Search

Systems for post-correction of OCR-results for historical texts are based on statistical correction models obtained by supervised learning. For training, suitable collections of ground truth materials are needed. In this paper we investigate the dependency of the power of automated OCR post-correction on the form of ground truth data and other training settings used for the computation of a post-correction model. The post-correction system A-PoCoTo considered here is based on a profiler service that computes a statistical profile for an OCR-ed input text. We also look in detail at the influence of the profiler resources and other settings selected for training and evaluation. As a practical result of several fine-tuning steps, a general post-correction model is achieved where experiments for a large and heterogeneous collection of OCR-ed historical texts show a consistent improvement of base OCR accuracy. The results presented are meant to provide insights for libraries that want to apply OCR post-correction to a larger spectrum of distinct OCR-ed historical printings and ask for "representative" results.

Simple Summary Predictive markers are necessary for immune checkpoint inhibitor (ICI) therapy. The aim of our retrospective study was to investigate the relationship between the occurrence of lymphopenia under ICI and disease outcome. A total of 116 patients with metastatic melanoma who received ICI therapy with normal lymphocyte counts at baseline were analyzed. Lymphopenia occurred in 42.2% of patients with a mean onset after 17 weeks (range 1–180 weeks). The occurrence of lymphopenia during immunotherapy was significantly associated with a shorter PFS and OS. Patients who developed lymphopenia (n = 49) had a mean PFS of 13.3 months (range 1–67 months) compared to 16.9 months (range 1–73 months) for patients who did not develop lymphopenia (n = 67; p = 0.025). Similarly, patients with lymphopenia had a significantly shorter OS of 28.1 months (range 2–70 months) compared with 36.8 months (range 4–106 months) in patients who did not develop lymphopenia (p = 0.01). Abstract Predictive markers for immune checkpoint inhibitor (ICI) therapy are needed. Thus, baseline blood counts have been investigated as biomarkers, showing that lymphopenia at the start of therapy with (ICI) is associated with a worse outcome in metastatic melanoma. We investigated the relationship between the occurrence of lymphopenia under ICI and disease outcome. Patients with metastatic melanoma who had undergone therapy with ICI were identified in our database. Only patients with a normal lymphocyte count at baseline were included in this retrospective study. Progression-free survival (PFS) and overall survival (OS) were compared between patients in which lymphopenia occurred during ICI therapy and those who did not develop lymphopenia. In total, 116 patients were analyzed. Lymphopenia occurred in 42.2% of patients, with a mean onset after 17 weeks (range 1–180 weeks). The occurrence of lymphopenia during immunotherapy was significantly associated with a shorter PFS and OS. Patients who developed lymphopenia (n = 49) had a mean PFS of 13.3 months (range 1–67 months) compared to 16.9 months (range 1–73 months) for patients who did not develop lymphopenia (n = 67; p = 0.025). Similarly, patients with lymphopenia had a significantly shorter OS of 28.1 months (range 2–70 months) compared with 36.8 months (range 4–106 months) in patients who did not develop lymphopenia (p = 0.01). Patients with metastatic melanoma who develop lymphopenia during ICI therapy have a worse prognosis with significantly shorter PFS and OS compared with patients who do not develop lymphopenia.

Immune checkpoint inhibitors (ICIs) may induce persistent immune-related adverse events (irAEs). We investigated persistent irAEs and implications on patients' lives compared to non-ICI-induced autoimmune diseases (AIs).The multicentre, cross-sectional study comprised 200 patients with cancer ≥12 weeks after ICI cessation (ICI-patients) and 2705 patients with AIs (AI-patients), recruited in German outpatient clinics and support groups. The prevalence of persistent irAEs subdivided in long-term (12 weeks to 12 months) and chronic irAEs (≥12 months) since ICI discontinuation, health-related quality of life (HRQoL) using the EuroQol 5D-5L (EQ-Index/VAS score), and burden of autoimmune symptoms and respective therapies were assessed.Long-term/chronic irAEs occurred in 51.9%/35.5% of outpatient ICI-patients, including arthralgia (16.7%/16.1%), myalgia (13.0%/14.0%), hypothyroidism (11.1%/10.8%), xerostomia (7.4%/8.6%), vitiligo (13.0%/7.5%) and hypophysitis (9.3%/7.5%). ICI-patients with long-term/chronic irAEs reported clinically significantly reduced HRQoL compared to ICI-patients without long-term/chronic irAEs (EQ-Index score: 0.767/0.752 versus 0.920/0.923, p 0.001/0.001; EQ-VAS score: 52.2/52.0 versus 63.6/74.7, p =/ 0.040/0.001). Multiple linear regression analyses confirmed clinically significant reductions in HRQoL scores by chronic irAEs (EQ-Index/VAS score: -0.163/-23.4, p 0.001/0.001). HRQoL, burden of autoimmune symptoms and burden of respective therapies in ICI-patients with chronic irAEs were similar to AI-patients with non-exacerbated AIs. Patients with chronic irAEs felt inadequately informed about side-effects compared to patients without chronic irAEs (p 0.001).Persistent irAEs impose a significant burden on patients after ICI cessation. Especially in early tumour stages, risk-benefit ratios must be carefully evaluated, and patients need to be informed about potential long-term sequelae.

Bereits seit einigen Jahren werden große Anstrengungen unternommen, um die im deutschen Sprachraum erschienenen Drucke des 16.-18. Jahrhunderts zu erfassen und zu digitalisieren. Deren Volltexttransformation konzeptionell und technisch vorzubereiten, ist das übergeordnete Ziel des DFG-Projekts OCR-D, das sich mit der Weiterentwicklung von Verfahren der Optical Character Recognition befasst. Der Beitrag beschreibt den aktuellen Entwicklungsstand der OCR-D-Software und analysiert deren erste Teststellung in ausgewählten Bibliotheken., For some years, great efforts have been made to record and digitise the printed works of the 16th-18th centuries published in the German-speaking countries. Preparing their full-text transformation conceptually and technically is the overall goal of the DFG-project OCR-D, which is concerned with the further development of optical character recognition methods. The article describes the current state of development of the OCR-D software and analyses its initial testing in selected libraries.

