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DONES is planned to operate on a continuous basis with only two beam stop periods per year for maintenance. The planned operational availability is 70 %, which calls for a carefully analyzed preventive maintenance. The purpose of the research is to propose a realistic and comprehensive logistics and maintenance plan. All the maintenance activities are included in a Maintenance Matrix based on the Plant Breakdown Structure of the project. This is the basis for the creation of a maintenance plan that will lead to a Work Schedule. Special mention within this matrix will be given to those Maintenance operations that must be included in order to comply with regulation. The need of replacement of components impose some requirements on the dimensions of architec tural features of the main building such as doors, airlocks, corridors and shipping bays. To enable these re placements, the flow of materials has been developed and analyzed by an intralogistics simulation with AnyLogic. The results of this simulation lead to modifications on either the building or the components such that the replacements are feasible. The periodic replacement of an activated component has been analyzed using FMEA methodology resulting in proposals for the plant equipment designers as well as the remote handling equipment designers. Virtual reality simulations are used for a staged approach to the maintenance operation. The simulation of the HEBT scraper helped to define in detail each step or the maintenance operation. This tool has proven to be very useful to prompt changes in both the plant equipment design and the remote handling equipment. Also, the procedure of the operation itself can be refined and optimized. The conclusion of the research activities is the contribution to the definition of the building, plant equipment and achievement of the target availability., European Commission 101052200

Context. The rotation period of stars is an important parameter together with mass, radius, and effective temperature. It is an essential parameter for any radial velocity monitoring, as stellar activity can mimic the presence of a planet at the stellar rotation period. Several methods exist to measure it, including long sequences of photometric measurements or temporal series of stellar activity indicators. Aims. Here, we use the circular polarization in near-infrared spectral lines for a sample of 43 quiet M dwarfs and compare the measured rotation periods to those obtained with other methods. Methods. From Stokes V spectropolarimetric sequences observed with SPIRou at the Canada-France-Hawaii Telescope and the data processed with the APERO pipeline, we computed the least-squares deconvolution profiles using different masks of atomic stellar lines with known Landé factor appropriate to the effective temperature of the star. We derived the longitudinal magnetic field to examine its possible variation in 50 to 200 observations of each star. To determine the stellar rotation period, we applied a Gaussian process regression, enabling us to determine the rotation period of stars with evolving longitudinal field. Results. We were able to measure a rotation period for 27 of the 43 stars of our sample. The rotation period was previously unknown for 8 of these stars. Our rotation periods agree well with periods found in the literature based on photometry and activity indicators, and we confirm that near-infrared spectropolarimetry is an important tool for measuring rotation periods, even for magnetically quiet stars. Furthermore, we computed the ages for 20 stars of our sample using gyrochronology.

Tuberculosis (TB), which is caused by the bacterium Mycobacterium tuberculosis (Mtb), is still one of the deadliest infectious diseases. Understanding how the host and pathogen interact in active TB will have a significant impact on global TB control efforts. Exosomes are increasingly recognized as a means of cell-to-cell contact and exchange of soluble mediators. In the case of TB, exosomes are released from the bacillus and infected cells. In the present study, a comprehensive lipidomics and proteomics analysis of size exclusion chromatography-isolated plasma-derived exosomes from patients with TB lymphadenitis (TBL) and treated as well as untreated pulmonary TB (PTB) was performed to elucidate the possibility to utilize exosomes in diagnostics and knowledge building. According to our findings, exosome-derived lipids and proteins originate from both the host and Mtb in the plasma of active TB patients. Exosomes from all patients are mostly composed of sphingomyelins (SM), phosphatidylcholines, phosphatidylinositols, free fatty acids, triacylglycerols (TAG), and cholesterylesters. Relative proportions of, e.g., SMs and TAGs, vary depending on the disease or treatment state and could be linked to Mtb pathogenesis and dormancy. We identified three proteins of Mtb origin: DNA-directed RNA polymerase subunit beta (RpoC), Diacyglycerol O-acyltransferase (Rv2285), and Formate hydrogenase (HycE), the latter of which was discovered to be differently expressed in TBL patients. Furthermore, we discovered that Mtb infection alters the host protein composition of circulating exosomes, significantly affecting a total of 37 proteins. All TB patients had low levels of apolipoproteins, as well as the antibacterial proteins cathelicidin, Scavenger Receptor Cysteine Rich Family Member (SSC5D), and Ficolin 3 (FCN3). When compared to healthy controls, the protein profiles of PTB and TBL were substantially linked, with 14 proteins being co-regulated. However, adhesion proteins (integrins, Intercellular adhesion molecule 2 (ICAM2), CD151, Proteoglycan 4 (PRG4)) were shown to be more prevalent in PTB patients, while immunoglobulins, Complement component 1r (C1R), and Glutamate receptor-interacting protein 1 (GRIP1) were found to be more abundant in TBL patients, respectively. This study could confirm findings from previous reports and uncover novel molecular profiles not previously in focus of TB research. However, we applied a minimally invasive sampling and analysis of circulating exosomes in TB patients. Based on the findings given here, future studies into host–pathogen interactions could pave the way for the development of new vaccines and therapies.

