bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic and prognostic implications of parafibromin immunohistochemistry in parathyroid carcinomaT
Authors: Pyo Jung-Soo , Cho Won Jin
Published: March 2019

The aim of the present study was to elucidate the diagnostic and prognostic implications of parafibromin immunohistochemistry (IHC) in parathyroid carcinoma (PC). We performed a meta-analysis to examine the rate of loss of parafibromin expression from 18 eligible studies. In addition, a diagnostic test accuracy review was conducted to investigate the diagnostic role of parafibromin in PC. The rates of loss of parafibromin expression were 0.522 (95% CI: 0.444–0.599), 0.291 (95% CI: 0.207–0.391), 0.027 (95% CI: 0.011–0.064), and 0.032 (95% CI: 0.008–0.119) in PC, atypical parathyroid adenoma (APA), parathyroid adenoma (PA), and parathyroid hyperplasia, respectively. In the diagnostic test accuracy review for diagnosis of PC, the pooled sensitivity and specificity of parafibromin IHC was 0.53 (95% CI: 0.46–0.59) and 0.96 (95% CI: 0.95–0.97), respectively. The diagnostic odds ratio and the area under curve on summary receiver operating characteristic curve was 25.31 (95% CI: 8.91–71.87) and 0.7954, respectively. In addition, the meta-analysis demonstrated that loss of parafibromin expression was significantly correlated with worse disease-free survival (hazard ratio: 2.832; 95% CI: 1.081–7.421). Loss of parafibromin IHC expression was significantly higher in PC than in APA, PA, and parathyroid hyperplasia. Parafibromin IHC could be useful for diagnosis and prediction of prognosis of PC in daily practice.
Parathyroid hormone-related protein induces fibronectin up-regulation in rat mesangial cells through reactive oxygen species/Src/EGFR signaling
Authors: Chen Hong-Min , Dai Jia-Jia , Zhu Rui , Peng Fang-Fang , Wu Su-Zhen , Yu Hong , Krepinsky Joan C. , Zhang Bai-Fang
Published: March 2019

Parathyroid hormone-related protein (PTHrP) is known to be up-regulated in both glomeruli and tubules in patients with diabetic kidney disease (DKD), but its role remains unclear. Previous studies show that PTHrP-induced hypertrophic response in mesangial cells (MCs) and epithelial-mesenchymal transition (EMT) in tubuloepithelial cells can be mediated by TGF-β1. In the present study, although long-term PHTrP (1–34) treatment increased the mRNA and protein level of TGF-β1 in primary rat MCs, fibronectin up-regulation occurred earlier, suggesting that fibronectin induction is independent of TGF-β1/Smad signaling. We thus evaluated the involvement of epidermal growth factor receptor (EGFR) signaling and found that nicotinamide adenine dinucleotide phosphate oxidase-derived reactive oxygen species mediates PTHrP (1–34)-induced Src kinase activation. Src phosphorylates EGFR at tyrosine 845 and then transactive EGFR. Subsequent PI3K activation mediates Akt and ERK1/2 activation. Akt and ERK1/2 discretely lead to excessive protein synthesis of fibronectin. Our study thus demonstrates the new role of PTHrP in fibronectin up-regulation for the first time in glomerular MCs. These data also provided new insights to guide development of therapy for glomerular sclerosis.
Multi-line Herschel/HIFI observations of water reveal infall motions and chemical segregation around high-mass protostars
Authors: van der Tak F. F. S. , Shipman R. F. , Jacq T. , Herpin F. , Braine J. , Wyrowski F.
Published: March 2019

Context. The physical conditions during high-mass star formation are poorly understood. Outflow and infall motions have been detected around massive protostellar objects, but their dependence on mass, luminosity, and age is unclear. In addition, physical conditions and molecular abundances are often estimated using simple assumptions such as spherical shape and chemical homogeneity, which may limit the accuracy of the results.

Aims. We aim to characterize the dust and gas distribution and kinematics of the envelopes of high-mass protostars. In particular, we search for infall motions, abundance variations, and deviations from spherical symmetry, using Herschel data from the WISH program.

Methods. We used HIFI maps of the 987 GHz H2O 202–111 emission to measure the sizes and shapes of 19 high-mass protostellar envelopes. To identify infall, we used HIFI spectra of the optically thin C18O 9–8 and H218O 111–000 lines. The high-J C18O line traces the warm central material and redshifted H218O 111–000 absorption indicates material falling onto the warm core. We probe small-scale chemical differentiation by comparing H2O 752 and 987 GHz spectra with those of H218O.

Results. Our measured radii of the central part of the H2O 202–111 emission are 30–40% larger than the predictions from spherical envelope models, and axis ratios are <2, which we consider good agreement. For 11 of the 19 sources, we find a significant redshift of the H218O 111–000 line relative to C18O 9–8. The inferred infall velocities are 0.6–3.2 km s−1, and estimated mass inflow rates range from 7 × 10−5 to 2 × 10−2 M⊙ yr−1. The highest mass inflow rates seem to occur toward the sources with the highest masses, and possibly the youngest ages. The other sources show either expanding motions or H218O lines in emission. The H218O 111–000 line profiles are remarkably similar to the differences between the H2O 202–111 and 211–202 profiles, suggesting that the H218O line and the H2O 202–111 absorption originate just inside the radius where water evaporates from grains, typically 1000–5000 au from the center. In some sources, the H218O line is detectable in the outflow, where no C18O emission is seen.

