A Web-based Teaching and Training Network in Neurosurgery

In: A.J. Kallenberg and M.J.J.M. van de Ven (Eds), 2002, The New Educational Benefits of ICT in Higher Education: Proceedings. Rotterdam: Erasmus Plus BV, OECR ISBN 90-9016127-9The era we are living in is often referred to as the “information age” because new information and communication technology (ICT) has had an enormous influence and a revolutionary impact to change the way we do business, live and learn. New educational concepts, technologies and course contents will be required with consideration of topics, e.g. - Teaching/learning strategies, - E-learning environments, - Development and production of learning modules, - Web-based learning resources/tools, - Virtual learning labs/classrooms in conventional universities, - Collaborative learning in small groups, - Policies, ethics, worldwide (EU) standards. These new ICT systems open up new forms and ways of learning. In the German Federal Ministry of Education and Research (BMBF) granted project "Teaching and Training Network in Neurosurgery" (TT-Net), modern multimedia and information technology is used in the hospital in order to leverage it for the training of students and physicians. The aim is to compose web-based course modules for a virtual education system for neurological diseases. The TT-Net is being realized in a very well equipped and highly competent learning environment in the Hannover Medical School campus network

Surface instabilities of ferrofluids

We report on recent progress in understanding the formation of surface protuberances on a planar layer of ferrofluid in a magnetic field oriented normally to the surface. This normal field or Rosensweig instability can be tackled by a linear and a nonlinear description. In the linear regime of small amplitudes we focus on the wave number of maximal growth, its corresponding growth rate and the oscillatory decay of metastable pattern, accessible via a pulse technique. A quantitative comparison of measurements with predictions of the linear stability analysis is performed, whereby the viscosity and the finite depth of the liquid layer are taken into account. In the nonlinear regime the fully developed peak pattern can be predicted by a minimization of the free energy and by numerics employing the finite element method. For a comparison with the results of both methods, the three-dimensional surface profile is recorded by a radioscopic measurement technique. In the bistable regime of the flat and patterned state we generate localized states (ferrosolitons) which are recovered in analytical and numerical model descriptions. For higher fields an inverse hysteretic transition from hexagonal to square planforms is measured. % Via a horizontal field component the symmetry can be broken in the experiment, resulting in liquid ridges and distorted hexagons, as predicted by theory. Replacing ferrofluid by ferrogel also an elastic energy contribution has to be taken into account for a proper model description, yielding a linear shift of the threshold and an increased bistability range. Parametric excitation in combination with magnetic fields is widening the horizon of pattern formation even further. For the mono-spike oscillator harmonic and subharmonic response as well as deterministic chaos is observed and modeled. In a ring of spikes the formation of domains of different wavelengths and spatio-temporal intermittency is quantitatively studied. For an extended layer of ferrofluid we predict that a stabilizing horizontal field counteracted by vertical vibrations will result in oblique rolls with preselected orientation

Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: A pooled analysis of 97 prospective cohorts with 1·8 million participants

Background Body-mass index (BMI) and diabetes have increased worldwide, whereas global average blood pressure and cholesterol have decreased or remained unchanged in the past three decades. We quantified how much of the effects of BMI on coronary heart disease and stroke are mediated through blood pressure, cholesterol, and glucose, and how much is independent of these factors. Methods We pooled data from 97 prospective cohort studies that collectively enrolled 1·8 million participants between 1948 and 2005, and that included 57 161 coronary heart disease and 31 093 stroke events. For each cohort we excluded participants who were younger than 18 years, had a BMI of lower than 20 kg/m2, or who had a history of coronary heart disease or stroke. We estimated the hazard ratio (HR) of BMI on coronary heart disease and stroke with and without adjustment for all possible combinations of blood pressure, cholesterol, and glucose. We pooled HRs with a random-effects model and calculated the attenuation of excess risk after adjustment for mediators. Findings The HR for each 5 kg/m2 higher BMI was 1·27 (95% CI 1·23-1·31) for coronary heart disease and 1·18 (1·14-1·22) for stroke after adjustment for confounders. Additional adjustment for the three metabolic risk factors reduced the HRs to 1·15 (1·12-1·18) for coronary heart disease and 1·04 (1·01-1·08) for stroke, suggesting that 46% (95% CI 42-50) of the excess risk of BMI for coronary heart disease and 76% (65-91) for stroke is mediated by these factors. Blood pressure was the most important mediator, accounting for 31% (28-35) of the excess risk for coronary heart disease and 65% (56-75) for stroke. The percentage excess risks mediated by these three mediators did not differ significantly between Asian and western cohorts (North America, western Europe, Australia, and New Zealand). Both overweight (BMI ≥25 to <30 kg/m2) and obesity (BMI ≥30 kg/m2) were associated with a significantly increased risk of coronary heart disease and stroke, compared with normal weight (BMI ≥20 to <25 kg/m2), with 50% (44-58) of the excess risk of overweight and 44% (41-48) of the excess risk of obesity for coronary heart disease mediated by the selected three mediators. The percentages for stroke were 98% (69-155) for overweight and 69% (64-77) for obesity. Interpretation Interventions that reduce high blood pressure, cholesterol, and glucose might address about half of excess risk of coronary heart disease and three-quarters of excess risk of stroke associated with high BMI. Maintenance of optimum bodyweight is needed for the full benefits