Coordinative challenging exercises in changing environments referred to as open-skill exercises seem to be beneficial on cognitive function. Although electroencephalographic research allows to investigate changes in cortical processing during movement, information about cortical dynamics during open-skill exercise is lacking. Therefore, the present study examines frontal brain activation during table tennis as an open-skill exercise compared to cycling exercise and a cognitive task. 21 healthy young adults conducted three blocks of table tennis, cycling and n-back task. Throughout the experiment, cortical activity was measured using 64-channel EEG system connected to a wireless amplifier. Cortical activity was analyzed calculating theta power (4–7.5 Hz) in frontocentral clusters revealed from independent component analysis. Repeated measures ANOVA was used to identify within subject differences between conditions (table tennis, cycling, n-back; p p ηp2 = 0.35) and frontocentral (p ηp2 = 0.39) brain areas. Post-hoc tests revealed increased theta power in table tennis compared to cycling in frontal brain areas (p d = 1.42). In frontocentral brain areas, theta power was significant higher in table tennis compared to cycling (p d = 1.03) and table tennis compared to the cognitive task (p d = 1.06). Increases in theta power during continuous table tennis may reflect the increased demands in perception and processing of environmental stimuli during open-skill exercise. This study provides important insights that support the beneficial effect of open-skill exercise on brain function and suggest that using open-skill exercise may serve as an intervention to induce activation of the frontal cortex.

A new and uniquely structured matrix of mammalian phenotypes,MaTrics(MammalianTraits for Comparative Genomics) is presented in a digital form. By focussing on mammalian species for which genome assemblies are available,MaTricsprovides an interface between mammalogy and comparative genomics.MaTricswas developed as part of a project to link phenotypic differences between mammals to differences in their genomes usingForward Genomics.Apart from genomes this approach requires information on homologous phenotypes that are numerically encoded (presence-absence; multistate character coding*) in a matrix.MaTricsprovides these data, links them to at least one reference (e.g., literature, photographs, histological sections, CT-scans, or museum specimens) and makes them available in a machine actionable NEXUS-format. By making the data computer readable,MatTricsopens a new way for digitizing collections. Currently,MaTricscovers 147 mammalian species and includes 207 characters referring to structure, morphology, physiology, ecology and ethology. Researching these traits revealed substantial knowledge gaps, highlighting the need for substantial phenotyping efforts in the genomic era. Using the trait information documented inMaTrics, previous Forward Genomics screens identified changes in genes that are associated with various phenotypes, ranging from fully-aquatic lifestyle to dietary specializations. These results motivate the continuous expansion of phenotype information, both by filling research gaps or by adding additional taxa and traits.MaTricsis digitally available online within the data repository Morph·D·Base (www.morphdbase.de).

