Detection of fractures of hand and forearm in whole-body CT for suspected polytrauma in intubated patients

Background: The aim of this study was to evaluate the potential of whole-body CT for diagnosis of hand and forearm fractures in intubated patients with suspected polytrauma. Methods: We performed a retrospective analysis on data collected from two trauma centres in Germany, including demographics, ISS, clinical symptoms, depiction in whole-body CT, and time to diagnosis. Results: Out of 426 patients included in the study, 66 (15.5%) suffered a hand or forearm fracture. The total number of fractures was 132, the whole-body CT report mentioned 98 (74.2%). 16 (12,1%) fractures of 12 patients were diagnosed later than 24 h after admission. Late diagnoses of fractures of the hand occurred more often if the hand was not fully included in the CT scan field. The sensitivity of whole-body CT for cases with fractures of hand and/or forearm with full inclusion of the corresponding area in the scan field was 80.2%. Conclusions: This study shows that whole-body CT is a valuable diagnostic tool for hand fractures in polytrauma patients. Hands should be evaluated regardless of clinical presentation in intubated patients after suspected polytrauma if they are included in the whole-body CT. © 2020 The Author(s)

Beglaubigte Abschrift des Taufscheins der Garnison-Kirche Potsdam vom 23.6.1848, Potsdam, 1.12.1905, 1 S., hs. ausgefüllter Vordruck, Generallandesarchiv Karlsruhe, 236-15267/2. Aktentitel: Großherzogtum Baden. Ministerium des Innern. Generalia. Staatsverfassung und Landstände. Die Wahl der Abgeordneten zur ersten Kammer | hier | des Abgeordneten der Universität Heidelberg betr. Gewählt: Dr. Wilhelm Windelband Geheimerat u. Professor in Heidelberg. 1905: Forschungsgrundlagen Wilhelm Windelband

Beglaubigte Abschrift des Taufscheins der Garnison-Kirche Potsdam vom 23.6.1848, Potsdam, 1.12.1905, 1 S., hs. ausgefüllter Vordruck, Generallandesarchiv Karlsruhe, 236-15267/2. Aktentitel: Großherzogtum Baden. Ministerium des Innern. Generalia. Staatsverfassung und Landstände. Die Wahl der Abgeordneten zur ersten Kammer | hier | des Abgeordneten der Universität Heidelberg betr. Gewählt: Dr. Wilhelm Windelband Geheimerat u. Professor in Heidelberg. 1905 Tauf-Schein. Heinrich Wilhelm Windelband ehelicher Sohn des Regierungs-Secretärs Johann Friedrich Wilhelm Windelband und dessen Ehefrau Dorothea Charlotte Friederike geborenen Gerloff ist am 11ten (elften Mai 1848) Eintausend acht hundert acht und vierzig in Potsdam geboren und hat am 23ten Juni 1848 die heilige Taufe empfangen. Solches wird laut Taufregister der Königlichen Hof- und Garnisonkirche vom Jahre 1848 Nr. 4 hiermit amtlich bescheinigt. Potsdam, den 1ten Dezember 1905 Der Königliche Hofprediger[a] Kessler[b] Plötz[c] Hof-Küster. Anmerkungen zum Textbefund a↑Der Königliche Hofprediger ] am linken Rand Siegel der Garnison-Kirche b↑Kessler ] eigenhändige Unterschrift c↑Plötz ] eigenhändige Unterschrif

Review on quality assurance along the CFRP value chain - Non-destructive testing of fabrics, preforms and CFRP by HF radio wave techniques

Eddy current testing is well established for non-destructive testing of electrical conductive materials [1]. The development of radio frequency (RF) eddy current technology with frequency ranges up to 100 MHz made it possible to extend the classical fields of application even towards less conductive materials like CFRP [2][3](Table 2). It turns out that RF eddy current technology on CFRP generates a growing number of valuable information for comprehensive material diagnostic. Both permittivity and conductivity of CFRP influence the complex impedance measured with RF eddy current devices. The electrical conductivity contains information about fiber texture like orientations, gaps or undulations in a multilayered material. The permittivity characterization influenced by dielectric properties allows the determination of local curing defects on CFRP e.g. hot spots, thermal impacts or polymer degradation. An explanation for that effect is seen in the measurement frequency range and the capacitive structure of the carbon rovings. Using radio wave frequencies for testing, the effect of displacement currents cannot be neglected anymore. The capacitive structures formed by the carbon rovings is supposed to further strengthen the dielectric influences on eddy current measurement signal [3]. This report gives an overview of several realized applications and should be understood as a general introduction of CFRP testing by HF Radio Wave techniques

Feasibility of a standardized ultrasound examination in patients with rheumatoid arthritis: A quality improvement among rheumatologists cohort.

