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Precise time underpins critical infrastructure in modern society, including telecommunications, computer networks, electrical power grids and broadcasting. At present, Global Navigation Satellite S...

The Nuussuaq Basin in West Greenland has an obvious exploration potential. Most of the critical elements are well documented, including structures that could form traps, reservoir rocks, seals and oil and gas seepage that documents petroleum generation. And yet, we still lack a full understanding of the petroleum systems, especially the distribution of mature source rocks in the subsurface and the vertical and lateral migration of petroleum into traps. A recently proposed anticlinal structural model could be very interesting for exploration if evidence of source rocks and migration pathways can be found. In this paper, we review all existing, mostly unpublished, data on gas observations from Nuussuaq. Furthermore, we present new oil and gas seepage data from the vicinity of the anticline. Occurrence of gas within a few kilometres on both sides of the mapped anticline has a strong thermogenic fingerprint, suggesting an origin from oil-prone source rocks with a relatively low thermal maturity. Petroleum was extracted from an oil-stained hyaloclastite sample collected in the Aaffarsuaq valley in 2019, close to the anticline. Biomarker analyses revealed the oil to be a variety of the previously characterised “Niaqornaarsuk type,” reported to be formed from Campanian-age source rocks. Our new analysis places the “Niaqornaarsuk type” 10 km from previously documented occurrences and further supports the existence of Campanian age deposits developed in source rock facies in the region.

Wahrend Erkrankungen der Lunge ursachlich zu einem Sauerstoffmangel, einer Hypoxamie, fuhren mit der Indikation, Sauerstoff zu geben, ist die Uberlastung der Atempumpe Ursache fur Hyperkapnie und Luftnot, die durch Beatmung zu behandeln sind. Fruhzeitige Diagnostik ermoglicht eine rechtzeitige nichtinvasive Beatmungstherapie und kann ein Atemversagen und eine akute invasive Beatmung vermeiden. Dafur stehen diagnostische Masnahmen zur Verfugung, sodass das Risiko fur ein zukunftiges Atemversagen fruhzeitig erfassbar ist. Auch die Therapie der Atempumpinsuffizienz, der ventilatorischen Insuffizienz, ist etabliert: die Entlastung der Atempumpe durch intermittierende Beatmung. Tausende Patienten mit ventilatorischer Insuffizienz nutzen eine intermittierende oder kontinuierliche Beatmung jeden Tag, um ihre Atemmuskulatur zu entlasten. Mehrere Studien haben eine Verlangerung der Lebenserwartung und eine Steigerung der Lebensqualitat belegt, wenn diese Entlastung zusammen mit einer Erniedrigung des pCO2 (Kohlendioxidpartialdruck) sowohl unter Beatmung als auch unter Spontanatmung erreicht wird. Wird dieses Ziel der pCO2-Erniedrigung nicht erreicht, so kann ein Effekt der Beatmung nicht nachgewiesen werden. Je schwerer die Erkrankung, desto schwerer ist es, Entlastung zu erreichen, weil die erheblichen Atemanstrengungen des Betroffenen durch nur unterstutzende Beatmung kaum entlastet werden konnen. Eine vollstandig passive Hyperventilation, sodass der Patient unterhalb der Apnoeschwelle nicht selbst atmen muss, garantiert die Entlastung. Dazu sind ein hohes Atemzugvolumen, eine ausreichende Atemfrequenz und eine ausreichend lange Inspirationszeit notwendig, um den pCO2 unter den Normbereich abzusenken und die passive Beatmung herbeizufuhren. Lungenschaden sind bei dieser an einer Vielzahl von Patienten eingesetzten Therapie nicht beobachtet worden.

Objective: To report the incidence of venous thromboembolism (VTE) after nephrectomy in Denmark and explore associated risk factors. Materials and Methods: A nationwide population-based retrospective cohort study was performed. All nephrectomies from January 2010 to August 2018 were assessed for postoperative VTE events. Univariable and multivariable analyses were used to evaluate the odds ratio (OR) of clinical variables’ effect on postoperative VTEs, within 4 weeks and 4 months after nephrectomy. Results: In 5213 nephrectomized patients, postoperative VTE incidence was 1% and 2% within 4 weeks and 4 months, respectively. Multivariable analyses revealed that predictors of postoperative VTE within 4 months were: open nephrectomy (OR 2.5, P =.001), history of VTE (OR 13.3, P

We present a method for reproducible manufacture of multiassay platforms with tunable mechanical properties for muscle tissue strip analysis. The platforms result from stereolithographic 3D printing of low protein-binding poly(ethylene glycol) diacrylate (PEGDA) hydrogels. Contractile microtissues have previously been engineered by immobilizing suspended cells in a confined hydrogel matrix with embedded anchoring cantilevers to facilitate muscle tissue strip formation. The 3D shape and mechanical properties of the confinement and the embedded cantilevers are critical for the tissue robustness. High-resolution 3D printing of PEGDA hydrogels offers full design freedom to engineer cantilever stiffness, while minimizing unwanted cell attachment. We demonstrate the applicability by generating suspended muscle tissue strips from C2C12 mouse myoblasts in a compliant fibrin-based hydrogel matrix. The full design freedom allows for new platform geometries that reduce local stress in the matrix and tissue, thus, reducing the risk of tissue fracture.

Episodic breathlessness is frequent in palliative cancer patients. Opioids are the only pharmacological agents with sufficient evidence in treatment. In Denmark, the main recommendation is red morphine drops (RMD), an off-label solution of morphine, ethanol, and red color (cochenille) described since 1893 (Pharmacopoea Danica). In 2015, the Danish Medicines Agency increased focus on off-label medicines and recommended registered morphine drops without ethanol instead. However, our palliative patients told us that RMD was better. For that reason, we conducted a clinical trial to clarify any perceived difference between the two types of drops. We conducted a randomized, double blinded, crossover trial. Patients were asked to perform standardized activity (2-min walk) aiming to provoke breathlessness. Primary endpoint (breathlessness NRS) and secondary endpoints (saturation, pulse, respiratory frequency) were measured before (t = 0) and after test medicine at t = 1, t = 3, t = 5, t = 10, and t = 20 min. After 2–4 days (washout period), the patients repeated the test, receiving the alternative drops in a blinded setup (crossover). In the first 3 min, the relative drop in breathlessness for morphine drops with ethanol (RMD) was significant more than for morphine drops without ethanol. We found no significant difference in secondary endpoints. A conclusion could be that ethanol might facilitate morphine absorption in the mouth. Our results needs further research of opioid absorption in the mouth as well as trials, testing morphine vs. more lipophilic opioids. The RMD drops are cheap, easy to use, and noninvasive and keep the patient independent of health care professionals.

