Ein ungewöhnlicher Einsatz von Akupunktur bei unklarer Bewusstlosigkeit

Zusammenfassung: Ein tief bewusstloser Patient stellt den Notarzt vor eine besondere Herausforderung, vor allem wenn eine psychogene Ursache vermutet wird, aber eine organische Ursache nicht ausgeschlossen werden kann. Beschrieben wird der Fall einer Patientin, die nach Stimulation am Akupunkturpunkt Lenkergefäß26 durch den Notarzt zweimal aus einer tiefen Bewusstlosigkeit erwachte und mit unauffälligem neurologischem Befund in eine psychiatrische Klinik eingewiesen werden konnte. Als Diagnose wurde eine akute Belastungsreaktion mit dissoziativem Stupor gestellt. Der Fall zeigt, dass Akupunktur bei unklaren komatösen Zuständen mit Verdacht auf psychogene Ursache als Therapieversuch unternommen werden kan

Invasive Techniken in der Notfallmedizin: IV. Koniotomie im Notarztdienst

Zusammenfassung: Die Koniotomie im Notarztdienst ist eine sehr invasive Methode zur Atemwegssicherung. Sie ist aber unabdingbar, wenn andere weniger invasive Verfahren der Atemwegssicherung misslingen oder sich situationsabhängig als nicht zweckmäßig erweisen. Für die Durchführung wurden verschiedene Verfahren beschrieben, die in anatomisch-chirurgische Präpariertechniken und Punktionsverfahren unterteilt werden können. Das im jeweiligen Notarztsystem bevorzugte Verfahren orientiert sich meist an abteilungsüblichen Standards, die vom klinischen Vorgehen abgeleitet werden. Ausbildungs- und Trainingsmöglichkeiten für die einzelnen Verfahren bestehen in der Intensivmedizin, am Leichenpräparat und am Phantom. In dieser Arbeit werden verschiedene Methoden der Koniotomie besprochen sowie eine anatomische Präpariertechnik und 2Punktionsverfahren im Detail dargestell

Extending the theory of Owicki and Gries with a logic of progress

This paper describes a logic of progress for concurrent programs. The logic is based on that of UNITY, molded to fit a sequential programming model. Integration of the two is achieved by using auxiliary variables in a systematic way that incorporates program counters into the program text. The rules for progress in UNITY are then modified to suit this new system. This modification is however subtle enough to allow the theory of Owicki and Gries to be used without change

Which mathematics for the Information Society?

MathIS is a new project that aims to reinvigorate secondary- school mathematics by exploiting insights of the dynamics of algorithmic problem solving. This paper describes the main ideas that underpin the project. In summary, we propose a central role for formal logic, the development of a calculational style of reasoning, the emphasis on the algorithmic nature of mathematics, and the promotion of self-discovery by the students. These ideas are discussed and the case is made, through a number of examples that show the teaching style that we want to introduce, for their relevance in shaping mathematics training for the years to come. In our opinion, the education of software engineers that work effectively with formal methods and mathematical abstractions should start before university and would benefit from the ideas discussed here.Long-term collaboration with J. N. Oliveira on calculational approaches to mathematics is deeply acknowledged. We are also grateful to the anonymous referees for their valuable comments. This research was supported by FCT (the Portuguese Foundation for Science and Technology), in the context of the MATHIS Project under contract PTDC/EIA/73252/2006. The work of Joao F. Ferreira and AlexandraMendeswas further supported by FCT grants SFRH/BD/24269/2005 and SFRH/BD/29553/2006, respectively

Plasma afterglow-assisted oxidation of iron–copper bilayers

International audienceIron layers with variable thicknesses, deposited onto copper thin films, are oxidized by a plasma afterglow at atmospheric pressure. Such a bilayer arrangement enables the growth of caterpillar-like patterns covered by CuO and Fe2O3 nanostructures. Two main mechanisms are at stake: either copper comes up to the surface through cracks or boundaries between the columns of the coating, or it diffuses through parts of the Fe2O3 layer made permeable by tensile stress. Structures grown by the former mechanisms are characterized by a central channel, whereas those grown by the latter exhibit a plane interface above which stands an equiaxed grain heap. This result was used to localize the growth of nanowires in cracks formed priory to the afterglow-assisted treatment. By resorting to XPS microscopy experiments carried out with the scanning photoelectron microscope at the ESCAMicroscopy beamline of the Elettra synchrotron facility in Trieste, we could gain access to the surface composition of a single isolated pattern

