bluuebunny/crossref_metadata_2025 huggingface dataset:
DeepSOFA: A Continuous Acuity Score for Critically Ill Patients using Clinically Interpretable Deep Learning
Authors: Shickel Benjamin , Loftus Tyler J. , Adhikari Lasith , Ozrazgat-Baslanti Tezcan , Bihorac Azra , Rashidi Parisa
Published: February 2019

Traditional methods for assessing illness severity and predicting in-hospital mortality among critically ill patients require time-consuming, error-prone calculations using static variable thresholds. These methods do not capitalize on the emerging availability of streaming electronic health record data or capture time-sensitive individual physiological patterns, a critical task in the intensive care unit. We propose a novel acuity score framework (DeepSOFA) that leverages temporal measurements and interpretable deep learning models to assess illness severity at any point during an ICU stay. We compare DeepSOFA with SOFA (Sequential Organ Failure Assessment) baseline models using the same model inputs and find that at any point during an ICU admission, DeepSOFA yields significantly more accurate predictions of in-hospital mortality. A DeepSOFA model developed in a public database and validated in a single institutional cohort had a mean AUC for the entire ICU stay of 0.90 (95% CI 0.90–0.91) compared with baseline SOFA models with mean AUC 0.79 (95% CI 0.79–0.80) and 0.85 (95% CI 0.85–0.86). Deep models are well-suited to identify ICU patients in need of life-saving interventions prior to the occurrence of an unexpected adverse event and inform shared decision-making processes among patients, providers, and families regarding goals of care and optimal resource utilization.
Animal species identification in parchments by light
Authors: Alvarez Angel Martin Fernandez , Bouhy Julie , Dieu Marc , Charles Catherine , Deparis Olivier
Published: February 2019

Recently, historical and conservation studies have attached an increasing importance to investigating the materials used in historic documents. In particular, the identification of the animal species from which parchments are made is of high importance and is currently performed by either genetic or proteomic methods. Here, we introduce an innovative, non-invasive optical method for identifying animal species based on light-parchment interaction. The method relies on conservation of light energy through reflection, transmission and absorption from the sample, as well as on statistical processing of the collected optical data. Measurements are performed from ultraviolet (UV) to near-infrared (NIR) spectral ranges by a standard spectrophotometer and data are processed by Principal Component Analysis (PCA). PCA data from modern parchments, made of sheep, calf and goat skins, are used as a database for PCA analysis of historical parchments. Using only the first two principal components (PCs), the method confirmed visual diagnostics about parchment appearance and aging, and was able to recognise the origin species of historical parchment of among database clusters. Furthermore, taking into account the whole set of PCs, species identification was achieved, with all results matching perfectly their proteomic counterparts used for method assessment. The validated method compares favourably with genetic and proteomic methods used for the same purpose. In addition to animals’ proteomic and genetic signatures, a unique “optical fingerprint” of the parchments’ origin species is revealed here. This new method is non-invasive, straightforward to implement, potentially cheap and accessible to scholars and conservators, with minimal training. In the context of cultural heritage, the method could help solving questions related to parchment production and, more generally, medieval writing production.
Ghrelin Receptor Influence on Cocaine Reward is Not Directly Dependent on Peripheral Acyl-Ghrelin
Authors: Wenthur Cody J. , Gautam Ritika , Zhou Bin , Vendruscolo Leandro F. , Leggio Lorenzo , Janda Kim D.
Published: February 2019

The peptide hormone acyl-ghrelin and its receptor, GHSR1a, represent intriguing therapeutic targets due to their actions in metabolic homeostasis and reward activity. However, this pleotropic activity makes it difficult to intervene in this system without inducing unwanted effects. Thus, it is desirable to identify passive and active regulatory mechanisms that allow differentiation between functional domains. Anatomical restriction by the blood brain barrier represents one major passive regulatory mechanism. However, it is likely that the ghrelin system is subject to additional passive mechanisms that promote independent regulation of orexigenic behavior and reward processing. By applying acyl-ghrelin sequestering antibodies, it was determined that peripheral sequestration of acyl-ghrelin is sufficient to blunt weight gain, but not cocaine rewarding effects. However, both weight gain and reward-associated behaviors were shown to be blocked by direct antagonism of GHSR1a. Overall, these data indicate that GHSR1aeffects on reward are independent from peripheral acyl-ghrelin binding, whereas centrally-mediated alteration of energy storage requires peripheral acyl-ghrelin binding. This demonstration of variable ligand-dependence amongst functionally-distinct GHSR1apopulations is used to generate a regulatory model for functional manipulation of specific effects when attempting to therapeutically target the ghrelin system.
Lesson Resources and Teaching Strategies on Argumentation for Secondary Chemistry Education
Authors: Cullinane Alison , O'Dwyer Anne
Published: February 2019

This chapter provides some examples of resources and strategies useful for promoting argumentation in the secondary chemistry classroom from both authors’ personal experiences, as well as from a review of current literature. Literature has been used to describe how strategies could be operationalised in the classroom. Selected strategies include concept cartoons, evidence-based reasoning, and scenario analysis on social media. Some ideas and suggested resources have been developed for the chapter and therefore are a unique contribution to the area of chemistry argumentation. These include the examination of social media platforms to address plastic pollution and energy sources. The authors examine chemistry concepts and socio-scientific issues and how they can be situated in relation to argumentation in secondary chemistry education.
Using Computer Technology to Support the Teaching and Learning of Argumentation in Chemistry
Authors: Henderson J. Bryan , Osborne Jonathan F.
Published: February 2019

