bluuebunny/crossref_metadata_2025 huggingface dataset:
Water cycle algorithm‐based optimal control strategy for efficient operation of an autonomous microgrid
Authors: Hasanien Hany M. , Matar Mahmoud
Published: September 2018

This study presents a novel water cycle algorithm (WCA)‐based optimal control strategy with the purpose of obtaining an efficient operation of an autonomous microgrid. The proposed control strategy is based on the proportional–integral (PI) controllers, which are optimally designed by the WCA. The optimisation process depends on the simulation‐based optimisation approach and the criteria of integral squared error are chosen as an objective function. The control scheme is applied to an autonomous, decentralised, operation of a microgrid with multiple electronically interfaced distributed generation units and their local loads. In the islanded mode, the proposed controller is used to control the voltages of the islanded system despite the microgrid load and topological variability and uncertainties. The frequency of the islanded system is dictated through the use of an internal oscillator. The effectiveness of the proposed controller is compared with that obtained using the genetic algorithm‐based PI controller. The validity of the proposed control strategy is extensively checked based on simulation studies in the PSCAD/EMTDC environment under different operating conditions of the microgrid. With the application of the WCA‐based optimal PI control scheme, the microgrid operation can be further enhanced.
Graph theory based topology design and energy routing control of the energy internet
Authors: Guo Hui , Wang Fei , James Geoff , Zhang Lijun , Luo Jian
Published: September 2018

As a core of energy internet, the energy router (ER) controlled by information flows can better realise the large scale utilisation of renewable energy. In order to build a cost‐effective energy internet, a modified minimum spanning tree algorithm is proposed to optimise the cable layout among ERs, i.e. topology design. Considering the real‐time and the asynchrony of power transmission in the above topology determined energy internet, an energy routing control method based on Dijkstra algorithm is put forward for source‐and‐load pairs to find a no‐congestion minimum loss path. Besides, the loss allocation and congestion managements are realised at the same time. Finally, the simulation results prove the feasibility and effectiveness of proposed optimisation algorithms.
Denoising of ultrasound images affected by combined speckle and Gaussian noise
Authors: Mafi Mehdi , Tabarestani Solale , Cabrerizo Mercedes , Barreto Armando , Adjouadi Malek
Published: September 2018

This study introduces an image denoising method in the presence of combined speckle and Gaussian noise. The dual‐tree complex wavelet transform is applied to the image in order to obtain specific coefficients characterising these types of noise. Then, these extracted coefficients are removed by thresholding and an inverse wavelet transform is applied in order to obtain the reconstructed image. A comparison between the dual‐tree and standard wavelet‐based denoising filters is provided on the basis of different structural metrics. Finally, in order to remove any remaining noise, a spatial denoising filter is applied to the image. The results obtained on medical ultrasound images corrupted by this noise combination support the authors’ assertion on the method's resilience to the combined effects of speckle and Gaussian noise, and are compared to well‐known and most effective speckle–Gaussian denoising filters.
Fast single shot multibox detector and its application on vehicle counting system
Authors: Chen Lili , Zhang Zhengdao , Peng Li
Published: September 2018

Real‐time vehicle detection and counting of multiple types is a difficult problem. To solve this problem, this study presents an efficient method based on single shot detection (SSD) to construct a vehicle detection and counting system. The proposed method named Fast‐SSD first combines the Slim ResNet‐34 with Single Shot MultiBox Detector. Then the authors limit the location prediction at each cell in the feature map and modify the detection network. When the input size of the picture is 300 × 300, Fast‐SSD achieves the accuracy of 76.7 mAP on the PASCAL visual object classes 2007 test set. The network can be implemented at the speed of 20.8 FPS based on the GTX650Ti. Furthermore, they obtain the centre point of each type of vehicle which is detected by the Fast‐SSD model in the image and set the virtual loop detectors to specify the detection range. The number of vehicles is calculated when the centre of the vehicle passes the virtual loop detector. Results show that the vehicle detection accuracy achieves 99.3% and the classification accuracy is 98.9%.
Human–machine shared control for vehicle lane keeping systems: a Lyapunov‐based approach
Authors: Sentouh Chouki , Nguyen Anh‐Tu , Rath Jagat Jyoti , Floris Jérôme , Popieul Jean‐Christophe
Published: September 2018

In this work, a human‐centred steering assist controller based on dynamic allocation of control authority between driver and automatic e‐copilot has been proposed for lane keeping systems. Cooperative control between driver and steering assist controller is addressed taking into consideration human driving behaviour. The vehicle steering controller for lane keeping is designed using a driver model for representation of the conflict between the driver and the controller. The steering controller is designed employing the integrated driver‐vehicle model using Takagi–Sugeno control technique coupled with Lyapunov stability tools. The proposed design is robust to longitudinal speed variations and involves a trade‐off between the lane following performance and ratio of negative system interference. The proposed approach was implemented on dynamic vehicle simulator SHERPA and the results presented in this study demonstrate the effectiveness of the proposed structure for cooperative control action between human driver and the steering assistance system. Based on indices such as energies spent by driver, driver satisfaction level and contradiction level between driver and autonomous controller the proposed optimal approach shows 93.48% and 89.30% reductions in expended driver energy and contradiction levels. Further, the satisfaction level of driver increased by 67.80% while performing a lane change manoeuvre.
Multi‐objective optimal cooperative driving for connected and automated vehicles at non‐signalised intersection
Authors: Wang Jinxiang , Zhao Xing , Yin Guodong
Published: September 2018

