96 research outputs found
The Genesis of Venture Capital - Lessons from the German Experience
Why does venture capital work in some countries but not in others? This clinical study of the first German venture capital firm examines the difficulties of creating a venture capital market in a bank-based financial system. The analysis identifies the problem of creating appropriate governance structures to protect investor returns. It exposes the difficulties of established banks - not to mention government - to devise venture investment strategies. It identifies the availability of high quality entrepreneurs as a critical complement. And it provides a reinterpretation of the hypothesis of Black and Gilson (1997), arguing that the existence of an active stock market is a necessary, but by no means sufficient condition for the development of venture capital.
Multipurpose Polymer Bragg Grating-Based Optomechanical Sensor Pad
Flexible epoxy waveguide Bragg gratings are fabricated on a low-modulus TPX™ polymethylpentene polyolefin substrate for an easy to manufacture and low-cost optomechanical sensor pad providing exceedingly multipurpose application potentials. Rectangular EpoCore negative resist strip waveguides are formed employing standard UV mask lithography. Highly persistent Bragg gratings are inscribed directly into the channel waveguides by permanently modifying the local refractive indices through a well-defined KrF excimer laser irradiated +1/-1 order phase mask. The reproducible and vastly versatile sensing capabilities of this easy-to-apply optomechanical sensor pad are demonstrated in the form of an optical pickup for acoustic instruments, a broadband optical accelerometer, and a biomedical vital sign sensor monitoring both respiration and pulse at the same time
The Unruh-deWitt Detector and the Vacuum in the General Boundary formalism
We discuss how to formulate a condition for choosing the vacuum state of a
quantum scalar field on a timelike hyperplane in the general boundary
formulation (GBF) using the coupling to an Unruh-DeWitt detector. We explicitly
study the response of an Unruh-DeWitt detector for evanescent modes which occur
naturally in quantum field theory in the presence of the equivalent of a
dielectric boundary. We find that the physically correct vacuum state has to
depend on the physical situation outside of the boundaries of the spacetime
region considered. Thus it cannot be determined by general principles
pertaining only to a subset of spacetime.Comment: Version as published in CQ
Sex Differences in Clinical Course and Intensive Care Unit Admission in a National Cohort of Hospitalized Patients with COVID-19
Males have a higher risk for an adverse outcome of COVID-19. The aim of the study was to analyze sex differences in the clinical course with focus on patients who received intensive care. Research was conducted as an observational retrospective cohort study. A group of 23,235 patients from 83 hospitals with PCR-confirmed infection with SARS-CoV-2 between 4 February 2020 and 22 March 2021 were included. Data on symptoms were retrieved from a separate registry, which served as a routine infection control system. Males accounted for 51.4% of all included patients. Males received more intensive care (ratio OR = 1.61, 95% CI = 1.51–1.71) and mechanical ventilation (invasive or noninvasive, OR = 1.87, 95% CI = 1.73–2.01). A model for the prediction of mortality showed that until the age 60 y, mortality increased with age with no substantial difference between sexes. After 60 y, the risk of death increased more in males than in females. At 90 y, females had a predicted mortality risk of 31%, corresponding to males of 84 y. In the intensive care unit (ICU) cohort, females of 90 y had a mortality risk of 46%, equivalent to males of 72 y. Seventy-five percent of males over 90 died, but only 46% of females of the same age. In conclusion, the sex gap was most evident among the oldest in the ICU. Understanding sex-determined differences in COVID-19 can be useful to facilitate individualized treatments
Highly Sensitive Detection of Naphthalene in Solvent Vapor Using a Functionalized PBG Refractive Index Sensor
We report an optical refractive index sensor system based on a planar Bragg grating which is functionalized by substituted γ-cyclodextrin to determine low concentrations of naphthalene in solvent vapor. The sensor system exhibits a quasi-instantaneous shift of the Bragg wavelength and is therefore capable for online detection. The overall shift of the Bragg wavelength reveals a linear relationship to the analyte concentration with a gradient of 12.5 ± 1.5 pm/ppm. Due to the spectral resolution and repeatability of the interrogation system, this corresponds to acquisition steps of 80 ppb. Taking into account the experimentally detected signal noise a minimum detection limit of 0.48 ± 0.05 ppm is deduced
Potential Contributors to Increased Pulmonary Embolism Hospitalizations During the COVID-19 Pandemic: Insights From the German-Wide Helios Hospital Network
Background: After the first COVID-19 infection wave, a constant increase of pulmonary
embolism (PE) hospitalizations not linked with active PCR-confirmed COVID-19 was
observed, but potential contributors to this observation are unclear. Therefore, we
analyzed associations between changes in PE hospitalizations and (1) the incidence of
non-COVID-19 pneumonia, (2) the use of computed tomography pulmonary angiography
(CTPA), (3) volume depletion, and (4) preceding COVID-19 infection numbers in Germany.
