bluuebunny/crossref_metadata_2025 huggingface dataset:
Stacked Deep Inferior Epigastric Perforator Free Flaps with Immediate Implant Placement for Unilateral Breast Reconstruction
Authors: Hood Keith , Kumar Nishant , Braun Stephane , Higdon Kent
Published: July 2017

Background Autologous flaps can be used in combination with prosthesis in postmastectomy breast reconstruction. The deep inferior epigastric perforator (DIEP) flap is considered the preferred choice among autologous tissue transfer techniques. In patients with a breast volume asymmetry, there are several options for attaining an optimal reconstructive and aesthetic result.

Methods This report presents a patient who underwent a combination of reconstructive techniques to achieve volumetric symmetry.

Results The patient had a previous bilateral augmentation mammoplasty, was then treated for left breast carcinoma with a lumpectomy and radiation, and since that time had a recalcitrant left capsular contracture despite multiple operative interventions. The patient ultimately chose to have autologous left breast reconstruction and a stacked DIEP flap with simultaneous implant placement was performed.

Conclusion In cases of significant volumetric asymmetry, a stacked DIEP flap in combination with a prosthesis is a novel and safe solution.
Patient Satisfaction and Hand Performance Following Fingertip Reconstruction: A Retrospective Cohort Study
Authors: Kaji Daisuke , Omokawa Shohei , Nakanishi Akito , Kawamura Kenji , Shimizu Takamasa , Tanaka Yasuhito
Published: July 2017

Introduction Hand performance tests that evaluate hand dexterity and use in daily living have been frequently used to evaluate outcomes in patients with various hand disorders but not in patients with fingertip injuries. The present study aimed to evaluate patient satisfaction and hand performance following digital artery flap reconstruction for fingertip injury and identify factors associated with these outcomes.

Methods This retrospective cohort study included 25 patients with amputation injuries at our institution between 2003 and 2013. Patients with amputations at the Tamai 1 or 2 zone of their index (14 patients) or middle finger (11 patients) who underwent digital artery flap surgery and were followed up for > 1 year were included. Follow-up evaluations were conducted at an average of 44 months postoperatively (range, 12–105 months). The primary outcomes were patient satisfaction and hand performance determined by a 4-grade Likert scale and the Purdue Pegboard test, respectively. Secondary outcomes were recovery of sensitivity measured by Semmes–Weinstein monofilaments, total active finger motion (TAM), and tip pinch strength.

Results There were no postoperative complications. Patient satisfaction was rated as fair, good, and excellent, in 1, 15, and 9 patients, respectively. The average hand performance test scores were significantly lower in the affected finger than the adjacent finger (22 vs. 30, respectively; p < 0.05). The mean ± standard deviation (SD) sensitivity test score was 3.5 ± 1.6 (range, 2.4–4.0). The average percentage TAM and tip pinch strength compared with the contralateral hand were 82 (range, 45–100%) and 82% (range, 60–112%), respectively. The hand performance score significantly correlated with the recovery of sensitivity and age (r = – 0.42 and 0.43, respectively; both p < 0.05). Patient satisfaction was significantly correlated with TAM (r = 0.42, p < 0.05) and tended to correlate with the recovery of sensitivity (r = – 0.395, p = 0.051).

Conclusion Although reconstructed fingers had a lower performance score than the adjacent fingers, patient satisfaction with flap surgery was relatively high. Recovery of finger sensitivity contributed to patient satisfaction and enhanced dexterity of motor skill activities following fingertip reconstruction.
Intraartikuläre Tibiakopffrakturen
Authors: Reul Maike , Nijs Stefaan , Rommens Pol , Hoekstra Harm
Published: July 2017

Tibiakopffrakturen sind komplexe Gelenkfrakturen, deren adäquate Behandlung eine dezidierte klinische und radiologische Diagnostik erfordert. Bei der Behandlung hat sich das 3-Pfeiler-Konzept als ausgezeichnetes chirurgisches Planungsinstrument dieses komplexen Traumas erwiesen. Der Standard der Therapie ist die offene interne Stabilisierung (ORIF) mit anatomischer Rekonstruktion des Gelenks. Bei der Wahl der korrekten Behandlungsstrategie können gute funktionelle Resultate erreicht werden.
Naturheilkunde und Komplementäre Verfahren in der nationalen Versorgungsleitlinie „Nicht-spezifischer Kreuzschmerz“
Authors: Koch Anna K. , Klose Petra , Langhorst Jost
Published: July 2017

Unter der Einbindung der Task Force „Naturheilkunde und Komplementärmedizin in Medizinischen Leitlinien“ wurde anhand einer systematischen Literaturrecherche die Evidenzlage für komplementäre Methoden in der aktualisierten Version der Leitlinie „Nicht spezifischer Kreuzschmerz“ neu bewertet, in die Leitlinienkonferenz eingebracht und in den Leitlinien implementiert.

Die stärkste positive Empfehlung erhielt die Bewegungstherapie. Es werden ausdrücklich meditative Bewegungsformen wie Yoga, Tai-Chi und die Alexander-Technik empfohlen. Positive Bewertungen werden zudem ausgesprochen für Akupunktur, Progressive Muskelrelaxation und Mobilisation / Manipulation. Die Phytotherapie wird differenziert bewertet, und für einige Phytotherapeutika positive Bewertungen ausgesprochen.
Komplementäre Aspekte der Palliativmedizin bei Kindern
Authors: Pothmann Raymund
Published: July 2017

