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About 10% of Europe's surface area is prone to rapid flooding of rivers confined in valleys. The devastating potential of such floods is exacerbated by the deficits of existing gauging networks, including low station densities and recording frequencies, and lack of information beyond stage height. Here, we use seismic data of the July 2021 Ahrtal flood, Germany, to extract information to complement sparse hydrometric data, and to reconstruct the rapid evolution of this fatal event. We show that a seismic station can deliver essential flood metrics such as magnitude, propagation velocity and debris transport rate. These seismic products provide high resolution insight to the non‐linear flood behavior. We argue that an approach combining distributed low‐cost seismometers with existing seismic stations, can provide important real time data on future catastrophic floods and associated hazards in upland catchments, offering precious response time also in currently ungauged landscapes. Plain Language Summary: Rapidly evolving floods are a major hazard for 10% of European landscapes. They are hard to adequately detect and describe by the classic gauge station scheme, but seismic sensors provide a valuable alternative to this difficulty. A seismometer can sense a flood like the devastating one that hit the Ahr valley, Germany, in July 2021 up to 1.5 km away. The seismic footprint of the flood allows to provide information on flood magnitude, velocity and trajectory at sub‐minute resolution and at near real time. We show how this new approach can be utilized for future flood protection. Key Points: Seismic sensing of valley confined floods improves classic detection approachesNear‐real time information on flood magnitude, trajectory, and velocityGate keeper seismometer networks can improve flood risk management in Europe [ABSTRACT FROM AUTHOR]

The study was performed to compare real‐time PCR after nucleic acid extraction directly from stool samples as well as from samples stored and transported on Whatman papers or flocked swabs at ambient temperature in the tropics. In addition, the possible suitability for a clear determination of likely aetiological relevance of PCR‐based pathogen detections based on cycle threshold (Ct) values was assessed. From 632 Tanzanian children <5 years of age with and without gastrointestinal symptoms, 466 samples were subjected to nucleic acid extraction and real‐time PCR for gastrointestinal viral, bacterial and protozoan pathogens. Equal or even higher frequencies of pathogen detections from Whatman papers or flocked swabs were achieved compared with nucleic acid extraction directly from stool samples. Comparison of the Ct values showed no significant difference according to the nucleic acid extraction strategy. Also, the Ct values did not allow a decision whether a detected pathogen was associated with gastrointestinal symptoms. [ABSTRACT FROM AUTHOR]

Summary: Exosomes in plasma of head and neck squamous cell carcinoma (HNSCC) patients comprise subsets of vesicles derived from various cells. Recently, we separated CD3(+) from CD3(–) exosomes by immune capture. CD3(–) exosomes were largely tumour‐derived (CD44v3+). Both subsets carried immunosuppressive proteins and inhibited functions of human immune cells. The role of these subsets in immune cell reprogramming by the tumour was investigated by focusing on the adenosine pathway components. Spontaneous adenosine production by CD3(+) or CD3(–) exosomes was measured by mass spectrometry, as was the production of adenosine by CD4+CD39+ regulatory T cells (Treg) co‐incubated with these exosomes. The highest level of CD39/CD73 ectoenzymes and of adenosine production was found in CD3(–) exosomes in patients with the stages III/IV HNSCCs). Also, the production of 5′‐AMP and purines was significantly higher in Treg co‐incubated with CD3(–) than CD3(+) exosomes. Consistently, CD26 and adenosine deaminase (ADA) levels were higher in CD3(+) than CD3(–) exosomes. ADA and CD26 levels in CD3(+) exosomes were significantly higher in patients with early (stages I/II) than advanced (stages III/IV) disease. HNSCC patients receiving and responding to photodynamic therapy had increased ADA levels in CD3(+) exosomes with no increase in CD3(–) exosomes. The opposite roles of CD3(+) ADA+CD26+ and CD3(–)CD44v3+ adenosine‐producing exosomes in early versus advanced HNSCC suggest that, like their parent cells, these exosomes serve as surrogates of immune suppression in cancer. [ABSTRACT FROM AUTHOR]

Summary: Head and neck squamous cell carcinoma (HNSCC) is a highly immunosuppressive malignancy. Exosomes in HNSCC patients' plasma are enriched in inhibitory cargo and mediate immunosuppression. As these exosomes are products of various cells, the cellular origin of immunoregulatory proteins they carry is unknown. To test whether tumour‐ or T cell‐derived exosomes in patients' plasma are immunosuppressive and impact upon disease activity, we separated CD3(–) from CD3(+) exosomes by immunocapture using anti‐CD3 antibodies. The exosome protein cargo was evaluated for immunoregulatory proteins using on‐bead flow cytometry. Tumour protein‐enriched CD3(–) exosomes were CD44v3(+). Surprisingly, mean levels of programmed death ligand 1 (PD‐L1), cytotoxic T lymphocyte antigen 4 (CTLA‐4) and cyclooxygenase‐2 (COX‐2) were similar in CD3(+) and CD3(–) exosomes, although the latter induced higher (P < 0·0025) ex‐vivo apoptosis of CD8(+) T cells and greater (P < 0·005) conversion of CD4+ T cells to CD4(+)CD39(+) regulatory T cells (Treg). CD3(+) and CD3(–) exosomes carrying high levels of immunosuppressive proteins were highly effective in mediating these functions. Exosomes of patients with Union for International Cancer Control (UICC) stages III/IV disease had higher levels of PD‐L1 and COX‐2 than stages I/II patients (P < 0·005). Patients with nodal involvement had exosomes with the higher inhibitory protein content than N0 patients (P < 0·03). CD3(+) and CD3(–) exosomes of HNSCC patients had higher PD‐L1, COX‐2 and CD15s levels than healthy donors' exosomes (P < 0·009), although levels of immunostimulatory OX40 or OX40L were not different. By isolating CD3(–)/CD44v3‐enriched and CD3(+) exosomes from plasma, the cellular origins of immunoregulatory proteins they carry were identified. Association of exosome molecular profiles with disease progression supports the exosome potential as future cancer biomarkers. [ABSTRACT FROM AUTHOR]

Hepatitis C virus ( HCV) is a human hepatotropic virus, but many hepatoma cell lines are not permissive to this virus. In a previous study, we observed that SNU-182, SNU-398 and SNU-449 hepatoma cell lines were nonpermissive to HCV. To understand the nonpermissivity, we evaluated the ability of each cell line to support the different steps of HCV life cycle (entry, replication and production of infectious particles). Using retroviral pseudoparticles pseudotyped with HCV envelope proteins and recombinant HCV produced in cell culture, we observed that low level or absence of claudin-1 (CLDN1) expression limited the viral entry process in SNU-182 and SNU-398 cells, respectively. Our results also showed that supplementation of the three cell lines with miR-122 partly restored the replication of a JFH1 HCV replicon. Finally, we observed that expression of apolipoprotein E (ApoE) was very low or undetectable in the three cell lines and that its ectopic expression permits the production of infectious viral particles in SNU-182 and SNU-398 cells but not in SNU-449 cells. Nevertheless, the supplementation of SNU-182, SNU-398 and SNU-449 cells with CLDN1, miR-122 and ApoE was not sufficient to render these cells as permissive as HuH-7 cells. Thus, these cell lines could serve as cell culture models for functional studies on the role of CLDN1, miR-122 and ApoE in HCV life cycle but also for the identification of new restriction and/or dependency host factors essential for HCV infection. [ABSTRACT FROM AUTHOR]

