Patientenspezifische Planung für die Multi-Port Otobasischirurgie

Bisher werden Operationen im Bereich der seitlichen Schädelbasis (Otobasis) stark invasiv durchgeführt. Um die Traumatisierung für den Patienten zu reduzieren, wird seit kurzem ein Multi-Port Ansatz untersucht, bei dem bis zu drei dünne Bohrkanäle von der Schädeloberfläche bis zum Operationsziel angelegt werden. Aufgrund der Minimalinvasivität des neuen Eingriffs ist die visuelle Kontrolle durch den Chirurgen nicht mehr möglich. Somit ist eine präzise patientenspezifische Planung basierend auf Bilddaten zwingend erforderlich. Der Fokus dieser Arbeit liegt daher auf der Planung eines Multi-Port Eingriffs basierend auf patientenspezifischen Modellen. Zur Generierung dieser Modelle habe ich zunächst Methoden für die Segmentierung der Risikostrukturen der Otobasis in Computertomographiedaten entwickelt. Die Herausforderungen dabei sind die geringe Größe der Strukturen, der fehlende Kontrast zum umliegenden Gewebe sowie die zum Teil variierende Form und Bildintensität. Daher schlage ich die Verwendung eines modellbasierten Ansatzes – das Probabilistic Active Shape Model – vor. Dieses habe ich für die Risikostrukturen der Otobasis adaptiert und intensiv evaluiert. Dabei habe ich gezeigt, dass die Segmentierungsgenauigkeit im Bereich der manuellen Segmentierungsgenauigkeit liegt. Ferner habe ich Methoden für die automatische Planung der Bohrkanäle basierend auf den durch die Segmentierung gewonnenen patientenspezifischen Modellen entwickelt. Die Herausforderung hierbei ist, dass der Multi-Port Eingriff noch nicht im klinischen Einsatz ist und somit Erfahrung mit der neuen Strategie fehlt. Daher wurde zunächst ein Planungstool zur Berechnung einer Menge von zulässigen Bohrkanälen entwickelt und die manuelle Auswahl einer Bohrkanalkombination ermöglicht. Damit haben zwei Ärzte eine erste Machbarkeitsanalyse durchgeführt. Die so gewonnene Erfahrung und Datenbasis habe ich formalisiert und ein Modell für die automatische Planung einer Bohrkanalkombination abgeleitet. Die Evaluation zeigt, dass auf diese Weise Bohrkanalkombinationen vergleichbar mit der manuellen Wahl der Ärzte berechnet werden können. Damit ist erstmals die computergestützte Planung eines Multi-Port Eingriffs an der Otobasis möglich

Autonomous 13C measurements in the North Atlantic - a novel approach for identifying patterns and driving factors of the upper ocean carbon cycle

The North Atlantic Ocean plays a major role in climate change not least due to its importance in CO2 uptake and thus natural carbon sequestration. The CO2 concentration in its surface waters, which determines the ocean's CO2 sink/source function, varies on seasonal and interannual timescales and is mainly driven by air-sea gas exchange and biological production/respiration. However, the quantification of these processes is still afflicted with a high degree of uncertainty. In this thesis, a cavity ringdown spectrometer (G2131-i, Picarro, USA), which is able to measure the CO2 mole fraction and it's stable carbon isotope composition, was installed on a VOS line that regularly sails across the subpolar North Atlantic between North America and Europe. From summer 2012 to the end of 2014, two and a half years of d13C(CO2) underway data was obtained along with continuous measurements of temperature, salinity and fCO2. Combined with a discrete sampling program (consisting of DIC, TA, nutrients, Chl a, POM, DOC, d13C(POC) and d15N(PON) samples), the dynamics of the upper North Atlantic Ocean were studied. This analysis comprises interannual variations of fCO2 and d13C(CO2), relative changes of nutrient concentration in comparison with C:N ratios of suspended particle matter, biologically and mixing driven variability in DIC and d13C(DIC) and the fractionation between dissolved CO2 and particulate matter. Based on the variations in DIC, fCO2, DIC, fCO2, d13C(DIC), nitrate, phosphate and silicate, the respective change rates and overall inventory changes due to air-sea gas exchange, net community production and convective mixing were calculated utilizing a box model

