bluuebunny/crossref_metadata_2025 huggingface dataset:
Interne Konsistenz und Konstruktvalidität des demenzspezifischen Lebensqualitätsinstruments QUALIDEM
Authors: Hüsken Johann-Moritz , Reuther Sven , Halek Margareta , Holle Daniela , Dichter Martin N.
Published: August 2019

Zusammenfassung. Hintergrund: Die Aufrechterhaltung sowie Steigerung der Lebensqualität (LQ) von Menschen mit Demenz gilt als zentrales Ziel der pflegerischen und medizinischen Versorgung. Mit dem QUALIDEM existiert ein theoriebasiertes demenzspezifisches LQ-Instrument in deutscher Sprache. Zur Konstruktvalidität liegen bisher jedoch kaum Ergebnisse vor. Ziel: Evaluation der Itemschwierigkeit, internen Konsistenz und diskriminanten sowie konvergenten Validität des deutschsprachigen QUALIDEM. Methode: Die Überprüfung der Konstruktvalidität erfolgt anhand eines Multi-Trait-One-Method Ansatzes basierend auf einer Stichprobe von 167 Menschen mit einer leichten bis schweren und 71 mit einer sehr schweren Demenz. Ergebnisse: Der Zusammenhang zwischen den QUALIDEM-Subskalen und den Vergleichskonstrukten Agitation, Depression, Angst, Abweichendes motorisches Verhalten, Apathie, Schmerzempfinden und Lebensqualität, erfasst anhand des Alzheimer’s Disease Related Quality of Life Instruments, bestätigte sich in 82 % der vorformulierten Hypothesen in erwarteter Richtung. Der Korrelationskoeffizient zur diskriminanten Validität liegt zwischen 0,04 und −0,60 und für die konvergente Validität zwischen −0,21 und 0,71. Für die Mehrheit der QUALIDEM-Subskalen konnte eine gute interne Konsistenz ermittelt werden. Schlussfolgerungen: Die Ergebnisse der Studie liefern erste Hinweise für die Konstruktvalidität der QUALIDEM-Subskalen sowie zur Weiterentwicklung des Instruments. In zukünftigen Studien sollte die Validität des deutschsprachigen QUALIDEM weiter untersucht werden.
Executive Functions and Pain
Authors: Bunk Stefanie , Preis Lukas , Zuidema Sytse , Lautenbacher Stefan , Kunz Miriam
Published: August 2019

Abstract. A growing body of literature suggests that chronic-pain patients suffer from problems in various neuropsychological domains, including executive functioning. In order to better understand which components of executive functioning (inhibition, shifting and/or updating) might be especially affected by pain and which mechanisms might underlie this association, we conducted a systematic review, including both chronic-pain studies as well as experimental-pain studies. The chronic-pain studies (N = 57) show that pain is associated with poorer executive functioning. The findings of experimental-pain studies (N = 28) suggest that this might be a bidirectional relationship: Pain can disrupt executive functioning, but poorer executive functioning might also be a risk factor for higher vulnerability to pain.
Increasing Groundwater Availability and Seasonal Base Flow Through Agricultural Managed Aquifer Recharge in an Irrigated Basin
Authors: Kourakos George , Dahlke Helen E. , Harter Thomas
Published: August 2019

Groundwater aquifers provide an important “insurance” against climate variability. Due to prolonged droughts and/or irrigation demands, groundwater exploitation results in significant groundwater storage depletion. Managed aquifer recharge (MAR) is a promising management practice that intentionally places or retains more water in groundwater aquifers than would otherwise naturally occur. In this study, we examine the possibility of using large irrigated agricultural areas as potential MAR locations (Ag‐MAR). Using the California Central Valley Groundwater‐Surface Water Simulation Model we tested four different agricultural recharge land distributions, two streamflow diversion locations, eight recharge target amounts, and five recharge timings. These scenarios allowed a systematic evaluation of Ag‐MAR on changes in regional, long‐term groundwater storage, streamflow, and groundwater levels. The results show that overall availability of stream water for recharge is critical for Ag‐MAR systems. If stream water availability is limited, longer recharge periods at lower diversion rates allow diverting larger volumes and more efficient recharge compared to shorter diversion periods with higher rates. The recharged stream water increases both groundwater storage and net groundwater contributions to streamflow. During the first decades of Ag‐MAR operation, the diverted water contributed mainly to groundwater storage. After 80 years of Ag‐MAR operation about 34% of the overall diverted water remained in groundwater storage while 66% discharged back to streams, enhancing base flow during months with no recharge diversions. Groundwater level rise is shown to vary with the spatial and temporal distribution of Ag‐MAR. Overall, Ag‐MAR is shown to provide long‐term benefits for water availability, in groundwater and in streams.
The Methane Diurnal Variation and Microseepage Flux at Gale Crater, Mars as Constrained by the ExoMars Trace Gas Orbiter and Curiosity Observations
Authors: Moores John E. , King Penelope L. , Smith Christina L. , Martinez German M. , Newman Claire E. , Guzewich Scott D. , Meslin Pierre‐Yves , Webster Christopher R. , Mahaffy Paul R. , Atreya Sushil K. , Schuerger Andrew C.
Published: August 2019