Neben pflegerischen und medizinischen Angeboten in der Kinderpalliativmedizin sind zunehmend komplementäre Behandlungsansätze gefragt. Unzureichende Wirksamkeit oder Nebenwirkungen der pharmakologischen Behandlung, aber auch psychologische Defizite können sehr gut mit komplementärmedizinischen Maßnahmen angegangen werden. Ernährungstherapeutische Interventionen können die Schleimhautfunktion unterstützen. Akupressur und Akupunktmassage bilden v. a. bei Schmerzen eine hilfreiche begleitende Option. Mit Softlaser-Akupunktur lassen sich häufige palliative Symptome wie z. B. Dyspnoe, Angst, Xerostomie oder Juckreiz lindern. TENS kann jungen Palliativpatienten eine ergänzende Möglichkeit der Schmerztherapie an die Hand geben, die sie selbst aktiv steuern können.
Pharyngocutaneous fistula as an alternative access route for inserting a percutaneous endoscopic gastrostomy tube in head and neck cancer patients
Authors: Di Palma Louise , Mello Gustavo , Granados Cindy , Glória Ricardo , Dalbem Caroline , Cruz Rolantre , Ayres Ana , Lisboa Renata , Pelosi Alexandre , Ferreira Maria , Mansur Gilberto , Silva Simone , Ribeiro Theresa , Dias Fernando
Published: July 2017

Background and study aims Performing a percutaneous endoscopic gastrostomy (PEG) in head and neck cancer (HNC) patients can be challenging because of the presence of trismus, pharyngeal obstruction by tumor, and pharyngoesophageal strictures or fistula. Pharyngocutaneous fistula (PCF) is a major postoperative concern in patients submitted to total laryngectomy (TL). In the medical literature to date, the cervical fistula has been used as an access to PEG in only four reports. The aim of this study was to evaluate the safety of cervical fistula for insertion of a PEG tube.

Patients and methods Retrospective study at a single tertiary referral center, regarding the technical feasibility, safety and outcomes of a PEG tube introduced by a cervical fistula in HNC patients with obstructive lesions of the oropharynx.

Results The procedure was technically successful in all 21 patients. A PEG tube was used for a minimum of 1 month and a maximum of 120 months. Twelve patients died while using the PEG tube, 8 had it taken out because it was no longer needed, and only 1 had the tube still in use. Adverse events occurred in 8 patients: granuloma (19 %), dermatitis (9.5 %), accidental late removal of the tube (9.5 %), periprocedural gastric wall hematoma (9.5 %), peristomal wound infection (4.7 %), buried bumper syndrome (4.7 %), and traumatic gastric ulcer (4.7 %).

Conclusion A postoperative cervical fistula can successfully work as a reliable and safe access for a PEG tube procedure in HNC patients, avoiding unnecessary surgery and reducing costs.
Use of warm carbon dioxide insufflators does not affect intra-colonic gas temperature and has no effect on polyp detection rate during colonoscopy – a randomized controlled trial
Authors: Patel Akash , Green Jordan , Jowhari Fahd , Hookey Lawrence
Published: July 2017

Background and study aims Methods to improve polyp detection during colonoscopy have been investigated, with conflicting results for warm water irrigation. Carbon Dioxide (CO2) warmed to 37 °C may have similar or more pronounced effects on bowel motility. This study aimed to assess whether warmed CO2 would improve polyp detection compared to room temperature air insufflation.

Patients and methods This was a double-blind, randomized controlled trial that enrolled 204 patients undergoing screening or surveillance outpatient colonoscopy. The primary outcome was polyp per patient detection rate. Secondary outcomes included adenoma per patient detection rates, bowel spasm, and patient comfort.

Results The trial was terminated after an interim analysis determined futility. Between the warmed CO2 and room air groups, no significant differences were found in the per-colonoscopy polyp detection rate (P = 0.57); overall polyp detection rate (P = 0.69); or adenoma detection rates (P = 0.74). More patients in the room temperature group had lower spasm scores (p = 0.02); however, there was a trend towards greater patient comfort in the warmed CO2 group (P = 0.054). An ex-vivo study showed a significant difference between exiting CO2 temperature at the insufflator end vs. delivered CO2 temperature at the colonoscope tip end. The temperature of insufflation at the tip of the colonoscope was not different when using warmed vs. unwarmed insufflation (P = 0.62).

Conclusion When compared with room air insufflation, warmed CO2 insufflation did not affect polyp detection rates.
Schichtdickenmessungen der retinalen Nervenfaserschicht mit optischer Kohärenztomografie bei Glaukompatienten und Gesunden
Authors: Mardin Christian Yahya
Published: July 2017

Die Schichtdickenmessung der retinalen Nervenfaserschicht (RNF) bei Glaukomen ist zu einem wichtigen diagnostischen Kriterium und Verlaufsindikator geworden. Hohe Bildauflösung und fortgeschrittene Auswertealgorithmen machen dies möglich. Es werden im Folgenden die OCT-Anatomie, Aufnahmetechnik, Normwerte, Progressionsbeobachtung und der Einfluss von Artefakten auf die OCT-Messungen erörtert. Das Wissen um die Möglichkeiten und Fußangeln der OCT-Darstellung soll helfen, diese Technik in den Patientenversorgungsalltag zu integrieren.
Hilft das auch langfristig?
Authors: Bräunig Jochen , Ellger Björn , Gottschalk Antje
Published: July 2017

