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Septic complications after pancreatic surgery are common. However, it remains unclear if and how a shift of the microbiological spectrum affects morbidity. The aim of the present study was to assess the microbiological spectrum and antibiotic resistance patterns and their impact on outcome.We conducted a retrospective study including patients undergoing pancreatic surgery at our center between 2005 and 2018. A systematic literature review and descriptive meta-analysis of the published and original data was performed according to the PRISMA guidelines.A total of 318 patients were included in the analysis. Patients with biliary drainage had a significantly higher incidence of bacterobilia (93% vs. 25%) and received preoperative antibiotics (46% vs. 12%). The analyzed bile cultures showed no resistance to piperacillin/tazobactam, fluoroquinolones, or carbapenems. Resistance to cefuroxime was seen in 58% of the samples of patients without biliary drainage (NBD) and 93% of the samples of those with drainage (BD). In general, there was no significant difference in overall postoperative morbidity. However, superficial surgical site infections (SSIs) were significantly more common in the BD group. We included a total of six studies and our own data (1627 patients) in the descriptive meta-analysis. The percentage of positive bile cultures ranged from 53 to 81%. In patients with BD, the most frequent microorganisms were Enterococcus spp. (58%), Klebsiella spp. (29%), and E. coli (27%). Almost all studies demonstrated resistance to first- and second-generation cephalosporins and to third- and fourth-generation cephalosporins for patients with BD.A change in perioperative antibiotic strategy according to local resistance patterns, especially after BD, might be useful for patients undergoing pancreatic surgery. Appropriate perioperative antibiotic coverage may help to prevent abdominal infectious complications and especially superficial SSIs.

Purpose Anastomotic leakage (AL) and surgical site infection (SSI) account for most postoperative complications in colorectal surgery. The aim of this retrospective trial was to investigate whether perioperative selective decontamination of the digestive tract (SDD) reduces these complications and to provide a cost-effectiveness model for elective colorectal surgery. Methods All patients operated between November 2016 and March 2020 were included in our analysis. Patients in the primary cohort (PC) received SDD and those in the historical control cohort (CC) did not receive SDD. In the case of rectal/sigmoid resection, SDD was also applied via a transanally placed Foley catheter (TAFC) for 48 h postoperatively. A propensity score-matched analysis was performed to identify risk factors for AL and SSI. Costs were calculated based on German diagnosis-related group (DRG) fees per case. Results A total of 308 patients (154 per cohort) with a median age of 62.6 years (IQR 52.5–70.8) were analyzed. AL was observed in ten patients (6.5%) in the PC and 23 patients (14.9%) in the CC (OR 0.380, 95% CI 0.174–0.833; P = 0.016). SSI occurred in 14 patients (9.1%) in the PC and 30 patients in the CC (19.5%), representing a significant reduction in our SSI rate (P = 0.009). The cost-effectiveness analysis showed that SDD is highly effective in saving costs with a number needed to treat of 12 for AL and 10 for SSI. Conclusion SDD significantly reduces the incidence of AL and SSI and saves costs for the general healthcare system.

Concrete structures are increasingly becoming exposed to organic acid attack conditions, such as those found in agriculture and food-related industries. This paper aims to experimentally verify the thermodynamic modeling of cement pastes under acetic acid attack. For this, a modeling approach implemented in IPHREEQC via Matlab is described, and results are compared with measured pH and compositions of equilibrated solutions (MP-AES) as well as unreacted/precipitated solids (XRF, XRD and STA) for a wide range of acid concentrations. The 11% replacement of cement by silica fume (SF) led to a 60 or 70% reduction (measured or modeled, respectively) of Portlandite content in the hardened cement paste due to the pozzolanic reaction resulting in higher content of CSH phases, which has effects on the progression of dissolution processes and a resulting pH with increased acid concentrations. Considering that no fitting parameter was used, the model predictions showed good agreement with measured values of pH, dissolved ion concentrations and composition of the remaining (degraded) solids overall. The discrepancies here were more pronounced at very high acid concentrations (equilibrium pH < ~4), i.e., after the full dissolution of hydrate phases due to limitations in the model used to describe Al-, Si- and Fe-gel phases and/or identified experimental challenges in precipitation of calcium and aluminum acetate hydrates.

Concrete structures are increasingly becoming exposed to organic acid attack conditions, such as those found in agriculture and food-related industries. This paper aims to experimentally verify the thermodynamic modeling of cement pastes under acetic acid attack. For this, a modeling approach implemented in IPHREEQC via Matlab is described, and results are compared with measured pH and compositions of equilibrated solutions (MP-AES) as well as unreacted/precipitated solids (XRF, XRD and STA) for a wide range of acid concentrations. The 11% replacement of cement by silica fume (SF) led to a 60 or 70% reduction (measured or modeled, respectively) of Portlandite content in the hardened cement paste due to the pozzolanic reaction resulting in higher content of CSH phases, which has effects on the progression of dissolution processes and a resulting pH with increased acid concentrations. Considering that no fitting parameter was used, the model predictions showed good agreement with measured values of pH, dissolved ion concentrations and composition of the remaining (degraded) solids overall. The discrepancies here were more pronounced at very high acid concentrations (equilibrium pHlt; ~4), i.e., after the full dissolution of hydrate phases due to limitations in the model used to describe Al-, Si- and Fe-gel phases and/or identified experimental challenges in precipitation of calcium and aluminum acetate hydrates.

