Infrared thermography for the use in facial surgery

Abstract Today infrared thermography seems to be a useful and non-invasive tool in medical research as well as in clinical practice Therapy of midfacial fractures requires accurate reduction and fixation of bones to prevent mobility of fragments during fracture healing. This can be achieved by using titanium miniplates and screws. But drilling and screwing in bones shall be performed with an integrated cooling device for tissues and materials to avoid necrosis of hard and soft tissues. Even damage of nerval tissue and loss of the implants are possible. However, this can be prevented by the use of infrared thermography to measure temperatures on surfaces intraoperatively. In this study first observations were made during 36 experimental drillings on macerated human skulls. Then intraoperative measurements were done during treatment of 13 midfacial fractures

Sport coaches' experiences of athlete injury : the development and regulation of guilt

This study sought to examine coaches’ stories of guilt in the specific context of athlete injury. Using narrative interviews with a diverse group of ten coaches, guilt was found to be a commonly experienced emotion that the participants also sought to regulate. The coaches’ experiences of the embodiment and management of guilt is primarily, although not exclusively, interrogated using the mainstream psychological theorising of Kubany and Watson (2003). The article concludes by connecting the coaches’ experiences of guilt with critiques of the prevailing deontological approach used to define what it means to be a ‘good’ sport coach. Here we suggest that dominant perspectives in coach education may be instrumental in entrenching coaches’ experience of guilt

Management decisions in organization management model

This article focuses on the problem of improving management decision-making in the modern organization. Despite the existence of a large number of publications devoted to this subject, the relevance of the problem of managerial decision-making in modern management is very important. The article contains an analysis of classifications management decisions and proposes decomposition method to a better understanding of management decision, to expand the scope of its application, to define the degree of responsibility for decision-making, to improve efficiency of management decisions. And thus, the decomposition of management decisions acts as one of the foundations development of methodological approaches to the formation of an information for management solutions.Данная статья посвящена проблеме совершенствования процесса принятия управленческих решений в современных условиях на предприятии. Несмотря на существование большого количества публикаций, затрагивающих данную тему, вопрос об актуальности проблемы принятия управленческих решений в современном менеджменте остается весьма значимым. В статье автором проводится анализ классификационных признаков управленческих решений, раскрывается сам процесс принятия управленческих решений в организации, и предлагается метод декомпозиции, который позволит лучше понять сущность управленческого решения, расширить область его применения, обозначить степень ответственности за принятие решений, повысить эффективность принимаемых управленческих решений. И таким образом, декомпозиция управленческих решений выступает в роли одной из основ разработки методологических подходов к формированию информационной обеспечивающей управленческих решений

The Practice of Thresholds: Autonomy in Clinical Education Explored Through Variation Theory and the Threshold Concepts Framework

This paper demonstrates a practical dimension to the discussion about threshold concepts. Threshold concepts have thus far mostly been acknowledged to elucidate learning processes mainly connected to theoretical concepts. By exploring situations that prompted experiences of autonomy and authenticity in clinical learning, findings showed how a practical experience could have the same power to transform thinking and identity as theoretical thresholds and serve as a trigger for transformational learning, therefore making the discussion about ‘practical thresholds' or thresholds in practice possible. The present study explores situations that prompted autonomy and authenticity, and offers context for and substance to these situations by adopting variation theory and the threshold concept framework. In order to learn more about situations that prompt experiences of autonomy and authenticity, and create prerequisites for such experiences, this paper examines how students discern and interpret these situations by analysing them through variation theory and the threshold concept framework

Clinical characteristics and outcome of biopsy-proven myocarditis in children - Results of the German prospective multicentre registry "MYKKE"

BACKGROUND: Heart failure (HF) due to myocarditis might not respond in the same way to standard therapy as HF due to other aetiologies. The aim of this study was to investigate the value of endomyocardial biopsies (EMB) for clinical decision-making and its relation to the outcome of paediatric patients with myocarditis. METHODS: Clinical and EMB data of children with myocarditis collected for the MYKKE-registry between 2013 and 2020 from 23 centres were analysed. EMB studies included histology, immunohistology, and molecular pathology. The occurrence of major adverse cardiac events (MACE) including mechanical circulatory support (MCS), heart transplantation, and/or death was defined as a combined endpoint RESULTS: Myocarditis was diagnosed in 209/260 patients: 64% healing/chronic lymphocytic myocarditis, 23% acute lymphocytic myocarditis (AM), 14% healed myocarditis, no giant cell myocarditis. The median age was 12.8 (1.4–15.9) years. Time from symptom-onset to EMB was 11.0 (4.0–29.0) days. Children with AM and high amounts of mononuclear cell infiltrates were significantly younger with signs of HF compared to those with healing/chronic or healed myocarditis. Myocardial viral DNA/RNA detection had no significant effect on outcome. The worst event-free survival was seen in patients with healing/chronic myocarditis (24%), followed by acute (31%) and healed myocarditis (58%, p = 0.294). A weaning rate of 64% from MCS was found in AM. CONCLUSIONS: EMB provides important information on the type and stage of myocardial inflammation and supports further decision-making. Children with fulminant clinical presentation, high amounts of mononuclear cell infiltrates or healing/chronic inflammation and young age have the highest risk for MACE

