Pre main sequence: Accretion & Outflows

Low-mass pre-main sequence (PMS) stars are strong X-ray sources, because they possess hot corona like their older main-sequence counterparts. Unique to young stars, however, are X-rays from accretion and outflows, and both processes are of pivotal importance for star and planet formation. We describe how X-ray data provide important insight into the physics of accretion and outflows. First, mass accreted from a circumstellar disk onto the stellar surface reaches velocities up to a few hundred km/s, fast enough to generate soft X-rays in the post-shock region of the accretion shock. X-ray observations together with laboratory experiments and numerical simulations show that the accretion geometry is complex in young stars. Specifically, the center of the accretion column is likely surrounded by material shielding the inner flow from view but itself also hot enough to emit X-rays. Second, X-rays are observed in two locations of protostellar jets: an inner stationary emission component probably related to outflow collimation and outer components, which evolve withing years and are likely related to working surfaces where the shock travels through the jet. Jet-powered X-rays appear to trace the fastest jet component and provide novel information on jet launching in young stars. We conclude that X-ray data will continue to be highly important for understanding star and planet formation, because they directly probe the origin of many emission features studied in other wavelength regimes. In addition, future X-ray missions will improve sensitivity and spectral resolution to probe key model parameters (e.g. velocities) in large samples of PMS stars.Comment: Invited chapter for the "Handbook of X-ray and Gamma-ray Astrophysics" (Eds. C. Bambi and A. Santangelo, Springer Nature, 2022), accepted (34 pages, 11 figures

Generation of microbubbles in extracorporeal life support and assessment of new elimination strategies

Occurrence of microbubbles (MB) is a major problem during venoarterial extracorporeal life support (ECLS) with partially severe clinical complications. The aim of this study was to establish an in vitro ECLS setup for the generation and detection of MB. Furthermore, we assessed different MB elimination strategies. Patient and ECLS circuit were simulated using reservoirs, a centrifugal pump, a membrane oxygenator, and an occluder (modified roller pump). The system was primed with a glycerin solution of 44%. Three different revolution speeds (2500, 3000, and 3400 rpm) were applied. For MB generation, the inflow line of the pump was either statically or dynamically (15 rpm) occluded. A bubble counter was used for MB detection. The effectiveness of the oxygenator and dynamic bubble traps (DBTs) was evaluated in regard to MB elimination capacities. MB generation was highly dependent on negative pressure at the inflow line. Increasing revolution speeds and restriction of the inflow led to increased MB activity. The significant difference between inflow and outflow MB volume identified the centrifugal pump as a main source. We could show that the oxygenator’s ability to withhold larger MB is limited. The application of one or multiple DBTs leads to a significant reduction in MB count and overall gas volume. The application of DBT can significantly reduce the overall gas volume, especially at high flow rates. Moreover, large MB can effectively be broken down for faster absorption. In general, the incidence of MBs is significantly dependent on pump speed and restriction of the inflow. The centrifugal pump was identified as a major source of MB generation

Extracorporeal Circulation During Lung Transplantation Procedures: a Meta-Analysis

Extracorporeal circulation (ECC) is an invaluable tool in lung transplantation (lutx). More than the past years, an increasing number of centers changed their standard for intraoperative ECC from cardiopulmonary bypass (CPB) to extracorporeal membrane oxygenation (ECMO) - with differing results. This meta-analysis reviews the existing evidence. An online literature research on Medline, Embase, and PubMed has been performed. Two persons independently judged the papers using the ACROBAT-NRSI tool of the Cochrane collaboration. Meta-analyses and meta-regressions were used to determine whether veno-arterial ECMO (VA-ECMO) resulted in better outcomes compared with CPB. Six papers - all observational studies without randomization - were included in the analysis. All were considered to have serious bias caused by heparinization as co-intervention. Forest plots showed a beneficial trend of ECMO regarding blood transfusions (packed red blood cells (RBCs) with an average mean difference of -0.46 units 95{\%} CI = -3.72, 2.80, fresh-frozen plasma with an average mean difference of -0.65 units 95{\%} CI = -1.56, 0.25, platelets with an average mean difference of -1.72 units 95{\%} CI = -3.67, 0.23). Duration of ventilator support with an average mean difference of -2.86 days 95{\%} CI = -11.43, 5.71 and intensive care unit (ICU) length of stay with an average mean difference of -4.79 days 95{\%} CI = -8.17, -1.41 were shorter in ECMO patients. Extracorporeal membrane oxygenation treatment tended to be superior regarding 3 month mortality (odds ratio = 0.46, 95{\%} CI = 0.21-1.02) and 1 year mortality (odds ratio = 0.65, 95{\%} CI = 0.37-1.13). However, only the ICU length of stay reached statistical significance. Meta-regression analyses showed that heterogeneity across studies (sex, year of ECMO implementation, and underlying disease) influenced differences. These data indicate a benefit of the intraoperative use of ECMO as compared with CPB during lung transplant procedures regarding short-term outcome (ICU stay). There was no statistically significant effect regarding blood transfusion needs or long-term outcome. The superiority of ECMO in lutx patients remains to be determined in larger multi-center randomized trials