The problem of cooperative driving for the connected and automated vehicles (CAVs) at the non‐signalised intersection is addressed in this study. The conceptions of conflict point and intersection layout are used to formulate the mathematical model of the non‐signalised intersection. Based on this model, a novel cooperative control algorithm is proposed for the CAVs driving at the non‐signalised intersection. In the cooperative algorithm, the high‐dimensional problem of multi‐CAV cooperating at multi‐conflict points is expediently converted into the single‐dimensional problem of searching the optimal time for current CAV to enter the intersection. Then the analytical solution based on Pontryagin's minimum principle considering constraints of vehicles is used to control the CAVs at the intersection area. In addition, the modification of the switching input is used to reduce the CAVs’ jerk. With the cooperative control algorithm, the multi‐objectives are considered including guaranteeing CAV safety, alleviating traffic congestion, and improving the performance of fuel consumption. In particular, the low‐computational characteristic of the proposed algorithm guarantees that each CAV can get the optimal solution quickly and effectively. Simulation results verify that the proposed algorithm is capable of achieving coordination of CAVs with the various speeds at the non‐signalised intersection.
User‐perceived styling experience of smart vehicles: a method to combine eye tracking with semantic differences
Authors: Lin Li , Guo Gang , Xu Na
Published: September 2018

This study proposes a method to investigate the perceived experiences of the appearances of smart vehicles using a combination of eye‐movement tracking and semantics. The experiences of 89 participants regarding smart vehicle design were explored, targeting users’ perceived experiences of smart vehicles. The semantic results demonstrate that users felt ‘dynamic’, ‘fashionable’ and ‘sophisticated’, while designers felt ‘dependable’, ‘sophisticated’ and ‘dynamic’. Additionally, the eye‐movement data reveals that designers were more attracted to the grille, waistline, and hood, while users are more interested in the rear window. This indicates a clear inconsistency between designers and users in terms of the perceived styling semantics and interest areas for smart vehicles, which helps to provide the industry with valuable insight. This method can be used by smart vehicle researchers and development teams to identify the styling desires of target users in order to accurately convey findings to designers.
Approach to discovering companion patterns based on traffic data stream
Authors: Zhu Meiling , Liu Chen , Han Yanbo
Published: September 2018

A companion of moving objects is an object group that move together in a period of time. Platoon companions are a generalised companion pattern, which describes a group of objects that move together for time segments, each with some minimum consecutive duration of time. This study proposes a method that can instantly discover platoon companions from a special kind of streaming traffic data, called automatic number plate recognition data. Compared to related approaches, the authors transform the companion discovery into a frequent sequence mining problem. The authors propose a data structure, platoon tree (PTree), to record discovered platoon companions. To reduce the cost of tree traversal during mining platoon companions, they utilise the last two together‐moving objects of a group to update PTree. Finally, a lot of experiments have been carried out to show the efficiency and effectiveness of the proposed approach.
Understanding drivers' route choice behaviours in the urban network with machine learning models
Authors: Lai Xinjun , Fu Hui , Li Jun , Sha Zhiren
Published: September 2018

Drivers' route choice model is essential in transportation software such as navigation, fleet management, and simulation, where the random utility models (RUM) have dominated for years. The authors investigate here whether machine learning (ML) models could be applied into this field, and whether these approaches outperform the traditional models in goodness‐of‐fit and prediction. The application framework and data structure are proposed, where the challenging problems lie in: (i) to pool data from multiple origin–destination pairs; and (ii) to interpret results for behaviour analysis. All RUM and ML models are applied in a real network. Results suggest that the random forest, one of the ML models, has satisfying performances with acceptable computation time, making it suitable for large network and real‐time analysis. This study shows that the ML models can be adopted for behaviour analysis, such as to prioritise the importance of variables, compute the elasticity, and forecast for scenarios. Future directions on combining the RUM and ML models are discussed.
Improved approach for time‐based taxi trajectory planning towards conflict‐free, efficient and fluent airport ground movement
Authors: Zhang Tianci , Ding Meng , Zuo Hongfu
Published: September 2018

The ever‐growing air traffic demand arouses an urgent need for improved airport ground movement efficiency. New operational concepts are emerging which use time‐based taxi trajectories to reduce uncertainty and make more efficient use of the airport resource. In this study, an improved approach is proposed for time‐based taxi trajectory planning, which is formulated as the shortest path problem with time windows and the maximum traversal time constraint. With the introduction of the taxi time in the cost and the maximum traversal time constraint to limit the waiting time, more efficient and fluent ground movement of aircraft can be realised. An A*‐based solution algorithm is developed for the investigated problem, which utilises the arrival time interval and dominance‐based comparison to search for the best solution. Experimental results on real‐world problem instances demonstrate the effectiveness of the proposed approach as well as its advantages over the existing approach.
Trajectory planning and optimisation method for intelligent vehicle lane changing emergently
Authors: Jiang Haobin , Shi Kaijin , Cai Junyu , Chen Long
Published: September 2018