Nowadays demands for product quality and energy efficiency are increasing due to ongoing industrial development and rising costs of resources. In case of fluidized bed layering granulation profitability mainly depends on the total energy input required for fluidization, evaporation of the sprayed liquid and drying, in balance with product quality and process efficiency. This paper is focuses on temporal separation of process steps like growth and liquid evaporation as one way of intensification of batch processing. In order to optimize both sub-processes, granulation and particle drying, are operated alternating by switching the spraying rate and other process parameters. In order to obtain the required data, experimental and model based investigations for different parameter configurations are performed. The analysis of results is carried out in comparison to a benchmark case, for batch operation this comparison is based either on equal process time or product quality. The results show significant advantages of temporal separation in batch processes with respect to energy consumption while conserving product quality. [ABSTRACT FROM AUTHOR]

In this work, experimental results for a continuous fluidized bed spray layering process are used to identify product quality influencing process parameters, such as the shell porosity. The prediction of the shell porosity is based on an empirical relation established for fluidized bed layering in batch mode. It uses gas-side properties, which are represented by the drying potential of the gas. It is shown that the shell porosities forming in the continuous mode can be deduced from this relation by comparing experimental data and simulation results. Process stability and seed formation are also discussed using the obtained experimental data. [ABSTRACT FROM PUBLISHER]

We assess in mice, the electrophysiological criteria developed in humans and rats in vivo for unmyelinated (C) fibre differentiation into sub-classes, derived from the activity-induced latency increase (“slowing”) in response to electrical stimulation during 6 min at 0.25 Hz followed by 3 min at 2 Hz. Fibres are considered nociceptors if they show more than 10% slowing at 2 Hz; nociceptors are further divided into mechanosensitive (“polymodal”) and mechanoinsensitive (“silent”) ones according to a latency shift of less and more than 1% during the first minute at 0.25 Hz, respectively. Sympathetic postganglionics are recognised by 2–10% slowing at 2 Hz; units slowing less than 2% at 2 Hz remain uncategorised. For assessment of these criteria, we also developed a novel in vivo technique for recording of peripheral single-fibres in the mouse. We compared the theoretical slowing-rate discriminator criteria with experimental data obtained from mice in vivo/in vitro and rats in vitro . Out of 69 cutaneous mouse C-fibres in vitro and 19 in vivo , only 38 (67%) and 9 (47%) met the above 1% criterion, respectively; sympathetics were not identified. In contrast, out of 20 rats nerve fibres in vitro , 19 (95%) met this criterion. We conclude that (A) our novel electrophysiological technique is a practical method for examining mouse cutaneous single-fibres in vivo and (B) the published criterion for identifying silent nociceptors in rats and humans is not applicable in mice. [ABSTRACT FROM AUTHOR]

The lack of knowledge regarding cost-efficient design of whole production chains as well as the availability of powerful harvest machinery are some of the main obstacles for competitive production of bioenergy from short rotation coppices (SRC) at practice. In general, two different harvest lines are available: the cut-and-chip and the cut-and-store lines. Whereas the cut-and chip line provides wood chips which have to be stored until next heating season, the product for intermediate storage of the cut-and-store line are whole trees. Both process lines have major differences not only in harvesting, but also in transport, storage and process losses leading to different costs of the end product wood chips. On basis of data from several SRC harvest campaigns, production costs for wood chips have been calculated to identify best practice solutions taking the following factors into account: chip size determined by the harvest system, storage including related costs and losses, field size and shape as well as transport to storage. According to the results, mower-chippers and forage harvesters can provide wood chips at lowest production costs (43#8230;45 ⊂tdm-1) if field shape is favourable for harvest operations. Under less favourable field conditions costs are approx. 7 to 14% higher. Highest production costs have to be accepted if whole trees are harvested with a shoot harvester (64 to 72 ⊂tdm-1). The reduction in storage losses and storage costs are not sufficient to compensate higher machine costs for harvest and additional comminution with mobile chippers from forestry. [ABSTRACT FROM AUTHOR]

Particle coating experiments were performed in a lab-scale fluidized bed with varying process parameters, such as spraying rate and air inlet temperature, leading to different drying conditions. Porous (γ-Al 2 O 3 ) and non-porous (glass) initial particles were sprayed with a sodium benzoate solution. For each experiment, the particle size distribution as well as the layer porosity was measured. The results show a dependency of the layer porosity on the drying conditions, represented by the drying potential of the fluidization gas. The obtained relationship is expressed as a linear correlation, which can be used in process models. Apart from the experimental results, a model based on population balances and heat and mass balances is presented. Simulations performed using the obtained empirical correlation are in good agreement with experimental data. [ABSTRACT FROM AUTHOR]

Mountain environments represent heterogeneous environments with shallow soils that are sensitive to human impact and climate change. Despite the thin soil cover, high soil organic carbon content of mountain soils may provide a major source of atmospheric CO2, if released. However, the importance of mountain soils remains controversial, largely due to insufficient information on the spatial variability of mountain SOC stocks. Here, we study the spatial variability of soil properties and SOC stocks in a changing mountain environment in the Bernese Alps (Switzerland) and the methodologies to assess them. We use different interpolation techniques (averaging, inverse distance, ordinary-, block- and regression-kriging) and sampling densities and analyze the sources of uncertainty using a nested sampling approach and the Gaussian and Taylor error propagation. We found a low sensitivity of the median SOC stocks of the study area (ranging between 8.1 and 8.6 kg Cm-2 in the upper 30 cm), the general patterns of the predicted stocks and the explanatory power with respect to the utilized interpolation techniques. In contrast the small-scale SOC pattern fluctuates strongly between different interpolation techniques. All interpolation techniques, except regression kriging, show a low variability of the calculated root mean square errors of the predicted SOC stocks in terms of variable sampling densities. To improve spatial prediction using regression kriging, which combines the kriging approach with multiple linear regression based on factors controlling the SOC variability (e.g. soil type, land use and topography), large sampling density (>35 samples per km²) is required in alpine environments. This is especially true for the coarse mineral fraction, which introduces the largest source of uncertainty. Nested sampling designs seem to provide an efficient tool to study SOC inventories and their associated sources of uncertainties in mountain environments. [ABSTRACT FROM AUTHOR]

Micropowder of poly(tetrafluoroethylene) (PTFE) can be used in base oils to improve the tribological properties significantly, if oil molecules are covalently linked to primary PTFE particles in the dispersion. Enhanced properties are not only determined by the amount of PTFE micropowder added to the oil but as well by the surface charge, radical concentration, and the size and distribution of PTFE particles in the oil phase. The chemical compatibilization (=cc) between PTFE micropowder and ester oil by the use of two types of PTFE micropowder, which differ in radical concentration and the amount of functional groups is shown. The concentration of PTFE micropowder in the dispersions was varied from 5 to 20 wt%. Both the pure PTFE micropowder and the oil-PTFE-cc dispersions were characterized by ESR and FTIR spectroscopy as well as by zeta potential measurements. Rheological and tribological tests were performed on the ester oil and the oil-PTFE-cc dispersions. Qualitative differences are discussed in terms of particle interactions, dispersion stability, chemical compatibilization efficiency and the amount of functional groups. A correlation between flow properties and surface charge of the PTFE particles within the dispersions was obtained. The influence on tribological properties is discussed as well. [ABSTRACT FROM AUTHOR]