The affordances of both technology and evidence-based argumentation are central to the work of the professional scientific community. However, the use of technology to promote the learning of science through argumentation is a relatively recent educational practice. This chapter provides examples of how technology can support chemistry students’ engagement in argumentation, as well as how technology can aid analysis of student argumentation by both educational researchers and chemistry instructors. We seek to offer a practical perspective by pointing to technology that chemistry instructors can access easily through a basic web search at the time of this publication. We follow this review by highlighting several contemporary projects developing practical, next-generation technology to support science argumentation. These advances have the potential to scaffold and improve the quality of the argumentation process in the chemistry classroom, while expanding the possibilities for what we can ask students to produce at the end of class.
The Development of Argumentation Skills in the Chemistry Laboratory
Authors: Hofstein Avi , Katchevitch Dvora , Mamlok-Naaman Rachel
Published: February 2019

One of the key goals of science education is to provide students with the ability to construct arguments – reasoning and thinking critically in a scientific context. Over the years, many studies have been conducted on constructing arguments in science teaching, but only a few of them have dealt with studying argumentation in the science laboratory in general and in the chemistry laboratory in particular. Our research focuses on the process in which students construct arguments in the chemistry laboratory while conducting different types of inquiry experiments. The experiments that were assessed for their argumentation level differed in their level of complexity. It was found that the more complex experiments served as a better platform for developing arguments as well as regarding their relative numbers. Moreover, we identified a number of characteristics during the discourse that serve as a catalyst for raising arguments: asking questions and unexpected results obtained in the experiments.
One-step sensing of foodborne pathogenic bacteria using a 3D paper-based device
Authors: Kim Hyeok Jung , Kwon Chanho , Lee Byung Sub , Noh Hyeran
Published: February 2019

We developed a 3D paper sensor with functionalized layers for feasible one-step-based foodborne bacteria sensing.
The maximum occupancy condition for the localized property-optimized orbitals
Authors: Nikolaienko Tymofii Yu.
Published: February 2019

It is shown analytically that the Chemist's Localized Property-optimized Orbitals (CLPOs), which are the localized orbitals obtainable from the results of ab initio calculations by using the open-source program JANPA (http://janpa.sourceforge.net/) according to the recently proposed optimal property partitioning condition, form the Lewis structure with nearly maximum possible total electron occupancy.
Tunable electronic properties of an Sb/InSe van der Waals heterostructure by electric field effects
Authors: Zhang Zhihui , Zhang Yan , Xie Zifeng , Wei Xing , Guo Tingting , Fan Jibin , Ni Lei , Tian Ye , Liu Jian , Duan Li
Published: February 2019

An Sb/InSe heterostructure manifests a varied direct bandgap under an electric field which is more favorable to FETs and MEMS devices.
Monitoring solvent dynamics and ion associations in the formation of cubic octamer polyanion in tetramethylammonium silicate solutions
Authors: Chen Ying , Washton Nancy M. , Young Robert P. , Karkamkar Abhijeet J. , De Yoreo James J. , Mueller Karl T.
Published: February 2019

Solvent dynamics and ion associations were monitored during the formation of cubic octamer polysilicate using multiple NMR methods.
Synergistic effect of Mo–W carbides on selective hydrodeoxygenation of guaiacol to oxygen-free aromatic hydrocarbons
Authors: Tran Chi-Cong , Han Yinglei , Garcia-Perez Manuel , Kaliaguine Serge
Published: February 2019

Mo–W carbide was synthesizedviatemperature-programmed reduction to generate a β-Mo2C phase with bulk morphology.
Three-dimensionally ordered macroporous K0.5MnCeOx/SiO2 catalysts: facile preparation and worthwhile catalytic performances for soot combustion
Authors: Yu Xuehua , Zhao Zhen , Wei Yuechang , Zhao Linlin , Liu Jian
Published: February 2019

A series of novel catalysts with three-dimensionally ordered macroporous structures and active-component nanoparticles, exhibiting excellent catalytic performance for soot combustion, were fabricated.
Aromatics from lignin through ultrafast reactions in water
Authors: Abad-Fernández Nerea , Pérez Eduardo , Cocero María José
Published: February 2019

Nowadays, the valorization of lignin, the major natural source of aromatics, is a challenge for the scientific community.
Microfluidic assay for the on-chip electrochemical measurement of cell monolayer permeability
Authors: Wong Jeremy F. , Simmons Craig A.
Published: February 2019

An electrochemical permeability assay that enables the on-chip measurement of endothelial permeability with significant advantages over traditional fluorescent tracer-based assays.
Co-adsorption of an anionic dye in the presence of a cationic dye and a heavy metal ion by graphene oxide and photoreduced graphene oxide
Authors: Zhang Xiaorong , Qin Chengbing , Gong Yani , Song Yunrui , Zhang Guofeng , Chen Ruiyun , Gao Yan , Xiao Liantuan , Jia Suotang
Published: February 2019

The adsorption capacity of graphene oxide (GO) for orange II (OII) can be remarkably enhanced in the presence of methylene blue (MB) and Pb2+.
Cisplatin, glutathione and the third wheel: a copper-(1,10-phenanthroline) complex modulates cisplatin–GSH interactions from antagonism to synergism in cancer cells resistant to cisplatin
Authors: Vascellari Sarah , Valletta Elisa , Perra Daniela , Pinna Elisabetta , Serra Alessandra , Isaia Francesco , Pani Alessandra , Pivetta Tiziana
Published: February 2019

A new drug cocktail is proposed to overcome the cisplatin-resistance due to the presence of glutathione. A2780 cisplatin-resistant cells, treated with the drug cocktail, showed early apoptosis.
pDobz/pDobb protected diaminodiacid as a novel building block for peptide disulfide-bond mimic synthesis
Authors: Liu Chao , Zou Yan , Hu Honggang , Jiang Yunyun , Qin Luping
Published: February 2019