The real time and adaptability of emergency lane‐changing trajectory planning method is critical to the safe operation of the intelligent vehicle. This study presents the design and implementation of the trajectory planning and optimisation method of intelligent vehicle lane changing emergently based on hp‐adaptive pseudospectral method. The method divides the emergency lane‐changing process into the initial stage and tracking stage for trajectory planning based on road steering experiment and sigmoid functions. An hp‐adaptive pseudospectral method is introduced to connect and optimise the lane‐changing trajectory. PreScan and Matlab are used to simulate the planning of emergency lane‐changing trajectory under six conditions, and the simulation results verify the effectiveness and real time of the planning and optimisation method. In comparison with trajectory planning methods based on polynomial functions, this method is characterised by shorter response time and safety distance and has better adaptability under different conditions.
Complex network model for railway timetable stability optimisation
Authors: Meng Xuelei , Jia Limin , Xiang Wanli
Published: September 2018

Recent studies on train timetable are paying more and more attention to the dynamic characteristics. Among the dynamic characteristics, stability is a most important one, which determines the capacity of the train timetable to tolerate the disturbance in the train operation process. In this study, the authors build a complex network model to describe the train timetable, making it possible to utilise the complex network theory to study the train timetable optimisation problem. Then, they design the solving algorithm to solve the problem. Finally, they present a computing case to prove the approach to improve the train timetable stability is practical. The approach proposed in this study can generate referential advice for the railway operators design the train timetable.
GS242-03+37: a lucky survivor in the galactic gravitational field
Authors: Ehlerová S. , Palouš J.
Published: September 2018

Context. HI shells and supershells, found in discs of many galaxies including our own, are formed by the activity of young and massive stars (supernova explosions and stellar winds), but the formation of these structures may be linked to other energetic events, such as interactions of high-velocity clouds with the galactic disc. The larger structures in particular significantly influence their surroundings; their walls are often places where molecular clouds reside and where star formation happens.

Aims. We explore the HI supershell GS242-03+37, a large structure in the outer Milky Way. Its size and position make it a good case for studying the effects of large shells on their surrounding.

Methods. We perform numerical simulations of the structure with the simplified hydrodynamical code RING, which uses the thin-shell approximation. The best fit is found by a comparison with the HI data and then we compare our model with the distribution of star clusters near this supershell.

Results. The best model of GS242-03+37 requires, contrary to previous estimates, a relatively low amount of energy, and it has an old age of ∼100 Myr. We also find that the distribution of young star clusters (with ages <120 Myr) is correlated with walls of the supershell, while the distribution of older clusters is not. Clusters that have the highest probability of being born in the wall of the supershell show an age sequence along the wall.

Conclusions. GS242-03+37 is a relatively old structure, shaped by the differential rotation, and its wall is a birthplace of several star clusters. The star formation started at a time when the supershell was not already supersonically expanding; it was a result of the density increase due to the galactic shear and oscillations perpendicular to the disc of the Milky Way.
Analysis of state-dependent discrete-time queue with system disaster
Authors: Sudhesh Ramupillai , Vaithiyanathan Arumugam
Published: September 2018

An explicit expression for time-dependent system size probabilities is obtained for the general state-dependent discrete-time queue with system disaster. Using generating function for thenth state transient probabilities, the underlying difference equation of system size probabilities are transformed into three-term recurrence relation which is then expressed as a continued fraction. The continued fractions are converted into formal power series which yield the time-dependent system size probabilities in closed form. Further, the busy period distribution is obtained for the considered model. As a special case, the system size probabilities and busy period distribution of Geo/Geo/1 queue are deduced. Finally, numerical illustrations are presented to visualize the system effect for various values of the parameters.
Don‘t forget – Demenzabklärung in der Nuklearmedizin
Authors: Strack Verena
Published: September 2018

Angesichts der Tatsache, dass der demenzielle Fortschritt nicht gestoppt, aber mittels individueller Therapie verzögert werden kann, kommt der molekularen Bildgebung in der Demenzabklärung eine wesentliche Bedeutung zu. Gegenwärtig ermöglichen Bildgebungsverfahren wie SPECT und PET die visuelle Darstellung von Amyloidpathologien, weshalb diese Untersuchungsverfahren bereits zur Frühdiagnostik bei Alzheimer-Demenz eingesetzt werden.
“Von Schluck bis Druck” - Funktionelle Durchleuchtungsuntersuchungen
Authors: Friedrich-Marwitz Maximilian , Wagner Corinna , Lewentat Günter
Published: September 2018

Unter „Durchleuchtung“ versteht man verschiedene radiologische Verfahren, deren primäre Ziele sowohl die Abbildung von anatomischen Strukturen als auch die Darstellung der Funktionsweise sowie der möglichen funktionellen Störungen von Organen sind. Dieser Artikel stellt verschiedene Durchleuchtungsverfahren vor: ihre Indikationen, die Vorbereitung und Durchführung der jeweiligen Untersuchungen sowie die häufiger dabei beobachteten Pathologien.
Risk factors for conversion to snare resection during colorectal endoscopic submucosal dissection in an expert Western center
Authors: Pérez-Cuadrado-Robles Enrique , Snauwaert Christophe , Moreels Tom , Jouret-Mourin Anne , Deprez Pierre , Piessevaux Hubert
Published: September 2018

Background There are limited data regarding the risk factors and consequences of conversion to endoscopic mucosal resection (rescue EMR) during colorectal endoscopic submucosal dissection (ESD) in Western centers.

