bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual Dysfunction and Intimacy for Ostomates
Authors: Tenfelde Sandi , Hayden Dana , Albaugh Jeffrey
Published: May 2017

Sex and intimacy presents special challenges for the ostomate. Since some colorectal surgery patients will require either temporary or permanent stomas, intimacy and sexuality is a common issue for ostomates. In addition to the stoma, nerve damage, radiotherapy, and chemotherapy are often used in conjunction with stoma creation for cancer patients, thereby adding physiological dysfunction to the personal psychological impact of the stoma, leading to sexual dysfunction. The purpose of this paper is to describe the prevalence, etiology, and the most common types of sexual dysfunction in men and women after colorectal surgery and particularly those patients with stomas. In addition, treatment strategies for sexual dysfunction will also be described.
Use of Bowel in Reconstructive Urology: What a Colorectal Surgeon Should Know
Authors: Morrison Christopher , Kielb Stephanie
Published: May 2017

Urologists routinely use bowel in the reconstruction of the urinary tract. With an increasing prevalence of urinary diversions, it is important for surgeons to have a basic understanding of varied use and configuration of bowel segments in urinary tract reconstruction that may be encountered during abdominal surgery. The aim of this review article is to provide an overview of the various reconstructive urological surgeries requiring bowel and to guide physicians on how to manage these patients with urinary diversions.
General Care of the Pregnant Patient in the Intensive Care Unit
Authors: Crozier Timothy
Published: May 2017

Pregnant women represent a small subset of all intensive care unit (ICU) admissions and may require intensive care for “obstetric” or “nonobstetric” reasons. Women may be admitted to the ICU at any stage of pregnancy or in the postpartum period. Pregnancy may be discovered at the time of admission to the ICU. Pregnancy impacts on ICU care in a variety of ways and requires a multidisciplinary approach to management. Pregnancy is associated with considerable physiological changes that affect most organ systems, including an expansion in blood volume, an increase in minute ventilation, and an increased risk of thrombosis. The enlarging uterus may be associated with mechanical complications due to compression and displacement of other structures. The growing fetus places considerable demands upon the mother, being reliant on maternal systems for oxygenation, nutrition and disposal of carbon dioxide, and other waste products. This “second patient” must be considered when managing the pregnant woman. Optimal management of the mother usually constitutes best treatment for the fetus. Maternal shock and physiological disturbance, medications, and ionizing radiation from diagnostic imaging may have harmful effects on the unborn child. Delivery of the fetus for either maternal or fetal indications may be necessary and should be planned for, even if considered unlikely to be required. Care of the postpartum woman has its own challenges, including managing lactation and facilitating mother/infant contact. In this article, the general care aspects of ICU treatment of the pregnant woman will be discussed, including monitoring, physiological target setting, and general supportive care.
Asthma during Pregnancy: Exacerbations, Management, and Health Outcomes for Mother and Infant
Authors: Jensen Megan , Gibson Peter , Murphy Vanessa
Published: May 2017

One in 10 pregnant women worldwide has asthma and of these, 10% will have a severe exacerbation requiring oral corticosteroids (OCSs) in pregnancy. This review of recent publications in the field will describe the effects of exacerbation on maternal and neonatal health, the use of asthma medications during pregnancy, and will suggest novel management approaches for asthma in pregnancy. Pregnancy results in unpredictable changes in the disease; therefore, regular monitoring of symptoms is recommended. Uncontrolled asthma is frequently described in cohorts of pregnant women with asthma, and some recent studies show associations with adverse perinatal outcomes, as previously demonstrated with exacerbations. Guidelines for the management of asthma recommend the continued use of inhaled corticosteroids (ICSs) in pregnancy, with budesonide having a particularly good safety profile. Recent data suggest small effects of asthma and/or asthma medication use on congenital malformations; however, there is less data available on the safety of ICS/long-acting β agonist combinations, which are increasingly used for maintenance treatment. Novel management strategies are needed to address the complex needs of pregnant women with asthma. These include medication nonadherence and the presence of numerous comorbidities which can affect asthma, such as rhinitis, cigarette smoking, obesity, and mental health issues. Inflammation-based management has been shown to be effective in reducing exacerbations in pregnancy and may also improve perinatal outcomes. The involvement of a multidisciplinary team and the assessment of comorbidities have potential to improve the health of mothers and their offspring.
General Management Principles of the Pregnant Woman
Authors: Miller Margaret , Kaur Amanpreet
Published: May 2017

Pregnancy is a dynamic process that consists of profound physiological changes mediated by hormonal, mechanical, and circulatory pathways. Understanding of changes in physiology is essential for distinguishing abnormal and normal signs and symptoms in a pregnant patient. These physiological changes also have important pharmacotherapeutic considerations for a pregnant patient. Although there are limited data to guide decisions regarding medications and diagnostic procedures in pregnancy, a careful review of risks should be balanced with review of risk of withholding a medication or procedure. Interventional pulmonary procedures can be safely performed in pregnant women while keeping in mind the maternal anatomic and physiologic changes. Furthermore, management of a maternal cardiopulmonary arrest requires important modifications in patient positioning and intravenous access to ensure adequate efficacy of chest compressions, circulation, and airway management. This review will provide an overview of maternal physiologic changes with a focus on cardiopulmonary physiology, pharmacotherapeutic considerations, diagnostic and interventional pulmonary procedures during pregnancy, and cardiopulmonary resuscitation in pregnancy.
Predictors of Maternal Mortality and Prognostic Models in Obstetric Patients
Authors: Miranda Jezid , Rojas-Suarez Jose , Levinson Andrew
Published: May 2017

