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Purpose: The cemented Exeter V40 stem is known to migrate distally. Several previous studies have reported on the extent of stem migration and its influence on clinical outcome. However, no studies have investigated the influence of stem migration on Patient Reported Outcome Measures (PROM). Methods: One hundred and twelve total hip arthroplasties (THA) were included in a 2-year follow-up using Radiostereometric Analysis (RSA). Patients were evaluated using the Oxford Hip Score (OHS) and EQ-5D-3L PROMs. The purpose of this study was to assess the influence of stem migration, measured by Maximum Total Point Motion (MTPM), on the 2-year postoperative score (OHS and EQ-5D). Furthermore, the influence of pre-operative PROM, age, gender, acetabular component and BMI was associated with the 2-year postoperative OHS and EQ-5D scores. Results: MTPM was a non-significant predictor of the 2-year postoperative OHS (regression coefficient (B) = − 2.38 (CI − 5.44;.69)) and of the 2-year postoperative EQ-5D (B = − .01 (CI − .04;.02)). The only significant predictor of the 2-year postoperative OHS and 2-year postoperative EQ-5D was gender (B = 8.71 (CI 3.52; 13.90)) and (B =.13 (CI.07;.18)), respectively. Conclusion: Stem migration did not significantly influence PROMs at 2 years post-operatively. Using a patient-focused approach, our results seem to corroborate results reported by previous studies, showing that slow migration of the Exeter V40 stem does not seem to influence the clinical outcome.

We investigate climate change impacts transferred via foreign trade to Germany, a country that is heavily engaged in international trade. Specifically, we look at temperature changes and the associated labour productivity losses at a global scale until 2050. We assess the effects on Germany’s imports and exports by means of a global computable general equilibrium (CGE) model. To address uncertainty, we account for three Shared Socioeconomic Pathways (SSP1, SSP2 and SSP3) and two Representative Concentration Pathways (RCP4.5 and RCP8.5) using projections from five global climate models. We find that average annual labour productivity for high intensity work declines by up to 31% for RCP4.5 (and up to 38% for RCP8.5) in Southeast Asia and the Middle East by 2050, all relative to a 2050 baseline without climate change. As a consequence, for RCP8.5, Germany’s imports from regions outside Europe are lower by up to 2.46%, while imports from within Europe partly compensate this reduction. Also, Germany’s exports to regions outside Europe are lower, but total exports increase by up to 0.16% due to higher exports to EU regions. Germany’s GDP and welfare, however, are negatively affected with a loss of up to − 0.41% and − 0.46%, respectively. The results highlight that overall positive trade effects for Germany constitute a comparative improvement rather than an absolute gain with climate change.

In 2015 the United Nations proposed the Sustainable Development Goals (SDGs), a set of universal goals for meeting the urgent environmental, political and economic challenges in the world. Universities play an important role to support and contribute to the SDGs mainly through education and research. To evaluate the contributions through research, universities aim at relating their scientific publications to SDGs, and automatically quantify the connectedness of these publications to the detailed targets and the unique indicators under SDGs. In this paper, we apply deep learning techniques to estimate the unknown indicators (third level) and targets (second level) for each publication, and output all its possible goals (first level). Specifically, we first exploit the dependency of categories at different levels (goals, targets, and indicators) to extract the dependent label features. Then we calculate the degree of matching between categories and publications in a bottom-up way and design a hierarchical structure to transfer such matching information level by level until obtaining the predicted SDGs of the publications. This is the first application of a deep learning method on this SDG prediction task and our experiments clearly demonstrate the good performance of our model on this real-world SDGs matching task, the extraction of key information as well as the prediction of potential sub-categories. As auxiliary analysis, we visualize the extraction of key semantic information and the probability of the hierarchical SDG categories.

Repetitive transcranial magnetic stimulation (rTMS) is used to treat different neuropsychiatric conditions like Parkinson’s disease, essential tremor, stroke, cognitive decline, dementia and depression. rTMS may exert its therapeutic effects by influencing the biochemistry of neurotransmitters. In this exploratory study, safety symptom improvement and changes in the availability of neurotransmitter precursor amino acids were studied following prefrontal cortex (PFC) stimulation using repetitive transcranial stimulation with TheraCell apparatus R (Guth Meditec, Salach, Germany) as an additional treatment in ten patients with late life depression. Treatment was well tolerated with no serious adverse effects being observed. rTMS induced a significant improvement in the symptoms of depression and a significant decrease in the HAMD-7 (p

Atmospheric climate monitoring requires observations of high quality that conform to the criteria of the Global Climate Observing System (GCOS). Radio occultation (RO) data based on Global Positioning System (GPS) signals are available since 2001 from several satellite missions with global coverage, high accuracy, and high vertical resolution in the troposphere and lower stratosphere. We assess the consistency and long-term stability of multi-satellite RO observations for use as climate data records. As a measure of long-term stability, we quantify the structural uncertainty of RO data products arising from different processing schemes. We analyze atmospheric variables from bending angle to temperature for four RO missions, CHAMP, Formosat-3/COSMIC, GRACE, and Metop, provided by five data centers. The comparisons are based on profile-to-profile differences aggregated to monthly medians. Structural uncertainty in trends is found to be lowest from 8 to 25 km of altitude globally for all inspected RO variables and missions. For temperature, it is