Partizipation zu ermoglichen ist Teil des Auftrags der Offenen Kinder- und Jugendarbeit. Dazu gehort die Einbindung der Jugendlichen in die Angebotsentwicklung. Der Ansatz der Partizipativen Gesundheitsforschung kann einen Beitrag zur Umsetzung dieses Auftrags leisten. Die Durchfuhrung sog. „Autonomer Offnungen“ (AO) in Braunschweig, bei denen Jugendliche ihr Jugendzentrum (JZ) ohne Beisein der Fachkrafte offnen und die Zeit eigenverantwortlich gestalten, geht auf eine Forderung der stadtischen Jugendkonferenz zuruck. Jugendliche und Fachkrafte wurden mit partizipativen Methoden bei der Evaluation der AO wissenschaftlich begleitet. Diese Arbeit berichtet aus einem der drei mitwirkenden JZ. Nach jeder AO haben die Jugendlichen ihr Erlebtes in einem mit den Fachkraften erarbeiteten Fragebogen angegeben, der im digitalen Umfrageinstrument „Mentimeter“ hinterlegt ist. Die Erfahrungen der Fachkrafte wurden in Interviews erfragt. Im Zentrum der Erhebungen stehen das Einbringen eigener Interessen und die Entwicklung von Kompetenzen der Jugendlichen. Die Ergebnisse wurden von den Wissenschaftler*innen ausgewertet und in einem Workshop mit Jugendlichen und Fachkraften reflektiert. Im Zeitraum von zehn Monaten fanden zehn AO statt. Funf Jugendliche nahmen als Hauptverantwortliche und ca. 20 weitere als Mitverantwortliche teil. Es zeigte sich, dass die Jugendlichen ihre Interessen seit Beginn der AO verstarkt einbringen. Die Fachkrafte haben eine Entwicklung von Kompetenzen in verschiedenen Feldern beobachtet. Es wurden Kriterien zur Ubertragbarkeit der AO identifiziert. Belastbare Beziehungen, die einen vertrauensvollen Austausch auf Augenhohe zwischen Fachkraften und Jugendlichen ermoglichen, sind dabei bedeutsam.

Purpose This study investigates whether contrast enema (CE) and flexible endoscopy (FE) should be performed routinely after low anterior resection (LAR) before ileostomy reversal. Additionally, the impact of previous anastomotic leakage (AL) on diagnostic test accuracy (DTA) was assessed. Methods This is a retrospective analysis of prospectively collected tertiary care data of two centers. Consecutive rectal cancer patients undergoing LAR with loop ileostomy formation were included. Before ileostomy reversal, all patients were assessed by CE and FE. DTA of FE and CE for asymptomatic AL in patients who had previously suffered from clinically relevant AL (group 1) compared with those without apparent AL after LAR (group 0) were assessed separately. Results Two hundred ninety-three patients were included in the analysis, 86 in group 1 and 207 in group 0. Overall sensitivity for detection of asymptomatic AL was 76% (FE) and 60% (CE). Specificity was 100% for both tests. DTA of FE was equal or superior to CE in all subgroups. Prevalence of asymptomatic AL at the time of testing was 1.4% in group 0 and 25.6% in group 1. Conclusion Flexible endoscopy is the more accurate diagnostic test for the detection of asymptomatic anastomotic leaks prior to ileostomy reversal. Contrast enema showed no gain of information. In the group without complications after the initial rectal resection, 104 must be tested to find one leak prior to reversal. In those patients, routine diagnostic testing additional to digital rectal examination may be questioned.

Postoperative pulmonary embolism (PE) after pancreatic surgery is a potentially life-threatening complication. However, the magnitude of morbidity and mortality of PE is still uncertain. The present study aims to assess the incidence of PE after pancreatic surgery and analyze its impact on the outcome. We conducted a retrospective study including all patients who underwent pancreatic resections between 2005 and 2017. The development of PE was analyzed for a 90-day period following surgery. Risk factors were evaluated using regression models. The study investigated 947 patients undergoing pancreatic surgery. Overall, 26 (2.7%) patients developed PE. The median body mass index (BMI) of patients with PE was significantly higher (28.1 kg/m2 [24.7–31.8] vs. 24.8 kg/m2 [22.4–27.8], p