BACKGROUND: Quality improvement is important to facilitate valid patient outcomes. Standardized examination procedures may improve the validity of US. The aim of this study was to investigate the learning progress for rheumatologists during training of US examination of the hand in patients with rheumatoid arthritis (RA). METHODS: Rheumatologists with varying degrees of experience in US were instructed by skilled tutors. The program consisted of two days with hands-on training followed by personal US examinations performed in their individual clinics. Examinations were sent to the tutors for quality control. The US examinations were evaluated according to a scoring sheet containing 144 items. An acceptable examination was defined as > 80% correct scores. RESULTS: Thirteen rheumatologists participated in the study. They included a total of 104 patients with RA. Only few of the initial examinations were scored below 80%, and as experience increased, the scores improved (p = 0.0004). A few participants displayed decreasing scores. The mean time spent performing the standardized examination procedure decreased from 34 min to less than 10 minutes (p = 0.0001). CONCLUSION: With systematic hands-on training, a rheumatologist can achieve a high level of proficiency in the conduction of US examinations of the joints of the hand in patients with RA. With experience, examination time decreases, while the level of correctness is maintained. The results indicate that US may be applied as a valid measurement tool suitable for clinical practice and in both single- and multi-centre trials

Hilbert transforms in Clifford analysis

The Hilbert transform on the real line has applications in many fields. In particular in one–dimensional signal processing, the Hilbert operator is used to extract global as well as instantaneous characteristics, such as frequency, amplitude and phase, from real signals. The multidimensional approach to the Hilbert transform usually is a tensorial one, considering the so-called Riesz transforms in each of the cartesian variables separately. In this paper we give an overview of generalized Hilbert transforms in Euclidean space, developed within the framework of Clifford analysis. Roughly speaking, this is a function theory of higher dimensional holomorphic functions, which is particularly suited for a treatment of multidimensional phenomena since all dimensions are encompassed at once as an intrinsic feature

Vaccines against toxoplasma gondii : challenges and opportunities

Development of vaccines against Toxoplasma gondii infection in humans is of high priority, given the high burden of disease in some areas of the world like South America, and the lack of effective drugs with few adverse effects. Rodent models have been used in research on vaccines against T. gondii over the past decades. However, regardless of the vaccine construct, the vaccines have not been able to induce protective immunity when the organism is challenged with T. gondii, either directly or via a vector. Only a few live, attenuated T. gondii strains used for immunization have been able to confer protective immunity, which is measured by a lack of tissue cysts after challenge. Furthermore, challenge with low virulence strains, especially strains with genotype II, will probably be insufficient to provide protection against the more virulent T. gondii strains, such as those with genotypes I or II, or those genotypes from South America not belonging to genotype I, II or III. Future studies should use animal models besides rodents, and challenges should be performed with at least one genotype II T. gondii and one of the more virulent genotypes. Endpoints like maternal-foetal transmission and prevention of eye disease are important in addition to the traditional endpoint of survival or reduction in numbers of brain cysts after challenge

Genetic determinants of cortical structure (thickness, surface area and volumes) among disease free adults in the CHARGE Consortium

Cortical thickness, surface area and volumes (MRI cortical measures) vary with age and cognitive function, and in neurological and psychiatric diseases. We examined heritability, genetic correlations and genome-wide associations of cortical measures across the whole cortex, and in 34 anatomically predefined regions. Our discovery sample comprised 22,824 individuals from 20 cohorts within the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium and the United Kingdom Biobank. Significant associations were replicated in the Enhancing Neuroimaging Genetics through Meta-analysis (ENIGMA) consortium, and their biological implications explored using bioinformatic annotation and pathway analyses. We identified genetic heterogeneity between cortical measures and brain regions, and 160 genome-wide significant associations pointing to wnt/β-catenin, TGF-β and sonic hedgehog pathways. There was enrichment for genes involved in anthropometric traits, hindbrain development, vascular and neurodegenerative disease and psychiatric conditions. These data are a rich resource for studies of the biological mechanisms behind cortical development and aging

Quantity and quality of empathic responding by autistic and non-autistic adolescent girls and boys

Empathy evokes support for the person in distress, and thus strengthening social cohesion. The question is to what extent empathic reactions can be observed in autistic adolescents and autistic girls in particular, since there is evidence that they have better social skills than boys, which might hinder their recognition as autistic. We examined 193 adolescents (autistic/non-autistic boys/girls) during an in vivo task in which the experimenter hurt herself. In line with our predictions, no group or gender differences appeared related to their attention for the event; yet autistic girls and boys showed less visible emotional arousal, indicative of less affective empathy. Autistic girls and boys reacted by comforting the experimenter equally often as their non-autistic peers, but autistic boys seemed to address the problem more often than any other group; while girls (autistic and non-autistic) more often addressed the emotion of the person in need. Our findings highlight that empathic behaviour – to some extent – seems similar bet

ENIGMA and global neuroscience: A decade of large-scale studies of the brain in health and disease across more than 40 countries

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of "big data" (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA's activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors