Storm damage in the Black Forest caused by the winter storm "Lothar" - Part 1: Airborne damage assessment

An airborne survey of the Black Forest as affected by the winter storm "Lothar" in 1999 is performed by means of a color line scanner (CLS) with a CCD sensor, whose data in a visible and a near-infrared channel provide the Normalized Difference Vegetation Index (NDVI) as a measure of the damage in previously intact forest areas. The camera data, height data from a digital evelation model (DEM), land use information, and soil data are georeferenced and processed in a geographic information system (GIS) to derive relationship of the damage pattern to the characteristics of the local orography and soil types. The data cover an area of 4900 km$^2$, 2767 km$^2$ of which were forested. The 363 detected storm damage areas with a minimum detection size of 1.5 ha amount to 0.8% of the total forest area. Visual inspections at certain sites prove that none of the larger damage areas are missed, but areas smaller than 1.5 ha cause the total damage area to be up to twice our result, i.e. ≈1.6% of the forest area. More than 50% of the detected damaged areas are smaller than 5 ha and most of them have a size ranging from 1.5 to 3.5 ha. Forests on slopes with an inclination angle between 10 and 15 degrees show the highest fraction of damaged forest, doubling those on plains and below 5 degrees inclination angle. Forests on northwestern slopes are more affected than those on southwestern and western slopes, which faced the wind during highest wind speed occurrence. In contrast to other studies, this paper shows, that in steep areas, lee slopes are more damaged than the luv slopes. As expected, wet to moist soils represent an unstable location for the trees. But also medium-dry to dry locations that were considered to be relatively stable exhibited a highly damaged forest fraction. This can be attributed to mostly saturated soil from previous rain

Diagnostic workup for endometrioid borderline ovarian tumors (eBOT) requires histopathological evaluation of the uterus

BACKGROUND For young borderline ovarian tumor (BOT) patients, preservation of the uterus was incorporated as an accepted option into treatment guidelines. For the endometrioid subtype (eBOT) however, adequate histological evaluation is challenging and might be associated with synchronous endometrial disorders or misinterpreted as spread from uterine primaries. CASE PRESENTATION We report the cases of two young patients with eBOT who underwent treatment according to current guidelines. In both cases, unexpected findings of invasive uterine carcinomas were established in final histopathological evaluation. CONCLUSIONS This constellation highlights the challenging diagnostic workup of BOT and underlines that uterine curettage is indispensable for eBOT to exclude uterine primary tumors when fertility preservation is planned. Accordingly, we suggest to include this procedure into recommendations for diagnostic workup and to state the potential risk in treatment guidelines

Cirulating Sézary Cells in the Diagnosis of Sézary Syndrome (Quantitative and Morphometric Analyses)

Plastic-embedded circulating Sézary cells were examined in semithin and thin sections (assisted by the nuclear contour index-NCI). Eight cases of Sézary syndrome were analyzed as well as 11 controls (3 cases of widespread eczemas and 8 cases of erythroderma), 7 cases of mycosis fungoides, and 3 healthy individuals. Discriminating criteria between Sézary syndrome and benign diseases were sought: in addition to Sézary cells (NCI > 6.5) intermediate lymphocytes (5.0 < NCI ≤ 6.5) proved to be helpful. Cases with Sézary syndrome were clearly differentiated when the following 3 ultrastructural criteria were fulfilled: (1) Sézary cells (SC) > 9%; (2) intermediate lymphocytes (IL) > 20%; (3) the sum of SC and IL > 37%.A good correlation between thin and semithin sections was obtained (correlation coefficient for Sézary cells r = 0.82). Usually the values of SC were slightly higher on thin sections. The diagnosis of SS can be made on semithin sections when the ultrastructural criteria are fulfilled. In this way 8 of 12 samples of Sézary syndrome were correctly classified. Therefore, semithin sections (studied by light microscopy) are recommended as a routine method in the diagnosis of cases suspected of Sézary syndrome, whereas thin sections (studied by electron microscopy) appeared to be necessary in problem cases only