The products of explosive volcanic eruptions, in particular, volcanic ash, can pose a severe hazard to, for example, international aviation. Detecting volcanic clouds and monitoring their dispersal is hence, the subject of intensive current research. However, the discrepancies between the different available methods lead to detected cloud altitude with significant uncertainties. Here we show the results of an algorithm developed explicitly for high vertical resolution detection of volcanic cloud altitude by using the Global Navigation Satellite System radio occultation (RO) observations. Analyzing the energetic Kasatochi eruption of August 2008 in a case study, we find the volcanic cloud altitudes detected with RO in good agreement (within ~1 km) with cloud altitude estimations from Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) lidar backscatter images in the 4 h range between RO and CALIOP acquisitions. The tracking by combined RO and imaging of the volcanic cloud evolution during the weeks after the eruption indicates a promising potential for operational global cloud altitude monitoring.

Africa's Protected Area (PA) estate includes some of the world's most iconic wildlife and wildlands and preserves ecosystem services upon which people depend. However, Africa's PAs are facing a growing array of threats resulting in significant degradation, factors compounded by chronic funding shortages. In this opinion piece, drawing from the available literature and collective experience of the author group, we look at the potential for collaborative management partnerships (CMPs) between state wildlife agencies and Non-Governmental Organisations (NGOs) to attract investment and technical capacity to improve PA performance. The three main CMP models—financial and technical support, co-management, and delegated management—yield median funding that is 1.5, 2.6 and 14.6 times greater than baseline state budgets for PA management. However, several factors limit the scaling of CMPs in Africa. Significant barriers include concerns from African governments, such as reluctance to engage in co-management and delegated CMPs due to perceptions that such partnerships may represent an admission of failure, result in a loss of revenues for government, or undermine sovereignty. There are also constraints associated with NGOs and donors that limit scaling of CMPs. We discuss how these issues might be addressed and propose a reframing of the discourse around CMPs. Specifically, we recommend that governments view CMPs as strategic, proactive tools that will enable them to unlock funding, investment and expertise for conservation and make recommendations to attract such investment. Preliminary evidence and the experience of the author group suggests that expanding CMPs for PAs could; improve PA management; share the costs of protecting Africa's PAs with the global community; build local capacity; help protect the ecosystem services upon which Africa's economies depend; stimulate rural development; and benefit local communities.

Rationale & Objective Clinical practice guidelines for dietary intake in hemodialysis focus on individual nutrients. Little is known about associations of dietary patterns with survival. We evaluated the associations of dietary patterns with cardiovascular and all-cause mortality among adults treated by hemodialysis. Study Design Prospective cohort study. Setting & Participants 8,110 of 9,757 consecutive adults on hemodialysis (January 2014 to June 2017) treated in a multinational private dialysis network and with analyzable dietary data. Exposures Data-driven dietary patterns based on the GA2LEN food frequency questionnaire. Participants received a score for each identified pattern, with higher scores indicating closer resemblance of their diet to the identified pattern. Quartiles of standardized pattern scores were used as primary exposures. Outcomes Cardiovascular and all-cause mortality. Analytical Approach Principal components analysis with varimax rotation to identify common dietary patterns. Adjusted proportional hazards regression analyses with country as a random effect to estimate the associations between dietary pattern scores and mortality. Associations were expressed as adjusted HRs with 95% CIs, using the lowest quartile score as reference. Results During a median follow-up of 2.7 years (18,666 person-years), there were 2,087 deaths (958 cardiovascular). 2 dietary patterns, “fruit and vegetable” and “Western,” were identified. For the fruit and vegetable dietary pattern score, adjusted HRs, in ascending quartiles, were 0.94 (95% CI, 0.76-1.15), 0.83 (95% CI, 0.66-1.06), and 0.91 (95% CI, 0.69-1.21) for cardiovascular mortality and 0.95 (95% CI, 0.83-1.09), 0.84 (95% CI, 0.71-0.99), and 0.87 (95% CI, 0.72-1.05) for all-cause mortality. For the Western dietary pattern score, the corresponding estimates were 1.10 (95% CI, 0.90-1.35), 1.11 (95% CI, 0.87-1.41), and 1.09 (95% CI, 0.80-1.49) for cardiovascular mortality and 1.01 (95% CI, 0.88-1.16), 1.00 (95% CI, 0.85-1.18), and 1.14 (95% CI, 0.93-1.41) for all-cause mortality. Limitations Self-reported food frequency questionnaire, data-driven approach. Conclusions These findings did not confirm an association between mortality among patients receiving long-term hemodialysis and the extent to which dietary patterns were either high in fruit and vegetables or consistent with a Western diet.