Previous studies suggest an increased cancer risk in hypertension. Patients with hypertensive nephropathy have not been studied. A national registry study was performed to assess the presence and size of this association. Clinical data and cancer diagnoses for all patients with biopsy-proven hypertensive nephropathy between 1985 and 2015 in Denmark were extracted from four national registries and compared with age- and sex-adjusted national cancer rates. The risk of cancer was twice the background population. It was raised for renal cancer (odds ratio 10.4), myeloma (13.2), skin cancer (7.9), and other/unspecified (1.8). No increase in incidence was seen until 1 year before renal biopsy and then rose rapidly. It was again normal 5 years after biopsy. Hypertensive nephropathy is associated with an increased risk of myeloma, skin, renal, and other cancers. Screening of patients with hypertensive nephropathy, in the presence of reduced renal function or significant proteinuria, may be indicated.

Die Transposition des proximalen Radioulnargelenks wird als konvergente Ellenbogenluxation bezeichnet und ist eine extrem seltene Verletzung. Hierbei uberkreuzt der proximale Radius die proximale Ulna und konvergiert nach medial. Die Verletzung kann isoliert oder noch seltener in Kombination mit einer posterioren ulnohumeralen Dislokation vorkommen. Fast immer ist eine offene Reposition notwendig. Haufig kommt es zu einer verzogerten Diagnosestellung, da die Verletzung leicht ubersehen wird. In der Literatur sind bisher 13 Falle bei Kindern und 2 bei Erwachsenen beschrieben. Dies ist der erste Bericht einer kombinierten Ellenbogenluxation (posterior und konvergent) mit einer primar diagnostizierten und definitiv therapierten eingeklemmten Radiuskopftrummerfraktur beim Erwachsenen.

Orientador: Maria Salete Costa Gurgel Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas Resumo: Introdução: A glutationa S-transferase (GST) é um sistema enzimático localizado no citosol celular e é responsável pela eliminação de toxinas. Estudos realizados in vitro mostraram que a presença deste sistema nas células do carcinoma de mama pode promover a eliminação do quimioterápico, levando assim à diminuição da eficácia desta modalidade terapêutica em mulheres com carcinoma de mama que expressam tal sistema enzimático em suas células. Objetivo: O presente estudo teve como objetivo avaliar a associação entre a expressão da enzima GST Pi em células tumorais e a sobrevida global e livre de doença em mulheres com carcinoma de mama submetidas a tratamento quimioterápico. Sujeitos e Métodos: Entre janeiro de 1995 e junho de 1997, 554 pacientes foram submetidas a tratamento cirúrgico para câncer de mama no CAISM-UNICAMP. Destas, 160 tinham entre 18 e 70 anos ao diagnóstico, doença não metastática, foram submetidas à quadrantectomia/mastectomia com margens livres e linfadenectomia axilar, seguida de quimioterapia adjuvante, e foram acompanhadas até agosto de 2006. Os blocos de parafina estavam disponíveis para 95 destas pacientes. Neles foi realizada a pesquisa da GST Pi através da reação de imuno-histoquímica e sua expressão foi correlacionada com os dados clínicos obtidos de seus respectivos prontuários. Resultados: Dos 95 casos, 36 (38%) foram positivos para a expressão da GST Pi e 59 (62%) negativos. A expressão da GST Pi nas células tumorais não mostrou associação com a idade ao diagnóstico, tipo histológico do tumor, estágio da doença e expressão de receptores de estrogênio e progesterona. Os cânceres de mama com positividade para a enzima GST Pi mostraram associação significativa com tumores de grau histológico I e negatividade para a expressão da proteína HER-2. Não se observou associação com a sobrevida livre de doença e sobrevida global, após seguimento médio de 10,68 anos. Conclusões: Os achados deste estudo indicam que pacientes com tumores positivos para a enzima GST Pi têm o mesmo prognóstico do que pacientes com tumores negativos para GST Pi após serem tratados com quimioterapia Abstract: Introduction: The glutathione S-transferase is an enzymatic system located in the cytosol of the cells and it is responsible for the elimination of toxins. 'In vitro¿ studies showed that the presence of this enzymatic system in breast carcinoma cells can accelerate the elimination of the drug used in the chemotherapy. This would decrease the efficacy of this kind of treatment in women with GST Pi -positive breast cancer cells. Objectives: The scope of the present study was to evaluate the association between GST Pi-positive breast cancer and overall and disease free-survival in women with breast carcinoma submitted to chemotherapy. Methods: Between January, 1995 and July, 1997, 554 patients were undergone to breast cancer surgical treatment at CAISM-UNICAMP. Out of 554 patients, 160 were between 18 and 70 years old in the diagnosis, did not have metastatic disease, were submitted to quadrantectomy/mastectomy with free surgical margins and axillary dissection followed by adjuvant chemotherapy and had complete follow-up until August, 2006. The paraffin blocks were available for 95 of these patients. The immunohistochemical reactions were done and the GST Pi expression was correlated with the clinical data obtained from their respective medical records. Results: Of the 95 cases studied, 36 (38%) were positive for the GST Pi expression and 59 (62%) did not express the enzymatic system. The expression of GST Pi in breast cancer cells showed no relation with age, histological type, stage of disease and estrogen and progesterone receptor status. The GST Pi-positive breast cancers showed a significant relation with lower histological grade tumors and with negativity of the expression of HER-2. Also, the expression of GST Pi had no relation with overall and disease free survival after a median follow-up of 10.68 years. Conclusions: The findings of this study indicate that patients with GST Pi-positive tumors have the same prognosis as patients with GST Pi-negative tumors after chemotherapy Mestrado Tocoginecologia Mestre em Tocoginecologia

NPL is leading a programme called the National Timing Centre (NTC) to develop a robust, geographically distributed time scale infrastructure across the UK. The aims of the programme are to improve security and resilience in national time and frequency distribution, whilst supporting UK innovation and skills. Recent government studies have highlighted the dependence of services such as telecommunications, broadcasting, energy and finance on Global Navigation Satellite Systems (GNSS) for time and frequency reference signals. As GNSS signals are vulnerable to disruption, the availability of accurate time and frequency signals from a robust national timing infrastructure will, in future, complement GNSS and mitigate the impact of any disruption to GNSS signals to these critical services. At present, the UK’s national time scale UTC(NPL) is maintained by NPL in Teddington, London. Time dissemination services are provided over the whole country via the millisecond-level accuracy MSF radio time signal and an NTP internet time service. The NPLTime® service provides higher accuracy to a number of users in the London area and in several European locations. The new National Timing Centre programme will significantly improve the resilience and capability of this UK time scale infrastructure. In future, a distributed UTC(NPL) time scale infrastructure will operate from several locations across the UK, including a new NPL facility in Teddington, interconnected by two or more time and frequency transfer methods. The time scale design is based on signal measurement, frequency steering and distribution from hydrogen masers with significant built-in hardware redundancy, which will be replicated at each site. At NPL, development of the new time scale facility is underway with the arrival of new hydrogen masers and construction of an additional caesium fountain. Work is also in progress to develop a suite of software to automate, monitor and control the time scale. To enable geographically widespread availability of signals from this new time scale, several distribution nodes will provide points of access across the UK. At these nodes, a range of distribution technologies including fibre, communication satellites, terrestrial broadcasts and GNSS will deliver resilient, UTC-traceable time and frequency signals to critical national infrastructure, businesses and academia. As a result, the NTC programme will not only support essential services, it will enable technological growth and innovation in industry through the development of new time and frequency products and applications. Additionally, the NTC programme will enhance the UK’s research and development capabilities in time and frequency generation and dissemination. The NTC programme will also respond to the specialist skills shortage in the field of time and frequency. An assessment of the current and future workforce requirements in this field has been carried out to create a Training & Education Blueprint. Through collaboration with industry and academia, new training opportunities will be created, suitable for learners at a range of levels.