The use of predictive models has been proposed as a potential tool to reduce maternal morbidity and mortality, by aiding in the timely identification of potential high-risk patients. Prognostic models in critical care have been used to characterize the severity of illness of specific diseases. Physiological changes in pregnancy may result in general critical illness prediction models overestimating mortality in obstetric patients. Models that specifically reflect the unique characteristics of obstetric patients may have better prognostic value. Recently developed tools have focused on identifying at-risk patients before they require intensive care unit (ICU) admission to target early interventions and prevent acute clinical decompensation. The aim of the newest scoring systems, specifically designed for groups of obstetric patients receiving non-ICU care, is to reduce maternal morbidity and mortality by identifying early high-risk patients and initiating prompt effective medical responses.
Pulmonary Infections in Pregnancy
Authors: Gupta Amita , Mathad Jyoti
Published: May 2017

Pregnant women experience physiological and immunological changes that increase the risk or severity of certain pulmonary infections. These changes also affect drug disposition, which impacts treatment choices. In this article, we review the available data on (1) the physiological and immunological changes that specifically impact tuberculosis, influenza, and varicella pneumonia; (2) active and latent tuberculosis management, including drug monitoring and maternal–infant outcomes; (3) the treatment and prevention of influenza; and (4) the diagnosis and management of varicella pneumonia. Clinical trials often exclude pregnant women, but there is a consensus that treating pregnant women for tuberculosis, influenza, and varicella pneumonia improves outcomes for both the woman and her child.
High Varus Angle and Lower Posterior Tibial Slope Associated with PCL Injury in Cruciate Retaining Total Knee Arthroplasty: An MRI Study
Authors: İmren Yunus , Tekin Ali , Dedeoğlu Süleyman , Gürbüz Hakan , Çabuk Haluk
Published: May 2017

The posterior tibial slope (PTS) is important for performing a tibial cut that does not injure the posterior cruciate ligament (PCL). In this study, the amount of PCL fibers sacrificed under simulated tibial cuts with varying posterior inclinations was evaluated using magnetic resonance images (MRIs) of osteoarthritic varus knees. Knee X-rays, orthoroentgenograms, and MRIs of 113 Kellgren and Lawrence grades 3 to 4 osteoarthritic knees were included. Four different simulated tibial cuts were performed at 0, 3, 5 degrees and parallel to the tibia plateau 3 mm below of the most defective part of the cartilage in the medial plateau. Correlations between the PCL avulsion amount and the PTS and varus alignment of the lower extremity were analyzed for all four simulated tibial cut levels. The maximum amount of PCL was preserved with a 0-degree tibial cut in patients with a PTS of more than 8 degrees. With increased tibial cut angles, the posterior slope resulted in an increased amount of avulsed PCL. Although the amount of avulsed PCL was proportional with the varus alignment, it was inversely proportional with the sagittal slope. The number of injured PCLs also increased as the slope of the tibial cuts increased. Patients with mild varus alignments and high PTSs are more suitable for cruciate retaining total knee arthroplasty.
Platelet-Rich Fibrin Conduits as an Alternative to Nerve Autografts for Peripheral Nerve Repair
Authors: Fernandes Marcela , Valente Sandra , Santos João , Furukawa Rebeca , Fernandes Carlos , Leite Vilnei , Faloppa Flávio , Roth Felipe
Published: May 2017

Background Peripheral nerves have limited regeneration capacity despite best efforts. Platelet-rich fibrin (PRF) contains growth factors that may stimulate peripheral nerve regeneration. This study verified whether nerve regeneration using autogenous vein conduits filled with PRF is comparable to autologous nerve graft, which is the standard treatment.

Methods The sciatic nerve of the right paw of inbred rats was dissected, and a 10-mm segment was removed from rats randomized to receive autologous nerve graft (GRAFT) or vein conduit filled with PRF (PRF). A third group (SHAM) underwent surgery without nerve resection. The sciatic functional index (SFI) was measured 0, 30, 60, and 90 days postsurgery. Morphometry and morphology of the distal nerve injury were examined. Motor neurons in the anterior horn of spinal cord stained with FluoroGold and counted.

Results No significant difference in SFI was observed between the GRAFT and PRF groups at any time point (all p > 0.05); however, SFI was lower in both groups compared with SHAM (p < 0.05). Morphometric and morphologic indexes were not significantly different between the GRAFT and PRF groups (p > 0.05); however, nerve fibers, axons, and myelin sheaths were thinner in both groups compared with SHAM (p = 0.0001). Average motor neurons' count was similar between the GRAFT and PRF groups (p = 0.91); the count was lower in both groups compared with SHAM (p = 0.002 and p = 0.001), respectively.

Conclusion Autologous nerve GRAFT and PRF-filled autogenous vein conduits were associated with similar outcomes, and worse than those observed in SHAM controls. Vein conduits filled with PRF may be a favorable alternative treatment to nerve grafts.
Lipoprotein Heterogeneity Early in Pregnancy and Preterm Birth
Authors: Mackey Rachel , Scifres Christina , Bertolet Marnie , Simhan Hyagriv , Catov Janet
Published: May 2017

Background The concentration and size of lipoprotein particles are associated with race, inflammation, and disease. When triglycerides are high, as in pregnancy, lipoprotein particle size may have physiologic importance beyond conventional lipid measurements. We considered that lipoprotein particles may be related to preterm birth (PTB) and explored race differences.

