Flowcytometric assessment of fetomaternal hemorrhage during external cephalic version at term

External cephalic version (ECV) at term is a safe procedure and reduces the incidence of cesarean sections for breech presentation. One of the known complications, however, is an ECV-related disruption of the placental barrier and a subsequent transfusion of fetal blood into maternal circulation. While the incidence of ECV-related fetomaternal hemorrhage (FMH) has been determined recently in a large trial using a manual Kleihauer-Betke test (KBT), questions remain on the amount of ECV-related FMH. KBT, which detects fetal red blood cells (RBC) on the basis of acidic resistance of fetal hemoglobin (HbF), is known to be a sensitive test, yet prone to procedural errors limiting its accuracy in quantifying FMH. In this study we investigated 50 patients for FMH before and after ECV, using a dual-color flow cytometric test kit with a lower limit of quantification of 0.05% fetal RBC in maternal peripheral blood. Three patients had a quantifiable increase of fetal RBC detected after ECV (0.06%; 0.08%; 0.1%). None of these subtle increments was predictable by ECV-related clinical parameters or translated into fetal compromise. Using a sensitive and accurate flow cytometric test method, our data provide further assurance to mothers on the safety of ECV at term

Prediction of crack growth based on a hierarchical diffusion model

A general Bayesian approach for stochastic versions of deterministic growth models is presented to provide predictions for crack propagation in an early stage of the growth process. To improve the prediction, the information of other crack growth processes is used in a hierarchical (mixed-effects) model. Two stochastic versions of a deterministic growth model are considered. One is a nonlinear regression setup where the trajectory is assumed to be the solution of an ordinary differential equation with additive errors. The other is a diffusion model defined by a stochastic differential equation (SDE) where increments have additive errors. Six growth models in the two versions are compared with respect to their ability to predict the crack propagation in a large data example. Two of them are based on the classical Paris-Erdogan law for crack growth, and four are other widely used growth models. It turned out that the three-parameter Paris-Erdogan model and the Weibull model provide the best results followed by the logistic model. Suprisingly, the SDE approach has no advantage for the prediction compared with the nonlinear regression setup

Einführung des outputorientierten Haushalts bei kirchlichen Körperschaften: Konzeptionelle Grundsätze und erste Überlegungen zur Implementierung eines entscheidungsorientiertes Rechnungswesen

Auch auf dem Hintergrund der bereits vorliegenden Ergebnisse der Rats-AG ist es richtig, wenn die Kirchen die vorwiegend in den Kommunen entwickelten Modelle der neuen Steuerungsinstrumente nicht 1 zu 1 übernehmen, sondern auf ihre Belange und ihre Anforderungsprofile ausrichten. Nicht zuletzt deshalb ist es inzwischen kein Thema mehr, dass die Umstellung auch ein neues Buchhaltungssystem (z.B. kaufmännisches Rechnungswesen) erfordern würde. Die Instrumente der erweiterten Betriebskameralistik sowie die von der KIGST angebotenen Finanzwesenprogramme mit den Verbundrechnung als Grundphilosophie reichen für die kirchlichen Belange und der damit verbundenen Anforderungen vollkommen aus. Dies erleichtert den Verwaltungen wesentlich den technischen Paradigmenwechsel zu vollziehen. Auch ist mit einer solchen Entscheidung keineswegs ausgeschlossen, mittel- bis langfristig den sanften und gleitenden Übergang in ein kaufmännisch orientiertes Rechnungswesen vorzunehmen. --

Contributions of open-loop and closed-loop control in a continuous tracking task differ depending on attentional demands during practice

We provide tracking data of the analysed segments after filtering, cognitive performance data and indivdual force levels. To this end, the data set contains three zip-files of numbers of csv-files and an additional csv-file. In each csv-file, comma delimits information within the rows. Participant numbers range between 1 and 21 where the first 11 numbers always refer to the participants of the single-task training group and the final 10 numbers refer to the participants of the dual-task training group. The IndividualForceMaximum.csv includes separate rows of participant’s information about training group, individual force maximum, and the 10% value of the force maximum, which was important for adapting the required force to the individual applicable leg force. The CognitiveTaskData.zip contains four csv-files. Two files are for the TEST sessions, which include either the total number of responses or the number of correct responses per trial for each participant within a row. The other two files are for the TRAINING data (either total number of responses or number of correct responses) of the cognitive task for the participants of the dual-task training group. The file includes 15 trials of the first and the last five training days (i.e., days 1 to 5, and days 18 to 22). For each participant the training data is presented in a row. The tracking data is split with respect to the training groups in either the single-task training group, i.e., MotorTaskData_SingleTaskTrainingGroup.zip, or the dual-task training group, i.e., MotorTaskData_DualTaskTrainingGroup.zip. Each of the zip-files includes TESTING and TRAINING data in csv-files for each participant P separately. We further separated the TEMPLATE data and the PERFORMANCE data, i.e., for instance template test file of P1 corresponds with performance test file of P1. Each trial is presented in a row, where the header includes the segment information (i.e., first segment = 1, second segment = 2, and third segment = 3) for each data point. TEST data include trials with the practiced second segment and the catch trials with another second segment. TRAINING data include the 15 trials of the first and the last five training days (i.e., days 1 to 5, and days 18 to 22)