Conclusions. Together, the H218O absorption and C18O emission profiles show that the water abundance around high-mass protostars has at least three levels: low in the cool outer envelope, high within the 100 K radius, and very high in the outflowing gas. Thus, despite the small regions, the combination of lines presented in this work reveals systematic inflows and chemical information about the outflows.
Validation of Permeability and Relative Permeability Data Using Mercury Injection Capillary Pressure Data
Authors: Arabjamaloei Rasoul , Daniels David , Ebeltoft Einar , Petersen Egil , Pitman Richard John , Ruth Douglas
Published: March 2019

This paper reports on a study with the objective to validate a set of core analysis data using a combination of mercury injection capillary pressure (MICP) data and statistical correlation techniques. The data set is from an off-shore reservoir in Atlantic Canada. Analysis of this reservoir was complicated by the fact that the permeabilities of the samples were high, greater than 2400 mD. The analysis was done using an existing data set, not a data set specifically tailored for the techniques used in the analysis. The data analyzed included samples that represented seven zones in a single well. Porosities and permeabilities were available for the MICP samples. Electrical properties, along with porosities and permeabilities, were available on samples from each zone, but not from the same depths as the MICP samples. Steady-state relative permeabilities (SSRP) were available for stacked samples in each zone; one of the samples in the stack was a companion sample for one of the MICP samples from that zone. The MICP results were used to validate the permeability measurements using both the Swanson method (SM) and the Ruth-Lindsay-Allen (RLAM) method. The SM, using published correlation parameters, significantly under-predicted the permeabilities; the RLAM, which uses no correlation parameters, gave predictions within a maximum error of just over 33% and a mean error of -12%. The MICP data was used to validate the shapes of the SSRP curves using the Gates and Tempelaar-Lietz method (GT-LM), the Burdine method (BM), and a modified Burdine method (MBM). The GT-LM, which uses no correlation parameters, provided good predictions of the wetting phase SSRP curves but very poor predictions of the non-wetting phase SSRP curves. The BM, using published correlation parameters, provided poor predictions of the wetting phase SSRP curves but improved predictions of the non-wetting phase SSRP curves. The MBM provided good predictions of the wetting phase SSRP curves and acceptable predictions of the non-wetting phase SSRP curves. The MBM method does use a correlation parameter but a single value was used for all seven zones. This work provides a protocol for validating core analysis data that can be implemented in a straightforward manner to determine the “quality” of the data. The results emphasize the importance of MICP as an experimental technique. A proposed modified workflow is presented that would optimize the validation protocol.
Determination of Electrical Parameters in Carbonates with Micro-CT, NMR and Gas Displacement Experiments
Authors: Kewen Wang , Ning Li , Hongliang Wu , Gong Zhang , Zhou Feng , jun Yu
Published: March 2019

Understanding the electrical characteristics of carbonate formation and accurately determining the electrical parameters (cementation exponent m and saturation exponent n in Archie equation) are very important for carbonate formations evaluation. However, the study of electrical characteristics faces great challenge because of the variable pore types, the complicated pore structure and the big heterogeneity in carbonates. We selected representative carbonate cores to carry out experiment research based on newly developed technologies in digital core analysis and resistivity test. Three types of cores were selected: the void space is mainly intergranular and intercrystalline; the vugs are developed; the fractures are developed. Firstly, the porosity and permeability of the selected cores have been tested. Then micro-CT with high resolution is used to scan the cores and NMR T2 spectrums of the cores both in water-saturated state and in bound water state are obtained. Finally, the resistivity of the cores in different water saturation is tested by using gas displacement technology. The analysis results of the experimental data show that the intergranular and intercrystalline pore and the fracture both have great influence on R0 while the influence of secondary vug on R0 is slight. Cementation exponent m and saturation exponent n have great difference between different cores and there is no obvious relation between m, n and reservoir parameters (φ or K). However, if we classify the cores based on the pore type, and the values of both m and n have good relationship with bound water saturation.
Dos and Don’ts When Developing a System to Investigate Spontaneous Imbibition in Unconsolicdated Porous Media
Authors: Brattekås Bergit , Føyen Tore L. , Vabø Trond , Haugland Håkon , Reite Simon I. , Saunes Anders S. , Fernø Martin A.
Published: March 2019

This paper describes the development of a consistent model system to measure spontaneous imbibition and determine saturation functions in unconsolidated porous media. Sand grains or glass beads were packed in up to 0.5 m long, transparent glass tubes with optical access to local saturation development during spontaneous imbibition processes. The Two Ends Open-Free spontaneous imbibition (TEOFSI) boundary condition was used, where one end face is exposed to the wetting ﬂuid and the other end to the non-wetting ﬂuid. Dynamic measurement of the advancing displacement front and volumetric production from each open end-face enabled estimation of capillary pressure and relative permeability for the system. A range of wetting- and non-wetting phase viscosities and viscosity ratios was used during spontaneous imbibition in unconsolidated sand or glass packs. Wetting phase (water) viscosity was increased using water soluble glycerol or polymers. Air or mineral oil of varying composition provided a wide range of non-wetting phase viscosities. High permeable systems are extremely sensitive to laboratory properties, which may dominate the viscous resistance and determine ﬂow behaviour. Systematic discrepancies observed in early testing indicated that end effects were present, even in long systems, in the ﬁlters at each end of the glass tube to maintain the grains or beads in place. Different ﬁlters were tested (no ﬁlter, glass, paper and micro-porous discs) to determine the impact of the ﬁlter on spontaneous imbibition. In addition to slower oil recovery than anticipated, developmentof a non-uniform displacement front was observed, demonstrating the large inﬂuence from minute heterogeneities within the packs, and at the end faces. A standard sand grain packing procedure, using a custom-designed packing device, was therefore developed to ensure homogeneous properties throughout theporous media, and limited the spread in porosity and permeability values. Homogeneous sand packs with reproducible properties are necessary, to systematically investigate ﬂow parameters and changes in wettability in unconsolidated porous media.
An Investigation into Different Correlation Methods between NMR T2 Distributions and Primary Drainage Capillary Pressure Curves Using an Extensive Sandstone Database
Authors: Moss Adam K , Benson Tim , Barrow Tony
Published: March 2019

