Ultrasound-guided percutaneous tracheal puncture: a computer-tomographic controlled study in cadavers

Background Ultrasound-guided techniques are increasingly used in anaesthetic practice to identify tissues beneath the skin and to increase the accuracy of placement of needles close to targeted structures. To examine ultrasound's usefulness for dilatational tracheostomy, we performed ultrasound-guided tracheal punctures in human cadavers followed by computer-tomographic (CT) control. Methods The trachea of nine cadavers was punctured using an in-plane approach with a longitudinal ultrasound visualization of the trachea. As soon as a loss of resistance was felt, or air/fluid could be aspirated into the attached syringe, the syringe was disconnected and the ultrasound transducer set aside. Thereafter, a cricothyroidotomy guidewire was inserted through the needle into the trachea. The needle was then removed, leaving the wire in place and a control CT imaging of the neck and the chest was performed. Primary outcome was successful wire insertion into the trachea. Results Tracheal puncture and wire insertion was successful in eight of nine cadavers at the first attempt and in one at the second attempt (total of 10 puncture attempts, nine successful). In eight of nine successfully inserted wires, the wire was placed on the defined midline. Conclusions Ultrasound guidance can facilitate successful tracheal puncture. However, combining an in-plane approach with a longitudinal ultrasound visualization of the trachea neither guarantees an exact midline puncture nor allows detection of a misplaced guidewir

Influence heat-reflective coating on the decrease of heat losses of window constructions

Developed theoretical and methodological foundations of the optimal choice of space-planning and constructive decisions of low-rise buildings blocked type, aimed at improving efficiency of investment, energy and resource saving, creation of comfortable conditions for the population, ensure sustainable development of low-rise construction in the context of socio-economic priorities in the climatic zoning of the area of construction

Advances in surface EMG signal simulation with analytical and numerical descriptions of the volume conductor

Surface electromyographic (EMG) signal modeling is important for signal interpretation, testing of processing algorithms, detection system design, and didactic purposes. Various surface EMG signal models have been proposed in the literature. In this study we focus on 1) the proposal of a method for modeling surface EMG signals by either analytical or numerical descriptions of the volume conductor for space-invariant systems, and 2) the development of advanced models of the volume conductor by numerical approaches, accurately describing not only the volume conductor geometry, as mainly done in the past, but also the conductivity tensor of the muscle tissue. For volume conductors that are space-invariant in the direction of source propagation, the surface potentials generated by any source can be computed by one-dimensional convolutions, once the volume conductor transfer function is derived (analytically or numerically). Conversely, more complex volume conductors require a complete numerical approach. In a numerical approach, the conductivity tensor of the muscle tissue should be matched with the fiber orientation. In some cases (e.g., multi-pinnate muscles) accurate description of the conductivity tensor may be very complex. A method for relating the conductivity tensor of the muscle tissue, to be used in a numerical approach, to the curve describing the muscle fibers is presented and applied to representatively investigate a bi-pinnate muscle with rectilinear and curvilinear fibers. The study thus propose an approach for surface EMG signal simulation in space invariant systems as well as new models of the volume conductor using numerical methods

A polaritonic two-component Bose-Hubbard model

Published versio

ROP GTPase-Dependent Actin Microfilaments Promote PIN1 Polarization by Localized Inhibition of Clathrin-Dependent Endocytosis

A study in leaf epidermal pavement cells reveals that auxin activation of a Rho-like GTPase from plants induces inhibition of endocytosis through the clathrin-mediated pathway by regulating the accumulation of cortical F-actin

Possible import routes of proteins into the cyanobacterial endosymbionts/plastids of Paulinella chromatophora

The rhizarian amoeba Paulinella chromatophora harbors two photosynthetically active and deeply integrated cyanobacterial endosymbionts acquired ~60 million years ago. Recent genomic analyses of P. chromatophora have revealed the loss of many essential genes from the endosymbiont’s genome, and have identified more than 30 genes that have been transferred to the host cell’s nucleus through endosymbiotic gene transfer (EGT). This indicates that, similar to classical primary plastids, Paulinella endosymbionts have evolved a transport system to import their nuclear-encoded proteins. To deduce how these proteins are transported, we searched for potential targeting signals in genes for 10 EGT-derived proteins. Our analyses indicate that five proteins carry potential signal peptides, implying they are targeted via the host endomembrane system. One sequence encodes a mitochondrial-like transit peptide, which suggests an import pathway involving a channel protein residing in the outer membrane of the endosymbiont. No N-terminal targeting signals were identified in the four other genes, but their encoded proteins could utilize non-classical targeting signals contained internally or in C-terminal regions. Several amino acids more often found in the Paulinella EGT-derived proteins than in their ancestral set (proteins still encoded in the endosymbiont genome) could constitute such signals. Characteristic features of the EGT-derived proteins are low molecular weight and nearly neutral charge, which both could be adaptations to enhance passage through the peptidoglycan wall present in the intermembrane space of the endosymbiont’s envelope. Our results suggest that Paulinella endosymbionts/plastids have evolved several different import routes, as has been shown in classical primary plastids

Standardization of double blind placebo controlled food challenge with soy within a multicentre trial