Context. Type Ia supernovae (SN Ia) have become an invaluable cosmological tool because their exceptional brightness makes them observable even at very large distances (up to redshifts around z ≈ 1). To investigate possible systematic differences between local and distant SN Ia requires detailed models whose synthetic spectra can be compared to observations and in which the solution of the radiative transfer is a key ingredient. One commonly employed method is the Feautrier scheme, which is generally very robust but can lead to wrong results under certain conditions that frequently occur when modeling supernova ejecta or even the radiatively driven expanding atmospheres of hot stars. Aims. We attempt to improve the procedure we have developed for simulating the radiative transfer of metal-rich, intermediate- and low-density, line-dominated atmospheres to allow the method to be applied successfully even under conditions of high expansion velocities. Methods. We use a sophisticated model atmosphere code that considers the non-LTE effects and large velocity gradients that strongly affect the physics of SN Ia atmospheres at all wavelengths to simulate the formation of SN Ia spectra by the thousands of strong spectral lines that intricately interact with the "pseudo-continuum" formed entirely by these Doppler-shifted lines themselves. We focus on investigating the behavior of the Feautrier scheme under these conditions. Results. Synthetic spectra of SN Ia, a complex product of computer models replicating numerous physical processes that determine the conditions of matter and radiation in the ejecta, are affected by large spatial jumps of the line-dominated opacities and source functions for which the application of even well established methods may harbor certain pitfalls. We analyse the conditions that can lead to a breakdown of conventional procedures and we derive a modified description that yields more accurate results in the given circumstances for the Feautrier radiative transfer solver. [ABSTRACT FROM AUTHOR]

Context. In type Ia supernova (SN Ia) envelopes a huge number of lines of different elements overlap within their thermal Doppler widths, and this problem is exacerbated by the circumstance that up to 20% of these lines can have a line optical depth higher than 1. The stagnation of the lambda iteration in such optically thick cases is one of the fundamental physical problems inherent in the iterative solution of the non-LTE problem, and the failure of a lambda iteration to converge is a point of crucial importance whose physical significance must be understood completely. Aims. We discuss a general problem related to radiative transfer under the physical conditions of supernova ejecta that involves a failure of the usual non-LTE iteration scheme to converge when multiple strong opacities belonging to different physical transitions come together, similar to the well-known situation where convergence is impaired even when only a single process attains high optical depths. The convergence problem is independent of the chosen frequency and depth grid spacing, independent of whether the radiative transfer is solved in the comoving or observer's frame, and independent of whether a common complete-linearization scheme or a conventional accelerated lambda iteration (ALI) is used. The problem appears when all millions of line transitions required for a realistic description of SN Ia envelopes are treated in the frame of a comprehensive non-LTE model. The only solution to this problem is a complete-linearization approach that considers all ions of all elements simultaneously, or an adequate generalization of the established ALI technique that accounts for the mutual interaction of the strong spectral lines of different elements and which thereby unfreezes the "stuck" state of the iteration. Methods. The physics of the atmospheres of SN Ia are strongly affected by the high-velocity expansion of the ejecta, which dominates the formation of the spectra at all wavelength ranges. Thus, hydrodynamic explosion models and realistic model atmospheres that take into account the strong deviation from local thermodynamic equilibrium (LTE) are necessary for the synthesis and analysis of the spectra. In this regard one of the biggest challenges we have found in modeling the radiative transfer in SN Ia is the fact that the radiative energy in the UV has to be transferred only via spectral lines into the optical regime to be able to leave the ejecta. However, convergence of the model toward a state where this is possible is impaired when using the standard procedures. We report on improvements in our approach of computing synthetic spectra for SN Ia with respect to (i) an improved and sophisticated treatment of many thousands of strong lines that interact intricately with the "pseudo-continuum" formed entirely by Doppler-shifted spectral lines; (ii) an improved and expanded atomic database; and (iii) the inclusion of energy deposition within the ejecta arising from the radioactive decay of mostly 56Ni and 56Co. Results. We show that an ALI procedure we have developed for the mutual interaction of strong spectral lines appearing in the atmospheres of SNe Ia solves the long-standing problem of transferring the radiative energy from the UV into the optical regime. Our new method thus constitutes a foundation for more refined models, such as those including energy deposition. In this regard we furthermore show synthetic spectra obtained with various methods adopted for the released energy and compare them with observations. We discuss in detail applications of the diagnostic technique by example of a standard type Ia supernova, where the comparison of calculated and observed spectra revealed that in the early phases the consideration of the energy deposition within the spectrum-forming regions of the ejecta does not qualitatively alter the shape of the emergent spectra. Conclusions. The results of our investigation lead to an improved understanding of how the shape of the spectrum changes radically as function of depth in the ejecta, and show how different emergent spectra are formed as a result of the particular physical properties of SNe Ia ejecta and the resulting peculiarities in the radiative transfer. This knowledge provides an important insight into the process of extracting information from observed SN Ia spectra, since these spectra are a complex product of numerous unobservable SN Ia spectral features, which are thus analyzed in parallel to the observable SN Ia spectral features. [ABSTRACT FROM AUTHOR]

At 18 months, children engage in a variety of social behaviors that reflect their nascent ability to understand the intentions of other people (e.g. joint attention, empathy, cooperation and self-recognition). Although numerous contextual factors have been shown to predict social cognition in young children, the genetic underpinnings of social-cognitive traits has been understudied in this age group. Owing to the known effects of oxytocin on adult social cognition and psychopathology, this study hypothesized that variability in the oxytocin receptor gene ( OXTR) would be associated with social cognition in children at 18 months. Participants consisted of 350 children (182 males; 168 females) who were part of an ongoing longitudinal study that aimed to assess environmental and genetic contributions to children's cognitive and socio-emotional functioning. At 18 months, social cognition was measured using previously validated and developmentally sensitive tasks assessing children's joint attention, empathy, cooperation and self-recognition. Five potentially functional OXTR variants were genotyped: rs1042778, rs2254298, rs11131149, rs237897 and rs237899. A family-based association design was used to control for population admixture and stratification, and additional non-genomic covariates were controlled. Results showed that variability in rs11131149 was significantly associated with social cognition ( P = 0.009), with more copies of the major allele related to higher social cognition, and more copies of the minor (risk) allele associated with lower social cognition. A haplotype consisting of rs11131149-rs2254298 was also associated with social cognition ( P = 0.020). Implications for normative and pathological development are discussed, and key areas for future research are proposed. [ABSTRACT FROM AUTHOR]

