Anästhesie und Ahornsirupkrankheit: Fallbericht und perioperatives anästhesiologisches Management

Zusammenfassung: Die Ahornsirupkrankheit ist eine seltene autosomal-rezessive Stoffwechselerkrankung, der eine Störung der Decarboxylierung von verzweigtkettigen Aminosäuren zugrunde liegt. Erste Symptome zeigen sich bereits in der Neonatalperiode. Unbehandelt führt die Erkrankung zu rasch progredienter neurologischer Symptomatik. Während stressvoller Situationen wie Infektionen und Operationen können bei Patienten mit Ahornsirupkrankheit schwere ketoacidotische Zustände mit rapider neurologischer Verschlechterung und Hypoglykämien auftreten. Im vorliegenden Beitrag wird über das perioperative Management bei einem 26-jährigen Mann mit Ahornsirupkrankheit berichtet, ein Überblick über die Erkrankung gegeben, und die anästhesiologischen Implikationen werden diskutier

Effects of the Subterranean Aphid [\u3ci\u3eGeoica utricularia\u3c/i\u3e (Passerini)] on Forage Yield and Quality of Sand Lovegrass

In 1977 at Mead, Nebraska, replicated plots in two sand lovegrass (Eragroslis trichodes) nurseries naturally infested with root aphids (Geoica ufricularia Passerini) were treated with soil drenches of carbofuran and disulfoton (2.24 kg/ha AI) toquantify the economic importance of these aphids. In a nursery of ‘Nebraska 27’ sand lovegrass, the carbofurnn and disulfoton treated plots produced 45% and 16% more forage, respectively, than the untreated plots. In a nursery of another Nebraska experimental strain, the treated plots produced more forage than the untreated plots but the differences were not significant. There were no differences among treated and control plots in either nursery for dry matter, protein, and in vitro dry matter digestibility percentages

Effects of the Subterranean Aphid [\u3ci\u3eGeoica utricularia\u3c/i\u3e (Passerini)] on Forage Yield and Quality of Sand Lovegrass

In 1977 at Mead, Nebraska, replicated plots in two sand lovegrass (Eragroslis trichodes) nurseries naturally infested with root aphids (Geoica ufricularia Passerini) were treated with soil drenches of carbofuran and disulfoton (2.24 kg/ha AI) toquantify the economic importance of these aphids. In a nursery of ‘Nebraska 27’ sand lovegrass, the carbofurnn and disulfoton treated plots produced 45% and 16% more forage, respectively, than the untreated plots. In a nursery of another Nebraska experimental strain, the treated plots produced more forage than the untreated plots but the differences were not significant. There were no differences among treated and control plots in either nursery for dry matter, protein, and in vitro dry matter digestibility percentages

An Interactive Procedure for Multiobjective Analysis of Water Resources Allocation

This paper reports on part of IIASA's research concerning regional water management planning, focusing on the Western Skane region in Southern Sweden. The IIASA studies are concerned with four issues of particular importance to water resources management, namely, conflict resolution, criteria of choice, uncertainty, and institutional arrangements. This paper is related primarily to the first two of these issues. An interactive procedure seeking the satisfactory nondominated solution of the multiobjective water resources allocation problem is discussed. It is based on the Powell method with penalty function for the solution of scalar optimization problem and on a constraint and weighting method, or actually a reference objective method, for the solution of the multiobjective optimization problem. Application of the procedure is illustrated by an example referring to the situation in the Kavlinge River system in the Western Skane, Sweden

Probably Safe or Live

This paper presents a formal characterisation of safety and liveness properties \`a la Alpern and Schneider for fully probabilistic systems. As for the classical setting, it is established that any (probabilistic tree) property is equivalent to a conjunction of a safety and liveness property. A simple algorithm is provided to obtain such property decomposition for flat probabilistic CTL (PCTL). A safe fragment of PCTL is identified that provides a sound and complete characterisation of safety properties. For liveness properties, we provide two PCTL fragments, a sound and a complete one. We show that safety properties only have finite counterexamples, whereas liveness properties have none. We compare our characterisation for qualitative properties with the one for branching time properties by Manolios and Trefler, and present sound and complete PCTL fragments for characterising the notions of strong safety and absolute liveness coined by Sistla

Health-related quality of life in patients with a germline BRCA mutation and metastatic pancreatic cancer receiving maintenance olaparib