This dataset contains demographic, clinical, and health-related quality of life (HRQoL) data from 2905 patients including 200 cancer patients after immune checkpoint inhibitor (ICI) cessation and 2705 patients with a wide variety of autoimmune diseases. Within this multicenter, cross-sectional survey study data were collected questionnaire-based in cancer patients (ICI-patients) ≥ 18 years of age who had received at least one dose of ICI with ≥ 12 weeks since ICI discontinuation. Patients with autoimmune diseases (AI-patients) were ≥ 18 years, had at least one autoimmune disease and had never received ICI. ICI-patients were recruited in three skin cancer centers and via support groups. AI-patients were recruited in an outpatient clinic for internal medicine and via support groups. Specific questionnaires for ICI-patients/AI-patients were provided paper-based for patients from outpatient clinics and online for patients from support groups. Both questionnaires contained sections with demographic information, clinical data, and the standardized patient-reported outcome measure EuroQol 5D-5L (EQ-5D-5L) to assess HRQoL. Clinical data focused on autoimmunity and therapy of autoimmunity in (1) ICI-patients referring to particularly persistent immune-related adverse events (persistent irAEs) and in (2) AI-patients referring to respective autoimmune diseases. Additionally, specific items on cancer and cancer therapy were included in ICI-patients, and AI-patients were asked about the presence of acute exacerbations of autoimmune diseases. This dataset contains the raw data for ICI-patients and AI-patients, analyzed data on patient demographics, clinical characteristics and HRQoL scores among ICI-patients with/without persistent irAEs and among AI-patients. The data provide a basis for further investigations within the cohort of ICI-patients after ICI cessation and/or for AI-patients with different autoimmune diseases with regard to HRQoL, autoimmunity and therapy of autoimmunity.

Algorithms for building bimachines from functional transducers found in the literature are based on the following principle: each run of the bimachine simulates a particular successful path of the input transducer. Every single bimachine output exactly corresponds to the output of a single transducer transition. Here we introduce an alternative construction principle called the equalizer accumulation principle. It suggests that the bimachine steps take into account alternative parallel transducer paths, maximizing the possible output at each step using a joint view. This results in a construction where the deterministic left and right automaton of the bimachine both have size bounded by 2 | Q | where | Q | is the number of transducer states. In contrast, previous bimachine constructions lead to larger automata. We present a class of real-time functional transducers with n + 2 states for which the standard bimachine construction generates a bimachine with at least Θ ( n ! ) states whereas the construction based on the equalizer accumulation principle leads to 2 n + n + 3 states. On the other end we present a real-time functional transducers with 4 ( n + 1 ) states that cannot be represented as a bimachine with less than 2 n states. Therefore the space complexity of our construction is close to optimal in terms of the number of states. The new construction can be applied to rational functions from free monoids to “mge monoids”, a large class of monoids including free monoids, groups, and others that is closed under Cartesian products.

Summary Within an overlap area of two different seismic surveys of 2005 and 2018, changes of reservoir reflectivity were observed. With the help of reservoir engineers these anamalous changes could be linked to thermal stimulation. Subsequently a dedicated 4D seismic processing confirmed the initial observations. The NRMS volume is now being used to map steam effects and to optimize the reservoir model with regards to gas saturation and transmissibility of faults. Additionally the results of the 4D analysis allow to come up with a permanent seismic reservoir monitoring system.

In this chapter we present C(M) implementations of the main automata constructions. Our aim is to provide full descriptions of the implementations that are clear and easy to follow. In some cases the simplicity of the implementation is achieved at the expense of some inefficiency.

A fundamental task in natural language processing is the efficient representation of lexica. From a computational viewpoint, lexica need to be represented in a way directly supporting fast access to entries, and minimizing space requirements. A standard method is to represent lexica as minimal deterministic (classical) finite-state automata. To reach such a representation it is of course possible to first build the trie of the lexicon and then to minimize this automaton afterwards. However, in general the intermediate trie is much larger than the resulting minimal automaton. Hence a much better strategy is to use a specialized algorithm to directly compute the minimal deterministic automaton in an incremental way. In this chapter we describe such a procedure.

PoCoTo is known as a web-based interactive tool for the postcorrection of OCR-results on historical texts. In this paper we first introduce A-PoCoTo, a fully automated extension of PoCoTo designed for the use in large-scale digitization projects. Among other features, A-PoCoTo takes into account the recognition results of several OCR-engines on the given input text, and sentence context is used for refining rankings and decisions. Preliminary evaluation results are given. In view of the very high level of accuracy needed for many scholarly applications it is questionable if a fully automated process is always able to fully meet the standards expected by researchers in Digital Humanities. We describe the architecture of A-I-PoCoTo, a postcorrection system (under development) combining automated postcorrection as a first step and interactive postcorrection as an optional second step. In A-I-PoCoTo decisions and correction steps of the automated component are stored in a special protocol. Views offered by the graphical user interface help to efficiently confirm, reject, or improve these decisions as a first step of the manual postcorrection.

To investigate the perioperative management and outcome of patients undergoing abdominal surgery with additional vascular (comorbid) alterations for internal quality assurance of the clinical results.Over a defined study period all consecutive cases of the aforementioned profile were documented and retrospectively analyzed as part of an ongoing prospective monocentric observational study to reflect the daily surgical practice.Over 10 years (from January 1999 to December 2008), a total of 113 cases were registered. Pancreas resection including vascular reconstruction showed the highest percentage (30.1%). Within the target patient groups, similar outcome data were found compared with international reports. An exception was in the case of mesenteric ischemia, where open surgery was more frequently used in comparison to the study situation (included together were patients treated by surgery and interventions). The majority of vascular alterations during the postoperative course and iatrogenic lesions occurred following pancreas resection. In the therapeutic profile there are two particularly important measures, namely open surgery on one hand and image-guided radiology as well as endoscopy on the other hand. The majority of patients with a rare visceral artery aneurysm (considerable potential for rupture or erosion) were more frequently treated with image-guided interventional radiology versus open surgery. This conforms to the current well-established sequential patient (individual), results, and, in particular, risk-adapted staged treatment approach.Additional vascular surgical treatment of problematic situations during abdominal surgery or in emergency cases is not daily routine; however, it is a challenging field including a considerable potential for complications (morbidity) and definitely mortality. This requires an experienced surgeon with high expertise, if possible in a center for vascular medicine.

