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To determine the etiology, laterality, and time to presentation of unilateral vocal fold paralysis (UVFP) at a tertiary care institution over 10 years.Case series with chart review.Academic medical center.All patients seen between 2002 and 2012 by the Department of Otolaryngology at the Washington University School of Medicine (WUSM), with a diagnosis of unilateral vocal fold paralysis, were included. Medical records were reviewed for symptom onset date, presentation date(s), and etiology of UVFP.Of the patients, 938 met inclusion criteria and were included. In total, 522 patients (55.6%) had UVFP due to surgery; 158 (16.8%) were associated with thyroid/parathyroid surgery, while 364 (38.8%) were due to nonthyroid surgery. Of the patients, 416 (44.4%) had nonsurgical etiologies, 124 (13.2%) had idiopathic UVFP, and 621 (66.2%) had left-sided UVFP. The diagnosis was more common on the left side in cases of intrathoracic surgeries and malignancies, as expected, but also in idiopathic, carotid endarterectomy, intubation, and skull base tumors. In total, 9.8% of patients presented first to an outside otolaryngologist at a median time of 2.1 months after onset, but these patients presented to WUSM at a median time of 9.5 months. Overall, 70.6% of patients presented to a WUSM otolaryngologist within 3 months of onset.Iatrogenic injury remains the most common cause of UVFP. Thyroidectomy remains the leading cause of surgery-related UVFP. Patients are typically seen within 3-4 months of onset; however, a significant delay exists for those referred to WUSM.

Otitis media (OM) in children is the most frequent reason for physician visits in developed countries and burdens caregivers, society, and the child. Our objective was to describe the impact of OM severity on parent/caregiver quality of life (QoL).Multi-institutional prospective cross-sectional study.Otolaryngology, family, and pediatric practices.Children 6 to 24 months old with and without a primary diagnosis of recurrent OM and their caregivers. Physicians provided patient history, and parents/caregivers completed a Family Information Form, the PedsQL Family Impact survey, the Patient Reported Outcomes Measurement Information System (PROMIS) survey, and the OM 6-item severity survey (OM-6).A total of 2413 subjects were enrolled and data from 1208 patients and physician were analyzed. The average child age was 16 months, and 54% were male. The mean OM-6 score was 3.2. The mean PedsQL Family Impact score for parents was 66.9 from otolaryngology sites and 78.8 from pediatrics/family practice sites (P.001). Higher (worse) OM-6 scores correlated significantly with worse PedsQL Family Impact scores (Pearson r = -0.512, P.01). Similarly, increasing OM-6 scores strongly correlated with increased parental anxiety, depression, and fatigue, as well as decreased satisfaction (all P.01).Worse PedsQL Family Impact and PROMIS scores were highly correlated with elevated OM-6 scores, suggesting that severity of childhood OM significantly affects parent/caregiver QoL. Understanding the impact of a child's illness on parent/caregiver QoL can help physicians counsel patients and families and provide better family-centered, compassionate care.

Children with otitis media (OM) suffer sleep disturbances, loss of appetite, earache, and behavioral problems. Our objective was to quantitate the average burden of OM and to compare the associated impact of tympanostomy tubes on infant health related quality of life (HR-QoL).Multi-institutional prospective cross-sectional study.Otolaryngology, family practice, and pediatric clinics.Children ages 6 to 24 months of age with or without recurrent OM. Patient history, the PedsQL Infant QoL survey, and the 6-item child with OM survey (Otitis Media 6 [OM-6]) were collected from providers and parents.Data from 1208 patients were analyzed. Mean age was 14.7 months, and 54% were male. The mean OM-6 score of children with recurrent OM was 3.3, whereas similarly aged well-children had a mean OM-6 score of 2.5. The mean PedsQL Infant scores of recurrent OM patients were significantly worse than those of children from well-child visits. Worse OM-6 scores were correlated with poorer PedsQL Infant scores, Pearson r = -0.581 (1-12 months) and -0.558 (13-24 months), P.001. Otolaryngology patients who were recommended to undergo ear tube placement had significantly poorer OM-6 scores and worse PedsQL Infant scores, whereas patients with prior tube placement had significantly better OM-6 and PedsQL Infant scores.Children with recurrent OM had significantly worse HR-QoL than similarly aged healthy children. Increased burden of OM strongly affected HR-QoL, and recommendation for tube placement was associated with increased disease burden and poorer HR-QoL. The presence of tympanostomy tubes was associated with better OM-6 and PedsQL Infant scores.