Introduction:in: Prayer and Power

Einführung in den Sammelband. Die einzelnen Beiträge des Bandes beleuchten die Phase der Hochblüte der Institution der Gottesgemahlinnen Ägyptens: von der Dritten Zwischenzeit bis in die frühe Spätzeit. Schwerpunkte liegen u.a. auf der Entwicklung des Priesteramtes, der Verflechtung religiöser und politischer Aspekte, dem kulturellen Hintergrund der Gottesgemahlinnen, aber auch beim Einfluss der Femininität auf das maskulin dominierte ägyptische Königtum.Introduction to the anthology. The contributions to this anthology focus on the heyday of the institution of the God’s Wives of Amun in Egypt during the Third Intermediate Period as well as the early Late Period. They address the influence of individual God’s wives in contrast to the influence of femininity in general. Above all, questions concerning their artistic representation, different religious, political and social aspects of the God’s Wives of Amun and their building activities are discussed in several articles

An internally consistent dataset of δ13C-DIC in the North Atlantic Ocean – NAC13v1

The stable carbon isotope composition of dissolved inorganic carbon (δ13C-DIC) can be used to quantify fluxes within the carbon system. For example, knowing the δ13C signature of the inorganic carbon pool can help in describing the amount of anthropogenic carbon in the water column. The measurements can also be used for evaluating modeled carbon fluxes, for making basin-wide estimates of anthropogenic carbon, and for studying seasonal and interannual variability or decadal trends in interior ocean biogeochemistry. For all these purposes, it is not only important to have a sufficient amount of data, but these data must also be internally consistent and of high quality. In this study, we present a δ13C-DIC dataset for the North Atlantic which has undergone secondary quality control. The data originate from oceanographic research cruises between 1981 and 2014. During a primary quality control step based on simple range tests, obviously bad data were flagged. In a second quality control step, biases between measurements from different cruises were quantified through a crossover analysis using nearby data of the respective cruises, and values of biased cruises were adjusted in the data product. The crossover analysis was possible for 24 of the 32 cruises in our dataset, and adjustments were applied to 11 cruises. The internal accuracy of this dataset is 0.017 ‰

Using cavity ringdown spectroscopy for continuous monitoring of δ13C(CO2) and ƒCO2 in the surface ocean

The role of the global surface ocean as a source and sink for atmospheric carbon dioxide and the flux strengths between the ocean and the atmosphere can be quantified by measuring the fugacity of CO2 (ƒCO2) as well as the dissolved inorganic carbon (DIC) concentration and its isotopic composition in surface seawater. In this work, the potential of continuous wave cavity ringdown spectroscopy (cw-CRDS) for autonomous underway measurements of ƒCO2 and the stable carbon isotope ratio of DIC [δ13C(DIC)] is explored. For the first time, by using a conventional air-sea equilibrator setup, both quantities were continuously and simultaneously recorded during a field deployment on two research cruises following meridional transects across the Atlantic Ocean (Bremerhaven, Germany–Punta Arenas, Chile). Data are compared against reference measurements by an established underway CO2 monitoring system and isotope ratio mass spectrometric analysis of individual water samples. Agreement within ΔƒCO2 = 0.35 μatm for atmospheric and ΔƒCO2 = 2.5 μatm and Δδ13C(DIC) =0.33‰ for seawater measurements have been achieved. Whereas “calibration-free” ƒCO2 monitoring is feasible, the measurement of accurate isotope ratios relies on running reference standards on a daily basis. Overall, the installed CRDS/equilibrator system was shown to be capable of reliable online monitoring of ƒCO2, equilibrium δ13C(CO2), δ13C(DIC), and pO2 aboard moving research vessels, thus making possible corresponding measurements with high spatial and temporal resolution