Qualitat de vida relacionada amb la salut; Olaparib; Càncer de pàncreesCalidad de vida relacionada con la salud; Olaparib, Cáncer de páncreasHealth-related quality of life; Olaparib; Pancreatic cancerBackground Patients with metastatic pancreatic cancer often have a detriment in health-related quality of life (HRQoL). In the randomized, double-blind, phase III POLO trial progression-free survival was significantly longer with maintenance olaparib, a poly(ADP-ribose) polymerase inhibitor, than placebo in patients with a germline BRCA1 and/or BRCA2 mutation (gBRCAm) and metastatic pancreatic cancer whose disease had not progressed during first-line platinum-based chemotherapy. The prespecified HRQoL evaluation is reported here. Patients and methods Patients were randomized to receive maintenance olaparib (300 mg b.i.d.; tablets) or placebo. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item module at baseline, every 4 weeks until disease progression, at discontinuation, and 30 days after last dose. Scores ranged from 0 to 100; a ≥10-point change or difference between arms was considered clinically meaningful. Adjusted mean change from baseline was analysed using a mixed model for repeated measures. Time to sustained clinically meaningful deterioration (TSCMD) was analysed using a log-rank test. Results Of 154 randomized patients, 89 of 92 olaparib-arm and 58 of 62 placebo-arm patients were included in HRQoL analyses. The adjusted mean change in Global Health Status (GHS) score from baseline was <10 points in both arms and there was no significant between-group difference [−2.47; 95% confidence interval (CI) −7.27, 2.33; P = 0.31]. Analysis of physical functioning scores showed a significant between-group difference (−4.45 points; 95% CI −8.75, −0.16; P = 0.04). There was no difference in TSCMD for olaparib versus placebo for GHS [P = 0.25; hazard ratio (HR) 0.72; 95% CI 0.41, 1.27] or physical functioning (P = 0.32; HR 1.38; 95% CI 0.73, 2.63). Conclusions HRQoL was preserved with maintenance olaparib treatment with no clinically meaningful difference compared with placebo. These results support the observed efficacy benefit of maintenance olaparib in patients with a gBRCAm and metastatic pancreatic cancer.This study was sponsored by AstraZeneca and is part of an alliance between AstraZeneca and MSD (no grant number). This research was funded in part through the NIH/NCI Cancer Center Support Grant P30-17 CA008748

Oxygen isotope analyses of Equus teeth evidences early Eemian and early Weichselian palaeotemperatures at the Middle Palaeolithic site of Neumark-Nord 2, Saxony-Anhalt, Germany

We thank Annabell Reiner (MPI-EVA) for technical and practical support with preparation of samples and Bernd Steinhilber for the oxygen isotope measurements of the silver phosphate samples at the Institut für Geowissenschaften (Universität Tübingen); Thanks to the Landesamt für Denkmalpflege und Archäologie, Sachsen-Anhalt, and Landesmuseum Sachsen-Anhalt in Halle for providing samples; and to Geoff Smith (RGZM Monrepos and MPI-EVA) for comments on earlier versions of this manuscript. Financial support for the Neumark-Nord 2 excavations was provided by the Lausitzer Mitteldeutsche Braunkohlengesellschaft mbH, the Landesamt für Denkmalpflege und Archäologie Sachsen-Anhalt (Harald Meller, Susanne Friederich), the Römisch-Germanisches Zentralmuseum Mainz, the Leids Universiteits Fonds “Campagne voor Leiden” program and the NetherlandsOrganization for Scientific Research (N.W.O.). The isotope research was funded by the Max Planck Institute and a Deutscher Akademischer Austausch Dienst Junior Research Grant to KB (ref: A0970923). Thanks also to the University of Aberdeen, and The Leverhulme Trust (RPG-2017-410) for financial and professional support during this project and preparation of the manuscript. TT acknowledges funding by the German National Science foundation in the framework of the Emmy Noether Program (DFG grant TU 148/2-1 “Bone Geochemistry”).Peer reviewedPostprin

Colored Petri Nets to Verify Extended Event-Driven Process Chains

Business processes are becoming more and more complex and at the same time their correctness is becoming a critical issue: The costs of errors in business information systems are growing due to the growing scale of their application and the growing degree of automation. In this paper we consider Extended Event-driven Process Chains (eEPCs), a language which is widely used for modeling business processes, documenting industrial reference models and designing workflows. We describe how to translate eEPCs into timed colored Petri nets in order to verify processes given by eEPCs with the CPN Tools

Anomalous magnetic response of the spin-one-half Falicov-Kimball model

The infinite-dimensional spin one-half Falicov-Kimball model in an external magnetic field is solved exactly. We calculate the magnetic susceptibility in zero field, and the magnetization as a function of the field strength. The model shows an anomalous magnetic response from thermally excited local moments that disappear as the temperature is lowered. We describe possible real materials that may exhibit this kind of anomalous behavior.Comment: 17 pages, 6 encapsulated postscript figures (included), submitted to Phys. Rev.

A Cyanobacteria Enriched Layer of Shark Bay Stromatolites Reveals a New Acaryochloris Strain Living in Near Infrared Light.

The genus Acaryochloris is unique among phototrophic organisms due to the dominance of chlorophyll d in its photosynthetic reaction centres and light-harvesting proteins. This allows Acaryochloris to capture light energy for photosynthesis over an extended spectrum of up to ~760 nm in the near infra-red (NIR) spectrum. Acaryochloris sp. has been reported in a variety of ecological niches, ranging from polar to tropical shallow aquatic sites. Here, we report a new Acarychloris strain isolated from an NIR-enriched stratified microbial layer 4-6 mm under the surface of stromatolite mats located in the Hamelin Pool of Shark Bay, Western Australia. Pigment analysis by spectrometry/fluorometry, flow cytometry and spectral confocal microscopy identifies unique patterns in pigment content that likely reflect niche adaption. For example, unlike the original A. marina species (type strain MBIC11017), this new strain, Acarychloris LARK001, shows little change in the chlorophyll d/a ratio in response to changes in light wavelength, displays a different Fv/Fm response and lacks detectable levels of phycocyanin. Indeed, 16S rRNA analysis supports the identity of the A. marina LARK001 strain as close to but distinct from from the A. marina HICR111A strain first isolated from Heron Island and previously found on the Great Barrier Reef under coral rubble on the reef flat. Taken together, A. marina LARK001 is a new cyanobacterial strain adapted to the stromatolite mats in Shark Bay