Many workers have recognised the link between Nuclear Magnetic Resonance (NMR) derived T2 distributions and pore size distributions in reservoir rocks. This property has been used to develop models to obtain primary drainage capillary pressure curves from T2 distributions. These models often assume that the rocks pore space resembles a simple bundle of capillary tubes. They do not consider the existence of multiple pore body connections and pore body restrictions/throats. The most successful models utilise variable scaling factors to convert T2 times to pore diameters and hence capillary pressure. The variable scaling factor approach recognises the existence of variable surface relaxivity throughout the pore space due to variations in mineralogy and pore topography. This investigation uses SCAL data from the ART NMR Sandstone Rock Catalogue to obtain core calibrated variable scaling factors for 174 reservoir sandstone samples. The depositional environments for these samples include; aeolian, fluvial, coastal and shallow and deep marine. The samples used have a wide variety of mineralogy, diagenetic overprints and cover six orders of magnitude in absolute permeability. Three different methods for obtaining the scaling factors are presented and the relative merits of each discussed. A global model to predict capillary pressure from NMR T2 distributions in reservoir sandstones has been developed using correlations between the variable scaling factors and permeability.
Obtaining High Quality SCAL Data: Combining Different Measurement Techniques, Saturation Monitoring, Numerical Interpretation and Continuous Monitoring of Experimental Data
Authors: Wang Yingxue , Masalmeh Shehadeh K.
Published: March 2019

SCAL parameters (i.e., Relative Permeability and Capillary Pressure curves) are key inputs to understand and predict reservoir behavior in all phases of development. Techniques to measure relative permeability and capillary pressure have been well established and applied to a wide variety of core samples both from sandstone and carbonate reservoirs. On the other hand, we frequently encounter quality compromised data due to challenges in experimental procedures, lack of understanding of measurement techniques, and poor quality of raw data. As a result, relative permeability is often viewed as a parameter with large uncertainties and a ﬁtting parameter in history matching. A special core analysis program was recently carried out on selected core samples from a deep-water sandstone reservoir in the Gulf of Mexico. In this frontier, relative permeability has been ranked among the top subsurface uncertainties. It greatly impacts the production forecast and ﬁeld development plan. However, due to the high temperature, high salinity and ﬂuid compatibility issues, the core measurements faced very speciﬁc challenges and a good relative permeability dataset has not been obtained in the past for this area. In this work, we demonstrate that a quality set of relative permeability data can be obtained through close collaboration across disciplines, a properly designed protocol, adequate engagement with the laboratory, timely QA/QC of experimental raw data, and appropriate interpretation incorporating numerical simulations. Well-deﬁned and constrained relative permeability curve shave been derived with the combination of steady state and centrifuge techniques. The average trend can be described by a residual oil saturation of 22%, end-point relative permeabilities of 0.6 and 0.2 to oil and water, respectively and Corey exponents between 2 and 3.
Spatially resolved wettability measurements using nmr wettability index
Authors: Dick M. J. , Veselinovic D. , Green D.
Published: March 2019

Wettability is a crucial petrophysical parameter for determining accurate production rates in oil and gas reservoirs. However, industry standard wettability measurements (Amott Test and USBM) are expensive and time consuming. It is known that NMR response varies as a function of wettability change in rock core plug samples. This information was used to develop an NMR wettability index (NWI) based on T2 distributions. This NWI is capable of measuring changes in wettability as a function of oil/water saturations unlike traditional methods which are based on measurements at Swi and Sor only. In addition, these oil/water saturations are determined without the aid of any special oil or brine, such as D2O. This allows the NMR method to nondestructively monitor changes in wettability in real time (i.e. during a flooding experiment or an aging procedure). In this work, we have coupled this T2-based NWI to spatially resolved T2 NMR measurements to monitor changes in wettability and saturation along rock core plugs. In order to derive an NMR wettability index, NMR T2 spectra of 100% brine saturated, 100% oil saturated, bulk oil and bulk brine are needed. These spectra are then mixed to give a predicted T2 spectrum which is compared (via a least squares fit) to a T2 spectrum recorded from a sample partially saturated with both water and oil and whose wettability is to be determined. For initial testing, three sandstone samples were employed along with 2% KCl brine and dodecane. To achieve sample states of mixed wettability, 100% brine saturated samples had dodecane pushed into them via centrifugation. Centrifugation at different speeds resulted in samples of varying bulk and spatial wettabilities from which NWI parameters and oil/water saturations were determined. The bulk wettabilities were compared to measurements done using the standard Amott test and oil/water saturations were confirmed by repeating experiments using NMR invisible D2O.
Added insight from image-based wettability characterization
Authors: Held Rudolf , Schleifer Norbert , Genolet Luis , Fogden Andrew
Published: March 2019