Materials and Methods Samples were collected at 9 weeks' gestation (22 PTB [< 37 weeks]; 42 term births [≥ 37 weeks]). Lipids were assayed using standard techniques. Concentrations of high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein particles (HDL-P, LDL-P, and VLDL-P, respectively) and markers of systemic inflammation were quantified using nuclear magnetic resonance spectroscopy and related to PTB.

Results Women with PTB had lower VLDL-P (− 10.66 nmol/L, p = 0.03) and higher systemic inflammation (+ 19.2 µmol/L, p = 0.02) compared with women with term births, independent of race, pre-pregnancy body mass index, and smoking. Black versus white women had lower VLDL-P and higher HDL cholesterol (both p < 0.05). Race-specific results indicated that large HDL-P and inflammation (glycoprotein B) were higher with PTB versus term birth among black women only.

Conclusion Women with PTB had lower VLDL-P early in pregnancy, which may represent impaired lipid response. Black–white differences in the lipoprotein profile are similar to nonpregnant adults, but race-specific lipoprotein and inflammation associations with PTB warrant further study.
Epileptic Seizures Associated with Chromosomal Abnormalities Detected by Array Comparative Genomic Hybridization in Five Albanian Children
Authors: Babameto-Laku Anila , Grabova Serla , Kruja Jera , Vyshka Gentian
Published: May 2017

Epilepsy is an ever-changing field of research, with genetics and genomics playing a very important role in recent times. Novel technologies detecting chromosomal aberrations are applied widely, and array-based comparative genomic hybridization (array CGH) has become a basic diagnostic tool in a variety of neurologic and neuropsychiatric conditions. The authors describe five Albanian children suffering from epilepsy and screened for genetic problems using array CGH and other methods. A thorough neurological examination and imaging studies were performed for all patients, who in addition to seizures, suffered from diverse medical conditions such as microcephaly, developmental delay, intellectual disability, dysmorphic features, heart anomalies, cryptorchidism, and other clinical stigmata of an aberrant neurodevelopment. It is evident from our case reports that the array CGH as a diagnostic tool in molecular genetics has facilitated the recognition of microdeletions and microduplications as risk factors for both generalized and focal epilepsies. This method, therefore, clearly has a practical and scientific value in the investigation of children with epilepsy and associated intellectual disability and congenital anomalies.
Failed Vacuum and the Long-Term Neurological Impact on the Offspring
Authors: Wainstock Tamar , Sheiner Eyal , Landau Daniella , Sergienko Ruslan , Walfisch Asnat , Mastrolia Salvatore
Published: May 2017

Objective The objective of this study was to investigate the association between failed vacuum procedures and long-term pediatric neurological morbidity of the offspring (up to the age of 18 years).

Study Design We performed a population-based cohort study to assess the risk of long-term neurological morbidity, including children who were born following either a successful operative vaginal delivery or a failed procedure leading to an emergency cesarean delivery.

Results A total of 7,978 neonates underwent operative vaginal delivery during the study period, meeting the inclusion criteria. The procedure resulted in a successful vaginal delivery in 7,733 (96.9%) cases, while it failed in 245 (3.1%). Total neurological morbidity was comparable between the study groups (3.0 vs. 3.3%, p = 0.8). The Kaplan–Meier survival curve exhibited no difference in the cumulative incidence of total neurological morbidity (log rank, p = 0.967). In the Cox's regression model, a failed vacuum delivery was not associated with an increased long-term neurological morbidity, as compared with a successful procedure, after adjusting for confounders (adjusted hazard ratio: 1.04, 95% confidence interval: 0.5–2.1, p = 0.922).

Conclusion A failed vacuum delivery does not appear to be associated with an increased risk for neurological morbidity of the offspring studied up to 18 years following the event.
Evolutionary Triangulation to Refine Genetic Association Studies of Spontaneous Preterm Birth
Authors: Huang Minjun , Muglia Louis , Williams Scott , Manuck Tracy
Published: May 2017

Objective The objective of this study was to apply evolutionary triangulation, a novel technique exploiting evolutionary differentiation among three populations with variable disease prevalence, to spontaneous preterm birth (PTB) genetic association studies.

Study Design Single nucleotide polymorphism (SNP) allele frequency data were obtained from HapMap for CEU, GIH/MEX, and YRI/ASW populations. Evolutionary triangulation SNPs, then genes, were selected according to the overlaps of genetic population differences (CEU = outlier). Evolutionary triangulation genes were then compared with three PTB gene lists: (1) top maternal and fetal genes from a large genome-wide association study of PTB, (2) 640 genes from the database for PTB, and (3) 118 genes from a recent systematic review. Empirical p-values were calculated to determine whether evolutionary triangulation enriched for putative PTB associating genes compared with randomly selected sample genes.

Results Evolutionary triangulation identified 5/17 maternal genes and 8/16 fetal genes from PTB gene list 1. From list 2, 79/640 were identified by CEU_GIH_YRI evolutionary triangulation, and 57/640 were identified by CEU_ASW_MEX evolutionary triangulation. Finally, 20/118 genes were identified by evolutionary triangulation from gene list 3. For all analyses, p < 0.001 except CEU_ASW_MEX analysis of list 3 where p = 0.002.