Noncompliance with federal regulations, as monitored through institutional review boards for the ethical conduct of clinical research, can occur, even to seasoned investigators. The cause of this noncompliance can be that an investigator is overloaded, does not know the regulations, or does not take the time to pay attention to the details. Sometimes it happens just because of inevitable human error that can befall us all at any time. The authors begin by citing the inherent differences between clinical practice and clinical research. This is followed by an illustration of common noncompliance errors, with examples, followed by general and specific concepts and methods to minimize noncompliance events. The objective of this article is to condense the myriad details involved in conducting clinical research into a set of manageable recommendations that can be recalled easily before and during the research. The material supporting these recommendations comes from years of institutional review board work at several institutions and consultation with experienced principal investigators and their research coordinators.

Composite Ni–Y0.15Zr0.85O1.925 anodes were fabricated by axial-injection suspension plasma spraying in open atmosphere conditions. The composition of the anode is controllable by adjustment of the plasma gas composition, stand-off distance, and suspension feed rate. The total porosity is controllable through the addition of carbon black to the suspension as a sacrificial pore-forming material as well as by adjustment of the suspension feed rate. The size of the NiO particles in suspension affects both the composition and total porosity, with larger NiO particles leading to increased Ni content and porosity in the deposited coatings. The surface roughness increases with a decrease of the in-flight droplet momentum, which results from both smaller NiO particles in suspension and the addition of low density pore-forming materials. A solid oxide fuel cell was fabricated with both electrodes and electrolyte fabricated by axial-injection plasma spraying. Peak power densities of 0.718 W cm−2 and 1.13 W cm−2 at 750 °C and 850 °C, respectively, were achieved.

This study is an exploratory, qualitative investigation of breast cancer survivors' experiences of paradox, following psycho-spiritual integrative therapy (PSIT). Previous studies examined the role of paradox in spiritual development among women diagnosed with cancer; this study investigated a psycho-spiritual intervention for multicultural cancer survivors. Twelve multicultural breast cancer survivors, from a sample of 30 women participants in an 8-week PSIT group intervention, were recruited from oncologists, hospitals, support groups, outpatient oncology centers, surgeons, radiation therapy centers, cancer events, and websites. We conducted semi-structured, open-ended interviews lasting 1-2 h regarding participants' experiences coping with cancer and their experience of PSIT. We transcribed interviews and conducted blind searches for both new and previously identified paradoxes and themes. Two previously identified themes emerged: (1) attempting to maintain coherence in new and old ways and (2) letting go of ultimate control in life. Additionally, three novel themes emerged: (1) interconnection between helpers and hinderers, (2) spiritual edges and tensions, and (3) new paths to empowerment. Results of this qualitative analysis indicate participants experienced previously identified themes and experienced an expanded range of paradoxes. After learning compassionate acceptance through PSIT, breast cancer survivors develop greater access to the multidimensionality of paradoxes, which can go beyond a binary (either/or) construction to a more interdependent (both/and) relationship. Devoting greater attention to investigating and understanding how diverse participants engage with and move through paradoxical change processes could enhance the effectiveness of existential and spiritual interventions.

Microstructural evolution of a Solid Oxide Electrolyser Cell (SOEC) La0.6Sr0.4Co0.2Fe0.8O3 (LSCF) anode is investigated using 3D reconstruction techniques both on a reference and a long-term tested cell. In this framework, reconstructions have been obtained from focused ion beam-scanning electron microscopy and synchrotron X-ray nano-tomography techniques. Microstructural properties extracted from the 3D reconstructions exhibit a slight evolution during the test. Synchrotron X-ray Absorption Spectroscopy (XAS) was also performed, and a modification of the cobalt oxidation state is found. LSCF conductivity decrease due to the change in Co mixed valence has been discussed. Evolutions of both morphological parameters and electrical conductivity were introduced in an in-house micro model to evaluate their impacts on the electrode degradation.

"Comparative effectiveness research" (CER) is not a new concept; however, recently it has been popularized as a method to develop scientifically sound actionable data by which patients, physicians, payers, and policymakers may make informed health care decisions. Fundamental to CER is that the comparative data are derived from large diverse populations of patients assembled from point-of-care general primary care practices and that measured outcomes include patient value judgments. The challenge is to obtain scientifically valid data to be acted upon by decision-making stakeholders with potentially quite diversely different agenda. The process requires very thoughtful research designs modulated by complex statistical and analytic methods. This article is composed of a guiding narrative with an extensive set of tables outlining many of the details required in performing and understanding CER. It ends with short discussions of three example papers, limitations of the method, and how a practicing physician may view such reports.

