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Hintergrund: Durch die neue Datenschutz-Grundverordnung (DS-GVO) sind die Anforderungen an eine sachgerechte Aufklärung der Patienten über die Dokumentation pseudonymisierter, personenbezogener Daten in einem Register enorm gestiegen. Dies betrifft ganz besonders das TraumaRegister DGU®, da eine schriftliche Aufklärung schwer verletzter Patienten in der Akutsituation nicht immer gelingt. Ziel der Untersuchung war es, den Einfluss der infolge fehlender Aufklärung nichtdokumentierten Fälle auf die standardisierte Mortalitätsrate (SMR) zu untersuchen. Material und Methode: Im Jahr 2019 wurden 274 Patienten retrospektiv erfasst, die die Kriterien des Basiskollektivs erfüllen. Darunter waren 72 Sekundärverlegungen, die ausgeschlossen wurden. Bei den verbliebenen 197 Patienten konnte in allen Fällen der RISC II Score erhoben werden. Ergebnisse: Von den 197 primär (72 % männlich) versorgten Patienten wurden 147 (74,6 %) schriftlich aufgeklärt oder waren verstorben und wurden folglich dokumentiert. Die prognostizierte Letalität, tatsächliche Letalität und SMR betrug 18,5 %, 19,0 % resp. 1,03. Bei den Patienten, die nicht aufgeklärt wurden (n= 50), lagen die prognostizierte Letalität, tatsächliche Letalität und SMR bei 7,0 %, 0 % resp. 0. Bezieht man diese Fälle mit ein, ergibt sich eine deutlich günstigere SMR mit 0,93. Schlussfolgerung: Durch die fehlende schriftliche Einwilligung überlebender Patienten konnten nur etwa 75 % aller Patienten der Uniklinik Leipzig für das TraumaRegister DGU® dokumentiert werden. Da die lokale Gesetzeslage andererseits eine Registerdokumentation verstorbener Patienten zulässt, ergibt sich daraus eine nachteilige Beeinflussung der SMR, die in unserem Kollektiv etwa 10 % höher ausfällt, als sie in Realität ist.

Occup Environ Med 2003;60:821-830 Background: Previous studies mostly did not separate between symptomatic disc herniation combined with osteochondrosis/spondylosis of the lumbar spine and symptomatic disc herniation in radiographically normal intervertebral [...]

Background/Objectives:: Increasing nut consumption has been associated with reduced risk of obesity and type II diabetes, the risk factors for colorectal cancer. However, the association between nut consumption and colorectal cancer risk is unclear. We aimed to examine the association of long-term nut consumption with risk of colorectal cancer. Subjects/Methods:: We prospectively followed 75 680 women who were free of cancer at baseline in the Nurses’ Health Study, and examined the association between nut consumption and colorectal cancer risk. Nut consumption was assessed at baseline and updated every 2–4 years. Relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards models. Results:: During 2 103 037 person-years of follow-up, we identified 1503 colorectal cancer cases. After adjustment for other known or suspected risk factors, women who consumed nuts 2 or more times per week (that is, ⩾56 g per week) had a 13% lower risk of colorectal cancer compared with those who rarely consumed nuts, but the association was not statistically significant (RR: 0.87; 95% CI: 0.72–1.05; P-trend: 0.06). No association was observed for peanut butter. Conclusions:: In this large prospective cohort of women, frequent nut consumption was not significantly associated with colorectal cancer risk after adjusting for other risk factors.

L'analyse spectroscopique, de 110 à 600 nm, de l'émission des plasmas créés lors de l'ablation par laser à excimères (ArF : 193 nm) de cibles de graphite en atmosphère d'azote et sous vide, et l'analyse par spectroscopie de photoélectrons (XPS) des films C1-xNxobtenus ont permis la mise en évidence d'une loi de corrélation entre la valeur de x et la pression d'azote.

Generalized quantum measurements (also known as positive operator-valued measures or POVMs) are of great importance in quantum information and quantum foundations, but often difficult to perform. We present an experimental approach which can in principle be used to perform arbitrary POVMs in a linear-optical context. One of the most interesting POVMs, the symmetric, informationally complete-POVM (or SIC-POVM), is the most compact set of measurements that can be used to fully describe a quantum state. We use our technique to carry out the first experimental characterization of the state of a qutrit using SIC-POVMs. Because of the highly symmetric nature of this measurement, such a representation has the unique property that it permits all other measurement outcomes to be predicted by a simple extension of the classical Bayesian sum rule, making no use of complex amplitudes or Hilbert-space operators. We demonstrate this approach on several qutrit states encoded in single photons.

