bluuebunny/crossref_metadata_2025 huggingface dataset:
Pore-scale simulation of wettability and interfacial tension effects on flooding process for enhanced oil recovery
Authors: Zhao Jin , Wen Dongsheng
Published: August 2017

The effects of wettability and interfacial tension on the flooding process were simulated numerically at the pore-scale, which could explain nanofluid, surfactant and their hybrids flooding mechanisms, yielding insights into enhanced oil recovery.
Plasma-assisted and thermal atomic layer deposition of electrochemically active Li2CO3
Authors: Hornsveld N. , Put B. , Kessels W. M. M. , Vereecken P. M. , Creatore M.
Published: August 2017

Growth per cycle as a function of process table temperature for both plasma-assisted (squares) and thermal (circles) ALD processes.
Tunable luminescence from two dimensional BCNO nanophosphor for high-contrast cellular imaging
Authors: Gupta Bipin Kumar , Kumar Pawan , Kedawat Garima , Kanika Kanika , Vithayathil Sajna Antony , Gangwar Amit Kumar , Singh Satbir , Kashyap Pradeep Kumar , Lahon Rimli , Singh V. N. , Deshmukh Abhay D. , Narayanan Tharangattu N. , Singh Nidhi , Gupta Sarika , Kaipparettu Benny Abraham
Published: August 2017

Multi-colour emitting nanophosphors provide a paradigm shift in rare-earth free biocompatible nanoprobes for in vitro and in vivo imaging applications.
Atomistic simulations of graphite etching at realistic time scales
Authors: Aussems D. U. B. , Bal K. M. , Morgan T. W. , van de Sanden M. C. M. , Neyts E. C.
Published: August 2017

We demonstrate that long time-scale events in atomistic ion-surface bombardment simulations can be essential and need to be accounted for.
A β-Carbon elimination strategy for convenient in situ access to cyclopentadienyl metal complexes
Authors: Smits G. , Audic B. , Wodrich M. D. , Corminboeuf C. , Cramer N.
Published: August 2017

Stable pre-ligands and common metal salts provide,viaβ-carbon elimination, access to Cp-metal complexes suitable forin situcatalyst preparation.
Thiophene bridged aldehydes (TBAs) image ALDH activity in cells via modulation of intramolecular charge transfer
Authors: Maity Santanu , Sadlowski Corinne M. , George Lin Jung-Ming , Chen Che-Hong , Peng Li-Hua , Lee Eun-Soo , Vegesna Giri K. , Lee Charles , Kim Se-Hwa , Mochly-Rosen Daria , Kumar Sanjay , Murthy Niren
Published: August 2017

We present a new family of fluorescent probes which can image ALDH activity in cells.
Tethering mesoporous Pd nanoparticles to reduced graphene oxide sheets forms highly efficient electrooxidation catalysts
Authors: Iqbal Muhammad , Li Cuiling , Jiang Bo , Hossain Md. Shahriar A. , Islam Md. Tofazzal , Henzie Joel , Yamauchi Yusuke
Published: August 2017

Uniformly sized mesoporous palladium (Pd) nanoparticles supported on reduced graphene oxide (rGO) surfaces can be prepared by solution phase synthesis.
Nitrogen containing carbon spheres as an efficient electrocatalyst for oxygen reduction: Microelectrochemical investigation and visualization
Authors: Tiwari Aarti , Singh Vikram , Mandal Debaprasad , Nagaiah Tharamani C.
Published: August 2017

A fast-scanning ultramicroelectrode probe is employed to trace the mechanistic pathway followed by the designed nitrogen containing carbon spheres in highly alkaline medium.
Highly permeable and antifouling reverse osmosis membranes with acidified graphitic carbon nitride nanosheets as nanofillers
Authors: Gao Xiang , Li Yiming , Yang Xiaolong , Shang Yanan , Wang Yong , Gao Baoyu , Wang Zhining
Published: August 2017

Ultrathin graphitic carbon nitride (gCN) nanosheets, due to their two-dimensional graphene-like structure, regularly distributed triangular nanopores and structural defects on the laminar network, have attracted great research attention in fabricating high-performance water selective membranes.
A general strategy towards carbon nanosheets from triblock polymers as high-rate anode materials for lithium and sodium ion batteries
Authors: Chen Yaxin , Shi Liluo , Guo Shasha , Yuan Qiong , Chen Xiaohong , Zhou Jisheng , Song Huaihe
Published: August 2017

Carbon nanosheets from triblock polymers behave well as anode materials for lithium- and sodium-ion batteries.
A solar ultraviolet sensor based on fluorescent polyoxometalate and viologen
Authors: Liu Hong , Lv Yang , Li Si , Yang Fan , Liu Sheng , Wang Cheng , Sun Jia-Qi , Meng Hao , Gao Guang-Gang
Published: August 2017

A novel solar ultraviolet sensitive composite film, which can be coloured and bleached by photoreduction and air oxidation processes, has been readily prepared using fluorescent polyoxometalate and viologen.
Synthesis of an aggregation-induced emission (AIE) active salicylaldehyde based Schiff base: study of mechanoluminescence and sensitive Zn(ii) sensing
Authors: Pasha Sheik Saleem , Yadav Hare Ram , Choudhury Angshuman Roy , Laskar Inamur Rahaman
Published: August 2017

A simple AIE active organic molecule exhibits mechanoluminescence (ML) and turn-on Zn(ii) sensing and the causes behind such properties have been explored.
Stable narrowband red phosphor K3GaF6:Mn4+derived from hydrous K2GaF5(H2O) and K2MnF6
Authors: Deng T. T. , Song E. H. , Zhou Y. Y. , Wang L. Y. , Ye S. , Zhang Q. Y.
Published: August 2017

We synthesize a new hydrous single crystal, K2GaF5(H2O), and induce it to convert into stable moisture-proof phosphor K3GaF6:Mn4+for warm WLED applications by rapidly adding K2MnF6into its co-precipitate reaction system.
Wet-spinning of highly conductive nanocellulose–silver fibers
Authors: Wang Jinfeng , Huang Shu , Lu Xi , Xu Zhiguang , Zhao Yan , Li Jingliang , Wang Xungai
Published: August 2017