Thermo-mechanical properties of SOFC/SOEC electrodes have been computed by homogenization from three-dimensional reconstructions of their microstructure. The support and the functional layer of a Ni/YSZ supported cell and the oxygen electrode made of La 0.6 Sr 0.4 Co 0.2 Fe 0.8 O 3−δ (LSCF) have been studied. Values of the effective Young's modulus obtained for the thick porous Ni/YSZ support are in good agreement with the experimental data ( E = 35 GPa). Besides, for thin functional layers, the methodology supplies original values that are difficult to obtain by conventional experimental methods ( E = 105 GPa for the Ni/YSZ Functional Layer and E = 55 GPa for the LSCF electrode). Furthermore, it has been shown that the effective elastic parameters are influenced by the following morphological parameters: the porosity and the formation factor that could also be related to the manufacturing process. Theses morphological parameters have however negligible effect on the effective thermal expansion.

An in-house micro model has been built to describe the electrochemical mechanisms governing both H2 and O2 electrodes operating in SOEC mode. A special attention has been paid to take into account the microstructure properties of the ionic, electronic and gas phases as well as the processes occurring therein. A commercial LSM–YSZ symmetrical cell has been tested at 700, 750 and 850 °C in air. Simulations have been carried out to interpret the experimental data. It is suggested that the kinetic of O2 formation is controlled by a single charge transfer. A sensitivity analysis has been performed using the micro model to quantify the role of the microstructure in the electrode behaviour. Transport of oxygen ions in the functional layer has a strong impact on the cell response since it governs the delocalization of the electrochemical reactions. The density of TPB length is also a key parameter controlling the electrode efficiency. Evolutions of the microstructural parameters in operation have been associated to the degradation of the electrochemical performances. The decrease in TPB length due to Ni agglomeration has a moderate impact whereas the decrease in ionic conductivities of 8YSZ or LSFC could explain a large amount of the cell degradation.

With recent changes in the landscape of health care, clinical practice guidelines (CPGs) have proliferated. Attitudes about guidelines differ considerably, forming 2 competing viewpoints with considerable tension between them. Some feel CPGs are unneeded or are efforts to create automated "cookie cutter" medical practice; at best, they are perceived as suggestions that may be altered by experience. Others feel they are mandates that must be followed to the letter. This article attempts to explain how and why we have arrived at this point and to explain the origins of the differing viewpoints. We begin by describing the 2 viewpoints and proceed to define the origin of medicine as a profession and to chronicle the evolution of health insurance, medical education, and scientific methods for evaluating evidence.

Obesity is associated with ovulatory disorders, decreased rates of conception, infertility, early pregnancy loss and congenital abnormalities. Poor oocyte quality and reduced IVF success have also been reported in obese women. Recent attempts to understand the mechanism by which these defects occur have focused on mitochondria, essential organelles that are critical for oocyte maturation and subsequent embryo development. The oocyte relies on maternally supplied mitochondria until the resumption of mitochondrial replication in the peri-implantation period. Here we review current literature addressing the roles of mitochondria in oocyte function and how mitochondrial dysfunction can lead to fertility problems. The relationship between mitochondrial dysfunction and oocyte function is evaluated by examining the following examples of environmental exposures: tobacco smoke, aging, caloric restriction and hyperglycemia. Finally, we present new data from a mouse model of obesity that has demonstrated that oocyte mitochondria play a key role in obesity-associated reproductive disorders.

Conjunctive consolidation, one method of multivariable analysis by arranging data into clusters, is intuitive and transparent. An unexpected consequence in writing this article was the discovery of just how useful it is in critically analyzing articles and in designing new projects. It has stimulated a fresh understanding as to the value of multivariable thinking in all clinical research. This article is organized into the sequential steps for performing conjunctive consolidation for critically analyzing an article of interest and for completing the process, pending all required data are available. Investigators, particularly those who perform clinical research, should consider conjunctive consolidation as a valuable method of multivariable analysis with which to report data.

