Die E-Book-Umfrage an der UB Mannheim – Zusammenfassung der Ergebnisse

Im Dezember 2010 führte die UB eine Online-Umfrage zum Thema E-Books durch, um Anregungen für die Weiterentwicklung dieses Angebots insgesamt sowie Rückmeldungen zu der seit einigen Monaten im Test befindlichen Plattform "Dawsonera" zu bekommen, bei der E-Books zunächst "angelesen" und dann für eine elektronische Ausleihe angefragt werden können. Der Bericht fasst die wichtigsten Ergebnisse zusammen

EC872 Crop Budgets - Nebraska 2015

2015 Crop Budgeting Procedures • Table 1 Power Unit Cost Data Used for 2015 Budgets • Table 2 Machinery Cost Data Used for 2015 Budgets • Table 3 Material Prices Used for 2015 Budgets • Table 4 Conversion of Diesel to Electricity, Propane, Gasoline, and Natural Gas • Table 5 Table for Adjusting the Amount of Diesel Fuel Required for Center Pivots for Lifts and Pressures other than the 125 Feet of Lift and 35 psi Used in the Budgets 1 Alfalfa, Fall Establishment, Dryland • 2 Alfalfa, Roundup Ready® No-Till, Fall Establishment, Dryland • 3 Alfalfa, Roundup Ready®, Fall Establishment, Dryland • 4 Alfalfa, Establish Spring Seed with Herbicides, Dryland • 5 Alfalfa, Roundup Ready®, Establish Spring Seed, Dryland • 6 Alfalfa, Establish Spring Seed with Herbicides, Pivot Irrigated • 7 Alfalfa, Roundup Ready®, Establish Spring Seed, Pivot Irrigated • 8 Alfalfa, Fall Seeded with Subsequent Year Production, Gravity Irrigated, Canal • 9 Alfalfa, Large Round Bale, Dryland • 10 Alfalfa, Large and Small Square Bale, Pivot Irrigated • 11 Alfalfa, Roundup Ready®, Large and Small Square Bales, Pivot Irrigated • 12 Alfalfa, Large and Small Square Bales, Pivot Irrigated • 13 Alfalfa, Large Square Bale, Canal Irrigated • 14 Alfalfa, Roundup Ready®, Large Square Bale, Canal Irrigated • 15 Corn, Conventional Tillage, Continuous, 90 bu Yield Goal, Dryland • 16 Corn, No-till, Bt, ECB, RW and RR2 Continuous, 125 bu Yield Goal, Dryland • 17 Corn, No-till, SmartStax RIB Complete, Continuous, 130 bu Yield Goal, Dryland • 18 Corn, No-Till, Bt ECB After SoyBean, 135 bu Yield Goal, Dryland • 19 EcoFallow Corn, Follows Wheat, Two Crops in Three Years, RR2 and Bt ECB, 125 bu Yield Goal, Dryland • 20 Corn, Ridge-Till, Bt, ECB and RW, Continuous, 230 bu Yield Goal, Gravity Irrigated • 21 Corn, Ridge-Till, SmartStax, RIB Complete, Continuous, 240 bu Yield Goal, Gravity Irrigated • 22 Corn, Continuous, SmartStax RIB Complete, 190 bu Yield Goal, Canal Irrigated • 23 Corn, No-Till, Bt ECB and RW, Continuous, 240 bu Yield Goal, Pivot Irrigated • 24 Corn, No-Till, SmartStax, RIB Complete, Continuous, 250 bu Yield Goal, Pivot Irrigated • 25 Corn, Bt ECB and RW, Continuous, 230 bu Yield Goal, Pivot Irrigated • 26 Corn, SmartStax RIB Complete, 190 bu Yield Goal, Pivot Irrigated • 27 Corn, SmartStax, RIB