725 research outputs found
Early Holocene aeolian sediments in southwestern Crete−preliminary results
The soilscapes along the southern and western coast of Crete (Greece) are dominated by coarse-grained reddish-brown slope sediments whose natural (pre-anthropogenic) configuration and properties are difficult to reconstruct due to the long history of intense land use. As a consequence, datable terrestrial sediment archives of pre-anthropogenic genesis are scarce. We present preliminary results of a study performed on an accumulation within an alluvial fan south of Stomio Bay in southwestern Crete. The studied profile is located in a small depression and is composed of a sequence of sandy to silty yellowish-brown calcareous sediments overlying coarse-grained slope sediments, including a fossil topsoil horizon. Based on macroscopic, micromorphological, geochemical, geophysical and mineralogical analysis, we interpret the fine-grained sediments to have a local aeolian origin. OSL dating indicates a final deposition phase during the early Holocene. Considering the scarcity of early Holocene terrestrial archives in Crete, the analysed profile provides valuable data for the reconstruction of landscape dynamics and paleoecological conditions as well as soil-sediment configurations during this time period. Additional research is needed to address the specific source area(s) as well as the ages of the deposition of slope sediments and formation of the fossil topsoil
Potentials of Telemedicine for Green Health Care
Neurological facilities are traditionally centered in academic hospitals and often far away from the patients’ living area. Both, the transfer of patients to remote hospitals and inpatient treatment are associated with high energy consumption. Numbers of patients with neurological diseases are expected to increase along with the demographical changes and the environmental impact of neurological treatment should become a target for health policy, therefore. Positive effects have been demonstrated for the use of telemedicine by improving inpatient treatment in local community hospitals or avoiding hospital admissions via monitoring of complex diseases in outpatient settings. We discuss the potentials of telemedicine in the field of in- and outpatient neurological care as well as the need for more scientific evaluation on environmental impacts
The land use - land degradation nexus in Mediterranean landscapes - drivers of changes and key processes at selected Natura 2000 sites of Crete, Greece
The land use–land degradation nexus in Cretan landscapes in regions with Natura 2000 sites was analyzed by an explorative expert driven study based on literature, field work and photo documentation methods with the aim of determining status, drivers and key processes of change. Drivers of current land use changes have been worked out by (1) general tourism developments and tourism related land uses; (2) irrigated olive yard developments; (3) fenced large-scale goat pastures and (4) large scale greenhouses. Key processes of change have been identified and qualitatively assessed for 5 regions with NATURA 2000 areas based on a non-ranked set of 11 descriptive indicators. The analysis includes the status-description and the importance assessment of land degradation processes in selected NATURA 2000 sites. Threats and pressures taken from the NATURA 2000 documentation and the land use – land degradation nexus and the analysis are a suitable basis for future land management in order to reach land degradation neutrality. The result of our analysis opens a new research field for a better integration of the normally thematically isolated analysis in geography, biology/nature conservation and agricultural policy analysis about the drivers and processes in landscape systems towards a better understanding the trends in land cover change (e.g. vegetation/soil degradation), the trends in productivity or functioning changes caused by land uses and as well for the trends in carbon stock change
The Land Use - Land Degradation Nexus in Mediterranean Landscapes: – Drivers of Changes And Key Processes at Selected Natura 2000 Sites of Crete, Greece
The land use–land degradation nexus in Cretan landscapes in regions with Natura 2000 sites was analyzed by an explorative expert driven study based on literature, field work and photo documentation methods with the aim of determining status, drivers and key processes of change. Drivers of current land use changes have been worked out by (1) general tourism developments and tourism related land uses; (2) irrigated olive yard developments; (3) fenced large-scale goat pastures and (4) large scale greenhouses. Key processes of change have been identified and qualitatively assessed for 5 regions with NATURA 2000 areas based on a non-ranked set of 11 descriptive indicators. The analysis includes the status-description and the importance assessment of land degradation processes in selected NATURA 2000 sites. Threats and pressures taken from the NATURA 2000 documentation and the land use – land degradation nexus and the analysis are a suitable basis for future land management in order to reach land degradation neutrality. The result of our analysis opens a new research field for a better integration of the normally thematically isolated analysis in geography, biology/nature conservation and agricultural policy analysis about the drivers and processes in landscape systems towards a better understanding the trends in land cover change (e.g. vegetation/soil degradation), the trends in productivity or functioning changes caused by land uses and as well for the trends in carbon stock change
A Neurological Outpatient Clinic for Patients With Post-COVID-19 Syndrome — A Report on the Clinical Presentations of the First 100 Patients
Background and Objectives: Neurological and psychiatric symptoms are frequent in patients with post-COVID-19 syndrome (PCS). Here, we report on the clinical presentation of the first 100 patients who presented to our PCS Neurology outpatient clinic ≥ 12 weeks after the acute infection with SARS-CoV-2. To date, PCS is only defined by temporal connection to SARS-CoV-2 infection. Identification of clinical phenotypes and subgroups of PCS is urgently needed.