Methods This was a retrospective analysis of a prospectively collected database, from which 225 consecutive ESDs performed between 2013 and 2017 were selected. Of the included patients, 39 (18.6 %) required rescue EMR. Pre- and per-procedure characteristics were evaluated to determine the features associated with the need for rescue EMR. Outcomes and complications were also assessed.

Results 210 patients were included, with median tumor size of 40 mm (range 20 – 110) and most tumors being in a non-rectal location (66.2 %). When compared with full ESD, rescue EMR was significantly associated with lower rates of en bloc resection (43.6 % vs. 100 %) and complete resection (R0 status; 28.2 % vs. 88.9 %), and with a higher rate of recurrence (5.1 % vs. 0 %) and more need for surgery (15.4 % vs. 3.5 %). In multivariable analysis, non-lifting (adjusted odds ratio [ORa] 3.06, 95 % confidence interval [CI] 1.23 – 7.66; P = 0.02), nongranular-type laterally spreading tumor (LST-NG; ORa 2.56, 95 %CI 1.10 – 5.99; P = 0.03), and difficult retroflexion (OR 3.22, 95 %CI 1.01 – 10.28; P = 0.049) were independent risk factors associated with conversion to rescue EMR, while tumor size and location were not.

Conclusions During ESD, the presence of poor lifting, LST-NG morphology, and a difficult retroflexed approach were factors associated with the need to convert to rescue EMR. Conversion to rescue EMR remains a valuable strategy.
Postoperative Bildgebung nach Gelenkersatz – Knie, Hüfte, Schulter
Authors: Saupe Nadja , Romero Jose , Hersche Otmar , Zanetti Marco
Published: September 2018

Die Gelenke an Knie, Hüfte und Schulter werden häufig und mit gutem Erfolg ersetzt. Mit der weiteren Zunahme dieser Operationen wächst auch die Bedeutung der postoperativen Bildgebung. Besonders Röntgen und CT werden für Routinekontrollen und zum Nachweis von Komplikationen eingesetzt. Die MRT kann – fortgeschrittene Techniken zur Reduktion von Metallartefakten vorausgesetzt – die um die Prothese liegenden Weichteile am besten darstellen.
Copper-Catalyzed Base-Free N-Arylation of 8-Aminoquinoline Amides through Chelation Assistance
Authors: Xia Xiao-Feng , Zhang Guo-Wei , Zhou An-Xi , He Wei
Published: September 2018

A new and efficient approach for the N-arylation of 8-aminoquinoline amides with diaryliodonium salts has been developed. This chelation-assisted selective C–N cross-coupling reaction gave the desired N-arylated 8-aminoquinoline in moderate to good yields. In contrast to previous reports, no additional ligands and bases are used in this transformation. In addition, the anion of the diaryliodonium salt plays an important role in the success of the process.
Sex Hormonal Profile in Men and Women with Epilepsy on Enzyme-Inducing Antiepileptic Drugs: A Case-Control Study
Authors: Manchukonda Shivalaxmi , Jabeen Shaik , Mohammed Noorjahan , Cherian Ajith , Chandran Priscilla
Published: September 2018

Introduction Prevalence of sexual and reproductive dysfunction in men and women with epilepsy (MWE and WWE) ranges from 20 to 60% in different studies. Epilepsy and antiepileptic drugs both contribute in varying degrees to the reproductive endocrine dysfunction.

Aims and Objectives The aim of this study is to assess the alteration in sex hormone levels in MWE and WWE on enzyme-inducing antiepileptic drugs (EIAEDs).

Materials and Methods This is a cross-sectional case-control study of 29 MWE and 26 WWE on EIAEDs. Control group were age- and sex-matched healthy volunteers. Serum sex hormones such as total testosterone (TT), dehydroepiandrosterone sulfate (DHEAS), estradiol (E2) and progesterone, gonadotropins such as luteinizing hormone (LH), follicular-stimulating hormone (FSH), and sex hormone–binding globulin (SHBG) levels were estimated. Free testosterone (FT) and bioactive testosterone (BAT) were calculated. Gonadal efficiency in men was estimated by TT/LH and in women by E2/SHBG and LH/FSH ratios.

Results There was a significant decrease in TT/LH, FT, BAT, DHEAS, and progesterone along with a significant elevation of SHBG and E2 in MWE on EIAEDs. There was also significant elevation of gonadotropins such as LH, FSH, and prolactin (PRL) in MWE. A significant decrease in progesterone, DHEAS, and E2/SHBG along with a marked elevation in SHBG, LH, FSH, and PRL was found in WWE.

Conclusion This study clearly demonstrates that EIAEDs have an adverse effect on reproductive health in both MWE and WWE.
Aetiopathological mechanisms of negative symptoms in schizophrenia
Authors: Caputo F. , Giordano G. M. , Mucci A. , Galderisi S.
Published: September 2018

Background: Negative symptoms represent core features of schizophrenia and have an unfavorable impact on the disease outcome. Unfortunately, their aetiopathology has not been elucidated yet and the effectiveness of available treatments is not satisfactory. Aims: This review aims to provide a critical overview of research findings concerning negative symptom aetiopathology, highlighting limitations and future perspectives. Results: Enduring and transient negative symptoms, as well as motivation-related and expression-related domains of negative symptoms, have different risk factors and clinical correlates, and are associated to distinct brain abnormalities. Enduring negative symptoms seem to be related to subtle, pervasive deviations in neurodevelopmental trajectories. Expression deficit, as compared with avolition, shows a stronger association with neurological soft signs, cognitive impairment and diffuse disconnectivity. Avolition/apathy is a multifaceted construct probably related to deficits of reward and action valuation and instrumental learning, subtended by cortico-striatal dysfunctions. Conclusions: Research findings support the heterogeneity of negative symptoms and are likely to pave the way for the discovery of more effective treatments.
How to evaluate mental healthcare models
Authors: Großimlinghaus I. , Kerst A. , Otten M. , Zielasek J. , Gaebel W. , Kowitz S.
Published: September 2018

