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Objectives: Presentation and validation of software developed for automated and accurate application of a reference based algorithm (reference sphere method: RSM) inferring the effective imaging geometry from quantitative radiographic image analysis. Methods: The software uses modern pattern recognition and computer vision algorithms adapted for the particular application of automated detection of the reference sphere shadows (ellipses) with subpixel accuracy, it applies the RSM algorithm to the shadows detected, thereby providing three-dimensional Cartesian coordinates of the spheres. If the three sphere centres do not lie on one line, they uniquely determine the imaging geometry. Accuracy of the computed coordinates is investigated in a set of 28 charge coupled device (CCD)-based radiographs of two human mandible segments produced on an optical bench. Each specimen contained three reference spheres (two different radii r1 = 1.5 mm, r2 = 2.5 mm). True sphere coordinates were assessed with a manually operated calliper. Software accuracy was investigated for a weighted and unweighted algebraic ellipse-fitting algorithm. Results: The critical depth-(z-) coordinates revealed mean absolute errors ranging between 1.1 ± 0.7mm (unweighted version; r = 2.5mm) and 1.4 ± 1.4 mm (weighted version. r = 2.5 mm), corresponding to mean relative errors between 5% and 6%. Outliers resulted from complete circular dense structure superimposition and one obviously deformed reference sphere. Conclusions: The software provides information fundamentally important for the image formation and geometric image registration, which is a crucial step for three-dimensional reconstruction from ≥2 two-dimensional views. [ABSTRACT FROM AUTHOR]

BACKGROUND: hip fracture is a major cause of morbidity and mortality in older people; optimal post-surgical treatment is a matter of controversy. OBJECTIVE:to examine the effects of rehabilitation on the clinical outcome following surgical treatment of hip fracture. DESIGN: prospective longitudinal study in three groups of patients with different post-surgical care. METHODS: initial screening of 283 elderly patients with proximal femur fracture; documentation of medical and social history and clinical data; geriatric assessments (Activities of Daily Living and Instrumental Activities of Daily Living) during hospital stay and follow-up for 12 months. One hundred and forty-five patients (>or=65 years) of normal mental status were eligible for the study. Successful follow-up could be monitored in 120 and 117 patients for 6 and 12 months, respectively. Sixty-nine and 39 patients underwent supervised inpatient rehabilitation in an orthopaedic or geriatric hospital, respectively (intervention groups A and B, respectively) whereas 34 patients received no special rehabilitation as they were directly discharged home (control group C). RESULTS: initially a fall-/surgical-induced reduction (P<0.001) of the main outcome measure (Activities of Daily Living) was observed in all patients. Within 6 months of rehabilitation there was an improvement (P<0.01) in Activities of Daily Living; however the pre-fracture scores were not reached. The same time pattern was seen in group C. Therefore no significant differences between the three groups of patients in approaching the baseline status was visible. Moreover, the one-year total mortality in the studied population with normal mental status averaged 11.7% and did not differ between the three groups. CONCLUSION: based on our measured outcome variables institutional rehabilitation after surgical treatment of hip fracture apparently had no significant impact on mortality and morbidity in older patients of normal mental status. [ABSTRACT FROM AUTHOR]

Due to its high energy density, lithium metal is a promising electrode for future energy storage. However, its practical capacity, cyclability and safety heavily depend on controlling its reactivity in contact with liquid electrolytes, which leads to the formation of a solid electrolyte interphase (SEI). In particular, there is a lack of fundamental mechanistic understanding of how the electrolyte composition impacts the SEI formation and its governing processes. Here, we present an in-depth model-based analysis of the initial SEI formation on lithium metal in a carbonate-based electrolyte. Thereby we reach for significantly larger length and time scales than comparable molecular dynamic studies. Our multiscale kinetic Monte Carlo/continuum model shows a layered, mostly inorganic SEI consisting of LiF on top of Li 2 CO 3 and Li after 1 µs. Its formation is traced back to a complex interplay of various electrolyte and salt decomposition processes. We further reveal that low local Li + concentrations result in a more mosaic-like, partly organic SEI and that a faster passivation of the lithium metal surface can be achieved by increasing the salt concentration. Based on this we suggest design strategies for SEI on lithium metal and make an important step towards knowledge-driven SEI engineering., (© 2023. The Author(s).)