Methods: Claims data of Helios hospitals in Germany were used, and consecutive cases
with a hospital admission between May 6 and December 15, 2020 (PE surplus period),
were analyzed and compared to corresponding periods covering the same weeks in
2016–2019 (control period). We analyzed the number of PE cases in the target period
with multivariable Poisson general linear mixed models (GLMM) including (a) cohorts of
2020 versus 2016–2019, (b) the number of cases with pneumonia, (c) CTPA, and (d)
volume depletion and adjusted for age and sex. In order to associate the daily number of
PE cases in 2020 with the number of preceding SARS-CoV-2 infections in Germany, we
calculated the average number of daily infections (divided by 10,000) occurring between
14 up to 90 days with increasing window sizes before PE cases and modeled the data
with Poisson regression.
Results: There were 2,404 PE hospitalizations between May 6 and December 15,
2020, as opposed to 2,112–2,236 (total 8,717) in the corresponding 2016–2019 control
periods (crude rate ratio [CRR] 1.10, 95% CI 1.05–1.15, P < 0.01). With the use of
multivariable Poisson GLMM adjusted for age, sex, and volume depletion, PE cases
were significantly associated with the number of cases with pneumonia (CRR 1.09, 95%
CI 1.07–1.10, P < 0.01) and with CTPA (CRR 1.10, 95% CI 1.09–1.10, P < 0.01). The
increase of PE cases in 2020 compared with the control period remained significant
(CRR 1.07, 95% CI 1.02–1.12, P < 0.01) when controlling for those factors. In the
2020 cohort, the number of preceding average daily COVID-19 infections was associated
with increased PE case incidence in all investigated windows, i.e., including preceding
infections from 14 to 90 days. The best model (log likelihood −576) was with a window
size of 4 days, i.e., average COVID-19 infections 14–17 days before PE hospitalization
had a risk of 1.20 (95% CI 1.12–1.29, P < 0.01).
Conclusions: There is an increase in PE cases since early May 2020 compared
to corresponding periods in 2016–2019. This surplus was significant even when
controlling for changes in potential modulators such as demographics, volume depletion,
non-COVID-19 pneumonia, CTPA use, and preceding COVID-19 infections. Future
studies are needed (1) to investigate a potential causal link for increased risk of
delayed PE with preceding SARS-CoV-2 infection and (2) to define optimal screening
for SARS-CoV-2 in patients presenting with pneumonia and PE
protocol of a prospective, longitudinal study
Background Natural killer (NK) cells comprise the main components of
lymphocyte-mediated nonspecific immunity. Through their effector function they
play a crucial role combating bacterial and viral challenges. They are also
thought to be key contributors to the systemic spinal cord injury-induced
immune-deficiency syndrome (SCI-IDS). SCI-IDS increases susceptibility to
infection and extends to the post-acute and chronic phases after SCI. Methods
and design The prospective study of NK cell function after traumatic SCI was
carried out in two centers in Berlin, Germany. SCI patients and control
patients with neurologically silent vertebral fracture also undergoing
surgical stabilization were enrolled. Furthermore healthy controls were
included to provide reference data. The NK cell function was assessed at 7
(5–9) days, 14 days (11–28) days, and 10 (8–12) weeks post-trauma. Clinical
documentation included the American Spinal Injury Association (ASIA)
impairment scale (AIS), neurological level of injury, infection status,
concomitant injury, and medications. The primary endpoint of the study is
CD107a expression by NK cells (cytotoxicity marker) 8–12 weeks following SCI.