Background: One of the main measures of improving the quality of mental healthcare in Europe is to promote the implementation of effective healthcare services. The evaluation of such health-care models is needed to assess their effectiveness and efficiency. Objectives: The article points out the main methodological challenges of demonstrating the effectiveness and efficiency of mental healthcare models. Results: Implementing healthcare models is complex and includes several components and a high number of confounding variables. This makes it difficult to identify the “active ingredients”. The range of evaluation criteria is wide. Therefore, it is crucial to define the main aim of the intervention clearly and to choose evaluation assessments with relevance for these aims. Conclusion: Addressing the question how to evaluate mental healthcare models, evaluation studies have to provide information not only about the chosen evaluation criteria but also about the context, in which a healthcare model works.
Moving towards community mental healthcare
Authors: Ruggeri M. , Iozzino L.
Published: September 2018

Background: After the Psychiatric Reform in 1978 and the closure of large mental hospitals, a nation-wide network of Departments of Mental Health (DMH) has been developed in Italy and now delivers routinely outpatient and inpatient care, and runs semi-residential and residential facilities. Intensive effort has been promoted: inpatient care is provided all over Italy by General Hospital Psychiatric Units (GHPUs) with a maximum of 15 beds, and only a very low proportion of inpatient admissions are compulsory. Community Mental Health Centres are central to mental health services operating between 5 days per week for 12 hours a day in most Regions offering daytime and domiciliary care for those with severe and enduring mental illness; other community mental health services include residential facilities for long-term psychiatric care and day hospital/centres. However, there is still marked quantitative and qualitative variation in the provision of out- and inpatient care throughout the country, and service utilization patterns are uneven. Aim: Further efforts are required to improve quality of care and to develop a more effectively integrated system. Greater attention must be paid to topics such as quality of care and outcomes, and continuous monitoring that orient the overall process of care and particularly psychosocial interventions. Prevention and promotion of mental health, particularly in the early stages of illness, and in adolescence disorders and depression, should be promoted; outcome and quality of care in residential facilities should be targeted to prevent avoidable chronicization.
Versorgungsmodelle für psychische Störungen
Authors: Borrmann-Hassenbach M.
Published: September 2018

Hintergrund: Die Bundesarbeitsgemeinschaft der Träger psychiatrischer Krankenhäuser (BAG Psychiatrie) vertritt die Interessen von etwa 90% aller psychiatrischen Krankenhausträger mit Pflichtversorgungsauftrag in Deutschland. Dazu zählen kommunale, frei-gemeinnützige, kirchliche, staatliche und private Krankenhausträger. Seit mehr als 20 Jahren hat der normativ angelegte Strukturrahmen der Psychiatrie-Personalverordnung (Psych-PV) mit Finanzierungsanspruch der Krankenhäuser dazu beigetragen, dass die akutpsychiatrische, regionale Pflichtversorgung als Auftrag für alle Träger umsetzbar war. Erwartungen: Die Träger psychiatrischer Krankenhäuser haben in den vergangenen Jahren mit dem kontinuierlichen Ausbau der psychiatrischen Institutsambulanzen und regionalisierten Tageskliniken die versorgungsstrategische Aufgabe „ambulant vor stationär“ wesentlich mitgestaltet und unterstützen diese Entwicklung auch in Zukunft. Die BAG setzt sich dafür ein, dass Modellprojekte einen verlässlichen Rahmen erhalten und systemisch in die Flexibilisierung und Vernetzung der psychiatrischen Versorgung eingebunden werden. Hoffnungen: Herausforderung wird in den künftigen Jahren sein, wie der bereits sichtbare Widerspruch zwischen ökonomiegetriebener Marktentwicklung für die vollstationäre Versorgung psychischer Krankheiten insbesondere in der Psychosomatik und der Ressourcenverteilung weiter entwickelt wird. Regionale Pflichtversorgung auf Basis einer psychiatrischen Vollversorgung aller psychischen Störungsbilder muss als hoher Garant für die Sicherstellung der Versorgung angesehen werden, aus der heraus die bedarfsorientierte und individualisierte Flexibilisierung der Versorgungsstrukturen und Angebote geleistet werden kann.
Tianeptin
Authors: Volz H.-P.
Published: September 2018