The total synthesis of a contryphan-Vn disulfide bond mimic utilizing a novel pDobz/pDobb based diaminodiacid building block via the diaminodiacid strategy.
A novel nitrogen heterocycle platform-based highly selective and sensitive fluorescence chemosensor for the detection of Al3+ and its application in cell imaging
Authors: Liu Zengchen , Li Shujing , Ge Genwu , Li Yanxia , Zhao Chunxiang , Zhang Hui , Yang Zhiguang
Published: February 2019

In the study, a highly selective and sensitive fluorescence sensor derived from nitrogen heterocycle was synthesized and characterized.
Significant role of Asn-247 and Arg-64 residues in close proximity of the active site in maintaining the catalytic function of CTX-M-15 type β-lactamase
Authors: Maryam Lubna , Khalid Shamsi , Ali Abid , Khan Asad U.
Published: February 2019

Mutations of amino acid residues present near active site decrease the catalytic efficiency of beta lactamase enzymes.
Effects of corn stalk cultivation substrate on the growth of the slippery mushroom (Pholiota microspora)
Authors: Meng Lingsi , Fu Yongping , Li Dan , Sun Xiaozhong , Chen Yanqi , Li Xuefei , Xu Shuai , Li Xiao , Li Changtian , Song Bing , Li Yu
Published: February 2019

Corn stalks are a major source of agricultural waste in China that have the potential for more efficient utilisation. In this study, we designed substrate formulas with different proportions of corn stalks to cultivate the Pholiota microspora.
A first blue fluorescence composite film based on graphitic carbon nitride nanosheets/polyoxometalate for application in reversible electroluminescence switching
Authors: Fu Zhijing , Ma Zhiyuan , Yu Tian , Bi Lihua
Published: February 2019

A composite film containing g-C3N4NS and SiMoW was constructed by LBL assembly to realize fluorescence switch regulation.
Phase stability of intercalated V2O5 battery cathodes elucidated through the Goldschmidt tolerance factor
Authors: McColl Kit , Corà Furio
Published: February 2019

Structural stability, intercalation, layer translation, and ionic mobility investigated in α- and δ-V2O5 using hybrid-exchange DFT, including dispersion forces.
Vertically aligned ZnO/Ga2O3 core/shell nanowire arrays as self-driven superior sensitivity solar-blind photodetectors
Authors: You Daotong , Xu Chunxiang , Zhao Jie , Zhang Wei , Qin Feifei , Chen Jinping , Shi Zengliang
Published: February 2019

Well-aligned ZnO/Ga2O3 core/shell nanowire arrays were fabricated by VPT and the sputtering method as self-driven solar-blind photodetectors.
The lipid head group is the key element for substrate recognition by the P4 ATPase ALA2: a phosphatidylserine flippase
Authors: Theorin Lisa , Faxén Kristina , Sørensen Danny Mollerup , Migotti Rebekka , Dittmar Gunnar , Schiller Jürgen , Daleke David L. , Palmgren Michael , López-Marqués Rosa Laura , Günther Pomorski Thomas
Published: February 2019

Type IV P-type ATPases (P4 ATPases) are lipid flippases that catalyze phospholipid transport from the exoplasmic to the cytoplasmic leaflet of cellular membranes, but the mechanism by which they recognize and transport phospholipids through the lipid bilayer remains unknown. In the present study, we succeeded in purifying recombinant aminophospholipid ATPase 2 (ALA2), a member of the P4 ATPase subfamily in Arabidopsis thaliana, in complex with the ALA-interacting subunit 5 (ALIS5). The ATP hydrolytic activity of the ALA2–ALIS5 complex was stimulated in a highly specific manner by phosphatidylserine. Small changes in the stereochemistry or the functional groups of the phosphatidylserine head group affected enzymatic activity, whereas alteration in the length and composition of the acyl chains only had minor effects. Likewise, the enzymatic activity of the ALA2–ALIS5 complex was stimulated by both mono- and di-acyl phosphatidylserines. Taken together, the results identify the lipid head group as the key structural element for substrate recognition by the P4 ATPase.
Measuring similarity between geo‐tagged videos using largest common view
Authors: Ding Wei , Yang KwangSoo , Nam Kwang Woo
Published: February 2019

This Letter presents a novel problem for discovering similar trajectories based on the field of view of the video data. The problem is important for many societal applications such as grouping moving objects, classifying geo‐images, and identifying the interesting trajectory patterns. Prior works consider only either spatial locations or spatial relationship between two line‐segments. However, these approaches show a limitation to find similar moving objects with common views. In this Letter, the authors propose a new algorithm that can group both spatial locations and points of view to identify similar trajectories. The authors also propose novel methods that reduce the computational cost for the proposed work. Experimental results using real‐world datasets demonstrate that the proposed approach outperforms prior work and reduces the computational cost.
Model predictive controller for single‐phase distributed generator with seamless transition between grid and off‐grid modes
Authors: Sekhar Perumalla Chandra , Tupakula Ratna Rahul
Published: February 2019

This study develops a model predictive controller for single‐phase distributed generator with seamless transition between the grid and off‐grid modes of operation. In addition, a simple synchronisation mechanism is developed to achieve the smooth transition between the grid and off‐grid modes, thereby avoiding the complex multi‐loop controls. The voltage vectors, hence the switching pulses are generated by using space vector modulation technique based on the minimisation of the cost function of the predictive model. The two cost functions considered are instantaneous power errors and instantaneous voltage errors, respectively, for the grid and islanded operation of the single‐phase generator. The performance of the developed controller for feeding the set‐point powers in grid connected mode and serving the load at nominal voltage and frequency in off‐grid mode is verified using simulations. The simulation results are experimentally validated on a prototype.
Proportional‐type non‐linear excitation controller with power angle reference estimator for single‐machine infinite‐bus power system
Authors: Kim Seok‐Kyoon
Published: February 2019