Introduction/Background In the light of the development of polydigital hand prosthesis, we recently explored an intuitive control mode by surface EMG associated to phantom limb movements (PLM) in upper arm amputees (Jarrasse et al., 2017a, b). As little was known about PLM, we described types and characteristics of upper limb PLM and explored some factors potentially influencing these in a population of upper limb amputees (De Graaf et al., 2016; Touillet et al., submitted). We showed, among others, that one persistent characteristic of PLM is the associated fatigue, which potentially is a problem when using PLM for prosthesis control since fatigue diminish the mobilization capacity as well as the stability of the EMG signals and thus interferes with the prosthesis control. Material and method In the present study, we explored whether PLM training (not to confound with learning) can increase mobilization capacity and stabilize EMG signals. Five trans-humeral amputees volunteered for training of all their types of PLM at home on a daily basis during about 6 weeks. Kinematics (via the intact limb imitating the phantom movements) as well as EMG signals from the residual muscles were recorded just before and right after the training period. Results None of the participants experienced (phantom or residual limb) pain related to the training. Three participants increased the number of different PLM they could execute. All of them increased the amplitude and velocity, and thus diminished the cycle duration, as well as the number of cycles they could execute before the PLM blocked by fatigue. The amplitude of the EMG increased and became more specific to the type of PLM. Conclusion In conclusion, as is the case for intact limbs, training of PLM improves motor performance and stabilizes the EMG signals associated to PLM execution. This is encouraging for future PLM-based prosthesis control.

Wahrend fur Patienten mit akutem Koronarsyndrom sowie stabiler koronarer 1- und 2-Gefas-Erkrankung die perkutane Koronarintervention (PCI) therapeutischer Standard ist, wird die optimale Revaskularisationsstrategie von Patienten mit koronarer 3-Gefas-Erkrankung und/oder Hauptstammstenose weiterhin intensiv interdisziplinar diskutiert. Vor allem Registerdaten legen nahe, dass eine Revaskularisation mittels PCI einer chirurgischen Bypassoperation (CABG) hinsichtlich des Uberlebens und des Auftretens von Myokardinfarkten nicht unterlegen ist, fur die CABG-Gruppe allerdings ein hoheres Schlaganfallrisiko zu verzeichnen ist, wohingegen eine hohe Revaskularisationsrate klare „Achillesferse“ der PCI ist. Die SYNTAX-Studie liefert als prospektive, randomisierte Studie 5-Jahres-Outcome-Daten zum Vergleich von PCI und CABG: Diese legen nahe, dass bei Patienten mit geringerer Stenosenkomplexitat – reprasentiert durch einen niedrigen SYNTAX-Score – beide Interventionsstrategien vergleichbare Ergebnisse liefern, wohingegen Patienten mit komplexeren Lasionen von einer chirurgischen Therapie mehr zu profitieren scheinen. Wir sind aufgefordert, hierzu patientenindividuelle Strategien gemeinsam im „Heart Team“ zu diskutieren.

This case report demonstrates a satisfying response to topiramate in a 79-year-old patient with disabling essential tremor in whom propranolol as well as primidone had to be discontinued due to severe side effects. After 28 months of topiramate treatment, a clear decline in Mini Mental State Examination (MMSE) could be observed, stressing the use of care in prescribing topiramate in elderly patients.

The volcanic cloud top altitude and the atmospheric thermal structure after volcanic eruptions are studied using Global Positioning System (GPS) Radio Occultation (RO) profiles co-located with independent radiometric measurements of ash and SO2 clouds. We use the GPS RO data to detect volcanic clouds and to analyze their impact on climate in terms of temperature changes. We selected about 1300 GPS RO profiles co-located with two representative eruptions (Puyehue 2011, Nabro 2011) and found that an anomaly technique recently developed for detecting cloud tops of convective systems can also be applied to volcanic clouds. Analyzing the atmospheric thermal structure after the eruptions, we found clear cooling signatures of volcanic cloud tops in the upper troposphere for the Puyehue case. The impact of Nabro lasted for several months, suggesting that the cloud reached the stratosphere, where a significant warming occurred. The results are encouraging for future routine use of RO data for monitoring volcanic clouds.

Buzz about instant messaging (IM) customer service is becoming louder, both inside and outside the library field. In general, librarian opinions of IM are mixed and at times even combative. A survey was distributed to gather librarians' opinions of the usefulness of IM as compared to its feature-rich yet difficulty-prone sibling, commercial chat. Through detailed statistical analysis, this article provides an overview of trends in and opinions of IM reference, and offers analysis of its present and future in libraries.

Background Dental disease is more extensive in adults with chronic kidney disease, but whether dental health and behaviors are associated with survival in the setting of hemodialysis is unknown. Study Design Prospective multinational cohort. Setting & Participants 4,205 adults treated with long-term hemodialysis, 2010 to 2012 (Oral Diseases in Hemodialysis [ORAL-D] Study). Predictors Dental health as assessed by a standardized dental examination using World Health Organization guidelines and personal oral care, including edentulousness; decayed, missing, and filled teeth index; teeth brushing and flossing; and dental health consultation. Outcomes All-cause and cardiovascular mortality at 12 months after dental assessment. Measurements Multivariable-adjusted Cox proportional hazards regression models fitted with shared frailty to account for clustering of mortality risk within countries. Results During a mean follow-up of 22.1 months, 942 deaths occurred, including 477 cardiovascular deaths. Edentulousness (adjusted HR, 1.29; 95% CI, 1.10-1.51) and decayed, missing, or filled teeth score ≥ 14 (adjusted HR, 1.70; 95% CI, 1.33-2.17) were associated with early all-cause mortality, while dental flossing, using mouthwash, brushing teeth daily, spending at least 2 minutes on oral hygiene daily, changing a toothbrush at least every 3 months, and visiting a dentist within the past 6 months (adjusted HRs of 0.52 [95% CI, 0.32-0.85], 0.79 [95% CI, 0.64-0.97], 0.76 [95% CI, 0.58-0.99], 0.84 [95% CI, 0.71-0.99], 0.79 [95% CI, 0.65-0.95], and 0.79 [95% CI, 0.65-0.96], respectively) were associated with better survival. Results for cardiovascular mortality were similar. Limitations Convenience sample of clinics. Conclusions In adults treated with hemodialysis, poorer dental health was associated with early death, whereas preventive dental health practices were associated with longer survival.

