Analysis and Design of a Portal for Ionospheric Data

Since 2004 DLR Neustrelitz operates the Space Weather Application Center – Ionosphere (SWACI). This Center is involved in several projects of the Space Situational Awareness (SSA) program of ESA and of EU FP7. It is largely based on services and tools of DLR’s Data and Information Management System (DIMS) and its long-standing User interface EoWEB. SWACI provides access to near real time products and ensures long-term preservation. The lecture will analyze the existing solution and various project-specific applications and will derive requirements for a recent user interface. In the second part the talk will draw a design of an user interface for the Ionospheric Monitoring and Prediction Center (IMPC), which continues utilizing existing services of DLR, offers OGC compliant interfaces and which is so generalized that future projects can be easily plugged in

Cardiac MRI-based right-to-left ventricular blood pool T2 relaxation times ratio correlates with exercise capacity in patients with chronic heart failure

Background MRI T2 mapping has been proven to be sensitive to the level of blood oxygenation. We hypothesized that impaired exercise capacity in chronic heart failure is associated with a greater difference between right (RV) to left ventricular (LV) blood pool T2 relaxation times due to a higher level of peripheral blood desaturation, compared to patients with preserved exercise capacity and to healthy controls. Methods Patients with chronic heart failure (n = 70) who had undergone both cardiac MRI (CMR) and a 6-min walk test (6MWT) were retrospectively identified. Propensity score matched healthy individuals (n = 35) served as control group. CMR analyses included cine acquisitions and T2 mapping to obtain blood pool T2 relaxation times of the RV and LV. Following common practice, age- and gender-adjusted nominal distances and respective percentiles were calculated for the 6MWT. The relationship between the RV/LV T2 blood pool ratio and the results from 6MWT were evaluated by Spearman’s correlation coefficients and regression analyses. Inter-group differences were assessed by independent t-tests and univariate analysis of variance. Results The RV/LV T2 ratio moderately correlated with the percentiles of nominal distances in the 6MWT (r = 0.66) while ejection fraction, end-diastolic and end-systolic volumes showed no correlation (r = 0.09, 0.07 and − 0.01, respectively). In addition, there were significant differences in the RV/LV T2 ratio between patients with and without significant post-exercise dyspnea (p = 0.001). Regression analyses showed that RV/LV T2 ratio was an independent predictor of the distance walked and the presence of post-exercise dyspnea (p < 0.001). Conclusion The proposed RV/LV T2 ratio, obtained by two simple measurements on a routinely acquired four-chamber T2 map, was superior to established parameters of cardiac function to predict exercise capacity and the presence of post-exercise dyspnea in patients with chronic heart failure

Convalescent plasma treatment for SARS-CoV-2 infected high-risk patients: a matched pair analysis to the LEOSS cohort

Establishing the optimal treatment for COVID-19 patients remains challenging. Specifically, immunocompromised and pre-diseased patients are at high risk for severe disease course and face limited therapeutic options. Convalescent plasma (CP) has been considered as therapeutic approach, but reliable data are lacking, especially for high-risk patients. We performed a retrospective analysis of 55 hospitalized COVID-19 patients from University Hospital Duesseldorf (UKD) at high risk for disease progression, in a substantial proportion due to immunosuppression from cancer, solid organ transplantation, autoimmune disease, dialysis. A matched-pairs analysis (1:4) was performed with 220 patients from the Lean European Open Survey on SARS-CoV-2-infected Patients (LEOSS) who were treated or not treated with CP. Both cohorts had high mortality (UKD 41.8%, LEOSS 34.1%). A matched-pairs analysis showed no significant effect on mortality. CP administration before the formation of pulmonary infiltrates showed the lowest mortality in both cohorts (10%), whereas mortality in the complicated phase was 27.8%. CP administration during the critical phase revealed the highest mortality: UKD 60.9%, LEOSS 48.3%. In our cohort of COVID-19 patients with severe comorbidities CP did not significantly reduce mortality in a retrospective matched-pairs analysis. However, our data supports the concept that a reduction in mortality is achievable by early CP administration