This study suggests a non‐linear control algorithm for the exciter controlling a single‐machine infinite‐bus system, considering the non‐linear dynamics with parameter and sudden input power variations. This study provides three contributions: (i) an estimation algorithm is designed to estimate the power angle operating point for the terminal voltage to be regulated to its desired value, incorporating the disturbance observer (DOB); (ii) a DOB‐based proportional‐type non‐linear stabilising algorithm is systematically derived using the estimated power angle operating point; and (iii) it is rigorously shown that the proposed proportional‐type non‐linear controller always removes the steady‐state errors without integral actions for error variables. The simulation results confirm the effectiveness of the proposed technique under several transmission line fault scenarios.
Optimal deployment of sensor–emitter geometries for hybrid localisation using TDOA and AOA measurements
Authors: Wang Weijia , Bai Peng , Liang Xiaolong , Wang Yubing , Zhang Jiaqiang
Published: February 2019

The relative sensor–emitter geometry has a great impact on the localisation accuracy. In this study, optimal deployments of hybrid time‐difference‐of‐arrival (TDOA) and angle‐of‐arrival (AOA) localisation are studied. The explicit expression of the determinant of the Fisher information matrix is acquired and chosen as the criterion to determine optimal sensor deployments with the assumption of Gaussian measurement noise. The analytic solutions of the optimal sensor geometries are derived in both general and co‐located scenarios. Finally, the theoretical developments are corroborated by simulation examples of unmanned aerial vehicles path planning problem.
The solar chromosphere at millimetre and ultraviolet wavelengths
Authors: Jafarzadeh S. , Wedemeyer S. , Szydlarski M. , De Pontieu B. , Rezaei R. , Carlsson M.
Published: February 2019

Solar observations with the Atacama Large Millimeter/submillimeter Array (ALMA) provide us with direct measurements of the brightness temperature in the solar chromosphere. We study the temperature distributions obtained with ALMA Band 6 (in four sub-bands at 1.21, 1.22, 1.29, and 1.3 mm) for various areas at, and in the vicinity of, a sunspot, comprising quasi-quiet and active regions with different amounts of underlying magnetic fields. We compare these temperatures with those obtained at near- and far-ultraviolet (UV) wavelengths (and with the line-core intensities of the optically-thin far-UV spectra), co-observed with the Interface Region Imaging Spectrograph (IRIS) explorer. These include the emission peaks and cores of the Mg II k 279.6 nm and Mg II h 280.4 nm lines as well as the line cores of C II 133.4 nm, O I 135.6 nm, and Si IV 139.4 nm, sampling the mid-to-high chromosphere and the low transition region. Splitting the ALMA sub-bands resulted in an slight increase of spatial resolution in individual temperature maps, thus, resolving smaller-scale structures compared to those produced with the standard averaging routines. We find that the radiation temperatures have different, though somewhat overlapping, distributions in different wavelengths and in the various magnetic regions. Comparison of the ALMA temperatures with those of the UV diagnostics should, however, be interpreted with great caution, the former is formed under the local thermodynamic equilibrium (LTE) conditions, the latter under non-LTE. The mean radiation temperature of the ALMA Band 6 is similar to that extracted from the IRIS C II line in all areas with exception of the sunspot and pores where the C II poses higher radiation temperatures. In all magnetic regions, the Mg II lines associate with the lowest mean radiation temperatures in our sample. These will provide constraints for future numerical models.
Spectral analysis of the barium central star of the planetary nebula Hen 2−39
Authors: Löbling L. , Boffin H. M. J. , Jones D.
Published: February 2019

Context. Barium stars are peculiar red giants characterized by an overabundance of the elements synthesized in the slow neutron-capture nucleosynthesis (s-process elements) along with an enrichment in carbon. These stars are discovered in binaries with white dwarf companions. The more recently formed of these stars are still surrounded by a planetary nebula.

Aims. Precise abundance determinations of the various s-process elements, of further key elements that act as indicators for effectiveness of nucleosynthesis on the asymptotic giant branch and, especially, of the lightest, short-lived radionuclide technetium will establish constraints for the formation of s-process elements in asymptotic giant branch stars as well as mass transfer through, for example, stellar wind, Roche-lobe overflow, and common-envelope evolution.

Methods. We performed a detailed spectral analysis of the K-type subgiant central star of the planetary nebula Hen 2−39 based on high-resolution optical spectra obtained with the Ultraviolet and Visual Echelle Spectrograph at the Very Large Telescope using local thermodynamic equilibrium model atmospheres.

Results. We confirm the effective temperature of Teff = (4350 ± 150) K for the central star of the planetary nebula Hen 2−39. It has a photospheric carbon enrichment of [C∕H] = 0.36 ± 0.08 and a barium overabundance of [Ba∕Fe] = 1.8 ± 0.5. We find a deficiency for most of the iron-group elements (calcium to iron) and establish an upper abundance limit for technetium (log ɛTc < 2.5).