Time and frequency dissemination for industrial applications is still predominantly realised through radio signals and satellite time broadcasting, such as the widely used Global Positioning System (GPS). However, the weak signal power received on Earth from GPS and other Global Navigation Satellite Systems (GNSS) represents a significant threat to their integrity and resilience since they are vulnerable to jamming, spoofing, and disruption by space weather events. There is therefore considerable motivation to progress beyond GNSS-based time and frequency dissemination techniques. However, any alternative time and frequency distribution technique must have a high degree of resilience with built-in redundancy. Moreover, in order to facilitate widespread and rapid uptake by industrial and commercial users, any alternative should possess a number of features: it should lend itself to standardization and be capable of practical interfacing with existing network infrastructures; it should be scalable and address a range of user requirements; and it should enable measurement traceability to the time standard Coordinated Universal Time (UTC). One potential alternative to satellite-based techniques for time and frequency distribution which meets these criteria is the White Rabbit (PTP-WR) protocol. This open-source technology provides sub-nanosecond accuracy and picosecond-level precision of synchronization over optical fibre, scalable to many nodes. The protocol is developed at CERN in collaboration with research organisations and companies, leading to rapid innovation and commercialisation opportunities. It has recently been integrated into the IEEE 1588 Precision Time Protocol (PTP) standard as IEEE 1588-2019 PTP High Accuracy, a significant achievement which will facilitate industry uptake. In June 2018, the White Rabbit for Industrial Timing Enhancement (WRITE) project was started with the aim of further developing the PTP-WR hardware, monitoring and calibration techniques. The project will demonstrate resilient, validated, precision time dissemination to industrial and commercial user testbeds, which will be UTC traceable. As of October 2020, the WRITE project has already made significant progress in improving PTP-WR methods and devices, validating some techniques on in-field deployments. Four testbeds have been established, designed to demonstrate UTC(k) dissemination to industry partners alongside the ‘accuracy’, ‘precision’, ‘redundancy’ and ‘connectivity’ challenges identified by the project. Outreach activities such as a virtual Stakeholder workshop have facilitated the WRITE project engagement with end users in industry, research, NRENs (National Research and Education Networks) and metrology. As part of this project, new scalable calibration techniques have been developed for fibre propagation asymmetry, PTP-WR devices and SFPs. Calibration of each individual component of a PTP-WR link is required for interoperability of PTP-WR equipment from different manufacturers and replacement in the event of equipment failures. A system with calibrated components will in future lead to “plug-and-play” cost-effective time services to industry, replacing expensive in-situ end-to-end calibrations of each link. NPL are participating in this interoperability testing of a new PTP-WR device, using the White Rabbit Electrical Absolute Calibration technique. The WRITE project is also investigating network topologies and monitoring techniques to improve redundancy. Different hardware and software holdover mechanisms have been tested to improve resilience. Within this task, NPL are evaluating the PTP-WR holdover mechanism based on a commercial caesium clock.

Head and neck cancer (HNC) is the sixth most frequent malignancy worldwide among adults [1,2]. However, HNC is infrequent in adolescents and young adults and HNC accounts for approximately 8% of ca...

The physical examination has to be modified to accommodate to the virtual method. Active ranges of motion and movements of directional preference are visually assessed. Many provocative tests are performed by the patient through verbal and demonstrative guidance. The patient is educated about how to measure the girth of upper limbs obtaining its volumes with a tape measure focusing anatomical points used in the Cleveland Clinic webpage: Breast Cancer – Arm Volume Calculator [1]. Patients are educated and/or supervised on manual lymphatic self-drainage, functional compressive bandaging, and therapeutic exercise. These orientations are done to promote lymphatic and venous return of the upper limbs and can be daily or at least 3 times a week. Early intervention of shoulder joint mobilization plays an important role for preservation of shoulder kinematics and prevention of adhesions. Pendulum exercises decrease the pain through the effect of distraction and oscillation. It should be done three times a day [3]. Directed exercises of flexion, abduction, and external rotation are more efficient in the rehabilitation of ROM than the performance of free shoulder exercises and should be prescribed since first postoperative day [4]. Abduction, flexion, and functional diagonal of the shoulder—stretching maintained at least for 30 s are recommended (Fig. 1). Exercises examples that can be done throught telerehabilitation A multicomponent exercise program is considered to be the most adequate for breast cancer patient, especially aerobic and resistance training exercises (Fig. 1). It should be done 5 days a week, with adaptation in volume and intensity, at least 150 to 300 min/week of aerobic exercise (moderate intensity—40–60% heart rate reserve or 65–75% of maximal heart rate) and two resistance training sessions per week [5]. In case one does not have specific materials for training, the following options are available in any house for ROM exercises as moving up a wall with the fingers until the maximum limit of flexion and abduction, brushing the hair, or performing shoulder rolls and arm rotation, for muscle strength transporting items with light and moderate weights (vegetables, rice, water, etc.) can be done, and for aerobic exercises walking inside the house or dancing. Mella-Abarca W, Barraza-Sanchez V, Ramirez-Parada K (2020) Model of telerehabilitation for people with breast cancer during the COVID-19 pandemic in Chile. ecancer 14:1085 Article Google Scholar Green BN, Pence TV, Kwan L, Rokicki-Parashar J (2020) Rapid deployment of chiropractic telehealth at 2 worksite health centers in response to the COVID-19 pandemic: observations from the field. J Manipulative Physiol Ther S0161–4754(20):30129–30139 Google Scholar Akkaya N, Akkaya S, Gungor HR, Yasar G, Atalay NS, Sahin F (2017) Effects of weighted and un-weighted pendulum exercises on ultrasonographic acromiohumeral distance in patients with subacromial impingement syndrome. J Back Musculoskelet Rehabil 30(2):221–228 Article Google Scholar de Rezende LF, Franco RL, de Rezende MF, Beletti PO, Morais SS, Gurgel MS (2006) Two exercise schemes in postoperative breast cancer: comparison of effects on shoulder movement and lymphatic disturbance. Tumori 92(1):55–61 Article Google Scholar Jimenez-Pavon D, Carbonell-Baeza A, Lavie CJ (2020) Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis 63(3):386–388 Article Google Scholar Download references This study was funded by Conselho Nacional de Desenvolvimento Cientifico e Tecnologico—428926/2016-9. PhysicalTherapy Department, Centro Universitario das Faculdades Associadas de Ensino – UNIFAE, Largo Engenheiro Paulo Almeida Sandeville, 15, Sao Joao da Boa Vista, SP, Brazil Laura Ferreira de Rezende, Vinicius Emanoel Francisco & Ricardo Laier Franco You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar Correspondence to Laura Ferreira de Rezende. The authors declare that they have no conflicts of interest. Not applicable. Not applicable. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reprints and Permissions de Rezende, L.F., Francisco, V.E. & Franco, R.L. Telerehabilitation for patients with breast cancer through the COVID-19 pandemic. Breast Cancer Res Treat (2020). https://doi.org/10.1007/s10549-020-05926-6 Download citation Received: 21 August 2020 Accepted: 02 September 2020 Published: 10 September 2020 DOI: https://doi.org/10.1007/s10549-020-05926-6