Conclusion Genes identified in prior PTB association studies confirmed by evolutionary triangulation should be prioritized for further genetic prematurity research.
Feeding Jejunostomy: Is It a Safe Route in Pediatric Patients? Single Institution Experience
Authors: El Agami Hisham , Gobbi Dalia , Clarke Simon , Haddad Munther , Choudhry Muhammad , Fascetti-Leon Francesco
Published: May 2017

Introduction Impossibility to place a gastrostomy and failed gastroesophageal reflux surgery with unsafe swallow are the main indications to Feeding Jejunostomy (FJ) in children. The aim of this study is to quantify the incidence of complications associated with FJ.

Materials and Methods A retrospective review of patients who had surgically inserted FJ between January 2009 and August 2013 at our institution was conducted. Data were obtained from medical records, operative notes, and radiology database, focusing on complications.

Results A total of 19 patients, average age 39.6 months (3–168 months), were treated during the study period. Indications to FJ were gastroesophageal reflux disease (GERD) associated with unsafe swallow in 12, esophageal atresia in 5, and foregut dysmotility in 2. Seventeen FJ were inserted via laparotomy and 2 were laparoscopically assisted. In all cases, a serosal tunnel on the antimesenteric border was fashioned. No intraoperative complications were recorded. Tube dislodgement/blockage occurred on an average of 0.48 times per month in 18 out of 19 patients. The average radiation dose received for tube reinsertion/manipulation was 3.316 mSv/year/patient (0–10.66). Major postoperative complications occurred in 7 out of 19. After an average follow-up of 21 months, two have abandoned the use of FJ due to poor tolerance and three have fully weaned off. Two patients died due to unrelated causes.

Conclusion FJ, as an alternative means for enteral feeding, may require multiple readmissions and exposure to radiological procedures. The high risk of severe complications should be considered when offering this procedure.
Frühdiagnose der Chorea-Akanthozytose: orofaziale Dyskinesien, epileptische Anfälle und HyperCKämie
Authors: Schneider Christian , Danek Adrian , Hostmann Arwed , Fink Gereon , Burghaus Lothar
Published: May 2017

Die Chorea-Akanthozytose ist eine seltene neurodegenerative Erkrankung, deren Diagnose in der Frühphase eine klinische Herausforderung darstellt. Bei Auftreten der Trias orofaziale Dyskinesien, epileptische Anfälle und HyperCKämie sollte frühzeitig der Verdacht auf ein Neuroakanthozytose-Syndrom gestellt werden. Nach Ausschluss von Differenzialdiagnosen wird die Diagnose durch Nachweis einer Chorein-Defizienz oder molekulargenetisch (VPS13A-Mutation) gesichert.
Alter(n) und Depression
Authors: Gürtler Klaus
Published: May 2017

Resilienz Depressionen gehören neben demenziellen Erkrankungen zu den
häufigsten psychischen Erkrankungen im höheren Lebensalter. Unser Autor erklärt
die biologischen, psychologischen, existenziellen und sozialen Faktoren, die zu
einer Altersdepression führen können und wie man sie mildern kann. Seine Maxime
für die Behandlung lautet: Hoffnung einflößen.
Kasuistik: ECMO-Einsatz bei hyperkapnischer Hirndruckkrise
Authors: Unterberg Matthias , Nowak Hartmuth , Gottschalk André
Published: May 2017

Unter der Geburt trübte sich bei einer 29-jährigen Patientin die Vigilanz progredient bis zum Koma. Grund war eine schwere Hirnblutung als Komplikation eines bis dahin nicht erkennbaren HELLP-Syndroms. Nach der zerebralen OP entwickelte die Patientin aggravierend ein schweres ARDS mit Hyperkapnie und kritischem Anstieg des intrakraniellen Druckes. Trotz Kontraindikation war eine ECMO-Therapie für insgesamt 31 Tage letztlich erfolgreich.
Aktivierende Pflege und Physiotherapie bei Menschen mit
Demenz
Authors: Morgenstern Ulrike
Published: May 2017

Brain-Gym®-Konzept Der Aufbau von Handlungskompetenz bei Pflegenden und
Physiotherapeuten im Hinblick auf die Anwendung alternativer Interventionen ist
ein zentraler Schlüssel, um die Situation von dementen Patienten insbesondere in
der klinischen Versorgung zu verbessern. Eine passende Intervention könnte die
„Aktivierende Pflege und Physiotherapie“ auf der Grundlage des
Brain-Gym®-Konzepts sein. Hierdurch besteht die Möglichkeit, Patienten mit einer
geringen psychischen und physischen Belastbarkeit zu aktivieren. Wir stellen
Ihnen das Konzept vor.
Das will ich, das bin ich!
Authors: Holtbernd Thomas
Published: May 2017

Herzensangelegenheiten Manche Vorhaben sind wichtig und andere
bedeutungslos. Und es gibt Anliegen, die jemandem am Herzen liegen. Die
Formulierung weist darauf hin, dass eine solche Angelegenheit kein Ziel wie etwa
bei einem Zielvereinbarungsgespräch ist, sondern den ganzen Menschen betrifft
und über aktuelle Bestrebungen oder rein berufliche Wünsche hinausgeht. Das Ziel
ist ethisch aufgewertet, weil es mit Herzblut angestrebt wird, weil der Mensch
sich dafür verausgabt, weil seine Identität aufs Engste mit diesem Vorhaben
verbunden ist.
Phänomene aus der Praxis
Authors: Dißmann Steffen
Published: May 2017