Auswirkungen auf das Langzeit-Outcome (Teil 1) Frühzeitig beginnende Atemphysiotherapie leistet neben Physiotherapie einen wichtigen
Beitrag in der adäquaten und zielgerichteten Versorgung von Patienten auf der Intensivstation. Elementare physiologische Prozesse werden
durch Atemphysiotherapie initiiert im stetigen Bemühen, das Überleben der zumeist kritisch kranken und invasiv beatmeten Patienten zu
sichern. Sekretförderung, Verbesserung des Atemmusters vor allem nach thorakalen oder abdominellen Operationen und Atemmuskeltraining zur
Optimierung der Belüftung auch basal liegender Lungenabschnitte sind nur einige der positiven Effekte. Dieser Beitrag fasst die publizierten
Antworten auf die Frage zusammen, ob neben diesen belegten positiven Kurzzeiteffekten auch Langzeiteffekte nachweisbar sind, die nach
Entlassung von der Intensivstation und bis zur Rückkehr in das häusliche Umfeld dieser Patienten fortbestehen.
Evaluation of the bleeding risk with various antithrombotic therapies after gastric endoscopic submucosal dissection
Authors: Gotoda Tatsuhiro , Hori Keisuke , Iwamuro Masaya , Kono Yoshiyasu , Miura Kou , Kanzaki Hiromitsu , Kawano Seiji , Kawahara Yoshiro , Okada Hiroyuki
Published: July 2017

Background and study aims Patients receiving antithrombotic drugs have a higher risk of postoperative bleeding and thromboembolic events related to endoscopic procedures. The aim of this study was to evaluate the relationship between various antithrombotic therapies and bleeding after gastric endoscopic submucosal dissection (ESD) (post-ESD bleeding).

Patients and methods Among 529 consecutive gastric ESD procedures (483 patients with 579 legions), 100 patients with 121 lesions who underwent 108 procedures were on antithrombotic therapy (group A) and 382 patients with 458 lesions who underwent 421 procedures were not on antithrombotic therapy (group B). The ratio of post-ESD bleeding between the two groups and the bleeding risk related to various antithrombotic therapies were investigated.

Results Postoperative bleeding was more frequent in group A (11.1 %) than in group B (3.3 %). No thromboembolic events were reported in either group. Further investigation of antithrombotic therapies in group A demonstrated that various combinations of antithrombotic agents and heparin replacement were associated with a higher ratio of post-ESD bleeding. Multivariate analyses revealed that dual antiplatelet therapy (odds ratio [OR] 10.9, 95 % confidence interval [CI] 2.1 – 49.5; P = 0.005) and heparin replacement (OR 34.4, 95 %CI 9.4 – 133.2; P < 0.001) were associated with the increased risk of post-ESD bleeding. In patients on antiplatelet therapy, post-ESD bleeding tended to occur in the early postoperative period compared with patients on anticoagulant therapy.

Conclusions It is necessary to be cautious regarding post-ESD bleeding in patients requiring antithrombotic therapy, especially patients receiving dual antiplatelet therapy and heparin replacement. A further prospective study with a large sample will be needed to confirm these findings.
Location of colorectal cancer: colonoscopy versus surgery. Yield of colonoscopy in predicting actual location
Authors: Blum-Guzman Juan , Wanderley de Melo Silvio
Published: July 2017

Background and study aims Recent studies suggest that differences in biological characteristics and risk factors across cancer site within the colon and rectum may translate to differences in survival. It can be challenging at times to determine the precise anatomical location of a lesion with a luminal view during colonoscopy. The aim of this study is to determine if there is a significant difference between the location of colorectal cancers described by gastroenterologists in colonoscopies and the actual anatomical location noted on operative and pathology reports after colon surgery.

Patients and methods A single-center retrospective analysis of colonoscopies of patient with reported colonic masses from January 2005 to April 2014 (n = 380) was carried. Assessed data included demography, operative and pathology reports. Findings were compared: between the location of colorectal cancers described by gastroenterologists in colonoscopies and the actual anatomical location noted on operative reports or pathology samples.

Results We identified 380 colonic masses, 158 were confirmed adenocarcinomas. Of these 123 underwent surgical resection, 27 had to be excluded since no specific location was reported on their operative or pathology report. An absolute difference between endoscopic and surgical location was found in 32 cases (33 %). Of these, 22 (23 %) differed by 1 colonic segment, 8 (8 %) differed by 2 colonic segments and 2 (2 %) differed by 3 colonic segments.

Conclusion There is a significant difference between the location of colorectal cancers reported by gastroenterologists during endoscopy and the actual anatomical location noted on operative or pathology reports after colon surgery. Endoscopic tattooing should be used when faced with any luminal lesions of interest.
Endocardial Fibroelastosis of the Left Ventricle Affects Right Ventricular Performance in Fetuses with Hypoplastic Left Heart Syndrome: A Prospective Study Using M-Mode, PW- and Tissue Doppler Techniques
Authors: Graupner Oliver , Enzensberger Christian , Wieg Larissa , Degenhardt Jan , Wolter Aline , Khalil Markus , Schranz Dietmar , Yerebakan Can , Doelle Astrid , Herrmann Johannes , Axt-Fliedner Roland
Published: July 2017

Purpose Myocardial function (MF) of the systemic right ventricle (RV) influences the postnatal course of neonates with hypoplastic left heart syndrome (HLHS). Our study examines whether the presence of endocardial fibroelastosis of the left ventricle (LV EFE) influences MF of the RV in HLHS fetuses.

Materials and Methods A prospective study was conducted including 10 controls (group 1), 10 HLHS fetuses with (group 2) and 10 without LV EFE (group 3) – all matched for gestational age. M-mode was used to assess tricuspid plane systolic excursion (TAPSE) and the shortening fraction (SF). PW-Doppler-derived and PW-TDI-derived velocities were assessed. E/A, E/e', e'/a' ratios and the myocardial performance index (mpi’) were calculated.

Results The examination of MF revealed significantly lower s’ velocities (p < 0.05) and higher values for SF in group 2 compared to group 3. e’/a’ ratio, et’ (ejection time), E wave velocity, E/e’ and SF showed significantly higher values in group 2 compared to group 1. In group 2 a’ velocity increased significantly over gestational age. In group 3 but not in group 2, TAPSE increased during gestation.

