Narrow band imaging (NBI) during medical thoracoscopy: first impressions

<p>Abstract</p> <p>Background</p> <p>This is the first ever evaluation of narrow band imaging (NBI), an innovative endoscopic imaging procedure, for the visualisation of pleural processes.</p> <p>Methods</p> <p>The pleural cavity was examined in 26 patients with pleural effusions using both white light and narrow band imaging during thoracoscopy under local anaesthesia.</p> <p>Results</p> <p>In the great majority of the patients narrow band imaging depicted the blood vessels more clearly than white light, but failed to reveal any differences in number, shape or size. Only in a single case with pleura thickened by chronic inflammation and metastatic spread of lung cancer did narrow band imaging show vessels that were not detectable under white light.</p> <p>Conclusion</p> <p>It is not yet possible to assess to what extent the evidence provided by NBI is superior to that achieved with white light. Further studies are required, particularly in the early stages of pleural processes.</p

Mechanical losses in low loss materials studied by Cryogenic Resonant Acoustic spectroscopy of bulk materials (CRA spectroscopy)

Mechanical losses of crystalline silicon and calcium fluoride have been analyzed in the temperature range from 5 to 300 K by our novel mechanical spectroscopy method, cryogenic resonant acoustic spectroscopy of bulk materials (CRA spectrocopy). The focus lies on the interpretation of the measured data according to phonon-phonon interactions and defect induced losses in consideration of the excited mode shape.Comment: 4 pages, 4 figures, proceedings of the PHONONS 2007, submitted to Journal of Physics: Conference Serie

Improving system of objectives maturity through systematic reuse of knowledge using ontology-based knowledge representations

Technical products are developed to meet the needs of different stakeholders. In addition, various constraints from all phases of the product life cycle have to be considered. In existing work, this information and its dependencies are systematically represented in the so-called system of objectives. A major challenge in modeling the system of objectives is that the necessary information in the system of objectives is often incomplete and uncertain. In addition, this uncertainty and the maturity of the system of objectives cannot be directly quantified because the target state of the system of objectives often cannot be unambiguously described. This research investigates a methodical approach to assess and improve the maturity of the system of objectives. Two means to reduce uncertainty and thus increase the maturity of the system of objectives are the systematic reuse of knowledge and the systematic building of knowledge through verification and validation activities

Genetic Organization of Acquired Antimicrobial Resistance Genes and Detection of Resistance-Mediating Mutations in a Gallibacterium anatis Isolate from a Calf Suffering from a Respiratory Tract Infection

Gallibacterium (G.) anatis isolates associated with respiratory diseases in calves and harboring acquired antimicrobial resistance genes have been described in Belgium. The aim of this study was to analyze the genetic organization of acquired resistance genes in the G. anatis isolate IMT49310 from a German calf suffering from a respiratory tract infection. The isolate was submitted to antimicrobial susceptibility testing, and a closed genome was obtained by a hybrid assembly of Illumina MiSeq short-reads and MinION long-reads. Isolate IMT49310 showed elevated MIC values for macrolides, aminoglycosides, florfenicol, tetracyclines, and trimethoprim/sulfamethoxazole. The acquired resistance genes catA1, floR, aadA1, aadB, aphA1, strA, tet(M), tet(B), erm(B), and sul2 were identified within three resistance gene regions in the genome, some of which were associated with IS elements, such as ISVsa5-like or IS15DII. Furthermore, nucleotide exchanges within the QRDRs of gyrA and parC, resulting in amino acid exchanges S83F and D87A in GyrA and S80I in ParC, were identified. Even if the role in the pathogenesis of respiratory tract infections in cattle needs to be further investigated, the identification of a G. anatis isolate with reduced susceptibility to regularly used antimicrobial agents in cases of fatal bovine respiratory tract infections is worrisome, and such isolates might also act as a reservoir for antimicrobial resistance genes

Whole-Genome Sequence of the Mycoplasma (Mesomycoplasma) hyorhinis DSM 25591 Type Strain

The whole-genome sequence of the type strain Mycoplasma (Mesomycoplasma) hyorhinis DSM 25591 is reported and compared to the available sequences of the corresponding type strains from other strain collections to ascertain conformity. Knowledge of the identity of type strains is of importance for their application in standardized test systems

On the mechanical quality factors of cryogenic test masses from fused silica and crystalline quartz