Novel slim and shapely sp3-rich nitrogen containing heterocyclic ring systems are sought-after platforms for the expansion of molecular diversity in lead discovery. The present work describes the synthesis and characterization of a series of derivatives of hitherto unknown 3-methylsulfanyl-5,6,7,8-tetrahydro-1H-[1,2,4]triazolo[1,2-a]pyridazines 2. This approach was guided by a computational study, aiming at an optimization of previously reported [1,2,4]triazolo[1,2-a]pyridazine-1-thiones 1 known to inhibit the inducible nitric oxide synthase (iNOS). The title compounds are accessible by methylation of compounds 1 under mild conditions. The products were biologically evaluated by the same cell-based assay as applied for previous products of type 1 using RINm5F cells, which were stimulated to produce NO on the influence of proinflammatory cytokines IL-1β and IFN-γ. Compounds 2 did not display the anticipated improved iNOS inhibitory activity in the selected assay but contribute to SAR in the field. In addition, an unprecedented formation of side-products 3 via oxidation has been investigated. The novel scaffolds represent attractive starting points for the construction of diverse molecules which differ considerably from known compounds based on flat and lipophilic aromatic scaffolds.

Eberswalde was once famous for the entomological collection which was based on the acquisition of specimen from Ratzeburg (1801–1871) and Altum (1849–1900). But these collections were either lost, destroyed, or dispersed at the end of Second World War and in 1963 when the forest academy in northeastern Germany was closed down for political reasons. After the reunification of Germany, a new university was founded in Eberswalde, and since then, zoological collections have been established again: new collections in old rooms—rising like Phoenix from the ashes.

Im Gegensatz zu anderen mechanischen Unterstutzungssystemen werden komplette Kunstherzen („total artificial hearts“, TAH) orthotop implantiert. Typische Indikationen zur Verwendung eines TAH sind infarktbedingte Gewebezerstorungen nach Myokardinfarkten (z. B. ausgedehnter Vorderwandinfarkt und Infarktventrikelseptumdefekt) sowie die notfallmasige Stabilisierung eines Patienten im kardiogenen Schock infolge eines biventrikularen Pumpversagens. Ziele der TAH-Therapie sind also die Stabilisierung des Patienten und die Uberbruckung bis zur Transplantation. Eine primare Langzeittherapie ist mit den aktuell verfugbaren Systemen nicht sinnvoll, da die erwartete Laufzeit sehr limitiert ist. Die Lebensqualitat der Patienten am TAH ist im Vergleich mit aktuellen nichtpulsatilen linksventrikularen Unterstutzungssystemen durch hohe Gerauschentwicklung und sperrige Antriebseinheiten oft deutlich eingeschrankt. Aufgrund der bauartbedingten Grose konnen Erwachsene mit kleinem Thoraxdurchmesser und Kinder in der Regel nicht mit einem TAH versorgt werden. Der vorliegende Beitrag beschreibt die Entwicklung der TAH und behandelt die Indikationen/Patientenselektion sowie Kontraindikationen der TAH-Implantation. Besonderes Augenmerk wird auf das perioperative Management und potenzielle Komplikationen gerichtet.

Systemic therapy for advanced hepatocellular carcinoma (HCC) is still challenging. A biomodulatory therapy approach targeting the communicative infrastructure of HCC, including metronomic low-dose chemotherapy with capecitabine, pioglitazone and rofecoxib, has been evaluated in patients with non-curative HCC. Altogether 38 patients were evaluable in this one-arm, multicenter phase II trial. The primary endpoint, median progression-free survival was 2.7 months (95% CI: 1.6–3.79) for all evaluable patients and 8.4 months (95% CI: 0–18.13) for patients ≥ 6 weeks on protocol. Median overall survival (OS) was 6.7 months (95% CI: 4.08–9.31) and 9.4 months (95% CI: 4.82–13.97), respectively. Most common adverse events were edemas grade 3, which were commonly related to the advanced stage, with 66% of the patients suffering from liver cirrhosis. Exploratory data analyses showed significant impact of ECOG performance status grade 0 versus 1 and CLIP score 0/1 versus > 1 on OS, 9.8 months (95% CI: 4.24–15.35) versus 2.7 months (95% CI: 1.03–4.36; P = 0.002), and 9.8 months (95% CI: 3.23–16.37) versus 4.4 months (95% CI: 3.14–5.66; P = 0.009), respectively. Preceding tumor surgery had significant beneficial impact on survival, as well as maximal tumor diameter of

Nonadherence may cause severe health problems in heart transplant (HTx) recipients.The present study aimed to investigate adherence to prescribed medication and recommended lifestyle habits in post-HTx patients and to assess associations between adherence, quality of life (QOL), and psychological well-being.A questionnaire package was sent to all HTx patients from our clinic (n = 858) to answer questions anonymously on medication adherence, dietary recommendations (avoidance of raw animal products and ice cream), pet keeping (risk of zoonosis), anxiety and depression, QOL, and posttraumatic stress disorders.Of the contacted patients, 524 (61%) responded and 505 fulfilled the inclusion criteria (age ≥18 years and ability to understand German). Of the study participants, 72.4% reported taking their medications very correctly, 72.2% stated consuming alcohol less often than once a week, 58.3% performed physical exercise at least once a week, one-third reported eating nonrecommended foods, 22.1% stated pet keeping, and 4.3% reported smoking. Adherence to prescribed medication was positively associated with age ( P.001) and mental QOL ( P = .015) but was unrelated to eating nonrecommended foods ( P.05). Depressiveness correlated inversely with physical QOL ( r = -0.232; P.01) and mental QOL ( r = -0.411; P.01). Stress disorders and minor stressful events were reported by 7.8% and 46.6%, respectively. Stress disorders correlated inversely with mental QOL ( r = -0.282; P.01) and physical QOL ( r = -0.422; P.01).Many HTx patients adhere to prescribed medications and health advice. Nevertheless, nonadherence is a problem, especially in younger HTx patients, indicating the need for a nonadherence crisis intervention program for long-term HTx patients.

