A microfluidic array with cellular valving for single cell co-culture

We present a highly parallel microfluidic approach for contacting single cell pairs. The approach combines a differential fluidic resistance trapping method with a novel cellular valving principle for homotypic and heterotypic single cell co-culturing. Differential fluidic resistance was used for sequential single cell arraying, with the adhesion and flattening of viable cells within the microstructured environment acting to produce valves in the open state. Reversal of the flow was used for the sequential single cell arraying of the second cell type. Plasma stencilling, along the linear path of least resistance, was required to confine the cells within the trap regions. Prime flow conditions with minimal shear stress were identified for highly efficient cell arraying (similar to 99%) and long term cell culture. Larger trap dimensions enabled the highest levels of cell pairing (similar to 70%). The single cell co-cultures were in close proximity for the formation of connexon structures and the study of contact modes of communication. The research further highlights the possibility of using the natural behaviour of cells as the working principle behind responsive microfluidic element

Refurbishment works in a hospital during normal operation

Background: Construction and renovation work in hospitals pose risks of fungal airborne infections for immunosuppressed patients. If possible, reconstruction work will be postponed to periods without patient treatment. However, in many situations urgent damage demands immediate refurbishment works before the transferring of patients to other wards or closure of wards is possible. Reported here are infection control related measures and implemented procedures after two incidents of water damage which occurred on a surgical ward and an intensive care unit at the University hospital of Essen

Agri-Environmental Policy Measures in Israel: The Potential of Using Market-Oriented Instruments

This paper examines the possibilities of developing agri-environmental policy measures in Israel, focusing on market-oriented instruments. A conceptual framework for developing agri-environmental policy measures is presented, first in very broad lines (mandatory regulations, economic instruments and advisory measures) and subsequently focusing on economic instruments, and specifically, on market-oriented ones. Two criteria of choice between the measures are suggested: their contribution to improving the effectiveness of the policy; and the feasibility of their implementation. This is the framework used for analyzing agri-environmental measures in Israel. Israel currently implements a mix of mandatory regulations, economic instruments and advisory measures to promote the agri-environment. The use of additional economic instruments may improve the effectiveness of the policy. When comparing the effectiveness of various economic measures, we found that the feasibility of implementation of market-oriented instruments is greater, due to the Israeli public’s preference for strengthening market orientation in the agricultural sector. Four market-oriented instruments were practiced in a pilot project conducted in an Israeli rural area. We found that in this case study, the institutional feasibility and acceptance by stakeholders were the major parameters influencing the implementation of the market-oriented instruments, whereas the instruments’ contribution to enhancing the ecological or economic effectiveness were hardly considered by the stakeholders as arguments in favor of their use

S3 guidelines for intensive care in cardiac surgery patients: hemodynamic monitoring and cardiocirculary system

Hemodynamic monitoring and adequate volume-therapy, as well as the treatment with positive inotropic drugs and vasopressors are the basic principles of the postoperative intensive care treatment of patient after cardiothoracic surgery. The goal of these S3 guidelines is to evaluate the recommendations in regard to evidence based medicine and to define therapy goals for monitoring and therapy. In context with the clinical situation the evaluation of the different hemodynamic parameters allows the development of a therapeutic concept and the definition of goal criteria to evaluate the effect of treatment

Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI))

Practice guidelines are systematically developed statements and recommendations that assist the physicians and patients in making decisions about appropriate health care measures for specific clinical circumstances taking into account specific national health care structures. The 1st revision of the S-2k guideline of the German Sepsis Society in collaboration with 17 German medical scientific societies and one self-help group provides state-of-the-art information (results of controlled clinical trials and expert knowledge) on the effective and appropriate medical care (prevention, diagnosis, therapy and follow-up care) of critically ill patients with severe sepsis or septic shock. The guideline had been developed according to the “German Instrument for Methodological Guideline Appraisal” of the Association of the Scientific Medical Societies (AWMF). In view of the inevitable advancements in scientific knowledge and technical expertise, revisions, updates and amendments must be periodically initiated. The guideline recommendations may not be applied under all circumstances. It rests with the clinician to decide whether a certain recommendation should be adopted or not, taking into consideration the unique set of clinical facts presented in connection with each individual patient as well as the available resources

The massive binary companion star to the progenitor of supernova 1993J

The massive star which underwent core-collapse to produce SN1993J was identified as a non-variable red supergiant star in images of the galaxy M81 taken before explosion. However the stellar source showed an excess in UV and B-band colours that suggested it had either a hot, massive companion star or was embedded in an unresolved young stellar association. The spectra of SN1993J underwent a remarkable transformation between a hydrogen-rich Type II supernova and a helium-rich (hydrogen-deficient) Type Ib. The spectral and photometric peculiarities were explained by models in which the 13-20 solar mass supergiant had lost almost its entire hydrogen envelope to a close binary companion. The binary scenario is currently the best fitting model for the production of such type IIb supernovae, however the hypothetical massive companion stars have so far eluded discovery. Here we report the results of new photometric and spectroscopic observations of SN1993J, 10 years after explosion. At the position of the fading SN we detect the unambiguous signature of a massive star, the binary companion to the progenitor. This is evidence that this type of SN originate in interacting binary systems.Comment: 18 pages (3 figures

Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study

The role of veno-venous extracorporeal membrane oxygenation therapy (V-V ECMO) in severe COVID-19 acute respiratory distress syndrome (ARDS) is still under debate and conclusive data from large cohorts are scarce. Furthermore, criteria for the selection of patients that benefit most from this highly invasive and resource-demanding therapy are yet to be defined. In this study, we assess survival in an international multicenter cohort of COVID-19 patients treated with V-V ECMO and evaluate the performance of several clinical scores to predict 30-day survival. Methods: This is an investigator-initiated retrospective non-interventional international multicenter registry study (NCT04405973, first registered 28 May 2020). In 127 patients treated with V-V ECMO at 15 centers in Germany, Switzerland, Italy, Belgium, and the United States, we calculated the Sequential Organ Failure Assessment (SOFA) Score, Simplified Acute Physiology Score II (SAPS II), Acute Physiology And Chronic Health Evaluation II (APACHE II) Score, Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) Score, Predicting Death for Severe ARDS on V-V ECMO (PRESERVE) Score, and 30-day survival. Results: In our study cohort which enrolled 127 patients, overall 30-day survival was 54%. Median SOFA, SAPS II, APACHE II, RESP, and PRESERVE were 9, 36, 17, 1, and 4, respectively. The prognostic accuracy for all these scores (area under the receiver operating characteristic—AUROC) ranged between 0.548 and 0.605. Conclusions: The use of scores for the prediction of mortality cannot be recommended for treatment decisions in severe COVID-19 ARDS undergoing V-V ECMO; nevertheless, scoring results below or above a specific cut-off value may be considered as an additional tool in the evaluation of prognosis. Survival rates in this cohort of COVID-19 patients treated with V-V ECMO were slightly lower than those reported in non-COVID-19 ARDS patients treated with V-V ECMO

Euclid: On the reduced shear approximation and magnification bias for Stage IV cosmic shear experiments

Stage IV weak lensing experiments will offer more than an order of magnitude leap in precision. We must therefore ensure that our analyses remain accurate in this new era. Accordingly, previously ignored systematic effects must be addressed. In this work, we evaluate the impact of the reduced shear approximation and magnification bias, on the information obtained from the angular power spectrum. To first-order, the statistics of reduced shear, a combination of shear and convergence, are taken to be equal to those of shear. However, this approximation can induce a bias in the cosmological parameters that can no longer be neglected. A separate bias arises from the statistics of shear being altered by the preferential selection of galaxies and the dilution of their surface densities, in high-magnification regions. The corrections for these systematic effects take similar forms, allowing them to be treated together. We calculate the impact of neglecting these effects on the cosmological parameters that would be determined from Euclid, using cosmic shear tomography. We also demonstrate how the reduced shear correction can be calculated using a lognormal field forward modelling approach. These effects cause significant biases in Omega_m, n_s, sigma_8, Omega_DE, w_0, and w_a of -0.51 sigma, -0.36 sigma, 0.37 sigma, 1.36 sigma, -0.66 sigma, and 1.21 sigma, respectively. We then show that these lensing biases interact with another systematic: the intrinsic alignment of galaxies. Accordingly, we develop the formalism for an intrinsic alignment-enhanced lensing bias correction. Applying this to Euclid, we find that the additional terms introduced by this correction are sub-dominant

Euclid: The reduced shear approximation and magnification bias for Stage IV cosmic shear experiments

Context: Stage IV weak lensing experiments will offer more than an order of magnitude leap in precision. We must therefore ensure that our analyses remain accurate in this new era. Accordingly, previously ignored systematic effects must be addressed. / Aims: In this work, we evaluate the impact of the reduced shear approximation and magnification bias on information obtained from the angular power spectrum. To first-order, the statistics of reduced shear, a combination of shear and convergence, are taken to be equal to those of shear. However, this approximation can induce a bias in the cosmological parameters that can no longer be neglected. A separate bias arises from the statistics of shear being altered by the preferential selection of galaxies and the dilution of their surface densities in high-magnification regions. / Methods: The corrections for these systematic effects take similar forms, allowing them to be treated together. We calculated the impact of neglecting these effects on the cosmological parameters that would be determined from Euclid, using cosmic shear tomography. To do so, we employed the Fisher matrix formalism, and included the impact of the super-sample covariance. We also demonstrate how the reduced shear correction can be calculated using a lognormal field forward modelling approach. / Results: These effects cause significant biases in Ωm, σ8, ns, ΩDE, w0, and wa of −0.53σ, 0.43σ, −0.34σ, 1.36σ, −0.68σ, and 1.21σ, respectively. We then show that these lensing biases interact with another systematic effect: the intrinsic alignment of galaxies. Accordingly, we have developed the formalism for an intrinsic alignment-enhanced lensing bias correction. Applying this to Euclid, we find that the additional terms introduced by this correction are sub-dominant