinakis Nikos , Host Bernard
Published: January 2019

We prove a structural result for measure preserving systems naturally associated with any finite collection of multiplicative functions that take values on the complex unit disc. We show that these systems have no irrational spectrum and their building blocks are Bernoulli systems and infinite-step nilsystems. One consequence of our structural result is that strongly aperiodic multiplicative functions satisfy the logarithmically averaged variant of the disjointness conjecture of Sarnak for a wide class of zero entropy topological dynamical systems, which includes all uniquely ergodic ones. We deduce that aperiodic multiplicative functions with values plus or minus one have super-linear block growth. Another consequence of our structural result is that products of shifts of arbitrary multiplicative functions with values on the unit disc do not correlate with any totally ergodic deterministic sequence of zero mean. Our methodology is based primarily on techniques developed in a previous article of the authors where analogous results were proved for the Möbius and the Liouville function. A new ingredient needed is a result obtained recently by Tao and Teräväinen related to the odd order cases of the Chowla conjecture.