Die Vermeidung von Blutungs- und thrombembolischen Komplikationen ist immer noch ein zentrales Problem bei der Behandlung von Patienten mit einem „ventricular assist device“ (VAD). Probleme der etablierten gerinnungshemmenden Therapie werden diskutiert und neue Erkenntnisse uber „device-induzierte“ Storungen des Gerinnungssystems dargestellt. Die klinischen Erfahrungen mit dem weitverbreiteten Heart-Mate-II-System werden detailliert diskutiert. Die etablierten gerinnungshemmenden Therapien weisen Limitationen bzw. ausgepragte Nebenwirkungen auf. Neue direkte orale Antikoagulanzien und Thrombozytenaggregationshemmer sind in die klinische Praxis eingefuhrt worden. Die Ergebnisse sind vielversprechend. Daten zur speziellen Gruppe der Patienten mit VAD liegen bislang nicht vor. Die Erkenntnis, dass ein sehr hoher Prozentsatz dieser Patienten eine hamophile Komponente durch einen Mangel an den hochmolekularen Multimeren des Willebrand-Faktors entwickelt, konnte zu einem Paradigmenwechsel der etablierten gerinnungshemmenden Kombinationstherapie fuhren. Grosere klinische Studien sind notwendig, um die Implikationen eines erworbenen Willebrand-Syndroms auf die gerinnungshemmende Therapie bei Patienten mit VAD zu untersuchen. Die neuen direkten oralen Antikoagulanzien und Thrombozytenaggregationshemmer sollten bei dieser speziellen Patiengruppe eingehender untersucht werden.

Die optimale Betreuung vor, wahrend und nach der „Ventricular-assist-device“(VAD)-Operation, wahrend der Rehabilitation und nach der Entlassung aus der Klinik fuhrt in der Regel dazu, dass Komplikationen fruh erkannt oder vermieden werden und die Gesamtuberlebensraten sich verbessern. Anhand der langjahrigen Erfahrungen der multidisziplinaren Teamarbeit im Herz- und Diabeteszentrum (HDZ) NRW werden Patientenmanagement und Koordination erlautert. Im multidisziplinaren Team nehmen die „VAD-Koordinatoren“ zentrale Aufgaben wahr. Neben dem Koordinationsteam sind zahlreiche andere Disziplinen in die erfolgreiche und sachgerechte Versorgung eingebunden. Die wachsenden Unterstutzungszeiten am System gehen mit gestiegenen Anforderungen an die Versorgungsqualitat einher. Nicht nur in der Akutphase (pra-, intra- und fruh postoperativ) sind daher intensive Betreuungsbemuhungen unverzichtbar, sondern auch in der Phase der Rekonvaleszenz und Rehabilitation. Hier liegt der Fokus auf Patientenedukation und -schulung sowie der Uberwachung und Vermeidung von Komplikationen. Bei nach Hause entlassenen Patienten gehort hierzu auch die Etablierung eines Notfallalarmsystems unter Integration und entsprechender Schulung von Angehorigen und Hausarzten. Insgesamt stellt die Versorgung von VAD-Patienten hohe Anforderungen an die Professionalitat, Motivation und Interaktionfahigkeit der Teammitglieder. Die optimale interdisziplinare Betreuung gewahrleistet jedoch ein hohes Mas an Patientensicherheit und verbessert die Ergebnisse nachhaltig. Durch Bindung an die Teamansprechpartner ist eine zusatzliche Sicherheitsoption fur den Patienten gewahrleistet, die den Wechsel in die heimatnahe oder hausliche Versorgung erleichtert.

Die chronisch obstruktive Bronchitis (COPD) und das Lungenemphysem sind durch eine Einschrankung der Diffusionskapazitat charakterisiert. Die relativen Anteile der Teilkomponenten Membranfaktor (Dm) und kapillares Volumen (Vc) sind bisher unbekannt. Diese Teilkomponenten konnen mit Hilfe der Messung der NO-Diffusion charakterisiert werden. Im Rahmen einer prospektiven Studie wurden 183 Patienten mit einer COPD unterschiedlicher Schweregrade lungenfunktionsanalytisch mit der Spirometrie, Bodyplethysmografie und der Single-Breath-Diffusionsmessungen fur CO (DLCO) und NO (DLNO) untersucht. Die DLCO zeigte eine schweregradabhangige Reduktion. Ebenso waren sowohl Dm als auch Vc mit der Einsekundenkapazitat (FEV1) positiv korreliert. Die Einschrankung von Vc stand im Vergleich zu Dm bei allen Schweregraden der COPD quantitativ im Vordergrund und war bei Patienten mit schwerer COPD statistisch signifikant starker ausgepragt. Es wird geschlussfolgert, dass sowohl Dm als auch Vc schweregradabhangig an der Einschrankung der pulmonalen Diffusionskapazitat bei der COPD beteiligt sind mit einem Uberwiegen der vaskularen Komponente. Dies stutzt pathogenetische Konzepte einer funktionellen Relevanz des Verlustes pulmonaler Kapillaren bei der COPD.