The upper bound of 50 parts per trillion by volume for Mars methane above 5 km established by the ExoMars Trace Gas Orbiter, substantially lower than the 410 parts per trillion by volume average measured overnight by the Curiosity Rover, places a strong constraint on the daytime methane flux at the Gale crater. We propose that these measurements may be largely reconciled by the inhibition of mixing near the surface overnight, whereby methane emitted from the subsurface accumulates within meters of the surface before being mixed below detection limits at dawn. A model of this scenario allows the first precise calculation of microseepage fluxes at Gale to be derived, consistent with a constant 1.5 × 10−10 kg·m−2·sol−1 (5.4 × 10−5 tonnes·km−2·year−1) source at depth. Under this scenario, only 2.7 × 104 km2 of Mars's surface may be emitting methane, unless a fast destruction mechanism exists.
Constraining the Magnitude and Uncertainty of Specific Yield for Use in the Water Table Fluctuation Method of Estimating Recharge
Authors: Crosbie Russell S. , Doble Rebecca C. , Turnadge Chris , Taylor Andrew R.
Published: August 2019

The water table fluctuation method of estimating recharge is widely used because it is conceptually simple and easy to implement. The major source of uncertainty in the recharge estimates come from the specific yield. The apparent specific yield has a dependence on the depth to water table that makes its measurement difficult (if not impossible) for appropriate use in the water table fluctuation method. This study has treated the specific yield as a conceptual parameter that cannot be measured and has constrained it using a rejection sampling approach using probabilistic estimates of net recharge from the chloride mass balance method and excess water derived from the difference between precipitation and remotely sensed actual evapotranspiration. The method developed here provided probabilistic estimates of the ultimate specific yield and a probabilistic time series of gross recharge, both important in shallow water table environments. An additional benefit of the method is that by jointly constraining the three different recharge types (i.e., excess water, gross, and net recharge) they are assured of being internally consistent. The method was implemented for 58 bores across four catchments in Northern Australia that may see increased development in coming years.
T-cell expression of Bruton’s tyrosine kinase promotes autoreactive T-cell activation and exacerbates aplastic anemia
Authors: Xia Simo , Liu Xiang , Cao Xuetao , Xu Sheng
Published: August 2019

The role of Bruton’s tyrosine kinase (BTK) in BCR signaling is well defined, and BTK is involved in B-cell development, differentiation, and malignancies. However, the expression of Btk in T cells and its role in T-cell function remain largely unknown. Here, we unexpectedly found high expression and activation of BTK in T cells. Deficiencies in BTK resulted in the impaired activation and proliferation of autoreactive T cells and ameliorated bone marrow failure (BMF) in aplastic anemia. Mechanistically, BTK is activated after TCR engagement and then phosphorylates PLCγ1, thus promoting T-cell activation. Treatment with acalabrutinib, a selective BTK inhibitor, decreased T-cell proliferation and ameliorated BMF in mice with aplastic anemia. Our results demonstrate an unexpected role of BTK in optimal T-cell activation and in the pathogenesis of autoimmune aplastic anemia, providing insights into the molecular regulation of T-cell activation and the pathogenesis of T-cell-mediated autoimmune disease.
Dynamics of TMAO and urea in the hydration shell of the protein SNase
Authors: Voloshin Vladimir , Smolin Nikolai , Geiger Alfons , Winter Roland , Medvedev Nikolai N.
Published: August 2019

MD simulations reveal dynamic properties of the natural osmolytes TMAO and urea in the hydration shell of the protein SNase.
Future green chemistry and sustainability needs in polymeric coatings
Authors: Cunningham Michael F. , Campbell J. David , Fu Zhenwen , Bohling James , Leroux J. Gary , Mabee Warren , Robert Tobias
Published: August 2019

Challenges and opportunities for paints and coatings.
Compton-thick active galactic nuclei from the 7 Ms observation in the Chandra Deep Field South
Authors: Corral A. , Georgantopoulos I. , Akylas A. , Ranalli P.
Published: August 2019

We present the X-ray spectroscopic study of the Compton-thick (CT) active galactic nuclei (AGN) population within the Chandra Deep Field South (CDF-S) by using the deepest X-ray observation to date, the Chandra 7 Ms observation of the CDF-S. We combined an optimized version of our automated selection technique and a Bayesian Monte Carlo Markov chains (MCMC) spectral fitting procedure, to develop a method to pinpoint and then characterize candidate CT AGN as less model dependent and/or data-quality dependent as possible. To obtain reliable automated spectral fits, we only considered the sources detected in the hard (2−8 keV) band from the CDF-S 2 Ms catalog with either spectroscopic or photometric redshifts available for 259 sources. Instead of using our spectral analysis to decide if an AGN is CT, we derived the posterior probability for the column density, and then we used it to assign a probability of a source being CT. We also tested how the model-dependence of the spectral analysis, and the spectral data quality, could affect our results by using simulations. We finally derived the number density of CT AGN by taking into account the probabilities of our sources being CT and the results from the simulations. Our results are in agreement with X-ray background synthesis models, which postulate a moderate fraction (25%) of CT objects among the obscured AGN population.
Characterization of the L 98-59 multi-planetary system with HARPS
Authors: Cloutier R. , Astudillo-Defru N. , Bonfils X. , Jenkins J. S. , Berdiñas Z. , Ricker G. , Vanderspek R. , Latham D. W. , Seager S. , Winn J. , Jenkins J. M. , Almenara J. M. , Bouchy F. , Delfosse X. , Díaz M. R. , Díaz R. F. , Doyon R. , Figueira P. , Forveille T. , Kurtovic N. T. , Lovis C. , Mayor M. , Menou K. , Morgan E. , Morris R. , Muirhead P. , Murgas F. , Pepe F. , Santos N. C. , Ségransan D. , Smith J. C. , Tenenbaum P. , Torres G. , Udry S. , Vezie M. , Villasenor J.
Published: August 2019

Aims.L 98-59 (TIC 307210830, TOI-175) is a nearby M3 dwarf around which TESS revealed three small transiting planets (0.80, 1.35, 1.57 Earth radii) in a compact configuration with orbital periods shorter than 7.5 days. Here we aim to measure the masses of the known transiting planets in this system using precise radial velocity (RV) measurements taken with the HARPS spectrograph.