Objective: Carotid endarterectomy (CEA) aims to reduce the risk of stroke in patients with atherosclerotic carotid disease. Preoperative risk assessments that predict complications are needed to optimize the care in this patient group. The current approach, namely relying solely on symptomatology and degree of stenosis, is outdated and calls for innovation. The Agatston calcium score was applied in several vascular specialties to assess cardiovascular risk profile but has been little studied in carotid surgery. It is hypothesized that a higher calcium burden at initial presentation equates to a worse prognosis attributable to an increased cerebrovascular and cardiovascular risk profile. The aim was to investigate the association between preoperative ipsilateral calcium score and postoperative all-cause mortality in patients undergoing CEA., Methods: This single-center retrospective cohort study included 89 patients who underwent CEA at a tertiary referral center between 2010 and 2018. Preoperative calcium scores were measured on contrast-enhanced computed tomography images with patient-specific Hounsfield thresholds at the level of the carotid bifurcation. The association between these calcium scores and all-cause mortality was analyzed using multivariable adjusted Cox proportional hazard analysis., Results: Cox proportional hazard analysis demonstrated a significant association between preoperative ipsilateral carotid calcium score and all-cause mortality (hazard ratio, 1.10; 95% confidence interval, 1.03-1.16; P = .003). After adjusting for age, preoperative estimated glomerular filtration rate, and diabetes mellitus, a significant association remained (hazard ratio, 1.07; 95% confidence interval, 1.00-1.15; P = .05)., Conclusions: A higher calcium burden was predictive of worse outcome, which might be explained by an overall poorer health status. These results highlight the potential of calcium measurements in combination with other traditional risk factors, for preoperative risk assessment and thus for improved patient education and care., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: This study aimed to compare the results of irradiation with protons versus irradiation with carbon ions in a raster scan technique in patients with skull base chordomas and to identify risk factors that may compromise treatment results., Methods: A total of 147 patients (85 men, 62 women) were irradiated with carbon ions (111 patients) or protons (36 patients) with a median dose of 66 Gy (RBE (Relative biological effectiveness); carbon ions) in 4 weeks or 74 Gy (RBE; protons) in 7 weeks at the Heidelberg Ion Beam Therapy Center (HIT) in Heidelberg, Germany. The median follow-up time was 49.3 months. All patients had gross residual disease at the beginning of RT. Compression of the brainstem was present in 38%, contact without compression in 18%, and no contact but less than 3 mm distance in 16%. Local control and overall survival were evaluated using the Kaplan-Meier Method based on scheduled treatment (protons vs. carbon ions) and compared via the log rank test. Subgroup analyses were performed to identify possible prognostic factors., Results: During the follow-up, 41 patients (27.9%) developed a local recurrence. The median follow-up time was 49.3 months (95% CI: 40.8-53.8; reverse Kaplan-Meier median follow-up time 56.3 months, 95% CI: 51.9-60.7). No significant differences between protons and carbon ions were observed regarding LC, OS, or overall toxicity. The 1‑year, 3‑year, and 5‑year LC rates were 97%, 80%, and 61% (protons) and 96%, 80%, and 65% (carbon ions), respectively. The corresponding OS rates were 100%, 92%, and 92% (protons) and 99%, 91%, and 83% (carbon ions). No significant prognostic factors for LC or OS could be determined regarding the whole cohort; however, a significantly improved LC could be observed if the tumor was > 3 mm distant from the brainstem in patients presenting in a primary situation., Conclusion: Outcomes of proton and carbon ion treatment of skull base chordomas seem similar regarding tumor control, survival, and toxicity. Close proximity to the brainstem might be a negative prognostic factor, at least in patients presenting in a primary situation., (© 2022. The Author(s).)

The microbiological impurities are the most critical ones in a water system and are thus of special concern. In case of contamination of a purification unit or a distribution system, the user must react quickly. The authors have written down their experience and explain details about the typical microbiome of a water system. In addition, advice is given on how to remediate microbial contamination., (© PDA, Inc. 2022.)

