Susceptibility functions for slow relaxation processes in supercooled liquids and the search for universal relaxation patterns

In order to describe the slow response of a glass former we discuss some distribution of correlation times, e.g., the generalized gamma distribution (GG) and an extension thereof (GGE), the latter allowing to reproduce a simple peak susceptibility such as of Cole-Davidson type as well as a susceptibility exhibiting an additional high frequency power law contribution (excess wing). Applying the GGE distribution to the dielectric spectra of glass formers exhibiting no beta-process peak (glycerol, propylene carbonate and picoline) we are able to reproduce the salient features of the slow response (1e-6 Hz - 1e9 Hz). A line shape analysis is carried out either in the time or frequency domain and in both cases an excess wing can be identified. The latter evolves in a universal way while cooling and shows up for correlation times tau_alpha > 1e-8 s. It appears that its first emergence marks the break down of the high temperature scenario of mode coupling theory. - In order to describe a glass former exhibiting a beta-process peak we have introduced a distribution function which is compatible with assuming a thermally activated process in contrast to some commonly used fit functions. Together with the GGE distribution this function allows in the frame of the Williams-Watts approach to completely interpolate the spectra, e.g. of fluoro aniline (1e-6 Hz - 1e9 Hz). The parameters obtained indicate an emergence of both the excess wing and the beta-process again at tau_alpha > 1e-8s.Comment: 22 pages, 12 figure

Predictors associated with mortality of extracorporeal life support therapy for acute heart failure: single-center experience with 679 patients

Background: Extracorporeal life support (ECLS) therapy is increasingly used for cardiac and respiratory support postcardiotomy, refractory cardiogenic shock and cardiopulmonary resuscitation. This study aims to describe in-hospital mortality of patients requiring ECLS, identify independent predictors associated with mortality and analyze changes of mortality over time. Methods: This retrospective study includes all adult ECLS cases at the University Hospital Zurich, a designated ECLS center in Switzerland, in the period 2007 to 2019. Results: ECLS therapy was required in 679 patients (median age 60 years, 27.5% female). In-hospital mortality was 55.5%. Cubic spline interpolation did not detect evidence for a change in mortality over the whole period of 13 years. In-hospital mortality significantly varied between ECLS indications: 70.7% (152/215) for postcardiotomy, 67.9% (108/159) for cardiopulmonary resuscitation, 47.0% (110/234) for refractory cardiogenic shock, and 9.9% (7/71) for lung transplantation and expansive thoracic surgery (P<0.001). Logistic regression modelling showed excellent discrimination in the receiver operating characteristic (ROC) area under the curve (AUC) of 0.89 [95% confidence interval (CI): 0.87-0.92] and identified significant mortality predictors: age, simplified acute physiology score (SAPS) II, as well as new liver failure and each allogenic blood transfusion unit given per day. ECLS after cardiopulmonary resuscitation was associated with significantly higher mortality compared to ECLS for refractory cardiogenic shock. Conclusions: In-hospital mortality of patients treated with ECLS therapy is high. Outcomes have not changed significantly in the observed period. We identified age, SAPS II, new liver failure and each allogenic blood transfusion unit given per day as independent mortality predictors. Knowledge of predictors strongly associated with in-hospital mortality may affect future decisions about ECLS indications and the respective management to use this elaborate therapy more effectively. Keywords: Extracorporeal circulation; extracorporeal life support (ECLS)/extracorporeal membrane oxygenation (ECMO); mortality; outcome; predictor

An evaluation of physical and augmented patient-specific intracranial aneurysm simulators on microsurgical clipping performance and skills: a randomized controlled study

Objective: In the era of flow diversion, there is an increasing demand to train neurosurgeons outside the operating room in safely performing clipping of unruptured intracranial aneurysms. This study introduces a clip training simulation platform for residents and aspiring cerebrovascular neurosurgeons, with the aim to visualize peri-aneurysm anatomy and train virtual clipping applications on the matching physical aneurysm cases. Methods: Novel, cost-efficient techniques allow the fabrication of realistic aneurysm phantom models and the additional integration of holographic augmented reality (AR) simulations. Specialists preselected suitable and unsuitable clips for each of the 5 patient-specific models, which were then used in a standardized protocol involving 9 resident participants. Participants underwent four sessions of clip applications on the models, receiving no interim training (control), a video review session (video), or a video review session and holographic clip simulation training (video + AR) between sessions 2 and 3. The study evaluated objective microsurgical skills, which included clip selection, number of clip applications, active simulation time, wrist tremor analysis during simulations, and occlusion efficacy. Aneurysm occlusions of the reference sessions were assessed by indocyanine green videoangiography, as well as conventional and photon-counting CT scans. Results: A total of 180 clipping procedures were performed without technical complications. The measurements of the active simulation times showed a 39% improvement for all participants. A median of 2 clip application attempts per case was required during the final session, with significant improvement observed in experienced residents (postgraduate year 5 or 6). Wrist tremor improved by 29% overall. The objectively assessed aneurysm occlusion rate (Raymond-Roy class 1) improved from 76% to 80% overall, even reaching 93% in the extensively trained cohort (video + AR) (p = 0.046). Conclusions: The authors introduce a newly developed simulator training platform combining physical and holographic aneurysm clipping simulators. The development of exchangeable, aneurysm-comprising housings allows objective radio-anatomical evaluation through conventional and photon-counting CT scans. Measurable performance metrics serve to objectively document improvements in microsurgical skills and surgical confidence. Moreover, the different training levels enable a training program tailored to the cerebrovascular trainees' levels of experience and needs

Sonatas, flute, piano, op. 15

score and part. 34 cm

Fantasie, organ

26 p. 23 x 31 cm. Cover title

Suites, flute, piano, op. 16

score and part. 35 cm

Passacaglia, organ

7 p. 31 cm. Cover title