Background: Harmful alcohol consumption in Germany is a serious public health problem: About 7.7 million adults in Germany can be classified as risky alcohol consumers, about 74,000 deaths per year are related to alcohol consumption, and about 1.8 million adults in Germany (18–64 years) are classified as alcohol dependent. A treatment rate of 9% of all alcohol dependent patients in Germany implies a lack of supply and misuse of medical care. The aim of the study was to examine whether family practitioners (FPs) and psychiatrists have sufficient skills to diagnose and treat patients with alcohol problems. Methods: A total of 6324 FPs and psychiatrists in the states of Saxony and Rhineland-Palatinate in Germany were invited to participate in this survey. Nine hundred seventy-four participants (90.3%/FPs) could be included in the statistical analysis (response rate: 14.3%/FPs, 21.6%/psychiatrists). Data was analysed descriptively and logistical regressions were used to identify predictors for physicians' ability to feel adequately trained to diagnose and treat patients with alcohol problems. Results: In comparison to psychiatrists, less FPs reported feeling sufficiently trained to counsel patients with alcohol problems (81.5% vs. 44.8%). Regression analysis revealed that FPs who felt not adequately trained had less experience with patients with alcohol dependence (OR 7.4), had attended fewer hours on alcohol addiction in continuing medical education (OR 4.8), and were more likely to be female (OR 1.9). A minimum of 10 h of training was associated with improved self-assessed competence. Conclusion: Harmful drinking is a serious public health problem, and patients with alcohol dependence represent a large and demanding patient group in primary health care setting. Our study shows that the lack of training is a severe barrier in the work with this patient group in the primary care setting. [ABSTRACT FROM AUTHOR]

Purpose: Arteriosclerosis of the vascular system is associated with many accompanying diseases. Especially cerebral arteriosclerosis is a main risk factor for ischemic strokes. We want to verify the practicability of intravascular imaging like intravascular ultrasound and optical coherence tomography for the assessment of cerebral vessel walls and plaques. Methods: We examined 18 Circuli arteriosi willisii postmortem. The data contained 48 plaques from 48 different vessel parts. The samples underwent intravascular and histological imaging to conduct a quantitative assessment of vessel wall parameters (healthy vessel wall, thinnest vessel wall, plaque thickness and vessel diameter) as well as to qualitatively evaluate the healthy vessel wall, fibrotic plaques, calcifications and cholesterol deposits in diseased vessels. Results: The comparison showed statistically significant smaller measurements for thinnest vessel walls, normal vessel walls and vessel diameters in histology than in imaging. No statistically significant difference was reached for plaque diameters. Fibrotic plaques were characterized as hyper-intense with dorsal attenuation and calcifications as hypo-intense with dorsal attenuation in optical coherence tomography. In intravascular ultrasound, fibrotic plaques showed a homogeneous echogenicity without distal attenuation and calcifications were depicted as hyperechoic with dorsal sound shadows. Cholesterol deposits were hyper-intense in optical coherence tomography with strongly attenuated signals and in intravascular ultrasound; the deposits were hyper-intense with almost no attenuation. Conclusion: Both intravascular methods allow for plaque characterization and quantification of plaque diameter in cerebral vessel walls. When compared with histology, a statistically significant bias was obtained for the ex vivo measurements of the normal vessel wall diameters. [ABSTRACT FROM AUTHOR]

Context. Rotational mixing is known to significantly affect the evolution of massive stars; however, we still lack a consensus regarding the various possible modeling approaches and mixing recipes describing this process. The empirical investigation of surface abundances of carbon, nitrogen, and oxygen (CNO) in large samples of O- and B-type stars will be essential for providing meaningful observational constraints on the different available stellar evolution models. Aims. Setting up and testing adequate tools to perform CNO surface abundance determinations for large samples of O-type stars, by means of the fast performance, NLTE, unified model atmosphere code FASTWIND. Methods. We have developed a set of semi-automatic tools for measuring and analyzing the observed equivalent widths of strategic optical C, N, and O lines from different ions. Our analysis strategy is based on a χ2 minimization of weighted differences between observed and synthetic equivalent widths, the latter computed from tailored model grids. We have paid special attention to the (significant) errors introduced by typical uncertainties in stellar parameters. In this pilot study, we describe these tools, and test their performance and reliability using a set of high quality spectra of a sample of 18 presumably single Galactic O-type stars with low projected rotational velocities (v sin i≲100 km s−1), and previously determined stellar parameters. In particular, we have compared the outcome of our analysis with results from existing studies and theoretical stellar evolution models. Results. Most of our results for carbon and nitrogen agree, within the errors, with both theoretical expectations and literature values. While many cooler dwarfs display C and N abundances close to solar, some of the early- and mid-O dwarfs – and most supergiants – show significant enrichment in N and depletion in C. Our results for oxygen in late-O dwarfs are, however, unexpectedly low, possibly indicating deficiencies in the adopted oxygen model atom. For all other objects, no systematic problems in their oxygen content have been identified. Specific stars in our sample show peculiarities in their abundances, and we suggest hypotheses regarding their origin. Conclusions. Our method is (almost) ready to be applied to large samples of late and mid O-type stars – although the oxygen model atom needs to be improved and carefully tested first. For early O-type stars (O4 and hotter), a simultaneous UV analysis seems to be inevitable, due to the scarcity and weakness of optical C and O lines. This will necessarily imply a more complex modeling, additionally accounting for the effects of X-rays from wind-embedded shocks and wind inhomogeneities. [ABSTRACT FROM AUTHOR]

Context. The diffuse ionized gas (DIG) constitutes the largest fraction of the total ionized interstellar matter in star-forming galaxies, but it is still unclear whether the ionization is driven predominantly by the ionizing radiation of hot massive stars, as in H II regions, or whether additional sources of ionization have to be considered. Key to understanding the ionization mechanisms in the DIG is the line emission by the ionized gas. Aims. We systematically explore a plausible subset of the parameter space involving effective temperatures and metallicities of the ionizing sources, the effects of the hardening of their radiation by surrounding "leaky" H II regions with different escape fractions, as well as different scenarios for the clumpiness of the DIG, and compute the resulting line strength ratios for a number of diagnostic optical emission lines. Methods. For the ionizing fluxes we computed a grid of stellar spectral energy distributions (SEDs) from detailed, fully non-LTE model atmospheres that include the effects of stellar winds and line blocking and blanketing. To calculate the ionization and temperature structure in the interstellar gas we used spherically symmetric photoionization models and state-of-the-art three-dimensional (3D) non-LTE radiative transfer simulations, considering hydrogen, helium, and the most abundant metals. We first applied these methods to classical H II regions around hot stars, using the model SEDs at different metallicities and effective temperatures as ionizing fluxes, and compute the SEDs of the escaping radiation for different escape fractions of hydrogen-ionizing photons. In a second step, we studied the effects of the escaping radiation on the more dilute and extended DIG. Using 3D models simulating a section of a galactic spiral arm, we computed the ionization structure in the DIG for different scenarios for the inhomogeneity of the gas, assuming ionization by a stellar population SED based on plausible parameters. Results. We provide quantitative predictions of how the line ratios from H II regions and the DIG vary as a function of metallicity Z, stellar effective temperature Teff, and escape fraction fesc from the H II region. The range of predicted line ratios reinforces the hypothesis that the DIG is ionized by (filtered) radiation from hot stars. At one-tenth solar metallicity, radiation hardening is mostly due to hydrogen and helium, whereas at solar metallicity absorption by metals plays a significant role. The effects of hardening are seen primarily in the increase in the emission line ratios of the most important cooling lines of the gas, [N II]∕Hβ and [O II]∕Hβ at lower Teff, and [O III]∕Hβ at higher Teff. For low Teff nearly the entire He I-ionizing radiation is absorbed in the H II regions, thereby preventing the formation of high ionization stages such as O III in the DIG. The ionization structure of the DIG depends strongly on both the clumping factor fcl = 〈nH2〉/〈nH2〉 ${f_{\textrm{cl}}}\,{=}\,\langle{n_{\textrm{H}}}^2\rangle/\langle{n_{\textrm{H}}}\rangle^2$ f cl   =   〈 n H 2 〉 / 〈 n H 〉 2 and the large-scale distribution of the gas. In our simulations about 10% of the ionizing radiation produced by hot massive stars in a spiral arm is sufficient to ionize the DIG up to a height of approximately 1 kpc above the galactic plane for a clumping factor close to the observed value of fcl ~ 5. Even small changes in simulation parameters such as the clumping factor can lead to considerable variation in the ionized volume. Both for a more homogeneous gas and a very inhomogeneous gas containing both dense clumps and channels with low gas density, the ionized region in the dilute gas above the galactic plane can cease to be radiation-bounded, allowing the ionizing radiation to leak into the intergalactic medium. Comparison of observed and predicted line ratios indicates that the DIG is typically ionized with a softer SED than predicted by the chosen stellar population synthesis model. [ABSTRACT FROM AUTHOR]