Conductive nanocellulose fibers were achieved by the wet-spinning of renewable cellulose nanofibrils (CNFs) and silver nanowires (AgNWs) from a single spinneret.
MicroRNA-29b inhibits supernatants from silica-treated macrophages from inducing extracellular matrix synthesis in lung fibroblasts
Authors: Lian Ximeng , Chen Xiaowei , Sun Jingping , An Guoliang , Li Xiaoli , Wang Yan , Niu Piye , Zhu Zhonghui , Tian Lin
Published: August 2017

Supernatants from silica-treated macrophages induced the lung fibroblasts proliferation, miR-29b reduced and extracellular matrix synthesis increased, which could be markedly inhibited by overexpression of miR-29b.
Analysis of reduced‐set construction using image reconstruction from a HOG feature vector
Authors: Jung Ho Gi
Published: August 2017

Recently, several methods have been published that demonstrate how to reconstruct an image from a discriminative feature vector. This study explains that previous approaches minimising the histogram‐of‐oriented‐gradient (HOG) feature error in the principal component analysis (PCA) domain of the learning database have a disadvantage in that they cannot reflect the different dynamic range of each PCA dimension, and proposes an improved method to exploit the eigenvalue as the weighting factor of each PCA dimension. Experimental results using pedestrian and vehicle image databases quantitatively show that the proposed method improves the quality of reconstructed images. Additionally, the proposed method is applied to the image reconstruction of the resultant support vectors (SVs) of reduced‐set construction which showed the best performance among SV number reduction methods. As the resultant SVs of reduced‐set construction are not corresponding to any image of the learning database, it is hard to analyse the problem and performance of the method. By observing the images of the resultant SVs, one potential problem regarding the database used is newly considered and the direction of further study can be established in order to address the problem.
Segmentation and semantic labelling of RGBD data with convolutional neural networks and surface fitting
Authors: Pagnutti Giampaolo , Minto Ludovico , Zanuttigh Pietro
Published: August 2017

We present an approach for segmentation and semantic labelling of RGBD data exploiting together geometrical cues and deep learning techniques. An initial over‐segmentation is performed using spectral clustering and a set of non‐uniform rational B‐spline surfaces is fitted on the extracted segments. Then a convolutional neural network (CNN) receives in input colour and geometry data together with surface fitting parameters. The network is made of nine convolutional stages followed by a softmax classifier and produces a vector of descriptors for each sample. In the next step, an iterative merging algorithm recombines the output of the over‐segmentation into larger regions matching the various elements of the scene. The couples of adjacent segments with higher similarity according to the CNN features are candidate to be merged and the surface fitting accuracy is used to detect which couples of segments belong to the same surface. Finally, a set of labelled segments is obtained by combining the segmentation output with the descriptors from the CNN. Experimental results show how the proposed approach outperforms state‐of‐the‐art methods and provides an accurate segmentation and labelling.
Efficient Bayesian approach to saliency detection based on Dirichlet process mixture
Authors: Rabbani Navid , Nazari Behzad , Sadri Saeid , Rikhtehgaran Reyhaneh
Published: August 2017

Saliency detection has shown a great role in many image processing applications. This study introduces a new Bayesian framework for saliency detection. In this framework, image saliency is computed as product of three saliencies: location‐based, feature‐based and centre‐surround saliencies. Each of these saliencies is estimated using statistical approaches. The centre‐surround saliency is estimated using Dirichlet process mixture model. The authors evaluate their method using five different databases and it is shown that it outperform state‐of‐the‐art methods. Also, they show that the proposed method has a low computational cost.
Synthesis of Penta-2,4-dienenitriles by the Horner–Wadsworth–Emmons Olefination of Enones
Authors: Bencke Carlos , Marangoni Mário , Camargo Adriano , Fantinel Cassio , Bonacorso Helio , Martins Marcos , Zanatta Nilo
Published: August 2017

Three new series of compounds, 5-alkoxy-3-(trifluoromethyl)penta-2,4-dienenitriles, 5-(phenylthio)-3-(trifluoromethyl)penta-2,4-dienenitriles, and ethyl 4-alkoxy-2-(cyanomethylene)but-3-enoates, obtained from the olefination reaction of the respective enones with diethyl cyanomethylphosphonate via the Horner–Wadsworth–Emmons olefination are reported. All products were obtained as single regioisomers; however, the composition of the stereoisomers changed according to the enone substituents. A study based on 1H and 13C NMR chemical shifts, 1H–19F and 13C–19F NMR coupling constants, 1H NMR signal integrals, and HSQC, HMBC, and NOESY experiments was performed in order to assign the structure and percentage of each stereoisomer obtained.
X-linked Dilated Cardiomyopathy with Mutation in the 5′ Splice Site Intron 1 of Dystrophin Gene with Utrophin Upregulation
Authors: Chan Sophelia Hoi-shan , Ho Ronnie Siu-lun , Lo Ivan Fai-man , Kan Amanda Nim-chi , Lun Kin-Shing
Published: August 2017

We report a teenage boy presented with dilated cardiomyopathy (DCM) with no initial skeletal involvement and initial normal creatine kinases. One year after the heart transplantation, he had exercise-induced transient muscle weakness with elevated creatine kinases (CKs). Muscle biopsy showed normal structures and normal dystrophin immunohistochemical labeling, but utrophin, which is an autosomal homologue of dystrophin, was overexpressed at sarcolemma. Sanger sequencing confirmed a heterozygous c.31 + 1G > A, 5′ splice site point mutation at the first intron of dystrophin gene. A review of previous reports of patients with different point mutations in the same region, the first exon–intron boundary that involved the muscle promotor to exon 1, confirmed a high correlation of cardiospecific phenotype sparing the muscles with this specific site of mutations. The confirmation of upregulation of brain and Purkinje isoforms of dystrophin protein in the skeletal muscles but not in the heart in past studies help to explain the skeletal sparing presentation. X-linked DCM (XLDCM) is an important cause of isolated cardiomyopathy. Routine immunohistochemical staining study including dystrophin in cardiac muscle biopsy, and dystrophin and utrophin labelling on skeletal muscle biopsy for patients with subsequent muscle symptoms or raised creatine kinases, help in the early diagnosis of the XLDCM. Future experimental study to determine the aberrant pre-mRNA splicing of this specific splice site mutation involving exon 1 and intron 1 will help to understand better the underlying complex mechanism of the splicing regulation.
Sleep and Epilepsy
Authors: Bazil Carl
Published: August 2017