The aim of this study was to investigate whether the washout length between glycemic response tests influences their reliability. A total of 3 men and 12 women performed eight identical blood glucose tolerance tests: four tests on consecutive days (short interval) and four tests spread over 20–30 days, with 5–10 days between the tests (long interval). No difference was observed in the coefficient of variation (P=0.32) of the incremental area under the blood glucose response curve between the short and long interval, and there was no drift within the short (P=089) and long interval (P=0.20). The first test did not differ from any of the subsequent tests (P>0.99). In conclusion, glycemic response testing on consecutive days does not seem to influence the variability of glycemic response tests compared with longer intervals and it does not cause any data drift under conditions of earlier diet and habitual exercise control. In addition, familiarization trials do not seem to be necessary for glycemic response tests.

The global positioning system meteorology (GPS/MET) experiment was the first practical demonstration of global navigation satellite system (GNSS)-based active limb sounding employing the radio occultation technique. This method measures, as principal observable and with millimetric accuracy, the excess phase path (relative to propagation in vacuum) of GNSS-transmitted radio waves caused by refraction during passage through the Earth's neutral atmosphere and ionosphere in limb geometry. It shows great potential utility for weather and climate system studies in providing an unique combination of global coverage, high vertical resolution and accuracy, long-term stability, and all-weather capability. We first describe our GPS/MET data processing scheme from excess phases via bending angles to the neutral atmospheric parameters refractivity, density, pressure and temperature. Special emphasis is given to ionospheric correction methodology and the inversion of bending angles to refractivities, where we introduce a matrix inversion technique (instead of the usual integral inversion). The matrix technique is shown to lead to identical results as integral inversion but is more directly extendable to inversion by optimal estimation. The quality of GPS/MET-derived profiles is analyzed with an error estimation analysis employing a Monte Carlo technique. We consider statistical errors together with systematic errors due to upper-boundary initialization of the retrieval by a priori bending angles. Perfect initialization and properly smoothed statistical errors allow for better than 1 K temperature retrieval accuracy up to the stratopause. No initialization and statistical errors yield better than 1 K accuracy up to 30 km but less than 3 K accuracy above 40 km. Given imperfect initialization, biases >2 K propagate down to below 30 km height in unfavorable realistic cases. Furthermore, results of a statistical validation of GPS/MET profiles through comparison with atmospheric analyses of the European Centre for Medium-range Weather Forecasts (ECMWF) are presented. The comparisons indicate the high utility of the occultation data in that very good agreement of upper troposphere/lower stratosphere temperature (better than 1.5 K rms, Key words. Atmospheric composition and structure (pressure; density and temperature), Meteorology and atmospheric dynamics (instruments and techniques), Radio science (remote sensing)

A mode-locked Ti:sapphire regenerative amplifier system pumped with a single argon ion laser produces /spl mu/J energy 100 femtosecond pulses of 800 nm wavelength at 250 kHz repetition rate. Pumping a Type II BaB/sub 2/O/sub 4/ (BBO) optical parametric amplifiers (OPA) with this output generates 500 nJ infrared pulses and continuous tuning from 1.1 /spl mu/m to beyond 2.5 /spl mu/m. Difference frequency generation of the signal idler output from this OPA source in AgGaS/sub 2/ produces 60 nJ mid infrared pulses and continuous tuning from 2.4 /spl mu/m to beyond 12 /spl mu/m.

[1] To examine the claim that Global Positioning System (GPS) radio occultation (RO) data are useful as a benchmark data set for climate monitoring, the structural uncertainties of retrieved profiles that result from different processing methods are quantified. Profile-to-profile comparisons of CHAMP (CHAllenging Minisatellite Payload) data from January 2002 to August 2008 retrieved by six RO processing centers are presented. Differences and standard deviations of the individual centers relative to the inter-center mean are used to quantify the structural uncertainty. Uncertainties accumulate in derived variables due to propagation through the RO retrieval chain. This is reflected in the inter-center differences, which are small for bending angle and refractivity increasing to dry temperature, dry pressure, and dry geopotential height. The mean differences of the time series in the 8 km to 30 km layer range from −0.08% to 0.12% for bending angle, −0.03% to 0.02% for refractivity, −0.27 K to 0.15 K for dry temperature, −0.04% to 0.04% for dry pressure, and −7.6 m to 6.8 m for dry geopotential height. The corresponding standard deviations are within 0.02%, 0.01%, 0.06 K, 0.02%, and 2.0 m, respectively. The mean trend differences from 8 km to 30 km for bending angle, refractivity, dry temperature, dry pressure, and dry geopotential height are within ±0.02%/5 yrs, ±0.02%/5 yrs, ±0.06 K/5 yrs, ±0.02%/5 yrs, and ±2.3 m/5 yrs, respectively. Although the RO-derived variables are not readily traceable to the international system of units, the high precision nature of the raw RO observables is preserved in the inversion chain.

