„Ei“-Pakete in Pinna decussata Goldfuss (Bivalvia) – ein indirekter Nachweis kreidezeitlicher Pinnotheridae de Haan (Crustacea

Eiähnliche Gebilde aus Feuerstein- und Kreidefüllungen der Steckmuschel Pinna decussata Goldfuss, 1837 (Bivalvia: Ostreida) aus dem oberen Unter-Maastrichtium der Insel Rügen/Vorpommern werden beschrieben. Gegenüber der ersten vorläufigen Beschreibung durch Kutscher (1970) können diese früheren Deutungen dahingehend erweitert werden, dass es sich bei den „Eiern“, bzw. „Ei“-Pake-ten, um den Laich muschelbewohnender Krebse handeln könnte. Weitere Interpretationen werden diskutiert. Die durch Kříž& Soukup (1975) vertretene Meinung, dass es sich um Kalziumphosphat-Ooide handelt, kann ausgeschlossen werden. Die Untersuchung der Steinkern-Oberflächen der „eier“führenden Muscheln ergab bei 30 % von ihnen den Nachweis von Krebsresten. Sollte sich die vermutete Beziehung zwischen Pinna, den „Eiern“ und den derzeit unbestimmbaren Krebsresten bewahrheiten, wäre dies der erstmalige indirekte Nachweis für die Existenz muschelbewohnender Krebse (Pinnotheridae de Haan, 1833) in der Ober-Kreide Europas.Kutscher M & Weinrich M: Egg packages in fossil Pinna decussata Goldfuss (Bivalvia) provide indirect evidence of Cretaceous mem-bers of the Pinnotheridae de Haan (Crustacea).Egg-like structures, occurring singly or clustered into packages, have been discovered from the flint or chalk infillings of fossil Pinna decussata Goldfuss, 1837 (Bivalvia: Ostreida) from upper Lower Maastrichtian chalk of the Isle of Ruegen, western Pomerania. The initial description of these structures by Kutscher (1970) is revised, and the hypothesis offered that the “eggs” and “egg” packages could repre-sent the spawn of clam-inhabiting crabs. The interpretation of the “eggs” as calciumphosphatic oolites (Kříž & Soukup 1975) is dismissed. Thorough screenings of the steinkern surfaces of the “egg”-bearing bivalves revealed that 30% of the specimens contained brachyuran remains. If in fact a relationship existed between Pinna, the “eggs” and the remains of decapod crustaceans, then the discovery would represent the first record of Late Cretaceous clam-inhabiting crabs (Pinnotheridae de Haan, 1833) from Europe

Haemorrhagic pseudocyst of the pancreatic tail causing acute abdominal pain in a 12-year-old girl

Pancreatic disorders are a relatively uncommon event in children, particularly the development of pancreatic pseudocysts. The most common cause for the development of such pseudocysts is blunt abdominal trauma with injury of the pancreatic parenchyma. Further aetiologies include congenital anomalies of the pancreatic duct such as pancreatic divisum, hereditary or idiopathic pancreatitis. Various treatment options for pancreatic pseudocysts including internal or external drainage have been described. We describe the case of a 12-year-old girl with acute abdominal pain and a left-sided retroperitoneal tumour. She underwent laparotomy to identify the aetiology of her severe abdominal pain. A haemorrhagic pancreatic pseudocyst was identified as the underlying pathology. Internal drainage by pseudocyst jejunostomy was performed. The postoperative course was uneventful. The underlying aetiology of the pseudocyst remains unclear. As there was no  previous history of pancreatitis, unrecognized blunt trauma was the most likely  cause.Keywords: childhood, haemorrhage, pancreatic pseudocyst, retroperitoneal tumou

Property and Shape Modulation of Carbon Fibers Using Lasers

An exciting challenge is to create unduloid-reinforcing fibers with tailored dimensions to produce synthetic composites with improved toughness and increased ductility. Continuous carbon fibers, the state-of-the-art reinforcement for structural composites, were modified via controlled laser irradiation to result in expanded outwardly tapered regions, as well as fibers with Q-tip (cotton-bud) end shapes. A pulsed laser treatment was used to introduce damage at the single carbon fiber level, creating expanded regions at predetermined points along the lengths of continuous carbon fibers, while maintaining much of their stiffness. The range of produced shapes was quantified and correlated to single fiber tensile properties. Mapped Raman spectroscopy was used to elucidate the local compositional and structural changes. Irradiation conditions were adjusted to create a swollen weakened region, such that fiber failure occurred in the laser treated region producing two fiber ends with outwardly tapered ends. Loading the tapered fibers allows for viscoelastic energy dissipation during fiber pull-out by enhanced friction as the fibers plough through a matrix. In these tapered fibers, diameters were locally increased up to 53%, forming outward taper angles of up to 1.8°. The tensile strength and strain to failure of the modified fibers were significantly reduced, by 75% and 55%, respectively, ensuring localization of the break in the expanded region; however, the fiber stiffness was only reduced by 17%. Using harsher irradiation conditions, carbon fibers were completely cut, resulting in cotton-bud fiber end shapes. Single fiber pull-out tests performed using these fibers revealed a 6.75-fold increase in work of pull-out compared to pristine carbon fibers. Controlled laser irradiation is a route to modify the shape of continuous carbon fibers along their lengths, as well as to cut them into controlled lengths leaving tapered or cotton-bud shapes