The evolution of intracranial pressure (ICP) of critically ill patients admitted to a neurointensive care unit (ICU) is difficult to predict. Besides the underlying disease and compromised intracranial space, ICP is affected by a multitude of factors, many of which are monitored on the ICU, but the complexity of the resulting patterns limits their clinical use. This paves the way for new machine learning techniques to assist clinical management of patients undergoing invasive ICP monitoring independent of the underlying disease. An institutional cohort (ICP-ICU) of patients with invasive ICP monitoring (n = 1346) was used to train recurrent machine learning models to predict the occurrence of ICP increases of ≥22 mmHg over a long (>2 h) time period in the upcoming hours. External validation was performed on patients undergoing invasive ICP measurement in two publicly available datasets [Medical Information Mart for Intensive Care (MIMIC, n = 998) and eICU Collaborative Research Database (n = 1634)]. Different distances (1-24 h) between prediction time point and upcoming critical phase were evaluated, demonstrating a decrease in performance but still robust AUC-ROC with larger distances (24 h AUC-ROC: ICP-ICU 0.826 ± 0.0071, MIMIC 0.836 ± 0.0063, eICU 0.779 ± 0.0046, 1 h AUC-ROC: ICP-ICU 0.982 ± 0.0008, MIMIC 0.965 ± 0.0010, eICU 0.941 ± 0.0025). The model operates on sparse hourly data and is stable in handling variable input lengths and missingness through its nature of recurrence and internal memory. Calculation of gradient-based feature importance revealed individual underlying decisions for our long short time memory-based model and thereby provided improved clinical interpretability. Recurrent machine learning models have the potential to be an effective tool for the prediction of ICP increases with high translational potential., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain.)

Human language is inherently embodied and grounded in sensorimotor representations of the self and the world around it. This suggests that the body schema and ideomotor action-effect associations play an important role in language understanding, language generation, and verbal/physical interaction with others. There are computational models that focus purely on non-verbal interaction between humans and robots, and there are computational models for dialog systems that focus only on verbal interaction. However, there is a lack of research that integrates these approaches. We hypothesize that the development of computational models of the self is very appropriate for considering joint verbal and physical interaction. Therefore, they provide the substantial potential to foster the psychological and cognitive understanding of language grounding, and they have significant potential to improve human-robot interaction methods and applications. This review is a first step toward developing models of the self that integrate verbal and non-verbal communication. To this end, we first analyze the relevant findings and mechanisms for language grounding in the psychological and cognitive literature on ideomotor theory. Second, we identify the existing computational methods that implement physical decision-making and verbal interaction. As a result, we outline how the current computational methods can be used to create advanced computational interaction models that integrate language grounding with body schemas and self-representations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Röder, Özdemir, Nguyen, Wermter and Eppe.)

We report on in vitro wound-healing and cell-growth studies under the influence of radio-frequency (rf) cell stimuli. These stimuli are supplied either by piezoactive surface acoustic waves (SAWs) or by microelectrode-generated electric fields, both at frequencies around 100 MHz. Employing live-cell imaging, we studied the time- and power-dependent healing of artificial wounds on a piezoelectric chip for different cell lines. If the cell stimulation is mediated by piezomechanical SAWs, we observe a pronounced, significant maximum of the cell-growth rate at a specific SAW amplitude, resulting in an increase of the wound-healing speed of up to 135 ± 85% as compared to an internal reference. In contrast, cells being stimulated only by electrical fields of the same magnitude as the ones exposed to SAWs exhibit no significant effect. In this study, we investigate this effect for different wavelengths, amplitude modulation of the applied electrical rf signal, and different wave modes. Furthermore, to obtain insight into the biological response to the stimulus, we also determined both the cell-proliferation rate and the cellular stress levels. While the proliferation rate is significantly increased for a wide power range, cell stress remains low and within the normal range. Our findings demonstrate that SAW-based vibrational cell stimulation bears the potential for an alternative method to conventional ultrasound treatment, overcoming some of its limitations., Competing Interests: The authors declare no competing interest.

