Kathetergestützte Aortenklappenimplantation: Was müssen Anästhesisten wissen?

Zusammenfassung: Der chirurgische Aortenklappenersatz gilt als Goldstandard in der Therapie der hochgradigen Aortenklappenstenose. Die veränderte Demografie konfrontiert die behandelnden medizinischen Fachdisziplinen jedoch mit einem zunehmend höheren Risikoprofil der Patienten; dies machte die Entwicklung neuer weniger invasiver Behandlungsalternativen in der operativen Therapie der Aortenklappenstenose erforderlich. Dieser Entwicklungsprozess führte über die Minithorakotomie hin zur kathetergestützten Aortenklappenimplantation ("transcatheter aortic valve implantation", TAVI). Die TAVI ist ein neues therapeutisches Verfahren zur Behandlung von Patienten mit hochgradiger Aortenklappenstenose und hohem perioperativen Morbiditäts- sowie Mortalitätsrisiko für einen konventionellen Aortenklappenersatz. Da die TAVI am schlagenden Herzen ohne Sternotomie und Herz-Lungen-Maschine durchgeführt werden kann, eignet sich dieses Verfahren insbesondere für den älteren, multimorbiden und/oder kardial voroperierten Patienten. Die ersten Ergebnisse großer prospektiver Multizenterstudien unterstreichen den Stellenwert der TAVI in der modernen Behandlung von Hochrisikopatienten mit symptomatischer Aortenklappenstenose. Die TAVI erfordert vom Anästhesisten neben dem Verständnis des chirurgischen Ablaufs die genaue Kenntnis des perioperativen anästhesiologischen Managements und der möglichen Komplikationen des Verfahren

Heating and Trapping of Electrons in ECRIS from Scratch to Afterglow

Plasmas in Electron Cyclotron Resonance Ion Sources (ECRIS) are collisionless and can therefore be simulated by just following the motion of electrons in the confining static magnetic and oscillating microwave (MW) electric field of ECRIS. With a powerful algorithm the three-dimensional trajectories of 104 ECR-heated and confined electrons are calculated in a standard ECRIS with a deep minimum of |B| and a new ECRIS with a very flat minimum of |B|. The spatial electron (plasma) densities and electron energy densities deduced from these trajectories yield new and surprising insight in the performance of ECRIS. With computer animation we plan to present: The energy increase of certain electrons on extremely stable trajectories, the power dependence of the electron energy density up to the X-ray collapse, the time dependent build up of the electron density and energy density distributions, and the time evolution of these electron distributions under afterglow conditions

ClimWood2030, Climate benefits of material substitution by forest biomass and harvested wood products: Perspective 2030 - Final Report

The ClimWood2030 study, commissioned by DG CLIMA of the European Commission, quantifies the five ways in which the EU forest sector contributes to climate change mitigation: carbon sequestration and storage in EU forests, carbon storage in harvested wood products in the EU, substitution of wood products for functionally equivalent materials and substitution of wood for other sources of energy, and displacement of emissions from forests outside the EU. It also explores through scenario analysis, based on a series of interlocking models (GLOBIOM, G4M and WoodCarbonMonitor), along with detailed analysis of Forest Based Functional Units, based on life cycle assessment (LCA), the consequences for GHG balances of policy choices at present under consideration. The focus is on the EU-28, but GHG balances for other parts of the world are also considered, notably to assess consequences of EU policy choices for other regions. The five scenarios are (I) The ClimWood2030 reference scenario, (II) Increase carbon stock in existing EU forests, (III) Cascade use – increase recovery of solid wood products, (IV) Cascade use – prevent first use of biomass for energy and (V) Strongly increase material wood use. The study presents detailed scenario results for key parameters, the policy instruments linked to the scenarios, and main conclusions

Integrated Detector Control and Calibration Processing at the European XFEL

The European X-ray Free Electron Laser is a high-intensity X-ray light source currently being constructed in the area of Hamburg, that will provide spatially coherent X-rays in the energy range between $0.25\,\mathrm{keV}$ and $25\,\mathrm{keV}$. The machine will deliver $10\,\mathrm{trains/s}$, consisting of up to $2700\,\mathrm{pulses}$, with a $4.5\,\mathrm{MHz}$ repetition rate. The LPD, DSSC and AGIPD detectors are being developed to provide high dynamic-range Mpixel imaging capabilities at the mentioned repetition rates. A consequence of these detector characteristics is that they generate raw data volumes of up to $15\,\mathrm{Gbyte/s}$. In addition the detector's on-sensor memory-cell and multi-/non-linear gain architectures pose unique challenges in data correction and calibration, requiring online access to operating conditions and control settings. We present how these challenges are addressed within XFEL's control and analysis framework Karabo, which integrates access to hardware conditions, acquisition settings (also using macros) and distributed computing. Implementation of control and calibration software is mainly in Python, using self-optimizing (py) CUDA code, numpy and iPython parallels to achieve near-real time performance for calibration application.Comment: Proceeding ICALEPS 201