Bayesian prediction for a jump diffusion process with application to crack growth in fatigue experiments

In many felds of technological developments, understanding and controlling material fatigue is an important point of interest. This article is concerned with statistical modeling of the damage process of prestressed concrete under low cyclic load. A crack width process is observed which exhibits jumps with increasing frequency. Firstly, these jumps are modeled using a Poisson process where two intensity functions are presented and compared. Secondly, based on the modeled jump process, a stochastic process for the crack width is considered through a stochastic differential equation (SDE). It turns out that this SDE has an explicit solution. For both modeling steps, a Bayesian estimation and prediction procedure is presented

Interrupting Trauma with Hope, Kindness, Art and Healing

ArtForce Iowa is a 501c3 nonprofit organization based in Des Moines Iowa. Founded in 2012, ArtForce Iowa has a mission to transform youth in need through art. ArtForce Iowa has pioneered a non-pathologizing approach to working with children targeted as in need of services. We offer a critical humanizing perspective through case studies. Seven youth artists are highlighted to provide windows into complicated, troubling, and hopeful effects of their relationship with their own healing. This article aims to shed light on the promise and innovation of authentic supportive kindness and youth leadership to support the social and emotional lives of children from marginalized communities

Principles for innovation management in family firms: An analysis of long-term successful good practices with a practitioner validation of the principles

Purpose: Family firms (FF) reveal a considerable heterogeneity in their innovation behavior. Due to the successful long-term preservation of their innovation capacity via special resources and routines, multi-generational FF are of special interest in terms of learning from good practices. Against this background, the purpose of this paper is to ascertain principles for successful innovation behavior in long-term successful FF and to contribute to bridging the theory-practice gap. Design/method/Approach: Results are generated by analyzing innovation and innovation processes in five cases of long-term successful FF. On the basis of these good practice cases, the "rules of the game" of innovating are re-constructed using fine and system analyses based on narrative interviews with the FF CEOs. Findings: Intense reflection on the innovation characteristics of the five good practice cases along with a critical examination of the literature on innovation in FF were used to derive practical suggestions for FF in the form of 11 principles for FF taking a proactive interest in innovation. Practical implications: The 11 generated principles of successfully innovative FF were validated by FF CEOs who confirmed the practical relevance of these principles as valuable guidelines for successful innovation. Owners and managers may reflect on these principles against the background of the innovation behavior of their firms and adapt them to their contextual conditions. Originality/value: These principles serve as tangible suggestions for developing adequate innovation management strategies for individual FF. Furthermore, two FF CEOs were invited to comment on the viability of principles based on their comprehensive practical experience

A proposed conceptualization of therapeutic competence: the three level model

A model of therapeutic competence that equally satisfies the requirements of practice and research is still lacking. The existing models are not widely accepted, at least partially because the postulated competences can often not be operationalized in a satisfactory manner. Yet, in order to be measurable, therapeutic competences need to be operationalized. We present the Three Level Model of Therapeutic Competence as a working model for studying therapeutic competence. The model proposes that therapeutic competence develops based on rather stable individual Dispositions, which promote the acquisition of therapeutic competences. We further distinguish between Basic Competences, which are mostly independent of the theoretical orientation of the therapeutic approach, and Specific Competences, which are defined based on the theoretical underpinnings of a therapeutic orientation (e.g. Cognitive Behavioral Therapy). We describe this model and outline how it can be used to operationalize and assess therapeutic competence

Severe immune dysregulation with neurological impairment and minor bone changes in a child with spondyloenchondrodysplasia due to two novel mutations in the ACP5 gene

Spondyloenchondrodysplasia (SPENCD) is a rare skeletal dysplasia, characterized by metaphyseal lesions, neurological impairment and immune dysregulation associated with lupus-like features. SPENCD is caused by biallelic mutations in the ACP5 gene encoding tartrate-resistant phosphatase. We report on a child, who presented with spasticity, multisystem inflammation, autoimmunity and immunodeficiency with minimal metaphyseal changes due to compound heterozygosity for two novel ACP5 mutations. These findings extend the phenotypic spectrum of SPENCD and indicate that ACP5 mutations can cause severe immune dysregulation and neurological impairment even in the absence of metaphyseal dysplasia