Central needle embolization is a rare complication of intravenous drug abuse which has only been reported on a handful of occasions. Previously reported cases of needle embolization to the heart have been managed conservatively (observation alone) or by surgical intervention. We report a case of purulent pericarditis without evidence of valvular vegetations resulting from an embolized, infected needle fragment. In the present case, the needle was successfully removed from the right ventricle percutaneously. This case illustrates the unique finding of purulent pericarditis due to a persistent foreign body in the right ventricle, and the nontraditional intervention performed for needle fragment removal which resulted in full clinical recovery of the patient.

The evaluation of Schottky-diode capacitances or reliable freecarrier concentration profiles in doped semiconductors by admittance measurements need a time- and money-consuming diode structuring process since the rectifiying and ohmic contacts are produced separately. The formation of both contacts simultaneously during the same process step reduces costs. However, since alloying cannot be done, the diodes exhibit a poor ohmic contact. Consequently, minority carrier influence, series resistance effects, and deep level influence lead to frequencydependent admittances. In this work, frequency-dependent admittance analysis on such diodes and a simple small- signal equivalent circuit model are used to evaluate space-charge capacitances reflecting only the free carriers of the doped material. This method is useful for the automatic routine control of semiconductors. The minority carrier, deep level, and series resistance influence on the diode admittance is reviewed.

Citation: Steiner, A. K., G. Kirchengast, B. C. Lackner, B. Pirscher, M. Borsche, and U. Foelsche (2010), Correction to “Atmospheric temperature change detection with GPS radio occultation 1995 to 2008,” Geophys. Res. Lett., 37, L03704, doi:10.1029/2010GL042427. [1] In the paper “Atmospheric temperature change detection with GPS radio occultation 1995 to 2008” by A. K. Steiner et al. (Geophys. Res. Lett., 36, L18702, doi:10.1029/2009GL039777), Figure S7 of the auxiliary material is incorrect and the corrected version appears here.

The pharmacokinetic properties and first clinical experiences with the antihypertensive dopamine (DA2) agonist, carmoxirole, are summarized. In man carmoxirole was rapidly absorbed. On oral administration the maximum plasma concentration was reached after 2-3 h. The drug was metabolized, mainly to an ester-type glucuronide, and was excreted (unchanged carmoxirole plus glucuronide) largely by the kidneys. The plasma half-life of the parent compound was 5.5 h. For the dose range tested (0.5 to 1.5 mg) the pharmacokinetics were linear. The drug was rapidly distributed in animals but only very small amounts penetrated the blood-brain barrier. Carmoxirole did not affect supine blood pressure in healthy subjects, but under the conditions of the Schellong's test some orthostatic reactions occurred with high doses. In patients the blood pressure was reduced for at least 8 h after single oral doses. On repeated administration for several weeks a relevant antihypertensive effect was still measurable 12 and 24 h after dose. The most frequently reported adverse events have been headache, dizziness, tiredness, nausea, and gastric disorders. These symptoms are considered to be mainly due to blood pressure reduction, as is frequently observed at the beginning of antihypertensive therapy. In patients the incidence of orthostatic reactions is appreciably lower than in healthy subjects, and in both change of position was sufficient to relieve the symptoms.

A 100-kHz mode-locked Ti:sapphire-seeded regenerative amplifier pumping an optical parametric amplifier generates femtosecond pulses tunable from 470 to 710 nm. This output was compressed with a pair of prisms to bandwidth-limited pulses of 80- to 40-fs duration and more than 150 nJ of energy. These tunable pulses were then bandwidth expanded through self-phase modulation in bulk material and further compressed to less than 30-fs duration.

Background International research in recent years has begun to focus on the medical problems of individuals with intellectual disabilities and on family stress in accessing health services for persons with developmental disabilities. Less is known about the needs of individuals in different diagnostic groups, or about their experiences of systems of care. Therefore, we report the results of focus groups with parents of children or adults with fragile X syndrome, autism or Down syndrome. Methods Semi-structured group interviews with parents of children, youth or adults from each of three diagnostic groups probed perceptions of challenges and successes in obtaining and negotiating healthcare services in Ontario, Canada. Results Parents described diverse barriers to care, the need for advocacy in securing services, perceptions of service delivery and the role of healthcare professionals in regulating access to a wide range of services. Diagnostic services represented one area of central concern to parents from all three groups. Discussion Focus group data yielded a wide range of concerns. Suggestions for enhancing the system included expanding syndrome-specific education for medical students and health professionals and creating a centre that could offer service-related information for parents.

Several GPS Radio Occultation (RO) missions (GRACE-A (GRavity And Climate Experiment), FORMOSAT-3/COSMIC (FORMOsa SATellite mission-3/Constellation Observing System for Meteorology, Ionosphere, and Climate), and MetOp) started data provision in 2006 and 2007. Together with the measurements from CHAMP (CHAllenging Minisatellite Payload, since 2001) and the recently launched (June 15, 2007) TerraSAR-X an operational multi-satellite constellation for precise GPS based atmospheric sounding became reality. The data base is supplemented by measurements from SAC-C (Satelite de Aplicaciones Cientificas-C). Our contribution briefly reviews current GFZ activities regarding processing and application of GPS RO data from different satellites. These activities include precise satellite orbit determination and the provision of near-real time analysis results for weather forecast centers within 2 h after measurement. Available satellite data are used for climatological investigations of global gravity wave characteristics.