Secondary endpoints are the NK cell’s TNF-α and IFN-γ production by the NK
cells 8–12 weeks following SCI. Discussion The protocol of this study was
developed to investigate the hypotheses whether i) SCI impairs NK cell
function throughout the post-acute and sub-acute phases after SCI and ii) the
degree of impairment relates to lesion height and severity. A deeper
understanding of the SCI-IDS is crucial to enable strategies for prevention of
infections, which are associated with poor neurological outcome and elevated
mortality. Trial registration DRKS00009855
The spinal cord injury-induced immune deficiency syndrome: results of the SCIentinel study
Infections are prevalent after spinal cord injury (SCI), constitute the main cause of death and are a rehabilitation confounder associated with impaired recovery. We hypothesize that SCI causes an acquired lesion-dependent (neurogenic) immune suppression as an underlying mechanism to facilitate infections. The international prospective multicentre cohort study (SCIentinel; protocol registration DRKS00000122; n = 111 patients) was designed to distinguish neurogenic from general trauma-related effects on the immune system. Therefore, SCI patient groups differing by neurological level, i.e. high SCI [thoracic (Th)4 or higher]; low SCI (Th5 or lower) and severity (complete SCI; incomplete SCI), were compared with a reference group of vertebral fracture (VF) patients without SCI. The primary outcome was quantitative monocytic Human Leukocyte Antigen-DR expression (mHLA-DR, synonym MHC II), a validated marker for immune suppression in critically ill patients associated with infection susceptibility. mHLA-DR was assessed from Day 1 to 10 weeks after injury by applying standardized flow cytometry procedures. Secondary outcomes were leucocyte subpopulation counts, serum immunoglobulin levels and clinically defined infections. Linear mixed models with multiple imputation were applied to evaluate group differences of logarithmic-transformed parameters. Mean quantitative mHLA-DR [ln (antibodies/cell)] levels at the primary end point 84 h after injury indicated an immune suppressive state below the normative values of 9.62 in all groups, which further differed in its dimension by neurological level: high SCI [8.95 (98.3% confidence interval, CI: 8.63; 9.26), n = 41], low SCI [9.05 (98.3% CI: 8.73; 9.36), n = 29], and VF without SCI [9.25 (98.3% CI: 8.97; 9.53), n = 41, P = 0.003]. Post hoc analysis accounting for SCI severity revealed the strongest mHLA-DR decrease [8.79 (95% CI: 8.50; 9.08)] in the complete, high SCI group, further demonstrating delayed mHLA-DR recovery [9.08 (95% CI: 8.82; 9.38)] and showing a difference from the VF controls of -0.43 (95% CI: -0.66; -0.20) at 14 days. Complete, high SCI patients also revealed constantly lower serum immunoglobulin G [-0.27 (95% CI: -0.45; -0.10)] and immunoglobulin A [-0.25 (95% CI: -0.49; -0.01)] levels [ln (g/l × 1000)] up to 10 weeks after injury. Low mHLA-DR levels in the range of borderline immunoparalysis (below 9.21) were positively associated with the occurrence and earlier onset of infections, which is consistent with results from studies on stroke or major surgery. Spinal cord injured patients can acquire a secondary, neurogenic immune deficiency syndrome characterized by reduced mHLA-DR expression and relative hypogammaglobulinaemia (combined cellular and humoral immune deficiency). mHLA-DR expression provides a basis to stratify infection-risk in patients with SCI
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