AbstractA major challenge in nuclear fusion research is the coherent combination of measurements from heterogeneous diagnostics. Different measurement techniques for measuring the same subset of physical parameters provide complementary and redundant data for, e.g., improving the reliability of physical parameters, increasing the spatial and temporal resolution of profiles, and resolving data inconsistencies.The concept of integrated data analysis within the framework of Bayesian probability theory was applied to the combined analysis of lithium beam emission spectroscopy (LIB), deuterium cyanide laser interferometry, electron cyclotron emission (ECE), and Thomson scattering spectroscopy. The four heterogeneous diagnostics enable the simultaneous estimation of electron density and temperature profiles with high spatial and temporal resolution. The coherent analysis of the profile diagnostics allows one to consider diagnostic interdependencies correlating density and temperature profiles, e.g., ECE shine-through, and diagnostics alignment. The benefits of a combined analysis of diagnostics will be shown in a modular way by successively increasing the set of diagnostics starting with the LIB diagnostics.

In quantum mechanics, systems can be described in phase space in terms of the Wigner function and the star‐product operation. Quantum characteristics, which appear in the Heisenberg picture as the Weyl's symbols of operators of canonical coordinates and momenta, can be used to solve the evolution equations for symbols of other operators acting in the Hilbert space. To any fixed order in the Planck's constant, many‐body potential scattering problem simplifies to a statistical‐mechanical problem of computing an ensemble of quantum characteristics and their derivatives with respect to the initial canonical coordinates and momenta. The reduction to a system of ordinary differential equations pertains rigorously at any fixed order in ħ. We present semiclassical expansion of quantum characteristics for many‐body scattering problem and provide tools for calculation of average values of time‐dependent physical observables and cross sections. The method of quantum characteristics admits the consistent incorporation of specific quantum effects, such as non‐locality and coherence in propagation of particles, into the semiclassical transport models. We formulate the principle of stationary action for quantum Hamilton's equations and give quantum‐mechanical extensions of the Liouville theorem on conservation of the phase‐space volume and the Poincaré theorem on conservation of 2p‐forms. The lowest order quantum corrections to the Kepler periodic orbits are constructed. These corrections show the resonance behavior.

In this paper several transport phenomena are described and explained through a (quasi) linear description of the micro-instabilities. This paper deals with the following phenomena: density peaking, electron heat transport, density pump-out, reactor density profiles and the stabilization of the ion temperature gradient (ITG) mode in transport barriers. Density peaking is observed to increase with decreasing collisionality—a phenomenon that can be explained by the influence of collisions on the trapped electron response. The density pump-out due to central electron heating is observed to occur only if the dominant instability is the trapped electron mode (TEM). The proposed explanation involves the thermo-diffusive contribution to the particle flux which is outwards for the TEM while it is inwards for the ITG. The insight in the density profile behaviour can be used to predict moderately peaked density profiles in a reactor. Collisionality is also found to influence the electron heat flux in discharges with dominant electron heating even at relatively small values of the density. The dominant instability under dominant electron heating is found to be the TEM, and the dependence of the electron heat flux on the electron temperature gradient is reasonably described by the quasi-linear results. At higher density (and collisionality) the growth rate of the TEM is reduced and a transition to a dominant ITG is found. This transition is reflected in the speed of the electron heat pulse propagation. Finally, it has been found that the ITG under experimentally relevant conditions is not stabilized by a uniform radial electric field.

Space–time picture of the anisotropic flow evolution in Au+Au collisions at BNL RHIC is studied for strange hadrons within the microscopic quark–gluon string model. The directed flow of both mesons and hyperons demonstrates wiggle structure with the universal antiflow slope at |y|  2 for minimum bias events. This effect increases as the reaction becomes more peripheral. The development of both components of the anisotropic flow is closely related to particle freeze-out. Hadrons are emitted continuously, and different hadronic species are decoupled from the system at different times. These hadrons contribute differently to the formation and evolution of the elliptic flow, which can be decomposed onto three components: (i) flow created by hadrons emitted from the surface at the onset of the collision; (ii) flow produced by jets; (iii) hydrodynamic flow. Due to these features, the general trend in elliptic flow formation is that the earlier mesons are frozen, the weaker their elliptic flow. In contrast, baryons frozen at the end of the system evolution have stronger v₂.

We compare multiplicities as well as rapidity and transverse momentum distributions of protons, pions and kaons calculated within presently available transport approaches for heavy-ion collisions around 1 A GeV. For this purpose, three reactions have been selected: Au+Au at 1 and 1.48 A GeV and Ni+Ni at 1.93 A GeV.

