High vulnerability of juvenile Nathusius' pipistrelle bats (Pipistrellus nathusii) at wind turbines

Large numbers of bats are killed by wind turbines globally, yet the specific demographic consequences of wind turbine mortality are still unclear. In this study, we compared characteristics of Nathusius' pipistrelles (Pipistrellus nathusii) killed at wind turbines (N = 119) to those observed within the live population (N = 524) during the summer migration period in Germany. We used generalized linear mixed-effects modeling to identify demographic groups most vulnerable to wind turbine mortality, including sex (female or male), age (adult or juvenile), and geographic origin (regional or long-distance migrant; depicted by fur stable hydrogen isotope ratios). Juveniles contributed with a higher proportion of carcasses at wind turbines than expected given their frequency in the live population suggesting that juvenile bats may be particularly vulnerable to wind turbine mortality. This effect varied with wind turbine density. Specifically, at low wind turbine densities, representing mostly inland areas with water bodies and forests where Nathusius' pipistrelles breed, juveniles were found more often dead beneath turbines than expected based on their abundance in the live population. At high wind turbine densities, representing mostly coastal areas where Nathusius' pipistrelles migrate, adults and juveniles were equally vulnerable. We found no evidence of increased vulnerability to wind turbines in either sex, yet we observed a higher proportion of females than males among both carcasses and the live population, which may reflect a female bias in the live population most likely caused by females migrating from their northeastern breeding areas migrating into Germany. A high mortality of females is conservation concern for this migratory bat species because it affects the annual reproduction rate of populations. A distant origin did not influence the likelihood of getting killed at wind turbines. A disproportionately high vulnerability of juveniles to wind turbine mortality may reduce juvenile recruitment, which may limit the resilience of Nathusius' pipistrelles to environmental stressors such as climate change or habitat loss. Schemes to mitigate wind turbine mortality, such as elevated cut-in speeds, should be implemented throughout Europe to prevent population declines of Nathusius' pipistrelles and other migratory bats

Prozesssimulation beim Siegeln und Thermoformen

Viele Prozesse in der Verarbeitungs- und Verpackungstechnik sind durch eine komplexe Wechselwirkung der Wirkpaarung Verarbeitungsgut, i.d.R. Packstoff und/oder Füllgut sowie dem Arbeitsorganen gekennzeichnet. In den überwiegenden Fällen können die Vorgänge und Prozessgrößen im Prozess selbst nicht erfasst werden und einzig das Endergebnis des Vorgangs bewertet werden, worüber ein empirischer Zusammenhang zu dem Prozesseingangsgrößen hergestellt werden. Der Prozess selbst stellt sich dabei als „Black-Box“ dar, bei dem die orts- und zeitaufgelösten Prozessgrößen der Verarbeitungsgüter in der Regel unbekannt und auch messtechnisch nur schwer zu erfassen sind. Physikalische Prozesssimulationen erlauben die Zusammenhänge zwischen Prozessparametern (Stellgrößen des Prozesses) und den Prozessgrößen, wie beispielsweise vorherrschenden Temperaturen und deren Verteilung oder lokal wirkende Prozesskräfte und daraus resultierende Beanspruchungen der Verarbeitungsgüter unter Berücksichtigung der spezifischen Eigenschaften der Verarbeitungsgüter abzubilden. Vor diesem Hintergrund werden nachfolgend am Beispiel von Siegel- und Thermoformprozessen die Potenziale in Hinblick auf die Prozessanalyse und daraus abgeleiteter Prozessverbesserungen in der Kunststoffverarbeitung diskutiert

Integrale Prozessauslegung und digitales Thermoformen für optimale Ressourcennutzung

Das Thermoformen, umgangssprachlich auch als Tiefziehen bezeichnet, stellt neben dem Spritzguss ein zentrales Verfahren zur Herstellung formstabiler Verpackungen aus Folien dar. Vorrangig werden Produkte des alltäglichen Bedarfs wie Verpackungen für Lebensmittel, Pharmazeutika oder technische Produkte hergestellt. Aber auch technische Bauteile wie z.B. Gehäuse von Elektrogeräten, Verkleidungsteile von Fahrzeugen oder zunehmend auch Komponenten für die Biotechnologie, bspw. Gehäuse oder permeable Membranen. Allein die weltweite Nachfrage nach formstabilen Kunststoffverpackungen lag im Jahr 2010 bei einem Marktvolumen von 144 Mrd. $. Bei einer jährlichen Wachstumsrate von durchschnittlich 6$ ansteigt (Aranca 2012). In Europa werden jährlich ca. 12 Mrd. thermogeformte Verpackungen hergestellt. Der Anteil thermogeformter Produktverpackungen lag dabei im Jahr 2011 bei ca. 10%. Durch die weltweit steigende Nachfrage nach Kunststoffverpackungen, insbesondere aber durch die ökonomisch vorteilhaften Eigenschaften des Thermoformprozesses gegenüber anderen Herstellungsverfahren der Kunststoffverarbeitung, wird erwartet, dass der Anteil thermogeformter Produktverpackungen bis zum Jahr 2019 auf ein Marktvolumen von 17 Mrd. $ anwächst (ReportsnReports 2012 & ReportLinker 2014). [... aus der Einleitung