Low extracellular vesicle concentrations predict survival in patients with heart failure

BackgroundHeart disease is of worldwide importance due to high morbidity and mortality. Extracellular vesicle (EV) concentration and size represent novel diagnostic and prognostic biomarkers, e.g. in patients with liver cancer, but data on their prognostic relevance in heart disease are lacking. Here, we investigated the role of EV concentration, size and zeta potential in patients with heart disease.MethodsVesicle size distribution, concentration and zeta potential were measured by nanoparticle tracking analysis (NTA) in 28 intensive care unit (ICU) and 20 standard care (SC) patients and 20 healthy controls.ResultsPatients with any disease had a lower zeta potential compared to the healthy controls. Vesicle size (X50) was significantly higher in ICU patients (245 nm) with heart disease as compared to those patients with heart disease receiving standard care (195 nm), or healthy controls (215 nm) (p = 0.001). Notably, EV concentration was lower in ICU patients with heart disease (4.68 × 1010 particles/ml) compared to SC patients with heart disease (7,62 × 1010 particles/ml) and healthy controls (1.50 × 1011 particles/ml) (p = 0.002). Extracellular vesicle concentration is prognostic for overall survival in patients with heart disease. Overall survival is significantly reduced when the vesicle concentration is below 5.55 × 1010 particles/ml. Median overall survival was only 140 days in patients with vesicle concentrations below 5.55 × 1010 particles/ml compared to 211 days in patients with vesicle concentrations above 5.55 × 1010 particles/ml (p = 0.032).SummaryConcentration of EVs is a novel prognostic marker in ICU and SC patients with heart disease

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Moderne Webtechnologien und –standards als Basis für die Entwicklung eines Webportals für das Projekt IMPC

Die Verwendung von globalen Navigationssatellitensystemen (GNSS) ist ein fester Bestandteil in unserer modernen Welt. Dabei werden die Signale vom Satelliten zum Empfänger auf der Erde durch verschiedene Faktoren mehrfach gestört. Das Ionosphere Monitoring and Prediction Center (IMPC), ein stabiles und wettbewerbsfähiges Echtzeit-Datenzentrum des Deutschen Zentrums für Luft- und Raumfahrt e.V. (DLR), stellt verschiedenen Nutzern Echtzeitinformationen, Vorhersagen und ggf. Warnungen zum Zustand der Ionosphäre als einer dieser Einflussfaktoren zur Verfügung. Zentrale Anlaufstelle wird hierfür ein Webportal sein, welches auch als Pilot-System für die Unterstützung weiterer Projekte dient und dazu einen Multiprojekt-Ansatz verfolgen soll. Die angebotenen Dienste und Produkte sollen Kommunen, Behörden, Dienstleistern aber auch Privatpersonen als Werkzeuge bei ihrer täglichen Arbeit dienen. Um diesem Anspruch gerecht zu werden, orientiert sich die Plattform selbst an aktuellen Webtechnologien und –standards unter Berücksichtigung der Anforderungen an das Projekt IMPC und deren Nutzer. Die vorliegende Arbeit nimmt sich dieser Aufgabe an und untersucht dabei die praktische Umsetzbarkeit des aktuellen Stands der technischen Entwicklung unter Berücksichtigung moderner Anforderungen an das Nutzererlebnis im WorldWideWeb. The use of global navigation satellite systems (GNSS) is an integral part in our modern world. The signals from the satellite to the receiver on the ground are disturbed by various factors multiply. The Ionosphere Monitoring and Prediction Center (IMPC), a stable and competitive real-time data center of the German Aerospace Center (DLR), provides for various users real time information, forecast and possibly warnings about the state of the ionosphere as one of these factors. The central point for this is a web portal, which is also serves as a pilot system to support additional projects and to adopt a multi-project approach. The offered services and products should serve communities, government agencies, service providers and individuals as tools at their daily work. To meet this requirement, the platform itself is oriented to current web technologies and standards taking into account the requirements of the IMPC project and their users. 4/63 The present study addresses this task and is examining the practicability of the current state of technological development taking into account modern demands on the user experience in the WorldWideWeb