It is often of great importance in engineering to know precisely the properties of a material used with regard to its strength, its plasticity or its brittleness, its elasticity, and some other properties. For this purpose, material samples are tested in a tensile test by clamping the sample with a known starting cross-section in a tensile testing machine and loading it with a tensile force F. The force is then graphically displayed over the length change ΔL caused. This curve is called the force-extension diagram. In this study, a new measurement method enables for the first time, depending on the applied uniaxial stress, an insight at the atomic level into various energy dissipation processes at cement-based materials with the help of infrared spectroscopy. The samples are modified by adding SiO2 particles, which are coated by a polymer (PEG-MDI-DMPA) of different PEG molecular weights. Results show that elongating and breakage of [Formula: see text] and [Formula: see text] bonds play an essential role in the strain energy dissipation. Compared to the pure cement, the modified samples are affected more by elongating and breakage of [Formula: see text] as the admixture can effectively reduce the energy barrier of the hydrolytic reaction. The incorporating of particles into the cement matrix induces new mechanisms for energy dissipation by stretching of [Formula: see text] bending vibrations. Stretching vibration of the [Formula: see text] group indicates that part of the energy is dissipated by breakage of hydrogen bonding between the carboxyl group and PEG chains. Besides, a higher value of the ultimate fracture force following an increase in the molecular weight of PEG shows stronger bonding between particles and the cement matrix. As the chain-length of PEG is increased, less energy is absorbed through the other processes (especially at a higher level of strain). Thus, there is a balance between the whole deformation (toughness) and the strength of samples with the increase of the PEG molecular weight.

Background: Chronic pancreatitis (CP) often leads to recurrent pain as well as exocrine and/or endocrine pancreatic insufficiency. This study aimed to investigate the effect of pancreatic head resections on glucose metabolism in patients with CP. Methods: Patients who underwent pylorus-preserving pancreaticoduodenectomy (PPPD), Whipple procedure (cPD), or duodenum-preserving pancreatic head resection (DPPHR) for CP between January 2011 and December 2020 were retrospectively analyzed with regard to markers of pancreatic endocrine function including steady-state beta cell function (%B), insulin resistance (IR), and insulin sensitivity (%S) according to the updated Homeostasis Model Assessment (HOMA2). Results: Out of 141 pancreatic resections for CP, 43 cases including 31 PPPD, 2 cPD and 10 DPPHR, met the inclusion criteria. Preoperatively, six patients (14%) were normoglycemic (NG), 10 patients (23.2%) had impaired glucose tolerance (IGT) and 27 patients (62.8%) had diabetes mellitus (DM). In each subgroup, no significant changes were observed for HOMA2-%B (NG: p = 0.57; IGT: p = 0.38; DM: p = 0.1), HOMA2-IR (NG: p = 0.41; IGT: p = 0.61; DM: p = 0.18) or HOMA2-%S (NG: p = 0.44; IGT: p = 0.52; DM: p = 0.51) 3 and 12 months after surgery, respectively. Conclusion: Pancreatic head resections for CP, including DPPHR and pancreatoduodenectomies, do not significantly affect glucose metabolism within a follow-up period of 12 months.

Simple Summary Pelvic exenteration is often the only curative treatment option for selected locally advanced tumours, and especially for recurrent cancers. Because of the heterogeneous patient population with different clinical pictures, it is not possible to standardize the indication, treatment strategy and surgical technique for this procedure. For the same reason, as well as a rather low annual number of total cases, clinical trials are notably difficult to design. However, it is important to underline the often-underestimated possibilities of surgical treatment when a R0 resection is achievable, with a low mortality and acceptable postoperative quality of life. Abstract Purpose: The practice of exenterative surgery is sometimes controversial and has garnered a certain scepticism. Surgical studies are difficult to conduct due to insufficient data. The aim of this review is to present the current standing of pelvic exenteration from a surgical, gynaecological and urological point of view. Methods: This review is based upon a literature review (MEDLINE (PubMed), CENTRAL (Cochrane) and EMBASE (Elsevier)) of retrospective studies on exenterative surgery from 1993–2020. Using MeSH (Medical Subject Headings) search terms, 1572 publications were found. These were evaluated and screened with respect to their eligibility using algorithms and well-defined inclusion and exclusion criteria. Therefore, the guidelines for systematic reviews (PRISMA) were used. Results: A complete tumour resection (R0) often represents the only curative option for advanced pelvic carcinomas and their recurrences. A recent systematic review showed significant symptom relief in 80% of palliative patients after pelvic exenteration. Surgical limitations (distant metastases, involvement of the pelvic wall, etc.) are diminished by adequate surgical expertise and close interdisciplinary cooperation. While the mortality rate is low (2–5%), the still relatively high morbidity rate (32–84%) can be minimized by optimizing the perioperative setting. Following exenterations, roughly 79–82% of patients report satisfying results according to PROs (patient-reported outcomes). Conclusion: Due to multimodality treatment strategies combined with extended surgical expertise and patients’ preferences, pelvic exenteration can be offered nowadays with low mortality and acceptable postoperative quality of life. The possibilities of surgical treatment are often underestimated. A multi-centre database (PelvEx Collaborative) was established to collect data and experiences to optimize the research in this field.