Lerninhalte der Kinder- und Jugendpsychiatrie Welche Phänomene,
Tätigkeiten und Belastungen lassen sich aus der Sicht von Auszubildenden und
examinierten Pflegekräften für den Bereich der Kinder- und Jugendpsychiatrie
identifizieren und zu Lerninhalten transformieren? Welche Erwartungen haben
Auszubildende und Pflegende bezogen auf die methodische Umsetzung des Themas
„psychisch kranke Menschen pflegen“? Zur Beantwortung dieser Fragen führte unser
Autor im Rahmen seiner Bachelorarbeit Interviews und leitet daraus
psychiatrierelevante Lerninhalte für die Ausbildung ab.
Akutschmerztherapie bei Appendektomie
Authors: Freys Stephan
Published: May 2017

Schmerztherapie spielt in der Chirurgie eine zentrale Rolle. Eine strukturierte Akutschmerztherapie verbessert unmittelbar die Lebensqualität, senkt mittelfristig die Morbidität und verhindert langfristig eine Schmerzchronifizierung – bei deutlichen ökonomischen Vorteilen wie reduzierter Krankenhausverweildauer und kürzerem Krankenstand. Diese 4 Aspekte werden oft und gerade bei scheinbar „kleinen Operationen“ stiefmütterlich behandelt.
Psychoedukationsmodul Rückkehr an den Arbeitsplatz – Eine Interventionsstudie
Authors: Hölzle Patricia , Baumbach Anna , Mernyi Lena , Hamann Johannes
Published: May 2017

Ziel der Studie Im Mittelpunkt der vorliegenden Studie stand die Frage, inwieweit Patienten von einem Psychoedukationsmodul zum Thema Rückkehr an den Arbeitsplatz profitieren können.

Methoden Durch eine randomisiert-kontrollierte Studie (n = 82) wurden die Effekte auf die Einstellungen zum Arbeitsplatz, Wissen zu rechtlichen Aspekten bei der Rückkehr und Dauer bis zur Rückkehr evaluiert.

Ergebnisse Die Psychoedukationsgruppe erhöhte die Sicherheit bei der Rückkehr, allerdings nicht die Dauer bis zum Wiedereinstieg.

Schlussfolgerung Das Psychoedukationsmodul wurde sehr gut angenommen und stellt offenbar eine gute Ergänzung zur sozialpädagogischen Einzelberatung dar.
Lithiumtherapie bei eingeschränkter Nierenfunktion: Zwischen Skylla und Charybdis
Authors: Dehning Julia , Grunze Heinz , Born Christoph , Hausmann Armand
Published: May 2017

Einleitung Bei vielen Patienten mit bipolaren Störungen gibt es keine gleichwertige Alternative zur Lithiumtherapie, auch
bei eingeschränkter Nierenfunktion. Lässt sich eine Lithiumtherapie trotz eingeschränkter Nierenfunktion durch Veränderung der
Dosierung und/oder Einnahmehäufigkeit fortführen?

Kasuistik Wir berichten über eine an Bipolar-I-Störung leidende 65-jährige Patientin, die über viele Jahre Lithium als
Phasenprophylaktikum erhielt. Unter dieser Therapie reduzierte sich die glomeruläre Filtrationsrate (GFR) als Ausdruck der
Nierenfunktion bis zu Werten unter 60 mL/min/1,73 m2. Es stellte sich die Frage nach einer nierenschonenden
Weiterführung oder des Ausschleichens der Lithium-Therapie.

Schlussfolgerung Die abendliche Einzelgabe mit 25%-iger Dosisreduktion senkte den Lithium-Serumspiegel nicht. Erst eine
Dosisreduktion um 50%, die mit einer Erniedrigung des Lithiumserumspiegels einherging, konnte die reduzierte GFR wieder anheben.
Eine nierenschonende Lithiumtherapie bei Patienten mit reduzierter Nierenfunktion bewegt sich zwischen „Skylla und Charybdis“.
Neue Daten zur Device-Therapie
Authors: Brachmann Johannes
Published: May 2017

Der interventionelle Vorhofohrverschluss ist eine leitliniengerechte Therapiemöglichkeit für Patienten mit nicht valvulärem Vorhofflimmern, die nicht mit einer Langzeitantikoagulation behandelt werden können.

Implantierbare Loop-Rekorder können bei Verdacht auf kardiale Arrhythmien und bei Hochrisikopatienten ohne klare Ursache für eine Synkope bis zu 3 Jahre den Herzrhythmus beobachten, pathologische Ereignisse erkennen und abspeichern.

Dieser Artikel fasst für beide Verfahren die wichtigsten Fakten zusammen: Indikationen, Durchführung und verfügbare Geräte. Anhand der aktuellen Studiendaten zum interventionellen Vorhofohrverschluss und zum Einsatz von Event-Rekordern werden die derzeitigen Erfahrungen mit den beiden Verfahren dargestellt.
The Foxgloves (Digitalis) Revisited
Authors: Kreis Wolfgang
Published: May 2017

This review provides a renewed look at the genus Digitalis. Emphasis will be put on those issues that attracted the most attention or even went through paradigmatic changes since the turn of the millennium. PubMed and Google Scholar were used (“Digitalis” and “Foxglove” were the key words) to identify research from 2000 till 2017 containing data relevant enough to be presented here. Intriguing new results emerged from studies related to the phylogeny and taxonomy of the genus as well as to the biosynthesis and potential medicinal uses of the key active compounds, the cardiac glycosides. Several Eastern and Western Foxgloves were studied with respect to their propagation in vitro. In this context, molecular biology tools were applied and phytochemical analyses were conducted. Structure elucidation and analytical methods, which have experienced less exciting progress, will not be considered here in great detail.
Simplification rules for birdtrack operators
Authors: Alcock-Zeilinger J. , Weigert H.
Published: May 2017