Purpose: The purpose of this study was to find out whether pneumothorax detection and exclusion is superior in expiratory digital chest radiography. Materials and Methods: 131 patients with pneumothorax with paired inspiratory and expiratory chest radiographs were analyzed regarding localization and size of pneumothorax. Sensitivity, specificity, negative (npv) and positive predictive value (ppv) as well as the positive (LR+) and negative likelihood ratio (LR-) were determined in a blinded randomized interobserver study with 116 patients. The evaluation was performed by three board-certified radiologists. Results: In 131 patients, there were 139 pneumothoraces, 135 (97.1 %) were located apical, 88 (63.3 %) lateral and 33 (23.7 %) basal. Sensitivity was 99 % for inspiratory and 97 % for expiratory radiographs. The interobserver study yielded a mean sensitivity of 86.1 %/86.1 %, specificity of 97.3 %/93.4 %, npv of 88.7 %/88.5 % and ppv of 96.7 %/92.1 % for inspiration/expiration. For inspiratory radiographs the LR+/LR- were 40.2/0.14 and for expiration 13.9 and 0.15. McNemar-Test showed no significant difference for the detection of pneumothoraces in in-/exspiration. Conclusion: Inspiratory and expiratory digital radiographs are equally suitable for pneumothorax detection. Inspiratory radiographs are recommended as the initial examination of choice for pneumothorax detection, an additional expiratory radiograph is only recommended in doubtful cases. Key Points: • Basal pneumothoraces during inspiration demonstrate a greater width than during expiration. • There is statistically no difference between inspiration/expiration for the diagnosis of pneumothorax. • An image taken during inspiration is recommended to confirm or rule out a pneumothorax. Citation Format: • Thomsen L, Natho O, Feigen U et al. Value of Digital Radiography in Expiration in Detection of Pneumothorax. Fortschr Rontgenstr 2014; 186: 267 – 273

UNLABELLED HISTORY AND INTERVENTION: A 52-year-old female patient underwent open abdominothoracic cardia and esophageal resection with gastric transposition because of histologically diagnosed Barrett metaplasia with "high-grade" intraepithelial neoplasia (HGIEN) and parts of an invasive adenocarcinoma. The anastomotic insufficiency on the 10th postoperative day including an esophagobronchial fistula prompted to a subsequent surgical re-intervention with suture of the fistula, lavage and additional drainage, an endoscopic stenting of the fistula from esophageal site, as well as repeated (n = 22) bronchoscopic applications of fibrin glue (1-3 ml each) into the lumen of the fistula after each bronchoscopic lavage of the fistula until the complete closure was achieved. The changeful clinical course of 77 days on the surgical ICU was characterized by secondary complications such as pneumonia, mediastinitis and respiratory insufficiency with long-term artificial respiration and creation of a percutaneous dilatation tracheotomy. CONCLUSION The application of fibrin glue can be considered a promising, minimally invasive therapeutic option in the management of postoperative fistula after esophageal resection, which requires expertise in decision-making and the finding-specific approach, in particular, if indicated inital steps of the sequential complication management such as surgical re-intervention and conventional endoscopic measures (stenting, Endo-VAC[-sponge]) do not provide great therapeutic potential any more due to the prolonged postoperative time course and the unfavorable local findings. In the presented case, modes of an assisted artificial respiration with low pressure and short phases of apnoe after fibrin glue application were the crucial predictions for an initial and favorable adhesion of this glue and finally for a successful sealing resulting in a sufficient closure of the fistula.

Objectives Several plaque and lesion characteristics have been associated with an increased risk for procedural stroke during or shortly after carotid artery stenting (CAS). While technical advancements in stent design and cerebral protection devices (CPD) may help reduce the procedural stroke risk, and anatomy remains important, tailoring stenting procedures according to plaque and lesion characteristics might be a useful strategy in reducing stroke associated with CAS. In this descriptive report of the ongoing Asymptomatic Carotid Surgery Trial-2 (ACST-2), it was assessed whether choice for stent and use or type of CPD was influenced by plaque and lesion characteristics. Materials and methods Trial patients who underwent CAS between 2008 and 2015 were included in this study. Chi-square statistics were used to study the effects of plaque echolucency, ipsilateral preocclusive disease (90–99%), and contralateral high-grade stenosis (>50%) or occlusion of the carotid artery on interventionalists' choice for stent and CPD. Differences in treatment preference between specialties were also analysed. Results In this study, 831 patients from 88 ACST-2 centres were included. Almost all procedures were performed by either interventional radiologists (50%) or vascular surgeons (45%). Plaque echolucency, ipsilateral preocclusive disease (90–99%), and significant contralateral stenosis (>50%) or occlusion did not affect the choice of stent or either the use of cerebral protection and type of CPD employed (i.e., filter/flow reversal). Vascular surgeons used a CPD significantly more often than interventional radiologists (98.6% vs. 76.3%; p < .001), but this choice did not appear to be dependent on patient characteristics. Conclusions In ACST-2, plaque characteristics and severity of stenosis did not primarily determine interventionalists' choice of stent or use or type of CPD, suggesting that other factors, such as vascular anatomy or personal and centre preference, may be more important. Stent and CPD use was highly heterogeneous among participating European centres.

Der Erfolg einer VAD-Therapie hangt wesentlich vom postoperativen Management ab. Die biventrikulare Optimierung der Hamodynamik und ein adaquates Gerinnungsregime spielen in diesem Zusammenhang ebenso eine grose Rolle wie die systemische und lokale Infektionsprophylaxe und eine Patienten-individuelle Weaning-Strategie. Bei Patienten, die eine mechanische Herz-Kreislauf-Unterstutzung benotigen, handelt es sich um chronisch kranke Menschen, fur deren Lebensqualitat Rehabilitationsmasnahmen und eine psychologische Betreuung einen nicht zu vernachlassigenden Stellenwert darstellen.