Conclusion These significant differences in MF between the groups might lend support to the notion of negative ventricular-ventricular interaction in the case of HLHS with LV EFE possibly influencing surgical outcomes.
High-definition-iSCAN virtual chromoendoscopy has high sensitivity and specificity for the diagnosis of eosinophilic esophagitis
Authors: Gregory Eustace , Fort Gasia Miriam , Gui Xianyong , Ghosh Subrata , Iacucci Marietta
Published: July 2017

Background and study aims A major challenge in eosinophilic esophagitis (EoE) is disease recognition during endoscopy as there are no pathognomonic findings. We aimed to determine the utility of high-definition (HD) iSCAN virtual chromoendoscopy (VC) in diagnosis of EoE.

Patients and methods One hundred eighty-nine consecutive patients presenting with dysphagia or food bolus impaction were assessed using HD-iSCAN VC (Pentax, Japan) with biopsies from distal, mid, upper esophagus and from furrows where visible.

Results Of 189 patients, 45 (23.8 %, male = 29, median age 40y) had a histological diagnosis of EoE; 73.3 % of the patients were newly diagnosed. iSCAN endoscopic features of EoE were linear furrows (91 %), edema (77.8 %), rings or tracheal appearance (73.3 %), whitish exudates (26.6 %) and narrowing or stricture (5 %). One patient (2.2 %) had all 5 endoscopic features. Ten patients (22.2 %) had linear furrows, edema,rings or tracheal appearance and whitish exudates on iSCAN, with a positive predictive value (PPV) 100 % (95 % CI 69.1 %-100 %) and negative predictive value (NPV) 80.4 % (95 % CI 73.9 %-86 %). Thirteen patients (29 %) presented with linear furrows, edema and rings or tracheal appearance on iSCAN, with a PPV 100 % (95 % CI 75.3 %-100 %) and NPV 81.8 % (95 % CI 75.3 %-87.2 %). Six patients (13.3 %) had furrows and edema and 6 patients (13.3 %) had furrows and rings or tracheal appearance on iSCAN, with a PPV 100 % (95 % CI 54.1 %-100 %) and NPV 78.69 % (95 % CI 72 %-84.4 %), respectively. The sensitivity and specificity of HD-iSCAN endoscopy were 97.62 % (95 % CI 87.43 %-99.94 %) and 89.58 % (95 % CI 83.40 %-94.05 %). The accuracy of HD-iSCAN endoscopy was 92.47 % (95 % CI 87.67 %-95.56 %).

Conclusion HD-iSCAN endoscopy is sensitive and specific with good accuracy for EoE diagnosis. Linear furrows, edema and tracheal appearance were the most common findings and these 3 endoscopic features had a high predictive value for diagnosis of EoE.
Peroral endoscopic myotomy using FlushKnife BT: a single-center series
Authors: Tanaka Shinwa , Toyonaga Takashi , Kawara Fumiaki , Grimm Ian , Hoshi Namiko , Abe Hirofumi , Ohara Yoshiko , Morita Yoshinori , Umegaki Eiji , Azuma Takeshi
Published: July 2017

Background and study aims Peroral endoscopic myotomy (POEM) is an evolving new treatment strategy for achalasia. Although several kinds of electrosurgical knives have been used in performing POEM, the best device has yet to be determined. The FlushKnife BT is a waterjet-emitting short needle-knife with a small ball tip (BT) that offers the potential to perform all aspects of POEM with a single device. In this study, we evaluated the safety and efficiency of the FlushKnife BT for POEM.

Patients and methods A total of 54 consecutive patients with achalasia and other spastic esophageal motility disorders, such as jackhammer esophagus or distal esophageal spasm, who underwent POEM between January 2016 and August 2016, were included in this retrospective study.

Results The median operation time was 73.0 minutes (range 39 – 184 minutes). All procedures were completed using only the FlushKnife BT without changing to any other electrosurgical instrument. The median number of additional submucosal injections with an injection needle was 0 (range 0 – 1). Endoscopic vessel sealing was performed a mean of 3 times (range 0 – 7). The median number of bleeding episodes requiring treatment with hemostatic forceps was 0 (range 0 – 5). There were no significant adverse events. Seven of 52 patients (13.5 %) reported symptoms of gastroesophageal reflux disease such as heartburn or acid reflux at 3 month follow-up.

Conclusions The FlushKnife BT enabled POEM to be performed with very few device exchanges, either for re-injection or to control intraoperative bleeding. In this uncontrolled case series, the ability of the FlushKnife BT to perform nearly all aspects of the POEM procedure seems to make it particularly well suited to this procedure.
Incidence of small bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy
Authors: Haanstra Jasmijn , Al-Toma Abdul , Dekker Evelien , Vanhoutvin Steven , Nagengast Fokko , Mathus-Vliegen Elisabeth , van Leerdam Monique , de Vos tot Nederveen Cappel Wouter , Veenendaal Roeland , Cats Annemieke , Sanduleanu Silvia , Vasen Hans , Kleibeuker Jan , Koornstra Jan
Published: July 2017

Background and study aims Lynch syndrome (LS) patients have an increased risk of small bowel cancer. The question is whether surveillance will lead to early detection of (pre)malignant lesions. We recently reported on prevalence of small bowel neoplasia (SBN) in LS patients as assessed by video capsule endoscopy (VCE). The aim of this prospective study was to determine the incidence of SBN.

Patients and methods Asymptomatic LS patients who underwent a VCE were invited to undergo a second VCE procedure 2 years later. If abnormalities or polypoid lesions larger than 1 cm were detected, subsequent endoscopic procedures were performed.

Results A total of 155 (78 %) of the initial 200 patients underwent a second VCE procedure after a mean of 2.2 (range 1 – 6) years. In 17 of the 155 (11 %) patients possibly significant lesions were detected, which required further investigation by means of gastroduodenoscopy (n = 8) or balloon-assisted endoscopy (n = 9). These procedures revealed no SBN.