Introduction: Cardiac involvement is frequent in inflammatory myopathies. Electrocardiogram (ECG) may show evidence of this involvement and its changes should be well-known and described. Objectives: Due to the lack of studies in the literature, we conducted an analysis of the ECG findings in patients with dermatomyositis (DM) and polymyositis (PM), comparing them with a control group. Methods: This cross-sectional study compared the ECG of 86 individuals with no rheumatic disorders (controls) with 112 patients (78 DM and 34 PM), during 2010 to 2013. The ECG findings between DM and PM were also compared. Results: Demographic characteristics, comorbidities and ECG abnormalities were similar between controls and patients (p > 0.05), except for a higher frequency of left ventricular hypertrophy (LVH) in patients (10.7% vs. 1.2%, p = 0.008). Demographic characteristics, comorbidities, clinical and laboratory manifestations, were also similar between the groups PM and DM, except for the presence of cutaneous lesions only in DM. One third of the patients had ECG abnormalities, which were more prevalent in PM than DM (50% vs. 24.4%, p = 0.008). LVH, left atrial enlargement, rhythm and conduction abnormalities were more frequent in PM than DM (p < 0.05 for all), especially the left anterior fascicular block. Conclusions: We showed distinct ECG changes between DM and PM and a higher frequency of LVH in patients compared to controls. Investigation of cardiac involvement should be considered even in asymptomatic patients, especially PM. Further studies are necessary in order to determine the correlation of ECG findings with other complementary tests, clinical manifestations, disease activity and progression to other cardiac diseases. RESUMO Introdução: Acometimento cardíaco nas miopatias inflamatórias é frequente. Eletrocardiograma (ECG) pode mostrar indícios desse acometimento e suas alterações devem ser bem conhecidas e descritas. Objetivos: Devido à escassez de trabalhos na literatura, analisamos as alterações de ECG em pacientes com dermatomiosite (DM) e polimiosite (PM) e as comparamos com um grupo controle. Métodos: Este estudo transversal comparou ECGs de 86 indivíduos sem doenças reumatológicas (controles) com 112 pacientes (78 DM e 34 PM), de 2010 a 2013. Também comparamos os ECGs entre DM e PM. Resultados: Características demográficas, comorbidades e alterações de ECG foram semelhantes entre controles e pacientes (p > 0,05), exceto pela maior frequência de sobrecarga de ventrículo esquerdo (SVE) nos pacientes (10,7% vs. 1,2%; p = 0,008). Características demográficas, comorbidades, manifestações clínicas e laboratoriais também foram semelhantes entre os grupos PM e DM, exceto por lesões cutâneas apenas em pacientes com DM. Um terço dos pacientes apresentou alterações de ECG, que foram mais prevalentes em PM do que em DM (50% vs. 24,4%, p = 0,008). Sobrecarga de câmaras esquerdas (SCE), distúrbios do ritmo e da condução foram mais encontrados em PM do que em DM (p < 0,05 para todos), sobretudo o bloqueio divisional do ramo anterossuperior. Conclusões: Encontramos alterações distintas de ECG entre PM e DM e frequência aumentada de SVE em pacientes quando comparados com controles. Investigação do acometimento cardíaco nessas doenças deve ser considerada mesmo em pacientes assintomáticos, especialmente em se tratando de PM. Mais estudos são necessários para correlacionar os achados de ECG com outros exames complementares, manifestações clínicas, atividade das miopatias e evolução para outras doenças cardíacas.

Clearing a space was first developed as a preparatory step for focusing. Since then this process has been expanded to include a direct engagement with the cleared space. Research results show its impact upon increased self-care and positive body image, recovery from trauma, and experiences of wholeness. Little attention has been paid to exploring its value within ongoing psychotherapy. This paper demonstrates how this expanded approach to clearing a space shifts one's relationship to particular issues towards a greater unification of the person and alignment with higher values and purpose. A summary of research and the presentation of six common characteristics of direct engagement with the cleared space are presented. Discussion of two philosophical concepts sheds light on the difference this process makes in psychotherapy. A final discussion examines how this expanded approach to clearing a space may contribute to a more spiritually informed change process.