To date, it has not been possible to combine the high optical quality of silver particles with the good chemical stability and synthetic convenience in a fully aqueous system, while simultaneously allowing chemical surface functionalization. We present a synthetic pathway for future developments in information, energy and medical technology where strong optical/electronic properties are crucial. Therefore, the advantages inherent to gold are fused with the plasmonic properties of silver in a fully aqueous Au/Ag/Au core-shell shell system. These nanoparticles inherit low dispersity from their masked gold cores, yet simultaneously exhibit the strong plasmonic properties of silver. Protecting the silver surface with a thin gold layer enables oxidant stability and functionality without altering the Ag-controlled optical properties. This combines both worlds-optical quality and chemical stability-and is not limited to a specific particle shape., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The phase shift of the electron wave is a useful measure for the projected magnetic flux density of magnetic objects at the nanometer scale. More important for materials science, however, is the knowledge about the magnetization in a magnetic nano-structure. As demonstrated here, a dominating presence of stray fields prohibits a direct interpretation of the phase in terms of magnetization modulus and direction. We therefore present a model-based approach for retrieving the magnetization by considering the projected shape of the nano-structure and assuming a homogeneous magnetization therein. We apply this method to FePt nano-islands epitaxially grown on a SrTiO 3 substrate, which indicates an inclination of their magnetization direction relative to the structural easy magnetic [001] axis. By means of this real-world example, we discuss prospects and limits of this approach., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Radiotherapy has a central role in the treatment of sinonasal malignancies, either as postoperative or as primary therapy. To study the efficacy and safety of intensity modulated radiotherapy (IMRT) for sinonasal tumors a single center retrospective evaluation focusing on survival and therapy related toxicity was performed., Methods: One hundred twenty two patients with primary (n = 82) or recurrent (n = 40) malignant sinonasal tumors were treated with intensity modulated radiotherapy between 1999 and 2009 at the University Clinic of Heidelberg and the German Cancer Research Center and retrospectively analyzed. Most patients had adenoid cystic carcinomas (n = 47) or squamous cell carcinoma (n = 26). 99 patients received postoperative radiotherapy. The median total dose was 64 Gy in conventional fractionation (1.8-2 Gy). Overall survival (OS), progression free survival (PFS) and local recurrence free survival (LRFS) rates were calculated using the Kaplan-Meier method. The log-rank test and Fishers Exact test were applied for univariate analysis, Cox-regression was used for multivariate analysis., Results: Median follow up was 36 months. 1-, 3- and 5-year estimated overall survival rates were 90, 70 and 54 % respectively. Median progression free survival and local recurrence free survival was 45 and 63 months respectively. Progression free survival and local recurrence free survival at 1, 3 and 5 years were 76, 57 and 47, and 79, 60 and 51 % respectively. 19 patients (15.5 %) were diagnosed with distant metastases. Univariate analysis revealed significantly improved OS and LRFS for treatment of tumors after primary diagnosis, first series of irradiation and radiation dose ≥60 Gy. Multivariate analysis revealed only treatment in primary situation as an independent prognostic factor for OS and LRFS. Acute CTC grade III mucositis was seen in 5 patients (4.1 %) and CTC grade II dysgeusia in 19 patients (15.6 %). Dysgeusia, dysosmia and ocular toxicity were the most common late adverse events., Conclusions: Our data support the results of previous studies and indicate that intensity modulated radiation therapy (IMRT) represents an effective and safe treatment approach for patients with sinonasal carcinomas.

As proposed recently, a tilted reference wave in off-axis electron holography is expected to be useful for aberration measurement and correction. Furthermore, in dark-field electron holography, it is considered to replace the reference wave, which is conventionally diffracted in an unstrained object area, by a well-defined object-independent reference wave. Here, we first realize a tilted reference wave by employing a biprism placed in the condenser system above three condenser lenses producing a relative tilt magnitude up to 20/nm at the object plane (300kV). Paraxial ray-tracing predicts condenser settings for a parallel illumination at the object plane, where only one half of the round illumination disc is tilted relative to the optical axis without displacement. Holographic measurements verify the kink-like phase modulation of the incident beam and return the interference fringe contrast as a function of the relative tilt between both parts of the illumination. Contrast transfer theory including condenser aberrations and biprism instabilities was applied to explain the fringe contrast measurement. A first dark-field hologram with a tilted - object-free - reference wave was acquired and reconstructed. A new application for bright/dark-field imaging is presented., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Using a combination of condenser electrostatic biprism with dedicated electron optic conditions for sample illumination, we were able to split a convergent beam electron probe focused on the sample in two half focused probes without introducing any tilt between them. As a consequence, a combined convergent beam electron diffraction pattern is obtained in the back focal plane of the objective lens arising from two different sample areas, which could be analyzed in a single pattern. This splitting convergent beam electron diffraction (SCBED) pattern has been tested first on a well-characterized test sample of Si/SiGe multilayers epitaxially grown on a Si substrate. The SCBED pattern contains information from the strained area, which exhibits HOLZ lines broadening induced by surface relaxation, with fine HOLZ lines observed in the unstrained reference part of the sample. These patterns have been analyzed quantitatively using both parts of the SCBED transmitted disk. The fine HOLZ line positions are used to determine the precise acceleration voltage of the microscope while the perturbed HOLZ rocking curves in the stained area are compared to dynamical simulated ones. The combination of these two information leads to a precise evaluation of the sample strain state. Finally, several SCBED setups are proposed to tackle fundamental physics questions as well as applied materials science ones and demonstrate how SCBED has the potential to greatly expand the range of applications of electron diffraction and electron holography., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Nanomagnets form the building blocks for a variety of spin-transport, spin-wave and data storage devices. In this work we generated nanoscale magnets by exploiting the phenomenon of disorder-induced ferromagnetism; disorder was induced locally on a chemically ordered, initially non-ferromagnetic, Fe60Al40 precursor film using  nm diameter beam of Ne(+) ions at 25 keV energy. The beam of energetic ions randomized the atomic arrangement locally, leading to the formation of ferromagnetism in the ion-affected regime. The interaction of a penetrating ion with host atoms is known to be spatially inhomogeneous, raising questions on the magnetic homogeneity of nanostructures caused by ion-induced collision cascades. Direct holographic observations of the flux-lines emergent from the disorder-induced magnetic nanostructures were made in order to measure the depth- and lateral- magnetization variation at ferromagnetic/non-ferromagnetic interfaces. Our results suggest that high-resolution nanomagnets of practically any desired 2-dimensional geometry can be directly written onto selected alloy thin films using a nano-focussed ion-beam stylus, thus enabling the rapid prototyping and testing of novel magnetization configurations for their magneto-coupling and spin-wave properties.