Complete, Continuous, 240 bu Yield Goal, Pivot Irrigated • 28 Corn, No-Till, Bt ECB, after Beans, 240 bu Yield Goal, Pivot Irrigated • 29 Corn Silage, No-Till following Corn, Pivot Irrigated • 30 Dry Beans, Reduced Till with Wheat Cover Crop after Harvest, Pivot Irrigated • 31 Dry Beans, Conventional Tillage, Canal Irrigated • 32 Dry Beans, Conventional Tillage Using Pumped Water, Pivot Irrigated • 33 Dry Beans, Direct Harvest, Conventional Tillage using Pumped Water, Pivot Irrigated • 34 Grain Sorghum, Conventional Tillage, 105 bu Yield Goal, Dryland • 35 Grain Sorghum, No-Till, 125 bu Yield Goal, Dryland • 36 Grain Sorghum, Ecofallow, After Wheat, Two Crops in Three Years, 115 bu Yield Goal, Dryland • 37 Grain Sorghum, No-till, Limited Irrigation, 165 bu Yield Goal, Pivot Irrigated • 38 Grass, Fall Establishment, Pivot Irrigated, 800 GMP 35 PSI • 39 Grass Hay, Large Round, Dryland • 40 Millet, Stubble Mulch Fallow, Followed by Wheat, Two Crops in Three Years, 22 cwt yld goal, Dryland • 41 Millet, No-Till, Dryland • 42 Oats, No-Till, 90 bu Yield Goal, Dryland • 43 Pasture, Grazing, Pivot Irrigated • 44 Peas, No-Till, Dryland • 45 Sorghum-Sudan, Annually Planted, Large Round Bale, Dryland • 46 SoyBeans, Tilled seed bed, Roundup Ready®, Dryland • 47 SoyBeans, No-Till, Roundup Ready® after Corn, Dryland • 48 SoyBeans, No-Till, Roundup Ready® Continuous, Dryland • 49 SoyBeans, Tilled seedbed, Roundup Ready® after Corn, Pivot Irrigated • 50 SoyBeans, Ridge-Till, RR after RR Corn, Gravity Irrigated • 51 SoyBeans, No-Till 15-inch Row, Roundup Ready® after Corn, Pivot Irrigated • 52 SoyBeans Roundup Ready®, No-Till Narrow Row, Continuous, Pivot Irrigated • 53 SoyBeans, No-Till Drilled 75-inch rows, Roundup Ready® after Corn, Pivot Irrigated • 54 Sugarbeet Roundup Ready®, One Pass Zone-Tillage, Canal Irrigated • 55 Sugarbeet Roundup Ready®, Conventional Tillage, Gravity Irrigated, Canal • 56 Sugarbeet Roundup Ready®, One Pass Zone-Tillage, Pivot Irrigated • 57 Sugarbeet Roundup Ready®, Conventional Tillage, Pivot Irrigated • 58 Sunflower, No-Till, Following Corn or Grain Sorghum, Dryland • 59 Sunflower, Ecofallow, after Wheat, Two Crops in Three Years, Dryland • 60 Sunflower, No-Till, Pivot Irrigated • 61 Wheat, No-Till after Row Crop, 50 bu Yield Goal, Dryland • 62 Wheat, No-Till Fallow, One Crop in Two Years, 60 bu Yield Goal, Dryland • 63 Wheat, Stubble Mulch Fallow, One Crop in Two Years, 55 bu Yield Goal, Dryland • 64 Wheat, Clean Till Fallow, One Crop in Two Years, 50 bu Yield Goal, Dryland • 65 Wheat, No-Till Wheat before Corn, Two Crops in Three Years, 65 bu Yield Goal, Dryland • 66 Wheat, No-Till after Beans, 100 bu Yield Goal, Pivot Irrigated • 67 Wheat, No-Till, in Rotation, Pivot Irrigated • 68 Cover Crop, Conventional Tillage • 69 Cover Crop, No-Til