Context. The determination of chemical abundances constitutes a fundamental requirement for obtaining a complete picture of a star. Particularly in massive stars, CNO abundances are of prime interest, due to the nuclear CNO-cycle, and various mixing processes which bring these elements to the surface. The precise determination of carbon abundances, together with N and O, is thus a key ingredient for understanding the different phases of stellar evolution. Aims. We aim to enable a reliable carbon spectroscopy for our unified non-LTE atmosphere code FASTWIND. Methods. We have developed a new carbon model atom including C II/III/IV/V, and we discuss specific problems related to carbon spectroscopy in O-type stars. We describe different tests we have performed to examine the reliability of our implementation, and investigate which mechanisms influence the carbon ionization balance. By comparing with high-resolution spectra from six O-type stars, we verified to what extent observational constraints can be reproduced by our new carbon line synthesis. Results. Carbon lines are even more sensitive to a variation of Teff, log g, and Ṁ, than hydrogen and helium lines. We are able to reproduce most of the observed lines from our stellar sample, and to estimate those specific carbon abundances which bring the lines from different ions into agreement (three stages in parallel for cool objects, two for intermediate O-types). For hot dwarfs and supergiants earlier than O7, X-rays from wind-embedded shocks can have an impact on the synthesized line strengths, particularly for C IV, potentially affecting the abundance determination. Dielectronic recombination has a significant impact on the ionization balance in the wind. Conclusions. We demonstrate our capability to derive realistic carbon abundances by means of FASTWIND, using our recently developed model atom. We find that complex effects can have a strong influence on the carbon ionization balance in hot stars. For a further understanding, the UV range needs to be explored as well. By means of detailed and available nitrogen and oxygen model atoms, we will be able to perform a complete CNO abundance analysis for larger samples of massive stars, and to provide constraints on corresponding evolutionary models and aspects. [ABSTRACT FROM AUTHOR]

Five Iron Age ceramic lamps from a tomb at the site of Sahab in the south-eastern part of central Jordan were analysed using gas chromatography - mass spectrometry (GC-MS). The results of this study provide data on the type of fuel used in three of these lamps. The study proposes that animal fat, possibly of ruminant origin, was used in three Early Iron Age II lamps. The material used in the other two Iron Age I lamps could not be determined due to the absence of diagnostic biomarkers. The data obtained from the lamps can be put in conjunction with the archaeological evidence on the availability of domestic animals and, most probably, use of their products at the site of Sahab during the Iron Age. [ABSTRACT FROM AUTHOR]

Background: The incidence of synchronous bilateral tonsil carcinoma seems to be underreported. For adequate oncologic treatment, it is mandatory to remove all primaries to prevent recurrence or metachronic disease. The purpose of this manuscript is to provide a comprehensive review on this topic and to emphasize the need of bilateral tonsillectomy in cases of cancer of unknown primary (CUP) as well as in the case of a unilateral tonsillar carcinoma. Material and methods: A systematic review of the literature was performed for "bilateral tonsillar neoplasm", "synchronous cancer of the oropharynx" and "cancer of unknown primary in head and neck". Results: We present a clinical case with bilateral tonsillar carcinoma in initially suggested cancer of unknown primary. Clinically, both tonsillar sites were unsuspicious, but in PET/CT an ipsilateral enhancement of the tonsil area was detected. The pathological work up of bilateral tonsillectomy specimens revealed bilateral squamous cell carcinoma with HPV-type 16 positivity. The review of the literature revealed 29 cases of bilateral tonsil cancer. Conclusion: The handling of tonsillar tissue in the frame of panendoscopy in the case of CUP is still controversial. We recommend a bilateral tonsillectomy as a routine procedure for cancer of unknown primary as well as unilateral tonsillar carcinoma. Herewith the detrimental consequences of occult metachronous contralateral tonsillar carcinoma can be prevented. [ABSTRACT FROM AUTHOR]

Computational Fluid Dynamics is intensively used to deepen the understanding of aneurysm growth and rupture in order to support physicians during therapy planning. However, numerous studies considering only the hemodynamics within the vessel lumen found no satisfactory criteria for rupture risk assessment. To improve available simulation models, the rigid vessel wall assumption has been discarded in this work and patient-specific wall thickness is considered within the simulation. For this purpose, a ruptured intracranial aneurysm was prepared ex vivo, followed by the acquisition of local wall thickness using μCT. The segmented inner and outer vessel surfaces served as solid domain for the fluid-structure interaction (FSI) simulation. To compare wall stress distributions within the aneurysm wall and at the rupture site, FSI computations are repeated in a virtual model using a constant wall thickness approach. Although the wall stresses obtained by the two approaches—when averaged over the complete aneurysm sac—are in very good agreement, strong differences occur in their distribution. Accounting for the real wall thickness distribution, the rupture site exhibits much higher stress values compared to the configuration with constant wall thickness. The study reveals the importance of geometry reconstruction and accurate description of wall thickness in FSI simulations. [ABSTRACT FROM AUTHOR]

β-Ga2O3 thin films were grown on the substrates of sapphire, GaN, and single crystals of β-Ga2O3, using plasma-assisted molecular beam epitaxy. By varying deposition conditions, pure-phase epitaxial β-Ga2O3 thin films were obtained, and the crystal quality of the as-grown films was optimized. A systematic characterization and a detailed analysis were performed on the films, including the nucleation process, surface morphology, crystal quality, thermal stability, as well as electrical and optical properties. Optical absorption was investigated using photothermal deflection spectroscopy, which provides detailed information about sub-gap optical absorption. Photocurrent measurements indicated a pronounced persistent photo-conductivity of β-Ga2O3. A blue-UV emission with an energy of 3–3.5 eV was observed by cathodoluminescence spectroscopy. The Fermi level position of the as-grown film was determined based on temperature-dependent electrical conductivity measurements. It is proposed that oxygen vacancies in the film form a defect band at around E c -0.8 eV that pins the Fermi level and is related to the observed photocurrent and cathodoluminescence characteristics. [ABSTRACT FROM AUTHOR]