The recently derived general transfer theory for off-axis electron holography provides a new approach for reconstructing the electron wave beyond the conventional sideband information limit. Limited ensemble coherence of the electron beam between object and reference area leads to an attenuation of spatial frequencies of the object exit wave in the presence of aberrations of the objective lens. Concerted tilts of the reference wave under the condition of an invariant object exit wave are proposed to diminish the aberration impact on spatial frequencies even beyond the sideband information limit allowing its transfer with maximum possible contrast. In addition to the theoretical considerations outlined in detail, an experimental proof-of-principle is presented. A fully controlled tilt of the reference wave, however, remains as a promising task for the future. The use of a hologram series with varying reference wave tilt is considered for linearly synthesizing an effective aperture for the transfer into the sideband with broader bandwidth compared to conventional off-axis electron holography allowing us to correct the incoherent aberrations in transmission electron microscopy. Furthermore, tilting a reference wave with respect to a plane wave is expected to be an alternative way for measuring the coherent and incoherent aberrations of a transmission electron microscope. The capability of tilting the reference wave is expected to be beneficial for improving the signal-to-noise ratio in dark-field off-axis electron holography as well., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Current developments in TEM such as high-resolution imaging at low acceleration voltages and large fields of view, the ever larger capabilities of hardware aberration correction and the systematic shaping of electron beams require accurate descriptions of TEM imaging in terms of wave optics. Since full quantum mechanic solutions have not yet been established for, e.g., the theory of aberrations, we are exploring semiclassical image formation in the TEM from the perspective of quantum mechanical phase space, here. Firstly, we use two well-known semiclassical approximations, Miller's semiclassical algebra and the frozen Gaussian method, for describing the wave optical generalization of arbitrary geometric aberrations, including nonisoplanatic and slope aberrations. Secondly, we demonstrate that the Wigner function representation of phase space is well suited to also describe incoherent aberrations as well as the ramifications of partial coherence due to the emission process at the electron source. We identify a close relationship between classical phase space and Wigner function distortions due to aberrations as well as classical brightness and quantum mechanical purity., (Copyright © 2014 Elsevier B.V. All rights reserved.)