Heme oxygenase-1 genotype and restenosis after balloon angioplasty: a novel vascular protective factor

AbstractObjectivesWe investigated the association of the heme oxygenase-1 (HO-1) promoter genotype with the inflammatory response and restenosis after balloon angioplasty.BackgroundHeme oxygenase-1, which is induced by balloon angioplasty, can inhibit neointima formation and vascular remodeling. A dinucleotide repeat in the HO-1 gene promoter shows a length polymorphism that modulates HO-1 gene transcription. Short (<25 guanosine thymidine [GT]) repeats are associated with a 10-fold greater up-regulation of HO-1 than are longer repeats.MethodsWe studied 381 consecutive patients who underwent femoropopliteal balloon angioplasty (n = 210) and comparison groups with femoropopliteal stenting (n = 68) and lower limb angiography (n = 103). C-reactive protein (CRP) was measured at baseline, 24, and 48 h. We evaluated patency at six months by duplex sonography and assessed the association of the length of GT repeats in the HO-1 gene promoter with postintervention CRP and restenosis.ResultsRestenosis within six months was found in 74 patients (35%) after balloon angioplasty and in 21 patients (31%) after stenting. After balloon angioplasty, carriers of the short length (<25 GT) dinucleotide repeats had a lower postintervention CRP at 24 h (p = 0.009) and 48 h (p < 0.001) and a reduced risk for restenosis (adjusted relative risk 0.43, 95% confidence interval: 0.24 to 0.71, p < 0.001) compared with patients with longer alleles. After stenting or angiography, we found no association between the HO-1 genotype with CRP or restenosis.ConclusionsThe HO-1 promoter genotype that controls the degree of HO-1 up-regulation in response to stress stimuli is associated with the postintervention inflammatory response and the restenosis risk after balloon angioplasty

Rising Sound Intensity: An Intrinsic Warning Cue Activating the Amygdala

Human subjects overestimate the change of rising intensity sounds compared with falling intensity sounds. Rising sound intensity has therefore been proposed to be an intrinsic warning cue. In order to test this hypothesis, we presented rising, falling, and constant intensity sounds to healthy humans and gathered psychophysiological and behavioral responses. Brain activity was measured using event-related functional magnetic resonance imaging. We found that rising compared with falling sound intensity facilitates autonomic orienting reflex and phasic alertness to auditory targets. Rising intensity sounds produced neural activity in the amygdala, which was accompanied by activity in intraparietal sulcus, superior temporal sulcus, and temporal plane. Our results indicate that rising sound intensity is an elementary warning cue eliciting adaptive responses by recruiting attentional and physiological resources. Regions involved in cross-modal integration were activated by rising sound intensity, while the right-hemisphere phasic alertness network could not be supported by this stud