Tracer Survey in the Cape Verde Region Traceraufnahme in der Kapverdenregion Cruise No. 10, Leg 1 October 31 – December 06, 2008 Ponta Delgada (Portugal) – Mindelo (Cape Verde Islands)

The research cruise MSM10/1 was extremely successful. All programs were able to collect high quality data and the anticipated goals of the expedition were fully met. We have been able to carry out the first comprehensive survey of a tracer release in the Guinea Upwelling region (GUTRE) roughly seven month after the tracer was released at 8°N 23°W in April 2008. We have estimated that a total of 40% of the tracer was found during this cruise. While the horizontal spreading and mixing was larger than anticipated, the vertical extent of the tracer found was small. The low vertical tracer spreading rate estimates are supported by the micro structure profile data. The extensive survey of the upper 1000m of the oxygen minimum zone (OMZ) allowed comparing our sections with several previous surveys. We found that the lowest oxygen values in the core of the OMZ have dropped at record low values below 40 μmol/kg. The preliminary findings from the trace metal work focused on Fe ligand measurements shows a slight higher excess ligand concentration in the surface (50m) for three stations. The two other stations show a slight decrease at this depth. A large number of biochemical samples were taken and were analyzed in Kiel for DNA and RNA diversity. The tracer release experiment provided an ideal environment for repeated biochemical sampling in the same water mass

Heatwave-associated Vibrio infections in Germany, 2018 and 2019

Background: Vibrio spp. are aquatic bacteria that prefer warm seawater with moderate salinity. In humans, they can cause gastroenteritis, wound infections, and ear infections. During the summers of 2018 and 2019, unprecedented high sea surface temperatures were recorded in the German Baltic Sea. Aim: We aimed to describe the clinical course and microbiological characteristics of Vibrio infections in Germany in 2018 and 2019. Methods: We performed an observational retrospective multi-centre cohort study of patients diagnosed with domestically-acquired Vibrio infections in Germany in 2018 and 2019. Demographic, clinical, and microbiological data were assessed, and isolates were subjected to whole genome sequencing and antimicrobial susceptibility testing. Results: Of the 63 patients with Vibrio infections, most contracted the virus between June and September, primarily in the Baltic Sea: 44 (70%) were male and the median age was 65 years (range: 2–93 years). Thirty-eight patients presented with wound infections, 16 with ear infections, six with gastroenteritis, two with pneumonia (after seawater aspiration) and one with primary septicaemia. The majority of infections were attributed to V. cholerae (non–O1/non-O139) (n = 30; 48%) or V. vulnificus (n = 22; 38%). Phylogenetic analyses of 12 available isolates showed clusters of three identical strains of V. vulnificus, which caused wound infections, suggesting that some clonal lines can spread across the Baltic Sea. Conclusions: During the summers of 2018 and 2019, severe heatwaves facilitated increased numbers of Vibrio infections in Germany. Since climate change is likely to favour the proliferation of these bacteria, a further increase in Vibrio-associated diseases is expected.Peer Reviewe

Silver-Mobility - near field mobility concepts for the age group 50+

The research group “Silver-Mobility - near-field mobility concepts for the age group 50plus” develops concepts to support elder people with beginning or advanced loss of their personal key mobility. Also the improvements of existing systems to substitute loosen abilities like wheel-chairs are in focus of the research group. The paper gives an overview about the approaches and some resulting concepts, mainly for overcoming of obstacles with wheel-based mobility aids, for energy storing solutions and for different assistance systems for mobility aids. The main principle for all these concepts was to get know and analyze the future users, their requirements and needs and then derive solutions from these analyses. The results show the necessity to develop adaptable, individualisable and re-configurable systems