Dermatofibrosarcoma Protuberans: Altered Collagen Metabolism in Cell Culture

Dermatofibrosarcoma protuberans is a low-grade malignant tumor that grows invasively but rarely forms metastases. Its origin is still controversial. We characterized the synthesis of collagen in detail in cells which were obtained from dermatofibrosarcoma protuberans tumors by enzymatic tissue disintegration. Similar to fibroblasts, all tumor cell strains produced considerable amounts of collagen. However, the rate was reduced compared to normal skin fibroblasts. Cells grown from the tumors synthesized type I collagen, but no type III could be detected. After serial passaging the cultures started to produce type III collagen, which is probably due to a slow overgrowth by normal fibroblasts

Implantação de indicadores de performance em uma indústria metalúgica: uma contribuição à gestão de resultados

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de Produção.A Pesquisa aborda a questão da geração, comunicação e utilização interna de indicadores de performance nas indústrias. Pesquisa a eficácia dos indicadores hoje disponíveis aos gerentes, como ferramentas capazes de responder às perguntas feitas no dia a dia da operação e nas necessidades de decisões. Verifica se há possibilidade de se criar de forma sistemática e adequada esse indicadores, após a escolha de um método para solução de problemas complexos, a SSM (Soft Sistem Metodology). Utiliza como fio condutor para as análises, fundamentações teóricas sobre modernas técnicas necessárias aos sistemas de informações gerenciais, modelagens sobre métodos racionais para solução de problemas complexos e pesquisa de campo sobre o estado da arte no uso de indicadores, aplicada aos alunos das últimas séries dos cursos de Administração de Empresas, Economia e Ciências Contábeis nos câmpi de Joinville e São Bento do Sul, da Universidade da Região de Joinville - UNIVILLE, pressupondo-os conhecedores dos sistemas informacionais nas empresas em que atuam, e focalizadamente, entrevistas realizadas com aplicação de questionário, aos gerentes de uma metalúrgica em Joinville. Os resultados obtidos mostraram como os usuários percebem os indicadores colocados à sua disposição e as carências que atribuiram aos sistemas de informação. Com base na análise das necessidades e dos possíveis modelos, disponíveis para suprirem as necessidades, pôde-se demostrar através de um processo racional, que envolveu gerentes de diversas áreas de uma metalúrgica, a geração e os benefícios em elaborar um indicador de performance eficaz, utilizando o método de aprendizagem/descoberta/ação denominado SSM (Soft Sistem Metodology)

Introducing a Specific Term to Present Caries Experience in Populations with Low Caries Prevalence: Specific Affected Caries Index (SaC)

Up to now, indices like the mean dmft/DMFT and the SiC (Significant Caries Index) have been used to depict caries experience in populations with high prevalence. With the caries decline, particularly for populations with low caries levels, these indices reach their statistical limits. This paper aims to introduce a specific term, the Specific affected Caries Index (SaC) for the risk groups in populations with low caries prevalence and to illustrate its use based on the consecutive German National Oral Health Survey (GNOHS) in children. In groups with a caries prevalence less than one-third of the population, many caries-free children (DMFT = 0) are included in the SiC (risk group), which calls for a new way of illustration. Mean caries experience (DMFT), caries prevalence, the SiC and SaC were portrayed for 12-year-olds in the GNOHS from 1994/95 to 2016. The SaC describes the mean caries experience (DMFT) in the group presenting caries experience (DMFT > 0). In 12-year-old 6th graders in Germany, the mean caries experience decreased from 2.4 (1994/95) to 0.4 DMFT (2016), with a recent prevalence of 21.2% (DMFT > 0, 2016). In 2016, the mean number of affected teeth in children with DMFT > 0 (SaC) was 2.1, while the SiC including 12% DMFT-free children in the risk group was 1.3. The SiC fails to reflect the caries severity in children in a population with low caries prevalence. Therefore, the newly introduced term Specific affected Caries Index (SaC) may be used to describe accurately caries experience in caries risk children in populations presenting low caries prevalence

Alternative caries management options for primary molars:2.5-yr outcomes of a randomised clinical trial