The Deep Underground Neutrino Experiment (DUNE) is an international, world-class experiment aimed at exploring fundamental questions about the universe that are at the forefront of astrophysics and particle physics research. DUNE will study questions pertaining to the preponderance of matter over antimatter in the early universe, the dynamics of supernovae, the subtleties of neutrino interaction physics, and a number of beyond the Standard Model topics accessible in a powerful neutrino beam. A critical component of the DUNE physics program involves the study of changes in a powerful beam of neutrinos, i.e., neutrino oscillations, as the neutrinos propagate a long distance. The experiment consists of a near detector, sited close to the source of the beam, and a far detector, sited along the beam at a large distance. This document, the DUNE Near Detector Conceptual Design Report (CDR), describes the design of the DUNE near detector and the science program that drives the design and technology choices. The goals and requirements underlying the design, along with projected performance are given. It serves as a starting point for a more detailed design that will be described in future documents. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

In the present work, we investigate how the large-scale magnetic field of the Sun, in its three vector components, has evolved during most of cycle 24, from 2010 Jan to 2018 Apr. To filter out the small-scale field of the Sun, present in high-resolution synoptic maps, we use a spherical harmonic decomposition method, which decomposes the solar field in multipoles with different l degrees. By summing together the low-l multipoles, we reconstruct the large-scale field at a resolution similar to observed stellar magnetic fields, which allows the direct comparison between solar and stellar magnetic maps. During cycle 24, the `Sun-as-a-star' magnetic field shows a polarity reversal in the radial and meridional components, but not in the azimuthal component. The large-scale solar field remains mainly poloidal with > 70% of its energy contained in the poloidal component. During its evolution, the large-scale field is more axisymmetric and more poloidal when near minima in sunspot numbers, and with a larger intensity near maximum. There is a correlation between toroidal energy and sunspot number, which indicates that spot fields are major contributors to the toroidal large-scale energy of the Sun. The solar large-scale magnetic properties fit smoothly with observational trends of stellar magnetism reported in See et al. The toroidal (Etor) and poloidal (Epol) energies are related as Etor ~Epol^{1.38 \pm 0.04}. Similar to the stellar sample, the large-scale field of the Sun shows a lack of toroidal non-axisymmetric field., Comment: 11 pages, 9 figures, 3 tables. Accepted to MNRAS

The grain structure of high-performance (HP) multicrystalline silicon (mc-Si) is characterized by a small initial grain size with randomly oriented grains and a high length fraction of random grain boundaries. However, the remaining unmelted feedstock at the ingot bottom used as seeding layer for achieving the HP mc-Si properties in the standard crystallization procedure causes yield loss. To overcome this disadvantage, the influence of wetting angle, and surface roughness of non-Si nucleation layers at the crucible bottom on the grain structure properties of mc-Si ingots with a weight of 14.5 kg was investigated and compared to classical HP mc-Si. For that purpose, SiC and SiO 2 nucleation layers realized by spraying and embedding of particles with different sizes resulting in different surface morphologies and wetting angles were studied. Nucleation on rough layers of both materials with a root mean square roughness value greater than 100 µm yielded an initially fine grain structure comparable to HP mc-Si. This did not necessarily result in a random orientation distribution and high length fraction of random grain boundaries. Nucleation on SiC layers caused random grain boundary length fractions between 20 and 30% and non-uniform grain distributions. But, nucleation on SiO 2 layers yielded increased random grain boundary length fractions between 50 and 70% and homogenous grain distributions, both values are similar to HP mc-Si. These differences are discussed in terms of the thermal conductivity of the different nucleation layers.

We were interested to read the study by Fabbri et al. ([1][1]), a meta-analysis which investigated the association between health literacy and outcomes in heart failure patients. The study demonstrated an increased risk of death (risk ratio [RR]: 1.41; 95% confidence interval [CI]: 1.06 to 1.88)