Conclusion No SBN was found after 2 years. Surveillance of the small bowel by VCE does not seem to be warranted in asymptomatic LS patients.

This study was registered in the Clinical Trials.gov registry with identifier NCT00898768.
Diagnostische Zuverlässigkeit der konfokalen Scanning-Laser-Ophthalmoskopie bei großen Papillen mit physiologischer Exkavation – eine Langzeitstudie
Authors: Koch Eva , Plange Niklas , Fuest Matthias , Schimitzek Hannah , Kuerten David
Published: July 2017

Wir haben wiederholt 17 Probanden mit vermuteter bilateraler physiologischer Exkavation bei großen Papillen untersucht. Diese Probanden waren in einer initialen Messung pathologisch oder grenzwertig durch den Heidelberg Retina Tomograph (HRT, Softwareversion 3.0) gewertet worden. Wir wollten die diagnostische Zuverlässigkeit der initialen Messung im Langzeitverlauf untersuchen und bestimmen, welche der Probanden wirklich nur eine physiologische Exkavation zeigten, bzw. die Progression zum Glaukom überwachen.

Probanden und Methoden 17 Probanden einer initialen Studie zum HRT konnten für diese Langzeituntersuchung rekrutiert werden. Alle Probanden zeigten eine vermutete physiologische Exkavation bei großen Papillen (Papillengröße > 2,3 mm2). In den regelmäßigen Untersuchungen wurden der intraokulare Druck mittels Goldmann-Applanationstonometrie (GAT) und die retinale Nervenfaserschichtdicke mittels optischer Kohärenztomografie (OCT) gemessen sowie Gesichtsfelduntersuchungen und wiederholte HRT-Messungen durchgeführt. Eine Veränderung der Papillenexkavation wurde mittels der im HRT enthaltenen Analyseverfahren (Stereometric Trend Analysis [STA] und Topographic Change Analysis [TCA]) untersucht.

Ergebnisse In der Moorfields Regression Analysis (MRA) waren alle 17 Probanden in einer initialen HRT-Messung als „pathologisch“ bzw. „grenzwertig“ klassifiziert worden. Über den Kontrollzeitraum von 9,2 ± 5 Jahren zeigte nur 1 Patient eine gesicherte Progression zu einem Normaldruckglaukom (NDG) mit glaukomatösen Gesichtsfelddefekten. Von den anderen 16 Probanden konnte eine signifikante Progression bei 1 Probanden übereinstimmend durch STA und TCA, bei 3 Probanden nur durch STA und bei 1 Probanden nur durch TCA nachgewiesen werden. Keiner dieser Probanden zeigt bis heute glaukomatöse Gesichtsfelddefekte.

Fazit Nach über 9 Jahren zeigte nur 1 der 17 Probanden, die initial als pathologisch klassifiziert worden waren, ein gesichertes Glaukom. Bei 5 weiteren Probanden zeigten die HRT-Messungen eine statistisch signifikante Progression, ohne dass Veränderungen des Gesichtsfelds gefunden werden konnten. Insgesamt scheint die diagnostische Zuverlässigkeit insbesondere bei Patienten mit großen Papillen und physiologischer Exkavation eingeschränkt zu sein.
Melting of superheated molecular crystals
Authors: Cubeta Ulyana , Bhattacharya Deepanjan , Sadtchenko Vlad
Published: July 2017

Melting dynamics of micrometer scale, polycrystalline samples of isobutane, dimethyl ether, methyl benzene, and 2-propanol were investigated by fast scanning calorimetry. When films are superheated with rates in excess of 105 K s−1, the melting process follows zero-order, Arrhenius-like kinetics until approximately half of the sample has transformed. Such kinetics strongly imply that melting progresses into the bulk via a rapidly moving solid-liquid interface that is likely to originate at the sample’s surface. Remarkably, the apparent activation energies for the phase transformation are large; all exceed the enthalpy of vaporization of each compound and some exceed it by an order of magnitude. In fact, we find that the crystalline melting kinetics are comparable to the kinetics of dielectric α-relaxation in deeply supercooled liquids. Based on these observations, we conclude that the rate of non-isothermal melting for superheated, low-molecular-weight crystals is limited by constituent diffusion into an abnormally dense, glass-like, non-crystalline phase.
Mechanisms of titania nanoparticle mediated growth of turbostratic carbon nanotubes and nanofibers
Authors: Kudo A. , Steiner S. A. , Bayer B. C. , Kidambi P. R. , Hofmann S. , Strano M. S. , Wardle B. L.
Published: July 2017

Turbostratic carbon nanotubes (CNTs) and nanofibers (CNFs) are synthesized by chemical vapor deposition using titania nanoparticle catalysts, and a quantitative lift-off model is developed to explain CNT and CNF growth. Micron-scale long turbostratic CNTs and CNFs were observed when acetylene is utilized as a carbon feedstock, and an alumina substrate was incorporated to improve the homogeneity of catalyst distribution. Turbostratic CNTs/CNFs are always found attached to nanoparticle corners, in the absence of the graphitic cage that is typically observed with metal nanoparticle-mediated growth. The observed morphology in turbostratic CNTs/CNFs supports a model in which several layers of graphene lift off from high-curvature corners of the titania nanoparticle catalysts. This model explains a key feature, which differentiates the growth of turbostratic CNTs/CNFs via non-metallic nanoparticles from growth using standard metal nanoparticle catalysts. The observed CNT/CNF growth and the accompanying model can impact the assessment of other metal-oxide nanoparticle catalysts, with the findings here contributing to a metal-free synthesis of turbostratic CNTs/CNFs.
Tungsten-encapsulated gadolinium nanoislands with enhanced magnetocaloric response
Authors: Logan J. M. , Rosenmann D. , Sangpo T. , Holt M. V. , Fuesz P. , McNulty I.
Published: July 2017