EC872 Crop Budgets: Nebraska - 2014

This publication contains 66 crop production budgets for 13 crops, as well as tables of power, machinery, labor, and input costs used to develop these budgets. Each budget consists of five sections: • Heading • List of representative field operations • List of materials and services used • Operations and interest tabulations • Overhead costs including real estate taxes and opportunitycharges The budgets are presented in a worksheet format with a “Your Estimate” column for recording cost modifications. Budget Divisions The heading consists of the crop name, system description, and method of water application. The list of representative field operations is organized in a table with columns for the operation name, quantity or number of times used with units, labor, fuel and lube, power source, and implement costs for both repairs and ownership. “Times” or “Quantity” is typically in acres with a decimal denoting where an operation is done on a fraction of acres or where it represents the probability of an operation being done. Those operations that are done multiple times, for example swathing several cuttings of hay, show the number of times. If a unit is other than “acres,” it is specified in the “Unit” column. Other units used are bushels (bu), hundredweight (cwt), tons, and acre-inches (ai). Labor costs for each operation were calculated from machinery accomplishment rates and adjusted for additional time required for getting machinery ready, adjusting machinery, and handling fertilizer and other supplies. The estimated costs for completing these operations are multiplied by the number in the “Times” or “Quantity” column, the product of which is multiplied by the hourly wage ($20 per hour) and labor factor. Fuel costs also use machinery accomplishment rates as well as estimated fuel consumption rates to determine fuel use. This is multiplied by a lube factor and the price of energy which is$3.50 per gallon for diesel and $0.10 per kwh for electricity. Repairs and depreciation costs were estimated using functions and factors from the AgriculturalEngineer’s Yearbook which is published by the American Society of Agricultural and Biological Engineers. It requires making assumptions about the size and age of the equipment. It was assumed that machinery chosen was fully utilized. Data used to calculate power unit costs are in Table 1 and machinery operation costs are in Table 2. Irrigation costs were calculated using engineering performance standards and typical water application rates which will depend on the rainfall area. Power costs for irrigation refer to the pump and power unit; implement costs are for the delivery system (pipe or pivot). Depreciation and interest for the well are budgeted with land costs. Materials and services are calculated by multiplying the application rate by the application price (Table 3) and then by the percent acres applied. A value less than 100% is used when a material or service is applied on only part of the acres or part of the time. For example, fields planted with Bt corn seed must have 20 percent of the acres planted to a refuge crop. There would be 20 percent in the column called “Percent Acres Applied” for the non- Bt seed and 80 percent for the Bt seed. Another example is when a practice is not always used. If an insecticide is used one year out of four, a “25 percent” would be entered in the column “Percent Acres Applied.” The cost for each material/service is computed by multiplying the percentage of acres by the quantity per acre and then by the price per unit. Note: All prices for materials and services in the budgets were obtained in October 2012. The value in the “Operation Index” column in the “Materials and Services” section indicates the corresponding operation in the “Field Operations” section. Data for calculating materials cost is in Table 3. The operations and interest is the sum of totals of the first two sections with interest calculated on the cash costs. Cash costs in interest calculations include labor, fuel, and repairs from the list of field operations and all costs from the materials and services. Overhead costs include accounting, liability insurance, vehicle cost, and office expense. Real estate values used are from the UNL publication Nebraska Farm Real Estate Market Developments 2012-2013 published in June 2012. Taxes on real estate are not included in interest calculations because in Nebraska they are due at the end of the year in which they accrue and are not delinquent until May and September of the following year. A cost per unit of production and cash cost per unit of production is calculated. The cost per unit of production is the sum of all costs divided by the projected yield. The cash cost per unit of production is the sum of labor, fuel, repairs, materials and services, and interest, divided by the projected yield. It should be noted that many enterprise budgets are cost and return estimates. These budgets are cost estimates only so have no estimates as to profitability

The effects of playing Nintendo Wii on depression, sense of belonging and social support in Australian aged care residents: A protocol study of a mixed methods intervention trial