Background: When a child is diagnosed with autism, parents are faced with the task of choosing from many different intervention options. To find information about the options available, parents turn to a number of different sources. This study explores parents' (n = 23) intervention decisionmaking processes and information preferences following the diagnosis of ASD for their child. Methods: Qualitative thematic analysis of verbatim transcripts from interviews and focus groups involving parents of children with an autism diagnosis was undertaken. Results: Analysis of the results revealed that there are concurrent emotional and pragmatic intervention 'journeys' undertaken by parents post diagnosis, which encompass the primary themes of: (1) information sources used, (2) parents' information preferences and (3) factors influencing intervention decision making. Parents described a journey from the point of diagnosis that involved seeking information on ASD interventions from multiple sources, with the Internet being the primary source. They were overwhelmed by the sheer volume of information available, and their preferences for information varied according to their stage in the journey post diagnosis. Parents had a 'trial and error' approach to choosing ASD interventions, with confidence increasing as they became more familiar with their child's condition, and had opportunities to explore numerous information sources about their child's diagnosis. While confidence increased over time, consideration of the effectiveness or evidence supporting interventions remained largely absent throughout the journey. Conclusion: This study highlights the need for parents of children with ASD to be supported to make informed intervention decisions, particularly with consideration for research evidence. [ABSTRACT FROM AUTHOR]

Aim Intact surface active agent (surfactant) composed of surfactant-associated proteins ( SPs) and lipids is necessary for respiration and prevents alveoli from collapsing. CD26, a transmembrane glycoprotein exerting dipeptidyl peptidase activity ( DPP4), highly expressed in lung parenchyma, is involved in inflammatory processes. A pharmacological inhibition of DPP4 influenced not only the inflammation but also elevated the SPs. Thus, DPP4 inhibitors may be a novel drug for treatment of diseases with surfactant deficiency. Therefore, we tested firstly the hypothesis that DPP4 inhibitors increase the expression of SPs in healthy rats. Methods SP mRNA and protein expression were determined different times after nebulization of aerosolized DPP4 inhibitors [L-isoleucine-thiazolidide (L-Ile-Thia), L-valine-pyrrolidide (L-Val-Pyrr)], budesonide, saline or stereoisomers. Results Compared with negative controls (1) L-Ile-Thia as well as budesonide led to a significant higher and L-Val-Pyrr had the tendency to a significant higher expression of SP-A mRNA 6 h after nebulization, (2) the expression of SP-D mRNA increased significantly 6 h after nebulization with L-Ile-Thia and 3 and 6 h after nebulization with Val-pyrr, (3) SP-B mRNA levels showed significantly higher values 3 and 6 h after nebulization with L-Val-Pyrr, (4) protein levels of SP-A, SP-B and SP-C were elevated significantly 6 h after nebulization with L-Val-Pyrr as well as with budesonide, and (5) phospholipids were also increased in response to DPP4 inhibition; the minimal surface tension was comparable. Conclusion DPP4 inhibition influence differently the expression of surfactant proteins in healthy rats and may be suitable to elevate surfactant synthesis in different diseases accompanied with surfactant deficiencies. [ABSTRACT FROM AUTHOR]

Purpose: Septal deviation and nose deformities are widely prevalent. As a consequence, patients may complain about difficulties in nasal breathing leading to a perception of diminished disease-specific quality of life. In a prospective randomized trial, we aimed to analyse the outcome of septoplasty (SPL) and septorhinoplasty (SRP) on patient satisfaction. Methods: Patients with functional indication for SPL (n = 19) or SRP (n = 54) were included and randomized for additional turbinoplasty. Preoperative clinical symptoms were collected with SNOT-20 GAV (Sinu-nasal outcome test-20—German adapted version) and NOSE© (nasal obstruction symptom evaluation) questionnaires. The final evaluation of treatment success was performed 9 months after surgery with SNOT-20 GAV, NOSE© and a self-established feedback questionnaire. Nasal breathing and obstruction were objectively measured with rhinomanometry and acoustic rhinometry [minimum cross-sectional area 2 (MCA2)]. Results: Minimum cross-sectional area 2 was statistically improved compared to the pre-treatment value in SPL (p = 0.0004) and SRP (p = 0.0001). Regarding MCA2 values of matched patient groups, similar findings were detected (SPL: p = 0.0013, SRP: p < 0.0001). Sinu-nasal outcome test-20 GAV and NOSE© scores were significantly reduced after both surgical procedures (NOSE©: SPL: p < 0.0001, SRP: p < 0.0001; SNOT-20 GAV: SPL: p = 0.0068, SRP: p < 0.0001). Evaluation of patient satisfaction in a self-established feedback questionnaire revealed a motivation of 81% of patients to redo the surgery (SPL 13/16, SRP 34/42) and a notably general satisfaction of 86% for SPL and 80% for SRP. Conclusion: Rhinosurgery leads to quantitative better nasal breathing and increased disease-specific satisfaction. However, this study implies the importance of the right selection of patients and the correct indication of the surgical technique. [ABSTRACT FROM AUTHOR]

Background: Head and neck cancers (HNSCC) are highly immunosuppressive. Plasma-derived exosomes of HNSCC patients carry immunomodulatory molecules, and their cargo correlates with clinical parameters. Here, we evaluated the exosomal molecular profile for early detection of treatment failure in locally advanced HNSCC patients treated with conventional therapy.Methods: Plasma from 17 HNSCC patients was collected before, during, and after treatment by surgery with adjuvant (chemo)radiation and at recurrence. Exosomes were isolated by size-exclusion chromatography. Total exosomal protein (TEP) was used to estimate exosome load and on-bead flow cytometry to evaluate relative fluorescence intensity (RFI) of tumour-associated and immunoregulatory proteins on exosomes. Exosomal effects on the activity of and adenosine production by T cells was assessed by flow cytometry and mass spectrometry.Results: TEP and the ratio of tumour-/immune-cell-derived exosomes varied during and after therapy with an overall decrease in the tumour-free follow-up but an increase at recurrence. RFI values of immunoregulatory proteins on exosomes, their ability for T cell inhibition and adenosine production changed during and after therapy. PD-L1 was the earliest discriminator for treatment failure and disease-free survival.Conclusions: Monitoring of plasma exosomes during therapy represents a promising opportunity for early detection of treatment failure and risk stratification to delay/avoid recurrence. [ABSTRACT FROM AUTHOR]