We report a method for growing chemically pure, oxide-free, air-stable Gd nanoislands with enhanced magnetic properties. These nanoislands are grown by solid-state dewetting and are fully encapsulated in tungsten such that they remain stable in ambient environments. They display good crystalline properties with hexagonally close-packed crystal structure and strong preferential orientation. We show that the choice of substrate strongly affects their shape, crystal orientation, and magnetic properties. The temperature-dependent magnetic coercivity and remanence of the Gd islands can vary by as much as a factor of three depending on the substrate used. The magnetocaloric properties of Gd islands grown on a sapphire substrate exceed those of high-quality Gd thin films.
Diffusion of small particles in polymer films
Authors: Polanowski Piotr , Sikorski Andrzej
Published: July 2017

The motion of small probe molecules in a two-dimensional system containing frozen polymer chains was studied by means of Monte Carlo simulations. The model macromolecules were coarse-grained and restricted to vertices of a triangular lattice. The cooperative motion algorithm was used to generate representative configurations of macromolecular systems of different polymer concentrations. The remaining unoccupied lattice sites of the system were filled with small molecules. The structure of the polymer film, especially near the percolation threshold, was determined. The dynamic lattice liquid algorithm was then employed for studies of the dynamics of small objects in the polymer matrix. The influence of chain length and polymer concentration on the mobility and the character of motion of small molecules were studied. Short- and long-time dynamic behaviors of solvent molecules were also described. Conditions of anomalous diffusions’ appearance in such systems are discussed. The influence of the structure of the matrix of obstacles on the molecular transport was discussed.
Self-assembly of Janus disks induced by small molecules in two-dimensional systems
Authors: Borówko M. , Rżysko W. , Sokołowski S. , Staszewski T.
Published: July 2017

We study the co-assembly of amphiphilic Janus disks and isotropic molecules by Monte Carlo simulations. A Janus particle is composed of two parts, one being attractive, A, and the other one being repulsive, R. Fluid molecules are strongly attracted by the R-sides and repelled by the A-sides. As the fluid density increases, the structure of the system changes from chaotically distributed Janus particles, through lamellar-like and gel-like structures, to the phase containing finite aggregates of Janus particles dispersed in the fluid. We show that “adsorption” of fluid molecules on the R-parts of Janus particles plays a key role in the co-assembly. The bond-switching between Janus particles is observed as the fluid density varies.
Laser pulse sharpening with electromagnetically induced transparency in plasma
Authors: Qu Kenan , Fisch Nathaniel J.
Published: July 2017

We propose a laser-controlled plasma shutter technique to generate sharp laser pulses using a process analogous to electromagnetically induced transparency in atoms. The shutter is controlled by a laser with moderately strong intensity, which induces a transparency window below the cutoff frequency, and hence enables propagation of a low frequency laser pulse. Numerical simulations demonstrate that it is possible to generate a sharp pulse wavefront (sub-ps) using two broad pulses in high density plasma. The technique can work in a regime that is not accessible by plasma mirrors when the pulse pedestals are stronger than the ionization intensity.
Determination of the non-ideal response of a high temperature tokamak plasma to a static external magnetic perturbation via asymptotic matching
Authors: Fitzpatrick Richard
Published: July 2017

Asymptotic matching techniques are used to calculate the response of a high temperature tokamak plasma with a realistic equilibrium to an externally generated, non-axisymmetric, static, magnetic perturbation. The plasma is divided into two regions. In the outer region, which comprises most of the plasma, the response is governed by the linearized equations of marginally stable, ideal-magnetohydrodynamics (MHD). In the inner region, which is strongly localized around the various rational surfaces within the plasma (where the marginally stable, ideal-MHD equations become singular), the response is governed by Glasser-Greene-Johnson linear layer physics. For the sake of simplicity, the paper focuses on the situation where the plasma at one of the internal rational surfaces is locked to the external perturbation, whereas that at the other surfaces is rotating.
Ionic size effects on the Poisson-Boltzmann theory
Authors: Colla Thiago , Nunes Lopes Lucas , dos Santos Alexandre P.
Published: July 2017

In this paper, we develop a simple theory to study the effects of ionic size on ionic distributions around a charged spherical particle. We include a correction to the regular Poisson-Boltzmann equation in order to take into account the size of ions in a mean-field regime. The results are compared with Monte Carlo simulations and a density functional theory based on the fundamental measure approach and a second-order bulk expansion which accounts for electrostatic correlations. The agreement is very good even for multivalent ions. Our results show that the theory can be applied with very good accuracy in the description of ions with highly effective ionic radii and low concentration, interacting with a colloid or a nanoparticle in an electrolyte solution.
Turbulent clustering of initially well-mixed buoyant particles on a free-surface by Lagrangian coherent structures
Authors: Pratt Kenneth R. , True Aaron , Crimaldi John P.
Published: July 2017