Conclusions. The quality of the available optical spectra is not sufficient to measure abundances of all s-process elements accurately. Despite large uncertainties on the abundances as well as on the model yields, the derived abundances are most consistent with a progenitor mass in the range 1.75–3.00 M⊙ and a metallicity of [Fe∕H] = −0.3 ± 1.0. This result leads to the conclusion that the formation of such systems requires a relatively large mass transfer that is most easily obtained via wind-Roche lobe overflow.
Too much fear for radioactive contamination of seawater
Authors: Goudriaan J.
Published: February 2019

Radioactive contamination of seawater has often caused concern, for example about releases from Sellafield and Le Havre and later about the Fukushima disaster. Repeated reporting has contributed to the general feeling that the sea is particularly sensitive to radioactive contamination (Greenpeace,1998). This is not the case, it is rather the opposite. Marine life is much better protected against radioactive contamination than life on land. This protection is due to three natural factors: shielding, dilution and isotope competition.
Risk factors for remaining liver injury in patients with virological elimination of chronic hepatitis C
Authors: Mauss Stefan , Buendgens Lukas , Christensen Stefan , Ingiliz Patrick , Berger Florian , Hüppe Dietrich , Simon Karl , Lutz Thomas , Schewe Knud , Boesecke Christoph , Tacke Frank
Published: February 2019

Background and aims Disease activity, but also demographics, lifestyle, and comorbidities, may influence alanine aminotransferase (ALT) levels in hepatitis C virus (HCV)-infected patients. Direct-acting antiviral agents (DAA) achieve virological cure in > 90 % of patients, regardless of HCV genotype and fibrosis stage. This allows assessing determinants for ALT levels before and after elimination of HCV.

Methods Our prospective cohort included HCV- and HIV/HCV-infected patients treated with DAA at 9 German centers (GECCO cohort). We analyzed all consecutive patients with sustained virological response (SVR) at week 12 (SVR12) and/or 24. Normal ALT was defined as ≤ 35 U/L, regardless of sex.

Results At baseline, 1477 out of 1774 patients (83 %) had ALT > 35 U/L, and 297 (17 %) had ALT ≤ 35 U/L. Baseline ALT > 35 U/L was independently associated with male sex, higher body mass index (BMI), liver cirrhosis, and not being on opioid substitution. After SVR, > 80 % of patients normalized ALT, and even patients with low baseline ALT further reduced ALT levels. However, ALT remained > 35 U/L in 15 % (221/1477) after SVR12. By multivariate analysis, ALT > 35 U/L at SVR12 was associated with male sex, higher BMI, liver cirrhosis, baseline ALT, HCV genotype 2, and younger age. Obesity, cirrhosis, and ALT were also independent factors associated with ALT > 15 U/L at SVR12 in patients with normal ALT at baseline.

Conclusions Male sex, advanced liver fibrosis, and obesity are main risk factors for the lack of ALT normalization and/or ALT decline after SVR, indicative of fatty liver disease as a relevant comorbidity in hepatitis C.
Interdisziplinarität in der akademischen Plastischen
Chirurgie – belanglos oder zukunftsorientiert?
Authors: Kemper Robert , Horch Raymund , Giunta Riccardo , Prantl Lukas
Published: February 2019

Hintergrund Die Plastische Chirurgie ist wie kein anderes Fach in der Lage
alle Körperregionen nicht nur formbewahrend/-gebend zu operieren, sondern auch
funktionell anatomische Einheiten zu rekonstruieren. Im Rahmen einer
interdisziplinären Behandlung komplexer traumatologischer, Tumor- und
infektionsbedingter Erkrankungen benötigen andere Fachbereiche diese spezielle
Expertise. Die Ärztliche Approbationsordnung (ÄApprO) sieht aber trotz der
vielzähligen interdisziplinären Aufgaben kein eigenständiges Lehrcurriculum für
die Plastische Chirurgie vor. Daher ist die Entwicklung der akademischen
Plastischen Chirurgie problematisch. In dieser Arbeit wird die akademische und
klinische Interdisziplinarität dieses Fachs beleuchtet.

Methoden Anhand eines Fragebogens werden die akademischen Aufgaben der
Plastischen Chirurgie sowie deren operativ interdisziplinäre Leistungsfähigkeit
erhoben und diskutiert.

Ergebnisse An 12 der 36 Universitätskliniken gibt es keine Plastische
Chirurgie. Es gibt 11 Kliniken, 5 Abteilung, 4 Sektionen und 4
Funktionsbereiche. Die 13 an der Evaluation teilnehmenden Einrichtungen haben
sich im medizinischen Lehrcurriculum über das Wahlfach hinaus etablieren können.
Die Diskrepanz in Bezug auf den Lehraufwand erscheint unabhängig von
Eigenständigkeit und Personalschlüssel. 10 der 13 Zentren wären bereit, mehr
akademischen Aufwand zu leisten. Alle teilnehmenden Zentren prüfen im
Staatsexamen. 2015 wurden durch die 13 teilnehmenden Zentren 1476 Fälle
interdisziplinär behandelt. In 1165 Fällen erfolgte keine Leistungsabrechnung
durch die Plastische Chirurgie.

Zusammenfassung Das interdisziplinäre Aufgabenfeld der Plastischen
Chirurgie ist in der Hochleistungsmedizin unabdingbar. An 12
Universitätskliniken gibt es bis heute keine akademische Plastische Chirurgie.
Dabei stellt gerade die Interdisziplinarität unseres Fachs eine hervorragende
Voraussetzung zur Integration im modularen Unterricht dar.