This paper derives a set of easy-to-use tools designed to simplify calculations with birdtrack operators comprised of symmetrizers and antisymmetrizers. In particular, we present cancellation rules allowing one to shorten the birdtrack expressions of operators and propagation rules identifying the circumstances under which it is possible to propagate symmetrizers past antisymmetrizers and vice versa. We exhibit the power of these simplification rules by means of a short example in which we apply the tools derived in this paper on a typical operator that can be encountered in the representation theory of 𝖲𝖴(N) over the product space V⊗m. These rules form the basis for the construction of compact Hermitian Young projection operators and their transition operators addressed in companion papers [J. Alcock-Zeilinger and H. Weigert, “Compact Hermitian Young projection operators,” e-print arXiv:1610.10088 [math-ph] and J. Alcock-Zeilinger and H. Weigert, “Transition operators,” e-print arXiv:1610.08802 [math-ph]].
Compact Hermitian Young projection operators
Authors: Alcock-Zeilinger J. , Weigert H.
Published: May 2017

In this paper, we describe a compact and practical algorithm to construct Hermitian Young projection operators for irreducible representations of the special unitary group 𝖲𝖴(N) and discuss why ordinary non-Hermitian Young projection operators are unsuitable for physics applications. The proof of this construction algorithm uses the iterative method described by Keppeler and Sjödahl [J. Math. Phys. 55, 021702 (2014)]. We further show that Hermitian Young projection operators share desirable properties with Young tableaux, namely, a nested hierarchy when “adding a particle.” We close by exhibiting the enormous advantage of the Hermitian Young projection operators constructed in this paper over those given by Keppeler and Sjödahl.
A high-flux upgrade for the BRISP spectrometer at ILL
Authors: Zanatta M. , Barocchi F. , De Francesco A. , Farhi E. , Formisano F. , Guarini E. , Laloni A. , Orecchini A. , Paciaroni A. , Petrillo C. , Pilgrim W.-C. , Suck J.-B. , Sacchetti F.
Published: May 2017

To date, the BRISP spectrometer represents the state-of-the-art for every instrument aiming to perform Brillouin neutron scattering. Exploiting accurate ray-tracing McStas simulations, we investigate an improved configuration of the BRISP primary spectrometer to provide a higher flux at the sample position, while preserving all the present capabilities of the instrument. This configuration is based on a neutron guide system and is designed to fit the instrument platform with no modifications of the secondary spectrometer. These evaluations show that this setup can achieve a flux gain factor ranging from 3 to 6, depending on the wavelength. This can expand the experimental possibilities of BRISP towards smaller samples, possibly using also complex sample environments.
An open-source platform to study uniaxial stress effects on nanoscale devices
Authors: Signorello G. , Schraff M. , Zellekens P. , Drechsler U. , Bürge M. , Steinauer H. R. , Heller R. , Tschudy M. , Riel H.
Published: May 2017

We present an automatic measurement platform that enables the characterization of nanodevices by electrical transport and optical spectroscopy as a function of the uniaxial stress. We provide insights into and detailed descriptions of the mechanical device, the substrate design and fabrication, and the instrument control software, which is provided under open-source license. The capability of the platform is demonstrated by characterizing the piezo-resistance of an InAs nanowire device using a combination of electrical transport and Raman spectroscopy. The advantages of this measurement platform are highlighted by comparison with state-of-the-art piezo-resistance measurements in InAs nanowires. We envision that the systematic application of this methodology will provide new insights into the physics of nanoscale devices and novel materials for electronics, and thus contribute to the assessment of the potential of strain as a technology booster for nanoscale electronics.
The application of chaotic oscillator in detecting weak resonant signal of MEMS resonator
Authors: Shi Huichao , Li Wenlong
Published: May 2017

In this paper, a detection model of a chaotic oscillator is applied in the weak signal detection of an electrothermal excitation MEMS resonator, and the maximum Lyapunov exponent is used to obtain the threshold value and monitor the motion transition of a detection system. The phase drift caused by the electrothermal excitation is studied theoretically and experimentally, and according to the results of above study, the phase of a reference current signal is set to eliminate the phase when the resonator is in a resonant state. Then a new detection algorithm is proposed to detect the resonant signal. The simulation experiment on a weak signal under different magnifications and different levels of noises is conducted, after the impact of the quality factor Q of a resonator on detection results is analyzed. Finally, experiments on the output signal of a detected sensor sample are carried out by a proposed algorithm. Simulation and experiment results show that the detection model can effectively detect the weak signal and accurately obtain the resonant frequency, and it is immune to the noises.
A novel dual-color bifocal imaging system for single-molecule studies
Authors: Jiang Chang , Kaul Neha , Campbell Jenna , Meyhofer Edgar
Published: May 2017

In this paper, we report the design and implementation of a dual-color bifocal imaging (DBI) system that is capable of acquiring two spectrally distinct, spatially registered images of objects located in either same or two distinct focal planes. We achieve this by separating an image into two channels with distinct chromatic properties and independently focusing both images onto a single CCD camera. The two channels in our device are registered with subpixel accuracy, and long-term stability of the registered images with nanometer-precision was accomplished by reducing the drift of the images to ∼5 nm. We demonstrate the capabilities of our DBI system by imaging biomolecules labeled with spectrally distinct dyes and micro- and nano-sized spheres located in different focal planes.
Practical considerations in the modeling of field emitter arrays with line charge distributions
Authors: Harris J. R. , Jensen K. L. , Petillo J. J. , Maestas S. , Tang W. , Shiffler D. A.
Published: May 2017