The neurophysiology of the brain is complicated and nuanced. It is responsible for the normal sleep/wake states that every person experiences, and for the changes in brain neurophysiology that result in epileptic seizures and in disorders of sleep. It is therefore not surprising that sleep, sleep disorders, and epilepsy interact on many levels. The sleep state influences the detection of interictal epileptiform discharges, important for diagnosis of epilepsy. The state of sleep also influences whether a seizure will occur at a given time, and this differs considerably for various epilepsy syndromes. Sleep disruption of any kind, including from sleep disorders, can worsen epileptic seizures and contribute to intractability. Finally, anticonvulsant medications can influence sleep and sleep disorders in both positive and negative ways. Understanding this interplay between epilepsy and sleep is helpful in the optimal treatment of all patients with epileptic seizures.
Pediatric Intestinal Rehabilitation and Transplantation Registry: Initial Report from a European Collaborative Registry
Authors: Boscarelli Alessandro , Hermans Dominique , Dall'Oglio Luigi , Diamanti Antonella , d'Aische Aloys , Pakarinen Mikko , Reding Raymond , Morini Francesco , Bagolan Pietro , Fusaro Fabio , Totonelli Giorgia , Tambucci Roberto
Published: August 2017

Introduction Short bowel syndrome (SBS) is the main cause of intestinal failure (IF) in the pediatric population. To promote the standardization of care of these patients, the registry of Pediatric Intestinal Rehabilitation and Transplantation (PIRAT) has been established. The aim of this study is to describe patients with IF using PIRAT database.

Materials and Methods Data from two tertiary care European referral Centers registered in PIRAT (https://www.studeon.eu/pirat) were analyzed (1994–2015). Neonatal SBS-related IF was defined as need for parenteral nutrition (PN) to sustain life and growth for more than 75 days, after extensive bowel resection during neonatal period. Data included patient demographics, disease at birth, residual small intestine, and intestinal autonomy (PN on/off).

Results In this study, 114 children with SBS-related IF were identified (male 60%). Median gestational age was 35.3 weeks (interquartile range [IQR]: 33.0–38.0); median birth weight was 2,440 g (IQR: 1,700–2,990). The main causes of SBS were intestinal atresia in 31 (27%), midgut volvulus in 29 (25%), necrotizing enterocolitis in 23 (20%), and gastroschisis in 12 (11%). Nine (7.9%) patients died on PN (six sepsis, two IF-associated liver disease, and one multiorgan failure). Median residual small bowel length was 46 cm (IQR: 13.0–92.5). Ileocecal valve was resected in 48 patients (42%). Intestinal autonomy was achieved in 68% patients.

Conclusion We present the web-based registry PIRAT and the first results of patients with IF registered from two European Centers. PIRAT could give the opportunity to create a dedicated international network (IF-net) to standardize, improve, and spread the therapeutic paths for the rare and heterogeneous condition of SBS-related IF.
Postnatal Germ Cell Development in the Cryptorchid Testis: The Key to Explain Why Early Surgery Decreases the Risk of Malignancy
Authors: Clasen-Linde Erik , Li Ruili , Reinhardt Susanne , Kvist Kolja , Vikraman Jaya , Southwell Bridget , Hutson John , Cortes Dina , Thorup Jorgen
Published: August 2017

Purpose Cryptorchidism is a risk factor for testicular malignancy and surgical treatment lowers this risk. This study aimed to investigate the germ cell behavior in prepubertal cryptorchid testes using immunohistochemical markers for germ cell malignancy to understand how early orchiopexy may possibly prevent cancer developing.

Materials and Methods Histology sections from 1,521 consecutive testicular biopsies from 1,134 boys aged 1 month to 16.5 years operated for cryptorchidism were incubated with antibodies including antiplacental-like alkaline phosphatase (PLAP), anti-Oct3/4, anti-C-kit, and anti-D2–40.

Results Oct3/4 and D2–40-positive germ cells are found throughout the first 2 years of life, with declining frequency thereafter. After 2 years, they should have disappeared and may indicate neoplasia. PLAP-positive cells were seen in 57 to 82% and C-kit-positive cells in 5 to 21% of cryptorchid testes between 4 and 13 years. Not until puberty did PLAP and C-kit-positive undifferentiated spermatogonial stem cells vanish. Only 0.3% of the present material had obvious prepubertal intratubular germ cell neoplasia (ITGCN) and they all had syndromic cryptorchidism. An additional three boys (0.3%) older than 2 years had weak Oct3/4 expression in undescended testes, but all cases were D2–40 negative.

Conclusion Prepubertal ITGCN was rare and mostly seen in syndromic cryptorchidism. In nonsyndromic cryptorchidism PLAP-positive undifferentiated spermatogonial stem cells persisted in a significant proportion of nontreated undescended testes and they will be especially sensitive to long-lasting abnormally high temperature that may be the single most important cause facilitating the accumulation of mutations during cell replication and the development of ITGCN to be prevented by orchiopexy.
Nonspanning Total Wrist Arthrodesis with a Low-Profile Locking Plate
Authors: Rancy Schneider , Ek Eugene , Paul Sophia , Hotchkiss Robert , Wolfe Scott
Published: August 2017

Purpose This study aims to compare the outcomes and complications of our technique for nonspanning total wrist arthrodesis using a locking plate with the standard carpometacarpal spanning technique.