CCQM-K125 was organized by the Inorganic Analysis Working Group (IAWG) of CCQM to assess and document the capabilities of the national metrology institutes (NMIs) or the designated institutes (DIs) to measure the mass fractions of trace elements (K, Cu and I) in infant formula. Government Laboratory, Hong Kong SAR (GLHK) acted as the coordinating laboratory. In CCQM-K125, 25 institutes submitted the results for potassium, 24 institutes submitted the results for copper and 8 institutes submitted the results for iodine. For examination of potassium and copper, most of the participants used microwave-assisted acid digestion methods for sample dissolution. A variety of instrumental techniques including inductively coupled plasma mass spectrometry (ICP-MS), isotope dilution inductively coupled plasma mass spectrometry (ID-ICP-MS), inductively coupled plasma optical emission spectrometry (ICP-OES), atomic absorption spectrometry (AAS), flame atomic emission spectrometry (FAES) and microwave plasma atomic emission spectroscopy (MP-AES) were employed by the participants for determination. For analysis of iodine, most of the participants used alkaline extraction methods for sample preparation. ICP-MS and ID-ICP-MS were used by the participants for the determination. Generally, the participants' results of CCQM-K125 were found consistent for all measurands according to their equivalence statements. Except with some extreme values, most of the participants obtained the values of di /U(di ) within ± 1 for the measurands. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

The standard construction of a bimachine from a functional transducer involves a preparation step for converting the transducer into an unambiguous transducer (A transducer is unambiguous if there exists at most one successful path for each label.). The conversion involves a specialized determinization. We introduce a new construction principle where the transducer is directly translated into a bimachine. For any input word accepted by the transducer the bimachine exactly imitates one successful path of the transducer. For some classes of transducers the new construction can build a bimachine with an exponentially lower number of states compared to the standard construction. We first present a simple and generic variant of the construction. A second specialized version leads to better complexity bounds in terms of the size of the bimachine.

Systeme zur biventrikularen Herzunterstutzung spielen in Relation zu den Linksherzunterstutzungssystemen quantitativ eher eine nachrangige Rolle. Fur ausgewahlte Patienten stellen sie jedoch oft die einzige mittel- und langfristige Therapieoption dar. Daher werden in diesem Kapitel sowohl kommerziell erhaltliche, komplette Kunstherzen als auch zusammengestellte Systeme aus univentrikularen Einzelkomponenten fur die intra- und parakorporale Anwendung dargestellt.

In the absence of ground truth it is not possible to automatically determine the exact spectrum and occurrences of OCR errors in an OCR'ed text. Yet, for interactive postcorrection of OCR'ed historical printings it is extremely useful to have a statistical profile available that provides an estimate of error classes with associated frequencies, and that points to conjectured errors and suspicious tokens. The method introduced in Reffle (2013) computes such a profile, combining lexica, pattern sets and advanced matching techniques in a specialized Expectation Maximization (EM) procedure. Here we improve this method in three respects: First, the method in Reffle (2013) is not adaptive: user feedback obtained by actual postcorrection steps cannot be used to compute refined profiles. We introduce a variant of the method that is open for adaptivity, taking correction steps of the user into account. This leads to higher precision with respect to recognition of erroneous OCR tokens. Second, during postcorrection often new historical patterns are found. We show that adding new historical patterns to the linguistic background resources leads to a second kind of improvement, enabling even higher precision by telling historical spellings apart from OCR errors. Third, the method in Reffle (2013) does not make any active use of tokens that cannot be interpreted in the underlying channel model. We show that adding these uninterpretable tokens to the set of conjectured errors leads to a significant improvement of the recall for error detection, at the same time improving precision.

INTRODUCTION: Knowledge on potentially pathogenic microbes including characteristics of their antibiotic resistance in septic patients as well as on the ward- and department-specific microbial spectrum can be considered essential for an efficient initiation of an adequate antimicrobial treatment, which turns out to become pivotal for patient outcome. Permanent changes in microbial patterns and antibiotic resistance can only be identified by a continuous investigation of various microbiological specimens. AIM: Based on the retrospective evaluation of prospectively collected data on microbiological investigations of the surgical ICU in 1996, 2002, 2004 and 2005, the short- and long-term changes by trend of microbial spectrum and antibiotic resistance following reorganisation and restructuring of the University Hospital from the more traditional pavillon-based system to a multidisciplinary complex building in 2003 were investigated. MATERIAL AND METHODS: Twice a week, routine microbiological testing of blood and urinary cultures as well as swabs from wound areas and endotracheal swabs were initiated in septic patients (suspect, manifestation) or in case of their clinical impairment. The microbial spectrum was sub-divided according to Gram-staining (Gram-posi-tive / -negative), various species and fungi with descriptive absolute and relative data values. -Various groups and time periods were statisti-cally compared using χ 2 test as appropriate. P val-ues < 0.05 were considered statistically significant. RESULTS: In total (n Total = 4 899), microbiological testing resulted in the detection of microbes in 699 and 833 blood and urinary cultures (14.3 % and 17 %, respectively) as well as 1 232 wound swabs (25.1 %) together with 2 135 samples from the endotracheal sites (43.6 %). During the short- (2002 vs. 2004) and long-term analyses (1996 vs. 2005), the proportion of Gram-positive microbes increased. Al-though Gram-positive bacteria can be considered the most frequent microbes for bacteriemia, there was a shift onto urinary and wound infections as well as pneumonias through the observation period. Despite the decreasing incidence of Enterococcus and the consistent proportion of MRSA, the increase of resistant Enterococcus strains (0 % vs. 43.2 %; P < 0.05) is critical. However, in the Gram-negative microbial spectrum there was an increase of the bacteraemia rate but a fall of the detection rate in wound and endotracheal swabs. In parallel, an increase of the detection rate of E. coli in blood (6.5 % vs. 45.5 %; P < 0.05) and endotracheal swabs (9.2 % vs. 16.2 %; P < 0.05) is associated with an increase of multiresistant Enterobacteriaceae strains (0 % vs. 30.7 %; P < 0.05). The portion of multiresistant strains of Pseudomonas with 31 % stayed the same through the 10-year time period. While Candida-based colonisation showed a decreased incidence (25 % vs. 15 %; P < 0.05) during the whole investigation period, there was a relative rise in the frequency of candidemia. CONCLUSION: ICU relocation from the pavillon-based system to a new complex clinic building was not associated with any significant alteration of the microbial spectrum on the surgical ICU. Increasing incidences of resistant Enterococcus and Gram-negative problematic microbes may indicate a general spread of multi-resistant microbes under the steady selecting pressure of a not always adequately initiated antibiotic / antimicrobial therapeutic regimen and underline the required but specific and selected microbiological screening.