From the Feynman-Schwinger representation to the non-perturbative relativistic bound state interaction

We write the 4-point Green function in QCD in the Feynman-Schwinger representation and show that all the dynamical information are contained in the Wilson loop average. We work out the QED case in order to obtain the usual Bethe-Salpeter kernel. Finally we discuss the QCD case in the non-perturbative regime giving some insight in the nature of the interaction kernel.Comment: 25 pages, RevTex, 3 figures included, typos corrected, to appear in Phys. Rev. D 5

Detection of air trapping in chronic obstructive pulmonary disease by low frequency ultrasound

<p>Abstract</p> <p>Background</p> <p>Spirometry is regarded as the gold standard for the diagnosis of COPD, yet the condition is widely underdiagnosed. Therefore, additional screening methods that are easy to perform and to interpret are needed. Recently, we demonstrated that low frequency ultrasound (LFU) may be helpful for monitoring lung diseases. The objective of this study was to evaluate whether LFU can be used to detect air trapping in COPD. In addition, we evaluated the ability of LFU to detect the effects of short-acting bronchodilator medication.</p> <p>Methods</p> <p>Seventeen patients with COPD and 9 healthy subjects were examined by body plethysmography and LFU. Ultrasound frequencies ranging from 1 to 40 kHz were transmitted to the sternum and received at the back during inspiration and expiration. The high pass frequency was determined from the inspiratory and the expiratory signals and their difference termed ΔF. Measurements were repeated after inhalation of salbutamol.</p> <p>Results</p> <p>We found significant differences in ΔF between COPD subjects and healthy subjects. These differences were already significant at GOLD stage 1 and increased with the severity of COPD. Sensitivity for detection of GOLD stage 1 was 83% and for GOLD stages worse than 1 it was 91%. Bronchodilator effects could not be detected reliably.</p> <p>Conclusions</p> <p>We conclude that low frequency ultrasound is cost-effective, easy to perform and suitable for detecting air trapping. It might be useful in screening for COPD.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01080924">NCT01080924</a></p

Spawning rings of exceptional points out of Dirac cones

The Dirac cone underlies many unique electronic properties of graphene and topological insulators, and its band structure--two conical bands touching at a single point--has also been realized for photons in waveguide arrays, atoms in optical lattices, and through accidental degeneracy. Deformations of the Dirac cone often reveal intriguing properties; an example is the quantum Hall effect, where a constant magnetic field breaks the Dirac cone into isolated Landau levels. A seemingly unrelated phenomenon is the exceptional point, also known as the parity-time symmetry breaking point, where two resonances coincide in both their positions and widths. Exceptional points lead to counter-intuitive phenomena such as loss-induced transparency, unidirectional transmission or reflection, and lasers with reversed pump dependence or single-mode operation. These two fields of research are in fact connected: here we discover the ability of a Dirac cone to evolve into a ring of exceptional points, which we call an "exceptional ring." We experimentally demonstrate this concept in a photonic crystal slab. Angle-resolved reflection measurements of the photonic crystal slab reveal that the peaks of reflectivity follow the conical band structure of a Dirac cone from accidental degeneracy, whereas the complex eigenvalues of the system are deformed into a two-dimensional flat band enclosed by an exceptional ring. This deformation arises from the dissimilar radiation rates of dipole and quadrupole resonances, which play a role analogous to the loss and gain in parity-time symmetric systems. Our results indicate that the radiation that exists in any open system can fundamentally alter its physical properties in ways previously expected only in the presence of material loss and gain

The SXS Collaboration catalog of binary black hole simulations

Accurate models of gravitational waves from merging black holes are necessary for detectors to observe as many events as possible while extracting the maximum science. Near the time of merger, the gravitational waves from merging black holes can be computed only using numerical relativity. In this paper, we present a major update of the Simulating eXtreme Spacetimes (SXS) Collaboration catalog of numerical simulations for merging black holes. The catalog contains 2018 distinct configurations (a factor of 11 increase compared to the 2013 SXS catalog), including 1426 spin-precessing configurations, with mass ratios between 1 and 10, and spin magnitudes up to 0.998. The median length of a waveform in the catalog is 39 cycles of the dominant $\ell=m=2$ gravitational-wave mode, with the shortest waveform containing 7.0 cycles and the longest 351.3 cycles. We discuss improvements such as correcting for moving centers of mass and extended coverage of the parameter space. We also present a thorough analysis of numerical errors, finding typical truncation errors corresponding to a waveform mismatch of $\sim 10^{-4}$. The simulations provide remnant masses and spins with uncertainties of 0.03% and 0.1% ($90^{\text{th}}$ percentile), about an order of magnitude better than analytical models for remnant properties. The full catalog is publicly available at https://www.black-holes.org/waveforms .Comment: 33+18 pages, 13 figures, 4 tables, 2,018 binaries. Catalog metadata in ancillary JSON file. v2: Matches version accepted by CQG. Catalog available at https://www.black-holes.org/waveform