43 research outputs found

    BariSurg trial: Sleeve gastrectomy versus Roux-en-Y gastric bypass in obese patients with BMI 35–60 kg/m2 – a multi-centre randomized patient and observer blind non-inferiority trial

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    Background: Roux-en-Ygastric bypass (RYGB) and sleeve gastrectomy (SG) rank among the most frequently applied bariatric procedures worldwide due to their positive risk/benefit correlation. A systematic review revealed a similar excess weight loss (EWL) 2 years postoperatively between SG and RYGB. However, there is a lack of randomized controlled multi-centre trials comparing SG and RYGB, not only concerning EWL, but also in terms of remission of obesity-related co-morbidities, gastroesophageal reflux disease (GERD) and quality of life (QoL) in the mid- and long-term. Methods: The BariSurg trial was designed as a multi-centre, randomized controlled patient and observer blind trial. The trial protocol was approved by the corresponding ethics committees of the centres. To demonstrate EWL non-inferiority of SG compared to RYGB, power calculation was performed according to a non-inferiority study design. Morbidity, mortality, remission of obesity-related co-morbidities, GERD course and QoL are major secondary endpoints. 248 patients between 18 and 70 years, with a body mass index (BMI) between 35–60 kg/m2 and indication for bariatric surgery according to the most recent German S3-guidelines will be randomized. The primary and secondary endpoints will be assessed prior to surgery and afterwards at discharge and at the time points 3–6, 12, 24, 36, 48 and 60 months postoperatively. Discussion: With its five year follow-up, the BariSurg-trial will provide further evidence based data concerning the impact of SG and RYGB on EWL, remission of obesity-related co-morbidities, the course of GERD and QoL. Trial registration: The trial protocol has been registered in the German Clinical Trials Register DRKS0000476

    Micro-Raman Mapping of 3C-SiC Thin Films Grown by Solid–Gas Phase Epitaxy on Si (111)

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    A series of 3C-SiC films have been grown by a novel method of solid–gas phase epitaxy and studied by Raman scattering and scanning electron microscopy (SEM). It is shown that during the epitaxial growth in an atmosphere of CO, 3C-SiC films of high crystalline quality, with a thickness of 20 nm up to few hundreds nanometers can be formed on a (111) Si wafer, with a simultaneous growth of voids in the silicon substrate under the SiC film. The presence of these voids has been confirmed by SEM and micro-Raman line-mapping experiments. A significant enhancement of the Raman signal was observed in SiC films grown above the voids, and the mechanisms responsible for this enhancement are discussed

    MRI of the lung (2/3). Why … when … how?

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    Background Among the modalities for lung imaging, proton magnetic resonance imaging (MRI) has been the latest to be introduced into clinical practice. Its value to replace X-ray and computed tomography (CT) when radiation exposure or iodinated contrast material is contra-indicated is well acknowledged: i.e. for paediatric patients and pregnant women or for scientific use. One of the reasons why MRI of the lung is still rarely used, except in a few centres, is the lack of consistent protocols customised to clinical needs. Methods This article makes non-vendor-specific protocol suggestions for general use with state-of-the-art MRI scanners, based on the available literature and a consensus discussion within a panel of experts experienced in lung MRI. Results Various sequences have been successfully tested within scientific or clinical environments. MRI of the lung with appropriate combinations of these sequences comprises morphological and functional imaging aspects in a single examination. It serves in difficult clinical problems encountered in daily routine, such as assessment of the mediastinum and chest wall, and even might challenge molecular imaging techniques in the near future. Conclusion This article helps new users to implement appropriate protocols on their own MRI platforms. Main Messages • MRI of the lung can be readily performed on state-of-the-art 1.5-T MRI scanners. • Protocol suggestions based on the available literature facilitate its use for routine • MRI offers solutions for complicated thoracic masses with atelectasis and chest wall invasion. • MRI is an option for paediatrics and science when CT is contra-indicate

    Factors associated with reduced longer-term capacity to work in patients after polytrauma : a Swiss trauma center experience

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    Knowledge of the factors associated with longer-term reduced capacity to work (RCW) is lacking in patients after polytrauma

    Neutral beam energy and power requirements for expanding radius and full bore startup of tokamak reactors

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    Natural beam power and energy requirements are compared for full density full bore and expanding radius startup scenarios in an elongated plasma, The Next Step (TNS), as a function of beam pulse time and plasma density. Because of the similarity of parameters, the results should also be applicable to Engineering Test Facility (ETF) and International Tokamak Reactor (INTOR) studies. A transport model consisting of neoclassical ion conduction and anomalous electron conduction and diffusion based on ALCATOR scaling leads to average densities in the range approx. 0.8 to 1.2 x 10/sup 14/ cm/sup -3/ being sufficient for ignition. Neutral deuterium beam energies in the range 120 to 180 keV are adequate for penetration, with the required power injected into the plasma decreasing with increasing beam energy. The neutral beam power decreases strongly with increasing beam pulse length b/sub b/ until t/sub b/ exceeds a few total energy confinement times, yielding b/sub b/ approx. = 4 to 6 s for the TNS plasma
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