Onkologische Notfalle in der Viszeralchirurgie stellen keine Seltenheit, jedoch eine erhebliche Herausforderung fur den behandelnden Chirurgen und den Patienten gleichermasen dar. Der Patient ist durch die Tumorerkrankung latent und durch die Notfallsituation akut gefahrdet. Der Chirurg muss daher nicht nur dem Notfall an sich, sondern auch der gesamtonkologische Situation bei seiner Entscheidungsfindung fur eine Therapie und wahrend dieser Phase Rechnung tragen. Hierbei sollten auch stets die individuellen Patientenwunsche und -vorstellungen beachtet und, wenn moglich, die Angehorigen in den Entscheidungsprozess eingebunden werden. Ein wesentlicher Punkt im Zuge der Bewertung des Notfalls ist neben der Indikationsstellung fur eine Operation die Unterscheidung zwischen einer palliativen und kurativen onkologischen Gesamtkonstellation. Dies erfordert daher neben der chirurgischen Erfahrung fur die Notfalloperation auch eine entsprechende onkologische Expertise des Chirurgen. Ziel war die Erstellung eines Uberblicks und Zusammenfassung der aktuellen chirurgischen und interventionellen Behandlungsmoglichkeiten onkologischer Notfalle in der Abdominalchirurgie. Es wurde eine selektive PubMed-basierte Literaturrecherche zum Thema chirurgischer und interventioneller Therapiemoglichkeiten onkologischer Notfalle in der Abdominalchirurgie, insbesondere im Hinblick auf Tumorblutung, -perforation und -obstruktion im Bereich des Gastrointestinaltrakts durchgefuhrt und deren Ergebnisse zusammengefasst und aufbereitet. Der Artikel bietet einen Uberblick uber den aktuellen Stand der Behandlungsmoglichkeiten onkologischer Notfalle im Bereich der Abdominalchirurgie.

OBJECTIVES The aim of this study was to assess intraoperative changes of hepatic macrohemodynamics and their association with ascites and posthepatectomy liver failure (PHLF) after major hepatectomy. SUMMARY OF BACKGROUND DATA Large-scale ascites and PHLF remain clinical challenges after major hepatectomy. No study has concomitantly evaluated arterial and venous liver macrohemodynamics in patients undergoing liver resection. METHODS Portal venous pressure (PVP), portal venous flow (PVF), and hepatic arterial flow (HAF) were measured intraoperatively pre- and postresection in 67 consecutive patients with major hepatectomy (ie, resection of ≥3 liver segments). A group of 30 patients with minor hepatectomy served as controls. Liver macrohemodynamics and their intraoperative changes (ie, Δ) were analyzed as predictive biomarkers of ascites and PHLF using Fisher exact, t test, or Wilcoxon rank sum test for univariate and logistic regression for multivariate analyses. RESULTS Major hepatectomy increased PVP by 26.9% (P = 0.001), markedly decreased HAF by 40.7% (P < 0.001), and slightly decreased PVF by 13.4% (P = 0.011). Minor resections had little effects on hepatic macrohemodynamics. There was no significant association of liver macrohemodynamics with ascites. While middle hepatic vein resection caused higher postresection PVP after right hepatectomy (P = 0.04), the Pringle maneuver was associated with a significant PVF (P = 0.03) and HAF reduction (P = 0.03). Uni- and multivariate analysis revealed an intraoperative PVP increase as an independent predictor of PHLF (P = 0.025). CONCLUSION Intraoperative PVP kinetics serve as independent predictive biomarker of PHLF after major hepatectomy. These data highlight the importance to assess intraoperative dynamics rather than the pre- and postresection PVP values.

An ever growing variety of smart, connected Internet of Things (IoT) devices poses completely new challenges for businesses regarding security and privacy. In fact, the adoption of smart products may depend on the ability of organizations to offer systems that ensure adequate sensor data integrity while guaranteeing sufficient user privacy. In light of these challenges, previous research indicates that blockchain technology could be a promising means to mitigate issues of data security arising in the IoT. Building upon the existing body of knowledge, we propose a design theory, including requirements, design principles, and features, for a blockchain-based sensor data protection system (SDPS) that leverages data certification. To support this, we designed and developed an instantiation of an SDPS (CertifiCar) in three iterative cycles intented to prevent the fraudulent manipulation of car mileage data. Following the explication of our SDPS, we provide an ex post evaluation of our design theory considering CertifiCar and two additional use cases in the areas of pharmaceutical supply chains and energy microgrids. Our results suggest that the proposed design ensures the tamper-resistant gathering, processing, and exchange of IoT sensor data in a privacy-preserving, scalable, and efficient manner.