[1] To examine the suitability of GPS radio occultation (RO) observations as a climate benchmark data set, this study aims at quantifying the structural uncertainty in GPS RO-derived vertical profiles of refractivity and measured refractivity trends obtained from atmospheric excess phase processing and inversion procedures. Five years (2002–2006) of monthly mean climatologies (MMC) of retrieved refractivity from the experiment aboard the German satellite CHAMP generated by four RO operational centers were compared. Results show that the absolute values of fractional refractivity anomalies among the centers are, in general, ≤0.2% from 8 to 25 km altitude. The median absolute deviations among the centers are less than 0.2% globally. Because the differences in fractional refractivity produced by the four centers are, in general, unchanging with time, the uncertainty of the trend for fractional refractivity anomalies among centers is ±0.04% per 5 years globally. The primary cause of the trend uncertainty is due to different quality control methods used by the four centers, which yield different sampling errors for different centers. We used the National Centers for Environmental Prediction reanalysis in the same period to estimate sampling errors. After removing the sampling errors, the uncertainty of the trend for fractional refractivity anomalies among centers is between −0.03 and 0.01% per 5 years. Thus 0.03% per 5 years can be considered an upper bound in the processing scheme–induced uncertainty for global refractivity trend monitoring. Systematic errors common to all centers are not discussed in this article but are generally believed to be small.

Gate-voltage-dependent mobility profiles in long-, short-, wide-, and narrow-channel WN/sub x/-BPLDD (buried p-type buffer lightly doped drain region) GaAs MESFETs have been determined (L/sub G/=10, 4, 2, 1, 0.8, 0.5, 0.3 mu m, W/sub G/=20 mu m; W/sub G/-100, 40, 20, 10, 4, 2 mu m, L/sub G/=0.5 mu m). The mobility mainly depends on the channel width, while the gate length has much less influence. Thus, using proper gate dimensions the channel mobility can be tuned. The highest drift mobility values agree quite well with the measured Hall mobilities. Mobility profiles of large-area MESFETs are probably degraded by the WN/sub x/-gate fabrication process. Injected excess charges at gate length below 0.5 mu m distorts the mobility evaluations. >

Asymmetric tilt-angle-implanted lightly doped drain (LDD)-WN/sub x/-GaAs MESFETs with an optimized transconductance performance are discussed. A tilt-angle implantation is used to reduce the parasitic source resistance below the gate sidewall without increasing short- and narrow-channel effects. This leads to a transconductance increase of nearly 25% for submicrometer FETs while the gate-source capacitance increase is almost negligible. The influence of the implantation angle on the threshold voltage transconductance, and Schottky-barrier characteristics is reported. >

One of the most prominent topics in climate research is the investigation, detection, and allocation of climate change. In this paper, we aim at identifying regions in the atmosphere (e.g., certain height layers) which can act as sensitive and robust indicators for climate change. We demonstrate how interactive visual data exploration of large amounts of multi-variate and time-dependent climate data enables the steered generation of promising hypotheses for subsequent statistical evaluation. The use of new visualization and interaction technology--in the context of a coordinated multiple views framework--allows not only to identify these promising hypotheses, but also to efficiently narrow down parameters that are required in the process of computational data analysis. Two datasets, namely an ECHAM5 climate model run and the ERA-40 reanalysis incorporating observational data, are investigated. Higher-order information such as linear trends or signal-to-noise ratio is derived and interactively explored in order to detect and explore those regions which react most sensitively to climate change. As one conclusion from this study, we identify an excellent potential for usefully generalizing our approach to other, similar application cases, as well.

We report the implementation and operation of novel superhigh-reflectivity negative-dispersion dielectric mirrors for use in tunable ultrafast laser systems. The mirror structure is divided into two distinct regions: an underlying superhigh-reflectivity dielectric quarter-wavelength stack and an overlying negative-dispersion section consisting of only a few layers and forming simple multiple Gires-Tournois interferometers. The example that we present was designed for operation from 800 to 900 nm and has a near-constant group-delay dispersion of -40 fs(2) and a peak reflectivity greater than 99.99%. We show a comparison of the predicted and the measured mirror performance and application of these mirrors in a mode-locked Ti:sapphire laser tunable from 805 to 915 nm.

A major application of the CHAMP occultation data is the preparation of processing systems for future occultation missions. The University of Graz (IGAM) uses data and analysis results to prepare for the ACE+ multi-satellite occultation mission, which is currently foreseen to be launched in 2008. We compare vertical profiles of refractivity, derived by GFZ and IGAM, with ECMWF data (European Centre for Medium-Range Weather Forecasts) and discuss the deviations. Good agreement is observed in the upper troposphere and stratosphere. The magnitude of the observed refractivity bias in the lower troposphere depends significantly on the quality control criterion. The bias can be nearly eliminated by the application of the Full Spectrum Inversion analysis method down to ∼1 km above the Earth's surface.