Particles that float on the surface of a 3D incompressible turbulent flow are exposed to non-divergence-free properties that result in clustering and unmixing, a reversal of how turbulence normally acts to mix and dilute scalars. Particle clustering is dominated by Lagrangian processes that depend on the time history of the flow; this suggests that Lagrangian coherent structures (LCS) might serve as templates for cluster formation. In this study, non-divergence-free clustering is examined both experimentally and numerically to elucidate the role of LCS in the formation of particle clusters and voids. Experiments are performed on the free-surface of a water-filled tank with turbulence driven by the random pulsing of centrifugal pumps on the tank bottom. Clustering is quantified by imaging fluorescent, buoyant particles that are placed in an initially random distribution on the free-surface. Within clusters, concentrations are observed to increase by an order of magnitude, with the likelihood of observing enhanced concentrations increasing by two orders of magnitude. LCS, obtained from velocity fields utilizing particle image velocimetry, are shown to act as templates for cluster formation. In addition, LCS are shown to possess a dilatation component in non-divergence-free flows that is responsible for unmixing. Numerically, a non-divergence-free chaotic model consisting of interacting Taylor vortices is utilized to investigate processes responsible for cluster formation seen in the experiments. The model results support the experimental finding that LCS act as templates for particle clusters, with scalar unmixing driven by the dilatation component.
Superintegrable classical Zernike system
Authors: Pogosyan George S. , Wolf Kurt Bernardo , Yakhno Alexander
Published: July 2017

We consider the differential equation that Zernike proposed to classify aberrations of wavefronts in a circular pupil, as if it were a classical Hamiltonian with a non-standard potential. The trajectories turn out to be closed ellipses. We show that this is due to the existence of higher-order invariants that close into a cubic Higgs algebra. The Zernike classical system thus belongs to the class of superintegrable systems. Its Hamilton-Jacobi action separates into three vertical projections of polar coordinates of sphere, polar, and equidistant coordinates on half-hyperboloids, and also in elliptic coordinates on the sphere.
Ion-size dependent electroosmosis of viscoelastic fluids in microfluidic channels with interfacial slip
Authors: Mukherjee Siddhartha , Goswami Prakash , Dhar Jayabrata , Dasgupta Sunando , Chakraborty Suman
Published: July 2017

We report a study on the ion-size dependent electroosmosis of viscoelastic fluids in microfluidic channels with interfacial slip. Here, we derive an analytical solution for the potential distribution in a parallel plate microchannel, where the effects of finite sized ionic species are taken into account by invoking the free energy formalism. Following this, a purely electroosmotic flow of a simplified Phan-Thien-Tanner (sPTT) fluid is considered. For the sPTT model, linear, quadratic, and exponential kernels are chosen for the stress coefficient function describing its viscoelastic nature across various ranges of Deborah number. The theoretical framework presented in our analysis has been successfully compared with experimental results available in the literature. We believe that the implications of the considered effects on the net volumetric throughput will not only provide a deeper theoretical insight to interpret the electrokinetic data in the presence of ionic species but also serve as a fundamental design tool for novel electrokinetically driven lab-on-a-chip biofluidic devices.
Diffusive heat and mass transfer in oscillatory pipe flow
Authors: Brereton G. J. , Jalil S. M.
Published: July 2017

The enhancement of axial heat and mass transfer by laminar flow oscillation in pipes with axial gradients in temperature and concentration has been studied analytically for the cases of insulated and conducting walls. The axial diffusivity can exceed its molecular counterpart by many orders of magnitude, with a quadratic scaling on the pressure-gradient amplitude and the Prandtl or Schmidt number, and is a bimodal function of oscillatory frequency: quasi-steady behavior at low frequencies and a power-law decay at high frequencies. When the pipe wall is conductive and of sufficient thickness, and the flow oscillation is quasi-steady, the axial diffusivity may be enhanced by a further factor of about ten as a result of increased radial diffusion, for liquid and gas flows in pipes with walls with a wide range of thermal conductivities. Criteria for the wall thickness required to achieve this additional enhancement and for the limits placed on the validity of these solutions by viscous dissipation are also deduced. When the heat transfer per unit flow work achieved by oscillatory pipe flow is contrasted with that of a conventional parallel-flow heat exchanger, it is found to be of comparable size and the ratio of the two is shown to be a function only of the pipe geometry, heat-exchanger mean velocity, and fluid viscosity.
Universal interrelation between measures of particle and polymer size
Authors: Vargas–Lara Fernando , Mansfield Marc L. , Douglas Jack F.
Published: July 2017

The characterization of many objects involves the determination of a basic set of particle size measures derived mainly from scattering and transport property measurements. For polymers, these basic properties include the radius of gyration Rg, hydrodynamic radius Rh, intrinsic viscosity [η], and sedimentation coefficient S, and for conductive particles, the electric polarizability tensor αE and self-capacity C. It is often found that hydrodynamic measurements of size deviate from each other and from geometric estimates of particle size when the particle or polymer shape is complex, a phenomenon that greatly complicates both nanoparticle and polymer characterizations. The present work explores a general quantitative relation between αE, C, and Rg for nanoparticles and polymers of general shape and the corresponding properties η, Rh, and Rg using a hydrodynamic-electrostatic property interrelation.
Threshold voltage control of electrolyte solution gate field-effect transistor by electrochemical oxidation
Authors: Naramura Takuro , Inaba Masafumi , Mizuno Sho , Igarashi Keisuke , Kida Eriko , Mohd Sukri Shaili Falina , Shintani Yukihiro , Kawarada Hiroshi
Published: July 2017

Diamond electrolyte solution-gate-field effect transistors (SGFETs) are suitable for applications as chemical ion sensors because of their wide potential window and good physical and chemical stabilities. In this study, we fabricated an anodically oxidized diamond SGFET from a full hydrogen-terminated diamond SGFET and demonstrated control of the device threshold voltage by irreversible anodic oxidation. The applied anodic bias voltage (VAO) was varied gradually from low to high (1.1–1.7 V). As the anodic oxidation proceeded, the threshold voltage shifted to more negative values with no degradation of hole mobility. Thus, anodic oxidation is a useful method for controlling the threshold voltage of diamond SGFETs.
Assessment of elastic models in supercooled water: A molecular dynamics study with the TIP4P/2005f force field
Authors: Guillaud Emmanuel , Joly Laurent , de Ligny Dominique , Merabia Samy
Published: July 2017

