The Residence Time in the Elbe River Focussing on the Estuary

Eco-Hydraulics and Eco-Hydrolog

Long-term Changes of the Tidal Amplitudes and Phases in the Elbe Estuary

Climate Change, Adaptation and Long-Term Prediction

Mean sea level variability and influence of the North Atlantic oscillation on long-term trends in the German Bight

Changes in the seasonal cycle of mean sea level (MSL) may affect the heights of storm surges and thereby flood risk in coastal areas. This study investigates the intra- and inter-annual variability of monthly MSL and its link to the North Atlantic Oscillation using records from 13 tide gauges located in the German Bight. The amplitudes of the seasonal MSL cycle are not regionally uniform and vary between 20 and 29 cm. Generally, the amplitudes are smaller at the southwestern stations, increasing as one travels to the northeastern part. The amplitudes, as well as the phase of the seasonal cycle, are characterized by a large inter-annual and inter-decadal variability, but no long-term trend could be detected. Nevertheless, in the last two decades annual maximum peaks more frequently occurred in January and February, whereas beforehand an accumulation was detected for the November and December period. These changes in phase in the various sea level time series are consistent with a shift in the annual cycle, which is, however, not significant. The changes are associated with strongly increasing trends in monthly MSL of the winter season (J–M), which are considerably higher compared to the remaining seasons. For the same season, the MSL and North Atlantic Oscillation (NAO) indices show strong similarities, resulting in statistically significant correlations (r ~ 0.7). Hence, these changes are linked with changing pressure conditions over the North Atlantic, which lead to a strong phase of positive values in the NAO index between the 1960’s and 1990’s

Results of Operational Sea-Wave Monitoring with Radar Gauges

The German Federal Institute of Hydrology (BfG) developed a low-cost, non-contact sea-wave monitoring system based on a single radar sensor. A short description of the measuring system and the analysis of wave parameters is given. Furthermore, long-term wave measurements with this system, in combination with wind-measurements and statistics, are used to analyse possible future changes in wave heights. The results are in good agreement with those of other methods. Due to the good results achieved with the single radar sensor, an extension of the system which will be capable of recording directional information, is now under development. First results are presented in this study.El Instituto Federal Alemán de Hidrología (BfG) ha desarrollado un sistema de seguimiento de bajo coste, que no tiene contacto con la ola, basado en un sensor con un único radar. Se proporciona en el presente artículo una breve descripción del sistema de medición y del análisis de los parámetros de las olas. Además, las mediciones de olas por periodos largos efectuadas con este sistema, en combinación con las medidas del viento y las estadísti-cas, se utilizan para analizar los posibles cambios futuros en las alturas de las olas. Los resultados concuerdan con aquellos obtenidos mediante otros métodos. Debido a los buenos resultados obtenidos con el sensor de radar único, una extensión del sistema, que está ahora en fase de desarrollo, podrá registrar la información direccional. En este estudio se presentan los primeros resultados.L’Institut fédéral allemand d’hydrologie (BfG) a élaboré un système peu onéreux de surveillance à distance des vagues à partir d’un unique sondeur radar. Une brève description du système de mesure ainsi que l’analyse des paramètres des vagues est donnée. De plus, les mesures à long-terme des vagues avec ce système, combinées avec les mesures du vent et les statistiques sont utilisées pour analyser les changements futurs possibles des hauteurs de vagues. Les résultats concordent avec ceux établis au moyen d’autres méthodes. Du fait des bons résultats de l’unique sondeur radar, une extension du système qui pourrait enregistrer des informations relatives à la direction, est actuellement en cours de développement. Les premiers résultats sont présentés dans cette étud

Ultrahydrophobe chitosanstabilisierte Composite-Schichten auf Aluminiumwerkstoffen

Selbstreinigende, ultrahydrophobe Oberflächen lassen sich in der Technik vielfältig einsetzen. Das ultrahydrophobe Verhalten beruht einerseits auf einer Rauigkeit im μm-Bereich und andererseits auf der chemischen Zusammensetzung der Oberfläche. Durch den gegebenen Oberflächenaufbau sind derartige Materialien jedoch empfindlich gegen Verschleiß. In diesem Beitrag wird ein Schichtverbund bestehend aus Aluminiumoxid und zwei polymeren Komponenten vorgestellt. Die Aluminiumoxidschicht wird auf dem Wege der anodischen Oxidation erzeugt. Dieses seit langem bekannte Verfahren ermöglicht nicht nur die Oxidation der Aluminiumoberfläche, sondern gestattet es, auch, definierte Oberflächenprofile einzustellen. Durch den gezielten Einbau des hochmolekularen Polymers Chitosan in die mikroprofilierte Aluminiumoxidschicht wurde eine mechanische Stabilisierung der Schicht im Sinne eines anorganisch-organischen Composites erreicht. Außerdem dienten die Amino-Seitengruppen des Chitosans als reaktives Interface für die notwendige chemische Hydrophobierung und als Reaktionszentrum für Vernetzungen, wodurch eine weitere mechanische Stabilisierung bewirkt wird. Der Schichtaufbau hat wesentliche

Radiomic Analysis Reveals Prognostic Information in T1-Weighted Baseline Magnetic Resonance Imaging in Patients With Glioblastoma