Methods A retrospective review of charts was performed to identify patients who underwent total wrist arthrodesis by the senior author (S.W.W.). We compared the outcomes of 15 cases of nonspanning wrist fusion with a 2.4/2.7 mm locking T plate to 11 cases of spanning wrist fusion with a 2.7/3.5 mm locking compression plate. Minimum follow-up was 3 months. Indications for fusion included rheumatoid arthritis, posttraumatic arthritis, Kienböck's disease, primary osteoarthritis, juvenile inflammatory arthropathy, psoriasis, brachial plexopathy, failed hemi or total wrist arthroplasty, failed four-corner fusion, and failed proximal row carpectomy. The primary outcome was fusion. Secondary outcomes included time to union, patient-rated wrist evaluation score, numerical rating scale pain score, grip strength, and complications.

Results All the wrists got fused. There were no significant differences in objective and subjective outcomes between cohorts. There were three complications (27%) in the spanning group, including tendon rupture and peri-implant fracture at the third metacarpal. This was compared with three complications (20%) in the nonspanning group, consisting of hardware removal.

Discussion We achieved similar fusion rates employing both spanning and nonspanning total wrist arthrodesis techniques, without necessitating carpometacarpal arthrodesis in the latter. Complications associated with our method were comparably less severe than those reported in the literature. We advocate nonspanning arthrodesis as an alternative method for total wrist fusion with a high union rate and minimal risk of complications at the carpometacarpal joint.

Level of Evidence Therapeutic level IV.
Spectrum of Neurocutaneous Syndromes in Children in Neurology Practice
Authors: Kaur Sukhjot , Kaur Simrat , Goraya Jatinder
Published: August 2017

Neurocutaneous syndromes (NCSs) are a well-recognized cause of neurological dysfunction in children. While there is large body of literature describing individual neurocutaneous disorders, composite studies describing the relative frequency of these disorders and their modes of presentation in pediatric neurology practice are sparse. Charts of 87 children, 54 boys and 33 girls, with NCSs were reviewed. Tuberous sclerosis was diagnosed in 47 children, followed by neurofibromatosis type 1 and ataxia-telangiectasia in 10 each. Six children had Sturge-Weber syndrome, five had hypomelanosis of Ito, and three had Sjogren-Larsson syndrome. Sixty children presented with seizures, of which 46 had tuberous sclerosis. Others presented with developmental delay and ataxia/movement disorder. Family history of NCS was noted in 20 (21.6%) children. Thirty-four (39%) children had developmental delay or intellectual disability at the time of presentation. Our study reveals that tuberous sclerosis is the most common NCS in pediatric neurology practice.
Verletzungen der Halswirbelsäule im Kindes- und Jugendalter
Authors: Jarvers J. , Völker A. , von der Höh N. , Josten C. , Heyde C.
Published: August 2017

Kommt es bei Säuglingen und Kleinkindern eher zu Verletzungen des zervikothorakalen Übergangs und der oberen HWS, so finden sich mit zunehmendem Alter zumeist Verletzungen der unteren HWS, aufgrund der zu der erwachsenen Wirbelsäule mehr und mehr angeglichenen Anatomie und Biomechanik.

Aufgrund des seltenen Auftretens von HWS-Verletzungen im Kindes- und Jugendalter bedarf es einer genauen Kenntnis möglicher Verletzungsformen und der physiologischen Entwicklung der HWS einschließlich möglicher Anomalien, um die Verletzungen nicht zu übersehen und um die adäquate Therapie einzuleiten.

Je nach Lokalisation und Verletzungen kommen konservative Therapiemaßnahmen mit Ruhigstellung in Orthesen oder dem Halofixateur in Betracht. Bei entsprechendem Verletzungsmuster können jedoch auch im Kindesalter Osteosynthesen und Fusionen notwendig werden.
Operative Therapie – Mitralklappenrekonstruktion oder Mitralklappenersatz?
Authors: Sündermann Simon , Falk Volkmar
Published: August 2017

Das Auftreten einer Mitralklappeninsuffizienz (MI) basiert auf 2 völlig unterschiedlichen pathologischen Mechanismen: Bei der primären MI kommt es zu degenerativen Veränderungen an der Mitralklappe. Hier ist die Goldstandardtherapie die chirurgische Mitralklappenrekonstruktion mit exzellenten Langzeitergebnissen. Die sekundäre MI ist die Folge einer ischämischen oder dilatativen Kardiomyopathie mit Veränderungen der Ventrikelgeometrie, die zu einer Veränderung der Klappengeometrie führen. Für eine erfolgreiche Rekonstruktion ist es notwendig, dass genügend viables Myokard vorhanden ist, sodass ein reverses Remodeling wahrscheinlich ist. Außerdem müssen verschiedene Faktoren wie der Sphericity-Index und die Symmetrie des Tetherings berücksichtigt werden, um den Erfolg einer Rekonstruktion abzuschätzen. Liegt eine ungünstige Konstellation vor, sollte ein Mitralklappenersatz oder eine alternative Therapie wie z. B. die Mitraclip-Implantation angestrebt werden.
Arthrosonographic Reference Values of the Shoulder Joint in Healthy Children and Adolescents: A Cross-Sectional Multicentre Ultrasound Study
Authors: Trauzeddel Ralf , Windschall Daniel , Trauzeddel Ralf , Nirschl Christine , Ganser Gerd , Palm-Beden Katharina , Berendes Rainer , Haller Maria , Krumrey-Langkammerer Manuela , Nimtz-Talaska Antje , Schoof Philipp , Lehmann Hartwig
Published: August 2017

Background Defining of gray scale ultrasound standard reference values of the shoulder joint in childhood and adolescence during maturation. Patients: We examined 445 healthy girls and boys between 1 year and 18 years of age.

Method A cross-sectional multicentre grey-scale ultrasound study was performed to examine the shoulder joint on both sides. The children were divided according to their gender and were further classified into six age groups, which constituted three-year age ranges, to record anatomical development changes. We measured the capsule-bone distance (BCD) as a representation of the intracapsular cavity, as well as the thickness of the joint capsule and joint cartilage. Values were expressed in mean±standard deviation (SD) and minimum-maximum (min-max). The shape of the joint capsule and capsule-bone junction zone was qualitatively analysed.