Mu2e Technical Design Report

The Mu2e experiment at Fermilab will search for charged lepton flavor violation via the coherent conversion process mu- N --> e- N with a sensitivity approximately four orders of magnitude better than the current world's best limits for this process. The experiment's sensitivity offers discovery potential over a wide array of new physics models and probes mass scales well beyond the reach of the LHC. We describe herein the preliminary design of the proposed Mu2e experiment. This document was created in partial fulfillment of the requirements necessary to obtain DOE CD-2 approval.Comment: compressed file, 888 pages, 621 figures, 126 tables; full resolution available at http://mu2e.fnal.gov; corrected typo in background summary, Table 3.

Meta-analysis of type 2 Diabetes in African Americans Consortium

Type 2 diabetes (T2D) is more prevalent in African Americans than in Europeans. However, little is known about the genetic risk in African Americans despite the recent identification of more than 70 T2D loci primarily by genome-wide association studies (GWAS) in individuals of European ancestry. In order to investigate the genetic architecture of T2D in African Americans, the MEta-analysis of type 2 DIabetes in African Americans (MEDIA) Consortium examined 17 GWAS on T2D comprising 8,284 cases and 15,543 controls in African Americans in stage 1 analysis. Single nucleotide polymorphisms (SNPs) association analysis was conducted in each study under the additive model after adjustment for age, sex, study site, and principal components. Meta-analysis of approximately 2.6 million genotyped and imputed SNPs in all studies was conducted using an inverse variance-weighted fixed effect model. Replications were performed to follow up 21 loci in up to 6,061 cases and 5,483 controls in African Americans, and 8,130 cases and 38,987 controls of European ancestry. We identified three known loci (TCF7L2, HMGA2 and KCNQ1) and two novel loci (HLA-B and INS-IGF2) at genome-wide significance (4.15 × 10(-94)<P<5 × 10(-8), odds ratio (OR)  = 1.09 to 1.36). Fine-mapping revealed that 88 of 158 previously identified T2D or glucose homeostasis loci demonstrated nominal to highly significant association (2.2 × 10(-23) < locus-wide P<0.05). These novel and previously identified loci yielded a sibling relative risk of 1.19, explaining 17.5% of the phenotypic variance of T2D on the liability scale in African Americans. Overall, this study identified two novel susceptibility loci for T2D in African Americans. A substantial number of previously reported loci are transferable to African Americans after accounting for linkage disequilibrium, enabling fine mapping of causal variants in trans-ethnic meta-analysis studies.Peer reviewe

Meso- and macrozooplankton communities in the Weddell Sea, Antarctica

The present paper describes composition and abundance of meso- and macrozooplankton in the epipelagic zone of the Weddell Sea and gives a systematic review of encountered species regarding results of earlier expeditions. Material was sampled from 6 February to 10 March 1983 from RV Polarstern with a RMT 1+8 m (320 and 4500 μm mesh size). In agreement with topography and water mass distribution three distinct communities were defined, clearly separated by cluster analysis: The Southern Shelf Community has lowest abundances (approx. 9000 ind./1000 m3). Euphausia crystallorophias and Metridia gerlachei are predominating. Compared with the low overall abundance the number of regularly occurring species is high (55) due to many neritic forms. Herbivores and omnivores are dominating (58% and 35%). The North-eastern Shelf Community has highest abundances (about 31 000 ind./1000 m3). It is predominated by copepodites I–III of Calanus propinquus and Calanoides acutus (61%). The faunal composition is characterized by both oceanic and neritic species (64). Fine-filter feeders are prevailing (65%). The Oceanic Community has a mean abundance of approximately 23 000 ind./1000 m3, consisting of 61 species. Dominances are not as pronounced as in the shelf communities. Apart from abundant species like Calanus propinquus, Calanoides acutus, Metridia gerlachei, Oithona spp. and Oncaea spp. many typical inhabitants of the Eastwind Drift are encountered. All feeding types have about the same importance in the Oceanic Community