Background: The proportion of people aged 65 or older is the fastest growing age group worldwide. Older adults in aged care facilities have higher levels of depression, and lower levels of social support and sense of belonging compared with older adults living in the community. Research has begun to assess the effectiveness of interventions to improve the mental health of residents and has found both cognitive and physical benefits of video game playing. The benefits of playing these games in a group may also lead to greater social interaction and decreased loneliness. The current study aims to investigate an intervention program designed to foster relationships among older adults in care based on shared interests. Residents will be assessed on the effectiveness of a 6 week program of playing Wii bowling in comparison to a control group. Method/Design: Participants will be allocated to the intervention (Wii bowling) or the control group based on their place of residence. Participants in the intervention group will be invited to participate in Wii bowling twice weekly, with up to three other residents for a period of 6 weeks. Residents in both conditions will be assessed for depression, social support, sense of belonging, and current self-rated mood at pre-intervention (0 weeks), post-intervention (6 weeks), and at 2-month follow up (14 weeks). Qualitative data on social interaction between group members will also be collected at weeks 1, 3, and 6. Both groups will receive a Wii console after week 6 to establish if residents and staff engage with the Wii without intervention. Discussion: The Wii provides a user friendly platform for older adults to use video games, and it incorporates both social and competitive aspects in the game play. Existing research has not extensively investigated the social aspects of using this type of technology with older adults. If found to be effective, incorporating Wii games into an activity schedule may benefit the mental health of older adults living in care by establishing an intervention that is fun, economical, and easy to use. Trial Registry: Australian New Zealand Clinical Trials Registry: ACTRN1261400044567

Abschlussbericht zur Umfrage an der Universitätsbibliothek Mannheim 2016

Unter dem Motto „Sagen Sie uns Ihre Meinung“ führte die Universitätsbibliothek Mannheim im Oktober 2016 eine große Online-Befragung zu ihrem gesamten Serviceangebot durch. Ziel der Umfrage war es, die aktuelle Zufriedenheit der NutzerInnen mit der Bibliothek abzufragen und die Erwartungen hinsichtlich zukünftiger Dienstleistungen zu ermitteln. Dieser Bericht präsentiert die wesentlichen Ergebnisse und Schlussfolgerungen aus Sicht der UB Mannheim

Vergleich unterschiedlicher Beurteilungsmethoden des Ductus venosus im Ersttrimesterscreening

