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The processing of organic substances by vacuum deposition is opening new possibilities for the properties of optical surfaces. Organic small molecules can be evaporated and deposited like optical thin films. Plasma etching, which has been successfully applied to generate nanostructures on polymer substrates, is now used for obtaining antireflective nanostructures on top of interference stacks on glass. The latest results in achieving excellent antireflective properties for a wide range of light incidence angles were accomplished through multiple etching of polymer substrates and organic layers.

State-of-the-art Earth system models typically employ grid spacings of O(100 km), which is too coarse to explicitly resolve main drivers of the flow of energy and matter across the Earth system. In this paper, we present the new ICON-Sapphire model configuration, which targets a representation of the components of the Earth system and their interactions with a grid spacing of 10 km and finer. Through the use of selected simulation examples, we demonstrate that ICON-Sapphire can (i) be run coupled globally on seasonal timescales with a grid spacing of 5 km, on monthly timescales with a grid spacing of 2.5 km, and on daily timescales with a grid spacing of 1.25 km; (ii) resolve large eddies in the atmosphere using hectometer grid spacings on limited-area domains in atmosphere-only simulations; (iii) resolve submesoscale ocean eddies by using a global uniform grid of 1.25 km or a telescoping grid with the finest grid spacing at 530 m, the latter coupled to a uniform atmosphere; and (iv) simulate biogeochemistry in an ocean-only simulation integrated for 4 years at 10 km. Comparison of basic features of the climate system to observations reveals no obvious pitfalls, even though some observed aspects remain difficult to capture. The throughput of the coupled 5 km global simulation is 126 simulated days per day employing 21 % of the latest machine of the German Climate Computing Center. Extrapolating from these results, multi-decadal global simulations including interactive carbon are now possible, and short global simulations resolving large eddies in the atmosphere and submesoscale eddies in the ocean are within reach.

Classical numerical models for the global atmosphere, as used for numerical weather forecasting or climate research, have been developed for conventional central processing unit (CPU) architectures. This hinders the employment of such models on current top-performing supercomputers, which achieve their computing power with hybrid architectures, mostly using graphics processing units (GPUs). Thus also scientific applications of such models are restricted to the lesser computer power of CPUs. Here we present the development of a GPU-enabled version of the ICON atmosphere model (ICON-A), motivated by a research project on the quasi-biennial oscillation (QBO), a global-scale wind oscillation in the equatorial stratosphere that depends on a broad spectrum of atmospheric waves, which originates from tropical deep convection. Resolving the relevant scales, from a few kilometers to the size of the globe, is a formidable computational problem, which can only be realized now on top-performing supercomputers. This motivated porting ICON-A, in the specific configuration needed for the research project, in a first step to the GPU architecture of the Piz Daint computer at the Swiss National Supercomputing Centre and in a second step to the JUWELS Booster computer at the Forschungszentrum Jülich. On Piz Daint, the ported code achieves a single-node GPU vs. CPU speedup factor of 6.4 and allows for global experiments at a horizontal resolution of 5 km on 1024 computing nodes with 1 GPU per node with a turnover of 48 simulated days per day. On JUWELS Booster, the more modern hardware in combination with an upgraded code base allows for simulations at the same resolution on 128 computing nodes with 4 GPUs per node and a turnover of 133 simulated days per day. Additionally, the code still remains functional on CPUs, as is demonstrated by additional experiments on the Levante compute system at the German Climate Computing Center. While the application shows good weak scaling over the tested 16-fold increase in grid size and node count, making also higher resolved global simulations possible, the strong scaling on GPUs is relatively poor, which limits the options to increase turnover with more nodes. Initial experiments demonstrate that the ICON-A model can simulate downward-propagating QBO jets, which are driven by wave–mean flow interaction.

Diffusion weighted brain imaging (DWI) is used in acute stroke, but may also be useful in patients wits minor stroke or TIA when seen several days or weeks after symptom [...]

Abstract Background Mental health disorders in the child and adolescent population are a pressing public health concern. Despite the high prevalence of psychopathology in this vulnerable population, the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) has many obstacles such as deficiencies in planning, organisational readiness and policy gaps. All these factors contribute to an inadequate and suboptimal transition process. A suite of measures is required that would allow young people to be assessed in a structured and standardised way to determine the on-going need for care and to improve communication across clinicians at CAMHS and AMHS. This will have the potential to reduce the overall health economic burden and could also improve the quality of life for patients travelling across the transition boundary. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Health Care) project aims to address the significant socioeconomic and societal challenge related to the transition process. This protocol paper describes the development of two MILESTONE transition-related measures: The Transition Readiness and Appropriateness Measure (TRAM), designed to be a decision-making aide for clinicians, and the Transition Related Outcome Measure (TROM), for examining the outcome of transition. Methods The TRAM and TROM have been developed and were validated following the US FDA Guidance for Patient-reported Outcome Measures which follows an incremental stepwise framework. The study gathers information from service users, parents, families and mental health care professionals who have experience working with young people undergoing the transition process from eight European countries. Discussion There is an urgent need for comprehensive measures that can assess transition across the CAMHS/AMHS boundary. This study protocol describes the process of development of two new transition measures: the TRAM and TROM. The TRAM has the potential to nurture better transitions as the findings can be summarised and provided to clinicians as a clinician-decision making support tool for identifying cases who need to transition and the TROM can be used to examine the outcomes of the transition process. Trial registration MILESTONE study registration: ISRCTN83240263 Registered 23-July-2015 - ClinicalTrials.gov NCT03013595 Registered 6 January 2017.