Neben der Katecholamin-Mangel-Hypothese der Depression hat in den letzten Jahren vermehrt die Veränderung der Stressachse (auch HPA-Achse genannt) Beachtung gefunden, zumal es eine Reihe von Beobachtungen gibt, die zeigen, dass zum einen Glukokortikoide direkt neurotoxisch, v.a. am Hippocampus, wirken können und zum anderen, dass eine erhöhte glutamaterge Transmission ebenfalls in dieselbe Richtung wirken könnte. In diese Regelmechanismen scheint auch Tianeptin, eine lange in einer Reihe von europäischen Ländern eingesetzte Substanz, die nun auch seit drei Jahren in Deutschland zur Verfügung steht, einzugreifen. Neben dem wahrscheinlichen pharmakodynamischen Wirkmechanismus der Substanz werden in der vorliegenden Übersicht die aktuelle Studienlage zur Wirksamkeit und Verträglichkeit zusammengefasst, aber auch Studien im Bereich kognitiver Störungen dargestellt. In einer Reihe von klinischen Studien konnte die Placebo überlegene und die zu mindestens ebenso gute antidepressive Effektivität von Tianeptin im Vergleich zu Standardantidepressiva (v.a. SSRIs und Trizyklika) gezeigt werden. Auch positive Langzeituntersuchungen liegen vor. Das Nebenwirkungsprofil ähnelt dem der SSRIs, allerdings gibt es Hinweise, dass gastrointestinale Nebenwirkungen, Tremor und Palpitationen vergleichsweise seltener auftreten, trockener Mund häufiger. Sexuelle Dysfunktionen sind selten. Erste Studien zeigen einen positiven Effekt auf die häufig bei Depressionen verschlechterten kognitiven Störungen. Das Interaktionsverhalten der Substanz ist sehr günstig. Somit steht eine interessante neue Möglichkeit der pharmakologischen Depressionstherapie zur Verfügung.
Mental healthcare for refugees
Authors: Gaebel W. , Falkai P. , Sartorius N. , Zielasek J.
Published: September 2018

Introduction: The current refugee situation in Europa also leads to an increasing number of people with mental disorders. Which measures need to be taken to ascertain adequate mental healthcare for refugees during and after fleeing from their home countries? Methods: Review of the current tasks, areas of action and future challenges of refugee mental healthcare. Results: Refugee healthcare poses new challenges for the receiving and the transit countries. Besides dealing with the acute refugee situation, long term aspects of mental and general healthcare for refugees need to be considered. This will also include the reconstruction of the healthcare systems in the countries of origin of refugees.
Reduktion der individuellen Stressvulnerabilität durch Sport und Diät bei schizophrenen Psychosen
Authors: Falkai P. , Keller-Varadi C. , Malchow B. , Schmitt A.
Published: September 2018

Hintergrund: Bei der Entwicklung schizophrener Psychosen spielen neben genetischen Risikofaktoren auch Umwelt-Risikofaktoren eine bedeutende Rolle. Zu den gemeinsamen Risikofaktoren, zumindest für ganze Bevölkerungsgruppen, können z.B. Konstellationen wie das Aufwachsen in einer Großstadt über 100 000 Einwohnern gezählt werden. Zu den eher individuellen Risikofaktoren, die den Verlauf negativ beeinflussen, sind der Mangel an Bewegung und eine einseitige Diät zu nennen. Hierzu sollen die Aspekte des gezielten körperlichen Trainings (Sport) und Modifikationen der individuellen Ernährung (Diät) dargestellt werden. Ziel: Beide Risikokonstellationen müssen früh erkannt werden und können somit gut beeinflusst werden, wie erste Studien mit aerobem Training sowie aus einer Kombination verbesserter Diät und optimierter körperlicher Fitness zeigen. Dieses sind zwei Beispiele, um das das individuelle Risiko zu modulieren und somit Effekte der Urbanisierung auszugleichen.
Using Ambulatory Assessment for experience sampling and the mapping of environmental risk factors in everyday life
Authors: Reichert M. , Törnros T. , Hoell A. , Dorn H. , Tost H. , Salize H.-J. , Meyer-Lindenberg A. , Zipf A. , Ebner-Priemer U. W.
Published: September 2018

Background: Psychiatric research is increasingly interested in the influence of social and environmental contexts on human health. According to recent findings, specific impacts of urban upbringing relate to the heightened prevalence of mental disorders. Although this is a major societal problem, it remains unknown which environmental components (e.g., psychosocial stressors, rare nature exposure) are responsible. Method: We introduce Ambulatory Assessment (AA) as a methodological approach to investigate contextual influences. GPS-triggered electronic diaries are suitable to capture data in everyday life, gathering information on both context and mental states to assess dynamic processes in real-life and real-time. Result: A longitudinal study at the Central Institute for Mental Health in Mannheim combines AA, fMRI and epigenetic approaches to investigate environmental factors influencing mental health. The findings might be incorporated in urban planning to reduce mental disorders.
Predictors and mechanisms of conversion to psychosis
Authors: Cannon T. D.
Published: September 2018

Background: Identifying predictors and elucidating mechanisms underlying onset of psychosis are critical for the development of preventive interventions. Methods: This paper reviews findings on risk prediction algorithms and potential mechanisms of onset in youth at clinical high-risk for psychosis. Results: An independently validated individualized risk calculator is available that incorporates risk factors from clinical, demographic, neurocognitive, and psychosocial assessments to predict likelihood of conversion to psychosis among individuals who meet criteria for a prodromal risk syndrome. At risk individuals who convert to psychosis show a steeper rate of gray matter reduction, most prominent in prefrontal cortex, compared with those who do not. Higher levels of pro-inflammatory cytokines at baseline predicted the accelerated reduction in prefrontal gray matter. These same markers are associated with microglial-mediated synaptic pruning and dendritic retraction in animal models. Conclusions: Processes that modulate microglial activation, such as dysregulated immune function and deficient synaptic plasticity, may represent convergent mechanisms that influence brain dysconnectivity and risk for onset of psychosis.
Early medication discontinuation in first episode schizophrenia – beneficial or risky?
Authors: Wunderink L. , Riesbeck M. , Gaebel W.
Published: September 2018

