Gefäßchirurgische Ausbildung in endovaskulären Techniken am Universitären Gefäßzentrum Aarau-Basel

Zusammenfassung: Endovaskuläre Techniken gewinnen in der gefäßchirurgischen Praxis zunehmend an Bedeutung und müssen deshalb in die Ausbildung integriert werden. Die gefäßchirurgische Ausbildung in der Schweiz umfasst nach neuen Richtlinien das Beherrschen von endovaskulären Techniken und fordert die Durchführung von mindestens 50 Katheterisierungen/Angiographien und 25 interventionellen Eingriffen. An unserer Klinik stützt sich die interventionelle Ausbildung auf verschiedene Pfeiler. Wichtig ist eine gute interdisziplinäre Zusammenarbeit mit der Abteilung für interventionelle Radiologie, die konsequente Durchführung der Kontrollangiographie bei offenen Operationen und Virtual-Reality-Training. Unter diesen Bedingungen ist eine Ausbildung möglich, die den schweizerischen Richtlinien entspricht. Verbesserungspotenzial sehen wir v.a. in festen Kooperationsvereinbarungen mit der interventionellen Radiologi

McCune-Albright syndrome and the extraskeletal manifestations of fibrous dysplasia

Fibrous dysplasia (FD) is sometimes accompanied by extraskeletal manifestations that can include any combination of café-au-lait macules, hyperfunctioning endocrinopathies, such as gonadotropin-independent precocious puberty, hyperthyroidism, growth hormone excess, FGF23-mediated renal phosphate wasting, and/or Cushing syndrome, as well as other less common features. The combination of any of these findings, with or without FD, is known as McCune-Albright syndrome (MAS). The broad spectrum of involved tissues and the unpredictable combination of findings owe to the fact that molecular defect is due to dominant activating mutations in the widely expressed signaling protein, Gsα, and the fact these mutations arises sporadically, often times early in development, prior to gastrulation, and can distribute across many or few tissues

Quality control of CarboEurope flux data ? Part II: Inter-comparison of eddy-covariance software

International audienceAs part of the quality assurance and quality control activities within the CarboEurope-IP network, a comparison of eddy-covariance software was conducted. For four five-day datasets, CO2 flux estimates were calculated by seven commonly used software packages to assess the uncertainty of CO2 flux estimates due to differences in post-processing. The datasets originated from different sites representing different commonly applied instrumentation and different canopy structures to cover a wide range of realistic conditions. Data preparation, coordinate rotation and the implementation of the correction for high frequency spectral losses were identified as crucial processing steps leading to significant discrepancies in the CO2 flux results. The overall comparison indicated a good although not yet perfect agreement among the different software within 5?10% difference for 30-min CO2 flux values. Conceptually different ideas about the selection and application of processing steps were a main reason for the differences in the CO2 flux estimates observed. A balance should be aspired between scientific freedom on the one hand, in order to advance methodical issues, and standardisation of procedures on the other hand, in order to obtain comparable fluxes for multi-site synthesis studies

Kinetics of neuropeptide Y, catecholamines, and physiological responses during moderate and heavy intensity exercises.

Neuropeptide Y 1-36 (NPY1-36) is a vasoconstrictor peptide co-secreted with norepinephrine (NE) by nerve endings during sympathetic activation. NPY1-36 potentiates NE action post-synaptically through the stimulation of the Y1 receptor, whereas its metabolite NPY3-36 resulting from DPP4 action activates Y2 presynaptic receptors, inhibiting NE and acetylcholine secretion. The secretions of NPY1-36 and NPY3-36 in response to sympathetic nervous system activation have not been studied due to the lack of analytical techniques available to distinguish them. We determined in healthy volunteers NPY1-36, NPY3-36 and catecholamine kinetics and how these neurotransmitters modulate the physiological stress response during and after moderate- and heavy-intensity exercises. Six healthy males participated in this randomized, double-blind, saxagliptin vs placebo crossover study. The volunteers performed an orthostatic test, a 30-min exercise at moderate intensity and a 15-min exercise at heavy intensity each followed by 50 min of recovery in two separate sessions with saxagliptin or placebo. Oxygen consumption (V̇O <sub>2</sub> ), ventilation and heart rate were continuously recorded. NE, epinephrine, NPY1-36 and NPY3-36 were quantified by tandem mass spectrometry. We found that exercise triggers NPY1-36 and NE secretion in an intensity-dependent manner and that NE returns faster to the baseline concentration than NPY1-36 after exercise. NPY3-36 rises during recovery parallel to the decline of NPY1-36. Saxagliptin reverses the NPY1-36/NPY3-36 ratio but does not affect hemodynamics, nor NPY1-36 and catecholamine concentrations. We found that NPY1-36 half-life is considerably shorter than previously established with immunoassays. NPY1-36 and NE secretions are finely regulated to prevent an excessive physiological Y1 stimulating response to submaximal exercise