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Antibodies to heat shock protein (hsp) are strongly associated with atherosclerotic cardiovascular disease in the non-diabetic population as well as in patients with type 2 diabetes mellitus. In type 1 diabetes increased antibody titers to hsp were found to be a symptom of the autoimmune disease leading to beta-cell damage. We asked whether hsp antibody titers are related to metabolic control and late complications in type 1 diabetic patients. Serum neopterin, also an indicator of chronic inflammation, was also evaluated. The hsp65 antibody titer was determined in 138 patients with type 1 diabetes, 47 women and 91 men, aged 35.5 +/- 12 years with a mean diabetes duration of 16.6 +/- 10.5 years. A history of diabetic late complications and cardiovascular disease was taken. A fundoscopy and a neurological examination were performed, nephropathy was assessed by measurement of the urinary albumin excretion rate. For the measurement of the hsp antibody titer an enzyme-linked immunosorbent assay (ELISA) was applied, for neopterin a radio-immuno assay (RIA) was used. The hsp65 antibody titer was found to be positively related to the patients' age (r = 0.237; p < 0.035). Patients with retinopathy revealed significantly higher hsp65 antibody titers (307.2 +/- 38.6) than those without retinopathy (150.0 +/- 18.5;p < 0.003). No correlation was found between hsp antibody titer and metabolic control. Serum neopterin levels revealed a trend towards a positive relationship with diabetes duration (r = 0.205; p < 0.0539) and a significant correlation with serum cholesterol levels (r = 0.436; p < 0.001), but not with HbA1 c values. Our data add further information to the role of inflammatory markers in the development of diabetic microangiopathy.

Soil tillage by hoe or plough was identified as one of the principal causes of soil degradation in vast regions of Africa. Inspired by the impressing spread of no-tillage practices in Latin America GTZ conducted a study on the potential of no-tillage practices in sub-Saharan Africa. Limited access to information and lacking exchange between research and development institutions within and across countries was identified as one reason for the limited advance of these new technologies throughout Africa. Participants of an international workshop conducted in Zimbabwe proposed the founding of a regional conservation tillage network. With financial and technical from GTZ and FAO, the objectives and structure of such a network were defined, and a permanent secretariat opened early 2000. The network is seen as a network of country networks. Purpose of the network is to enhance the dissemination of conservation tillage in smallholder agriculture. The core functions were defined as, support to the formation/strengthening of national networks; dissemination, mobilisation, provision and inventory of information; documentation and dissemination of the evidence of conservation tillage benefits; organisation of learning through exposure/seeing; support to lobbying at national level; support to the development of dissemination material.

The global coverage, all-weather capability, high accuracy, and self-calibrated nature of radio occultation (RO) data suggests them as a near-ideal resource to build global climatologies of fundamental atmospheric variables such as temperature and humidity. Such climatologies are not available yet, but some heritage exists from an on-going project on a climate observing system simulation experiment using realistically simulated RO data (GNSS-CLIMATCH, a joint project of IGAM/Univ. of Graz and MPI for Meteorology, Hamburg). The CHAMP (Challenging Minisatellite Payload) RO data will provide the very first opportunity to create real RO based climatologies. We aim at using the complete CHAMP RO data flow for month-to-month, season-to-season, and year-to-year global climate monitoring via temperature, geopotential height, and humidity fields.

Plasma-charging damage is known to be a high-field injection phenomenon during plasma processing. It is also known that it can happen in either the gate-injection mode or substrate-injection mode, depending on the plasma potential distribution. However, the effect of this polarity difference on damage is seldom addressed. A number of groups have studied the impact of plasma-charging damage on low frequency MOSFET noise. The consensus is that plasma charging damage increases the low frequency noise of a MOSFET. However, in this work, we observed a strong dependence of the MOSFET low frequency noise on the polarity of plasma-charging damage. When the plasma-charging damage is of the gate-injection type, the MOSFET low frequency noise is insensitive to damage whereas when the polarity is of the substrate-injection type, the MOSFET low frequency noise is very sensitive to damage.

Today there is a wide range of research disciplines that deal with the creation, administration, maintenance and evaluation of knowledge. We focus on two established approaches to knowledge management systems-namely superimposed information as well as domain ontologies. We also focus on problems arising with Web content management systems. Since the underlying abstract model of topic maps provides a high degree of power and flexibility, they can be used to combine these approaches. Moreover, topic maps offer a framework supporting the evolutionary construction of computer-based organizational memories. The presented system architectures have been developed in cooperation with one of the largest Internet sites in Austria as well as with an international lawyer's office.

In this paper, we show how topic maps (semantically structured, self-describing link networks standardized by ISO/IEC 13250) can be used to represent superimposed information as well as domain ontologies - two established approaches to knowledge management systems. Superimposed information enriches explicit knowledge resources for purposes like retrieval or connection, without modifying this base information. Domain ontologies are frequently used to capture and formalize implicit domain-specific knowledge. Since the underlying abstract model of topic maps provides a high degree of power and flexibility, topic maps can be also used to combine both approaches and provide a framework that supports the evolutionary construction of organizational memories that are able to grow both in structure and extent.