Current interferometric gravitational wave detectors (IGWDs) are operated at room temperature with test masses made from fused silica. Fused silica shows very low absorption at the laser wavelength of 1064 nm. It is also well suited to realize low thermal noise floors in the detector signal band since it offers low mechanical loss, i. e. high quality factors (Q factors) at room temperature. However, for a further reduction of thermal noise, cooling the test masses to cryogenic temperatures may prove an interesting technique. Here we compare the results of Q factor measurements at cryogenic temperatures of acoustic eigenmodes of test masses from fused silica and its crystalline counterpart. Our results show that the mechanical loss of fused silica increases with lower temperature and reaches a maximum at 30 K for frequencies of slightly above 10 kHz. The losses of crystalline quartz generally show lower values and even fall below the room temperature values of fused silica below 10 K. Our results show that in comparison to fused silica, crystalline quartz has a considerably narrower and lower dissipation peak on cooling and thus has more promise as a test mass material for IGDWs operated at cryogenic temperatures. The origin of the different Q factor versus temperature behavior of the two materials is discussed.Comment: 11 pages, 2 figures, submitted to Class. Quantum Gra

Cost evaluation of an innovative outreach clinic across social insurance codes in rural Northern Germany - A routine data analysis

A community outreach clinic was established in 2013 in a rural part of Germany to counsel and better integrate patients with mental health disorders or clients with psychosocial problems into the healthcare and complementary social assistance system. In a pilot study, we aimed to evaluate the costs of the integration assistance system after the outreach clinic was opened, the number of visits and the trend in the costs of the social assistance system of the federal state. Anonymised secondary cost data were used to evaluate the costs associated with the integration assistance receivers before (2010–2012) and after the establishment of the outreach clinic (2013–2015). Total costs were descriptively compared between the intervention group (consultation in the outreach clinic), the non-referral group, and a propensity score-matched control group for the years 2013–2015. To monitor the counselling activity, we used anonymised data on visits to the outreach clinic between 2013 and 2015. Data from 50 clients in the outreach clinic and 678 non-referral clients were analysed. The total costs of the integration assistance for the years 2013–2015 amounted to EUR 21,516 (95% CI 14,513–28,518) and EUR 28,464 (25,789–31,140) respectively. Propensity score matching of the controls resulted in equalised total costs for the years 2013 through 2015 for clients (n = 50, EUR 21,516 (14,513–28,518)) and controls (n = 250, EUR 21,725 (18,214–25,234)). The total number of integration assistance receivers in the district was lower than the average for the federal state. The number of consultations at the outpatient clinic steadily increased from 146 in 2013 to 1,090 in 2015. Counselling in the outreach clinic might help reduce the placement of clients into integration assistance, including supported housing, and slow the expected cost trend. However, counselling failed to lower total costs in the integration assistance service, possibly due to the selection of more severe cases

Genetic diversification of persistent Mycobacterium abscessus within cystic fibrosis patients

Mycobacterium (M.) abscessus infections in Cystic Fibrosis (CF) patients cause a deterioration of lung function. Treatment of these multidrug-resistant pathogens is associated with severe side-effects, while frequently unsuccessful. Insight on M. abscessus genomic evolvement during chronic lung infection would be beneficial for improving treatment strategies. A longitudinal study enrolling 42 CF patients was performed at a CF center in Berlin, Germany, to elaborate phylogeny and genomic diversification of in-patient M. abscessus. Eleven of the 42 CF patients were infected with M. abscessus. Five of these 11 patients were infected with global human-transmissible M. abscessus cluster strains. Phylogenetic analysis of 88 genomes from isolates of the 11 patients excluded occurrence of M. abscessus transmission among members of the study group. Genome sequencing and variant analysis of 30 isolates from 11 serial respiratory samples collected over 4.5 years from a chronically infected patient demonstrated accumulation of gene mutations. In total, 53 genes exhibiting non-synonymous variations were identified. Enrichment analysis emphasized genes involved in synthesis of glycopeptidolipids, genes from the embABC (arabinosyltransferase) operon, betA (glucose-methanol-choline oxidoreductase) and choD (cholesterol oxidase). Genetic diversity evolved in a variety of virulence- and resistance-associated genes. The strategy of M. abscessus populations in chronic lung infection is not clonal expansion of dominant variants, but to sustain simultaneously a wide range of genetic variants facilitating adaptation of the population to changing living conditions in the lung. Genomic diversification during chronic infection requires increased attention when new control strategies against M. abscessus infections are explored.Peer Reviewe