Due to the large number of spelling variants found in historical texts, standard methods of Information Retrieval (IR) fail to produce satisfactory results on historical document collections. In order to improve recall for search engines, modern words used in queries have to be associated with corresponding historical variants found in the documents. In the literature, the use of (1) special matching procedures and (2) lexica for historical language have been suggested as two alternative ways to solve this problem. In the first part of the paper, we show how the construction of matching procedures and lexica may benefit from each other, leading the way to a combination of both approaches. A tool is presented where matching rules and a historical lexicon are built in an interleaved way based on corpus analysis. In the second part of the paper, we ask if matching procedures alone suffice to lift IR on historical texts to a satisfactory level. Since historical language changes over centuries, it is not simple to obtain an answer. We present experiments where the performance of matching procedures in text collections from four centuries is studied. After classifying missed vocabulary, we measure precision and recall of the matching procedure for each period. Results indicate that for earlier periods, matching procedures alone do not lead to satisfactory results. We then describe experiments where the gain for recall obtained from historical lexica of distinct sizes is estimated.

Hintergrund Diese Studie ist eine vorab geplante Sekundaranalyse der deutschen Daten einer multinationalen multizentrischen Beobachtungsstudie. Ziel dieser retrospektiven Studie war es, die Alltagswirksamkeit („effectiveness“) von Caspofungin bei organtransplantierten Patienten mit wahrscheinlicher oder nachgewiesener invasiver Pilzerkrankung zu evaluieren.

INTRODUCTION: Retroperitoneal soft-tissue sarcomas (RSTS) represent a rare and heterogeneous class of diseases for which the clinical management is still largely non-standardised. Based on a selective review of recent publications, it was the purpose of the present review article to summarize the current concepts of disease classification, diagnostics and surgical as well as multimodal therapy for these tumors. METHOD: A clinically based empirical review derived from a literature search focusing on publications from the past 5 years was carried out. RESULTS: Due to the paucity of randomised-controlled trials, therapy for RSTS is largely based on personal experience, retrospectively gathered data and historical controls. Pre-therapeutic planning requires precise information on the localisation, extension, and texture of the tumor through cross-sectional imaging (CT, MRI) as well as histological diagnosis through percutaneous or open biopsy. Complete tumor resection is crucial. Recent studies have confirmed the importance of microscopically negative resection margins which has subsequently led to a trend towards more radical resection. Chemotherapy does not play a role in the adjuvant setting except in clinical trials; however, radiotherapy has been controversely debated in adjuvant RSTS therapy. Efforts to limit radiation toxicity include modern techniques as well as a strategy of using pre-resection radiotherapy instead of postoperative radiation. Surgery is also the treatment of choice for locally recurrent RSTS and pulmonary metastases. The prognosis of RSTS depends on the quality of surgical care and several disease-specific factors (histological type, grading). CONCLUSION: The clinical management of RSTS is complex and can only partly be considered as evidence-based. Due to the required level of experience in the treatment of these tumor lesions and the involvement of several subspecialties, pre-therapeutic planning, treatment and follow-up should be limited to high-volume surgical centres. In order to achieve microscopically negative resection margins, multivisceral resections are a valuable option after thorough consideration of the risks and benefits. Adjuvant radiotherapy needs to be decided upon on an individual basis, taking into account patient- and tumor-specific factors as well as resection status.

Lymphoid hyperplasia of the intestine has been associated with multiple diseases and symptoms. This study was undertaken to analyze the number and topographical distribution of the lymphoid follicles. A total of 302 adult consecutive patients were enrolled when they underwent elective colonoscopy. Standardized pictures from terminal ileum and colon were taken using video colonoscopes. In each picture, the number, size, and mucosal elevation of lymphoid follicles were analyzed in relation to histological and immunological findings and medical history. Lymphoid hyperplasia was found to be most extensive in the terminal ileum and cecum. Patients with untreated gastrointestinally mediated allergy (GMA) showed the highest number of lymphoid follicles per visible field in the terminal ileum ( P < 0.001) and cecum ( P = 0.003) vs. the control group. Patients with infectious colitis also showed a high number of lymphoid follicles per endoscopic visible field in the transverse colon ( P = 0.020). The presence of lymphoid hyperplasia is a frequent finding during colonoscopy. It may indicate an enhanced immunological mucosal response to antigenic stimulation such as GMA or infection.

M. Winkler, J. Pratschke, U. Schulz, S. Zheng, M. Zhang, W. Li, M. Lu, D. Sgarabotto, G. Sganga, P. Kaskel, S. Chandwani, L. Ma, J. Petrovic, M. Shivaprakash. Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study. Transpl Infect Dis 2010: 12: 230–237. All rights reserved Objective. This study was designed to determine clinical outcomes with caspofungin in patients with proven or probable invasive fungal infection (IFI) after a solid organ transplant (SOT) procedure. Methods. In this retrospective observational study, data were collected for a single episode of IFI in patients with an SOT between January 2004 and June 2007. Response was determined by the investigator as favorable (complete or partial) or unfavorable (stable disease or failure) at the end of caspofungin therapy (EOCT). The primary effectiveness population was the proportion of patients who received ≥5 doses of caspofungin (modified all-patients-treated population). Safety was assessed for patients who received ≥1 dose of caspofungin. Results. A total 81 of patients from 13 sites in China, Germany, Italy, and the United Kingdom were enrolled, including 49 (60%) liver, 22 (27%) heart, 5 (6%) lung, 2 (2%) kidney, 2 (2%) liver and kidney, and 1 (1%) pancreas and kidney recipients. Candidiasis was diagnosed in 64/81 patients (79%) and aspergillosis in 22/81 patients (27%). Most patients received caspofungin monotherapy (75%). Caspofungin was given as first-line therapy to 59 (73%) patients. The overall favorable response at EOCT was 87% (58/67; 95% confidence interval [CI]: 76%, 94%), with favorable responses in 88% (43/49; 95% CI: 75%, 95%) of patients receiving caspofungin monotherapy and 83% (15/18; 95% CI: 59%, 96%) of patients receiving combination therapy with caspofungin (modified all-patients-treated population). Response by type of SOT was as follows: liver 87% (39/45), heart 93% (14/15), kidney 100% (5/5), and lung 50% (2/4). An overall survival rate (all-patients-treated) of 69% (56/81; 95% CI: 59%, 79%) was observed at 7 days post EOCT. No serious drug-related adverse events were reported. Conclusion. In this study, caspofungin was effective and well tolerated in the treatment of IFIs involving SOT recipients.