Predictive models of field emission remain elusive, in part, due to the sensitivity of this process to emitter surface details at length scales ranging from macroscopic to atomic. Moving towards more fully predictive models requires that we develop techniques to disentangle contributions of features on the largest length scales, which can be easily measured and controlled, from contributions on smaller length scales, which are generally difficult to measure or control. Here, specific challenges are addressed, with an emphasis on comparisons between a Line Charge Model (LCM) and experimental measurements of ungated carbon fiber field emitter arrays. The LCM with appropriate corrections is used to understand the macroscale contributions to field enhancement and emission current for physical emitters, with contributions from the microscale structure isolated using suitable approximations. We will show that excellent agreement can be obtained between the LCM and experiments when the net contributions of the microscale structure are substantially similar across the emitters being used, and when appropriate corrections are introduced to account for the structure on the macroscale which is not already included in the LCM.
Radiative transport equation for the Mittag-Leffler path length distribution
Authors: Liemert André , Kienle Alwin
Published: May 2017

In this paper, we consider the radiative transport equation for infinitely extended scattering media that are characterized by the Mittag-Leffler path length distribution p(ℓ)=−∂ℓEα(−σtℓα), which is a generalization of the usually assumed Lambert-Beer law p(ℓ)=σtexp(−σtℓ). In this context, we derive the infinite-space Green’s function of the underlying fractional transport equation for the spherically symmetric medium as well as for the one-dimensional string. Moreover, simple analytical solutions are presented for the prediction of the radiation field in the single-scattering approximation. The resulting equations are compared with Monte Carlo simulations in the steady-state and time domain showing, within the stochastic nature of the simulations, an excellent agreement.
High-temperature thermal conductivity of thermoelectric clathrates
Authors: Beekman Matt , VanderGraaff Aaron
Published: May 2017

We have carried out an evaluation of the lattice thermal conductivity for 19 different type-I intermetallic clathrate compositions at temperatures near or above their respective Debye temperatures. Although the low temperature data (T < 300 K) show that the thermal transport can vary from glasslike to crystalline depending on the composition, the high temperature lattice thermal conductivity values (T > 300 K) appear to be relatively well described by a simple model that assumes only anharmonic three-phonon scattering processes. The analysis suggests the large number of atoms in the unit cell accompanied by a significant degree of anharmonicity and relatively low Debye temperatures produce low lattice thermal conductivities in these materials above 300 K, regardless of composition or the nature and influence of guest rattling behavior on thermal transport below room temperature. The dominant mechanism underlying the universally low lattice thermal conductivity of type-I intermetallic clathrates (ranging from ∼0.6 to ∼2 W/m K) in the temperature regime of importance for thermoelectric power generation is therefore clarified.
Photoinduced quantum spin/valley Hall effect and its electrical manipulation in silicene
Authors: Bao Hairui , Liao Wenhu , Zhang Xincheng , Yang Hong , Yang Xuexian , Zhao Heping
Published: May 2017

Based on the Kubo linear response theorem, we have investigated theoretically the quantum spin/valley Hall (QS/VH) conductivities and longitudinal conductivity of silicene in the presence of a perpendicular electric field and off-resonant circularly polarized light at the high frequency limit. It has been demonstrated that the electronic structure for silicene can be effectively modulated to be spin degenerate, (Floquet) topologically insulated, valley-spin polarized metallic, and band insulated states by the electric field and/or off-resonant light. Both the spin and valley Hall conductivities of the system for different effective energies induced by the off-resonant light behave a pronounced stepwise structure with the quantized values of (0, ±1, ±2)e2∕h and are symmetry with the back-gate voltage controllable staggered sublattice potential. The step-like quantum spin and valley Hall conductivities should be smoothed with the increase in the temperature. Wherever the system longitudinal conductivity exhibits a pronounced resonance structure corresponding to the jump/fall from a plateau to another in the quantum spin and/or valley Hall conductivities, it is believed that the obtained results are of significance in exploring the new effects and optoelectronic applications of the silicene-based electron devices.
Effects of partial time delays on phase synchronization in Watts-Strogatz small-world neuronal networks
Authors: Sun Xiaojuan , Perc Matjaž , Kurths Jürgen
Published: May 2017

In this paper, we study effects of partial time delays on phase synchronization in Watts-Strogatz small-world neuronal networks. Our focus is on the impact of two parameters, namely the time delay τ and the probability of partial time delay pdelay, whereby the latter determines the probability with which a connection between two neurons is delayed. Our research reveals that partial time delays significantly affect phase synchronization in this system. In particular, partial time delays can either enhance or decrease phase synchronization and induce synchronization transitions with changes in the mean firing rate of neurons, as well as induce switching between synchronized neurons with period-1 firing to synchronized neurons with period-2 firing. Moreover, in comparison to a neuronal network where all connections are delayed, we show that small partial time delay probabilities have especially different influences on phase synchronization of neuronal networks.
Enhanced photoelectric performance of composite nanostructures combining monolayer graphene and a RbAg4I5 film
Authors: Yin Jun , Liu Yu , Zhu Jia-Lin , Dong Zhanmin , Ma Wanyun , Zhang Wei , Sun Jia-Lin
Published: May 2017