By means of off-axis electron holography the local distribution of the magnetic induction within and around a poly-crystalline Permalloy (Ni81Fe19) thin film is studied. In addition the stray field above the sample is measured by magnetic force microscopy on a larger area. The film is deposited on a periodically nanostructured (rippled) Si substrate, which was formed by Xe(+) ion beam erosion. This introduces the periodical ripple shape to the Permalloy film. The created ripple morphology is expected to modify the magnetization distribution within the Permalloy and to induce dipolar stray fields. These stray fields play an important role in spinwave dynamics of periodic nanostructures like magnonic crystals. Micromagnetic simulations estimate those stray fields in the order of only 10 mT. Consequently, their experimental determination at nanometer spatial resolution is highly demanding and requires advanced acquisition and reconstruction techniques such as electron holography. The reconstructed magnetic phase images show the magnetized thin film, in which the magnetization direction follows mainly the given morphology. Furthermore, a closer look to the Permalloy/carbon interface reveals stray fields at the detection limit of the method in the order of 10 mT, which is in qualitative agreement with the micromagnetic simulations., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The reduced density matrix completely describes the quantum state of an electron scattered by an object in transmission electron microscopy. However, the detection process restricts access to the diagonal elements only. The off-diagonal elements, determining the coherence of the scattered electron, may be obtained from electron holography. In order to extract the influence of the object from the off-diagonals, however, a rigorous consideration of the electron microscope influences like aberrations of the objective lens and the Möllenstedt biprism in the presence of partial coherence is required. Here, we derive a holographic transfer theory based on the generalization of the transmission cross-coefficient including all known holographic phenomena. We furthermore apply a particular simplification of the theory to the experimental analysis of aloof beam electrons scattered by plane silicon surfaces., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Off-axis electron holography provides access to the phase of the elastically scattered wave in a transmission electron microscope at scales ranging from several hundreds of nanometres down to 0.1nm. In many cases the reconstructed phase shift is directly proportional to projected electric and magnetic potentials rendering electron holography a useful and established characterisation method for materials science. However, quantitative interpretation of experimental phase shifts requires quantitative knowledge about the noise, which has been previously established for some limiting cases only. Here, we present a general noise transfer formalism for off-axis electron holography allowing to compute the covariance (noise) of reconstructed amplitude and phase from characteristic detector functions and general properties of the reconstruction process. Experimentally, we verify the presented noise transfer formulas for two different cameras with and without objects within the errors given by the experimental noise determination., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Make it connected! 2D close-packed layers of inorganic nanoparticles are interconnected by organic fibrils of oleic acid as clearly visualized by electron holography. These fibrils can be mineralised by PbS to transform an organic-inorganic framework to a completely interconnected inorganic semiconducting 2D array., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background: Chordomas are relatively rare lesions of the bones. About 30% occur in the sacrococcygeal region. Surgical resection is still the standard treatment. Due to the size, proximity to neurovascular structures and the complex anatomy of the pelvis, a complete resection with adequate safety margin is difficult to perform. A radical resection with safety margins often leads to the loss of bladder and rectal function as well as motoric/sensoric dysfunction. The recurrence rate after surgery alone is comparatively high, such that adjuvant radiation therapy is very important for improving local control rates. Proton therapy is still the international standard in the treatment of chordomas. High-LET beams such as carbon ions theoretically offer biologic advantages in slow-growing tumors. Data of a Japanese study of patients with unresectable sacral chordoma showed comparable high control rates after hypofractionated carbon ion therapy only., Methods and Design: This clinical study is a prospective randomized, monocentric phase II trial. Patients with histologically confirmed sacrococcygeal chordoma will be randomized to either proton or carbon ion radiation therapy stratified regarding the clinical target volume. Target volume delineation will be carried out based on CT and MRI data. In each arm the PTV will receive 64 GyE in 16 fractions. The primary objective of this trial is safety and feasibility of hypofractionated irradiation in patients with sacrococygeal chordoma using protons or carbon ions in raster scan technique for primary or additive treatment after R2 resection. The evaluation is therefore based on the proportion of treatments without Grade 3-5 toxicity (CTCAE, version 4.0) up to 12 months after treatment and/or discontinuation of the treatment for any reason as primary endpoint. Local-progression free survival, overall survival and quality of life will be analyzed as secondary end points., Discussion: The aim of this study is to confirm the toxicity results of the Japanese data in raster scan technique and to compare it with the toxicity analysis of proton therapy given in the same fractionation. Using this data, a further randomized phase III trial is planned, comparing hypofractionated proton and carbon ion irradiation., Trial Registration: ClinicalTrials.gov Identifier: NCT01811394.

Background: To analyze our experience with intraoperative electron radiation therapy (IOERT) followed by moderate doses of external beam radiation therapy (EBRT) in patients with locally recurrent renal cell carcinoma., Methods: From 1992 to 2010, 17 patients with histologically proven, locally recurrent renal cell carcinoma (median tumor size 7 cm) were treated by surgery and IOERT with a median dose of 15 Gy. All patients met the premise of curative intent including 7 patients with oligometastases at the time of recurrent surgery, which were resected and/or irradiated. The median time interval from primary surgery to local recurrence was 26 months. Eleven patients received additional 3D-conformal EBRT with a median dose of 40 Gy., Results: Surgery resulted in free but close margins in 6 patients (R0), while 9 patients suffered from microscopic (R1) and 2 patients from macroscopic (R2) residual disease. After a median follow-up of 18 months, two local recurrences were observed, resulting in an actuarial 2-year local control rate of 91%. Eight patients developed distant failures, predominantly to liver and bone, resulting in an actuarial 2-year progression free survival of 32%. An improved PFS rate was found in patients with a larger time interval between initial surgery and recurrence (> 26 months). The actuarial 2-year overall survival rate was 73%. Lower histological grading (G1/2) was the only factor associated with improved overall survival. Perioperative complications were found in 4 patients. No IOERT specific late toxicities were observed., Conclusions: Combination of surgery, IOERT and EBRT resulted in high local control rates with low toxicity in patients with locally recurrent renal cell cancer despite an unfavorable surgical outcome in the majority of patients. However, progression-free and overall survival were still limited due to a high distant failure rate, indicating the need for intensified systemic treatment especially in patients with high tumor grading and short interval to recurrence.