Background: T lymphocyte collection through leukapheresis is an essential step for chimeric antigen receptor T (CAR-T) cell therapy. Timing of apheresis is challenging in heavily pretreated patients who suffer from rapid progressive disease and receive T cell impairing medication. Methods: A total of 75 unstimulated leukaphereses were analyzed including 45 aphereses in patients and 30 in healthy donors. Thereof, 41 adult patients with Non-Hodgkin&rsquo, s lymphoma (85%) or acute lymphoblastic leukemia (15%) underwent leukapheresis for CAR-T cell production. Results: Sufficient lymphocytes were harvested from all patients even from those with low peripheral lymphocyte counts of 0.18/nL. Only four patients required a second leukapheresis session. Leukapheresis products contained a median of 98 &times, 108 (9 - 341 &times, 108) total nucleated cells (TNC) with 38 &times, 108 (4 - 232 &times, 108) CD3+ T cells. Leukapheresis products from healthy donors as well as from patients in complete remission were characterized by high TNC and CD3+ T lymphocyte counts. CAR-T cell products could be manufactured for all but one patient. Conclusions: Sufficient yield of lymphocytes for CAR-T cell production is feasible also for patients with low peripheral blood counts. Up to 12&ndash, 15 L blood volume should be processed in patients with absolute lymphocyte counts &le, 1.0/nL.

BackgroundWe tested the joint hypotheses that both perineural and systemic dexmedetomidine prolong the duration of an ulnar nerve block (UNB) compared with ropivacaine alone and that systemic dexmedetomidine is noninferior compared with perineural dexmedetomidine in block prolongation.MethodsWe performed bilateral UNBs in 22 healthy volunteers on two separate days. On the first day, each arm was randomized to either 4 mL ropivacaine 5 mg/mL+1 mL dexmedetomidine 100 µg/mL (Perineural) or 4 mL ropivacaine 5 mg/mL+1 mL saline (Systemic). On the subsequent treatment day, each arm was randomized to 1 mL of saline plus 4 mL of ropivacaine at either 7.5 mg/mL(HiRopi) or 5 mg/mL (NoDex). The primary outcome measure was the duration of sensory block assessed by mechanical discrimination.ResultsMean sensory block duration was longer in both the Perineural (14.4 hours, 95% CI 13.1 to 15.6) and Systemic treatments (9.2 hours, 95% CI 8.6 to 9.8) compared with the NoDex treatment (7.1 hours, 95% CI 6.6 to 7.6) (pConclusionsAdding dexmedetomidine perineurally to ropivacaine doubles the duration of an UNB. Systemic dexmedetomidine also prolongs the duration of UNB, but has less of an effect compared with the perineural route.Trial registration numberNCT03222323.

Background The objective of this trial is to optimize the transmuscular quadratus lumborum (TQL) block, by investigating the minimal effective volume (MEV90 ) of ropivacaine 0.75% for single-shot TQL block in percutaneous nephrolithotomy (PNL) patients. Methods This double-blind, randomized and controlled dose-finding trial is based on a biased coin up-and-down sequential design, where the volume of local anaesthetic administered to each patient depends on the response from the previous one. Investigating the TQL block, the first patient recruited receives 20 ml ropivacaine 0.75% preoperatively. In case of block failure, the next patient will receive the same volume with an increment of 2 ml. Given a successful block for the first patient, the next patient will be randomized to either a lower volume (previous volume with a reduction of 2 ml), or the same volume as the previous patient. The respective probabilities being b = 0.11 for a reduced volume and 1-b = 0.89 for the same volume. Block success is defined as patient reported pain score numeric rated scale (NRS) ≤3 (0-10/10) 30 minutes after arrival in the post anaesthesia care unit (PACU). The NRS pain score is our primary and only outcome for block success. A minimum of 25 eligible patients are needed to achieve precise estimation of MEV90 with narrow 95% confidence intervals derived by bootstrapping. Discussion Recruiting will begin June 2020 and is expected to finish November 2020. Data analysis will be performed at interims during and after the study. Results will be published in an international peer-reviewed medical journal.

Background: The association of increased cancer risk with glomerulonephritis (GN) is well known, but controversy exists concerning which types of GN are involved, and the size of the association. A national registry survey was performed to assess the size of this association, and the temporal relationship of cancer diagnosis to GN diagnosis. Methods: All patients with biopsy-proven GN between 1985 and 2015 in Denmark were extracted from The Danish Renal Biopsy Registry and the National Pathology Data Bank. Incident cancer diagnoses between 10 years previous and 10 years subsequent to the GN diagnosis were extracted from the Danish Cancer Registry. Residence, birth and death data were obtained from the National Patient Register. Expected cancer incidence, classified according to cohort, age and sex were extracted from the Nordcan database. Results: Nine hundred eleven cancers were diagnosed in 5594 patients. Thirty five percent were prevalent at renal biopsy. Prevalence at biopsy was 5.5% (expected 3.1%), but incidence was not increased < 1 year before biopsy. Increased cancer rates were seen for GN forms: minimal change, endocapillary, focal segmental glomerulosclerosis, mesangioproliferative, membranous, focal segmental, membranoproliferative, proliferative, ANCA-associated vasculitis, lupus nephritis and unclassified. Increased cancer rates were seen for lung, prostate, renal, non-Hodgkin lymphoma, myeloma, leukaemia and skin. The increased incidence was mainly limited to - 1 to 1 year after biopsy, but skin cancer showed an increased risk over time. Some diagnoses showed an increase 5-10 years after biopsy. Incidence was raised for patients with uraemia and nephrosis, but less for proteinuria or haematuria. Cancers in patients < 45 years were rare. The risk of developing cancer 0-3 years after biopsy for patients 45-64 years varied from 7.3% (minimal change) to 15.8% (unclassified GN); > 64 years from 11.8 (endocapillary GN) to 20.3% (unclassified). The diagnosis with the highest risk was membranoproliferative GN (8.6 & 19.6%). Conclusions: Cancer rates are increased for many cancer and most GN diagnoses. Cancer screening for patients < 45 years and for patients without nephrosis or uraemia may not be necessary. The findings suggest that screening programs for specific GN diagnoses can be extended to other GN forms.