Beim Ersttrimesterscreening handelt es sich um eine kombinierte Screeningmethode. Zum einen wird per Ultraschall die Nackentransparenz des Ungeborenen gemessen und zum anderen werden mit dem sogenannten Double Test zwei biochemische Laborwerte analysiert. In Kombination mit dem mütterlichen Alter, dem genauen Gestationsalter, der Breite der Nackentransparenz und der Konzentration der Werte aus dem Double-Test lässt sich ein individuelles Risiko für eine Chromosomenstörung berechnen. 90-95% der Schwangerschaften mit einem Down-Syndrom können auf diese Weise erkannt werden. Die Falschpositivrate liegt bei 3-5%. Das Screening wird in den Schwangerschaftswochen 11+0 bis 13+6 durchgeführt. Mehrere Studien haben gezeigt, dass eine zusätzliche Messung des fetalen Blutflusses im Ductus venosus die Spezifität des Ersttrimesterscreenings verbessert. Man kann den Blutfluss im Ductus venosus auf zwei unterschiedliche Arten messen. Die gängigere Messmethode beruht auf der dichotomen Bestimmung der Flussrichtung der a-Welle. Ein fehlender oder retrograder Fluss im Ductus venosus spiegelt sich in einer negativen a-Welle wider. Er entsteht durch einen erhöhten Druck im rechten Vorhof und weist häufig auf eine unspezifisch veränderte kardiale Funktion hin. In mehreren Studien wurde ein negativer Fluss signifikant häufiger bei Trisomie 21, Trisomie 13, Trisomie 18 und angeborenen Herzfehlern nachgewiesen. Dieser Zusammenhang war unabhängig von der kardialen Funktion. Die dichotome Messmethode ist stark untersucherabhängig und bei mehrdeutigen Ergebnissen der Doppleruntersuchung kann keine klare Aussage über die Pathologie getroffen werden. Die alternative Messmethode liegt in der Bestimmung des Pulsatilitätsindexes. Der PIV repräsentiert den gesamten Flusszyklus des Ductus venosus und nicht nur die a-Welle. In dieser Arbeit wird mittels retrospektiver Datenanalyse untersucht, inwiefern die Qualität des Ersttrimesterscreenings durch die Kombination dieser zwei sonographischen Messmethoden verbessert werden kann. Die retrospektive Datenanalyse wurde an der Universitätsfrauenklinik Tübingen, einem tertiären Referenzzentrum, durchgeführt. Es wurden alle Einlingsschwangerschaften ausgesucht, welche zwischen 2007 und 2016 zum Ersttrimesterscreening vorstellig waren. Die Untersuchungsgeräte verfügen über einen automatischen Messalgorithmus zur Erhebung des PIV. Die Beurteilung der a-Welle erfolgte jeweils durch den Untersucher. Alle Untersucher sind durch die Fetal Medicine Foundation UK zertifiziert. Alle Messungen wurden in Übereinstimmung mit bereits veröffentlichten Richtlinien durchgeführt. Insgesamt konnten 5.407 schwangere Patientinnen in die Studie eingeschlossen werden. Bei jeder Patientin wurde das Risiko für die eingeschlossenen Chromosomenstörungen basierend auf maternalem Alter und Gewicht, Gestationsalter, fetale Nackenfaltendicke, und dem Blutfluss im Ductus venosus (entweder Klassifikation anhand der a-Welle oder die Messung des PIV) berechnet. Außerdem wurde das auf dem maternalen Alter, der fetalen Nackendichte und des PIV basierende Risiko, mit den entsprechenden positiven oder negativen Wahrscheinlichkeitsverhältnissen multipliziert, je nachdem ob die a-Welle negativ war oder nicht. Anhand dieser Analysen konnten das Risiko für das Vorliegen einer Trisomie 21 basierend auf dem mütterlichen Alter, der fetalen Nackendichte und dem Blutfluss im Ductus venosus (als PIV, als dichotome Klassifikation, oder beide Methoden in Kombination) miteinander verglichen werden. Des Weiteren wurde die Nackentransparenzmessung aus den drei zuvor berechneten Risiken ausgeschlossen, um so den alleinigen Effekt des Blutflusses im Ductus venosus zu untersuchen. In der Karyotypisierung zeigten sich 97,7% der untersuchten Feten euploid (n=5.280), wiederum 2,3% (n=127) wiesen eine Trisomie 21 auf. Mittels ROC-Kurven von Screenings auf Trisomie 21, basierend auf dem maternalen Alter, fetaler Nackentransparenz und der zusätzlichen Untersuchung des Ductus venosus mittels Ausrichtung der a-Welle, mittels PIV oder beidem, konnte kein signifikanter Unterschied zwischen den Messmethoden festgestellt werden. Beide Messmethoden führten zu ähnlichen Detektionsraten (87% für eine festgesetzte Detektionsrate von 3%). Die parallele Erhebung beider Ductus venosus Messmethoden in Kombination mit den Parametern des maternalen Alters und der fetalen Nackentransparenz erbrachte keine höhere Detektionsrate

Utilising Emotion Monitoring for Developing Music Interventions for People with Dementia:A State-of-the-Art Review

The demand for smart solutions to support people with dementia (PwD) is increasing. These solutions are expected to assist PwD with their emotional, physical, and social well-being. At the moment, state-of-the-art works allow for the monitoring of physical well-being; however, not much attention is delineated for monitoring the emotional and social well-being of PwD. Research on emotion monitoring can be combined with research on the effects of music on PwD given its promising effects. More specifically, knowledge of the emotional state allows for music intervention to alleviate negative emotions by eliciting positive emotions in PwD. In this direction, the paper conducts a state-of-the-art review on two aspects: (i) the effect of music on PwD and (ii) both wearable and non-wearable sensing systems for emotional state monitoring. After outlining the application of musical interventions for PwD, including emotion monitoring sensors and algorithms, multiple challenges are identified. The main findings include a need for rigorous research approaches for the development of adaptable solutions that can tackle dynamic changes caused by the diminishing cognitive abilities of PwD with a focus on privacy and adoption aspects. By addressing these requirements, advancements can be made in harnessing music and emotion monitoring for PwD, thereby facilitating the creation of more resilient and scalable solutions to aid caregivers and PwD

Chemokines in the balance: Maintenance of homeostasis and protection at CNS barriers