HOME MECHANICAL VENTILATION OF CHILDREN

The medical records of 89 ventilator-assisted children followed at the University of Michigan Medical Center from 1978 to 1993 were reviewed. The status of these children was remarkably stable. Parameters of communication, nutrition, education, and mobility changed very little over time, and fewer than half had to be rc-admitted. Children aged 9 to 12 years had the most nursing hours; in terms of diagnosis, those with spinal cord injury and bronchopulmonary dysplasia had the most. The younger children had the longest initial hospital stay and the most re-admissions. The authors conclude that appropriate rehabilitation during the initial hospitalization can minimize later changes, instability and rehospitalizations, and that careful follow-up and periodic evaluation can improve the patients' health and function. R SUM Ventilation assist e a domicile chez enfant: param tres ďune volution durant quinze ans ďexp rience Les dossiers m dicaux de 89 enfants ayant b n fici ďune ventilation assist e et suivis par le Centre M dical de Universit du Michigan entrc 1978 et 1993 ont t examines. tat de ces enfants est apparu remarquablement stable. Les param tres de communication, alimentation. ducation et d placements volu rent tr s peu et moms de la moiti des enfants devaient tre r hospitalis e. Les enfants de 9 12 ans cxigeaient le plus ďheures ďinfirmi re; de m me, en terme de diagnostic, les enfants avec lesions de la moelle epiniere ou une dysplasie broncho-pulmonaire. Les enfants les plus jeunes exigeaient le temps hospitalier initial le plus long et les r hospitalisations les plus fr quentes. Les auteurs concluent qu'une prise en charge appropri e durant hospitalisation initiate peut att nuer les modifications ult rieures, instabilit ou la r hospitalisation, et qu'un suivi soigneux et des valuations p riodiques peuvent am liorer la sant et les capacit s des patients. ZUSAMMENFASSUNG Heimbeatmimg von Kindern: Ver ndemngen nach 15 Jaliren Erfalirung Die Krankengeschichten von 89 Kindern mit assistierter Beatmung, die von 1978 zu 1993 in der Universitatsklinik von Michigan betreut wurden, sind durchgesehen worden. Der Zustand dieser Kinder war bemerkenswert stabil. Die Parameter f r Kommunikation, Ern hrung, Erziehung und Mobilit t nderten sich in diesem Zeitraum kaum und weniger als die H lfte mu ten wieder aufgenommen werden. Kinder im Alter zwischen 9 und 12 Jahren brauchten die meisten Pflegestunden, unter Ber cksichtigung der Diagnose hatten Kinder mit Riickenmarksverletzungen und bronchopulmonaler Dysplasie die meisten. Die j ngeren Kinder warcn am l ngsten in der Klinik und mu tcn am h ufigsten wieder aufgenommen werden. Die Autoren schlie en daraus, da eine ausreichende Rehabilitation beim ersten Krankenhausaufenthalt sp tere Ver nderungen, Instabilit ten und Rehospitalisierungen reduzieren und sorgf ltige Kontrollen und periodische Beurteilungen die Gesundheit und Funktion der Patienten verbessern k nnen. R SUM Ventilaci n mec nica de ni os a domicilio: par metros de cambio en una experiencia de quince a as Se revisaron las historias cl nicas de 89 ni os con ventilaci n asistida, seguidos en el Medical Center de la Universidad de Michigan dcsde 1978 a 1993. El estado de estos ni os era notablemente estable. Los par metros de comunicaci n, nutrici n, educaci n y movilidad cambiaron muy poco a lo largo del tiempo y s 1o tuvieron que reingresar menos de la mitad de ellos. Los ni os de 9 a 12 a os ten an el mayor numero de horas decuidados y en t rminos de diagn stico los ni os con lesion medular y displasia broncopulmonar necesitaban el m ximo de cuidados. Los ni os m s peque os presentaban el estadio inicial hospitalario m s largo y el mayor n mero de reingresos. Los autorcs concluyen que una apropiada rehabilitaci n durante el inicio de la hospitalizaci n puede minimizar los cambios posteriores, la inestabilidad y las rehospitalizaciones. Igualmente un seguimiento cuidadoso y evaluaciones peri dicas pueden mejorar la salud y la funcion de los pacientes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66446/1/j.1469-8749.1996.tb12140.x.pd

Systematic Review of the Performance of Noninvasive Tests in Diagnosing Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms

Context: Several noninvasive tests have been developed for diagnosing bladder outlet obstruction (BOO) in men to avoid the burden and morbidity associated with invasive urodynamics. The diagnostic accuracy of these tests, however, remains uncertain. Objective: To systematically review available evidence regarding the diagnostic accuracy of noninvasive tests in diagnosing BOO in men with lower urinary tract symptoms (LUTS) using a pressure-flow study as the reference standard. Evidence acquisition: The EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central, Google Scholar, and WHO International Clinical Trials Registry Platform Search Portal databases were searched up to May 18, 2016. All studies reporting diagnostic accuracy for noninvasive tests for BOO or detrusor underactivity in men with LUTS compared to pressure-flow studies were included. Two reviewers independently screened all articles, searched the reference lists of retrieved articles, and performed the data extraction. The quality of evidence and risk of bias were assessed using the QUADAS-2 tool. Evidence synthesis: The search yielded 2774 potentially relevant reports. After screening titles and abstracts, 53 reports were retrieved for full-text screening, of which 42 (recruiting a total of 4444 patients) were eligible. Overall, the results were predominantly based on findings from nonrandomised experimental studies and, within the limits of such study designs, the quality of evidence was typically moderate across the literature. Differences in noninvasive test threshold values and variations in the urodynamic definition of BOO between studies limited the comparability of the data. Detrusor wall thickness (median sensitivity 82%, specificity 92%), near- infrared spectroscopy (median sensitivity 85%, specificity 87%), and the penile cuff test (median sensitivity 88%, specificity 75%) were all found to have high sensitivity and specificity in diagnosing BOO. Uroflowmetry with a maximum flow rate of 10 mm was reported to have similar diagnostic accuracy, with median sensitivity of 68% and specificity of 75%. Conclusions: According to the literature, a number of noninvasive tests have high sensitivity and specificity in diagnosing BOO in men. However, although the majority of studies have a low overall risk of bias, the available evidence is limited by heterogeneity. While several tests have shown promising results regarding noninvasive assessment of BOO, invasive urodynamics remain the gold standard. Patient summary: Urodynamics is an accurate but potentially uncomfortable test for patients in diagnosing bladder problems such as obstruction. We performed a thorough and comprehensive review of the literature to determine if there were less uncomfortable but equally effective alternatives to urodynamics for diagnosing bladder problems. We found that some simple tests appear to be promising, although they are not as accurate. Further research is needed before these tests are routinely used in place of urodynamics. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.Peer reviewe