Abstract Background Transition from distinct Child and Adolescent Mental Health (CAMHS) to Adult Mental Health Services (AMHS) is beset with multitude of problems affecting continuity of care for young people with mental health needs. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge globally. The overall aim of the Managing the Link and Strengthening Transition from Child to Adult Mental Health Care in Europe (MILESTONE) project (2014–19) is to improve transition from CAMHS to AMHS in diverse healthcare settings across Europe. MILESTONE focuses on current service provision in Europe, new transition-related measures, long term outcomes of young people leaving CAMHS, improving transitional care through ‘managed transition’, ethics of transitioning and the training of health care professionals. Methods Data will be collected via systematic literature reviews, pan-European surveys, and focus groups with service providers, users and carers, and members of youth advocacy and mental health advocacy groups. A prospective cohort study will be conducted with a nested cluster randomised controlled trial in eight European Union (EU) countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS users, their carers, and clinicians. Discussion Improving transitional care can facilitate not only recovery but also mental health promotion and mental illness prevention for young people. MILESTONE will provide evidence of the organisational structures and processes influencing transition at the service interface across differing healthcare models in Europe and longitudinal outcomes for young people leaving CAMHS, solutions for improving transitional care in a cost-effective manner, training modules for clinicians, and commissioning and policy guidelines for service providers and policy makers. Trial registration “MILESTONE study” registration: ISRCTN ISRCTN83240263 Registered 23 July 2015; ClinicalTrials.gov NCT03013595 Registered 6 January 2017.

AbstractProblems in the area of text and document processing can often be described as text rewriting tasks: given an input text, produce a new text by applying some fixed set of rewriting rules. In its simplest form, a rewriting rule is given by a pair of strings, representing a source string (the ?original?) and its substitute. By a rewriting dictionary, we mean a finite list of such pairs; dictionary-based text rewriting means to replace in an input text occurrences of originals by their substitutes. We present an efficient method for constructing, given a rewriting dictionary D, a subsequential transducer that accepts any text tas input and outputs the intended rewriting result under the so-called ?leftmost-longest match? replacement with skips, t'. The time needed to compute the transducer is linear in the size of the input dictionary. Given the transducer, any text tof length |t| is rewritten in a deterministic manner in time O(|t|+|t'|), where t' denotes the resulting output text. Hence the resulting rewriting mechanism is very efficient. As a second advantage, using standard tools, the transducer can be directly composed with other transducers to efficiently solve more complex rewriting tasks in a single processing step. [ABSTRACT FROM AUTHOR]

Wachkraniotomien in der Tumor- und Epilepsiechirurgie oder bei der stereotaktischen Elektrodenimplantation für die tiefe Hirnstimulation erfordern spezifische anästhesiologische Strategien. Mit Propofol werden kurze Aufwachzeiten sichergestellt, und die respiratorische Funktion des üblicherweise spontan atmenden Patienten wird nur wenig beeinträchtigt. Die Schmerzausschaltung sollte primär durch einen Hemiskalpblock bei großflächiger Trepanation oder eine lokale Anästhetikainfiltration bei der Tiefenelektrodenimplantation erfolgen. Zusätzlich kann bei einer Trepanation (Tumor- oder Epilepsiechirurgie) Remifentanil in niedriger Dosierung empfohlen werden. Durch einen transnasal eingeführten Tubus, dessen Spitze unter der Epiglottis platziert wird, kann der Atemweg frei gehalten werden. Zum Schutz vor Erbrechen ist eine ausreichende antiemetische Prophylaxe erforderlich. [ABSTRACT FROM AUTHOR]

The coracoacromial arch is a static anterior-superior stabilizer of the humeral head. Thus coracoacromial arch inclination, which varies depending on coracoid tip position, may be related to shoulder pathologies. Therefore, we retrospectively analysed coracoid tip positions in the true anterior posterior view of different shoulder pathologies: reference shoulders (n=27), shoulders with rotator cuff tear (supraspinatus tear n=29; subscapularis tear n=21) and shoulders with anterior glenohumeral instability (traumatic n=17; atraumatic n=14). In supraspinatus tear shoulders, the coracoid tip projected onto inferior glenoid half in 86% of cases (type I coracoid), extending more inferiorly compared with reference group (p=0.0002) or subscapularis tear shoulders (p<0.0001). In contrast, 78% of cases with subscapularis tear show the coracoid tip projected onto the superior glenoid half (type II coracoid). Atraumatic glenohumeral instabilities had a more superior coracoid tip position than traumatic instabilities (p=0.04), but no differences were observed on basis of coracoid type or in comparison with normal controls. We conclude that coracoid tip position is highly variable. Since type I coracoids are predominant in shoulders with supraspinatus tears and type II coracoids in shoulders with subscapularis tears, coracoid tip position may thus provide a simple diagnostic complement for a probable site of rotator cuff tears. [ABSTRACT FROM AUTHOR]

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Power dissipation besides chip area is still one main optimization issue in high performance CMOS design. Regarding high throughput building blocks for digital signal processing architectures which are optimized down to the physical level a complementary two-phase clocking scheme (CTPC) is often advantageous concerning ATE-efficiency. The clock system dissipates a significant part of overall power up to more than 50% in some applications. One efficient power saving strategy for CTPC signal generation is the charge balancing technique. To achieve high efficiency with this approach a careful optimization of timing relations within the control is inevitable. However, as in modern CMOS processes device variations increase, timing relations between sensitive control signals can be affected seriously. In order to compensate for the influence of global and local variations in this work, an adaptive control system for charge balancing in a CTPC generator is presented. An adjustment for the degree of charge recycling is performed in each clock cycle. In the case of insufficient recycling the delay elements which define duration and timing position of the recycling pulse are corrected by switchable timing units. In a benchmark with the conventional clock generation system, a power reduction gain of up to 24.7% could be achieved. This means saving in power of more than 12% for a complete number-crunching building block.