Design: We assessed clinical data of our first 100 ambulatory patients regarding clinical presentations; self-questionnaires focusing on daytime sleepiness, mood, and fatigue; and a screening assessment for detecting cognitive impairment.
Results: A total of 89% of the patients presenting to the Neurology outpatient clinic had an initially mild course of COVID-19 and had not been hospitalized. The majority of the patients were female (67 vs. 33% male). The most frequent symptom reported was cognitive impairment (72%). There were 30% of patients who reported cognitive deficits and scored below 26 points on the Montreal Cognitive Assessment Scale. Fatigue (67%), headache (36%), and persisting hyposmia (36%) were also frequently reported; 5.5% of all patients showed signs of severe depression.
Discussion: To our knowledge, this is the first report of patient data of a PCS Neurology outpatient clinic. Neurological sequelae also exist for more than 3 months after mainly mild SARS-CoV-2 acute infections. The reported symptoms are in accordance with recently published data of hospitalized patients
An Analysis of the Perception of and Reaction to Reviewers in Fine-Dining
Our society has seen a proliferation of valuation devices leading to the existence of
multiple devices that valuate the same product or service. Studies of valuation devices
have demonstrated wide-ranging implications for the objects they valuate as well as for the
context, in which they are embedded. However, what remains opaque is the
understanding of how these valuation devices themselves are valuated by actors in and
around the devices. Aiming to enrich this understanding, this thesis gives an answer to the
following research question: How are multiple valuation devices valuated by the actors in
and around the devices in one particular context, in this thesis the Copenhagen fine-dining
context and what are implications of this valuation?
Theoretically, this thesis mobilizes the notion of valuation devices and is built on two
theoretical pillars that originate out of economic sociology: valuation studies and studies of
devices. Through delving into their common roots and reviewing previous studies, this
thesis finds that both areas of research suggest the aspect of multiplicity and the aspect of
the valuation of valuation devices as aspects needing in-depth exploration. I aim to shed
light on these two theoretical gaps. In addition, the thesis elaborates on the effects of
valuation devices, centering on performativity and reactivity, introducing the former and
going deeper into the latter
Direct sums and the Szlenk index
For an ordinal and , we determine a necessary and
sufficient condition for an -direct sum of operators to have Szlenk
index not exceeding . It follows from our results that the
Szlenk index of an -direct sum of operators is determined in a natural
way by the behaviour of the -Szlenk indices of its summands. Our
methods give similar results for -direct sums.Comment: The proof of Proposition~2.4 has changed, with some of the arguments
transferred to the proof of an added-in lemma, Lemma~2.8. Changes have been
made to the Applications sectio
Computer-assisted intraoperative 3D-navigation for liver surgery: a prospective randomized-controlled pilot study.
BACKGROUND
Liver surgery is the standard of care for primary and many secondary liver tumors. Due to variability and complexity in liver anatomy preoperative imaging is necessary to determine resectability and for planning the surgical strategy. In the last few years, computer-assisted resection planning has been introduced in liver surgery. Aim of this trial was the evaluation of computer-assisted three-dimensional (3D)-navigation for liver surgery.
METHODS
This study was a prospective randomized-controlled pilot trial and patients were randomized in navigated or non-navigated group. Primary end point was the quotient of intraoperative resected volume and planned resection volume. Secondary end points included operation time, resection margin and postoperative complications. 3D reconstructions were performed with MeVis Distant Services (MeVis AG, Bremen, Germany). The navigation system CAS-One Liver (CAScination AG, Bern, Switzerland) was used for intraoperative computer-assisted 3D-navigation.