Results The joint cartilage thickness decreased with increasing age in all joints independently from sex and body side. However, the BCD and the capsule thickness increased with age. There was no intraarticular fluid visible. The joint capsule had a predominantly concave form, whereas the capsule-bone junction was mostly sharp.

Discussion This study is the first describing age-related normal values of the intracapsular cavity, joint capsule and cartilage thickness as well as their respective shape in a large cohort of healthy children.

Conclusion The findings could be helpful to differentiate between physiological and pathological joint conditions and thereby distinguishing age-related variations from alterations caused by inflammation.
Should Breast Cancer Surgery Be Done in an Outpatient Setting?
Authors: Formago Margaret , Schrauder Michael , Rauh Claudia , Hack Carolin , Jud Sebastian , Hildebrandt Thomas , Schulz-Wendtland Rüdiger , Frentz S. , Graubert S. , Beckmann Matthias , Lux Michael
Published: August 2017

Introduction The care of patients with breast cancer is extremely complex and requires interdisciplinary care in certified facilities. These specialized facilities provide numerous services without being correspondingly remunerated. The question whether breast cancer surgery should be performed in an outpatient setting to reduce costs is increasingly being debated. This study compares inpatient surgical treatment with a model of the same surgery performed on an outpatient basis to examine the potential financial impact.

Material and Methods A theoretical model was developed and the DRG fees for surgical interventions to treat primary breast cancer were calculated. A theoretical 1-day DRG was then calculated to permit comparisons with outpatient procedures. The costs of outpatient surgery were calculated based on the remuneration rates of the AOP (Outpatient Surgery) Contract and the EBM (Uniform Assessment Scale) and compared to the costs of the 1-day DRG.

Results The DRG fee for both breast-conserving surgery and mastectomy is higher than the fee paid in the context of the EBM system, although the same procedures were carried out in both systems. If a hospital were to carry out breast-conserving surgery as an outpatient procedure, the fee would be € 1313.81; depending on the type of surgery, the hospital would therefore only receive between 39.20% and 52.82% of the DRG fee. This was the case even for a 1-day treatment. Compared to the real DRG fees the difference would be even more striking.

Conclusion Carrying out breast cancer surgery as an outpatient procedure would result in a significant shortfall of revenues. Additional services from certified centers, such as the interdisciplinary planning of treatment, psycho-oncological and social-medical care with the involvement of relatives, detailed documentation, etc., which are currently provided without surcharge or adequate remuneration, could no longer be maintained. The quality of processes and excellent results which have been achieved and ultimately the care given by certified facilities would be significantly at risk.
Interventionell-radiologische Behandlung von Interkostalarterienblutungen – eine retrospektive Analyse
Authors: Kupczyk Patrick , Meyer Carsten , Thomas Daniel , Schild Hans , Pieper Claus
Published: August 2017

Hintergrund Interkostalarterienblutungen sind potenziell lebensbedrohliche Verletzungen, die neben einer konservativen und chirurgischen Therapie auch einer interventionell-radiologischen Notfallmaßnahme zugeführt werden können. Wir berichten über unsere Erfahrungen mit der notfallmäßigen Interkostalarterienembolisation.

Material und Methoden Retrospektiv wurden alle Patienten identifiziert, die in einem Zeitraum von 7 Jahren aufgrund einer akuten arteriellen Blutung mittels Interkostalarterienembolisation behandelt wurden. Neben technischem und klinischem Erfolg wurden weitere klinische und prozedurale Parameter sowie die Überlebenszeit der Patienten erfasst.

Ergebnisse Zwischen 2010 und 2017 wurden 27 Embolisationsprozeduren bei 24 Patienten (14 Männer, mittleres Alter 65,7 ± 13,9 Jahre) durchgeführt. Die Mehrzahl der Patienten litt an iatrogenen Interkostalarterienblutungen (n = 17; 70,1%; vorwiegend nach Thorakozentese). Bei 5 Patienten war zuvor ein frustraner Versuch einer thorakoskopischen Blutstillung erfolgt. 25/27 Interventionen waren primär technisch erfolgreich. In 2 Fällen kam es zu Nachblutungen über Kollateralen, sodass eine Reintervention notwendig war (sekundärer technischer Erfolg). In 15 Fällen war eine sekundäre chirurgische Hämatomausräumung erforderlich. Die Interkostalarterienembolisation war bei 23/24 Patienten klinisch erfolgreich, eine Patientin verstarb trotz erfolgreicher Embolisation an den Folgen des ausgedehnten Hämatothorax. Eine spinale Ischämie trat als Majorkomplikation auf.

Schlussfolgerung Die Interkostalarterienembolisation ist eine effektive interventionell-radiologische Notfallmaßnahme bei Patienten mit akuten Blutungen und stellt eine Alternative zur chirurgischen Therapie, auch nach erfolgloser chirurgischer Blutstillung, dar. Angesichts der potenziell schweren Komplikationsmöglichkeiten sollte der Eingriff durch einen erfahrenen Interventionalisten durchgeführt werden.
Indikationsfremde Anwendung von Medikamenten und Medizinprodukten in der Notfallmedizin
Authors: Ittner Karl , Koppenberg Joachim , Walter Ute
Published: August 2017

Wenn zugelassene Arzneimittel außerhalb der in der entsprechenden Fachinformation dargelegten Beschreibungen angewendet werden, dann spricht man von einer nicht zulassungskonformen Anwendung oder von einem Off-Label-Use. Wie in fast allen medizinischen Fachgebieten gibt es auch im Rettungsdienst sogenannte Off-Label-Use-Pharmakotherapien. Sofern evidenzbasierte Informationen zu einer nicht zulassungskonformen Anwendung vorliegen, und insbesondere im konkreten Notfall keine zulassungskonforme Möglichkeit besteht, dann ist diese gerechtfertigt. Verwendet ein Notarzt aber ein Medizinprodukt außerhalb der Zulassung, dann stellt er ein neues Produkt her und haftet persönlich bei einem Patientenschaden.
Moderne Diagnostik der Mitral- und Trikuspidalklappe – was ist wirklich notwendig?
Authors: Spieker Maximilian , Kelm Malte , Westenfeld Ralf
Published: August 2017