Helicity is a fundamental property of a magnetic field but to date it has only been possible to observe its evolution in one star - the Sun. In this paper we provide a simple technique for mapping the large-scale helicity density across the surface of any star using only observable quantities: the poloidal and toroidal magnetic field components (which can be determined from Zeeman-Doppler imaging) and the stellar radius. We use a sample of 51 stars across a mass range of 0.1-1.34 M$_\odot$ to show how the helicity density relates to stellar mass, Rossby number, magnetic energy and age. We find that the large-scale helicity density increases with decreasing Rossby number $R_o$, peaking at $R_o \simeq 0.1$, with a saturation or decrease below that. For both fully- and partially-convective stars we find that the mean absolute helicity density scales with the mean squared toroidal magnetic flux density according to the power law: $|\langle{h\,}\rangle|$ $\propto$ $\langle{\rm{B_{tor}}^2_{}\,\rangle}^{0.86\,\pm\,0.04}$. The scatter in this relation is consistent with the variation across a solar cycle, which we compute using simulations and observations across solar cycles 23 and 24 respectively. We find a significant decrease in helicity density with age., 11 pages, 7 figures

Numerous attempts to estimate the rate at which low-mass stars lose angular momentum over their lifetimes exist in the literature. One approach is to use magnetic maps derived from Zeeman-Doppler imaging (ZDI) in conjunction with so-called "braking laws". The use of ZDI maps has advantages over other methods because it allows information about the magnetic field geometry to be incorporated into the estimate. However, ZDI is known to underestimate photospheric field strengths due to flux cancellation effects. Recently, Lehmann et al. (2018) conducted synthetic ZDI reconstructions on a set of flux transport simulations to help quantify the amount by which ZDI underestimates the field strengths of relatively slowly rotating and weak activity solar-like stars. In this paper, we evaluate how underestimated angular momentum-loss rate estimates based on ZDI maps may be. We find that they are relatively accurate for stars with strong magnetic fields but may be underestimated by a factor of up to $\sim$10 for stars with weak magnetic fields. Additionally, we re-evaluate our previous work that used ZDI maps to study the relative contributions of different magnetic field modes to angular momentum-loss. We previously found that the dipole component dominates spin-down for most low-mass stars. This conclusion still holds true even in light of the work of Lehmann et al. (2018)., Comment: 8 pages, 3 figures, 1 table, accepted for publication by ApJ

Additional file 3. GP perceived valuing of SPHC activities.

Additional file 1. The development of the questionnaire.

Additional file 2. Questionnaire: English version.

This paper presents results of a statistical investigation of the grain size-, grain orientation- and grain boundary type distribution of six industrially grown conventional multicrystalline (mc-Si) silicon bricks and six high performance (hp) mc-Si bricks of different producers. It was found that hp mc-Si wafers have a more uniform initial grain size (coefficient of variation CV < 2.5) and grain orientation (CV < 1.5) distribution, with a smaller mean grain size (60%) in comparison to the conventional mc-Si wafers. Despite the totally different initial grain structures between the hp and conventional me-Si bricks the grain structure of the top wafers is more or less comparable. It was concluded that the grain structure development of the hp mc-Si bricks is driven by an energy minimization due to the surface energy as well as the grain boundary energy. The grain structure investigations show clearly that especially the initial grain structure of the bricks significantly influences the area fraction of electrical active defects as well as the solar cell efficiency. The hp mc-Si bricks show the lowest area fraction of electrical active defects up to 4% and the highest solar cell efficiency of 18.8%, whereas the conventional mc-Si bricks have an area fraction of electrical active defects up to 14% and a maximum solar cell efficiency of about 18.4%.

The large-scale magnetic fields of stars can be obtained with the Zeeman-Doppler-Imaging (ZDI) technique, but their interpretation is still challenging as the contribution of the small-scale field or the reliability of the reconstructed field properties is still not fully understood. To quantify this, we use 3D non-potential magnetic field simulations for slowly rotating solar-like stars as inputs to test the capabilities of ZDI. These simulations are based on a flux transport model connected to a non-potential coronal evolution model using the observed solar flux emergence pattern. We first compare four field prescriptions regarding their reconstruction capabilities and investigate the influence of the spatial resolution of the input maps on the corresponding circularly polarised profiles. We then generate circularly polarised spectra based on our high resolution simulations of three stellar models with different activity levels, and reconstruct their large-scale magnetic fields using a non-potential ZDI code assuming two different stellar inclination angles. Our results show that the ZDI technique reconstructs the main features of slowly rotating solar-like stars but with $\sim\,$one order of magnitude less magnetic energy. The large-scale field morphologies are recovered up to harmonic modes $\ell \sim 5$, especially after averaging over several maps for each stellar model. While ZDI is not able to reproduce the input magnetic energy distributions across individual harmonic modes, the fractional energies across the modes are generally within $20\,\%$ agreement. The fraction of axisymmetric and toroidal field tends to be overestimated for stars with solar flux emergence patterns for more pole-on inclination angles., 26 pages, 16 figures, accepted for publication in MNRAS