Internet-pornography-viewing disorder (IPD) is considered one type of Internet-use disorder. For IPD's development, it was assumed theoretically that a dysfunctional use of Internet pornography to cope with depressive mood or stress might be considered to be a risk factor. To address the effect of Internet pornography use on mood, an online study with three measuring points with a sample of male participants was conducted. Participants were investigated regarding their tendencies towards IPD, personal use of Internet pornography, general mood, perceived stress, and their Internet pornography use motivation. Moreover, participants were asked regarding their current mood, sexual arousal, and need to masturbate before and after they watched Internet pornography self-determinedly in a private environment. Data showed that tendencies towards IPD were associated negatively with feeling generally good, awake, and calm and were correlated positively with perceived stress in daily life and using Internet pornography for excitation seeking and emotional avoidance. Self-determined use of Internet pornography in their private environment was accompanied by changes in mood and indicators of sexual arousal. Moreover, tendencies towards IPD were negatively related to mood before and after Internet-pornography use as well as an actual increase of good and calm mood. The results showed effects of watching Internet pornography on mood and sexual arousal which can be considered having reinforcing effects for the user. Thus, the results are in line with theoretical assumptions on IPD's development, in which the positive (and negative) reinforcement received by Internet-pornography use is related to cue-reactivity and craving reactions., Highlights • Investigation of mood and sexual arousal before and after self-determined Internet pornography use in private environment • Watching pornography was associated to changes in mood and indicators of sexual arousal • Current mood as well as changes in mood were associated to symptoms of Internet-pornography-viewing-disorder

Background The European Resuscitation Council Guidelines 2015 recommend bystanders to activate their mobile phone speaker function, if possible, in case of suspected cardiac arrest. This is to facilitate continuous dialogue with the dispatcher including (if required) cardiopulmonary resuscitation instructions. The aim of this study was to measure the bystander capability to activate speaker function in case of suspected cardiac arrest. Method In 87 days, a systematic prospective registration of bystander capability to activate the speaker function, when cardiac arrest was suspected, was performed. For those asked, “can you activate your mobile phone’s speaker function”, audio recordings were examined and categorized into groups according to the bystanders capability to activate speaker function on their own initiative, without instructions, or with instructions from the emergency medical dispatcher. Time delay was measured, in seconds, for the bystanders without pre-activated speaker function. Results 42.0% (58) was able to activate the speaker function without instructions, 2.9% (4) with instructions, 18.1% (25) on own initiative and 37.0% (51) were unable to activate the speaker function. The median time to activate speaker function was 19 s and 8 s, with and without instructions, respectively. Conclusion Dispatcher assisted cardiopulmonary resuscitation with activated speaker function, in cases of suspected cardiac arrest, allows for continuous dialogue between the emergency medical dispatcher and the bystander. In this study, we found a 63.0% success rate of activating the speaker function in such situations.

BackgroundElective cesarean section (ECS) can cause moderate to severe pain that often requires opioid administration. To enhance maternal recovery, and promote mother and baby interaction, it is important to reduce postoperative pain and opioid consumption. Various regional anesthesia techniques have been implemented to improve postoperative pain management following ECS. This study aimed to investigate the efficacy of bilateral ultrasound-guided transmuscular quadratus lumborum (TQL) block on reducing postoperative opioid consumption following ECS.MethodsA randomized double-blind trial with concealed allocation was conducted in 72 parturients who received bilateral TQL block with either 30 mL ropivacaine 0.375% or saline. TQL block injectate was deposited in the interfascial plane between the quadratus lumborum and psoas major muscles, posterior to the transversalis fascia. Primary outcome was opioid consumption, which was recorded electronically. Pain scores and time to first opioid request were also evaluated.ResultsOpioid consumption (oral morphine equivalents, OME) was significantly reduced in group ropivacaine (GRO) in the first 24 hours compared with group saline (65 mg OME vs 94 mg OME) with a mean difference of 29 mg OME; 95% CI 3 to 55, pConclusionsBilateral TQL block significantly reduced 24 hours’ opioid consumption. Further, we observed significant prolongation in time to first opioid, and significant reduction of pain during the first 6 postoperative hours.

Introduction: Axillary Web Syndrome (AWS) is well described until 3 months postoperative breast cancer surgery. Methods: We report a case of a 47 years old patient that arrived our rehabilitation service with pain and limited shoulder range of movement in the ipsilateral side of a breast cancer surgery. Results: An Axillary Web Syndrome was diagnosed 83 months after the surgery. Conclusion: It is important to mention that AWS might persist for a long time and also affect patients a long time after the surgery.

Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respira-tory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preserva-tion of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed.

INTRODUCTION: Greenland has one of the highest prevalences of otitis media in the world. However, access to ear specialists throughout Greenland is limited and currently there are no national guidelines for treatment or prevention. Tele-otoscopy may be beneficial in optimizing diagnosis and treatment. The smartphone otoscopy device, Cupris®, has previously been validated when used by medical doctors on a population primarily consisting of adults. In this study we evaluated the usability of the Cupris® otoscope when used by local health care workers with different levels of training and education, examining children aged 1-6 years.METHODS: We conducted a cross-sectional study in three Greenlandic towns. Health care personnel were asked to perform video-otoscopy on children contacting the health clinic for any reason. The videos were sent for remote evaluation by three ear specialists who rated the videos on a five-point Likert scale and provided information on challenges with the videos. The dichotomous outcome "not useful/useful" was defined as 1-3 and 4-5 on the Likert scale, respectively.RESULTS: In total, 142 videos were recorded on 84 patients. Mean proportion of useful videos was 18.1%, with a modified Fleiss' Kappa interrater agreement coefficient of 0.67 95% CI [0.57-0.76] corresponding to substantial agreement among the three raters.CONCLUSIONS: In this study the usefulness of the Cupris® TYM otoscope did not prove to be sufficient with the presented instruction in the hands of local health care workers when examining Greenlandic children. Focus on training and education of local health personnel is crucial and warranted before advantageous implementation for non-specialist health care workers can be expected.