Less invasive caries management techniques for treating cavitated carious primary teeth, which involve the concept of caries control by managing the activity of the biofilm, are becoming common. This study aimed to compare the clinical efficacy (minor/major failures) and survival rates (successful cases without any failures) of 3 carious lesion treatment approaches, the Hall Technique (HT), non-restorative caries treatment (NRCT), and conventional restorations (CR), for the management of occlusoproximal caries lesions (ICDAS 3-5) in primary molars. Results at 2.5 years are presented. A total of 169 children (3- to 8-year-olds) were enrolled in this secondary care-based, 3-arm parallel-group, randomised controlled trial. Participants were allocated to: HT (n = 52; sealing caries with stainless-steel crowns without caries removal), NRCT (n = 52; opening up the cavity and applying fluoride varnish), CR (n = 65; control arm, complete caries removal and compomer restoration). Statistical analyses were: non-parametric Kruskal-Wallis analysis of variance, Mann-Whitney U test and Kaplan-Meier survival analyses. One hundred and forty-two participants (84%; HT = 40/52; NRCT = 44/52; CR = 58/65) had follow-up data of 1-33 months (mean = 26). Overall, 25 (HT = 2, NRCT = 9, CR = 14) of 142 participants (17.6%) presented with at least 1 minor failure (reversible pulpitis, caries progression, or secondary caries; p = 0.013, CI = 0.012-0.018; Mann-Whitney U test). Ten (HT = 1, NRCT = 4, CR = 5) of 142 participants (7.04%) experienced at least 1 major failure (irreversible pulpitis, abscess, unrestorable tooth; p = 0.043, CI = 0.034-0.045). Independent comparisons between 2 samples found that NRCT-CR had no statistically significant difference in failures (p > 0.05), but for CR-HT (p = 0.037, CI = 0.030-0.040) and for NRCT-HT (p = 0.011, CI = 0.010-0.016; Kruskal-Wallis test) significant differences were observed. Cumulative survival rates were HT = 92.5%, NRCT = 70.5%, and CR = 67.2% (p = 0.012). NRCT and CR outcomes were comparable. HT performed better than NRCT and CR for all outcomes. This study was funded by the Paediatric Dentistry Department, Greifswald University, Germany (Trial registration No. NCT01797458)

Cost-effectiveness of managing cavitated primary molar caries lesions:A randomized trial in Germany

The Hall Technique (HT), Non-Restorative Cavity Control (NRCC) and conventional carious tissue removal and restoration (CR) are strategies for managing cavitated caries lesions in primary molars. A randomized controlled three-arm parallel group trial in a university clinic in Germany was used to measure the cost-effectiveness of these strategies. 142 children (HT: 40; NRCC: 44; CR: 58) were followed over a mean 2.5 years. A German healthcare perspective was chosen. The primary outcome was estimated molar survival; secondary outcomes were not needing extraction, not having pain or needing endodontic treatment/extraction, or not needing any re-intervention at all. Initial, maintenance and endodontic/restorative/extraction re-treatment costs were derived from fee items of the statutory insurance. Cumulative cost-effectiveness and cost-effectiveness acceptability were estimated from bootstrapped samples. HT molars survived longer (estimated mean; 95% CI: 29.7; 26.6–30.5 months) than NRCC (25.3; 21.2–28.7 months) and CR molars (24.1; 22.0–26.2 months). HT was also less costly (66; 62–71 Euro) than NRCC (296; 274–318 Euro) and CR (83; 73–92 Euro). HT was more cost-effective than NRCC and CR in >96% of samples, and had acceptable cost-effectiveness regardless of a payer’s willingness-to-pay. This superior cost-effectiveness was confirmed for secondary health outcomes. Cost-advantages were even more pronounced when costs were calculated per year of tooth retention (mean annual costs were HT: 29, NRCC: 154, CR: 61 Euro). HT was more cost-effective than CR or NRCC for managing cavitated caries lesions in primary molars, yielding better dental health outcomes at lower costs. If choosing between these three strategies for managing cavitated caries lesions in primary molars, dentists should prefer HT over NRCC or CR. This would also save costs for the healthcare payer