A key question in understanding the observed magnetic field topologies of cool stars is the link between the small- and the large-scale magnetic field and the influence of the stellar parameters on the magnetic field topology. We examine various simulated stars to connect the small-scale with the observable large-scale field. The highly resolved 3D simulations we used couple a flux transport model with a non-potential coronal model using a magnetofrictional technique. The surface magnetic field of these simulations is decomposed into spherical harmonics which enables us to analyse the magnetic field topologies on a wide range of length scales and to filter the large-scale magnetic field for a direct comparison with the observations. We show that the large-scale field of the self-consistent simulations fits the observed solar-like stars and is mainly set up by the global dipolar field and the large-scale properties of the flux pattern, e.g. the averaged latitudinal position of the emerging small-scale field and its global polarity pattern. The stellar parameters flux emergence rate, differential rotation and meridional flow affect the large-scale magnetic field topology. An increased flux emergence rate increases the magnetic flux in all field components and an increased differential rotation increases the toroidal field fraction by decreasing the poloidal field. The meridional flow affects the distribution of the magnetic energy across the spherical harmonic modes., 20 pages, 16 figures, accepted for publication in MNRAS

Mechanical ventilation is a life-saving intervention, which despite its use on a routine basis, poses the risk of inflicting further damage to the lung tissue if ventilator settings are chosen inappropriately. Medical decision support systems may help to prevent such injuries while providing the optimal settings to reach a defined clinical goal. In order to develop and verify decision support algorithms, a test bench simulating a patient’s behaviour is needed. We propose a Java based system that allows simulation of respiratory mechanics, gas exchange and cardiovascular dynamics of a mechanically ventilated patient. The implemented models are allowed to interact and are interchangeable enabling the simulation of various clinical scenarios. Model simulations are running in real-time and show physiologically plausible results.

We present new magnetic field measurements of the K2 main-sequence star ϵ Eri based on principal components analysis (PCA) line-profile reconstructions. The aim of this paper is to quantify the surface-averaged magnetic field and search for possible variations. A total of 338 optical echelle spectra from our robotic telescope facility STELLA with a spectral resolution of 55 000 were available for analysis. This time-series was used to search for the small line-profile variations due to a surface magnetic field with the help of a PCA. Evidence for a spatial and temporal inhomogeneous magnetic field distribution is presented. The mean, surface averaged, magnetic field strength was found tobe 〈B〉 = 186 ± 47 G in good agreement with previous Zeeman-broadening measurements. Clear short-term variations of the surface averaged magnetic field of up to few tens Gauss were detected together with evidence for a three-year cycle in the surface-averaged magnetic field of ϵ Eri. (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

Chevron has addressed the challenge of providing global learning opportunities for the early career development employees in a cost constrained, budget restricted environment. One solution was to pilot the blended learning versions of Petroskills' Production Operations 1 and Applied Reservoir Engineering. This presentation is a case study of sessions that were completed in 2016 and 2017. Using industry approved content from two production and reservoir engineering courses, blended skill modules were developed to cover all key aspects of the traditional instructor-led course. Each module uses the most effective mode of delivery, including videos, narrated slideshows, interactive exercises, reading assignments, and live virtual instructor led sessions. Based on competency models, knowledge is transferred and assured with pre-assessment and post assessment testing. Learners advance at a pace that suits their work situation and learning style. The blended method delivers content that is relevant to current job roles, just-in-time. The primary benefits of blended learning observed from the two pilot sessions are 1) reduced expenses, travel, and days away from work, 2) increased flexibility in learning styles and schedule preferences, 3) optimized learner's use of time and knowledge with test-out option, 4) metrics to prove learning occurs via pre and post assessments, 5) allowed for networking and communication among learners, 6) longer time to digest the material and retain knowledge according to adult learning principles. Key learnings are to engage internal stakeholders early and often, emphasize the message that this type of learning requires learners to take ownership of the course schedule, and leverage internal metrics (i.e. scorecards) to not only keep learners on track but to also improve quality of skill modules. Change management is a key component to a successful blended delivery. This approach to blended learning is a relatively new concept for both oil and gas operators and learning and development organizations. The methodology and lessons learned presented in this presentation will benefit others who are evaluating the feasibility of incorporating blended learning into their organizations.