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Assessment of Quality of Life after Endovascular and Open Abdominal Aortic Aneurysm Repair: A Retrospective Single-Center Study

Postoperative quality of life is an important outcome parameter after treatment of abdominal aortic aneurysms. The aim of this retrospective single-center study was to assess and compare the health-related quality of life (HRQoL) of patients after open repair (OR) or endovascular treatment (EVAR), and furthermore to investigate the effect of incisional hernia (IH) formation on HRQoL. Patients who underwent OR or EVAR for treatment of an abdominal aortic aneurysm between 2008 and 2016 at a University Medical Center were included. HRQoL was assessed using the SF-36 questionnaire. The incidence of IH was recorded from patient files and by telephone contact. SF-36 scores of 83 patients (OR: n = 36; EVAR: n = 47) were obtained. The mean follow-up period was 7.1 years. When comparing HRQoL between OR and EVAR, patients in both groups scored higher in one of the eight categories of the SF36 questionnaires. The incidence of IH after OR was 30.6%. In patients with postoperative IH, HRQoL was significantly reduced in the dimensions “physical functioning”, “role physical” and “role emotional” of the SF-36. Based on this data, it can be concluded that neither OR nor EVAR supply a significant advantage regarding HRQoL. In contrast, the occurrence of IH has a relevant impact on the HRQoL of patients after OR

Evaluation of Hyperspectral Imaging for Follow-Up Assessment after Revascularization in Peripheral Artery Disease

Background: Assessment of tissue oxygenation is an important aspect of detection and monitoring of patients with peripheral artery disease (PAD). Hyperspectral imaging (HSI) is a non-contact technology for assessing microcirculatory function by quantifying tissue oxygen saturation (StO2). This study investigated whether HSI can be used to monitor skin oxygenation in patients with PAD after appropriate treatment of the lower extremities. Methods: For this purpose, 37 patients with PAD were studied by means of ankle–brachial index (ABI) and HSI before and after surgical or endovascular therapy. Thereby, the oxygenation parameter StO2 and near infrared (NIR) perfusion index were quantified in seven angiosomes on the diseased lower leg and foot. In addition, the effects of skin temperature and physical activity on StO2 and the NIR perfusion index and the respective inter-operator variability of these parameters were investigated in 25 healthy volunteers. Results: In all patients, the ABI significantly increased after surgical and endovascular therapy. In parallel, HSI revealed significant changes in both StO2 and NIR perfusion index in almost all studied angiosomes depending on the performed treatment. The increase in tissue oxygenation saturation was especially pronounced after surgical treatment. Neither heat nor cold, nor physical activity, nor repeated assessments of HSI parameters by independent investigators significantly affected the results on StO2 and the NIR perfusion index. Conclusions: Tissue oxygen saturation data obtained with HSI are robust to external confounders, such as temperature and physical activity, and do not show inter-operator variability; therefore, can be used as an additional technique to established methods, such as the ABI, to monitor peripheral perfusion in patients with PAD

Concomitant chronic venous insufficiency in patients with peripheral artery disease: insights from MR angiography

Objectives!#!The clinical presentation of peripheral artery disease (PAD) and chronic venous insufficiency (CVI) can overlap and the conditions may co-exist. The purpose of our study was to investigate the prevalence and clinical significance of concomitant CVI in patients with PAD examined with run-off MR angiography (MRA).!##!Methods!#!We analysed 180 patients (median age 69 years, range 27 to 91) with known or suspected PAD who underwent MRA at our institution between 2012 and 2018. MRA datasets were re-evaluated for manifestations of CVI. Electronic charts were reviewed to analyse whether diagnosis of CVI was documented and to determine Fontaine stage of PAD.!##!Results!#!Evidence of possible CVI on MRA was found in 38 (21%) patients. Only seven (18%) of these patients had a documented diagnosis of CVI. Patients with co-existing PAD and CVI were more likely obese (median BMI 29.7 vs. 26.3 kg/m!##!Conclusions!#!Signs of possible concomitant CVI can be seen in approximately one-fifth of patients with known or suspected PAD examined with run-off MRA. If present, these findings should be reported since CVI may mimic or contribute to symptoms attributed to PAD.!##!Key points!#!• In total, 21% of patients with PAD patients examined with MR angiography show signs of possible co-existing CVI. • Patients with co-existing CVI were 1.7-fold more likely to have a clinical diagnosis of stage IV PAD. • Our data also showed that co-existing chronic venous insufficiency is under-diagnosed in patients with PAD