Background Prenatal exposures have known adverse effects on maternal and neonatal outcomes. Professional societies recommend routine screening for environmental, occupational, and dietary exposures to reduce exposures and their associated sequelae. Objective Our objective was to determine the frequency of environmental exposure screening by obstetricians and gynecologists (OBGYNs) at initial patient visits. Study design Practicing OBGYNs were approached at the University of Colorado and by social media. The survey instrument queried demographics, environmental literacy, and screening practices. Statistical analysis was performed using Chi-square and two-sample t-test. Results We received 312 online survey responses (response rate of 12%). Responding OBGYNs were predominantly female (96%), board-certified (78%), generalists (65%) with a mean age of 37.1 years. Fewer than half of physicians screened for the following factors: occupational exposures, environmental chemicals, air pollution, pesticide use, personal care products, household cleaners, water source, use of plastics for food storage, and lead and mercury exposure. Eighty five percent of respondents reported that they did not feel comfortable obtaining an environmental history and 58% respondents reported that they performed no regular screening of environmental exposures. A higher frequency of screening was associated with > 4 years of practice (p = 0.001), and having read the environmental committee opinion (p = Conclusion The majority of OBGYNs did not incorporate screening for known environmental exposures into routine practice. Reading the environmental committee opinions was strongly and significantly associated with a higher rate of screening. Improving physician comfort in counseling patients may enhance screening for exposures that affect reproductive health.

Background Stenotrophomonas maltophilia is a multidrug-resistant Gram-negative bacillus that has been implicated in serious nosocomial infections. This microbe has also been isolated from sinus cultures in refractory chronic rhinosinusitis (CRS). The goal of this study was to elucidate the implications of S. maltophilia–positive cultures in the setting of CRS. The objectives of the study were (1) to define clinical and microbiological characteristics and (2) to assess management strategy and overall outcomes of S. maltophilia–positive sinus cultures in CRS patients. Methods A retrospective review was performed of 101 patients over a 5-year period. Results The mean age was 56.9 years with a female/male ratio of 1.1:1. Previous sinus surgery had been performed in 90.1% of patients. Greater than 97% of patients had been given antibiotics in the previous 6 months. The most common presenting symptom was discolored nasal drainage (76.2%) with endoscopic evidence of pus or crusting in 83.2% of cases. Monotherapy with trimethoprim sulfamethoxazole (TMX) or fluoroquinolones was used in 41 and 26%, respectively. This intervention resulted in overall symptom and endoscopic improvement in 70% of cases. Conclusion The presence of S. maltophilia isolates on culture are associated with clinically relevant symptoms and endoscopic findings in patients with refractory CRS. Despite its multidrug-resistant nature, monotherapy with TMX or fluoroquinolones appears to be effective in providing patients with bacterial infection with symptom relief in a majority of cases.

Interleukin 7 (IL-7) and T cell antigen receptor signals have been proposed to be the main drivers of homeostatic T cell proliferation. However, it is not known why CD4(+) T cells undergo less-efficient homeostatic proliferation than CD8(+) T cells do. Here we show that systemic IL-7 concentrations increased during lymphopenia because of diminished use of IL-7 but that IL-7 signaling on IL-7 receptor-alpha-positive (IL-7Ralpha(+)) dendritic cells (DCs) in lymphopenic settings paradoxically diminished the homeostatic proliferation of CD4(+) T cells. This effect was mediated at least in part by IL-7-mediated downregulation of the expression of major histocompatibility complex class II on IL-7Ralpha(+) DCs. Our results indicate that IL-7Ralpha(+) DCs are regulators of the peripheral CD4(+) T cell niche and that IL-7 signals in DCs prevent uncontrolled CD4(+) T cell population expansion in vivo.

Accumulating data suggest that regular physical exercise reduces mortality and extends the functional life span of men and women. This review seeks to describe the current state of the medical literature on this topic.A narrative review of the current medical literature including randomized clinical trials and clinical guidelines that address the benefits of physical fitness and regular exercise on the health of midlife and postmenopausal women.Reduction and avoidance of obesity and its related comorbidities (hypertension, glucose intolerance, dyslipidemia, and heart disease) are one major benefit of exercise. However, long-term physical exercise is also associated with reduced rates of cancer, dementia and cognitive decline, adverse mood and anxiety symptoms, and reduction of osteoporosis, osteopenia, falls, and fractures. Beneficial physical activity includes exercise that will promote cardiovascular fitness (aerobic), muscle strength (resistance), flexibility (stretching), and balance (many of the preceding, and additional activities such as yoga).Given that it is unambiguously beneficial, inexpensive, and minimal risk, maintaining a healthy exercise regimen should be a goal for every participant to enhance lifelong wellness. Clinicians should use a number of behavioral strategies to support the physical fitness goals of their participants.