Methods.We considered both trained and untrained Gaussian process regression models of stellar activity, which are modeled simultaneously with the planetary signals. Our RV analysis was then supplemented with dynamical simulations to provide strong constraints on the planets’ orbital eccentricities by requiring long-term stability.

Results.We measure the planet masses of the two outermost planets to be 2.42 ± 0.35 and 2.31 ± 0.46 Earth masses, which confirms the bulk terrestrial composition of the former and eludes to a significant radius fraction in an extended gaseous envelope for the latter. We are able to place an upper limit on the mass of the smallest, innermost planet of <1.01 Earth masses with 95% confidence. Our RV plus dynamical stability analysis places strong constraints on the orbital eccentricities and reveals that each planet’s orbit likely hase< 0.1.

Conclusions.L 98-59 is likely a compact system of two rocky planets plus a third outer planet with a lower bulk density possibly indicative of the planet having retained a modest atmosphere. The system offers a unique laboratory for studies of planet formation, dynamical stability, and comparative atmospheric planetology as the two outer planets are attractive targets for atmospheric characterization through transmission spectroscopy. Continued RV monitoring will help refine the characterization of the innermost planet and potentially reveal additional planets in the system at wider separations.
Determining the energy performance of a rotating machine for fluid flow
Authors: Giovani Roza Albertino , Almaslamani Ammar , Tănase Elena Beatrice , Băran Nicolae , Constantin Mihaela
Published: August 2019

The rotating machine, to which the paper relates, refers to the following:

A rotating machine construction solution that can be used as a power machine (steam engine, pneumatic engine)

The same construction solution can be used as a working machine (pump, fan, and compressor). The constructive solution and the operating principle of the rotating machine are presented, the flow rate and the machine power computation model is indicated. At the end of the paper, the machine effective efficiency is experimentally determined.
A research on fuelling a truck diesel engine with hydrogen
Authors: Nutu Nikolaos Cristian , Pana Constantin , Negurescu Niculae , Cernat Alexandru , Fuiorescu Dinu , Mirica Ionel
Published: August 2019

The paper presents experimental and theoretical investigations results of a truck diesel engine fuelled with diesel fuel and hydrogen by diesel-gas method. The purpose of the paper is to reduce the level of the nitrogen oxides emission level and to improve the overall performances of the engine. The use of hydrogen represents a suitable method to reduce the classic fuels consumption, maintaining the energetic performances of the engine. The test bed situated in the Thermotechnics, Engines, Thermal Equipments and Refrigeration Instalations Department of University Politechnica of Bucharest was adapted for hydrogen fuelling of the truck diesel engine. The engine used for investigations is a turbocharged 10.2 l truck diesel engine which run at 1450 rpm and 40% engine load. By hydrogen fuelling if the investigated diesel engine a decrease has been achieved in the nitrogen oxides emission level and in the smoke emission level. Also the break energetic specific consumption decreased compared to the standard diesel engine. The theoretical investigations presented in tha paper are based on a semi-empirical corellation, used to simulate the nitrogen monoxide emission formation. The results of the experimental investigations confirm de viability of hydrogen as an alternative fuel for the diesel engine.
Researches on the mixture limits of animal fats with liquid hydrocarbons for combustion at industrial level
Authors: Bondrea Dana Andreya , Mihaescu Lucian , Lazaroiu Gheorghe , Pisa Ionel , Negreanu Gabriel
Published: August 2019

The experimental research has highlighted the variety of possibilities of combustion of animal fat from bovine and swine mixed with liquid hydrocarbons. Previous research has established that the upper limit for an efficient combustion was 30 %. For a perfect mixing, the lower temperature limit was set to 40 °C. In the fuel laboratory, at the department TMETF was determined the viscosity of the mixtures for different proportions. The values obtained for various concentrations and preheating temperatures were close to the values for liquid hydrocarbons. The experimental researches have studied the combustion of the mixture using a mechanically spraying burner with constant pressure between 14 and 18 bar. The aspiration of the mixture is done from a specially designed tank; this tank is equipped with an electric heater, in order to maintain the mixture at a constant temperature between 40 °C to 50 °C. After that, the burner heats again the mixture with an integrated heating device up to 75 °C. The burner is also equipped with an air blower, pump and a calibrated nozzle. The combustion resulted from the experimental boiler with a power rated to 55 kW were monitored with a thermal vision camera and an exhaust gas analyser. This research has demonstrated the viability of using this type of mixtures in energetic burning equipment designed for liquid hydrocarbons.
Experimental research on influence of functional parameters of combined installations designed at separating the impurities out of cereal seeds
Authors: Brăcăcescu Carmen , Ţenu Ioan , Mircea Costin , Bunduchi George
Published: August 2019