The "pseudo-sticking and pull", also nicknamed "blocky effect" (because of its general aspect), is a common acquisition artifact that reduces considerably the quality of wireline acoustic and microresistive image logs, even though it is not well known among image log interpreters, well-site geologists and engineers. This artifact is generated by heave motion influence when the wave movement is not minimized enough by the compensation systems during offshore wireline operations. In fact, it is well known that the linear or rotary compensator systems reduce the heave variance between 52-80% and, sometimes, other factors such as string weight and fluid density can affect, significantly, wireline logs quality by the heave variance not well compensated. In this case, mainly the wireline stationary tools and the ones that need lower acquisition speed, present depth uncertainties that may cause relevant problems. The image logs are largely used in pre-salt reservoirs for geomechanics, petrophysics, structural, sedimentological and stratigraphic studies due to their great contrast responses on carbonates. However, because acoustic image logs run at speeds around 425 ft/h (against 3600 ft/h from basic logs) and acquire between 180 and 250 samples data each 0,2 inches depth, this log becomes more affected by this artifact than the microresistive one (over 1500 ft/h). The residual heave affects directly the image quality by creating "pseudo-sticking and pull" at each wave period, distorting the image log significantly. Besides the artifact that immediately appears on the image during the logging, the residual heave can also be confirmed by observing when cable tension and vector Z accelerometer variation have the same frequency as the period of ocean waves, monitored by the meteo-oceanographic daily reports. Even though this artifact can be minimized with processing (better than true sticking and pull corrections), the loss of quality should be considered. Petrobras experience has also shown that interventions directly on the source by adjusting compensators and changing steering towards can be effective to handle this problem. In order to help the interested community in acquiring better data with minimum costs, this work shows some examples of this artifact on acoustic image logs from pre-salt wells. It can also show the results with processing, the differences reached after adjusting compensators and demands for future works.

Background: Percutaneous nephrolithotomy (PNL) is associated with severe postoperative pain. The current study aimed to investigate the analgesic efficacy of transmuscular quadratus lumborum (TQL) block for patients undergoing PNL surgery. Methods: Sixty patients were enrolled in this single centre study. The multimodal analgesic regime consisted of oral paracetamol 1 g and i.v. dexamethasone 4 mg before surgery and i.v. sufentanil 0.25 μg kg−1 30 min before emergence. After operation, patients received paracetamol 1 g regularly at 6 h intervals. Subjects were allocated to receive a preoperative TQL block with either ropivacaine 0.75%, 30 ml (intervention) or saline 30 ml (control). Primary outcome was oral morphine equivalent (OME) consumption 0–6 h after surgery. Secondary outcomes were OME consumption up to 24 h, pain scores, time to first opioid, time to first ambulation, and hospital length of stay. Results were reported as mean (standard deviation) or median (inter-quartile range). Results: Morphine consumption was lower in the intervention group at 6 h after surgery (7.2 [8.7] vs 90.6 [69.9] mg OME, P

The approach for identifying modal parameters of a structure from power spectral density transmissibility matrices, called the PSDTM-SVD method, is improved to identify modal parameters (in...

Within the last two decades, many studies have addressed the clinical phenomenon of Internet-use disorders, with a particular focus on Internet-gaming disorder. Based on previous theoretical considerations and empirical findings, we suggest an Interaction of Person-Affect-Cognition-Execution (I-PACE) model of specific Internet-use disorders. The I-PACE model is a theoretical framework for the processes underlying the development and maintenance of an addictive use of certain Internet applications or sites promoting gaming, gambling, pornography viewing, shopping, or communication. The model is composed as a process model. Specific Internet-use disorders are considered to be the consequence of interactions between predisposing factors, such as neurobiological and psychological constitutions, moderators, such as coping styles and Internet-related cognitive biases, and mediators, such as affective and cognitive responses to situational triggers in combination with reduced executive functioning. Conditioning processes may strengthen these associations within an addiction process. Although the hypotheses regarding the mechanisms underlying the development and maintenance of specific Internet-use disorders, summarized in the I-PACE model, must be further tested empirically, implications for treatment interventions are suggested. CA Brand

An active tuned mass damper (ATMD) is employed for damping of tower vibrations of fixed offshore wind turbines, where the additional actuator force is controlled using feedback from the tower displacement and the relative velocity of the damper mass. An optimum tuning procedure equivalent to the tuning procedure of the passive tuned mass damper combined with a simple procedure for minimizing the control force is employed for determination of optimum damper parameters and feedback gain values. By time domain simulations conducted in an aeroelastic code, it is demonstrated that the ATMD can be used to further reduce the structural response of the wind turbine compared with the passive tuned mass damper and this without an increase in damper mass. A limiting factor of the design of the ATMD is the displacement of the damper mass, which for the ATMD, increases to compensate for the reduction in mass. Copyright © 2016 John Wiley & Sons, Ltd.

Hintergrund Skaphoidfrakturen stellen die weitaus haufigsten Bruche der Handwurzelknochen dar und fuhren oft zu problematischen Heilungsverlaufen. Pseudarthrosen sind haufig und haben vielfaltige Ursachen. Unbehandelt fuhren sie zur Handgelenkarthrose und zum karpalen Kollaps. Ziel der Diagnostik und Behandlung von Skaphoidfrakturen ist deshalb die knocherne Ausheilung unter Erhaltung der normalen Knochenform und der langfristig normalen Funktion des Handgelenkes.

Die irregularen Rhesus-Antikorperspezifitaten Anti-D und Anti-C treten haufig als Kombination auf. Die serologische Diagnose dieser Kombination ist erschwert, da das zugehorige Reaktionsmuster zusatzlich auch von einer weiteren Antikorperspezifitat aus dem Rhesus-System, der Spezifitat Anti-G, begleitet oder auch ausschlieslich verursacht werden kann. Diese unerkannte Spezifitat ist der Tatsache geschuldet, dass Erythrozyten, die das Rhesus-D- oder das Rhesus-C-Antigen tragen, auch Rhesus-G-positiv sind (mit sehr seltenen Ausnahmen). Wahrend die exakte serologische Trennung der 3 genannten Spezifitaten bei der Transfusion von Erythrozytenkonzentraten entbehrlich ist, ist diese Trennung bei Schwangeren immer anzustreben, da bei Fehlen der Spezifitat Anti-D unbedingt eine Anti-D-Prophylaxe verabreicht werden muss, um eine Immunisierung zu vermeiden. Hierzu sind im Normalfall aufwendige serologische Techniken notwendig (sequenzielle Absorption/Elution), die jedoch unter Verwendung seltener Testzellen des Phanotyps Rhesus-D-positiv/Rhesus-G-negativ vermieden werden konnen. Im Rahmen einer Routine-Antikorperdifferenzierung wurde zufallig ein Spender dieses Phanotyps identifiziert, molekularbiologisch konnte der zugrunde liegende Rhesus-Hybrid-Typ RHD-CE(2)-RHD nachgewiesen werden. Dieser Typ wird in der ISBT-Nomenklatur als Dweak Typ 74 gefuhrt, fruher wurde auch die Bezeichnung Dpartial Kategorie IIIb verwendet. Eine kommerzielle Anwendung dieser Testerythrozyten eroffnet die Moglichkeit, in einem einstufigen Testansatz in Standard-Antiglobulintechnik die Frage zur Notwendigkeit der Gabe einer Anti-D-Prophylaxe zu beantworten.