SummaryCTLA-4 (CD152) is a surface molecule of activated T cells with sequence homology to CD28. Both molecules bind to the same ligands, B7.1 (CD80) and B7.2 (CD86) but have antagonistic functions. While CD28 is an important costimulator, CTLA-4 has an essential inhibitory function in maintaining the homeostasis of the immune system. Furthermore, CTLA-4 has a role in inducing a Th1 response and suppressing Th2 cytokines, an effect which is antagonized by CD28. Many autoimmune diseases are characterized by an overwhelming production of Th1 cytokines. Recently, the predominance of the Th1 cytokine pattern has been directly observed in the granulomatous inflammation of patients with Wegener's granulomatosis. The balance between CD28 and CTLA-4 expression by T lymphocytes could be a factor in the pathogenesis of autoimmune diseases. Down regulation of CD28 predominantly on CD8+ T cells has been described in Wegner's granulomatosis; however, analysis of CTLA-4 is complicated by its low expression levels. Here we have used potent signal enhancement to study CTLA-4 on PBMC in patients with Wegener's granulomatosis (n = 25) in comparison with healthy controls (n = 19). Expression levels of CTLA-4 were significantly increased selectively on CD4+ and possibly also on CD4−/CD8− T cells in Wegener's granulomatosis. High CTLA-4 expression by T lymphocytes was associated with more severe disease. In contrast, after stimulation with the mitogen PHA, CTLA-4 levels were strongly increased on T cells from controls but in T cells from Wegener's granulomatosis patients this response was severely impaired. Interestingly, while CTLA-4 was seen exclusively on T cells in control individuals, about half of the Wegener's patients showed CTLA-4 expression by a fraction of peripheral B lymphocytes. CTLA-4 positive B cells in the periphery were associated with less acute disease.

The aim of this study was to identify independent predictors of acquiring a nosocomial bloodstream infection (BSI) during extracorporeal membrane oxygenation (ECMO).This retrospective cohort consisted of 202 neonates treated with ECMO from 1989 to 1998 at the author' institution. Data collected included patient demographics, primary and secondary diagnoses, white blood cell counts, antibiotic usage, presence of central lines, operative procedures, and outcome. Surveillance blood cultures were drawn daily from the circuit using sterile technique to identify acquired pathogens. Statistical analyses included logistic regression, Cox proportional regression analysis, and discriminate analysis.There were 1,245 blood cultures drawn on 202 patients (6.2 cultures per patient), and a nosocomial BSI was identified in 7 patients (3.4%) during this 10-year span. These were infections that were neither present nor incubating on admission. Pre-ECMO diagnoses of patients who had a nosocomial BSI while on bypass included group B beta-hemolytic streptococcal sepsis (n = 2), herpes simplex viral sepsis (n = 1), congenital diaphragmatic hernia (n = 2), persistent pulmonary hypertension (n = 1), and congenital heart disease (n = 1). The median time on ECMO before obtaining a positive culture was 390 hours. The infectious agents responsible for these BSIs included Staphylococcus epidermidis (n = 5), Staphylococcus aureus (n = 1), and Escherichia coli (n = 1). The major factor associated with acquiring a nosocomial BSI on ECMO was the duration of bypass (391 v 141 hours, P =.002). Additionally, patients in the BSI group were more likely to have had an arterial catheter in place (16 v 7 days, P =.009) and to have received more screening blood cultures (16 v 6 cultures, P001). White blood cell counts, absolute neutrophil counts, and immature/total (I/T) ratios were not useful in predicting a nosocomial BSI. Of the 31 patients who required ECMO for more than 10 days, 7 (23%) had a positive blood culture, and 5 of these 7 infants (71%) died (P =.03).The only predictor of acquiring a nosocomial BSI on ECMO was the duration of support for greater than 10 days. Because classical predictors of infection are unreliable while the patient is on ECMO, the authors suggest that obtaining daily surveillance blood cultures beginning on the tenth day should be performed with prolonged ECMO courses. The authors confirmed previous reports of the association between a prolonged ECMO course and a high mortality rate. However, the authors speculate that, in actuality, the primary diagnosis leads to the prolonged course of support and is the major factor in the infant' demise.

We have integrated HfO/sub 2/ and Al/sub 2/O/sub 3/ gate dielectrics grown by atomic layer chemical vapor deposition (ALD) with poly-Si gate electrodes in the vertical replacement-gate (VRG) MOSFET geometry. These transistors are among the first reported with ALD HfO/sub 2/ gate dielectrics, and have HfO/sub 2/ target equivalent oxide thicknesses (tEOT's) down to 13 /spl Aring/. The poly-crystalline HfO/sub 2/ films in these VRG nMOSFETs exhibit extremely low gate leakage (GL) current densities of J/sub G/ /spl sim/ 10/sup -7/ A/cm/sup 2/ at V/sub G/-V/sub T,Long/ = 0.6 V for 15 /spl Aring/ tEOT devices. This indicates that amorphous gate dielectrics may not be necessary to meet GL requirements. HfO/sub 2/ devices with 50 nm gate length L/sub G/ exhibit drive currents [normalized by the coded width W/sub C/] of 490 /spl mu/A//spl mu/m for 1 V operation (overdrive V/sub GS/-V/sub T/ = 0.6 V) with good short-channel performance. These results demonstrate that ALD is compatible with the demanding VRG geometry, thereby illustrating that it should be well-suited to essentially any novel device structure built with Si-compatible materials.