Microtomographic rock and fluid imaging under in-situ conditions is applied for reservoir wettability characterization. The investigation entails careful sample preparation and cleaning of mini-plugs, operation with reservoir fluids, wettability restoration, centrifuge wettability testing cycles, repeated sample scanning and image analysis, parametrization of wettability and digital rocks simulation for input into reservoir modeling. The results are compared to conventional Amott testing performed in core laboratories. Determination of saturations from image analysis, instead of centrifuge production, allows the use of stock tank crude, rather than exchanged mineral oil. Doping of the synthetic formation water (here with 1 M sodium iodide) was applied for enhancement of the X-ray contrast. The digital imaging workflow offers insight on the liquid distributions from the plug scale down to the pore-scale, linked to applied pressure gradients and resulting pore fluid occupancies in the sequence of displacement states. An example is given with the investigation of a North-German oil field, where the image-based workflow led to a revised view of the reservoir conditions for spontaneous imbibition and drainage, and the overall wetting behavior.
Ultrafast lasers: from femtoseconds to attoseconds
Authors: Cerullo Giulio , Nisoli Mauro
Published: March 2019

We review the capability of lasers to generate light pulses of incredibly short duration, from a few femtoseconds (1 fs = 10-15 s) in the visible down to a few tens of attoseconds (1 as = 10-18 s) in the extreme-ultraviolet, reaching peak powers up to several petawatts (1 PW = 1015 W).
Study of an asymptotic preserving scheme for the quasi neutral Euler–Boltzmann model in the drift regime
Authors: Badsi Mehdi
Published: March 2019

We deal with the numerical approximation of a simplified quasi neutral plasma model in the drift regime. Specifically, we analyze a finite volume scheme for the quasi neutral Euler–Boltzmann equations. We prove the unconditional stability of the scheme and give some bounds on the numerical approximation that are uniform in the asymptotic parameter. The proof relies on the control of the positivity and the decay of a discrete energy. The severe non linearity of the scheme being the price to pay to get the unconditional stability, to solve it, we propose an iterative linear implicit scheme that reduces to an elliptic system. The elliptic system enjoys a maximum principle that enables to prove the conservation of the positivity under a CFL condition that does not involve the asymptotic parameter. The linear L2 stability analysis of the iterative scheme shows that it does not request the mesh size and time step to be smaller than the asymptotic parameter. Numerical illustrations are given to illustrate the stability and consistency of the scheme in the drift regime as well as its ability to compute correct shock speeds.
Low-rank approximation of linear parabolic equations by space-time tensor Galerkin methods
Authors: Boiveau Thomas , Ehrlacher Virginie , Ern Alexandre , Nouy Anthony
Published: March 2019

We devise a space-time tensor method for the low-rank approximation of linear parabolic evolution equations. The proposed method is a Galerkin method, uniformly stable in the discretization parameters, based on a Minimal Residual formulation of the evolution problem in Hilbert–Bochner spaces. The discrete solution is sought in a linear trial space composed of tensors of discrete functions in space and in time and is characterized as the unique minimizer of a discrete functional where the dual norm of the residual is evaluated in a space semi-discrete test space. The resulting global space-time linear system is solved iteratively by a greedy algorithm. Numerical results are presented to illustrate the performance of the proposed method on test cases including non-selfadjoint and time-dependent differential operators in space. The results are also compared to those obtained using a fully discrete Petrov–Galerkin setting to evaluate the dual residual norm.
Asymptotic analysis of the RS-IMEX scheme for the shallow water equations in one space dimension
Authors: Zakerzadeh Hamed
Published: March 2019

We introduce and analyse the so-calledReference Solution IMplicit-EXplicit schemeas a flux-splitting method for singularly-perturbed systems of balance laws. RS-IMEX scheme’s bottom-line is to use the Taylor expansion of the flux function and the source term around a reference solution (typically the asymptotic limit or an equilibrium solution) to decompose the flux and the source into stiff and non-stiff parts so that the resulting IMEX scheme is Asymptotic Preserving (AP) w.r.t. the singular parameter tending to zero. We prove the asymptotic consistency, asymptotic stability, solvability and well-balancing of the scheme for the case of the one-dimensional shallow water equations when the singular parameter is the Froude number. We will also study several test cases to illustrate the quality of the computed solutions and to confirm the analysis.
Inverse problem for the Helmholtz equation with Cauchy data: reconstruction with conditional well-posedness driven iterative regularization
Authors: Alessandrini Giovanni , De Hoop Maarten V. , Faucher Florian , Gaburro Romina , Sincich Eva
Published: March 2019

In this paper, we study the performance of Full Waveform Inversion (FWI) from time-harmonic Cauchy data via conditional well-posedness driven iterative regularization. The Cauchy data can be obtained with dual sensors measuring the pressure and the normal velocity. We define a novel misfit functional which, adapted to the Cauchy data, allows the independent location of experimental and computational sources. The conditional well-posedness is obtained for a hierarchy of subspaces in which the inverse problem with partial data is Lipschitz stable. Here, these subspaces yield piecewise linear representations of the wave speed on given domain partitions. Domain partitions can be adaptively obtained through segmentation of the gradient. The domain partitions can be taken as a coarsening of an unstructured tetrahedral mesh associated with a finite element discretization of the Helmholtz equation. We illustrate the effectiveness of the iterative regularization through computational experiments with data in dimension three. In comparison with earlier work, the Cauchy data do not suffer from eigenfrequencies in the configurations.
A local discontinuous Galerkin gradient discretization method for linear and quasilinear elliptic equations
Authors: Abdulle Assyr , Rosilho de Souza Giacomo
Published: March 2019