Die teils komplexen rekonstruktiven Eingriffe komplettieren den Behandlungserfolg
anderer Fachrichtungen. Die redundante fehlende ökonomische Teilhabe an diesem
Erfolg lässt die Entwicklung des Fachs hinterherhinken. Eine einheitliche
Integration in das Lehrcurriculum wäre eine zukunftsgerichtete Aufwertung der
Plastischen Chirurgie.
Pityriasis rubra pilaris – eine seltene entzündliche Dermatose mit vielen Facetten
Authors: Kahlert K. , Hamm H. , Goebeler M. , Kerstan A.
Published: February 2019

Die Pityriasis rubra pilaris (PRP) ist eine seltene entzündliche, papulosquamöse Dermatose, die in 6 verschiedenen Manifestationsformen (Subtypen) sowohl bei Kindern als auch bei Erwachsenen mit großer Variabilität auftreten kann. Bei allen Subtypen sind in den Anfangsstadien follikulär gebundene, keratotische Papeln zu beobachten, die nach variabler Latenz zu unterschiedlich großen, gut begrenzten Plaques mit krankheitstypischem, orange-rotem Farbton konfluieren. Dabei finden sich bei den ausgedehnteren Verlaufsformen charakteristischerweise innerhalb der Plaques Inseln gesunder Haut (nappes claires). Nicht selten entsteht eine palmare und plantare, wechselnd stark ausgeprägte Hyperkeratose. Die PRP bietet ein breites klinisches Spektrum, das von einem lokalisierten Befall der Extremitäten bis hin zu erythrodermatischen Formen reicht, die mitunter bereits im Säuglingsalter beginnen können.

Die vorliegende Arbeit gibt eine Übersicht über den aktuellen Kenntnisstand dieser bislang wenig verstandenen Dermatose.
Pachyonychia congenita und Steatocystoma multiplex durch Mutation im Keratin-17-Gen
Authors: Herz C. , Wobser M. , Fischer J. , Hamm H.
Published: February 2019

Die Pachyonychia congenita (PC) wird durch heterozygote Mutationen in den Keratin-Genen KRT6A, KRT6B, KRT6C, KRT16 oder KRT17 verursacht. Die Einteilung in PC Typ 1 und PC Typ 2 nach klinischen Kriterien wurde zugunsten einer molekulargenetischen Klassifikation auf Basis der 5 betroffenen Gene (PC-K6a, PC-K6b, PC-K6c, PC-K16, PC-K17) verlassen. Die Erkrankung wird autosomal-dominant vererbt, Spontanmutationen kommen in etwa 30 % der Fälle vor. Über 97 % der PC-Patienten weisen die 3 Hauptsymptome Verdickung der Fußnägel, Plantarkeratosen und Fußsohlenschmerzen auf.

Lokalisierte Steatozystome, Vellushaarzysten oder das diffuse Steatocystoma multiplex zeichnen die PC durch Keratin-17-Mutationen aus. Konnatale oder perinatale Zähne und follikuläre Hyperkeratosen an Ellenbogen, Knien und Rumpf sind ebenfalls häufig mit einer Mutation in KRT17 vergesellschaftet. Wir berichten über eine 40-jährige Patientin mit Steatocystoma multiplex, Verdickung und distaler Dystrophie aller Nägel, schmerzhaften Plantarkeratosen und palmoplantarer Hyperhidrose. Molekulargenetisch konnte mittels Next-Generation-Sequencing eine Mutation im Exon 1 des KRT17-Gens als ursächlich nachgewiesen werden.
Implementierung der Ultraschallausbildung in das Kerncurriculum des Medizinstudiums – das Ulmer Modell
Authors: Pfahler Matthias , Baumann Sven , Schuhbaur Jasmin , Kratzer Wolfgang ,   für die Dozenten im Kerncurriculum Sonografie
Published: February 2019

Die Sonografie ist neben der konventionellen Röntgenaufnahme die am häufigsten verwendete diagnostische Methode im klinischen Alltag. Bei angehenden Ärzten besteht besonders im Umgang mit der Sonografie eine Lücke zwischen den gestiegenen Anforderungen im klinischen Alltag und den bisher erworbenen Fähigkeiten. In dieser Arbeit möchten wir den Aufbau unseres Sonografie-Kurses und die Implementierung in das Ulmer Kerncurriculum des Medizinstudiums vorstellen. Der Sonografie-Kurs basiert auf zwei Säulen. Das Sonografie-Seminar (Säule 1) hat Vorlesungscharakter und vermittelt regelmäßig fächerübergreifend die theoretischen Inhalte, Grundlagen und möglichen Anwendungsgebiete der Sonografie während 13 Terminen à 45 Minuten. Das Praktikum (Säule 2) besteht aus vier Terminen von je zwei Stunden. Die Gruppen mit vier Studierenden werden jeweils von einem studentischen Tutor betreut. Vermittelt werden neben den technischen Grundlagen und einer Einführung in die Gerätekunde die Organsysteme Leber, Gallenblase und Gallenwege, Nieren und Nebennieren, Milz, Pankreas sowie abdominelle Gefäße und Lymphknoten. Der Schwerpunkt dabei liegt auf den realitätsnahen Übungen mit High-end-Ultraschallgeräten in Kleingruppen mit einer abschließenden praktischen Prüfung. Der Kursaufbau und -ablauf wird von den Studierenden insgesamt als sehr positiv evaluiert.
Assessment of Cardiac Involvement in Fabry Disease (FD) with Native T1 Mapping
Authors: Roller Fritz Christian , Fuest Sven , Meyer Marco , Harth Sebastian , Gündüz Dursun , Bauer Pascal , Schneider Christian , Rolfs Arndt , Krombach Gabriele Anja , Tanislav Christian
Published: February 2019

Purpose Fabry disease (FD) is an X-linked multi-organ disorder of lysosomal metabolism with cardiac disease being the leading cause of death. Identifying early FD-specific pathologies is important in the context of maximum therapeutic benefit in these stages. Therefore, the aim of this study was to investigate the value of quantitative cardiac T1 mapping as a potential disease-specific surrogate.