Purpose: Cancer patients have to overcome various barriers to obtain diagnostics and treatment at head and neck cancer centers. Travel distance to a specialized hospital may result in psychosocial and financial distress, thus interfering with diagnostics, treatment, and follow-up care. In this study, we have aimed to analyze the association of travel distance with cTNM status, UICC stage at primary diagnosis, and survival outcomes of head and neck cancer (HNC) patients. Methods: We have analyzed data of 1921 consecutive HNC patients diagnosed between 2014 and 2019 at the head and neck cancer center of the Comprehensive Cancer Center Ulm (CCCU), Germany. Postal code-based travel distance calculation in kilometers, TNM status, and UICC stage were recorded at initial diagnosis. The assembly of travel distance-related groups (short, intermediate, long-distance) has been investigated. Moreover, group-related survival and recurrence analysis have been performed. Results: In contrast to observations from overseas, no association of travel distance and higher cTNM status or UICC stage at primary diagnosis has been observed. Furthermore, no significant differences for recurrence-free survival and overall survival by travel distance were detected. Conclusion: In southern Germany, travel distance to head and neck cancer centers seems to be tolerable. Travel burden is not synonymous with travel distance alone but also involves sociodemographic, monetary, and disease-specific aspects as well as accessibility to proper infrastructure of transport and health care system. [ABSTRACT FROM AUTHOR]

Purpose: It is not always possible to create linear access to the larynx using a rigid operating laryngoscope for microlaryngoscopy. In this study, we evaluate the usability of a novel curved surgical prototype with flexible instruments for the larynx (sMAC) in a simulation dummy and human body donor. Methods: In a user study (n = 6), head and neck surgeons as well as medical students tested the system for visualization quality and accessibility of laryngeal landmarks on an intubation dummy and human cadaver. A biopsy of the epiglottis was taken from the body donor. Photographic and time documentation was carried out. Results: The sMAC system demonstrated general feasibility for laryngeal surgery. Unlike conventional microlaryngoscopy, all landmarks could be visualized and manipulated in both setups. Biopsy removal was possible. Visibility of the surgical field remained largely unobstructed even with an endotracheal tube in place. Overall handling of the sMAC prototype was satisfactorily feasible at all times. Conclusion: The sMAC system could offer an alternative for patients, where microlaryngoscopy is not applicable. A clinical trial has to clarify if the system benefits in clinical routine. [ABSTRACT FROM AUTHOR]

Introduction: The number of aging cancer patients has increased continuously and will do so further in the future. The immune system of elderly people experiences critical changes over the time. Therefore, tumor-induced changes in the immune system are believed to differ in young and elderly cancer patients as well. Methods: The effect of aging on the immune system was measured in peripheral blood lymphocytes (PBL) of healthy volunteers (n = 48, 21–84 yrs.) divided into three different age groups. Seventy years was set as a cut-off for defining subjects as elderly. Results were compared to two groups of adult cancer patients, which donated PBL and tumor infiltrating lymphocytes (TIL): young cancer patients (40–69 yrs.; blood: n = 13; TIL: n = 17) and elderly cancer patients (70–90 yrs.; blood: n = 20; TIL: n = 15) with head and neck squamous cell carcinoma (HNSCC). Frequencies and phenotypes of CD4+ and CD8+ T cells as well as regulatory T cells (Treg) were assessed by flow cytometry. Results: We observed lower frequencies of CD8+ cytotoxic T cells during aging in both groups. Frequencies of tumor infiltrating regulatory T cells were significantly higher than in the peripheral blood but showed a significant decline in older tumor patients. With increasing age, expression of immunosuppressive CD73 and CCR7 was lower and expression of PD1 elevated on peripheral T cells in healthy volunteers and tumor patients. Conclusion: Immunosenescence takes place in healthy donors and cancer patients. Our results suggest that in elderly tumor patients, the immune system is impaired and the tumor-induced immune escape is less pronounced. The increased expression of PD1 implies the potential for effective immunotherapies in elderly, as treatment with checkpoint inhibitors could be more beneficial for elderly HNSCC patients. [ABSTRACT FROM AUTHOR]

Purpose: Adenoid cystic carcinoma (ACC) of the head and neck is a rare and highly malignant tumor, characterized by perineural growth and early distant metastases. The composition of immune cells in the peripheral blood and the tumor microenvironment is critical to tumor growth and control. However, little is known about the frequency and function of the relevant immune cell subsets in this entity. Methods: In ACC patients (n = 11) and matched healthy donors (n = 11), the frequency of peripheral blood T and B cells was measured by flow cytometry at different treatment stages of disease (24 samples). Cells were further characterized by their expression of CCR7, PD-1, CD39 and CD73. Tumor-infiltrating lymphocytes (TIL) were analyzed by immunohistochemistry for ten patients and for three patients by flow cytometry. Results: CD4+ T cells had significantly lower frequency after radiotherapy (RT). All other cell frequencies, including Treg, were stable through course of the disease. In B cells, CD73 was reduced after RT. CCR7 expression on T and B cells in patients with relapse/metastases (R/M) differed significantly from patients with active disease. PD-1 remained stable. Treg were more present in TIL compared to peripheral blood. Conclusion: Composition of lymphocyte subgroups behaves similar to squamous cell carcinoma in the head and neck, except for Treg, which remained stable. Nevertheless, the CD4+/Treg ratio was lower after RT, which could stand for an immunosuppressive effect in these patients. Therefore, it could be beneficial treating ACC with combined RT and immunomodulatory drugs. [ABSTRACT FROM AUTHOR]

This work investigates the influence of temperature on the performance of hydrothermal carbonization of corn Stover between 175 and 250 °C, 240 min, 2.0 °C/min, and biomass-to-water ratio of 1:10. The performance analyzed for yields, energy densification and recovery. Aqueous phase analyzed for pH, acetic acid equivalent (HAc), HPLC, and GC, solid phase for dry and organic matter, ash, and elemental analysis. Solid yield (62.92–35.82%) increases with temperature, showing an inflection region between 200 and 225 °C, while that of liquid (35.43–54.59%) decreases in a similar behavior, and gas yield (1.49–9.59%) increases exponentially. GC identified alcohols, carboxylic acids, and furans. The concentration of furfural and Hidroxymethylfurfural (HMF) decreases exponentially and as a sigmoid with temperature, being not detectable at 250 °C. Carbon content increases, while oxygen and hydrogen decreases with temperature. The high heating values (HHV) increase, and the energy efficiency decreases with temperature. [ABSTRACT FROM AUTHOR]

Several studies have shown increased in vitro cytokine responses to non-related pathogens after Bacillus Calmette-Guérin (BCG) vaccination. A total of 158 infants (80 BCG administered within 7 days of birth; 78 controls) were bled 4 days post-randomization, and at age 3 and 13 months. Geometric mean concentrations of IL-1β, TNF-α, IL-6 (24 h stimulation) and IFN-γ, IL-10, IL-17, IL-22 (96 h stimulation) in response to in vitro stimulation with RPMI, LPS, PHA, Escherichia coli, Streptococcus pneumoniae, Candida albicans and BCG were compared among BCG vaccinated children and controls. BCG vaccination did not affect in vitro cytokine production, except IFN-γ and IL-22 response to BCG. Stratifying for 'age at randomization' we found a potentiating effect of BCG on cytokine production (TNF-α, IL-6, IL-10) in the 4 days post randomization stimulations, among children who were vaccinated at age 2-7 days versus age 0-1 days. BCG vaccination did not potentiate cytokine production to non-BCG antigens. At 4 days post randomization, BCG was associated with higher cytokine production in the later randomized children. [ABSTRACT FROM AUTHOR]