To determine the effect of short-term combined oral contraceptive (OCP) use on antral follicle count (AFC) in obese and nonobese women with infertility.A retrospective review of women who had an AFC (sum of 2-10 mm bilateral ovarian follicles on basal follicular phase ultrasound) measured before and after short-term OCP use between the years 2005 and 2010. These were women who had a baseline AFC measurement during an unsuccessful controlled ovarian hyperstimulation/intrauterine insemination who were then placed on OCPs prior to an in vitro fertilization (IVF) cycle that included a subsequent AFC measurement at baseline.A total of 57 IVF cycles met criteria for inclusion in the study. AFC was not impacted by OCP use in the nonobese cohort (BMI30). Baseline AFC in obese women (BMI ≥ 30), however, increased after OCP use (18 ± 6 vs. 28 ± 9, p = 0.002).Use of suppressive medications like OCPs in obese women increases AFC during IVF, potentially by AFC cohort synchrony. This observation warrants consideration when using AFC to predict gonadotropin/ART response as well as future prospective research to further elucidate potential etiologies.

Bereits zum fünften Mal beteiligte sich das Steinbuch Centre for Computing beim diesjährigen Girls’Day. Schülerinnen ab der fünften Klasse konnten an diesem Tag einen Einblick in die Tätigkeitsfelder von Wissenschaftlerinnen am KIT gewinnen. Berührungsängste mit den Naturwissenschaften abbauen und in die faszinierende Welt der Wissenschaft eintauchen, stand dabei im Vordergrund.

Eine aktuelle Publikation des Steinbuch Centre for Computing (SCC), die im Rahmen der Durchführung regelmäßiger GridKA-School Konferenzen entstanden ist, wurde auf der IEEE EDUCON2015 Konferenz mit einem renommierten Best Paper Award ausgezeichnet.

„IT ist nicht alles – aber ohne IT ist alles nichts“ lautete die thematische Klammer über dem Wissenschaftsdienstag am 25.08.2015. Die Veranstaltungsreihe Effekte im Pavillon, die regelmäßig im Rahmen des Wissenschaftsfestivals EFFEKTE zum dreihundertsten Karlsruher Stadtgeburtstag im Pavillon des Schlossgartens stattfand, wurde dieses Mal von der Dualen Hochschule Baden Württemberg (DHBW) in Karlsruhe und dem Steinbuch Centre for Computing (SCC) am Karlsruher Institut für Technologie (KIT) gestaltet.

The most common solid oxide fuel cell (SOFC) anode material, nickel - yttria stabilized zirconia (YSZ), displays excellent catalytic properties for fuel oxidation and good electronic conductivity. However, nickel-based anodes can cause carbon deposition when hydrocarbon fuels are used [1]. Nickel catalyzes the formation of carbon filaments in the presence of hydrocarbons under reducing conditions, resulting in coverage of the active sites of the anode, and potentially also to dissolution, precipitation, and metal dusting [2]. It is possible to avoid carbon deposition if sufficient steam is present such that the rate of carbon removal is comparable to or faster than the rate of carbon deposition. However, there is a corresponding decrease in electrical efficiency associated with dilution of the fuel. Metals with electronic structures similar to that of carbon may form an alloy with nickel at the surface, thus reducing carbide formation, and as a consequence, coking [3]. Tin, for example, has been reported to reduce carbon deposition on a Ni-YSZ cermet when present in low amounts such as 1 wt.% of tin with respect to nickel [4,5]. However, volatilization of a metallic tin phase at SOFC operating temperatures may present a problem for long term operation. To increase the stability of tin-containing anodes, we fabricated Ni-Ni3Sn-YSZ anodes using a hybrid solution-precursor / suspension plasma spray (SPPS-SPS) process and compared them to nickel-YSZ anodes made using the same process parameters. Thermogravimetric analyses in a 4% CH4 (balance nitrogen) atmosphere showed that the presence of tin in the anode reduced the rate of carbon deposition. Furthermore, higher amounts of tin resulted in less coking. Ni-Ni3Sn-YSZ and Ni-YSZ anodes were incorporated into metal-supported SOFCs that consisted of a porous metal support (Sandvik Sanergy), samaria-doped ceria (SDC) barrier layer, anode as previously described, YSZ electrolyte, and La0.6Sr0.4Co0.2Fe0.8O3-δ-SDC cathode. Cells were tested at 750°C with air as the oxidant and fuel consisting of 65% CH4, 32% H2, and 3% H2O. The cells were held at a current density of 0.15 A·cm-2 for 500 hours. The cell without tin in the anode began to degrade after approximately 200 hours and catastrophically failed at approximately 425 hours. After testing, we observed that the anode had disintegrated, and as a result, the electrolyte and cathode were completely detached from the metal support. On the other hand, the cell with an anode containing tin did not catastrophically fail, and the cell remained intact after 500 hours of operation. Over 500 hours, the cell potential degraded from 0.841 V to 0.743 V, and scanning electron micrographs showed that the anode had delaminated from the electrolyte in some areas. Nonetheless, the cell with the Ni-Ni3Sn-YSZ anode degraded significantly less than the cell containing a Ni-YSZ anode, suggesting that the addition of Ni3Sn to an anode could be a useful strategy for improving durability of SOFC anodes using hydrocarbon fuels. References 1. S. P. Jiang and S. H. Chan, J. Mater. Science, 39, 4405 (2004). 2. A. Atkinson, S. Barnett, R.J. Gorte, J.T.S Irvine, A.J. McEvoy, M. Mogensen, S.C. Singhal and J. Vohs, Nature Materials, 3, 17 (2004). 3. D.L. Trimm, Catal. Today, 49, 3 (1999). 4. Y. Shiratori, Y. Teroka and K.Sasaki, Solid State Ionics, 177, 1371 (2006). 5. K. Tomishige, Y. Chen and K. Fujimoto, J. Catalysis, 181, 91 (1999).