RESULTS
The data of 16 patients with 20 liver tumors were used in this analysis. Of these, 8 liver tumors were resected with the utilization of intraoperative navigation. Two postoperative complications were classified grade IIIa or higher. There was no difference in duration of operation (189 vs. 180 min, P=0.970), rate of postoperative complications (n=1 vs. n=1, P=0.696) and length of hospital stay (9 vs. 7 days, P=0.368) between the two groups. Minimal resection margin (0.15 vs. 0.40 cm, P=0.384) and quotient of planned to intraoperative resection volume (0.94 vs. 1.11, P=0.305) were also similar.
CONCLUSIONS
Intraoperative navigation is a technology that can be safely used during liver resection. Surgical accuracy is not yet superior to the current standard of intraoperative orientation. Further technological advances with suitable deformation algorithms and augmented reality systems will enable a further improvement of the technical feasibility
Physical Fitness Training in Patients with Subacute Stroke (PHYS-STROKE): multicentre, randomised controlled, endpoint blinded trial
OBJECTIVE:
To determine the safety and efficacy of aerobic exercise on activities of daily living in the subacute phase after stroke.
DESIGN:
Multicentre, randomised controlled, endpoint blinded trial.
SETTING:
Seven inpatient rehabilitation sites in Germany (2013-17).
PARTICIPANTS:
200 adults with subacute stroke (days 5-45 after stroke) with a median National Institutes of Health stroke scale (NIHSS, range 0-42 points, higher values indicating more severe strokes) score of 8 (interquartile range 5-12) were randomly assigned (1:1) to aerobic physical fitness training (n=105) or relaxation sessions (n=95, control group) in addition to standard care.
INTERVENTION:
Participants received either aerobic, bodyweight supported, treadmill based physical fitness training or relaxation sessions, each for 25 minutes, five times weekly for four weeks, in addition to standard rehabilitation therapy. Investigators and endpoint assessors were masked to treatment assignment.
MAIN OUTCOME MEASURES:
The primary outcomes were change in maximal walking speed (m/s) in the 10 m walking test and change in Barthel index scores (range 0-100 points, higher scores indicating less disability) three months after stroke compared with baseline. Safety outcomes were recurrent cardiovascular events, including stroke, hospital readmissions, and death within three months after stroke. Efficacy was tested with analysis of covariance for each primary outcome in the full analysis set. Multiple imputation was used to account for missing values.
RESULTS:
Compared with relaxation, aerobic physical fitness training did not result in a significantly higher mean change in maximal walking speed (adjusted treatment effect 0.1 m/s (95% confidence interval 0.0 to 0.2 m/s), P=0.23) or mean change in Barthel index score (0 (-5 to 5), P=0.99) at three months after stroke. A higher rate of serious adverse events was observed in the aerobic group compared with relaxation group (incidence rate ratio 1.81, 95% confidence interval 0.97 to 3.36).
CONCLUSIONS:
Among moderately to severely affected adults with subacute stroke, aerobic bodyweight supported, treadmill based physical fitness training was not superior to relaxation sessions for maximal walking speed and Barthel index score but did suggest higher rates of adverse events. These results do not appear to support the use of aerobic bodyweight supported fitness training in people with subacute stroke to improve activities of daily living or maximal walking speed and should be considered in future guidelines.
TRIAL REGISTRATION:
ClinicalTrials.gov NCT01953549
Collagen VI-Related Myopathy Caused by Compound Heterozygous Mutations of COL6A3 in a Consanguineous Kurdish Family
Collagen VI-related myopathies are caused by mutations of COL6A1, COL6A2, and COL6A3 and present with a wide phenotypic spectrum ranging from severe Ulrich congenital muscular dystrophy to mild Bethlem myopathy. Here, we report a consanguineous Kurdish family with 3 siblings affected by autosomal-recessive Bethlem myopathy caused by compound heterozygous mutations of COL6A3. We found the previously described missense mutation c.7447A > G/p.(Lys2483Glu) and a novel large deletion encompassing the exon 1-39 of the COL6A3 gene. Apart from the classical clinical symptoms, all patients had keratoconus, which expands the phenotype of the collagen VI-related myopathies
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