SUMMARY We describe a 33-yr-old man suffering from severe vertebral osteoporosis and urticaria pigmentosa due to systemic mast cell disease (SMCD). Because i.v. clodronate therapy could not prevent further vertebral fractures, an additional treatment with interferon alpha-2b was initiated. During 24 months of treatment, our patient had no further pain episodes, no new vertebral fractures were discovered, trabecular bone mineral density (BMD) increased significantly and urticarial symptoms improved. Nevertheless, the extent of skin lesions remained unchanged. On histological examination, a remarkable decrease of mast cells was observed in the bone marrow, but not in the skin. Five months after discontinuation of interferon alpha-2b, trabecular BMD decreased and urticarial symptoms deteriorated. These findings illustrate a beneficial effect of interferon alpha-2b on SMCD-induced osteoporosis as well as urticarial symptoms, and raise the question whether this treatment may have a diverse impact on mast cell populations in different tissues.

Hintergrund In Deutschland besteht der Versorgungsalltag darin, dass regelhaft Nichtgeriater die Indikation zur geriatrischen Fruhrehabilitation stellen. Das Risiko einer inadaquaten Patientenallokation ist dabei durch Unkenntnis oder Fehlbewertung der moglichen Erfolge einer Fruhrehabilitation, insbesondere zur Vermeidung oder Verzogerung von Pflegebedurftigkeit, erheblich. Von derartigen Fehleinschatzungen sind v. a. Hochbetagte betroffen.

The grain structure, especially the grain orientation, number and type of grain boundaries, influences many of the properties of multicrystalline (mc) silicon (Si) wafers used for manufacturing solar cells. In order to increase the efficiency of silicon solar cells, the relation between material defects, such as dislocations, impurities and precipitates, and the grain structure must be understood. Currently no measurement system exists that can determine the grain orientation on a full mc Si wafer with an area of 156 × 156 mm2. The most widely used measuring method is electron backscatter diffraction (EBSD). However, it is only possible to measure small sample sizes by EBSD depending on the scanning electron microscopy stage, and moreover a time-consuming surface preparation is needed. In this paper an innovative fast characterization method is presented that allows the orientation measurement of as-cut and polished Si samples up to 380 × 400 mm2. This method, known as the Laue scanner, is based on X-ray diffraction. Experimental and theoretical considerations, limits of the system and example results of possible tasks are shown and discussed.

Propylene production from current sources will not suffice in the long run to meet market requirements. The transformation of either ethylene or ethanol into propylene is hence an interesting alternative to conventional production routes. These two chemical processes were thermodynamically analyzed employing Gibbs energy minimization. Investigated process parameters included system pressures ranging from 1 to 20 bar and reaction temperatures between 250 and 750 °C. Regarding initial compositions, pure ethylene or ethanol feeds were considered as well as binary mixtures of aqueous ethanol containing water mass fractions up to 95%. The effect of catalyst-caused shape selectivity on the product spectrum was accounted for by using different species lists. Non-ideal behavior was incorporated using the virial equation but found to be negligible. Both ethanol and ethylene feeds gave a maximum propylene yield of approximately 42% (carbon atom basis) at a system pressure of 1 bar. Optimal reaction temperatures were found at 600 °C (ethanol feed) and 650 °C (ethylene feed), respectively. In addition, chemical equilibria revealed room for improvement as far as currently available catalysts are concerned. The results of this study are thus useful as a benchmark for future catalyst developments. The potential attractiveness of ethylene- or ethanol-based propylene production is pointed out from a general thermodynamic point of view.