A local weighted discontinuous Galerkin gradient discretization method for solving elliptic equations is introduced. The local scheme is based on a coarse grid and successively improves the solution solving a sequence of local elliptic problems in high gradient regions. Using the gradient discretization framework we prove convergence of the scheme for linear and quasilinear equations under minimal regularity assumptions. The error due to artificial boundary conditions is also analyzed, shown to be of higher order and shown to depend only locally on the regularity of the solution. Numerical experiments illustrate our theoretical findings and the local method’s accuracy is compared against the non local approach.
Assessment of knowledge and awareness of “sustainability” initiatives among college students
Authors: Msengi Israel , Doe Raymond , Wilson Twana , Fowler Danny , Wigginton Chelsey , Olorunyomi Sarah , Banks Isaiah , Morel Raquel
Published: March 2019

Campus sustainability is essential for any university. Campus sustainability denotes the potential of the university to develop new ideas regarding sustainability through research, teaching, and practices. It necessitates improved academic infrastructures, setting right faculty priorities and practices that ensure that the university community is aware of sustainable practices, and that its practices reflect sustainability. This study assesses college students' knowledge and awareness of sustainability issues. After IRB approval, data were collected using the campus sustainability questionnaire. Students from a university in the southeastern part of Texas in the United States were selected and asked to participate in the study voluntarily by answering a self-report questionnaire. Findings indicate that only a minority of the students knew what sustainability was, but 95.8% indicated it was important. Although the university has committed to climate and sustainability agreements, majority of the students were not aware of it and only about 17% knew that the University's Strategic Plan has a sustainability component. Nearly 36% of the students reported receiving information about sustainability during their campus orientation. In terms of recycling, majority of the students indicated unawareness of e-waste recycling on campus; however, more than 70% reported that the library limited free printing in computer labs. More than half of the students also indicated that sustainability issues were not infused into curriculum courses or programs, and they had no knowledge of any alternative power source for the university. We concluded that a majority of the students were not conversant with sustainability issues and were largely unaware of campus sustainability initiatives. We recommended more effort to increase sustainability initiatives on campus by involving faculty, staff, and students in such endeavors. Educational programs should incorporate sustainability into their curriculum to increase students' knowledge and consciousness regarding these issues.
Infektiologie – Pionier der Digitalen Medizin
Authors: Vehreschild Jörg , Claßen Annika , Jakob Carolin
Published: March 2019

Was ist neu?

Von der personalisierten zur digitalen Medizin Über Impfungen und gezielte Erregerdiagnostik und -therapie ist die Infektionsmedizin Vorreiterin der personalisierten Medizin. Datenprozesse im Rahmen neuer Infektionsepidemien sind Musterbeispiele der Möglichkeiten der digitalen Medizin.

Klinische Entscheidungshilfen Die oft gut definierten Krankheitsbilder der Infektiologie und das hohe Niveau der verfügbaren Leitlinien sind ideale Voraussetzungen für computerunterstützte Behandlungsentscheidungen.

Datengetriebene Infektionsforschung Durch die Verbindung von Daten aus elektronischen Patientenakten mit den umfassenden Datensätzen neuer Technologien aus der sogenannten „Omics“-Forschung können neue Zusammenhänge erkannt und Prognosen verbessert werden.

Elektronische Gesundheitsakte Die elektronische Gesundheitsakte eröffnet großes Potenzial im Sinne einer zielgerichteten Behandlung, insbesondere bei infektiologischen Notfällen.

Telemedizin In Deutschland fehlen Infektiologen, ein Strukturwandel kann nur schrittweise vollzogen werden. Telemedizinische Konsultationen können helfen, infektiologische Expertise in unzureichend versorgte Regionen zu bringen.

Mobile Health Die fast vollständige Verbreitung mobiler Digitalgeräte schafft neue Möglichkeiten für die Gestaltung der Arzt-Patient-Kommunikation sowie der heimatnahen Nachsorge.

Mobile Versorgung chronischer Infektionen Beim Langzeitmanagement chronischer Erkrankungen sowie bei der Versorgung in Regionen mit schwacher Infrastruktur entstehen Möglichkeiten einer verbesserten medizinischen Behandlung.

Balance der Interessen Die Digitale Medizin birgt Risiken durch die Schaffung großer Datensätze mit potenziell stigmatisierenden Patienteninformationen. Softwaresysteme, die Entscheidungen von klinischer Relevanz beeinflussen, bedürfen sorgfältiger Prüfung und Transparenz.
Digitalisierung in der Intensivmedizin
Authors: Baumgärtel Matthias , Riessen Reimer , John Stefan
Published: March 2019

Was ist neu?

Stand der Dinge Intensivstationen sind prädestiniert für den Einsatz digitaler Hilfsmittel. Digitale Systeme bieten eine gute Plattform für modernes Qualitätsmanagement und Forschungsprojekte.

Patientendatenmanagementsysteme (PDMS) Die Verwendung von Patientendatenmanagementsystemen ist die Grundvoraussetzung für eine erfolgreiche Digitalisierung in der Intensivmedizin und sollte nachhaltig gefördert werden.