Objectives The aim of this study was to investigate whether radiomic analysis with random survival forests (RSFs) can predict overall survival from T1-weighted contrast-enhanced baseline magnetic resonance imaging (MRI) scans in a cohort of glioblastoma multiforme (GBM) patients with uniform treatment. Materials and Methods This retrospective study was approved by the institutional review board and informed consent was waived. The MRI scans from 66 patients with newly diagnosed GBM from a previous prospective study were analyzed. Tumors were segmented manually on contrast-enhanced 3-dimensional T1-weighted images. Using these segmentations, P = 208 quantitative image features characterizing tumor shape, signal intensity, and texture were calculated in an automated fashion. On this data set, an RSF was trained using 10-fold cross validation to establish a link between image features and overall survival, and the individual risk for each patient was predicted. The mean concordance index was assessed as a measure of prediction accuracy. Association of individual risk with overall survival was assessed using Kaplan-Meier analysis and a univariate proportional hazards model. Results Mean overall survival was 14 months (range, 0.8-85 months). Mean concordance index of the 10-fold cross-validated RSF was 0.67. Kaplan-Meier analysis clearly distinguished 2 patient groups with high and low predicted individual risk (P = 5.5 x 10(-5)). Low predicted individual mortality was found to be a favorable prognostic factor for overall survival in a univariate Cox proportional hazards model (hazards ratio, 1.038;95% confidence interval, 1.015-1.062;P = 0.0059). Conclusions This study demonstrates that baseline MRI in GBM patients contains prognostic information, which can be accessed by radiomic analysis using RSFs

Gastrointestinal failure in intensive care: a retrospective clinical study in three different intensive care units in Germany and Estonia

BACKGROUND: While gastrointestinal problems are common in ICU patients with multiple organ failure, gastrointestinal failure has not been given the consideration other organ systems receive. The aim of this study was to evaluate the incidence of gastrointestinal failure (GIF), to identify its risk factors, and to determine its association with ICU mortality. METHODS: A retrospective analysis of adult patients (n = 2588) admitted to three different ICUs (two ICUs at the university hospital Charité-Universitätsmedizin Berlin, Germany and one at Tartu University Clinics, Estonia) during the year 2002 was performed. Data recorded in a computerized database were used in Berlin. In Tartu, the data documented in the patients' charts was retrospectively transferred into a similar database. GIF was defined as documented gastrointestinal problems (food intolerance, gastrointestinal haemorrhage, and/or ileus) in the patient data at any period of their ICU stay. ICU mortality, length of stay, and duration of mechanical ventilation were assessed as outcome parameters. RESULTS: GIF was identified in 252 patients (9.7% of all patients). Only 20% of GIF patients were identifiable at admission. GIF was related to significantly higher mortality (43.7% vs. 5.3% in patients without GIF), as well as prolonged length of ICU stay (10 vs. 2 days) and mechanical ventilation (8 vs. 1 day), p < 0.001, respectively. Patients' profile (emergency surgical or medical), APACHE II and SOFA scores and the use of catecholamines at admission were identified as independent risk factors for the development of GIF. Development of GIF during ICU stay was an independent predictor for death. CONCLUSION: Gastrointestinal failure represents a relevant clinical problem accompanied by an increased mortality, longer ICU stay and mechanical ventilation

Multiple Myeloma Treatment in Real-world Clinical Practice : Results of a Prospective, Multinational, Noninterventional Study

Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: M.M. has received personal fees from Janssen, Celgene, Amgen, Bristol-Myers Squibb, Sanofi, Novartis, and Takeda and grants from Janssen and Sanofi during the conduct of the study. E.T. has received grants from Janssen and personal fees from Janssen and Takeda during the conduct of the study, and grants from Amgen, Celgene/Genesis, personal fees from Amgen, Celgene/Genesis, Bristol-Myers Squibb, Novartis, and Glaxo-Smith Kline outside the submitted work. M.V.M. has received personal fees from Janssen, Celgene, Amgen, and Takeda outside the submitted work. M.C. reports honoraria from Janssen, outside the submitted work. M. B. reports grants from Janssen Cilag during the conduct of the study. M.D. has received honoraria for participation on advisory boards for Janssen, Celgene, Takeda, Amgen, and Novartis. H.S. has received honoraria from Janssen-Cilag, Celgene, Amgen, Bristol-Myers Squibb, Novartis, and Takeda outside the submitted work. V.P. reports personal fees from Janssen during the conduct of the study and grants, personal fees, and nonfinancial support from Amgen, grants and personal fees from Sanofi, and personal fees from Takeda outside the submitted work. W.W. has received personal fees and grants from Amgen, Celgene, Novartis, Roche, Takeda, Gilead, and Janssen and nonfinancial support from Roche outside the submitted work. J.S. reports grants and nonfinancial support from Janssen Pharmaceutical during the conduct of the study. V.L. reports funding from Janssen Global Services LLC during the conduct of the study and study support from Janssen-Cilag and Pharmion outside the submitted work. A.P. reports employment and shareholding of Janssen (Johnson & Johnson) during the conduct of the study. C.C. reports employment at Janssen-Cilag during the conduct of the study. C.F. reports employment at Janssen Research and Development during the conduct of the study. F.T.B. reports employment at Janssen-Cilag during the conduct of the study. The remaining authors have stated that they have no conflicts of interest. Publisher Copyright: © 2018 The AuthorsMultiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits.publishersversionPeer reviewe