The paper presents the experimental installation, the methodology and measuring apparatus used for experimental research of qualitative indexes of impurities separation out of grain seeds for combined separating systems (according to specific weight and aerodynamic properties of seeds). The experimental installation used was composed of a gravimetric separator with mechanical shaker with unbalanced masses (mounted on the platform working surface) and an aspiration installation with fan. The experimental research has aimed at quantitative and qualitative influence on separation quality index of the following operating parameters: material flow rate of shaking separator, the air flow of aspiration installation, tilting work surface, work surface oscillation amplitude. Based on data obtained by measurements and qualitative indicators the separating process indexes have been determined, namely: degree of impurities separation, degree of good seeds loss, as well as, the separation quality index for different types of combinations of separation installation parameters.
Modelling behaviour of a partially loaded road tanker with agro-food liquids during the breaking manoeuver
Authors: Milian Gabriela , Biriş Sorin-Ştefan , Ipate George
Published: August 2019

Longitudinal and lateral liquid sloshing in a partially filled tanker affect the braking performance of the tankers. The movement during braking of the liquid load is determined by the change in the position of the centre of gravity of the load inside the vehicle. Becoming an undesirable phenomenon when analyzing the performance of the vehicle braking manoeuver. In this paper modelling of the behaviour of the cross-section circular tank with baffles, partially filled with liquid agro-food products, was performed, which performs a braking manoeuver. Two different fluids have been used to simulate the sloshing effect of agro-food liquid cargo and study the behaviour of the tank. In to order generate the geometric model of the tank was done by using SolidWorks, and simulating the behaviour of the tank and cargo with agro-food products during the ANSYS-CFX braking manoeuver. A sequence of numerical experiments has been carried out to estimate the pressure developed over the tanker wall and the free surface displacement of the fluids for different fill levels. Simulations with the two liquids and the results obtained were compared to be able to analyze the behaviour of the tank partially filled into a braking manoeuver.
Researches on the separation of impurities from a seed flow based on the aerodynamic principle
Authors: Stroescu Gheorghe , Păun Anişoara , Voicu Gheorghe , Brăcăcescu Carmen , Popa Radu , Popa Vlad
Published: August 2019

Ensuring for production the necessary quantities of biological material of valuable varieties and hybrids to maintain their initial characteristics requires the permanent application of measures to be carried out on a scientific basis, depending on the biological particularities of the variety or hybrid. The production of seeds for leguminous plants is of great importance because the vast majority of species propagate that way. Due to the fact the yield obtained depends on the quality of the seeds, it is necessary to use seeds of varieties and hybrids with superior qualities and from higher biological categories without foreign bodies (impurities). Knowing the particularities of leguminous plant seed is of special practical importance because the conditioning technologies and machinery are based on it and also the culture technologies that are applied both in the field and in protected areas. The paper presents some theoretical aspects regarding the separation of seed mixtures based on the aerodynamic principle (resistance of the seed mass layer to the air passage, seed floating capacity, air flow working rates, total air flow, physical characteristics of seeds, etc.) which were the basis for designing a conditioning module for vegetable, flower and cereal seeds.
Aspects regarding FEM simulation of stress in hammer mill working tool
Authors: Moiceanu Georgiana , Paraschiv Gigel , Maican Edmond , Dincă Mirela , Găgeanu Iulia , Arsenoaia Vlad Nicolae
Published: August 2019

Considering the need for development and improvement of biomass processing equipment, researchers bring contribution by making suggestions to design also through simulation and modelling of different stresses that occur on equipment’s working tools. In this paper the stress in hammer mill working tools was analysed using FEM simulation with the help of SolidWorks 2016 Premium, projecting the geometric model and FEM simulation for a MC 22 hammer mill. The hammer mill has a four bolts rotor on which are the hammer disposed. The hammer mills rotor frequency is about 2940 rot/min. An important result in FEM simulation was the fact that the maximum reaction in the hammer joint was 11635 N. After FEM simulation experimental research were done using shredded miscanthus and energetic willow, the mill being equipped alternately with 4 types of hammers, with corners processed differently.
Theoretical research on kinematic and constructive parameters of roller presses for sweet sorghum
Authors: Olan Mihai , Matei Gheorghe , Apostol Livia , Jinga Vasile , Lipianu Steluţa , Găgeanu Paul , Zaica Ana , Voicea Iulian , Cristea Oana
Published: August 2019

The overall objective of the project is to develop an eco-innovative system for pressing sweet sorghum by the generalised object method specific to the technical creation applied in this field. (Vitalie Belouasov). The representative technical solutions of the companies recognised in this field are known and it is necessary to use a creativity method to analyze the existing solutions, to assess technical and economic characteristics by methods specific to value analysis but also to find new constructive variants and choose the optimal variant that will then be developed by the design-research activity for the realisation of the technical documentation for the execution of an industrial prototype. The generalized object of the technical creation is in the form of a cylindrical morphological matrix, each sector representing a solution (sector represented by a triple assembly BiCjDk, the total number of solutions being: N=i·j·k solutions, some of which are known, others unknown. The incompatible ones must be eliminated, while the others must be analyzed, as they can lead to particularly efficient constructions after their complete solving.
Soil compaction under the wheel of a sprayer
Authors: Ungureanu Nicoleta , Vlăduţ Valentin , Cujbescu Dan
Published: August 2019