Background: Multicentre trials investigating food allergies by double blind placebo controlled food challenges (DBPCFC) need standardized procedures, challenge meals and evaluation criteria. We aimed at developing a standardized approach for identifying patients with birch related soy allergy by means of DBPCFC to soy, including determination of threshold levels, in a multicentre setting. Methods: Microbiologically stable soy challenge meals were composed of protein isolate with consistent Gly m 4 levels. Patients sensitized to main birch allergen Bet v 1 and concomitant sensitization to its soy homologue Gly m 4 underwent DBPCFC. Outcome was defined according to presence and/or absence of ten objective signs and intensity of eight subjective symptoms as measured by visual analogue scale (VAS). Results: 138 adult subjects (63.8% female, mean age 38 years) underwent DBPCFC. Challenge meals and defined evaluation criteria showed good applicability in all centres involved. 45.7% presented with objective signs and 65.2% with subjective symptoms at soy challenge. Placebo challenge meals elicited non-cardiovascular objective signs in 11.6%. In 82 (59.4%) subjects DBPCFC was judged as positive. 70.7% of DPBCFC+ showed objective signs and 85.4% subjective symptoms at soy challenge. Subjective symptoms to soy challenge meal in DBPCFC+ subjects started at significantly lower dose levels than objective signs (p < 0.001). Median cumulative eliciting doses for first objective signs in DBPCFC+ subjects were 4.7 g [0.7–24.7] and 0.7 g [0.2–4.7] total soy protein for first subjective symptoms (p = 0.01). Conclusions: We present the hitherto largest group of adults with Bet v 1 and Gly m 4 sensitization being investigated by DBPCFC. In this type of food allergy evaluation of DBPCFC outcome should not only include monitoring of objective signs but also scoring of subjective symptoms. Our data may contribute to standardize DBPCFC in pollen-related food allergy in multicentre settings. Trial registration EudraCT: 2009-011737-27

Long-Term Neurodevelopmental Outcome of Monochorionic and Matched Dichorionic Twins

Contains fulltext : 79941.pdf (publisher's version ) (Open Access)BACKGROUND: Monochorionic (MC) twins are at increased risk for perinatal mortality and serious morbidity due to the presence of placental vascular anastomoses. Cerebral injury can be secondary to haemodynamic and hematological disorders during pregnancy (especially twin-to-twin transfusion syndrome (TTTS) or intrauterine co-twin death) or from postnatal injury associated with prematurity and low birth weight, common complications in twin pregnancies. We investigated neurodevelopmental outcome in MC and dichorionic (DC) twins at the age of two years. METHODS: This was a prospective cohort study. Cerebral palsy (CP) was studied in 182 MC infants and 189 DC infants matched for weight and age at delivery, gender, ethnicity of the mother and study center. After losses to follow-up, 282 of the 366 infants without CP were available to be tested with the Griffiths Mental Developmental Scales at 22 months corrected age, all born between January 2005 and January 2006 in nine perinatal centers in The Netherlands. Due to phenotypic (un)alikeness in mono-or dizygosity, the principal investigator was not blinded to chorionic status; perinatal outcome, with exception of co-twin death, was not known to the examiner. FINDINGS: Four out of 182 MC infants had CP (2.2%) - two of the four CP-cases were due to complications specific to MC twin pregnancies (TTTS and co-twin death) and the other two cases of CP were the result of cystic PVL after preterm birth - compared to one sibling of a DC twin (0.5%; OR 4.2, 95% CI 0.5-38.2) of unknown origin. Follow-up rate of neurodevelopmental outcome by Griffith's test was 76%. The majority of 2-year-old twins had normal developmental status. There were no significant differences between MC and DC twins. One MC infant (0.7%) had a developmental delay compared to 6 DC infants (4.2%; OR 0.2, 95% 0.0-1.4). Birth weight discordancy did not influence long-term outcome, though the smaller twin had slightly lower developmental scores than its larger co-twin. CONCLUSIONS: There were no significant differences in occurrence of cerebral palsy as well as neurodevelopmental outcome between MC and DC twins. Outcome of MC twins seems favourable in the absence of TTTS or co-twin death

Dynamical simulations of polaron transport in conjugated polymers with the inclusion of electron-electron interactions

Dynamical simulations of polaron transport in conjugated polymers in the presence of an external time-dependent electric field have been performed within a combined extended Hubbard model (EHM) and Su-Schrieffer-Heeger (SSH) model. Nearly all relevant electron-phonon and electron-electron interactions are fully taken into account by solving the time-dependent Schr\"{o}dinger equation for the $\pi$-electrons and the Newton's equation of motion for the backbone monomer displacements by virtue of the combination of the adaptive time-dependent density matrix renormalization group (TDDMRG) and classical molecular dynamics (MD). We find that after a smooth turn-on of the external electric field the polaron is accelerated at first and then moves with a nearly constant velocity as one entity consisting of both the charge and the lattice deformation. An ohmic region (3 mV/$\text{\AA}$ $\leq E_0\leq$ 9 mV/$\text{\AA}$) where the stationary velocity increases linearly with the electric field strength is observed for the case of $U$=2.0 eV and $V$=1.0 eV. The maximal velocity is well above the speed of sound. Below 3 mV/$\text{\AA}$ the polaron velocity increases nonlinearly and in high electric fields with strength $E_0\geq$ 10.0 mV/$\text{\AA}$ the polaron will become unstable and dissociate. The relationship between electron-electron interaction strengths and polaron transport is also studied in detail. We find that the the on-site Coulomb interactions $U$ will suppress the polaron transport and small nearest-neighbor interactions $V$ values are also not beneficial to the polaronic motion while large $V$ values favor the polaron transport