Telemedizin Es gibt vielversprechende neue Konzepte zur Nutzung der Telemedizin in der Intensivmedizin. Telemedizin ermöglicht die Betreuung von Intensivstationen in Krankenhäusern der Grundversorgung durch spezialisierte Zentren.

Digitale Stationsorganisation Die Logistik der Patientenversorgung ist ein häufig unterschätzter Faktor auf Intensivstationen. Digitale Systeme zur Stationsorganisation können hier eine Lücke schließen.

Ausblick Die weitere Digitalisierung kann dabei helfen, die Prozesse auf einer Intensivstation zu optimieren und eine Patientenversorgung auf dem aktuellen wissenschaftlichen Stand zu erleichtern.
Digital Health in der Rheumatologie – Statuserhebung 2018/19
Authors: Richter Jutta , Chehab Gamal , Kiltz Uta , Callhoff Johanna , Voormann Anna , Lorenz Hanns-Martin , Schneider Matthias , Specker Christof
Published: March 2019

Was ist neu?

Stand der Dinge Innovationen in der Informations- und Kommunikationstechnologie haben in der Rheumatologie eine jahrzehntelange Tradition, die Deutsche Gesellschaft für Rheumatologie hat im Jahr 2018 die Kommission „Digitale Rheumatologie“ gegründet.

Digitale Anwendungen in der deutschen Rheumatologie Mobile Datenerfassung rheumatologischer Patienten ist valide möglich. Sie eröffnet damit neuartige Möglichkeiten bei der Umsetzung moderner Behandlungsstrategien. Zum Screening auf entzündlich-rheumatische Systemerkrankungen stehen Interessierten z. B. mit dem „Rheuma-Check“ und dem „Bechterew-Check“ jederzeit digitale Anwendungen zur Verfügung. Die digitalen Angebote sowie moderne Netzwerkstrukturen erlauben eine Triage der Patienten. Mit dem Rhekiss- und dem RABBIT-SpA-Register stehen erstmals vollständig digitalisierte Register zur Verfügung, die kurzfristig Daten zu Fragestellungen liefern, die in klinischen Studien der pharmazeutischen Industrie nicht abgebildet werden.

Ausblick Durch die Digitalisierung in der Rheumatologie können wichtige Fragen der Versorgungsforschung zukünftig deutlich schneller beantwortet werden.
Digitalisierung in der Gastroenterologie
Authors: Weidemann Robin , Meining Alexander , Lynen Petra , Lammert Frank , Möller Yvonne , Malek Nisar , Hampe Jochen
Published: March 2019

Was ist neu?

Digitalisierung in der personalisierten Medizin Fortschritte in der genomischen Diagnostik und digitale innovative Technologien lassen die personalisierte Therapie gastrointestinaler entzündlicher und onkologischer Erkrankungen bald möglich erscheinen.

Digitalisierung in der interventionellen Diagnostik und Therapie In der interventionellen Gastroenterologie lassen sich neue IT-gestützte Diagnostik- und Therapieverfahren und Formen der Mensch-Technik-Kollaboration gut testen und im Versorgungalltag validieren.

Digitale Kompetenzen und Kommunikation Um die Arzt-Patienten-Kommunikation auf Augenhöhe zu erhalten, müssen auf beiden Seiten Kompetenzen im Umgang mit digitalen Anwendungen aufgebaut werden. Qualitativ hochwertige digitale Gesundheitsprodukte im unübersichtlichen Markt zu identifizieren bleibt eine Herausforderung.

Wissensmanagement und ärztliche Weiterbildung Die Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselerkrankungen entwickelt digitale Angebote für verschiedene Interessengruppen und engagiert sich bei der Wissensvermittung über soziale Netzwerke. Die ärztliche Weiterbildung im Zeitalter der Digitalisierung ist ebenfalls ein wichtiges Thema.

Implementierungsprobleme und Handlungsoptionen Um die Qualität technologischer Innovationen zu steigern und einen erfolgreichen Transfer in die Versorgung zu ermöglichen ist eine engere Kooperation zwischen Patienten, praktisch tätigen Ärzten und technischen Experten unabdingbar. Entsprechende Strukturen hierfür fehlen weitgehend.
Das Projekt PRIMA – Elektronische Erstellung und Aktualisierung von Medikationsplänen als gemeinsame Aufgabe von Ärzten und Apothekern
Authors: Eickhoff Christiane , Müller Uta , Strunz Ann Kathrin , Seidling Hanna M. , Lampert Anette , Felberg Miriam , Breiholz Sabine , Klintworth Dirk , Schulz Martin
Published: March 2019

Einleitung Der Gesamtüberblick über die Medikation eines Patienten ist wesentliche Voraussetzung für die Arzneimitteltherapiesicherheit. Ein aktueller und vollständiger Medikationsplan (MP) ist hierfür ein geeignetes Instrument. Ziel war zu untersuchen, inwiefern die elektronische Bearbeitung des bundeseinheitlichen Medikationsplans gemeinsam durch Arzt und Apotheker in ihren Primärsystemen technisch machbar ist, die definierten Prozesse praktikabel sind und akzeptiert werden.

Methoden Ärzte und Apotheker testeten in einem mehrstufigen Verfahren die elektronische Umsetzung. Die Bearbeitung der MP erfolgte anhand definierter Prozesse und Verantwortlichkeiten; Machbarkeit und Akzeptanz wurden in schriftlichen Befragungen und einem Workshop evaluiert.