Background: After acute treatment of a first episode in schizophrenia, continued antipsychotic maintenance treatment (MT) is effective regarding (positive) symptom remission and relapse prevention. Nevertheless, due to unwanted effects patients and clinicians sooner or later are faced with the decision to continue or discontinue antipsychotics. Evidence indicates that risk for relapse or symptom recurrence is 2- to 5-times higher after personalized dose-reduction (PDR) or complete drug discontinuation, even if early intervention in case of early warning signs of relapse is applied. Method: A recent 7-year follow up of an 18 months RCT comparing MT with PDR however, revealed advantages of PDR regarding functional outcome and recovery. Although only one study with its specific characteristics limits generalization, the findings have newly fueled the debate whether early drug discontinuation-strategies have more risks or benefits. Result: The paper discusses the pros and cons of early drug discontinuation-strategies, in particular of PDR, after a first episode in schizophrenia and summarizes the empirical evidence to support patients and clinicians in this essential treatment decision.
Brain stimulation methods for patients with schizophrenia – new therapies on the horizon?
Authors: Palm U. , Padberg F. , Wobrock T. , Hasan A.
Published: September 2018

Background: Non-invasive brain stimulation (NIBS) techniques offer new promising treatment options in schizophrenia. However, the evidence from meta-analyses and randomized clinical studies is limited. Results: For repetitive transcranial magnetic stimulation (rTMS) the clinical efficacy is highest for the 1-Hz rTMS over the left temporal cortex to improve auditory hallucinations, nevertheless there are studies showing no benefit. For negative symptoms rTMS could be offered keeping in mind the good tolerability. Transcranial direct current stimulation (tDCS) has a good risk-benefit ratio, but the evidence for schizophrenia symptoms is still derived from small sample studies. Electroconvulsive therapy (ECT) is the treatment option with the highest clinical efficacy for treatment-resistant schizophrenia, catatonia or other defined treatment circumstances, but has more adverse side effects. More research is needed to understand which stimulation technique could be recommended for a certain patient.
Improving outcomes: Factors influencing help-seeking behaviors in immigrants and ethnic minorities with first-episode psychosis
Authors: Berg A. O. , Leopold K. , Zarafonitis-Müller S. , Nerhus M. , Stouten L. H. , Bechdolf A. , Melle I.
Published: September 2018

Background: Immigrants have increased risk of a poor recovery from first episode psychosis (FEP). Early treatment can improve prognosis, but having an immigrant background may influence pathways to care. Method: We present research of service use and factors influencing treatment outcome in immigrants with FEP. Service use was assessed in in-patients at an early intervention center in Berlin, Germany. Duration of untreated psychosis and beliefs about illness was assessed in a FEP study in Oslo, Norway and cognitive functioning in patients with FEP schizophrenia from the regular mental health services in The Hague, the Netherlands. The proportion of immigrants in Berlin and Oslo was at level with the local populations, while the proportion in The Hague appeared to be higher. Result: There were clear indications that mental health literacy, probably based in different cultural expectations, were lower in first generation immigrants (FGI). Findings regarding clinical insight were ambiguous. There were also indications that FGI had more cognitive problems, based in higher stress levels or in cognitive styles. Early psychosis services must take issues of immigration and ethnicity into consideration.
Der Einfluss kurzzeitigen und länger anhaltenden Stresses sowie einer verhaltenstherapeutischen Intervention auf die Ticsymptomatik
Authors: Bodmer B. , Buse J. , Rößner V.
Published: September 2018

Hintergrund: Die Ticsymptomatik unterliegt einem physiologischen, unregelmäßigen und individuellen Schwankungsverlauf. Weiterhin werden Tics durch u.a. psychosozialen Stress moduliert, welcher ein Prädiktor für die zukünftige Entwicklung der Ticsymptomatik zu sein scheint. Interessanterweise zeigen Patienten mit einer Ticstörung (TS) im Vergleich zu gesunden Menschen eine erhöhte Anzahl an belastenden Lebensereignissen mit berichteten erhöhten Stressleveln. Außerdem scheinen Patienten mit TS physiologische Veränderungen in der Stressantwort zu zeigen. Methode: Um den Einfluss einzelner belastender Lebensereignisse mit psychosozialem Stress auf die Ticsymptomatik bei Kindern und Jugendlichen zu untersuchen, wurden in einer experimentellen Studie der Forschungsgruppe um Prof. Veit Rößner physiologische Parameter mit einer standardisierten Methode erhoben und mit einer objektiven Erfassung von Tics kombiniert. Psychosozialer Stress wurde mit dem Trier Social Stress Test (TSST) erzeugt. Ergebnis: Dabei zeigten die Patienten mit TS erhöhte Werte im Speichelcortisol, der Herzrate und der Hautleitfähigkeit während einer Stressbedingung. In der Stressbedingung wurden jedoch entgegen der Erwartung weniger Tics als in einer Entspannungs- und Konzentrationsbedingung beobachtet. Diese Erkenntnisse sind auch für verhaltenstherapeutische Behandlungsmöglichkeiten von Ticstörungen (z.B. CBIT) bedeutsam, da Stress Einfluss auf den Behandlungserfolg haben kann.
Milnacipran in der Praxis
Authors: Hienert M. , Spies M. , Lanzenberger R. , Kasper S.
Published: September 2018