The presentations in this symposium broadly look to explore the ‘darker’ constructs in organizational behavior in order to redress the prevalent focus on the positive side of organizational scholar...

Purpose To investigate if early mobilization after open reduction internal fixation of distal radius fractures improved the functional outcome. We hypothesized that early mobilization would lead to improved patient-reported outcome. Second, we aimed to assess whether early mobilization increased the risk of postoperative implant loosening or breakage. Methods All included patients were treated with a volar locking plate. After surgery, patients were randomized to either early mobilization (E-MOB) with a removable orthosis (wrist lacer) and daily wrist exercises or to late mobilization (L-MOB) with a standard dorsal plaster cast for 2 weeks and, after that, a removable orthosis and exercises. We measured all patients at 4 weeks and at 3, 6, and 12 months after surgery. At each postoperative visit, we measured range of motion and grip strength and patients filled out the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Radiographic implant loosening or breakage was assessed 14 days after surgery. Results A total of 47 patients were allocated to E-MOB and 48 to L-MOB. The DASH score improved substantially throughout the follow-up period with no significant differences between the 2 groups at any time point. Implant loosening and fracture redisplacement was observed in 1 patient in the E-MOB group. Range of motion and grip strength were similar between the 2 groups at all time points. Conclusions Early mobilization after surgical treatment of distal radius fractures does not lead to improved patient-reported outcome. Type of study/level of evidence Therapeutic I.

Especially in the field of autologous transplantation, it has been found necessary to develop methods that ensure long-term storage with maintenance of functionality of the cells to bridge the therapy-related temporal separation of collection and application.Based on the experiences of more than 40 years, some practical considerations, especially regarding the cell concentration, final volume, and possibly other exogenous substances, should be considered when establishing a protocol for the routine cryopreservation of peripheral blood stem cells. In the following chapter, we describe a freezing protocol for cryopreservation of peripheral blood stem cells which was used and optimized over the past 8 years and was applied to the cryopreservation of more than 2000 peripheral stem cell transplants.

Educational Data Mining (EDM) may be a very useful technique as much to understand student behavior as to plan and manage government investments in education. EDM helps to analyzes and to expose the hidden information of educational data. Particularly, an important application of EDM is to predict or analyze the students’ dropout. This problem affects several educational institutions in Brazil and the world, and identify its origin has been a relevant research motivator. This paper presents a brief introduction about EDM applied to predict students’ dropout and analyzes some important articles during the period from 2013 to 2018.

BACKGROUND: Personal resources are identified as important for the ability to return to work (RTW) for patients with ischaemic heart disease (IHD) or heart failure (HF) undergoing cardiac rehabilitation (CR). The patient education 'Learning and Coping' (LC) addresses personal resources through a pedagogical approach. This trial aimed to assess effect of adding LC strategies in CR compared to standard CR measured on RTW status at one-year follow-up after CR.METHODS: In an open parallel randomised controlled trial, patients with IHD or HF were block-randomised in a 1:1 ratio to the LC arm (LC plus CR) or the control arm (CR alone) across three Danish hospital units. Eligible patients were aged 18 to ≤60 and had not left the labour market. The intervention was developed from an inductive pedagogical approach consisting of individual interviews and group based teaching by health professionals with experienced patients as co-educators. The control arm consisted of deductive teaching (standard CR). RTW status was derived from the Danish Register for Evaluation of Marginalisation (DREAM). Blinding was not possible. The effect was evaluated by logistic regression analysis and reported as crude and adjusted odds ratios (OR) with 95% confidence interval (CI).RESULTS: The population for the present analysis was N = 244 (LC arm: n = 119 versus control arm: n = 125). No difference in RTW status was found at one year across arms (LC arm: 64.7% versus control arm: 68.8%, adjusted odds ratio OR: 0.76, 95% CI: 0.43-1.31).CONCLUSION: Addition of LC strategies in CR showed no improvement in RTW at one year follow-up.TRIAL REGISTRATION: www.clinicaltrials.gov identifier NCT01668394. First Posted: August 20, 2012.

Introduction: To examine interobserver agreement in intrapartum cardiotocography (CTG)classification in women undergoing trial of labor after a cesarean section (TOLAC) at term withor without complete uterine rupture.Materials and methods: Nineteen blinded and independent Danish obstetricians assessed CTGtracings from 47 women (174 individual pages) with a complete uterine rupture during TOLACand 37 women (133 individual pages) with no uterine rupture during TOLAC. Individual pageswith CTG tracings lasting at least 20 min were evaluated by three different assessors andcounted as an individual case. The tracings were analyzed according to the modified version ofthe Federation of Gynaecology and Obstetrics (FIGO) guidelines elaborated for the use of STAN(ST-analysis). Occurrence of defined abnormalities was recorded and the tracings were classifiedas normal, suspicious, pathological, or preterminal. The interobserver agreement was evaluatedusing Fleiss’ kappa.Results: Agreement on classification of a preterminal CTG was almost perfect. The interobserveragreement on normal, suspicious or pathological CTG was moderate to substantial. Regardingthe presence of severe variable decelerations, the agreement was moderate. No statisticaldifference was found in the interobserver agreement between classification of tracings fromwomen undergoing TOLAC with and without complete uterine rupture.Conclusions: The interobserver agreement on classification of CTG tracings from high-riskdeliveries during TOLAC is best for assessment of a preterminal CTG and the poorest for theidentification of severe variable decelerations.

The H2020 project CLONETS (www.clonets.eu) is a coordination and support action started in January 2017, and it aims at accelerating the take-up of the fibre link technology by indus-try, research and society. One of the main target is to prepare the deployment of a permanent pan-European fibre network, providing high performance clock services to European re-search, and supporting wider services to industry and society. We report an update of the project.

Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals. Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association (APA) has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the 2013 revision of their Diagnostic and Statistical Manual. Other Internet related behaviors, e.g., Internet pornography use, were not covered. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model. The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction. Future research needs to address whether or not there are specific differences between substance and behavioral addiction. OA gold - CA extern