Ergebnisse Erstmalig in Deutschland wurden die Voraussetzungen zur elektronischen Erstellung, zum Austausch und zur Aktualisierung von MP in einem Arzt- und vier Apothekenverwaltungssystemen geschaffen. Gelöste Probleme waren technische und AMTS-relevante Fehler, abweichende Darstellungen, mangelnde Benutzerfreundlichkeit und begrenzte Speicherkapazität des Barcodes. Elf Arzt-Apotheker-Teams betreuten 196 Patienten. Insgesamt waren 60 % mit den Prozessen und 80 % der Ärzte sowie 63 % der Apotheker mit den Verantwortlichkeiten zufrieden. Ärzte bewerteten die Erfassung der Gesamtmedikation durch Apotheker positiv. Die Kooperation verbesserte den fachlichen Austausch. Dies führt bei 70 % der Ärzte bei der Medikation und bei 88 % der Apotheker zum Gesundheitszustand der Patienten zu einem Wissenszuwachs. Alle Ärzte und Apotheker sahen eine strukturierte Zusammenarbeit als wichtig (25 %) oder sehr wichtig (75 %) für die Qualität der MP an.

Diskussion Der MP wurde erstmalig in Primärsysteme implementiert. Prozesse und Verantwortlichkeiten fanden bei Ärzten und Apothekern Akzeptanz. Dies sind wichtige Voraussetzungen, um den MP flächendeckend und nachhaltig zu implementieren.
Radiologic Update on Arthroplasties in the Wrist and Hand
Authors: Petscavage-Thomas Jonelle , Gustas-French Cristy , Walker Eric
Published: March 2019

Arthritis involving the hand and wrist can significantly impair functions of daily living. Although arthrodesis provides pain relief, it limits range of motion at the affected joint. Arthroplasty is an alternative surgical treatment for hand and wrist arthritis, providing both pain relief and restoration of a range of motion. Over the past decade, several advances have occurred in hand and wrist arthroplasty designs. This article reviews component design, normal imaging appearance, and common complications of arthroplasty used in the wrist and hand. It also introduces readers to newer arthroplasty designs.
Fractures Around the Shoulder: Radiologic Update on Surgical Fixation Techniques
Authors: Gaetke-Udager Kara , Yablon Corrie
Published: March 2019

Although radiologists are likely familiar with basic fracture patterns around the shoulder, certain fracture types in this area have particularly relevant and controversial clinical management issues. These include proximal humeral fractures, in which conservative management is favored but some patients receive surgical treatment; glenoid fractures and Hill-Sachs lesions, in which surgery may be performed depending on the amount of bone loss; and distal clavicular fractures, in which certain displaced fractures have high rates of nonunion, but there is no clearly favored surgical technique. Knowledge of the different clinical issues and surgical options can aid the radiologist in identifying key imaging findings and creating a useful report.
Current Fixation Options for Elbow, Forearm, Wrist, and Hand Fractures
Authors: Bartolotta Roger , Daniels Steven , Verret Claire , Fufa Duretti
Published: March 2019

The universal goals of upper limb fracture management are to restore anatomic alignment, establish stable fracture fixation (while preserving blood supply), and allow for early mobilization of the elbow, wrist, and digits. However, the indications for operative management and fixation constructs are specific to each fracture type. This article systematically reviews current classifications and treatment options for adult fractures of the distal humerus, radius, ulna, scaphoid, metacarpals, and phalanges. For each anatomic location, we discuss the salient imaging features to guide management decisions (conservative versus internal and/or external fixation). Specifically, we emphasize the amount of displacement, angulation, comminution, and/or intra-articular involvement typically guiding operative management for each fracture type. Through this understanding of the surgical indications, rationale behind different fixation options, and common complications, the radiologist can better support the orthopaedic surgeon via more informed fracture reporting.
Parkinson's Disease Dementia and Lewy Body Disease
Authors: Sezgin Mine , Bilgic Basar , Tinaz Sule , Emre Murat
Published: March 2019

Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PD-D) are Lewy body-related neurodegenerative disorders sharing common clinical and neuropathological findings. The clinical features of both conditions include cognitive impairment, behavioral symptoms, autonomic dysfunction, sleep disorders, and parkinsonism. The cognitive profile of both disorders is characterized by particularly severe deficits in executive and visuospatial functions as well as attention. Clinical differentiation between DLB and PD-D is based on an arbitrary distinction between the time of onset of parkinsonism and cognitive symptoms; extrapyramidal symptoms precede dementia in PD-D, whereas it coincides with or follows dementia within 1 year in DLB. When the clinical picture is fully developed, DLB and PD-D are practically indistinguishable. Although the diagnosis is basically clinical, structural and functional neuroimaging as well as cerebrospinal fluid biomarkers may help the clinician in the diagnosis. Placebo-controlled randomized trials of the cholinesterase inhibitors have shown modest but significant benefits in cognition, global function, and neuropsychiatric symptoms in both disorders. Behavioral symptoms such as hallucinations and delusions should be treated with caution with antipsychotics, as they have the potential to worsen motor and cognitive symptoms.
Rare Tauopathies
Authors: Ali Farwa , Josephs Keith
Published: March 2019

Tauopathies are rare neurodegenerative disorders related to microtubule-associated protein tau, which functions to stabilize microtubules. Pathological changes caused by overexpression or hyperphosphorylation of tau lead to the disengagement of tau from microtubules and accumulation of toxic intracellular inclusions. Tau pathology is the underlying mechanism for several sporadic and genetic disorders. These are collectively known as tauopathies. Each tauopathy is differentiated from others by its neuropathological features such as the presence of specific isoforms of tau, type of cellular inclusions, and the regions of the brain affected. Neuropathological features, with a few exceptions however, do not correspond to distinct clinical phenotypes. There is considerable phenotypic overlap between the different tauopathies. Interaction between tau and other protein inclusions further alters the clinical phenotype.