Electron holography initially was invented by Dennis Gabor for solving the problems raised by the aberrations of electron lenses in Transmission Electron Microscopy. Nowadays, after hardware correction of aberrations allows true atomic resolution of the structure, for comprehensive understanding of solids, determination of electric and magnetic nanofields is the most challenging task. Since fields are phase objects in the TEM, electron holography is the unrivaled method of choice. After more than 40 years of experimental realization and steady improvement, holography is increasingly contributing to these highly sophisticated and essential questions in materials science, as well to the understanding of electron waves and their interaction with matter., (© 2013 Elsevier B.V. All rights reserved.)

Arteriovenous malformations (AVM) can be treated with stereotactic radiosurgery. An infrequent, but important complication of this treatment is radionecrosis, which can be detected by MRI. However, the imaging characteristics of necrosis are unspecific in conventional MRI. Here, we report a case of necrosis after radiotherapy of an AVM to illustrate the potential of 7 Tesla MRI including amide proton transfer (APT) for necrosis imaging., (Copyright © 2012 Wiley Periodicals, Inc.)

A new generalized linear transfer theory describing the signal and noise transfer in image detectors is presented, which can be applied to calculate the pixelwise first and second statistical moment of arbitrary experimental images including correlation between pixels. Similar to the existing notion of a point spread function describing the transfer of the first statistical moment (the average), a noise spread function is introduced to characterize the spatially resolved transfer and generation of noise (second central moment, covariance). It is also shown that previously used noise characteristics like the noise power spectrum and detection quantum efficiency, derived from plainly illuminated images, contain only partial information of the complete noise transfer., (Copyright © 2012 Elsevier B.V. All rights reserved.)

A novel generalized linear transfer theory describing the signal and noise transfer in image detectors has been developed in Part I (Niermann, this issue, [1]) of this paper. Similar to the existing notion of a point spread function (PSF) describing the transfer of the first statistical moment (the average), a noise spread function (NSF) was introduced to characterize the spatially resolved transfer of noise (central second moment, covariance). Following the theoretic results developed in Part I (Niermann, this issue, [1]), a new experimental method based on single spot illumination has been developed and applied to measure 2D point and 4D noise spread functions of CCD cameras used in TEM. A dedicated oversampling method has been used to suppress aliasing in the measured quantities. We analyze the 4D noise spread with respect to electronic and photonic noise contributions., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objectives: Presentation and validation of software developed for automated and accurate application of a reference-based algorithm (reference sphere method: RSM) inferring the effective imaging geometry from quantitative radiographic image analysis., Methods: The software uses modern pattern recognition and computer vision algorithms adapted for the particular application of automated detection of the reference sphere shadows (ellipses) with subpixel accuracy. It applies the RSM algorithm to the shadows detected, thereby providing three-dimensional Cartesian coordinates of the spheres. If the three sphere centres do not lie on one line, they uniquely determine the imaging geometry. Accuracy of the computed coordinates is investigated in a set of 28 charge-coupled device (CCD)-based radiographs of two human mandible segments produced on an optical bench. Each specimen contained three reference spheres (two different radii r1=1.5 mm, r2=2.5 mm). True sphere coordinates were assessed with a manually operated calliper. Software accuracy was investigated for a weighted and unweighted algebraic ellipse-fitting algorithm., Results: The critical depth- (z-) coordinates revealed mean absolute errors ranging between 1.1+/-0.7 mm (unweighted version; r=2.5 mm) and 1.4+/-1.4 mm (weighted version, r=2.5 mm), corresponding to mean relative errors between 5% and 6%. Outliers resulted from complete circular dense structure superimposition and one obviously deformed reference sphere., Conclusions: The software provides information fundamentally important for the image formation and geometric image registration, which is a crucial step for three-dimensional reconstruction from > or =2 two-dimensional views.