Methods 16 consecutive FD patients (9 female, 7 male; median age: 54 years, IQR 17) and 16 control patients (9 female, 7 male; median age: 52 years, IQR 20) were investigated at 1.5 Tesla. Native T1 mapping was performed using a modified look locker inversion recovery sequence (MOLLI) and native T1 times were measured within the septal myocardium at the midventricular short-axis section. Also functional parameters, left ventricular morphology, presence of late-gadolinium enhancement, cTnI- and Lyso-Gb3-Levels were evaluated.

Results The median native septal T1 time for FD was 889.0 ms and 950.6 ms for controls (p < 0.003). LGE and positive cTnI values (0.26 ± 0.21) were present in 5 FD patients (31.25 %), and left ventricular hypertrophy (LVH) was present in 4 FD patients (25.00 %). The 4 cTnI and 8 Lyso-Gb3 positive FD patients had significantly lower native T1 values (p < 0.05, respectively p < 0.01). Assuming a T1 cut-off value of 900 ms for the identification of increased cardiac lipid deposit, 9 patients with FD (56.25 %) had pathologic values (4 patients cTnI and 8 patients Lyso-Gb3 positive). Moreover, native septal T1 showed a good negative correlation to Lyso-Gb3 (r = – 0.582; p = 0.018).

Conclusion A pathologic cardiac native T1 time obviously reflects cardiac involvement in the scope of FD at tissue level. In the future native T1 mapping as an imaging biomarker might allow identification of early stages of cardiac involvement in FD before morphological changes are obvious.

Key Points: 

Citation Format
What Role Does Synovitis Play in Craniomandibular Dysfunction (CMD)? A 3T-MRI Study
Authors: Stimmer Herbert , Ritschl Lucas , Goetz Carolin , Kolk Andreas , Hofauer Benedikt , Wirth Markus , Knopf Andreas , Ott Armin , Wolff Klaus-Dietrich
Published: February 2019

Purpose The purpose of the present study was to investigate the degree and clinical relevance of synovitis in craniomandibular dysfunction.

Materials and Methods In total, 140 temporomandibular joints were examined using a 3 T MRI scanner. Quantitative analysis of synovial enhancement was performed and interrelated with arthrosis deformans, degenerative disc disease, joint effusion, bone marrow edema and restriction of motion.

Results We found a statistically high and significant correlation between the degenerative changes as mentioned above and the intensity of synovial enhancement.

Conclusion The study shows that typical MRI findings in CMD patients are often combined with signs of synovitis. Presumably joint inflammation has an effect on the clinical signs and symptoms and also the prognosis of CMD. These results should be taken into consideration when selecting treatment.

Key Points: 

Citation Format
Postoperative Infection in Cementless and Cemented Total Knee Arthroplasty: A Propensity Score Matched Analysis
Authors: Anis Hiba K. , Ramanathan Deepak , Sodhi Nipun , Klika Alison K. , Piuzzi Nicolas S. , Mont Michael A. , Higuera Carlos A. , Molloy Robert M.
Published: February 2019

The ongoing debate on fixation in total knee arthroplasty (TKA) has become increasingly relevant with its increased use in a younger patient population and the advent of novel cementless prostheses. Recent literature suggests modern cementless implants are comparable to their cemented counterparts in terms of survivorship and functional outcomes. What has not been well-assessed is whether the two modalities differ with respect to infection rates which was the purpose of this study. Specifically, a propensity score matched study population was used to compare: (1) overall infection; (2) prosthetic joint infection (PJI); and (3) surgical site infection (SSI) rates between cementless and cemented TKAs. Using a large institutional database, 3,180 consecutive primary TKAs were identified. Cementless and cemented TKA patients were propensity score matched by age (p = 0.069), sex (p = 0.395), body mass index (BMI; p = 0.308), and Charlson's comorbidity index (CCI) score (p = 0.616) in a 1:1 ratio. Univariate analysis was performed to compare 2-year overall infection rates. Infections were further analyzed separately as PJIs (deep joint infections requiring surgery) and SSIs (skin/superficial wound infections). Multivariate logistic regression was performed to evaluate infection incidences after adjusting for procedure-related factors (i.e., operative time, hospital volume, and surgeon volume). There were no significant differences between the matched cohorts in terms of overall infection rates (3.8 vs. 2.3%, p = 0.722), as well as when PJI (p = 1.000) and SSI (p = 1.000) rates were analyzed separately. Multivariate analysis revealed no significant differences in overall postoperative infection rates (p = 0.285), PJI rates (p = 0.446), or SSI rates (p = 0.453) even after adjusting for procedure-related factors. There is increasing literature investigating various outcomes demonstrating the comparable efficacies of cementless versus cemented TKAs. To the best of the author's knowledge, this was the first matched case-control study to directly compare their post-operative infection rates. The findings from this study show that post-operative infection rates were similar between fixation modalities even after accounting for a range of patient- and procedure-related factors.
Effective Hamiltonians in surfaces of thin quantum waveguides
Authors: de Oliveira César R. , Hartmann Luiz , Verri Alessandra A.
Published: February 2019

Effective operators for the Laplacian in surfaces of three-dimensional waveguides are investigated as their diameters vanish.
Turbulence structure of a counter-flowing wall jet
Authors: Sharma Sachin , Jesudhas Vimaldoss , Balachandar Ram , Barron Ron
Published: February 2019