Facilitating participation is part of the mandate of open child and youth work. This also means youths have a voice in the development of youth center offerings. The participatory health research approach can support accomplishing this mandate.As a consequence of the municipal youth congress's demand for more autonomy so-called "Autonomous Openings" (AO) - the opening of youth centers by the youths themselves and spending their time independently - were implemented in Braunschweig, Germany. Participatory research methods were used to scientifically support the center's youths and professionals in evaluating the AOs. This paper reports on one of three contributing youth centers.After each AO the adolescents reflected on their experiences by filling in a questionnaire jointly developed by researchers and professionals. The survey was accessible via the digital tool "Mentimeter". The professionals' perspective was captured in interviews. Topics such as revealing one's personal interests and the development of competencies were the main interest. The gathered data was assessed by the researchers and reflected upon together with youths and professionals during a workshop.Ten AOs took place throughout a period of ten months. Five adolescents were preliminary responsible and about another 20 were co-responsible. The results show that young people revealed their own interests more substantially. Moreover, the professionals observed a strengthening of competencies in various fields. Several factors were identified that can facilitate transferability to other youth centers. Reliable relationships that enable a trusting and equal exchange between professionals and youths are essential.HINTERGRUND: Partizipation zu ermöglichen ist Teil des Auftrags der Offenen Kinder- und Jugendarbeit. Dazu gehört die Einbindung der Jugendlichen in die Angebotsentwicklung. Der Ansatz der Partizipativen Gesundheitsforschung kann einen Beitrag zur Umsetzung dieses Auftrags leisten.Die Durchführung sog. „Autonomer Öffnungen“ (AÖ) in Braunschweig, bei denen Jugendliche ihr Jugendzentrum (JZ) ohne Beisein der Fachkräfte öffnen und die Zeit eigenverantwortlich gestalten, geht auf eine Forderung der städtischen Jugendkonferenz zurück. Jugendliche und Fachkräfte wurden mit partizipativen Methoden bei der Evaluation der AÖ wissenschaftlich begleitet. Diese Arbeit berichtet aus einem der drei mitwirkenden JZ.Nach jeder AÖ haben die Jugendlichen ihr Erlebtes in einem mit den Fachkräften erarbeiteten Fragebogen angegeben, der im digitalen Umfrageinstrument „Mentimeter“ hinterlegt ist. Die Erfahrungen der Fachkräfte wurden in Interviews erfragt. Im Zentrum der Erhebungen stehen das Einbringen eigener Interessen und die Entwicklung von Kompetenzen der Jugendlichen. Die Ergebnisse wurden von den Wissenschaftler*innen ausgewertet und in einem Workshop mit Jugendlichen und Fachkräften reflektiert.Im Zeitraum von zehn Monaten fanden zehn AÖ statt. Fünf Jugendliche nahmen als Hauptverantwortliche und ca. 20 weitere als Mitverantwortliche teil. Es zeigte sich, dass die Jugendlichen ihre Interessen seit Beginn der AÖ verstärkt einbringen. Die Fachkräfte haben eine Entwicklung von Kompetenzen in verschiedenen Feldern beobachtet. Es wurden Kriterien zur Übertragbarkeit der AÖ identifiziert. Belastbare Beziehungen, die einen vertrauensvollen Austausch auf Augenhöhe zwischen Fachkräften und Jugendlichen ermöglichen, sind dabei bedeutsam.

This paper reports the design, fabrication and characterization of bulk acoustic wave (BAW) resonators of the SMR-type (surface mounted resonator) with highly c-axis oriented Al 0.8 Sc 0.2 N thin-films. Various filter topologies have been demonstrated for high frequencies with sharp roll-off, wide bandwidth BW and low insertion loss IL (rel. 3dB-BW up to 9% and min. IL of 0.9 dB to 1.5 dB at 2350 to 2550 MHz). Furthermore, the challenges regarding the integration of $\mathrm{Al}_{1-\mathrm{x}}\mathrm{Sc}_{\mathrm{x}}\mathrm{N}$ for n79 applications (4400 to 5000 MHz) are indicated. The demonstrations show promising results regarding acoustic-only filters at 5G frequencies.

Structural variants of the ‘de Vries-like’ mesogen 5-[4-(12,12,14,14,16,16-hexamethyl-12,14,16-trisilaheptadecyloxy)phenyl]-2-hexyloxypyrimidine (QL16-6), including two isomers with branched iso-tricarbosilane end-groups, were synthesized and their mesomorphic and ‘de Vries-like’ properties were characterized by polarized optical microscopy, differential scanning calorimetry, small angle and 2D X-ray scattering techniques. A comparative analysis of isomers with linear and branched tricarbosilane end-groups shows that they exhibit comparable mesomorphic and ‘de Vries-like’ properties. Furthermore, the difference in effective molecular length Leff between the linear and branched isomers in the SmA and SmC phases (ca. 4–5 A), which was derived from 2D X-ray scattering experiments, suggests that the linear tricarbosilane end-group is hemispherical in shape on the time-average, as predicted by a DFT conformational analysis at the B3LYP/6-31G* level.

The integration of multiple bands and higher power standards lead to enhanced interference problems and make higher attenuation levels in next-gen RF-Front-Ends necessary. This paper introduces an all-pass based BAW filter design concept for notch, band-stop and band-pass filter topologies to indicate the possibilities and the impact of key parameters like material electromechanical coupling factor $k_{eff}^2$, piezoelectric material quality factor Q m and inductor losses Q L . This work outlines the concept and design aspects. Also various examples will be proposed to show the main benefits of this approach.

Applications using BAW devices benefit from large intrinsic electromechanical coupling materials, e.g. Al 1-x Sc x N. This work reports BAW-SMRs using high piezoelectric Al 1-x Sc x N and investigates the relations between Sc content, crystal morphology and resonator RF performance. Finally, key requirements for high quality Al 1-x Sc x N thin-film growth are analyzed and discussed examplary for x = 20at.-%.