In the adult central nervous system (CNS), chemokines and their receptors are involved in developmental, physiological and pathological processes. Although most lines of investigation focus on their ability to induce the migration of cells, recent studies indicate that chemokines also promote cellular interactions and activate signaling pathways that maintain CNS homeostatic functions. Many homeostatic chemokines are expressed on the vasculature of the blood brain barrier including CXCL12, CCL19, CCL20, and CCL21. While endothelial cell expression of these chemokines is known to regulate the entry of leukocytes into the CNS during immunosurveillance, new data indicate that CXCL12 is also involved in diverse cellular activities including adult neurogenesis and neuronal survival, having an opposing role to the homeostatic chemokine, CXCL14, which appears to regulate synaptic inputs to neural precursors. Neuronal expression of CX3CL1, yet another homeostatic chemokine that promotes neuronal survival and communication with microglia, is partly regulated by CXCL12. Regulation of CXCL12 is unique in that it may regulate its own expression levels via binding to its scavenger receptor CXCR7/ACKR3. In this review, we explore the diverse roles of these and other homeostatic chemokines expressed within the CNS, including the possible implications of their dysfunction as a cause of neurologic disease

2016 Nebraska Crop Budgets

1-Alfalfa, Fall Establishment, Dryland 2-Alfalfa, Roundup Ready® No-Till, Fall Establishment, Dryland 3-Alfalfa, Roundup Ready®, Fall Establishment, Dryland 4-Alfalfa, Establish Spring Seed with Herbicides, Dryland 5-Alfalfa, Roundup Ready®, Establish Spring Seed, Dryland 6-Alfalfa, Establish Spring Seed with Herbicides, Pivot Irrigated 7-Alfalfa, Roundup Ready®, Establish Spring Seed, Pivot Irrigated 8-Alfalfa, Fall Seeded with Subsequent Year Production, Gravity Irrigated, Canal 9-Alfalfa, Large Round Bale, Dryland 10-Alfalfa, Large and Small Square Bale, Pivot Irrigated 11-Alfalfa, Roundup Ready®, Large and Small Square Bale, Pivot Irrigated 12-Alfalfa, Large and Small Square Bale, Pivot Irrigated 13-Alfalfa, Large Square Bale, Canal Irrigated 14-Alfalfa, Roundup Ready®, Large Square Bale, Canal Irrigated 15-Corn, Conventional Tillage, Continuous, 90 bu Yield Goal, Dryland 16-Corn, Eastern Nebraska Conventional Tillage, Continuous, 155 bu Yield Goal, Dryland 17-Corn, No-Till, Bt, ECB, RW & RR2, Continuous, 125 bu Yield Goal, Dryland 18-Corn, Eastern Nebraska, No-Till, Bt, ECB, RW & RR2, Continuous, 170 bu Yield Goal, Dryland 19-Corn, No-Till, SmartStax RIB Complete, Continuous, 130 bu Yield Goal, Dryland 20-Corn, Eastern Nebraska No-Till, SmartStax RIB Complete, Continuous, 175 bu Yield Goal, Dryland 21-Corn, No-Till, Bt & ECB, after Soybeans, 135 bu Yield Goal, Dryland 22-Corn, Eastern Nebraska No-Till, Bt & ECB, after Soybeans, 180 bu Yield Goal, Dryland 23-Corn, Ecofallow, Follows Wheat, Two Crops in Three Years, RR2, Bt & ECB, 125 bu Yield Goal, Dryland 24-Corn, Ridge Till, Bt, ECB & RW, Continuous, 230 bu Yield Goal, Gravity Irrigated 25-Corn, Ridge Till, SmartStax RIB Complete, Continuous, 240 bu Yield Goal, Gravity Irrigated 26-Corn, Panhandle Continuous, SmartStax RIB Complete, 