Mitral- und Trikuspidalklappenerkrankungen weisen eine hohe, mit dem Alter ansteigende Prävalenz in der Bevölkerung auf. Parallel mit den modernen und innovativen Therapieverfahren haben sich die Anforderungen an die Diagnostik von Vitien weiterentwickelt. Den Grundstein für eine erfolgreiche Therapie bildet auch weiterhin die echokardiografische Bildgebung, die präzise Informationen über Art und Ausmaß der Läsion, den Mechanismus, die Ätiologie sowie über die technische Durchführbarkeit einer Intervention liefern muss. Neue Innovationen im Bereich der Echokardiografie erlauben eine noch sensitivere Beschreibung der Pathomorphologie, eine valide Quantifizierung des Schweregrades und die Unterstützung bei der Klappenintervention. Neben den diagnostischen Untersuchungen spielt die klinische Beurteilung des Patienten eine wichtige Rolle und fordert eine kritische Wertung der Untersuchungsergebnisse unter Berücksichtigung der Klinik des Patienten.
Interventionelle Therapie der Mitralklappe: direkte und indirekte Anuloplastie – neue Optionen
Authors: Rottländer Dennis , Degen Hubertus , Haude Michael
Published: August 2017

Der Nutzen der konventionellen Mitralklappenoperation bei Patienten mit funktioneller Mitralklappeninsuffizienz ist unklar. Es wurden hohe Rezidivraten nach 2 Jahren beschrieben. Der chirurgische Goldstandard, die Anuloplastie, zielt auf die Reduktion der Dimensionen des Mitralklappenanulus. In der interventionellen Kardiologie unterscheidet man die indirekte (Carillon) von der direkten Anuloplastie (Cardioband, Mitralign, Accucinch). Das Carillon Mitral Contour System führt nach 12 Monaten zu einer signifikanten Reduktion der Mitralklappeninsuffizienz, einem vermehrten Reverse Remodeling, einer Verbesserung der klinischen Symptomatik und einer Zunahme der 6-Minuten-Gehstrecke. Das Cardioband reduziert die Mitralklappeninsuffizienz und führt zu einer Verbesserung der Herzinsuffizienzsymptomatik und 6-Minuten-Gehstrecke. Das Mitralign System reduziert bei 50% der Patienten die Mitralklappeninsuffizienz, führt zu einem Reverse Remodeling und bessert die Herzinsuffizienzsymptomatik. Das GDS Accucinch System befindet sich noch in ersten klinischen Testungen und klinische Studienergebnisse stehen aus. Eine individuelle Verfahrenswahl erscheint sinnvoll.
Thoraxtrauma: Diagnostik und Therapie
Authors: Redwan Bassam , Biancosino Christian , Nikolova Katina , Greve Thorsten , Bölükbas Servet
Published: August 2017

Patienten mit einem Thoraxtrauma können in den meisten Fällen durch die Anlage einer großlumigen Thoraxsaugdrainage und eine adäquate analgetische Therapie erfolgreich therapiert werden. Die initiale Behandlung richtet sich i. d. R. nach Feststellung der vitalen Notwendigkeit durch den Notarzt bzw. den behandelnden Chirurgen in der Notaufnahme. Schwere intrathorakale Verletzungen im Rahmen eines Polytraumas sind selten. Allerdings handelt es sich meist um akut lebensbedrohliche Situationen. Nach der initialen Stabilisierung stellt die Bildgebung eine essenzielle Grundlage der richtigen Versorgung und einer folgenden Operation dar. Die richtige Einschätzung der intrathorakalen Verletzungen sollte nur interdisziplinär in enger Kooperation zwischen der Anästhesie, Unfallchirurgie, Allgemeinchirurgie und Thoraxchirurgie erfolgen. Daher sollten Patienten mit Thoraxtraumata stets in spezialisierten Zentren mit der erforderlichen Fachexpertise behandelt werden. Dies führt zur Senkung der Sterblichkeit und Verkürzung der Langzeitbehandlung der Patienten.
Pulmonale Hypertonie bei Linksherzerkrankungen
Authors: Opitz Christian , Rieth Andreas , Rosenkranz Stephan
Published: August 2017

Die pulmonale Hypertonie (PH) bei Linksherzerkrankungen ist die weitaus häufigste Form der PH. Nach der hämodynamischen Definition liegt
hierbei eine post-kapilläre PH vor (PAPmean ≥ 25 mmHg, PAWP > 15 mmHg). Die Schwere einer PH sowie die Einschränkung der
rechtsventrikulären Funktion haben erhebliche Bedeutung für die Prognose von Patienten mit systolischer (Heart Failure with reduced Ejection
Fraction, HFrEF) oder diastolischer (Heart Failure with preserved Ejection Fraction, HFpEF) Herzinsuffizienz und/oder linksseitigen
Klappenerkrankungen. Die pathophysiologische Sequenz besteht in einer Rückwärtsübertragung pathologisch erhöhter Füllungsdrucke im linken
Herzen über die pulmonale Zirkulation bis zum rechten Herzen. Im Vordergrund der Therapie stehen daher eine leitliniengerechte Behandlung
der Linksherzerkrankung und die Optimierung des Volumenstatus. Gezielte PH-Medikamente sind primär nicht indiziert. Zeigen sich jedoch trotz
Entwässerung eine ausgeprägte PH und eine Rechtsherzbelastung, so sollte eine detaillierte Abklärung inklusive exakter hämodynamischer
Charakterisierung erfolgen. Die ESC/ERS-Leitlinien differenzieren unter Berücksichtigung des diastolischen Druckgradienten (DPG) und des
pulmonal vaskulären Widerstandes (PVR) zwischen isoliert post-kapillärer PH (Ipc-PH) und kombiniert post- und prä-kapillärer PH (Cpc-PH).
Während bei Ipc-PH kein therapeutisches Target in der pulmonalen Zirkulation besteht, kann bei Cpc-PH mit erhöhtem PVR und DPG ein
Therapieversuch mit gezielten PH-Medikamenten gerechtfertigt sein. Jedoch liegen für diese Form der PH nur präliminäre Daten vor, und
kontrollierte Studien sind notwendig.
Pulmonale Hypertonie bei Lungenerkrankungen
Authors: Lange Tobias J. , Klose Hans , Grimminger Jan F. , Held Matthias
Published: August 2017