In this work one high performance multi-crystalline silicon ingot and one conventional multi-crystalline silicon ingot, each with an extraordinary ingot height of 710 mm, were replicated by the successive growth of eight G1 ingots to evaluate the potential advantage of extraordinary tall HPM ingots in industrial production. By analyzing different grain structure parameters like mean grain size, grain orientation and grain boundary type distribution as well as the recombination active dislocation area over the complete ingot height, it was observed that the material properties strongly differ in the initial state of growth for the two material types. However, at ingot heights above 350 mm, the difference has vanished and the grain structure properties for both materials appear similar. It is shown that the evolution of the grain structure in both material types can be explained by the same grain selection and grain boundary generation/annihilation mechanisms whereas the current grain structure determines which mechanisms are the most dominant at a specific ingot height. Since the grain structure directly influences the dislocation content in the silicon material, also the recombination active dislocation area becomes equal in high performance and conventional multi-crystalline silicon material at ingot heights above 350 mm. From these results it is concluded that the advantage of high performance silicon material is limited to the first grown 350 mm of the ingot.

An S3 guideline on the diagnosis and differentiated management of gestational diabetes (GDM) was published in Germany in 2011. This guideline replaced the previously applicable recommendations for the diagnosis and treatment of GDM and, for the first time, compiled evidence-based recommendations for the care of patients with GDM. The new guideline has focused particularly on the counselling offered to all patients with GDM about the associated long-term health risks. In this study we investigated the state of knowledge about the guideline among gynecologists and diabetologists in Thuringia and Lower Saxony.A questionnaire with 23 questions was sent out to 773 gynecologists and 76 diabetologists providing outpatient care in Lower Saxony and Thuringia. The statistical analysis was descriptive and inferential for comparisons between groups.The response rate was 54 %; an average of 47.6 % of the individual questions were answered correctly in the completed questionnaires. The questions were answered correctly significantly more frequently by persons in the group with a good knowledge of the guidelines (75 vs. 61 %, p 0.001). There were no significant differences between groups when differences between federal states or medical specialties were compared.The results of our study show a good general state of knowledge of the guideline and point to a high level of willingness to implement the recommendations of the S3 guideline on GDM. With regard to the follow-up care provided to patients with GDM and depression, this study found a significant need for further training.

The aim of this study is to compare very elderly female patients with a younger control group after prolapse surgery with regard to co-morbidity and complications.In a case-control design, the consecutive data of patients after prolapse surgery at the age of over 80 years and those of a control group were analysed by means of the Clavien-Dindo (CD) classification of surgical complications, the Charlson Comorbidity Index and the Cumulative Illness Rating Scale Geriatrics (CIRS-G). Statistics: Student's t, Fisher's exact and Mann-Whitney U tests.The analysis comprised n = 57 vs. n = 60 operations. In the very elderly patients there was often a grade IV prolapse (p 0.001), apical fixations were more frequent (p 0.001), but the operating times were not different. In the very elderly patients 21 % CD II+III complications were observed, in the control group 6.6 % (p = 0.031). No CD IV and V complications occurred in either group, the duration of inpatient stay amounted to 5 (± 1) vs. 4.1 (± 0.8; p 0.001) days, the very elderly patients needed an inpatient follow-up more frequently (p 0.001). The co-morbidities of the very elderly patients differed from those of the control group in number (median 2.0 vs. 1.5; p 0.001), in CIRS-G (4.1 ± 2.2 vs. 2.4 ± 1.7; p 0.01) and in Charlson Index (1.6 ± 1.6 vs. 0.5 ± 0.7; p 0.001).A prolapse in very elderly women can be safely managed by surgery. In no case did the complications require intensive care treatment nor were they life-threatening, but they did lead to a longer duration of hospital stay and more frequently to further treatment geriatric or inpatient internal medicine facilities.