Objective Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods The applicability of the robotic endoscope guidance system with customfoot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15-90 degrees). Results Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging. [ABSTRACT FROM AUTHOR]

Searching for biomarkers or signatures of microbial transformations of minerals is a critical aspect for determining how life evolved on Earth, and whether or not life may have existed in other planets, including Mars. In order to solve such questions, several missions to Mars have sought to determine the geochemistry and mineralogy on the Martian surface. This research includes the two miniaturized Mössbauer spectrometers (MIMOS II) on board the Mars Exploration Rovers Spirit and Opportunity, which have detected a variety of iron minerals on Mars, including magnetite (Fe 2+ Fe 3+ 2 O 4 ) and goethite (α-FeO(OH)). On Earth, both minerals can derive from microbiological activity (e.g. through dissimilatory iron reduction of ferrihydrite by Fe(III)-reducing bacteria). Here we used a lab based MIMOS II to characterize the mineral products of biogenic transformations of ferrihydrite to magnetite by the Fe(III)-reducing bacteria Geobacter sulfurreducens . In combination with Raman spectroscopy and X-ray diffraction (XRD), we observed the formation of magnetite, goethite and siderite. We compared the material produced by biogenic transformations to abiotic samples in order to distinguish abiotic and biotic iron minerals by techniques that are or will be available onboard Martian based laboratories. The results showed the possibility to distinguish the abiotic and biotic origin of the minerals. Mossbauer was able to distinguish the biotic/abiotic magnetite with the interpretation of the geological context (Fe content mineral assemblages and accompanying minerals) and the estimation of the particle size in a non-destructive way. The Raman was able to confirm the biotic/abiotic principal peaks of the magnetite, as well as the organic principal vibration bands attributed to the bacteria. Finally, the XRD confirmed the particle size and mineralogy. [ABSTRACT FROM AUTHOR]

Keloids are benign cutaneous lesions, arising from proliferating fibroblasts. Keloids of the ear may occur after trauma, surgery or helix piercings and are difficult to treat, since they tend to form recurrences. Guidelines suggest multimodal therapy; however, recurrence rates remain high and distinct algorithms for the combination of different modalities are missing. To unravel the most effective combination of therapeutic options for keloids of the ear, 38 patients with the diagnosis of an ear keloid were included in our cohort. In a prospective subgroup (B) of this cohort ( n = 17), patients either underwent surgery using the 'fillet technique' (a meticulous peeling of the keloid skin) and intra-lesional injections of triamcinolone 10 mg/ml every 4-6 weeks for 6 months, or they were additionally treated with a non-customized pressure device which was recommended for at least 16/24 h per day over 6 months. To further compare our results, the remaining 21 patients of our cohort, who were treated at our clinic before, were retrospectively evaluated concerning their recurrence rates. The mean follow-up was 48 months. The mean count of adjuvant steroid injections was two in all patients, four in subgroup B. The recurrence rate was 30% (13/38) in all patients (subgroup B 0/17). Aesthetic results were good to excellent in all non-recurrent cases. No patient treated with fillet technique showed recurrence ( p < 0.001). However, we could not confirm a significant effect but a trend of repeated steroid injections for preventing recurrences ( p = 0.099). The application of pressure using our non-customized clip also showed a clear trend towards preventing recurrences in cross-table analysis ( p = 0.057). Although several studies on different treatment regimens for keloids of the ear exist, the effectiveness of a multimodal treatment regimen needs to be elucidated. Overall, the best results in preventing recurrences were achieved by combining three different treatments. However, the fillet technique was the only modality preventing recurrences of keloids in uni- and multivariate analysis. The application of pressure with a non-customized clip and repeated steroid injections also showed a positive trend but failed level of significance. Based on our data and the literature we recommend, when feasible, the combination of more than one therapeutic regimen, since relapse risk went down from single to dual and triple therapy from 40% (8/20) to 14.3% (2/14) to 0% (0/4), respectively in our cohort. The use of 'fillet technique' was especially beneficial. [ABSTRACT FROM AUTHOR]

Zenker's diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity. Here, we present the potential utilization of a flexible, single port, robot-assisted, and physician-controlled endoscope system to facilitate transoral surgical access to the hypopharynx and upper esophagus. Transoral surgery of the hypopharynx and upper esophagus was performed in human cadavers ( n = 5) using the Flex System (Medrobotics, Raynham, USA). Anatomical landmarks were identified, and posterior cricothyroid myotomy was performed with compatible flexible instruments in all cases. The approach to the hypopharynx and upper esophagus using the Flex system is feasible in a cadaveric model. Myotomy with a flexible tool and needle knife (from the perspective of treatment of Zenker´s diverticulum) was successful in all cases. Visualization of the surgical site with the system's HD camera is suitable and the flexible instruments meet the special needs of a micro-invasive transoral approach. Zenker´s diverticulum can be potentially treated with a transoral minimally invasive approach using a computer-assisted flexible endoscope system. This setup could be of advantage in patients with reduced mobility of the cervical spine to prevent open transcervical surgery. In our study, the Flex system enabled advanced visualization of the surgical site and extended intervention options, compared to standard flexible endoscopic treatment. However, general anesthesia is mandatory for the presented approach. Application in live patients with actual pathologies of the hypopharynx and upper esophagus will have to prove suitability for the treatment of Zenker's diverticulum. Further development of the system could include improved instrumentation and an adoption by other disciplines with challenging anatomy such as colorectal surgery. [ABSTRACT FROM AUTHOR]

With focus on renewable energy from agriculture governments can either support the growing production of energy crops or it can invest in technology or measures to reduce the energy consumption. But what is more efficient with regard to the use of the limited resource arable land: to insulate a building with fibre material grown on arable land to reduce the heating demand or to use such land for growing energy plants for the sustainable energy supply of a building? To answer this question, a long term balance calculation under consideration of numerous framework parameters is necessary. Based on traditional fibre plants like hemp, flax, and woody fibre crops (e.g. poplar), these agricultural plants and their processing to insulation material were examined. Based on available data for the typical building structure of detached and semi-detached houses in Germany, models of buildings were developed and the accessible potentials for heating energy savings by using suitable insulation measures with natural fibre materials were determined. As a comparable system for the supply of renewable energy, bio-methane from silage maize was chosen, since it can be used efficiently in conventional gas boilers for heat generation. The different levels of consideration allow the following interpretations of results: in a balance calculation period of 30 years, the required acreage for heating supply with methane can be reduced by approx. 20%, when at the beginning of the use period fibre plants for the insulation of the houses are grown on the arable acreage. Contrariwise, to compensate only the existing loss in heating energy due to inadequate insulation of older detached and semi-detached houses (build prior to 1979) an annual acreage of approx. 3 million ha silage maize for bio-methane would be required in Germany. Therefore, from the land use perspective the production of biogas plants in agriculture for heating should be accompanied by the production of fibre plants for a reasonable improvement of the heat insulation of houses. [ABSTRACT FROM AUTHOR]