Poplitealaneurysma

Zusammenfassung: Das Poplitealaneurisma (PA) ist eine typische Erkrankung von Männern über 65 Jahren, bei denen häufig Aneurysmen der Aorta, der iliacalen, femoralen und kontralateralen Poplitealarterie vorkommen. Als Ursache des Poplitealaneurysmas (PA) werden prioritär die Degradation durch Matrixmetalloproteinasen, eine entzündliche Reaktion mit Bildung von reaktiven Sauerstoffradikalen sowie der oxidative Stress in der Arterienwand postuliert. Zwei Drittel der Patienten kommen wegen Symptomen zum Chirurgen, die übrigen wegen eines Zufallsbefundes oder weil bereits die Gegenseite operiert wurde. Die akute und chronische Ischämie mit ihrer hohen Morbidität stehen im Vordergrund. Asymptomatische PA sollten ab einem Durchmesser von 2cm therapeutisch angegangen werden, besonders wenn sie partiell thrombosiert sind. Zur Diagnostik reicht eine Duplexuntersuchung. Die digitale Subtraktionsangiographie ist die wichtigste Untersuchung für die Operationsplanung. Lokalisierte Befunde, die auf die Kniekehle begrenzt sind, können von dorsal, langstreckige PA müssen durch einen Zugang von medial mit einem Interponat überbrückt werden. Dabei ist eine autologe Vene dem Kunststoffinterponat vorzuziehen. Im Fall eines Veneninterponates oder -bypasses kann mit einer Offenheitsrate von 85% nach 5Jahren gerechnet werden. Endografts sollen nur ausnahmsweise oder im Rahmen von Studien eingesetzt werde

Finite-Volume Energy Spectrum, Fractionalized Strings, and Low-Energy Effective Field Theory for the Quantum Dimer Model on the Square Lattice

We present detailed analytic calculations of finite-volume energy spectra, mean field theory, as well as a systematic low-energy effective field theory for the square lattice quantum dimer model. The analytic considerations explain why a string connecting two external static charges in the confining columnar phase fractionalizes into eight distinct strands with electric flux $\frac{1}{4}$. An emergent approximate spontaneously broken $SO(2)$ symmetry gives rise to a pseudo-Goldstone boson. Remarkably, this soft phonon-like excitation, which is massless at the Rokhsar-Kivelson (RK) point, exists far beyond this point. The Goldstone physics is captured by a systematic low-energy effective field theory. We determine its low-energy parameters by matching the analytic effective field theory with exact diagonalization results and Monte Carlo data. This confirms that the model exists in the columnar (and not in a plaquette or mixed) phase all the way to the RK point.Comment: 35 pages, 16 figure

On number fields with nontrivial subfields

What is the probability for a number field of composite degree $d$ to have a nontrivial subfield? As the reader might expect the answer heavily depends on the interpretation of probability. We show that if the fields are enumerated by the smallest height of their generators the probability is zero, at least if $d>6$. This is in contrast to what one expects when the fields are enumerated by the discriminant. The main result of this article is an estimate for the number of algebraic numbers of degree $d=e n$ and bounded height which generate a field that contains an unspecified subfield of degree $e$. If $n>\max\{e^2+e,10\}$ we get the correct asymptotics as the height tends to infinity

Two-dimensional Lattice Gauge Theories with Superconducting Quantum Circuits

A quantum simulator of U(1) lattice gauge theories can be implemented with superconducting circuits. This allows the investigation of confined and deconfined phases in quantum link models, and of valence bond solid and spin liquid phases in quantum dimer models. Fractionalized confining strings and the real-time dynamics of quantum phase transitions are accessible as well. Here we show how state-of-the-art superconducting technology allows us to simulate these phenomena in relatively small circuit lattices. By exploiting the strong non-linear couplings between quantized excitations emerging when superconducting qubits are coupled, we show how to engineer gauge invariant Hamiltonians, including ring-exchange and four-body Ising interactions. We demonstrate that, despite decoherence and disorder effects, minimal circuit instances allow us to investigate properties such as the dynamics of electric flux strings, signaling confinement in gauge invariant field theories. The experimental realization of these models in larger superconducting circuits could address open questions beyond current computational capability.Comment: Published versio

Evaluation of existing and desired antimicrobial stewardship activities and strategies in Swiss hospitals.