SafeWeb: A Middleware for Securing Ruby-Based Web Applications

Web applications in many domains such as healthcare and finance must process sensitive data, while complying with legal policies regarding the release of different classes of data to different parties. Currently, software bugs may lead to irreversible disclosure of confidential data in multi-tier web applications. An open challenge is how developers can guarantee these web applications only ever release sensitive data to authorised users without costly, recurring security audits. Our solution is to provide a trusted middleware that acts as a “safety net” to event-based enterprise web applications by preventing harmful data disclosure before it happens. We describe the design and implementation of SafeWeb, a Ruby-based middleware that associates data with security labels and transparently tracks their propagation at different granularities across a multi-tier web architecture with storage and complex event processing. For efficiency, maintainability and ease-of-use, SafeWeb exploits the dynamic features of the Ruby programming language to achieve label propagation and data flow enforcement. We evaluate SafeWeb by reporting our experience of implementing a web-based cancer treatment application and deploying it as part of the UK National Health Service (NHS)

Coulomb Drag Between Parallel Ballistic Quantum Wires

The Coulomb drag between parallel, {\it ballistic} quantum wires is studied theoretically in the presence of a perpendicular magnetic field B. The transresistance R_D shows peaks as a function of the Fermi level and splitting energy between the 1D subbands of the wires. The sharpest peaks appear when the Fermi level crosses the subband extrema so that the Fermi momenta are small. Two other kinds of peaks appear when either {\it intra}- or {\it inter}-subband transitions of electrons have maximum probability; the {\it intra}-subband transitions correspond to a small splitting energy. R_D depends on the field B in a nonmonotonic fashion: it decreases with B, as a result of the suppression of backscattering, and increases sharply when the Fermi level approaches the subband bottoms and the suppression is outbalanced by the increase of the Coulomb matrix elements and of the density of states.Comment: Text 14 pages in Latex/Revtex format, 4 Postscript figures. Phys. Rev. B,in pres

Quantification of serotonin and eight of its metabolites in plasma of healthy volunteers by mass spectrometry.

Serotonin is transformed into melatonin under the control of the light/dark cycle, representing a cornerstone of circadian rhythmicity. Serotonin also undergoes extensive metabolism to produce 5-hydroxyindoleacetic acid (5-HIAA), a biomarker for the diagnosis and monitoring of serotonin secreting neuroendocrine tumors (NETs). While serotonin, melatonin and their metabolites are part of an integrated comprehensive system, human observations about their respective plasma concentrations are still limited. We report here for the first time a multiplex UHPLC-MS/MS assay for the quantification of serotonin, 5-HIAA, 5-hydroxytryptophol (5-HTPL), N-acetyl-serotonin (NAS), Mel, 6-OH-Mel, 5-methoxytryptamine (5-MT), 5-methoxytryptophol (5-MTPL), and 5-methoxyindoleacetic acid (5-MIAA) in human plasma. Analytes were extracted by protein precipitation and solid phase extraction. Plasma concentrations for these analytes were determined in 102 healthy volunteers. The LLOQ of the assay ranges from 2.2 nM for serotonin to 1.0 pM for 6-OH-Mel. This sensitivity enables the quantification of circulating serotonin, 5-HIAA, NAS, Mel, and 5-MIAA, even at their lowest diurnal concentrations. This assay will enable specific, precise and accurate measurement of serotonin, Mel and their metabolites to draw a detailed picture of this complex pineal metabolism, allowing a dynamic understanding of these pathways and providing promising biomarkers and a metabolic signature for serotonin-secreting NETs

The many faces of publish/subscribe

Well adapted to the loosely coupled nature of distributed interaction in large-scale applications, the publish/subscribe communication paradigm has recently received increasing attention. With systems based on the publish/subscribe interaction scheme, subscribers register their interest in an event, or a pattern of events, and are subsequently asynchronously notified of events generated by publishers. Many variants of the paradigm have recently been proposed, each variant being specifically adapted to some given application or network model. This paper factors out the common denominator underlying these variants: full decoupling of the communicating entities in time, space, and synchronization. We use these three decoupling dimensions to better identify commonalities and divergences with traditional interaction paradigms. The many variations on the theme of publish/subscribe are classified and synthesized. In particular, their respective benefits and shortcomings are discussed both in terms of interfaces and implementations