Establishing the interaction between the CC chemokine ligand 5 and the receptors CCR1 and CCR5

Chemokines are important mediators and regulators of leukocyte trafficking, therefore, they play a crucial role in the development of inflammatory diseases. CCL5 or RANTES (regulated upon activation, normal T cell expressed and secreted) is a chemokine of relevance to many diseases. Moreover, CCL5-induced monocyte adhesion to inflamed endothelium was shown to be improved in the presence of CXCL4 (Platelet Factor 4). Since this synergy could be attributed to heterodimer formation, the first section of the present study surveys the structural interaction of CCL5 with CXCL4. The interaction was monitored employing the 15N-1H heteronuclear single quantum coherence (HSQC) nuclear magnetic resonance (NMR) technique. For this purpose, 15N-enriched CCL5 was recombinantly expressed in E. coli and subsequently purified. In HSQC spectroscopy, chemical shift changes were mainly observed in the N-terminal residues, which pointed toward a CC-type rather than a CXC-type interaction. Furthermore, small peptide antagonists, inhibiting the CXCL4/CCL5 dimerization, were designed (CKEY2 and the mouse orthologue MKEY). To investigate their pharmacological potential, the influence of MKEY on leukocyte adhesion to activated endothelium was monitored using intravital microscopy. As a control Met-CCT5, a strong antagonist for CCR1 and CCR5, was cloned, expressed and purified employing FPLC and HPLC techniques. Leukocyte recruitment was severely impaired in the presence of MKEY, compared to a control peptide (sMKEY) and in a similar range of Met-CCL5 which encourages the assumption that the synergy is mediated via the receptors CCR1 and/or CCR5. Despite all similarities, CCR1 and CCR5 were shown to mediate distinct functions when bound to CCL5, CCR1 rather mediates arrest and CCR5 appears to be more responsible for transendothelial migration. To establish which domains are important for this functional selectivity, we constructed different CCR5 variants with the distinct extracellular regions of CCR1. These chimeras were stably expressed in L1.2 and HEK293 cells and we investigated their function in response to CCL5, different CCL5 mutants, or together with CXCL4 using chemotaxis and cell arrest assays under laminar flow. First of all, CCL5, CCL5 40s and CCL5-E66A were recombinantly expressed and purified employing FPLC and HPLC techniques. By implementing CCL5 mutants (e.g. CCL5-E66A) with oligomerization defects in laminar flow assays, we were able to show that all receptor variants require oligomerization of CCL5 in order to function properly. In addition, our results reveal that the 40S loop of CCL5 is important for both the CCR1- and CCR5-mediated cell arrest. The 50s loop of CCL5, however, appeared to have a strong preference for CCR5 in inducing cell arrest, since CCR1 responded normal towards CCL5 50s and CCR5 being non-responsive. When the N-terminal domain of CCR5 was exchanged for that of CCR1, the resulting chimera was fully responsive towards CCL5 50s, suggesting that the N-terminal region of CCR1 interacts with the 50s domain of CCR5. The synergistic effect of CXCL4 on CCL5 induced cell arrest was observed in cells exclusively expressing CCR1 when compared to cells expressing CCR5. When the third extracellular loop of CCR1 was engineered into CCR5, the resulting chimeric receptor showed a significant response to the CXCL4/CCL5 heterocomplex, compared to CCL5 alone. These results were confirmed by constructing CCR1-based reverse chimeras for the N-terminal domain and the third extracellular loop. Furthermore we could show the heterodimerization of CCR1 and CCR5 and the synergy of the CXCL4/CCL5 complex is in THP-1 cells mediated via Gαi. In conclusion these results indicate that the extracellular regions of CCR1 and CCR5 have distinct and defined functions in leukocyte recruitment in response to CCL5. In the third section of this thesis the role of the sialyltransferase ST3Gal-IV on CCL5 receptor interaction was investigated, by using neutrophils and monocytes isolated from ST3Gal-IV deficient and from control mice in functional assays in vitro. The results indicate that the addition of sialic acids to the terminal portions of the N- or O-linked sugar chains of the corresponding receptors of CCL5 is of a minor importance for receptor binding and activation, since the cells similarly mobilize calcium upon stimulation with CCL5. Whereas, the adhesion of neutrophils and monocytes from ST3Gal-IV-/- was significant diminished. Taken together the results obtained here rather support the importance of ST3Gal-IV on the generation of functional selectins, which is in line with previous publications