Insbesondere fortgeschrittene und länger andauernde Lungenerkrankungen gehen oft mit einer pulmonalen Hypertonie (PH) einher, wobei diese in
der Regel hämodynamisch nur gering ausgeprägt ist und das klinische Erscheinungsbild nicht dominiert, aber dennoch die Prognose der
Patienten verschlechtert. Hinweise auf das Vorliegen einer PH bei Lungenerkrankungen können eine progrediente Dyspnoe und/ oder ein
rückläufiger Transferfaktor bei stabiler Ventilationsstörung in der Lungenfunktion, ein erhöhter oder steigender NT-proBNP-Wert, ein
erniedrigter oder fallender pCO2-Wert in der Blutgasanalyse oder das Auftreten kardialer Dekompensationszeichen sein.

Bei Verdacht auf PH bei Patienten mit Lungenerkrankungen sollte eine Echokardiografie erfolgen, um die Wahrscheinlichkeit für das Vorliegen
einer PH abzuschätzen. Bei niedriger PH-Wahrscheinlichkeit oder geringer Ausprägung der Rechtsherzbelastung sollten unter optimaler Therapie
der Grunderkrankung zunächst nicht-invasive Verlaufskontrollen erfolgen. Besteht anhand der nicht-invasiven Untersuchungen der Verdacht auf
eine schwere PH bzw. Rechtsherzbelastung, welche durch die Schwere der Lungenerkrankung nicht gut erklärt ist, müssen weitere PH-Ursachen
wie Linksherzerkrankungen und rezidivierende Lungenembolien ausgeschlossen werden, wobei letzteres jedoch insbesondere bei Patienten mit
fortgeschrittenen Lungenerkrankungen schwierig sein kann. Die zur definitiven Diagnosesicherung einer PH bei Lungenerkrankungen
erforderliche Rechtsherzkatheteruntersuchung wird nach aktuellen Leitlinien nur im Falle voraussichtlicher therapeutischer Konsequenzen wie
z. B. vor einer Lungentransplantation empfohlen.

Therapeutisch steht die optimale Behandlung der Lungenerkrankung im Vordergrund, der Einsatz Lungengefäß-erweiternder Medikamente wird
aufgrund fehlender Zulassung sowie möglicher nachteiliger Effekte nicht empfohlen. Patienten mit schwerer PH bei Lungenerkrankung sollten
zur Entscheidung über eine individuelle Therapie und für den Einschluss in klinische Studien im PH-Zentrum vorgestellt werden.
High-sensitivity silicon ultraviolet p+-i-n avalanche photodiode using ultra-shallow boron gradient doping
Authors: Xia Zhenyang , Zang Kai , Liu Dong , Zhou Ming , Kim Tong-June , Zhang Huilong , Xue Muyu , Park Jeongpil , Morea Matthew , Ryu Jae Ha , Chang Tzu-Hsuan , Kim Jisoo , Gong Shaoqin , Kamins Theodore I. , Yu Zongfu , Wang Zhehui , Harris James S. , Ma Zhenqiang
Published: August 2017

Photo detection of ultraviolet (UV) light remains a challenge since the penetration depth of UV light is limited to the nanometer scale. Therefore, the doping profile and electric field in the top nanometer range of the photo detection devices become critical. Traditional UV photodetectors usually use a constant doping profile near the semiconductor surface, resulting in a negligible electric field, which limits the photo-generated carrier collection efficiency of the photodetector. Here, we demonstrate, via the use of an optimized gradient boron doping technique, that the carrier collection efficiency and photo responsivity under the UV wavelength region have been enhanced. Furthermore, the ultrathin p+-i-n junction shows an avalanche gain of 2800 and an ultra-low junction capacitance (sub pico-farad), indicating potential applications in the low timing jitter single photon detection area.
Molecular mechanism of reflectin’s tunable biophotonic control: Opportunities and limitations for new optoelectronics
Authors: Levenson Robert , DeMartini Daniel G. , Morse Daniel E.
Published: August 2017

Discovery that reflectin proteins fill the dynamically tunable Bragg lamellae in the reflective skin cells of certain squids has prompted efforts to design new reflectin-inspired systems for dynamic photonics. But new insights into the actual role and mechanism of action of the reflectins constrain and better define the opportunities and limitations for rationally designing optical systems with reflectin-based components. We and our colleagues have discovered that the reflectins function as a signal-controlled molecular machine, regulating an osmotic motor that tunes the thickness, spacing, and refractive index of the tunable, membrane-bound Bragg lamellae in the iridocytes of the loliginid squids. The tunable reflectin proteins, characterized by a variable number of highly conserved peptide domains interspersed with positively charged linker segments, are restricted in intra- and inter-chain contacts by Coulombic repulsion. Physiologically, this inhibition is progressively overcome by charge-neutralization resulting from acetylcholine (neurotransmitter)-induced, site-specific phosphorylation, triggering the simultaneous activation and progressive tuning of reflectance from red to blue. Details of this process have been resolved through in vitro analyses of purified recombinant reflectins, controlling charge-neutralization by pH-titration or mutation as surrogates for the in vivo phosphorylation. Results of these analyses have shown that neutralization overcoming the Coulombic inhibition reversibly and cyclably triggers condensation and secondary folding of the reflectins, with the emergence of previously cryptic, phase-segregated hydrophobic domains enabling hierarchical assembly. This tunable, reversible, and cyclable assembly regulates the Gibbs-Donnan mediated osmotic shrinking or swelling of the Bragg lamellae that tunes the brightness and color of reflected light. Our most recent studies have revealed a direct relationship between the extent of charge neutralization and the size of the reflectin assemblies, further explaining the synergistic effects on the intensity and wavelength of reflected light. Mutational analyses show that the “switch” controlling reflectins’ structural transitions is distributed along the protein, while detailed comparisons of the sequences and structures of the recently evolved tunable reflectins to those of their ancestral, non-tunable homologs are helping to identify the specific structural determinants governing tunability.
Van der Waals epitaxy of topological insulator Bi2Se3 on single layer transition metal dichalcogenide MoS2
Authors: Chen K. H. M. , Lin H. Y. , Yang S. R. , Cheng C. K. , Zhang X. Q. , Cheng C. M. , Lee S. F. , Hsu C. H. , Lee Y. H. , Hong M. , Kwo J.
Published: August 2017