In the fields of electronics and optoelectronics, graphene has attracted much attention as a potential alternative material. Using the vapor deposition method, a monolayer graphene-based nanostructure modified by the superionic conductor RbAg4I5 is developed. At a small bias of 0.2 V, it exhibits excellent photoelectric characteristics at selected wavelengths 532 nm, 785 nm, and 808 nm in the spectral region from visible green to near infrared. Taking 532 nm as an example, the responsivity is 1.2 mA W−1 (an improvement of greater than 400 times) and the response time is 15 ms (a decrease of less than one order of magnitude), significantly superior to those of pristine monolayer graphene. Experimental and theoretical studies show that the dissociation and recombination of ion-electron bound states lead to nonlinear photon current with universal behavior in the composite nanostructure. These results pave the way for exploiting high-performance photodetectors based on monolayer graphene and RbAg4I5 film composite nanostructures.
Phase boundary and annealing dependent piezoelectricity in lead-free (K,Na)NbO3 nanorod arrays
Authors: He Yahua , Wang Zhao , Jin Wenchao , Hu Xiaokang , Li Luying , Gao Yihua , Zhang Xianghui , Gu Haoshuang , Wang Xiaolin
Published: May 2017

Orthorhombic (K,Na)NbO3 (KNN) nanorod arrays with the [110]-orientation were grown on SrTiO3 substrates by the hydrothermal method. The nanorods exhibited greatly enhanced piezoelectric performance, with the d33 piezoelectric coefficient increasing from 140 pm/V to 360 pm/V, after annealing in oxygen at temperatures ranging from 500 °C to 800 °C. The high temperature annealing process was accompanied by severe volatilization of K, which modified the K/Na ratio closer to 1:1. Thus, orthorhombic-tetragonal (O-T) phase boundaries appeared, which improved the piezoelectric property. Moreover, surface oxygen vacancies were passivated in the high-temperature oxygen atmosphere, which would reduce the charge density in the nanorods and contribute to the enhanced piezoelectricity. Therefore, excellent piezoelectricity in the KNN nanorod arrays was driven by the combination of the O-T phase boundaries and the oxygen vacancy passivation. This work demonstrates that KNN has great potential in piezoelectric materials area.
Direct characterization of the Li intercalation mechanism into α-V2O5 nanowires using in-situ transmission electron microscopy
Authors: Mukherjee Arijita , Ardakani Hasti Asayesh , Yi Tanghong , Cabana Jordi , Shahbazian-Yassar Reza , Klie Robert F.
Published: May 2017

The Li-V2O5 system has been well studied electrochemically, but there is a lack of systematic in-situ studies involving direct investigations of the structural changes that accompany the lithiation process. The open-cell battery setup inside a transmission electron microscope is ideal for studying the reaction pathway of intercalation of Li+ into nanowire cathodes. In this work, we utilize in-situ transmission electron microscopy to study the Li-V2O5 system. More specifically, we employ electron beam diffraction and electron energy-loss spectroscopy (EELS) in an open-cell battery setup to examine the phase changes within α-V2O5 nanowire cathodes upon in-situ lithiation. Our results suggest that the pristine α-V2O5 nanowire forms a Li oxide shell which then acts as a solid state electrolyte to conduct Li+ ions, and the bulk of the V2O5 nanowire undergoes transformation to the γ−Li2V2O5 phase.
Dispersive readout of a silicon quantum dot with an accumulation-mode gate sensor
Authors: Rossi A. , Zhao R. , Dzurak A. S. , Gonzalez-Zalba M. F.
Published: May 2017

Sensitive charge detection has enabled qubit readout in solid-state systems. Recently, an alternative to the well-established charge detection via on-chip electrometers has emerged, based on in situ gate detectors and radio-frequency dispersive readout techniques. This approach promises to facilitate scalability by removing the need for additional device components devoted to sensing. Here, we perform gate-based dispersive readout of an accumulation-mode silicon quantum dot. We observe that the response of an accumulation-mode gate detector is significantly affected by its bias voltage, particularly if this exceeds the threshold for electron accumulation. We discuss and explain these results in light of the competing capacitive contributions to the dispersive response.
Molecular characterisation and expression profiling of calcineurin B-like (CBL) genes in Chinese cabbage under abiotic stresses
Authors: Jung Hee-Jeong , Kayum Md. Abdul , Thamilarasan Senthil Kumar , Nath Ujjal Kumar , Park Jong-In , Chung Mi-Young , Hur Yoonkang , Nou Ill-Sup
Published: May 2017

Calcium signals act as a second messenger in plant responses to various abiotic stresses, which regulate a range of physiological processes. Calcium-binding proteins, like calcineurin B-like (CBL) proteins, belong to a unique group of calcium sensors that play a role in calcium signalling. However, their identities and functions are unknown in Chinese cabbage. In this study, 17 CBL genes were identified from the Brassica rapa L. (Chinese cabbage) database and Br135K microarray datasets. They were used to construct a phylogenetic tree with known CBL proteins of other species. Analysis of genomic distribution and evolution revealed different gene duplication in Chinese cabbage compared to Arabidopsis. The microarray expression analysis showed differential expression of BrCBL genes at various temperatures. Organ-specific expression was observed by RT–PCR, and qRT–PCR analyses revealed responsiveness of BrCBL genes to cold, drought and salt stresses. Our findings confirm that CBL genes are involved in calcium signalling and regulate responses to environmental stimuli, suggesting this family gene have crucial role to play in plant responses to abiotic stresses. The results facilitate selection of candidate genes for further functional characterisation. In addition, abiotic stress-responsive genes reported in this study might be exploited for marker-aided backcrossing of Chinese cabbage.