Although several studies have been carried out to analyze the characteristics of counter-flowing wall jets (CFWJs), their internal turbulence structure is yet to be fully understood. In this paper, a CFWJ issuing into a main flow is numerically examined using a three-dimensional, unsteady, improved delayed detached-eddy simulation. The results of the simulation are validated with the experimental results and are presented with pertinent discussions. The interaction of the jet with the wall and the main flow leads to the oscillation of the stagnation point (SP), further enhancing the turbulence. The analysis of the instantaneous flow field reveals the presence of a feedback mechanism between the stagnation region and the shear layer of the counter-flowing wall, resulting in the excitation of the jet. This feedback mechanism is responsible for the oscillation of the SP. To further evaluate the internal structure of turbulence, the coherent structures within the flow are identified using a vortex identification criterion. These structures are also quantitatively evaluated using proper orthogonal decomposition. The analysis of the coherent structures revealed the presence of large-scale structures in the vicinity of the SP. The complex dynamics of these structures and their interactions is presented with pertinent discussions.
A theoretical model for low-mode asymmetries in ICF implosions
Authors: Zhang Cunbo , Yu Chengxin , Yang Chen , Xiao Delong , Liu Jie , Fan Zhengfeng
Published: February 2019

Low-mode asymmetry is known to be a main source of yield degradation in implosion experiments performed at the National Ignition Facility at the Lawrence Livermore National Laboratory. In this paper, we present a theoretical model of the deceleration phase to investigate low-mode asymmetries, which is derived by considering the main fuel layer to be composed of thin shell pieces and neglecting the interaction between these pieces in the longitudinal direction. The model is able to characterize the evolution of low-mode asymmetries and assess the corresponding performance degradation, as validated numerically using the radiation hydrodynamics code LARED-S. The deceleration phases of implosions modulated separately by P2 (in Legendre polynomials) asymmetries in the shell mass, shell velocity, and hot-spot radius are studied using this model. It is found that asymmetries in the shell velocity and hot-spot radius have more pronounced effects than shell mass asymmetry on capsule distortion, resulting in greater yield degradation. The results obtained using this model indicate that yield degradation is mainly caused by the increase in residual kinetic energy at stagnation time, which is identical for all three types of asymmetries.
Detection and spatial mapping of conductive filaments in metal/oxide/metal cross-point devices using a thin photoresist layer
Authors: Nath Shimul Kanti , Nandi Sanjoy Kumar , Li Shuai , Elliman Robert Glen
Published: February 2019

A simple means of detecting and spatially mapping volatile and nonvolatile conductive filaments in metal/oxide/metal cross-point devices is introduced, and its application demonstrated. The technique is based on thermal discolouration of a thin photoresist layer deposited on the top electrode (TE) of the cross-point device and relies on the increase in temperature produced by local Joule heating of an underlying conductive filament. Finite element modelling of the temperature distribution and its dependencies shows that the maximum temperature at the TE/photoresist interface is particularly sensitive to the TE thickness. The technique is demonstrated on NbOx-based metal-oxide-metal cross-point devices with a 25 nm thick top (Pt) electrode, where it is used to undertake a statistical analysis of the filament location as a function of device area. This shows that filament formation is heterogeneous; the majority of filaments form preferentially along the TE edge, and the fraction of these increases with the decreasing device area. Transmission electron microscopy of the top and bottom electrode edges is used to explain this observation and suggests that it is due to a reduction in the effective oxide thickness in this region.
Low-level RF control of a klystron for medical linear accelerator applications
Authors: Min Sun-Hong , Kwon Ohjoon , Sattorov Matlabjon , Kim Seontae , Hong Dongpyo , Park Chawon , Hong Bong Hwan , Jung In Su , Cho Ilsung , Hwang Won Taek , Barik Ranjan Kumar , Bera Anirban , Park Gun-Sik
Published: February 2019

A klystron is an important vacuum device which is useful in medical linear accelerators because it amplifies the radio-frequency (RF) signals required to produce high-energy particle beams. The properties of the nonlinear input and output dynamics in the klystron circuit arouse distortion in various types of parameters pertaining to the beam voltage, beam current, RF power, and operating frequency from unpredictable external factors. Therefore, low-level RF (LLRF) control systems can facilitate the regulation of the output of the klystron to a desired level. Low-level RF control system of the klystron is designed to stabilize the applied voltage and control the resonance frequency of the cavity of the klystron. In this work, an infallible low-level RF control system, the most suitable for a klystron, is designed to use a beam monitoring and an interlock system with components that include an isolator and a phase shifter. Moreover, with regard to pulse distortion at the flap top at the RF output power, the stability of the RF power pulse at the flap top part was improved somewhat by a variable inductor which controlled the inside of the pulse modulator. In this LLRF control experiment, the pulse modulator generated 140kV-95A and succeeded in generating RF output power of 2.856GHz-6MW level of an S-band klystron. During this process, the efficiency of the RF power was approximately 42∼45% and the pulse repetition rate was 10 Hz. The flattop pulse width was measured and found to be 1 µs.
Numerical study of viscous effects on centreline shock reflection in axisymmetric flow
Authors: Shoev G. , Ogawa H.
Published: February 2019

Viscous effects on centreline shock reflection in an axisymmetric flow are studied numerically using Navier–Stokes and direct simulation Monte Carlo solvers. Computations at low Reynolds numbers have resulted in a configuration consisting of two shock waves, in contrast to the inviscid theory. On the other hand, computations at high Reynolds numbers have yielded a three-shock configuration in qualitative agreement with the inviscid theory prediction. This behaviour is explained by the presence of the so-called non-Rankine–Hugoniot zone, which accounts for the deviation of the shock structure from the inviscid paradigm. At Reynolds numbers on the verge of the transition from a two-shock to three-shock configuration, extremely high pressure that would be unattainable with the classical Rankine–Hugoniot relation for any shock configuration may occur. An analogy to the Guderley singularity in cylindrical shock implosion has been deduced for the shock behaviour from a mathematical viewpoint.