Soil degradation by artificial compaction is recognized by the European Union as a major environmental and agricultural problem. Artificial compaction has worsened with the intensification of mechanized agriculture where heavier machinery is used, often moving on soils with high moisture. Experimental research was designed to determine the influence of five wheel loads and tire inflation pressures, on the contact area, the shape of footprint and the contact pressure, under the wheel of a machine for high accuracy application of phytosanitary treatments in orchards. It was found that the only situation when compaction does not occur is when the tank is empty (2.45 kN wheel load), at lowest tire inflation pressure of 100 kPa. Subsoil compaction (at 0.3-0.4 m) occurs when the sprayer machine’s tank is filled with different amounts of liquid. With empty tank, the sprayer only causes topsoil compaction.
Cereal supply chain waste in the context of circular economy
Authors: Belc Nastasia , Mustatea Gabriel , Apostol Livia , Iorga Sorin , Vlăduţ Valentin-Nicolae , Mosoiu Claudia
Published: August 2019

Taking into consideration the circular economy context, from cereal production and processing result by-products and residues which can be transformed into the new raw materials. Straw, husks, brans, flours, bread waste, confectionary waste, so on, can be re-used using different processes such as: extraction, fermentation, microorganism cultivation, for obtaining added value products. These new products obtained can be: biofuels, enzymes, biodegradable material food contact, single cell protein, bio-adsorbent, nanoparticles, bio alcohol, bioactive compounds like fibres, phytochemicals, minerals, so on. This paper is a short review regarding sharing knowledge and good practices in implementing circular economy within food systems, specifically, cereal supply chain.
Energy -Efficient Reconstruction of Public Lighting in Pravets Municipality from Bulgaria
Authors: Kamburova Veselka , Rasheva Violeta , Velikanov Michail
Published: August 2019

Improving energy efficiency and reducing greenhouse gases is a central issue of the Europe 2020 strategy. Today enormous electric energy is consumed by the street lighting. Much of it could be saved through suitable energy-conservation measures (ECMs). The energy audit of the street lighting system in the Pravets municipality was carried out in compliance with the legislation in force in the EU and Bulgaria. Data about the present state of street lighting and electricity consumption for a period of 3 years were gathered and analysed. The baseline electricity consumption was defined. Classification of streets was done and the light class of the different categories streets was determined. The potential for energy savings was identified and a package of ECMs was developed. The annual electricity savings are 680 MWh (or 57,441 €/y) and the annual CO2 emissions savings are 557,640 t. The investment for implementation of the envisaged ECMs is 414,840 €. The expected electricity savings compared to the baseline are 75%.
Intraoral fibrolipoma: case report and review of literature
Authors: Le Gall Joey , Laurence Sébastien , Khalifa Bouthaïna , Boulagnon-Rombi Camille , Mauprivez Cédric , Lefèvre Benoit , Derruau Stéphane
Published: August 2019

Introduction: Lipomas are benign soft tissue tumors, characterized by the presence of mature adipocytes in histopathology. Their development is slow and their etiologies are still controversial. Frequently subcutaneous, this type of lesion is rarely present in the oral cavity. Observation: A 67-year-old man consulted for a nodule on the inner face of his right cheek which had been developing for several years, with severe discomfort during chewing. The typical clinical aspect of this lesion suggested a lipoma. Magnetic resonance imaging (MRI) was performed before surgical excision in order to establish a differential diagnosis with a well-differentiated liposarcoma. Comments: The various imaging examinations, particularly MRI, combined with the analysis of the fat component and the morphology of the non-fat component (septa) enable us to define several categories of lesions likely to have a benign or malignant character. However, some lesions remain difficult to classify, and it is the histopathological examination along with, if necessary, immunohistochemistry (anti-MDM2 and/or anti-CDK4), which allows to confirm or not the malignancy of a lesion. Histological examination suggested a fibrolipoma. Conclusion: Although benign, the size of a fibrolipoma may can lead to significant functional and aesthetic discomfort for the patient. Surgical excision remains the treatment of choice.
gebABCDE: Geburtshilfe-Algorithmus für den außerklinischen Notfallgeburtshelfer
Authors: Strauss Alexander , Gräsner Jan-Thorsten
Published: August 2019

Akute geburtshilfliche Komplikationen sind in jeder Lebenssituation und zu jedem Zeitpunkt während der Schwangerschaft möglich. Nicht immer kann der Transport der Patientin in eine Klinik rasch genug erfolgen, sodass in diesen Fällen die Notfallversorgung außerhalb einer stationären perinatologischen Einrichtung zumindest beginnen muss. Da die vielfältigen Möglichkeiten mütterlicher Gefahrenzustände mitunter sehr unterschiedliche Maßnahmen der Akutbehandlung verlangen, sind Rettungsteams subjektiv wie objektiv besonders durch ihr Zutreten zu einer überraschend beginnenden oder sehr rasch verlaufenden Geburt außerordentlich gefordert. Fachgerechte peripartale Diagnostik- und Therapieoptionen stehen in der Regel nicht zur Verfügung. Umso mehr ist für den hier perinatologisch wenig routinierten Notfall-Geburtshelfer klinisches Wissen zu spezifischen Symptomen, Differenzialdiagnosen, Gefährdungsprofilen und seinen Einflussmöglichkeiten gerade in der situationsimmanenten Beschränktheit der Mittel von hohem Wert. Der systematisierte Behandlungspfad entlang des Geburtshilfe-ABCDE-Schemas – gebABCDE leitet im prähospitalen Setting sicher von Schritt zu Schritt. Telemedizinische Unterstützung findet dieser praxisorientierte Notfallalgorithmus durch jederzeit und unmittelbar abrufbare perinatologische Facharztexpertise in Form einer geburtshilflichen Telefonhotline für Notärzte – gebHOTLINE.
Face Perception in Face Transplant Patients
Authors: Gülbetekin Evrim , Bayraktar Seda , Özkan Özlenen , Uysal Hilmi , Özkan Ömer
Published: August 2019