190 bu Yield Goal, Canal Irrigated 27-Corn, No-Till, Bt, ECB & RW, Continuous, 240 bu Yield Goal, Pivot Irrigated 28-Corn, No-Till, SmartStax RIB Complete, Continuous, 250 bu Yield Goal, Pivot Irrigated 29-Corn, Bt, ECB & RW, Continuous, 230 bu Yield Goal, Pivot Irrigated 30-Corn, Panhandle, SmartStax RIB Complete, 190 bu Yield Goal, Pivot Irrigated 31-Corn, SmartStax RIB Complete, Continuous, 240 bu Yield Goal, Pivot Irrigated 32-Corn, No-Till, Bt & ECB after Beans, 240 bu Yield Goal, Pivot Irrigated 33-Corn, Silage, No-Till following Corn, Pivot Irrigated 34-Dry Beans, Reduced Till with Wheat Cover Crop after Harvest, Pivot Irrigated 35-Dry Beans, Conventional Tillage, Canal Irrigated 36-Dry Beans, Conventional Tillage Using Pumped Water, Pivot Irrigated 37-Dry Beans, Direct Harvest, Conventional Tillage Using Pumped Water, Pivot Irrigated 38-Grain Sorghum, Conventional Tillage, 105 bu Yield Goal, Dryland 39-Grain Sorghum, No-Till, 125 bu Yield Goal, Dryland 40-Grain Sorghum, Ecofallow, After Wheat, Two Crops in Three Years, 115 bu Yield Goal, Dryland 41-Grain Sorghum, No-Till, Limited Irrigation, 165 bu Yield Goal, Pivot Irrigated 42-Grass, Fall Establishment, Pivot Irrigated 43-Grass Hay, Large Round Bale, Dryland 44-Millet, Stubble Mulch Fallow, Followed by Wheat, Two Crops in Three Years, Dryland 45-Millet, No-Till, Dryland 46-Oats, No-Till, 90 bu Yield Goal, Dryland 47-Pasture, Grazing, Pivot Irrigated 48-Peas, No-Till, Dryland 49-Sorghum-Sudan, Annually Planted, Large Round Bale, Dryland 50-Soybeans, Tilled Seed Bed, Roundup Ready® after Corn, Dryland 51-Soybeans, No-Till, Roundup Ready® after Corn, Dryland 52-Soybeans, No-Till, Roundup Ready® Continuous, Dryland 53-Soybeans, Tilled Seedbed, Roundup Ready® after Corn, Pivot Irrigated 54-Soybeans, Ridge Till, Roundup Ready® after Corn, Gravity Irrigated 55-Soybeans, No-Till 15-inch Row, Roundup Ready® after Corn, Pivot Irrigated 56-Soybeans, Roundup Ready®, No-Till Narrow Row, Continuous, Pivot Irrigated 57-Soybeans, No-Till Drilled 7.5-inch Rows, Roundup Ready® after Corn, Pivot Irrigated 58-Sugarbeet, Roundup Ready®, One Pass Zone-Tillage, Canal Irrigated 59-Sugarbeet, Roundup Ready®, Conventional Tillage, Gravity Irrigated, Canal 60-Sugarbeet, Roundup Ready®, One Pass Zone-Tillage, Pivot Irrigated 61-Sugarbeet, Roundup Ready®, Conventional Tillage, Pivot Irrigated 62-Sunflower, No-Till, Following Corn or Grain Sorghum, Dryland 63-Sunflower, Ecofallow, after Wheat, Two Crops in Three Years, Dryland 64-Sunflower, No-Till, Pivot Irrigated 65-Wheat, No-Till, Wheat after Row Crop, 50 bu Yield Goal, Dryland 66-Wheat, No-Till Fallow, One Crop in Two Years, 60 bu Yield Goal, Dryland 67-Wheat, Stubble Mulch Fallow, One Crop in Two Years, 55 bu Yield Goal, Dryland 68-Wheat, Clean Till Fallow, One Crop in Two Years, 50 bu Yield Goal, Dryland 69-Wheat, No-Till Wheat before Corn, Two Crops in Three Years, 65 bu Yield Goal, Dryland 70-Wheat, No-Till after Beans, 100 bu Yield Goal, Pivot Irrigated 71-Wheat, No-Till, in Rotation, Pivot Irrigated 72-Cover Crop, Conventional Tillage 73-Cover Crop, No-Til

Frühpostoperative chirurgische Ergebnisse bei Patient:innen mit Bentall- versus David/Yacoub-Operation und Ersatz- beziehungsweise Raffung der Aorta Ascendens