Women - Gender - Academia. Essays of an Interdisciplinary Research Symposium

Vom 21. Juni 2013 bis zum 23. Juni 2013 fand an der Universität Passau das Symposium „Gender.Frauen.Wissenschaft.“ statt, auf dem der vorliegende Sammelband basiert. Veranstalterin war das Frauenbüro der Universität Passau, welches mit der Veranstaltung verschiedene Ziele bezweckte. Ausgehend von der Tatsache, dass es an der Universität zu dem Zeitpunkt keine institutionalisierten Gender-Studies gab, aber viele Wissenschaftlerinnen und Wissenschaftler, die zu Genderfragen bzw. Genderaspekten in ihrem Fach forschen, sollte das Symposium solchen Personen die Gelegenheit geben, sich kennenzulernen, über die Forschungsprojekte sich auszutauschen und zu vernetzen. In der Tat glückte der intra- und interfakultäre Ansatz. Da sich das Symposium als Förderinstrument verstand, sollte der Schwerpunkt auf dem wissenschaftlichen Nachwuchs liegen. So versammelt der Band Beiträge von Autorinnen und Autoren in ganz unterschiedlichen Qualifizierungsphasen

Framework and baseline examination of the German National Cohort (NAKO)

The German National Cohort (NAKO) is a multidisciplinary, population-based prospective cohort study that aims to investigate the causes of widespread diseases, identify risk factors and improve early detection and prevention of disease. Specifically, NAKO is designed to identify novel and better characterize established risk and protection factors for the development of cardiovascular diseases, cancer, diabetes, neurodegenerative and psychiatric diseases, musculoskeletal diseases, respiratory and infectious diseases in a random sample of the general population. Between 2014 and 2019, a total of 205,415 men and women aged 19–74 years were recruited and examined in 18 study centres in Germany. The baseline assessment included a face-to-face interview, self-administered questionnaires and a wide range of biomedical examinations. Biomaterials were collected from all participants including serum, EDTA plasma, buffy coats, RNA and erythrocytes, urine, saliva, nasal swabs and stool. In 56,971 participants, an intensified examination programme was implemented. Whole-body 3T magnetic resonance imaging was performed in 30,861 participants on dedicated scanners. NAKO collects follow-up information on incident diseases through a combination of active follow-up using self-report via written questionnaires at 2–3 year intervals and passive follow-up via record linkages. All study participants are invited for re-examinations at the study centres in 4–5 year intervals. Thereby, longitudinal information on changes in risk factor profiles and in vascular, cardiac, metabolic, neurocognitive, pulmonary and sensory function is collected. NAKO is a major resource for population-based epidemiology to identify new and tailored strategies for early detection, prediction, prevention and treatment of major diseases for the next 30 years. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10654-022-00890-5

PTX3 Polymorphisms and Invasive Mold Infections After Solid Organ Transplant

Donor PTX3 polymorphisms were shown to influence the risk of invasive aspergillosis among hematopoietic stem cell transplant recipients. Here, we show that PTX3 polymorphisms are independent risk factors for invasive mold infections among 1101 solid organ transplant recipients, thereby strengthening their role in mold infection pathogenesis and patients' risk stratificatio