Pro Jahr erleiden 3,1 % der erwachsenen Deutschen beim Sport einen Unfall; 75 % der Verletzten sind mannliche Sportler mit einem Alter von 20–29 Jahren. Die obere Extremitat ist in knapp uber 20 % der Falle betroffen. Ein Drittel dieser Verletzungen betreffen die Hand und die Finger. In Deutschland sind uber eine halbe Million Sportler, mit steigender Tendenz, in Kampfsportverbanden organisiert. Kampfsportarten wird gemeinhin eine hohe Verletzungsgefahr fur die Hand zugesprochen. Ziele dieser Arbeit waren die Uberprufung dieser Hypothese sowie die Beschreibung der typischen kampfsportassoziierten Handverletzungen. Systematische Literaturrecherche (bis Januar 2015) in PubMed/Medline und der Cochrane Library sowie Ermittlung von Sekundarliteratur uber die Literaturverzeichnisse. Aussagekraftige vergleichende Studien zu Haufigkeit und Schwere von Handverletzungen, welche isoliert auf Kampfsporthandlungen zuruckzufuhren sind, konnen der aktuellen Literatur nicht entnommen werden. Das allgemeine Risiko fur Sportverletzungen scheint beim Kampfsport im Vergleich zu anderen Sportarten eher gering zu sein. Boxen scheint fur die obere Extremitat und speziell die Hand aber die gefahrlichste Sportart zu sein. Das Verletzungsmuster nach Faustschlagen (Notfallpatienten und Profiboxer) zeigt, dass uber die Halfte der schlaginduzierten Frakturen den 5. Mittelhandknochen betreffen, davon liegt in 25 % der Falle die klassische „boxer’s fracture“ vor. Dies weicht deutlich von der Frakturverteilung nach allgemeinen sportassoziierten Handfrakturen ab, wo die Phalangen am Haufigsten betroffen sind. Zwei seltenere Krankheitsbilder, die als Folge wiederholter Faustschlage auftreten konnen, werden als „carpal bossing“ und „boxer’s knuckle“ bezeichnet. Bei beiden Krankheitsbildern sind exzellente Ergebnisse nach operativer Therapie beschrieben.

Background The mortality following blood stream infection (BSI) and risk of subsequent BSI in relation to dialysis modality, vascular access, and other potential risk factors has received relatively little attention. Consequently, we assessed these matters in a retrospective cohort study, by use of the Danish nation-wide registries. Methods Patients more than 17 years of age, who initiated dialysis between 1.1.2010 and 1.1.2014, were grouped according to their dialysis modality and vascular access. Survival was modeled in time-dependent Cox proportional hazard analyses. Potential risk factors confined by a modified Charlson comorbidity index (MCCI), were subsequently assessed in stepwise selection models. Results At baseline, 764 patients received peritoneal dialysis (PD), and 434, 479, and 782 hemodialysis (HD) patients were dialyzed by use of arteriovenous fistulas (AVFs), tunneled catheters (TCs), and non-tunneled catheters (NTCs), respectively. We identified 1069 BSIs with an overall incidence rate of 17.7 episodes per 100 person years, and 216 BSIs occurred more than one time in the same patient. HRs of post BSI mortality relative to PD were 3.20 (95% CI 1.86–5.50; p

A measurement of the total pp cross section at the LHC at root s = 7 TeV is presented. In a special run with high-beta* beam optics, an integrated luminosity of 80 mu b(-1) was accumulated in order to measure the differential elastic cross section as a function of the Mandelstam momentum transfer variable t. The measurement is performed with the ALFA sub-detector of ATLAS. Using a fit to the differential elastic cross section in the vertical bar t vertical bar range from 0.01 GeV2 to 0.1 GeV2 to extrapolate to vertical bar t vertical bar —\textgreater 0, the total cross section, sigma(tot)(pp —> X), is measured via the optical theorem to be: σtot(pp→X)=95.35±0.38(stat.)±1.25(exp.)±0.37(extr.)mb, where the first error is statistical, the second accounts for all experimental systematic uncertainties and the last is related to uncertainties in the extrapolation to |t|→0|t|→0. In addition, the slope of the elastic cross section at small |t||t| is determined to be View the MathML sourceB=19.73±0.14(stat.)±0.26(syst.) GeV−2.

As it is planned to switch the heavy-ion synchrotron SIS18 from single- to dual-harmonic cavity operation after construction of the new Facility for Antiproton and Ion Research (FAIR), its closed-loop control system for the damping of coherent longitudinal oscillations needs an appropriate adjustment. To damp dipole oscillations, the phase shift, applied by the control system to the first cavity voltage (running with harmonic number h 1 ) has to be doubled for the second cavity (running with double frequency and harmonic number h 2 = 2 · h 1 ). Furthermore, the dipole oscillation frequency can no longer be estimated by linearization of the applied voltage like it is done in a single-harmonic cavity setting. In a dual-harmonic cavity setting as it is presented here, the dipole oscillation frequency depends nonlinearly on the bunch length. The control loop is closed by a digital signal processor, an optical splitter, and direct digital synthesizers. This paper describes the control loop and its theoretical background, and presents measurement results. In addition, simulation results and theoretical predictions are given, which are all in good agreement. Furthermore, optimal filter parameter settings are derived.

Objectives To investigate the relationship between dust exposure and annual change in lung function among employees in Norwegian silicon carbide (SiC) plants using a quantitative job exposure matrix (JEM) regarding total dust. Methods All employees, 20–55 years of age by inclusion (n=456), were examined annually for up to 5 years (1499 examinations). Spirometry was performed at each examination, and a questionnaire encompassing questions of respiratory symptoms, smoking status, job and smoking history, and present job held was completed. A JEM was constructed based on 1970 personal total dust exposure measurements collected during the study period. The association between lung function and total dust exposure was investigated using linear mixed models. Results The annual change in forced expiratory volume (FEV) in one second per squared height, FEV 1 /height 2 , per mg/m 3 increase in dust exposure was −2.3 (95% CI −3.8 to −0.79) (mL/m 2 )×year −1 . In an employee of average height (1.79 m) and exposure (1.4 mg/m 3 ) the estimated contribution to the annual change in FEV 1 associated with dust was 10.4 mL/year. The annual change in FEV 1 /height 2 in current, compared with non-smokers was −1.9 (−7.2 to 3.4) (mL/m 2 )×year −1 . The estimated overall annual decline in FEV 1 among current and non-smokers in the highest exposed group was −91.2 (−124.3 to −58.1) (mL/m 2 )×year −1 and −49.0 (−80.2 to −17.8) (mL/m 2 )×year −1 , respectively. Conclusions Dust exposure, expressed by a quantitative JEM, was found to be associated with an increased yearly decline in FEV 1 in employees of Norwegian SiC plants.

The metal smelting industry is an important industry in the majority of countries in the world and employs millions of workers. In most of the production types, a variety of pollutants are emitted into the workplace atmosphere. Some of these pollutants have sensitizing properties, whereas other act as irritants in the respiratory tract. This review will explore the recent studies (2010-2012) which address the impact of exposure to pollutants in the smelting industry on nonmalignant respiratory disorders.The association between different respiratory symptoms as well as pulmonary function and the level of exposure to different agents has been investigated. Likewise, the effect of primary prevention (exposure reduction) and secondary prevention (relocation) has been studied. Finally, the association between the incidence of community-acquired pneumonia and exposure to pollutants encountered at work in the smelting industry and the results from mortality studies are reported.It appears that exposure to emissions of pollutants in the smelting industry is associated with respiratory symptoms, including asthma, lung function decline and chronic obstructive pulmonary disease, depending on the type of production. Moreover, it is possible that these exposures may enhance the risk of infectious pneumonia.