Das Aneurysma der Aorta ascendens ist eine mit steigendem Alter immer häufiger verbreitete Entität. Unerkannt kann es zu einer tödlich verlaufenden Ruptur oder Dissektion der Aorta führen, die unbehandelt mit einer Mortalitätsrate von bis zu 50 % innerhalb der ersten 48 Stunden nach Symptombeginn assoziiert ist. Die häufigsten Ursachen des Aneurysmas sind die Atherosklerose gepaart mit der arteriellen Hypertonie, Bindegewebserkrankungen, kongenitale Störungen der Aortenklappe oder autoimmune bzw. infektiöse Vaskulitiden. In der Literatur beschäftigen sich viele Studien mit den Spätkomplikationen und entsprechenden Therapien der Ruptur und der Dissektion der Aorta. Ein Mangel besteht jedoch in der Auswertung und dem Vergleich der Aorta ascendens Eingriffe aufgrund einer pathologischen Aortendilatation im Sinne einer Aortenektasie oder eines Aorta ascendens Aneurysmas und deren frühpostoperativen Komplikationen. Ziel dieser vorliegenden Studie war, die perioperative Morbidität und Krankenhausmortalität dieser Patient:innen herauszuarbeiten und die Ergebnisse der verschiedenen Aorta ascendens Eingriffe miteinander zu vergleichen. Dabei sollten die frühoperative Krankenhausmortalität als primärer Endpunkt und häufige postoperative Komplikationen als sekundäre Endpunkte herausgearbeitet werden und gegebenenfalls zur gezielteren präoperative Risikostratifizierung für zukünftige operative Eingriffe an der Aorta ascendens dienen. Hierzu wurden die retrospektiven Daten von 335 Patient:innen, die sich im Zeitraum von Januar 2009 bis Dezember 2014 in der Klinik für Herz- und Thoraxchirurgie des Universitätsklinikums Köln einem Eingriff der Aorta ascendens unterzogen, analysiert. Die unterschiedlichen Operationsverfahren bildeten die vier Gruppen des Patient:innenkollektivs. Die Einteilung war wie folgt: Gruppe 1: (suprakoronarer) Aorta ascendens Ersatz – 122 Patient:innen Gruppe 2: Aortenraffung – 93 Patient:innen Gruppe 3: Operation nach David/Yacoub – 51 Patient:innen Gruppe 4: Operation nach Bentall – 69 Patient:innen Die Ergebnisse wurden nach primären und sekundären Endpunkten miteinander verglichen. Die primären Endpunkte waren die Krankenhausmortalität und die Todesursache. Sekundäre Endpunkte waren die Beatmungszeit und die Tracheotomie, das Auftreten von Vorhofflimmern, eine postoperative Reanimation, ein Low-cardiac-output-Syndrom, eine IABP- oder ECMO-Behandlung, unerwünschte kardiozerebrale Ereignisse wie ein neu aufgetretener Apoplex oder Myokardinfarkt, eine relevante postoperative Nachblutung, eine Niereninsuffizienz mit nachfolgender Hämodialyse und gastrointestinale Komplikationen. Nachweisen ließ sich eine Gesamtmortalität von 3,9 %. Im Vergleich der Gruppen sind 1,6 % aus Gruppe 1, 2,2 % aus Gruppe 2, 5,9 % aus Gruppe 3 und 8,7 % aus Gruppe 4 verstorben. Für Patient:innen aus Gruppe 4 konnte mit 8,7 % eine im Vergleich höhere Mortalität als in Gruppe 1 (2,2 %) nachgewiesen werden (p = 0.027). In die Gruppe der Bentall-Operationen gingen signifikant mehr Patient:innen mit präoperativer Endokarditis (10,1 %; p = 0.05) und Redo-Operationen (19,1 %; p = 0.039) ein, wobei es sich in beiden Fällen um ausgeprägte Risikofaktoren handelt, und prognostisch mit einem schlechterem perioperativem Ergebnis und einer höheren Mortalität vergesellschaftet ist. Operationen nach David/Yacoub oder Bentall benötigten signifikant längere Operationszeiten (Operationslänge, kardiopulmonale Bypasszeit, Klemmzeit, Reperfusionzeit), was durch eine höhere Komplexität der Eingriffe erklärbar ist (p 0.05)