Antimicrobial stewardship (AMS) is an important component in the fight against antimicrobial resistance. Currently, few hospitals have an ongoing institutional AMS programme. Swissnoso - the national centre for infection prevention - has launched a national Swiss AMS initiative supported by the office of public health. To guide AMS priorities and resources, current AMS activities in Switzerland were assessed. We distributed an internet-based questionnaire directed mainly to board-certified infectious diseases specialists and, if not available, senior internal medicine staff. Responses were received from 63/134 hospitals surveyed. More than 90% were in favour of national treatment guidelines currently in development under the umbrella of the Swiss society for infectious diseases. Many AMS activities - such as antimicrobial formulary restrictions and approval systems, review of antimicrobial prescriptions with point of care intervention, and direct feedback or therapeutic drug monitoring - are currently lacking in the majority of Swiss hospitals surveyed. Development of a modular formal AMS standard for Swiss hospitals may aid in advancing current AMS strategies and in introducing AMS programmes in Switzerland. In combination with the surveillance of antimicrobial use and resistance by ANRESIS, the national antimicrobial resistance surveillance system, this approach may reduce the use of antimicrobial agents and consequently the risk of emergence of multi-resistant pathogens

Canonical Representatives of Morphic Permutations

An infinite permutation can be defined as a linear ordering of the set of natural numbers. In particular, an infinite permutation can be constructed with an aperiodic infinite word over $\{0,\ldots,q-1\}$ as the lexicographic order of the shifts of the word. In this paper, we discuss the question if an infinite permutation defined this way admits a canonical representative, that is, can be defined by a sequence of numbers from [0, 1], such that the frequency of its elements in any interval is equal to the length of that interval. We show that a canonical representative exists if and only if the word is uniquely ergodic, and that is why we use the term ergodic permutations. We also discuss ways to construct the canonical representative of a permutation defined by a morphic word and generalize the construction of Makarov, 2009, for the Thue-Morse permutation to a wider class of infinite words.Comment: Springer. WORDS 2015, Sep 2015, Kiel, Germany. Combinatorics on Words: 10th International Conference. arXiv admin note: text overlap with arXiv:1503.0618

Perforated Peptic Ulcer Repair: Factors Predicting Conversion in Laparoscopy and Postoperative Septic Complications.

The surgical treatment for perforated peptic ulcers can be safely performed laparoscopically. The aim of the study was to define simple predictive factors for conversion and septic complications. This retrospective case-control study analyzed patients treated with either laparoscopic surgery or laparotomy for perforated peptic ulcers. A total of 71 patients were analyzed. Laparoscopically operated patients had a shorter hospital stay (13.7 vs. 15.1 days). In an intention-to-treat analysis, patients with conversion to open surgery (analyzed as subgroup from laparoscopic approach group) showed no prolonged hospital stay (15.3 days) compared to patients with a primary open approach. Complication and mortality rates were not different between the groups. The statistical analysis identified four intraoperative risk factors for conversion: Mannheim peritonitis index (MPI) > 21 (p = 0.02), generalized peritonitis (p = 0.04), adhesions, and perforations located in a region other than the duodenal anterior wall. We found seven predictive factors for septic complications: age >70 (p = 0.02), cardiopulmonary disease (p = 0.04), ASA > 3 (p = 0.002), CRP > 100 (p = 0.005), duration of symptoms >24 h (p = 0.02), MPI > 21(p = 0.008), and generalized peritonitis (p = 0.02). Our data suggest that a primary laparoscopic approach has no disadvantages. Factors necessitating conversions emerged during the procedure inhibiting a preoperative selection. Factors suggesting imminent septic complications can be assessed preoperatively. An assessment of the proposed parameters may help optimize the management of possible septic complications

Are there localized saddles behind the heterogeneous dynamics of supercooled liquids?

We numerically study the interplay between heterogeneous dynamics and properties of negatively curved regions of the potential energy surface in a model glassy system. We find that the unstable modes of saddles and quasi-saddles undergo a localization transition close to the Mode-Coupling critical temperature. We also find evidence of a positive spatial correlation between clusters of particles having large displacements in the unstable modes and dynamical heterogeneities.Comment: 7 pages, 3 figures, submitted to Europhys. Let