Treatment of hyperlipidemic patients with the thiol compound N-acetylcysteine (NAC) was previously shown to cause a significant dose-related increase in the high-density lipoprotein (HDL)-cholesterol serum level, suggesting the possibility that its disease-related decrease may result from a diminished thiol concentration and/or thiol/disulfide redox status (REDST) in the plasma. We therefore investigated plasma thiol levels and REDST in normo-/hyperlipidemic subjects with and without coronary heart disease (CHD). The thiol level, REDST, and amino acid concentrations in the plasma and intracellular REDST of peripheral blood mononuclear cells (PBMC) have been determined in 62 normo- and hyperlipidemic subjects. Thirty-three of these subjects underwent coronary angiography, because of clinical symptoms of CHD. All groups of hyperlipidemic patients under test and those normolipidemic individuals with documented coronary stenoses showed a marked decrease in plasma thiol concentrations, plasma and intracellular REDST of PBMCs, and a marked increase in plasma taurine levels. Individual plasma thiol concentrations and plasma REDST were strongly negatively correlated with the serum LDL-cholesterol and positively correlated with the serum HDL-cholesterol level. Together with the earlier report about the effect of NAC on the HDL-cholesterol serum level, our findings suggest strongly that lower HDL-cholesterol serum levels may result from a decrease in plasma thiol level and/or REDST possibly through an excessive cysteine catabolism into taurine.

The needs of insufficiently treated Turkish patients motivated to offer a group-psychotherapy in cooperation with an interpreter. Only on a trickful way his expenses could be paid by the health insurance. While the plan for such a group was made, it was estimated just as a second-rate escape for such patients. But already during the course of the first group-session a therapeutic concept developed which overcame barriers of language and culture. So this experiment turned out to be an important step for developing suitable therapeutic structures for migrants.

We have investigated the use of the tetracycline-dependent gene expression system to regenerate and propagate tobacco plants transformed with a gene whose product--when highly expressed--interferes with regeneration and/or further reproduction. Plants transformed with the Agrobacterium rhizogenes rolB gene under the control of the tetracycline-dependent expression system were phenotypically indistinguishable from wild type owing to efficient repression of the promoter. Induction of the rolB gene with tetracycline led to high-level expression of the rolB mRNA, which resulted in extremely stunted plants with necrotic and wrinkled leaves that did not develop a floral meristem. Upon cessation of tetracycline treatment healthy shoots developed even from severely affected meristems. Data on the dose response of the rolB phenotype as a function of tetracycline concentration demonstrate that the tetracycline-dependent gene expression system can be used to modulate the manifestation of a particular phenotype.

After a brief introduction into some existential-analytic points of view of the body and of conversion syndrome the actual socio-cultural situation of the migrant workers is explained with many details. For the understanding of the meaning of the conversion symptoms it is necessary to search for the existential concept of the patient which is actually in danger. The therapeutic procedure following this concept is demonstrated on the base of four clinical cases.

Perfusion of sinusoids and of functional portosystemic shunts was investigated before and after PPF-, Collins- and Ringer storage and in Ringer-trickle-perfusion of the liver using a physical-mathematical method. The increase of the sinusoidal resistance after PPF-storage is less than after preservation by electrolyte solutions. Accordingly the amount of volume passing the sinusoids is higher after PPF-storage. This fact is of great importance for haemodynamic integrity after transplantation.

Intestinal haemodynamics was examined invasively in 30 mongrel dogs. Beside registration of blood pressure values of the blood flow were evaluated especially. Measured flow values in the three main intestinal vessels - Truncus coeliacus, A. mesenterica superior and A. mesenterica inferior - were compared to aortal flow. Thereby the sum of intestinal arteries values was equal to intrarenal aortal flow. Two thirds of aortal flow may be expected in the portal vein. These relations make in possible to get informations about physiological intestinal circulation from single values without measurement of all intestinal vessels.

Hemodynamic parameters of livers--especially resistance of the sinusoids and of functional portosystemic shunts--are investigated using an electro-physical model. During liver perfusion the inflow conduit is compressed irregularly. The dynamic changes of pressure and flow allow a calculation of the volume passing the sinusoids and the functional shunts.

Turkish magic healers called hodjas are working in West-Germany today. Our knowledge about their influence on Turkish patients is poor. They are consulted at least from patients with psychogenous diseases. The degree and the multiple dimensions of their influence and the possibility for the doctor to master the conflicting cultural identity of these patients is demonstrated on the base of four clinical case-histories.