Glass formers exhibit a viscoelastic behavior: at the laboratory time scale, they behave like (glassy) solids at low temperatures and like liquids at high temperatures. Based on this observation, elastic models relate the long time supercooled dynamics to short time elastic properties of the supercooled liquid. In the present work, we assess the validity of elastic models for the shear viscosity and the α-relaxation time of supercooled water, using molecular dynamics simulations with the TIP4P/2005f force field over a wide range of temperatures. We show that elastic models provide a good description of supercooled water dynamics. For the viscosity, two different regimes are observed and the crossover temperature is found to be close to the one where the Stokes-Einstein relation starts to be violated. Our simulations show that only shear properties are important to characterize the effective flow activation energy. This study calls for experimental determination of the high frequency elastic properties of water at low temperatures.
Two color laser driven THz generation in clustered plasma
Authors: Malik Rakhee , Uma R. , Kumar Pawan
Published: July 2017

A scheme of terahertz (THz) generation, using nonlinear mixing of two color laser (fundamental ω1 and slightly frequency shifted second harmonic ω2) in clustered plasma, is investigated. The lasers exert ponderomotive force on cluster electrons and drive density perturbations at 2ω1 and ω2−ω1. The density perturbations beat with the oscillatory velocities to produce nonlinear current at ω2−2ω1, generating THz radiation. The radiation is enhanced due to cluster plasmon resonance and by phase matching introduced through a density ripple. The generation involves third order nonlinearity and does not require a magnetic field or inhomogeneity to sustain it. We report THz power conversion efficiency ∼10−4 at 1μm and 0.5μm wavelengths with intensity ∼3×1014W/cm2.
Transformation of the ordered internal structures during the acceleration of fast charged particles in a dense plasma focus
Authors: Kubes P. , Paduch M. , Cikhardt J. , Cikhardtova B. , Klir D. , Kravarik J. , Rezac K. , Zielinska E. , Sadowski M. J. , Szymaszek A. , Tomaszewski K. , Zaloga D.
Published: July 2017

The paper concerns important differences in the evolution of plasma column structures during the production of fusion neutrons in the first and subsequent neutron pulses, as observed for plasma-focus discharges performed with the deuterium filling. The first neutron pulse, of a more isotropic distribution, is usually produced during the formation of the first big plasmoid. The next neutron pulses can be generated by the fast deuterons moving dominantly in the downstream direction, at the instants of a disruption of the pinch constriction, when other plasmoids are formed during the constriction evolution. In both cases, the fusion neutrons are produced by a beam-target mechanism, and the acceleration of fast electron- and deuteron-beams can be interpreted by transformation and decay of the magnetic field associated with a filamentary structure of the current flow in the plasmoid.
Surface quasi periodic and random structures based on nanomotor lithography for light trapping
Authors: Golghasemi Sorkhabi Sh. , Ahmadi-Kandjani S. , Cousseau F. , Loumaigne M. , Zielinska S. , Ortyl E. , Barille R.
Published: July 2017

We compare the characteristics of two types of patterns obtained with two azopolymer materials: a Gaussian random pattern and a quasi-random grating pattern. The surface structurations have been obtained with a simple bottom-up technique, illuminating azopolymer thin films with a single laser beam. We demonstrate the interesting generated properties of these two surfaces. In particular, the surface with quasi-random gratings can address beam splitting for light coupling in different directions in an ultra-thin film. We use these two surfaces as a mold and replicate them on a transparent elastomeric material and demonstrate a very good light entrapment. We also show that the efficiency of light trapping is 20% better with the quasi-random gratings, than with the Gaussian random surface, and is close to 40%.
Emerging photoluminescence from bilayer large-area 2D MoS2 films grown by pulsed laser deposition on different substrates
Authors: Barvat Arun , Prakash Nisha , Satpati Biswarup , Singha Shib Shankar , Kumar Gaurav , Singh Dilip K. , Dogra Anjana , Khanna Suraj P. , Singha Achintya , Pal Prabir
Published: July 2017

We report the growth of continuous large area bilayer films of MoS2 on different substrates by pulsed laser deposition (PLD). The growth parameters for PLD were modified in such a way that results in bilayer 2D-MoS2 films on both c-Al2O3 (0001) (sapphire) and SiO2/Si (SO) substrates. The bilayer large area crystalline nature of growth in the 2 H-phase is determined by Raman spectroscopy. Cross-sectional transmission electron microscopy confirms the distinct thinnest ordered layered structure of MoS2. Chemical analysis reveals an almost stoichiometric 2 H-phase on both the substrates. The photoluminescence intensities of both the films match very well with those of the corresponding exfoliated flakes, as well as chemical vapor deposited (CVD) films as reported in the literature. The in-situ post growth annealing with optimal film thickness acts as a solid phase epitaxy process which provides continuous crystalline layers with a smooth interface and regulates the photoluminescence properties. In contrast, the PLD grown MoS2 monolayer shows poor crystalline quality and non-uniform coverage compared to that with the exfoliated and CVD grown films.
Spin waves with large decay length and few 100 nm wavelengths in thin yttrium iron garnet grown at the wafer scale
Authors: Maendl Stefan , Stasinopoulos Ioannis , Grundler Dirk
Published: July 2017

Using conventional coplanar waveguides (CPWs), we excited spin waves with a wavelength λ down to 310 nm in a 200 nm thin yttrium iron garnet film grown by liquid phase epitaxy. Spin-wave transmission was detected between CPWs that we separated by up to 2 mm. For magnetostatic surface spin waves, we found a large nonreciprocity of 0.9 and a high group velocity vg of up to 5.4 km/s. The extracted decay length ld amounted to 0.86 mm. Small λ, high vg, and large ld are key figures of merit when aiming at non-charged based signal transmission and logic devices with spin waves.