The authors tested face discrimination, face recognition, object discrimination, and object recognition in two face transplantation patients (FTPs) who had facial injury since infancy, a patient who had a facial surgery due to a recent wound, and two control subjects. In Experiment 1, the authors showed them original faces and morphed forms of those faces and asked them to rate the similarity between the two. In Experiment 2, they showed old, new, and implicit faces and asked whether they recognized them or not. In Experiment 3, they showed them original objects and morphed forms of those objects and asked them to rate the similarity between the two. In Experiment 4, they showed old, new, and implicit objects and asked whether they recognized them or not. Object discrimination and object recognition performance did not differ between the FTPs and the controls. However, the face discrimination performance of FTP2 and face recognition performance of the FTP1 were poorer than that of the controls were. Therefore, the authors concluded that the structure of the face might affect face processing.
Early Prognostication after Traumatic Brain Injury: Specific Validation of the IMPACT Prognostic Calculator in a Level 1 Trauma Center
Authors: Jung Anna , Arlt Felix , Rosolowski Maciej , Meixensberger Jürgen
Published: August 2019

The present study evaluated the usefulness of the IMPACT prognostic calculator (IPC) for patients receiving acute neurointensive care at a level 1 trauma center in Germany. A total of 139 patients with traumatic brain injury (TBI) were assessed. One day after trauma, the extended model of the IPC was found to provide the most valid prediction of 6-month mortality/unfavorable outcome. Different time frames within the first day could be determined by analyzing mild, moderate, and severe TBI cohorts. The CORE + CT model at time frame Z2 (<6 h from the point of first documentation) for mild TBI exhibited the highest values in the receiver operating characteristic (ROC) analysis (area under the curve [AUC], 0.9; sensitivity, 1; specificity, 0.7). For patients with moderate head injury at time frame Z2/3 (<6–12 h from point of first documentation), the extended model fit best. For patients with severe TBI, the extended model at time frame Z6 (48–72 h from point of first documentation) best predicted 6-month mortality and unfavorable outcome (ROC analysis: AUC, 0.542/0.445; sensitivity, 0.167/0.364; specificity, 0.575/0.444). Center-specific validation demonstrated the validity of the IPC in the early phase after TBI. These findings support the usefulness of the IPC for predicting the prognosis of patients with TBI. However, further prospective validation using a larger TBI cohort is needed.
A Study of the Diagnostic Accuracy of an Existing Multivariable Test to Predict Shoulder Dystocia
Authors: Easley Henry Alexander , Beste Todd Michael
Published: August 2019

Objectives To evaluate the diagnostic accuracy of a multivariable prediction model, the Shoulder Screen (Perigen, Inc.), and compare it with the American College of Obstetricians and Gynecologists (ACOG) guidelines to prevent harm from shoulder dystocia.

Study Design The model was applied to two groups of 199 patients each who delivered during a 4-year period. One group experienced shoulder dystocia and the other group delivered without shoulder dystocia. The model's accuracy was analyzed. The performance of the model was compared with the ACOG guideline.

Results The sensitivity, specificity, positive, and negative predictive values of the model were 23.1, 99.5, 97.9, and 56.4%, respectively. The sensitivity of the ACOG guideline was 10.1%. The false-positive rate of the model was 0.5%. The accuracy of the model was 61.3%.

Conclusion A multivariable prediction model can predict shoulder dystocia and is more accurate than ACOG guidelines.
Total Colonic Hirschsprung's Disease: The Hypermotility and Skin Rash Protocol
Authors: Vilanova-Sanchez Alejandra , Ivanov Monica , Halleran Devin R. , Wagner Andrea , Reck-Burneo Carlos Albert , Ruth Brenda , FIsher Meghan , Ahmad Hira , Weaver Laura , Nash Onnalisa , Buker Danielle , Rentea Rebecca Maria , Hoover Erin , Maloof Tassiana , Wood Richard J. , Levitt Marc A.
Published: August 2019

Introduction Total colonic Hirschsprung's disease (TCHD) presents a postoperative challenge due to multiple stools and perineal rash. We propose a protocol developed by pediatric surgeons and ostomy nurses to help prevent and treat hypermotility and severe perineal rash, especially in younger children who are not toilet trained.

Materials and Methods We retrospectively reviewed our TCHD patients' charts from 2014 to 2017. All patients received a prescribed protocol for the treatment of hypermotility and perineal rash. We describe patients who underwent their pull through before and after the age of urine toilet training, and assessed the number of bowel movements, the perineal skin status, and growth.

Results We treated 25 patients. Out of 25, 9 patients received a straight ileoanal pull through before the age of 18 months. Nine of 25 patients presented for a second opinion and had redo pull through. The remaining seven presented for bowel management after having a pull through at another institution. All these were treated following the hypermotility protocol. In total, 19 of 25 patients were not toilet trained. The mean number of bowel movements in all groups was 4 (3–5). All had a resolution of perineal rash and liquid stools after 3 months. Eleven of the 25 patients presented with failure to thrive. Two older patients experienced severe proctalgia requiring replacement of the ileostomy.