Medical Treatment of Nocturia in Men with Lower Urinary Tract Symptoms : Systematic Review by the European Association of Urology Guidelines Panel for Male Lower Urinary Tract Symptoms

Context: The treatment of nocturia is a key challenge due to the multi-factorial pathophysiology of the symptom and the disparate outcome measures used in research. Objective: To assess and compare available therapy options for nocturia, in terms of symptom severity and quality of life. Evidence acquisition: Medical databases (Embase, Medline, Cochrane Systematic Reviews, Cochrane Central) were searched with no date restriction. Comparative studies were included which studied adult men with nocturia as the primary presentation and lower urinary tract symptoms including nocturia or nocturnal polyuria. Outcomes were symptom severity, quality of life, and harms. Evidence synthesis: We identified 44 articles. Antidiuretic therapy using dose titration was more effective than placebo in relation to nocturnal voiding frequency and duration of undisturbed sleep; baseline serum sodium is a key selection criterion. Screening for hyponatremia (<130 mmol/l) must be undertaken at baseline, after initiation or dose titration, and during treatment. Medications to treat lower urinary tract dysfunction (alpha-1 adrenergic antagonists, 5-alpha reductase inhibitors, phosphodiesterase type 5inhibitor, antimuscarinics, beta-3 agonist, and phytotherapy) were generally not significantly better than placebo in short-term use. Benefits with combination therapies were not consistently observed. Other medications (diuretics, agents to promote sleep, nonsteroidal anti-inflammatories) were sometimes associated with response or quality of life improvement. The recommendations of the Guideline Panel are presented. Conclusions: Issues of trial designmake therapy of nocturia a challenging topic. The range of contributory factors relevant in nocturia makes it desirable to identify predictors of response to guide therapy. Consistent responses were reported for titrated antidiuretic therapy. For other therapies, responses were less certain, and potentially of limited clinical benefit. Patient summary: This review provides an overview of the current drug treatments of nocturia, which is the need to wake at night to pass urine. The symptom can be caused by several different medical conditions, and measuring its severity and impact varies in separate research studies. No single treatment deals with the symptom in all contexts, and careful assessment is essential to make suitable treatment selection. (C) 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.Peer reviewe

Get screened: a pragmatic randomized controlled trial to increase mammography and colorectal cancer screening in a large, safety net practice

Abstract Background Most randomized controlled trials of interventions designed to promote cancer screening, particularly those targeting poor and minority patients, enroll selected patients. Relatively little is known about the benefits of these interventions among unselected patients. Methods/Design "Get Screened" is an American Cancer Society-sponsored randomized controlled trial designed to promote mammography and colorectal cancer screening in a primary care practice serving low-income patients. Eligible patients who are past due for mammography or colorectal cancer screening are entered into a tracking registry and randomly assigned to early or delayed intervention. This 6-month intervention is multimodal, involving patient prompts, clinician prompts, and outreach. At the time of the patient visit, eligible patients receive a low-literacy patient education tool. At the same time, clinicians receive a prompt to remind them to order the test and, when appropriate, a tool designed to simplify colorectal cancer screening decision-making. Patient outreach consists of personalized letters, automated telephone reminders, assistance with scheduling, and linkage of uninsured patients to the local National Breast and Cervical Cancer Early Detection program. Interventions are repeated for patients who fail to respond to early interventions. We will compare rates of screening between randomized groups, as well as planned secondary analyses of minority patients and uninsured patients. Data from the pilot phase show that this multimodal intervention triples rates of cancer screening (adjusted odds ratio 3.63; 95% CI 2.35 - 5.61). Discussion This study protocol is designed to assess a multimodal approach to promotion of breast and colorectal cancer screening among underserved patients. We hypothesize that a multimodal approach will significantly improve cancer screening rates. The trial was registered at Clinical Trials.gov NCT00818857http://deepblue.lib.umich.edu/bitstream/2027.42/78264/1/1472-6963-10-280.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78264/2/1472-6963-10-280.pdfPeer Reviewe