Milnacipran gehört neben Venlafaxin und Duloxetin zur Gruppe der Serotonin-Noradrenalin-Wiederaufnahmehemmer (SNRI). In Österreich ist das Psychopharmakon seit 1998 und nun auch in Deutschland als Antidepressivum zugelassen, während es in den USA zur Therapie des Fibromyalgie-Syndroms eingesetzt wird. Die gleich starke Affinität für den Serotonin-sowie den Noradrenalintransporter und die sich daraus ergebenden klinischen Eigenschaften machen Milnacipran zu einem in dieser Wirkstoffklasse besonderen Medikament. In diesem Artikel wird anfangs auf die neurobiologischen Hintergründe der Depression und dem ihr zugrundeliegenden Erklärungsmodell, der Monoaminmangel-Hypothese, eingegangen. Im Anschluss werden die molekularen und klinischen Effekte von Milnacipran sowie die Neben- und Wechselwirkung dieses Psychopharmakons erläutert. Für den Kliniker bildet dieser Artikel eine praxisnahe Darstellung über Neurobiologie, Pharmakologie und Einsatzmöglichkeiten dieses First-Line Antidepressivums.
Erwärmungseffekte in der MRT, Teil 2: Tipps zum Umgang mit Implantaten
Authors: Bauer Reinhard
Published: September 2018

Grundsätzlich wird die MRT als sichere Untersuchung bezeichnet, jedoch birgt sie doch einige Sicherheitsrisiken, welche im klinischen Alltag unbedingt berücksichtigt werden müssen, z. B. erwärmungsbedingte Effekte. Im ersten Teil dieses Beitrags werden die physikalischen Grundlagen dargelegt. Der zweite Teil rückt die Erwärmungsproblematik von Implantaten in den Mittelpunkt und formuliert praktische Tipps zur sicheren Durchführung von MR-Untersuchungen.
Calibration methods for the simultaneous measurement of the impulse, mass loss, and average thrust of a pulsed plasma thruster
Authors: Yoshikawa T. , Tsukizaki R. , Kuninaka H.
Published: September 2018

This paper presents calibration devices and methods for the measurement of electric thruster performance parameters using a seesaw-type thrust stand to measure the mass loss of solid propellant in a vacuum. In previous studies, impact hammers and electrostatic combs have been manufactured for the calibration of the thrust and impulse using seesaw-type thrust stands. However, these conventional devices rely on self-calibration, which means that the input delivered by the device in unknown, and must undergo a calibration process themselves. In this paper, the manufactured calibration devices successfully reproduced known impulses, thrusts, and mass losses in a vacuum. By reproducing known inputs based on known masses, the proposed calibration devices can omit the conventionally required self-calibration process. The calibration results showed linear relations between outputs and known inputs and agreed with the theoretical values to within an error of 10%. Additionally, the uncertainties of all known inputs were less than 1.5%. On the basis of these results, the average thrust, impulse, and mass loss were measured using a calibrated thrust stand for the first time. The cumulative impulses obtained from the measured impulse and average thrust agreed with each other to within an error of 5%. The error of the measured mass loss per 1000 shots with respect to the actual mass loss measured using an electronic balance ranged from 1% to 17%.
Effect of addition of SiC and Al2O3 refractories on Kapitza resistance of antimonide-telluride
Authors: Nandihalli Nagaraj , Mori Takao , Kleinke Holger
Published: September 2018

Invoking Effective Media Percolation theory (EMPT), Hasselaman-Johnson effective media theory (EMT), and Nan and Birringer EMT, the effect of addition of SiC and Al2O3 nanoparticles on Kapitza resistance (RBd) of Ni0.05Mo3Sb5.4Te1.6 was investigated. Pore size and their volume distribution, and surface area were characterized using BET technique to correlate pore effect and surface area on RBd. Bounds for effective thermal conductivity were determined using Lipton–Vernescu model. Variation of thermal conductance with respect to temperature was studied and compared with the results of other materials. According to EMPT, RBd in Ni0.05Mo3Sb5.4Te1.6/SiC composites ranged from 3.84 × 10-7 to 5.42 × 10-7 m2KW–1 and 3.36 × 10-7 to 3.86 × 10-7 m2KW–1 for Ni0.05Mo3Sb5.4Te1.6/Al2O3 composites. Kapitza radius (aK) for SiC samples was ranged between 2.01 – 2.84 μm; for Al2O3 samples it was 1.86 μm. Hasselman-Johnson model gave RBd values 55%, 51%, and 8% more than what EMPT is predicting, but of the same order and aK values 3.5 μm, 4 μm, 3 μm for SiC samples and 1.2 μm, 0.6 μm, 0.55 μm for Al2O3 samples. Nan-Birringer model yielded large aK of 7.25 μm and RBd ∼ 1.4 × 10–6 m2KW–1 for Ni0.05Mo3Sb5.4Te1.6/SiC. So obtained parameters are reasonable estimates. Variation of effective thermal conductivity in Al2O3 samples is more sensitive to particle size compared to SiC samples. Mechanical properties were studied using micro–indentation technique and their effect on effective thermal properties was ascertained. Addition of Al2O3 nanoparticles have aided in enhancing mechanical properties of bulk material.