Conclusion TCHD patients who underwent definitive pull through had nine high incidence of multiple stool, perineal rash, and low growth. With the implementation of bowel management care to slow the stools and a perineal skin protocol to treat the skin, we believe that these symptoms can be minimized even in patients who are not toilet trained. Since the implementation of this protocol, we have changed our practice to perform the pull through in such patients between the age of 6 and 18 months.
Aspirin and Primary Prevention in Patients with Diabetes—A Critical Evaluation of Available Randomized Trials and Meta-Analyses
Authors: Schrör Karsten , Kristensen Steen D. , Storey Robert F. , Verheugt Freek W. A.
Published: August 2019

Primary prevention of cardiovascular events with aspirin in patients with elevated cardiovascular risk, including diabetics, is currently under intense discussion. Data from meta-analyses suggests that the efficacy of aspirin in these patients is low, whereas there is a significantly increased bleeding tendency. However, meta-analyses are based on trials that differ in many important aspects, including study selection. Fresh insights were expected from the ASCEND trial, by far the largest primary, randomized, placebo-controlled prevention trial in diabetics without known cardiovascular disease. There was a small but significant reduction in serious cardiovascular events by aspirin (8.6% vs. 9.6%) but also a significant increase in major bleeding: 4.1% versus 3.2%. Unfortunately, this trial did not meet the desired annual rate of elevated vascular risk of ≥ 2%. It was only 1.2 to 1.3%, and thus in the range of other primary prevention trials in low-risk patients. Apart from potential compliance problems, possible explanations for the small cardioprotective effect of antiplatelet treatment include a healthy lifestyle as well as improved vascular protection by comedication with vasoactive and anti-inflammatory drugs, such as statins or antihypertensive agents, as well as proton-pump inhibitors that might modify bleeding, specifically in the upper gastrointestinal tract—the most frequently affected site. Also, the introduction of new antidiabetic drugs with more favorable cardiovascular effects may in part explain the low event rate. ASCEND, similar to ARRIVE, did not study patients at elevated (as planned) but only at low vascular risk and, therefore, was largely confirmatory of earlier primary prevention trials.
Systemic to Pulmonary Collaterals in Extremely Low Birth Weight Infants: Incidence, Clinical Significance, and Hemodynamic Features
Authors: Hayek Cynthia , Cayabyab Rowena , Thompson Ima , Ebrahimi Mahmood , Siassi Bijan , Ramanathan Rangasamy
Published: August 2019

Objective This study aimed to determine the incidence of systemic to pulmonary collaterals (SPCs) in extremely low birth weight infants and to assess its clinical and hemodynamic significance beyond the neonatal period.

Study Design Retrospective cohort study was conducted on 61 infants with echocardiogram performed at the time of discharge to determine the presence of SPC and to measure the right and left ventricular outputs and left atrium to aortic ratio. We compared two groups: small or no SPC (Group 1) to moderate or large SPC (Group 2) on demographics, clinical outcomes, and echocardiographic parameters.

Results Sixty-one infants were included. The incidence of SPC was 57%; 21% of infants had moderate or large shunts and 31% had small SPC. Demographics, clinical outcomes, and echocardiographic parameters were not significantly different between small or no SPC and moderate to large SPC.

Conclusion More than half of the infants had SPC. The size of the shunt did not affect the clinical outcomes nor the echocardiographic parameters measured. All infants had cardiac output above the normative mean.
Design and characterization of dielectric filled TM110 microwave cavities for ultrafast electron microscopy
Authors: Verhoeven W. , van Rens J. F. M. , Kemper A. H. , Rietman E. H. , van Doorn H. A. , Koole I. , Kieft E. R. , Mutsaers P. H. A. , Luiten O. J.
Published: August 2019

Microwave cavities oscillating in the TM110 mode can be used as dynamic electron-optical elements inside an electron microscope. By filling the cavity with a dielectric material, it becomes more compact and power efficient, facilitating the implementation in an electron microscope. However, the incorporation of the dielectric material makes the manufacturing process more difficult. Presented here are the steps taken to characterize the dielectric material and to reproducibly fabricate dielectric filled cavities. Also presented are two versions with improved capabilities. The first, called a dual-mode cavity, is designed to support two modes simultaneously. The second has been optimized for low power consumption. With this optimized cavity, a magnetic field strength of 2.84 ± 0.07 mT was generated at an input power of 14.2 ± 0.2 W. Due to the low input powers and small dimensions, these dielectric cavities are ideal as electron-optical elements for electron microscopy setups.
InGaN microtube optical resonator with sub-wavelength wall thickness and its application to refractive index sensing
Authors: Li Yufeng , Hu Peng , Feng Lungang , Du Mengqi , Su Xilin , Li Qiang , Yun Feng
Published: August 2019

Subwavelength freestanding InGaN/GaN quantum well microtubes with a wall thickness of about 50 nm are formed by selective release of a coherently strained bilayer heterostructure from a hosting substrate. Highly polarized spontaneous and stimulated emissions due to whispering gallery mode oscillation were observed in photoluminescence spectra at room temperature. The quality factor was increased by a factor of 3 by elevating the microtube from the substrate and reducing light leakage before threshold. A lasing threshold was characterized as low as 3 mJ/cm2. Microtubes were immersed in different liquids with refractive index variation as small as 0.01 and tested below and above threshold. The peak positions shift obviously while exhibiting excellent repeatability. Using a simple optical probe-detect method, a 5-μm diameter microtube cavity achieves a sensitivity of 40 nm/refractive index unit (RIU) and a detection limit of 6 × 10−3 RIU.
The rising velocity of a slowly pulsating bubble in a shear-thinning fluid
Authors: De Corato Marco , Dimakopoulos Yannis , Tsamopoulos John
Published: August 2019