Recent advances in the development of tau biomarkers, especially the development of tau radioligands used in positron emission tomography neuroimaging, and a better understanding of biology and pathology of tau are important first steps toward the ultimate goal of accurate diagnosis and disease modification in tauopathies.
The Revolution within a Revolution: Personal Experiences of a Young Interventional Radiologist
Authors: Mehandru Sonali
Published: March 2019

Interventional radiology (IR) has undergone a paradigm shift, and has become more clinically directed. This is particularly true with the new training programs, which are all required to have outpatient clinics, admitting services, and consult services within their hospitals. Despite these changes in education, however, many jobs still require a significant amount of diagnostic imaging work, and many established groups are reticent to allow the time and resources needed to pursue this clinical model of IR practice. This lack of support can lead to frustration for the early career interventional radiologist. This article describes the experience of one early career interventional radiologist, including some of the challenges and opportunities that have arisen from the recent changes in training.
Interventional Radiology Private Practice Patterns
Authors: Peck Steven , Van Erp Jeffrey , Watabe John , Costantino Mary , Varma Manish
Published: March 2019

Private practice interventional radiology (IR) in the US takes many forms – from specialty coverage withing traditional diagnostic radiology (DR) models and hybrid IR/DR practices, to multispecialty groups and independent IR practitioners. The purpose of this article is to understand the value each of these current IR models offer and predict their future viability.
Evolution in Private Practice Interventional Radiology: Data Mining Trends in Procedure Volumes
Authors: Morrison James
Published: March 2019

Diversity of procedures is a mainstay of interventional radiology (IR) and the ability to adapt and acquire new procedural skills is a benefit in a constantly changing medical environment. Strategies for success include building direct referral patterns from primary care providers, fostering strong interpersonal relationships with referring services, and providing efficient care coordinated through a dedicated IR clinic. In this study, retrospective analysis of procedural volumes over 16 years within a single large private IR practice was performed to examine the evolution of private practice IR. Primary data are presented, with analysis of the internal and external factors that have determined current procedural scope.
Interpretation of Biomarker Data in Diagnosis of Primary Dementias
Authors: Salardini Arash
Published: March 2019

In the last few years, an improved understanding of dementia biomarkers has significantly increased the diagnostic accuracy for dementias. The National Institutes of Health Biomarkers Definitions Working Group defines a biomarker as “a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.” In the field of dementia, a biomarker is a biological measure pointing to a specific dementing pathology. Dementia biomarkers may also serve as surrogates for disease progression and as endpoints in clinical trials. Dementia biomarkers are best characterized for Alzheimer's disease, which is the most common form of primary dementia. The current “biological” conception of Alzheimer's disease is based on consideration of three biomarkers: amyloid, tau, and “neurodegeneration.” The status of these biomarkers may be determined by cerebrospinal fluid clinical chemistry or imaging. Biomarkers for other primary dementias are less reliable and rely chiefly on structural and functional imaging. When appropriate, genetic testing may help with diagnostic certainty in hereditary forms of dementia.
Nonlinear vibration of Al-Al based high entropy alloy circular sandwich panel
Authors: Liu X. M. , Fan J. T. , Liu X. S. , Li G.
Published: March 2019

Circular sandwich panels were designed with Aluminium being core material, steel and Al-Al-based high entropy alloy (Al-based HEA) as the surface board materials, respectively. The dynamic response and influence of small changes in thickness and inherent properties (poisson ratio and density) of the sandwich panels are investigated by a three-dimensional finite element modeling. The nonlinear vibration of the sandwich panel changes from steady state to multiple-periods-bifurcation and chaotic vibration state by changing the forced excitation frequency, amplitude and the initial conditions. Compared with Al-steel sandwich panel, Al-based HEA sandwich panel has good stability under high excitation frequency. Our research shows that Al-Al HEA has potential advantages to be a aircraft and aerospace sandwich panel candidate.
Near-infrared-light-induced decomposition of Rhodamine B triggered by localized surface plasmon at gold square dimers with well-defined separation distance
Authors: Kaneko Satoshi , Watanabe Shuhei , Kasai Shinya , Nishino Tomoaki , Tsukagoshi Kazuhito , Kiguchi Manabu
Published: March 2019

Localized surface plasmon-induced photoreactions at metal nanostructures have become central research topics in biology, catalysis, and analytical chemistry. In particular, the decomposition of organic pollutants is a popular topic. Rhodamine B is useful in the dye industry and biology; however, it is harmful to humans and the environment. In this study, we investigated the decomposition of the Rhodamine B molecule with a structurally well-defined array of gold square dimers. The array of gold square dimers was fabricated by electron beam lithography, which provided a homogenous well-defined reaction field. Continuous Raman spectral measurements using a near-infrared laser clearly showed that while the Rhodamine B molecules were stable in the absence of the gold square dimers, they were decomposed under near-infrared-light irradiation.