The importance of technical, i.e. product related services has significantly increased over the past years. Traditionally, technical services are provided during product usage. In light of the potential impact of technical services on the entire product life cycle, the application of life cycle engineering techniques to service design is suggested. Consequently, the presented research work aims at developing a service design process. Based on three main strategies for combining products with related services, a corresponding design process is proposed. It simultaneously considers the product, process and information dimensions of services.

The dependence of K⁺ production on the nuclear equation of state is investigated in heavy ion collisions. An increase in the excitation function of K⁺ multiplicities obtained in heavy (Au+Au) over light (C+C) systems when going far below the threshold which has been observed by the KaoS Collaboration, strongly favours a soft equation of state. This observation holds despite the influence of an in-medium kaon potential predicted by effective chiral models which is necessary to reproduce the experimental K⁺ yields. Phase space effects are discussed with respect to the K⁺ excitation function.

The experimental data on hadron yields and ratios in central Pb + Pb and Au + Au collisions at SPS and RHIC energies, respectively, are analysed within a two-source statistical model of an ideal hadron gas. These two sources represent the expanding system of colliding heavy ions, where the hot central fireball is embedded in a larger but cooler fireball. The volume of the central source increases with rising bombarding energy. Results of the two-source model fit to RHIC experimental data at midrapidity coincide with the results of the one-source thermal model fit, indicating the formation of an extended fireball, which is three times larger than the corresponding core at SPS.

Anisotropic flow of Ks, &barK;s and Λs is studied in heavy-ion collisions at SPS and RHIC energies within the microscopic quark–gluon string model. At SPS energy the directed flow of kaons differs considerably at midrapidity from that of antikaons, while at RHIC energy kaon and antikaon flows coincide. The change is attributed to the formation of dense meson-dominated matter at RHIC, where the differences in interaction cross-sections of hadrons become unimportant. The directed flows of strange particles, v₁^K,&barK;,Λ (y), have universal negative slope at |y| ≤ 2 at RHIC. The elliptic flow of strange hadrons is developed at midrapidity at times 3 ≤ t ≤ 10 fm/c. It increases almost linearly with rising p_t and stops rising at p_t ≥ 1.5 GeV/c reaching the same saturation value v₂^K,Λ(p_t) ≈ 10&percent; in accord with experimental results.

The in vivo dose–response laser-tissue experiment is usually performed on several subjects, each exposed several times at different tissue sites. The collected data are then unified into a single statistical batch and analysed under the tacit assumption that the tolerances of all the subjects are similar. However, if this assumption is incorrect the data unification may lead to very biased results. This study reanalyses a raw data set measured by the US Army Medical Research Detachment Walter Reed Army Institute of Research (USAMRD-WRAIR), which was used to study the influence of the laser wavelength on the energy threshold of retinal injury. The USAMRD-WRAIR report reveals a significant variation of threshold with small changes in wavelength. Despite an extensive study, performed by the USAMRD-WRAIR researchers, which included possible lasers variations, many aspects of experimental technique and biological absorption properties of the eye, a cause for the threshold variation was not found. Our current results suggest that unaccounted specimen's dissimilarity might be the cause for this unclear threshold variations.

Abstract:: We investigate differential in-plane and out-of-plane flow observables in heavy-ion reactions at intermediate energies from 0.2-2 AGeV within the framework of relativistic BUU transport calculations. The mean field is based on microscopic Dirac-Brueckner-Hartree-Fock (DB) calculations. We apply two different sets of DB predictions, those of ter Haar and Malfliet and more recent ones from the Tübingen group, which are similar in general but differ in details. The latter DB calculations exclude spurious contributions from the negative-energy sector to the mean field which results in a slightly softer equation of state and a less repulsive momentum dependence of the nucleon-nucleus potential at high densities and high momenta. For the application to heavy-ion collisions in both cases non-equilibrium features of the phase space are taken into account on the level of the effective interaction. The systematic comparison to experimental data favours the less repulsive and softer model. Relative to non-relativistic approaches one obtains larger values of the effective nucleon mass. This produces a sufficient amount of repulsion to describe the differential flow data reasonably well.

To present the development process, summarize the content and discuss the implications of the German evidence-based guideline for the treatment of obesity.