A supraomohyoidal plexus block designed to avoid complications

Interscalene blocks of the brachial plexus are used for surgery of the shoulder and are frequently associated with complications such as temporary phrenic block, Horner syndrome or hematoma. To minimize the risk of these complications, we developed an approach that avoids medially directed needle advancement and favors spread to lateral regions only: the supraomohyoidal block. We tested this procedure in 11 cadavers fixed by Thiel's method. The insertion site is at the lateral margin of the sternocleidomastoid muscle at the level of the cricoid cartilage. The needle is inserted in the axis of the plexus with an angle of approximately 35° to the skin, and advanced in lateral and caudal direction. Distribution of solution was determined in ten cadavers after bilateral injection of colored solution (20 and 30ml) and followed by dissection. In an eleventh cadaver, computerized tomography and 3D reconstruction after radio contrast injection was performed. In additional five cadavers we performed Winnie's technique with bilateral injection (20 and 30ml).Concerning the supraomohyoidal block the injection mass reached the infraclavicular region surrounded all trunks of the brachial plexus in the supraclavicular region and the suprascapular nerve in all cases. The solution did not spread medially beyond the lateral margin of the anterior scalene muscle into the scalenovertebral triangle. Therefore, phrenic nerve, stellate ganglion, laryngeal nerve nor the vertebral artery were exposed to the injected solution. Distribution was comparable with the use of 20 and 30ml of solution. Injections on five cadavers performing the interscalene block of Winnie resulted in an extended spread medially to the anterior scalene muscle.We conclude that our method may be a preferred approach due to its safety, because no structures out of interest were reached. Solution of 20ml is suggested to be enough for a successful bloc

Do Semantics Matter in Empathetic Person Perception of Children or Adults with Mental Illness?

Experiences of stigma, discrimination, or aggression negatively affect the well-being of people experiencing symptoms of psychopathology. However, empathy is thought to undermine prejudice and discrimination and is linked with positive outcomes (e.g., greater well-being, more social support, etc.) among those with stigmatized mental illnesses. The current work investigates the influence of target age (adult or child) and language type (person-first or identity-first) on how much empathic concern perceivers report toward individuals with a hypothetical mental health condition. This research contributes to an ongoing debate about whether person-first or identity-first language carries stigmatizing or protective effects, while also considering a novel potential moderator: target age (i.e., does person-first and identity-first language similarly affect perceptions of adults and children?). To this end, we employed an experimental vignette design examining empathy expressed toward individuals with a mental health condition, where age was manipulated within subjects and language was manipulated between subjects. The results determine that perceivers report greater empathy towards children than adults. However, the use of person-first and identity-first language did not result in significant findings. Thus, whether language type influences empathic concern remains uncertain. These findings suggest a need for increased empirical examination of interventions to inspire empathy towards people, perhaps especially adults, experiencing symptoms of psychopathology

Nanostructures design by plasma afterglow-assisted oxidation of iron–copper thin films

International audienceOxidizing thin films made of Fe-Cu alloy with an Ar-O 2 micro-afterglow operated at atmospheric pressure shows remarkable growth processes. The presence of iron in copper up to about 50% leads to the synthesis of CuO nanostructures (nanowalls, nanotowers and nanowires). Nanotowers show the presence of an amorphous phase trapped between crystalline domains. Beyond 50%, Fe 2 O 3 iron nano-blades are also found. CuO nanowires as small as 5 nm in diameter can be synthesized. Thanks to the presence of patterned domains induced by buckling, it was possible to show that the stress level decreases when the iron content in the alloy increases. Iron blades grow from the inner Fe 2 O 3 layer through the overlying CuO if it is thin enough

Characterization of novel \u3ci\u3eBrown midrib 6\u3c/i\u3e mutations affecting lignin biosynthesis in sorghum

The presence of lignin reduces the quality of lignocellulosic biomass for forage materials and feedstock for biofuels. In C4 grasses, the brown midrib phenotype has been linked to mutations to genes in the monolignol biosynthesis pathway. For example, the Bmr6 gene in sorghum (Sorghum bicolor) has been previously shown to encode cinnamyl alcohol dehydrogenase (CAD), which catalyzes the final step of the monolignol biosynthesis pathway. Mutations in this gene have been shown to reduce the abundance of lignin, enhance digestibility, and improve saccharification efficiencies and ethanol yields. Nine sorghum lines harboring five different bmr6 alleles were identified in an EMS-mutagenized TILLING population. DNA sequencing of Bmr6 revealed that the majority of the mutations impacted evolutionarily conserved amino acids while three-dimensional structural modeling predicted that all of these alleles interfered with the enzyme’s ability to bind with its NADPH cofactor. All of the new alleles reduced in vitro CAD activity levels and enhanced glucose yields following saccharification. Further, many of these lines were associated with higher reductions in acid detergent lignin compared to lines harboring the previously characterized bmr6-ref allele. These bmr6 lines represent new breeding tools for manipulating biomass composition to enhance forage and feedstock quality

Biomineral repair of Abalone shell apertures

The shell of the gastropod mollusc, abalone, is comprised of nacre with an outer prismatic layer that is composed of either calcite or aragonite or both, depending on the species. A striking characteristic of the abalone shell is the row of apertures along the dorsal margin. As the organism and shell grow, new apertures are formed and the preceding ones are filled in. Detailed investigations, using electron backscatter diffraction, of the infill in three species of abalone: Haliotis asinina, Haliotis gigantea and Haliotis rufescens reveals that, like the shell, the infill is composed mainly of nacre with an outer prismatic layer. The infill prismatic layer has identical mineralogy as the original shell prismatic layer. In H. asinina and H. gigantea, the prismatic layer of the shell and infill are made of aragonite while in H. rufescens both are composed of calcite. Abalone builds the infill material with the same high level of biological control, replicating the structure, mineralogy and crystallographic orientation as for the shell. The infill of abalone apertures presents us with insight into what is, effectively, shell repair