We use scanning electron orientation imaging microscopy to study the role of micrograin orientation and the role of the crystallographic character of micrograin boundaries during creep of two iron–chromium alloys with similar chromium contents. The ultra fine grained microstructure of a creep resistant tempered martensite ferritic steel (German grade X20) is characterized by carbides which pin micrograin boundaries. Without this type of stabilization, a binary Fe10Cr alloy processed by equal channel angular pressing (ECAP) with the same micrograin size creeps much faster. This difference in creep rate was attributed to the stabilization of micrograin boundaries by carbides [A. Kostka, K.-G. Tak, R.J. Hellmig, Y. Estrin, G. Eggeler, Acta Mater. 55 (2007) 539]. But it was not clear whether a difference in the crystallographic nature of micrograin boundaries also contributes to the difference in creep rates. The results obtained in the present study show that this is not the case. We also consider the formation of macro- and microtextures during processing (X20: pipe making followed by tempering, Fe10Cr: ECAP followed by tempering) and their evolution during creep. Creep deformation results in a decrease of preferential micrograin orientations in tempered martensite ferritic steels and triggers recrystallization events in the ECAP-processed binary Fe10Cr alloy.

PURPOSE: Ovarian hyperstimulation syndrome (OHSS) is a complication during ovarian stimulation. Patients with moderate and severe OHSS usually require inpatient or intensive-care support. There are scarce data regarding the course of laboratory parameters and no data concerning AB0 blood groups in patients with OHSS. MATERIAL AND METHODS: 174 patients with OHSS were hospitalized in the period of January 2000 to December 2005. Morbidity, pregnancy rate, course of laboratory parameters, blood groups and treatment options were collated. Frequency of AB0 blood groups were compared with 3 distinct control groups. RESULTS: Of 174 patients 32 had OHSS grade I, 71 grade II and 71 severe grade III. 40.8 % of all patients had a clinical pregnancy. The most frequent symptoms were ascites, pain and abdominal tension. Almost all patients received infusion therapy with anticoagulation. 20 - 50 % were treated with diuretics, analgesics or required ascites drainage. Highly significant changes of laboratory parameters in the course stationary treatment were found. Comparing blood group subtypes to the control groups revealed an increased risk to develop OHSS for non-0 or blood group A. The calculated odds ratios (OR) were between 1.52 and 1.65. These findings were significant or nearly significant. CONCLUSION: The morbidity of women suffering from OHSS is high, with marked changes in laboratory findings. Treatment options comprise intravenous therapy with crystalloids, fluid balancing, anticoagulation and ascites drainage. There is evidence that determination of AB0 blood groups may be a helpful tool to identify women with a predisposition for OHSS undergoing IVF treatment.

ZusammenfassungMit Zunahme der Lebenserwartung und einer veränderten Lebensführung im Zeitalter der Industrialisierung steigen die Prävalenz der Osteoporose und damit das Risiko, im Laufe des Lebens eine Fraktur eines Wirbelkörpers zu erleiden. Die klassischen Therapieoptionen mit einerseits medikamentöser Unterstützung des Knochenmetabolismus und Schmerztherapie sowie andererseits physikalischen Maßnahmen wie Steigerung des Aktivitätsgrads, Gangschulung, Sturzprophylaxe, Hilfsmittel-und Miederversorgung, werden in den letzten Jahren durch die operativen Verfahren der Vertebro-und Kyphoplastie ergänzt. Beide sind minimal invasive Operationsverfahren, die sich durch schnelle Beseitigung der Schmerzen und Verminderung der Kyphose auszeichnen. Besonders die Kyphoplastie erlaubt eine kontrollierte Stabilisierung des gebrochenen Wirbelkörpers durch Einbringen kontrastmittelgefüllter Ballone, mit denen der betroffene Wirbelkörper gezielt aufgerichtet und der entstandene Hohlraum kontrolliert mit Knochenzement aufgefüllt werden kann. In einem Kollektiv von nunmehr 389 operierten Wirbelkörpern bei 269 Patienten zeigten sich sowohl unmittelbar postoperativ als auch in der Nachsorge bis zu vier Jahre nach der Operation durchweg positive Resultate. Dabei beschränken sich die Ergebnisse nicht nur auf apparativ fassbare Ergebnisse wie Wirbelkörperhöhe, Kyphosewinkel und Zementlokalisation, sondern beziehen auch die Patientenzufriedenheit mit Steigerung des Aktivitätsgrads und Minderung der Schmerzen mit ein.

Problems in the area of text and document processing can often be described astext rewriting tasks: given an input text, produce a new text by applying some fixed set of rewriting rules. In its simplest form, a rewriting rule is given by a pair of strings, representing a source string (the “original”) and its substitute. By a rewriting dictionary, we mean a finite list of such pairs; dictionary-based text rewriting means to replace in an input text occurrences of originals by their substitutes. We present an efficient method for constructing, given a rewriting dictionaryD, a subsequential transducerthat accepts any texttas input and outputs the intended rewriting result under the so-called “leftmost-longest match” replacement with skips,t'. The time needed to compute the transducer is linear in the size of the input dictionary. Given the transducer, any texttof length |t| is rewritten in a deterministic manner in timeO(|t|+|t'|), wheret' denotes the resulting output text. Hence the resulting rewriting mechanism is very efficient. As a second advantage, using standard tools, the transducer can be directly composed with other transducers to efficiently solve more complex rewriting tasks in a single processing step.