Zusammenfassung: Für eine optimale und effektive Planung des täglichen Betriebs einer operativen Tagesklinik ist es unerläßlich, die Gründe für eine ungeplante stationäre Aufnahme ambulanter Patienten zu kennen. Ziel dieser Untersuchung war es, Einflussfaktoren und Prädiktoren für eine ungeplante stationäre Aufnahme für Patienten unserer Operativen Tagesklinik zu evaluieren. Dies erfolgte anhand von 3.152 Datensätzen tageschirurgischer Patienten, deren Aufenthalt computergestützt online erfaßt wurde. Methodik. 1997 bis einschließlich Juni 1999 wurden bei jedem tagesstationären Aufenthalt alle klinisch relevanten Parameter mit einem Anästhesie-Informations-Management-System (NarkoData®) erfaßt. Die potenziellen nominal bzw. ordinal skalierten Prädiktoren für die ungeplante stationäre Aufnahme wurden zunächst mit dem Chi-Quadrat-Test auf ihren Zusammenhang überprüft. Die Ermittlung von Prädiktoren für das Auftreten einer ungeplanten stationären Aufnahme erfolgte mit der Methode der univariaten Analyse. Als Maß für die Straffheit des Zusammenhangs für nominal und ordinal skalierte Parameter wurde der Kontingenzkoeffizient (CC) nach Pearson, für metrische Parameter das ZusammenhangsmaßEta berechnet. Ergebnisse. Von den 3.152 tagesstationären Patienten wurden 169 Patienten (5,4%) nicht geplant stationär aufgenommen. Für folgende geprüfte Parameter konnte ein signifikanter Zusammenhang mit der ungeplanten stationären Aufnahme nachgewiesen werden: Alter, ASA-Klassifikation, Diagnose (ICD-9), Aufnahmezeitpunkt, unterschiedliche Anästhesieverfahren und Anästhetika (Opioide und nichtdepolarisierende Muskelrelaxanzien), operierende Fachabteilung, Eingriff (ICPM), Operationsdauer, Blutverlust, intraoperativ bestimmter Hämoglobinwert sowie die Menge infundierter kolloidaler und kristalloider Lösungen. Aufgrund der Zusammenhangsmaße konnten die Parameter Blutverlust, intraoperativ bestimmter Hämoglobinwert und Gabe von kolloidalen Lösungen als gute Prädiktoren evaluiert werden. Schlussfolgerung. Die Ursachen für eine ungeplante stationäre Aufnahme von Patienten unserer Operativen Tagesklinik sind unterschiedlicher Genese. Neben Gründen, die den Patienten, die Anästhesie und die Organisation der Tagesklinik betreffen, spielt ein längeres operatives Trauma, das zu einem erhöhten intraoperativen Blutverlust führt, eine entscheidende Rolle.

Density-limit discharges in the W7-AS stellarator, with constant line-integrated density and a duration of up to 2 s, were studied at three values of the toroidal magnetic field (B= 0.8, 1.25 and 2.5 T). The central factor governing the physics of the density limit in stellarators was demonstrated to be the decreasing net power to the plasma when the centrally peaked radiated power density profile exceeds that of the deposited power density. The process was further accelerated by the peaking of electron density under these conditions. In discharges with B= 2.5 T, simulations of the centrally peaked radiation power density profiles could be shown to be due to peaked impurity density profiles. Laser blow off measurements clearly inferred an inward pinch of the injected aluminium. These discharges had the electron density profile form found in the improved confinement H-NBI mode on W7-AS.

In a recent paper, Deutsch claims to derive the ‘probabilistic predictions of quantum theory’ from the ‘non–probabilistic axioms of quantum theory’ and the ‘nonprobabilistic part of classical decision theory.’ We show that his derivation includes a crucial hidden assumption that vitiates the force of his argument. Furthermore, we point out that in classical decision theory a standard set of non–probabilistic axioms is already sufficient to endow possible outcomes with a natural probability structure. Within that context we argue that Gleason's theorem, relying on fewer assumptions than Deutsch, provides a compelling derivation of the quantum probability law.

Amorphous carbon nitride films are deposited at room temperature on silicon substrates by ArF excimer laser (193nm) ablation of a graphite target in nitrogen atmosphere. By tuning the process parameters, fine control of the carbon–carbon and carbon–nitrogen bond configuration is achieved in a broad range as followed by X-ray photoelectron spectroscopy (XPS) and infrared (IR) absorption spectroscopy. Based on the comparative and quantitative analysis of changes in measured IR versus XPS spectra as a function of reactive gas pressure, laser fluence and target-to-substrate distance, and on a critical review of the existing interpretation of IR data, an assignment of the components of the broad band extending from 900 to 1900cm−1in the IR spectra to specific carbon–carbon and carbon–nitrogen bond configurations is proposed.