Up to now, sensor applications have rarely used materials whose dielectric properties are a function of the gas concentration. A sensor principle, by which this material effect can be utilized, is based planar radio-frequency sensors. For the first time, such a sensor was equipped with an integrated heater and successfully operated at temperatures up to 700 ∘C. This makes it possible to apply materials that show gas-dependent changes in the dielectric properties only at higher temperatures. By coating the planar resonance structure with a zeolite, ammonia could be detected. The amount of ammonia stored in the sensitive layer can thereby be determined, since the resonant frequency of the sensor shifts with its ammonia loading. Desorption measurements showed a dependence of the storage behavior of the ammonia in the gas-sensitive layer on the operating temperature of the sensor. Thus, it was possible that by operating the sensor at 300 ∘C, it only shows a gas-concentration-dependent signal. At lower operating temperatures, on the other hand, the sensor could possibly be used for dosimetric determination of very low ammonia concentrations.

Background: In an aging society, the incidence and relevance of rectal cancer as one of the most frequent gastrointestinal cancers gains in importance. Excellent surgery and up-to-date multimodal treatments are essential for adequate oncological results and good quality of life. Summary: In this review, we describe modern developments in rectal cancer surgery and its embedment in modern multimodal therapy concepts. Key Message: Distinguished interdisciplinary cooperation combined with an outstanding surgical expertise is the basic requirement for an optimal treatment of rectal cancer. Thus, high standards of oncological outcome and patient’s quality of life can be achieved. Due to its localization within the rectum, rectal cancers are divided into tumors of the lower (0–6 cm), middle (6–12 cm), and upper (12–16 cm) third, assessed by rigid rectoscopy measured from the anal verge to the lower tumor margin. This classification is essential for the surgical strategy [2].

Many patients with chronic pancreatitis (CP) undergo a step-up approach with interventional procedures as first-line treatment and resection reserved for later stages. The aim of this study was to identify predictive factors for a significant clinical improvement (SCI) after surgical treatment. All patients operated for CP between September 2012 and June 2017 at our center was retrospectively reviewed. A prospective patient survey was conducted to measure patients postoperative outcome. The primary endpoint SCI was defined as stable health status, positive weight development and complete pain relief without routine pain medication. Additionally, risk factors for relaparotomy were analyzed. A total of 89 patients with a median follow-up of 38 months were included. In most cases, a duodenum-preserving pancreatic head resection (n = 48) or pancreatoduodenectomy (n = 28) was performed. SCI was achieved in 65.3% (n = 47) of the patients after the final medium follow-up of 15.0 months (IQR: 7.0–35.0 months), respectively. Patients with a longer mean delay (7.7 vs 4 years) between diagnosis and surgical resection were less likely to achieve SCI (P = .02; OR .88; 95%CI .80–98). An endocrine insufficiency was a negative prognostic factor for SCI (P = .01; OR .15; 95%CI .04–68). In total, 96.2% of the patients had a complete or major postoperative relief with a mean pain intensity reduction from 8.1 to 1.9 on the visual analogue scale. The results support that surgical resection for CP should be considered at early stages. Resection can effectively reduce postoperative pain intensity and improve long-term success.

An open question in predicting the rheological properties of cement suspensions has been whether changes of rheology during hydration are merely a result of shifts in the electrostatic interaction patterns of the particles over time, or whether and to which extent steric bridging by hydration products occurs. The latter could explain phenomena such as thixotropy. In this context, parallel investigations using both rheological tests and isothermal calorimetry, 1H NMR relaxometry, conductance and small-angle X-ray scattering (SAXS) measurments were carried out. It could be shown that as early as approx. 2.5 h after water addition at approx. 30 °C, small amounts of Calcium Silicate Hydrate (C-S-H) form which may contribute to a bridging of the cement particles. This phase is followed by rapid C-S-H formation, leading to a non-linear increase in paste stiffness. This phase ends with percolation, i.e. the paste stiffness increases dramatically, simultaneously with the formation of gel pore like structures, which could be observed using NMR.

Early mobilization is one essential item within the enhanced recovery after surgery (ERAS) concept, but lacks solid evidence and a standardized assessment. The aim was to monitor and increase the postoperative mobilization of patients after major visceral surgery by providing a continuous step count feedback using activity tracking wristbands. The study was designed as a randomized controlled single-center trial (NCT02834338) with two arms (open and laparoscopic surgery). Participants were randomized to either receive feedback of their step counts using an activity tracker wristband or not. The primary study endpoint was the mean step count during the first 5 postoperative days (PODs). A total of 132 patients were randomized. After laparoscopic operations, the average step count during PODs 1–5 was significantly increased by the feedback compared with the control group (P