We study the rising motion of small bubbles that undergo contraction, expansion, or oscillation in a shear-thinning fluid. We model the non-Newtonian response of the fluid using the Carreau-Yasuda constitutive equation, under the assumptions that the inertia of the fluid and the bubble is negligible and that the bubble remains spherical. These assumptions imply that the rising velocity of the bubble is instantaneously proportional to the buoyancy force, with the proportionality constant given by the inverse of the friction coefficient. Instead of computing the rising velocity for a particular radial dynamics of the bubble, we evaluate its friction coefficient as a function of the rheological parameters and of the instantaneous expansion/contraction rate. To compute the friction coefficient, we impose a translational motion and we linearize the governing equations around the expansion/contraction dynamics of the bubble, which we solve using a perturbation expansion along with the finite element method. Our results show that the radial motion of the bubble reduces the viscosity of the surrounding fluid and may thus markedly decrease the friction coefficient of the bubble. We use the friction coefficient to compute the average rise velocity of a bubble with periodic variations of its radius, which we find to be strongly increased by the radial pulsations. Finally, we compare our predictions with the experiments performed by Iwata et al. [“Pressure-oscillation defoaming for viscoelastic fluid,” J. Non-Newtonian Fluid Mech. 151(1-3), 30–37 (2008)], who found that the rise velocity of bubbles that undergo radial pulsations is increased by orders of magnitude compared to the case of bubbles that do not pulsate. Our results shed light on the mechanism responsible for enhanced bubble release in shear-thinning fluids, which has implications for bubble removal from complex fluids.
3-D phase-field simulations of self-organized composite morphologies in physical vapor deposited phase-separating binary alloys
Authors: Ankit Kumar , Derby Benjamin , Raghavan Rahul , Misra Amit , Demkowicz Michael J.
Published: August 2019

We use 3D phase-field simulations to investigate the role of deposition rates and atomic mobilities on morphological self-structuring in phase-separating, vapor-deposited alloys. Our numerical simulations predict the three distinct nanocomposite morphologies: vertical composition modulations (VCMs), lateral composition modulations (LCMs), and random composition modulations. We also observed a transitional region between VCM and LCM that exhibits the coexistence of features drawn from both morphologies. We compare these results with experiments carried out on co-deposited Cu-Mo alloys and find good agreement between the two.
A unified analysis of nano-to-microscale particle dispersion in tubular blood flow
Authors: Liu Z. , Clausen J. R. , Rao R. R. , Aidun C. K.
Published: August 2019

Transport of solid particles in blood flow exhibits qualitative differences in the transport mechanism when the particle varies from nanoscale to microscale size comparable to the red blood cell (RBC). The effect of microscale particle margination has been investigated by several groups. Also, the transport of nanoscale particles (NPs) in blood has received considerable attention in the past. This study attempts to bridge the gap by quantitatively showing how the transport mechanism varies with particle size from nano-to-microscale. Using a three-dimensional (3D) multiscale method, the dispersion of particles in microscale tubular flows is investigated for various hematocrits, vessel diameters, and particle sizes. NPs exhibit a nonuniform, smoothly dispersed distribution across the tube radius due to severe Brownian motion. The near-wall concentration of NPs can be moderately enhanced by increasing hematocrit and confinement. Moreover, there exists a critical particle size (∼1 μm) that leads to excessive retention of particles in the cell-free region near the wall, i.e., margination. Above this threshold, the margination propensity increases with the particle size. The dominance of RBC-enhanced shear-induced diffusivity (RESID) over Brownian diffusivity (BD) results in 10 times higher radial diffusion rates in the RBC-laden region compared to that in the cell-free layer, correlated with the high margination propensity of microscale particles. This work captures the particle size-dependent transition from Brownian-motion dominant dispersion to margination using a unified 3D multiscale computational approach and highlights the linkage between the radial distribution of RESID and the margination of particles in confined blood flows.
Development and vertical tests of a 166.6 MHz proof-of-principle superconducting quarter-wave beta = 1 cavity
Authors: Zhang Pei , Zhang Xinying , Li Zhongquan , Dai Jin , Guo Lin , Lin Haiying , Ma Qiang , Huang Tongming , Mi Zhenghui , Wang Qunyao , Meng Fanbo
Published: August 2019

A low-frequency superconducting cavity is needed in main accelerators for storage ring light sources with ultralow emittance. A compact 166.6 MHz superconducting proof-of-principle cavity was designed adopting a quarter-wave β = 1 geometry for a High Energy Photon Source (HEPS). It is a 6 GeV diffraction-limited synchrotron light source currently being developed at the Institute of High Energy Physics. The cavity is exceedingly compact in size yet possessing a low resonant frequency. The nearest higher order mode is largely separated from the fundamental, making the cavity an attractive geometry for effective damping of these modes in high current accelerators such as HEPS. The achieved accelerating voltage of 3.0 MV is well beyond the designed 1.5 MV and required 1.2 MV for HEPS operation. High surface electromagnetic fields were reached with excellent rf and mechanical performances, and multipacting barriers were easily processed. This constitutes the first demonstration of a compact low-frequency β = 1 superconducting cavity for HEPS. The design, fabrication, surface preparation, and cryogenic tests of the cavity are presented.