To describe a population of otolaryngology patients who developed systemic anticoagulation from pharmacologic deep vein thrombosis prophylaxis using subcutaneous low-dose unfractionated heparin and describe associated adverse events and identify risk factors for this occurrence.Retrospective case series with chart review.Single-institution, academic tertiary care center.Patients who developed prolonged partial thromboplastin times from routine administration of subcutaneous low-dose unfractionated heparin postoperatively were retrospectively identified during a 16-month period. Data regarding demographics, disease characteristics, laboratory values, associated complications, and risk factors were collected and analyzed.Five patients, all with head and neck cancer, postoperatively developed prolonged partial thromboplastin time levels with prophylactic subcutaneous low-dose unfractionated heparin. All had body mass index ≤ 20 kg/m(2) and received 5000 units of subcutaneous low-dose unfractionated heparin 3 times daily. Four had impaired renal function. Adverse events included 5 postoperative wound hematomas, an emergent reintubation, and a case of persistent mucosal bleeding. These bleeding complications accounted for 25% of all bleeding complications in otolaryngology patients during the same period.Unanticipated systemic effects of subcutaneous low-dose unfractionated heparin can cause significant morbidity in surgically treated patients with head and neck cancer. From this case series, risk factors appear to include subcutaneous low-dose unfractionated heparin 3 times daily dose frequency, low body mass index, and renal dysfunction. For this at-risk patient population, a protocol is needed to minimize both deep vein thromboses and complications of prophylactic therapy.

Der Zusammenschluss von Universität Karlsruhe und Forschungszentrum Karlsruhe zum Karlsruher Institut für Technologie stellte auch die gemeinsame IT-Versorgung vor große Herausforderungen. Die an beiden Institutionen gewachsenen und funktionierenden IT-Infrastrukturen und -Dienste mussten nach und nach auf eine gemeinsame Basis gestellt und damit verbundene IT-Prozesse vereinheitlicht werden.

Anwender aus den Bereichen Verwaltung, Forschung und Lehre am Karlsruher Institut für Technologie nutzen Microsoft SharePoint Teamseiten als zentrale Groupware-Plattform. Seit letztem Jahr ist die aktuelle Version SharePoint 2013 im Einsatz. Ein Mehrwert der neuen Plattform ist die Office Web Apps Technologie, die eine gemeinsame Bearbeitung von Office-Dokumenten im Web-Browser ermöglicht. Die einfache Zusammenarbeit mit internen und externen Partnern erhöht ebenfalls die Akzeptanz für die Verwendung der Lösung.

The trigger system for the AUGER fluorescence detector is presented. The main goals of the design were low price, high flexibility of the trigger, high reliability and good testability even at remote operation. The simulation of all boards using VHDL tools resulted in a design which is optimal with respect to these goals and highly independent of existing commercial solutions. The large-scale integration of modern FPGAs yielded a massive parallel system for recognition of tracks and suppression of background. The readout and control is carried out by low cost PCs under the LINUX operating system.