Although neoadjuvant radiochemotherapy (nRCTx) is an established oncological treatment in patients with advanced rectal cancer, little is known about its effects on the tumor microenvironment. Quantity and composition of tumor infiltrating lymphocytes (TILs) are known to influence patients' prognosis but nRCTx-induced modifications are still unclear. We determined the composition of the immune cell infiltrate in rectal cancer after nRCTx and its influence on tumor regression, local recurrence rate and survival. We investigated density and composition of tumor infiltrating CD3+ and CD8+ T-cells and the quantity and ratio of CD8+/GrzB+ T-cells to CD8+ T-cells in 130 rectal cancers after nRCTx compared to a cohort of 30 primarily resected rectal cancers. Furthermore, we analyzed 22 pretherapeutic rectal cancer biopsies, later treated with nRCTx and surgery to evaluate nRCTx-induced modifications of the tumor microenvironment. The total numbers of CD3+ and CD8+ T-cells in tumor stroma (p < 0.001) and tumor epithelium (p < 0.001 CD3; 0.002 CD8) were significantly lower in rectal cancers after nRCTx compared to primarily resected cases, while the ratio of CD8+/GrzB+ T-cells to CD8+ T-cells was significantly increased in the nRCTx cohort (p < 0.001). In multivariate analyses, CD8+/GrzB+ T-cells in the tumor stroma were significantly associated with high regression grade and a lower likelihood of local recurrence (p = 0.029). nRCTx modifies the tumor microenvironment of rectal cancer leading to a total decrease of TILs, but a relative increase in CD8+/GrzB+ T-cells in the tumor stroma. CD8+/GrzB+ T-cells may contribute to local tumor control and the better outcome.

Die Behandlungskonzepte des Rektumkarzinoms haben sich im letzten Jahrzehnt stark verandert und werden kontinuierlich weiterentwickelt. Moderne Rektumchirurgie findet heute im Rahmen multimodaler Therapiekonzepte in darauf spezialisierten High-Volume-Zentren mit guten Kurz- und Langzeitergebnissen statt. Evidenzbasierter Ubersichtsartikel zu aktuellen Konzepten in der onkologischen Rektumchirurgie. Mittels systematischer Literaturrecherche in Pubmed, Medline und manueller Recherche wurden relevante Publikationen bis September 2014 untersucht. Die flachendeckende Einfuhrung der totalen mesorektalen Exzision hat masgeblich zum deutlich verbesserten Langzeituberleben von Patienten mit einem Rektumkarzinom gefuhrt. Multimodale Therapiekonzepte sind heute ebenso wie laparoskopische Resektionen, Standard fur individuell selektionierte Patientengruppen. Rektumchirurgie findet heutzutage mit niedriger operativer Morbiditat und Mortalitat sowie guten onkologischen Langzeitergebnissen an spezialisierten High-Volume-Zentren statt.

A planar microstrip ring resonator structure on alumina was developed using the commercial FEM software COMSOL. Design parameters were evaluated, eventually leading to an optimized design of a miniaturized microwave gas sensor. The sensor was covered with a zeolite film. The device was successfully operated at around 8.5 GHz at room temperature as a humidity sensor. In the next step, an additional planar heater will be included on the reverse side of the resonator structure to allow for testing of gas-sensitive materials under sensor conditions.

A planar microstrip ring resonator structure on alumina was developed. It was covered with a zeolite film. The device was successfully operated at around 8.5 GHz at room temperature as a humidity sensor. In the next step, an additional planar heater will be included on the reverse side of the resonator structure to allow for testing of gas sensitive materials under sensor conditions.

Proceedings of the 2017 ACM International Joint Conference on Pervasive and Ubiquitous Computing and Proceedings of the 2017 ACM International Symposium on Wearable Computers (UbiComp '17), ISBN:9781450351904

Smectic liquid crystals with ‘de Vries-like’ properties are characterized by a maximum layer contraction of ≤1% upon transition from the orthogonal SmA phase to the tilted SmC phase. A defining structural characteristic of most ‘de Vries-like’ materials is a nanosegregating element that strongly promotes the formation of smectic layers. We show herein the effect of varying the length of a nanosegregating carbosilane end-group on ‘de Vries-like’ properties in three series of 5-phenyl-1,3,4-thiadiazole mesogens with chloro-terminated alkoxy chains (QL13-n, QL18-n and QL19-n). Shortening the end-group from a tricarbosilane to a monocarbosilane causes a decrease in ‘de Vries-like’ character, as measured by the reduction factor R, which is consistent with a decrease in nanosegregation and quality of the lamellar ordering. Measurements of the orientational order parameter S2 by 2D X-ray scattering of smectic monodomains show a concomitant increase in S2 that is consistent with the hypothesis that ‘de Vries-like’ behavior in these materials arises from a combination of high lamellar order and low orientational order. The requirement of a nanosegregating structural element to achieve ‘de Vries-like’ behavior is confirmed by the characterization of the chloro-terminated mesogen 2-(6-chlorohexyloxy)-5-(4-hexyloxyphenyl)-1,3,4-thiadiazole (QL28-6/6), which undergoes a SmA–SmC transition with a maximum layer contraction of 4.1% and behaves like a conventional smectogen.