We report the growth of high quality topological insulator Bi2Se3 thin films on a single layer, transitional metal dichalcogenide MoS2 film via van der Waals epitaxy in a planar geometry. In stark contrast to the reported growth of using 3-D crystalline substrates such as Al2O3(0001), Bi2Se3 thin films grown on a 2-D template made of single layer MoS2 showed excellent crystallinity starting immediately from the growth of the first quintuple layer. Excellent crystallinity of Bi2Se3 thin films is attained, with the increased size of the triangular shaped Bi2Se3 domains and 2–3 times enhancement in mobility, along with the observation of Shubnikov–de Haas oscillations in the magnetoresistance. Our approach of adopting a van der Waals type template may be extended to the thin film growth of other low dimensional layered materials.
Fe implantation effect in the 6H-SiC semiconductor investigated by Mössbauer spectrometry
Authors: Diallo M. L. , Diallo L. , Fnidiki A. , Lechevallier L. , Cuvilly F. , Blum I. , Viret M. , Marteau M. , Eyidi D. , Juraszek J. , Declémy A.
Published: August 2017

P-doped 6H-SiC substrates were implanted with 57Fe ions at 380 °C or 550 °C to produce a diluted magnetic semiconductor with an Fe homogeneous concentration of about 100 nm thickness. The magnetic properties were studied with 57Fe Conversion Electron Mössbauer Spectrometry at room temperature (RT). Results obtained by this technique on annealed samples prove that ferromagnetism in 57Fe-implanted SiC for Fe concentrations close to 2% and 4% is mostly due to Fe atoms diluted in the matrix. In contrast, for Fe concentrations close to 6%, it also comes from Fe in magnetic phase nano-clusters. This study allows quantifying the Fe amount in the interstitial and substitutional sites and the nanoparticles and shows that the majority of the diluted Fe atoms are substituted on Si sites inducing ferromagnetism up to RT.
Bandgap and composition of bulk InAsSbBi grown by molecular beam epitaxy
Authors: Webster Preston T. , Shalindar Arvind J. , Schaefer Stephen T. , Johnson Shane R.
Published: August 2017

The structural and optical properties of pseudomorphic InAsSbBi grown on GaSb are examined using reflection high-energy electron diffraction, X-ray diffraction, Rutherford backscattering spectrometry, and spectroscopic ellipsometry. The layer studied is 210 nm thick and was grown by molecular beam epitaxy at 280 °C under a (2 × 3) surface reconstruction using near-stoichiometric fluxes. The material is homogeneous and single crystal with no observable defects or surface Bi droplets. The group-V mole fractions are determined using Rutherford backscattering measurements of the Bi mole fraction and X-ray diffraction measurements of the lattice tetragonal distortion. The bandgap energy is determined from the room temperature optical constants measured using spectroscopic ellipsometry. These and measurements from pseudomorphic InAsSb and InAsBi on GaSb are utilized to describe the bandgap energy of InAsSbBi as a function of mole fraction using a bandgap bowing model.
New model for building-integrated semitransparent photovoltaic thermal system
Authors: Gupta Neha , Tiwari G. N. , Tiwari Arvind , Gupta V. S.
Published: August 2017

A new model has been developed in this paper to evaluate the impact of different photovoltaic modules on room, floor, and solar cell temperature, along with daylight savings and solar cell electrical efficiency. Computations have been carried out on a building-integrated semitransparent photovoltaic thermal system integrated with the roof of a room for Varanasi climatic conditions in winter months. The electrical efficiency of the module and temperature coefficient impact the system's performance significantly. Mono-Si, poly-Si, amorphous Si, and Photovoltaic Thermal (PVT) systems are discussed. Compared with the previous model, the results of the study indicate that there is a 4.39% decrease in the overall exergy efficiency; hence, the PVT system is recommended for energy efficiency, and m-Si is suitable for electrical exergy.
Effects of model error on cardiac electrical wave state reconstruction using data assimilation
Authors: LaVigne Nicholas S. , Holt Nathan , Hoffman Matthew J. , Cherry Elizabeth M.
Published: August 2017

Reentrant electrical scroll waves have been shown to underlie many cardiac arrhythmias, but the inability to observe locations away from the heart surfaces and the restriction of observations to only one or two state variables have made understanding arrhythmia mechanisms challenging. Recently, we showed that data assimilation from spatiotemporally sparse surrogate observations could be used to reconstruct a reliable time series of state estimates of reentrant cardiac electrical waves including unobserved variables in one and three spatial dimensions. However, real cardiac tissue is unlikely to be described accurately by mathematical models because of errors in model formulation and parameterization as well as intrinsic but poorly described spatial heterogeneity of electrophysiological properties in the heart. Here, we extend our previous work to assess how model error affects the accuracy of cardiac state estimates achieved using data assimilation with the Local Ensemble Transform Kalman Filter. We focus on one-dimensional states of discordant alternans characterized by significant wavelength oscillations. We demonstrate that data assimilation can provide high-quality estimates under a wide range of model error conditions, ranging from varying one or more parameter values to using an entirely different model to generate the truth state. We illustrate how multiplicative and additive inflation can be used to reduce error in the state estimates. Even when the truth state contains underlying spatial heterogeneity, we show that using a homogeneous model in the data assimilation algorithm can achieve good results. Overall, we find data assimilation to be a robust approach for reconstructing complex cardiac electrical states corresponding to arrhythmias even in the presence of model error.