Smectic liquid crystals with ‘de Vries-like’ properties are characterized by a maximum layer contraction of ≤1% upon transition from the orthogonal SmA phase to the tilted SmC phase. In an effort to expand the library of ‘de Vries-like’ liquid crystals required for the formulation of chevron-free ferroelectric liquid crystal mixtures, we report the synthesis of a homologous series of tricarbosilane 5-phenylpyrimidine liquid crystals QL16-n using an improved synthetic route, and the characterization of their liquid crystalline and ‘de Vries-like’ properties. Measurements of orientational order parameters S2 and effective molecular lengths Leff by monodomain 2D X-ray scattering suggest that ‘de Vries-like’ behavior in series QL16-n is due to the combined effect of an increase in S2 and a decrease in bilayer interdigitation, thus causing a smectic layer expansion that compensates for the molecular tilt in the SmC phase. We also show how the optical tilt angle in the SmC phase may be optimized for SSFLC displays—without compromising ‘de Vries-like’ properties—by shortening the tricarbosilane end-group to a dicarbosilane. Two of the new materials reported herein, 5-[4-(12,12,14,14,16,16-hexamethyl-12,14,16-trisilaheptadecyloxy)phenyl]-2-hexyloxypyrimidine (QL16-6) and 2-hexyloxy-5-[4-(12,12,14,14-tetramethyl-12,14-disilapentadecyloxy)phenyl]pyrimidine (QL24-6) rank among the best ‘de Vries-like’ materials reported heretofore, with broad SmC phases and reduction factors R of 0.17 and 0.18, respectively, at a reduced temperature T − TAC = −10 K. We also show that inverting the orientation of the 5-phenylpyrimidine core in the homologous series QL17-n causes a suppression of ‘de Vries-like’ properties. These results suggest that non-covalent core–core interactions in the intercalated smectic bilayers formed by these mesogens may influence ‘de Vries-like’ behavior.

Background Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. “Early mobilization” is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands. Methods/design Patients undergoing elective open and laparoscopic surgery of the colon, rectum, stomach, pancreas, and liver for any indication will be included. Further inclusion criteria are age between 18 and 75 years, American Society of Anesthesiologists Physical Status class less than IV, and a signed informed consent form. Patients will be stratified into two subgroups, laparoscopic and open surgery, and will be randomized 1:1 for automatic feedback of their step count using an activity tracker wristband. The control group will have no automatic feedback. The sample size (n = 30 patients in each of the four groups, overall n = 120) is calculated on the basis of an assumed difference in step count of 250 steps daily (intervention group versus control group). The primary study endpoint is the average step count during the first 5 postoperative days; secondary endpoints are the percentage of patients in the two groups who master the predefined mobilization (step count) targets, assessment of additional activity data obtained from the devices, assessment of preoperative mobility, length of hospital and intensive care unit stays, number of patients who receive physiotherapy, 30-day mortality, and overall 30-day morbidity. Discussion Early mobilization is a key element of ERAS. However, enhanced early mobilization is difficult to define, to assess objectively, and to implement in clinical practice. Consequently, there is a discrepancy between ERAS targets and actual practice, especially in patients undergoing major visceral surgery. This study is the first randomized controlled trial investigating the use and feasibility of activity tracking to monitor and enhance postoperative early mobilization. Trial registration ClinicalTrials.gov identifier: NCT02834338. Registered on 15 June 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1782-1) contains supplementary material, which is available to authorized users.

Background Postpartum Depression affects a considerable number of women worldwide. This condition inflicts severe consequences to mother and child health. Thus far, available treatments have low response and high relapse rates. We designed this trial to evaluate a safe and more efficacious innovative therapy. Aims To report a feasible and ethical study design to assess the safety and efficacy of a high frequency repetitive Transcranial Magnetic Stimulation 10 Hz (rTMS) compared to sham rTMS in women with moderate to severe Post-Partum Depression using standard treatment (sertraline). To conduct an ancillary, exploratory, randomized, active controlled, double blind study with a hypothesis to assess the safety and efficacy of 10 Hz rTMS compared to sertraline. Methods A multicenter, parallel arm, randomized, placebo-controlled, double-blind design to assess safety and efficacy of 10 Hz rTMS compared to sham. An ancillary study will be conducted with parallel arm, randomized, active controlled and double dummy design to assess safety and efficacy of 10 Hz rTMS compared to sertraline.

The sharing economy, the business of collectively using privately owned objects and services, has fuelled some of the fastest growing businesses of the past years. However, popular sharing platforms like Airbnb or Uber exhibit several drawbacks: a cumbersome sign up procedure, lack of participant privacy, overbearing terms and conditions, and significant fees for users. We demonstrate a Decentralised App (DAPP) for the sharing of everyday objects based on a smart contract on the Ethereum blockchain. This contract enables users to register and rent devices without involvement of a Trusted Third Party (TTP), disclosure of any personal information or prior sign up to the service. With increasing distribution of cryptocurrencies the use of smart contracts such as proposed in this paper has the potential to revolutionise the sharing economy., Proceedings of the 6th International Conference on the Internet of Things (IoT '16), ISBN:978-1-4503-4814-0