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The true molecular conformation and the crystal structure of benzo[e]dinaphtho[2,3-a;1′,2′,3′,4′-ghi]fluoranthene, 7,14-diphenylnaphtho[1,2,3,4-cde]bisanthene and 7,16-diphenylnaphtho[1,2,3,4-cde]helianthrene were determined ab initio by 3D electron diffraction. All three molecules are remarkable polycyclic aromatic hydrocarbons. The molecular conformation of two of these compounds could not be determined via classical spectroscopic methods due to the large size of the molecule and the occurrence of multiple and reciprocally connected aromatic rings. The molecular structure of the third molecule was previously considered provisional. These compounds were isolated as by-products in the synthesis of similar products and were at the same time nanocrystalline and available only in very limited amounts. 3D electron diffraction data, taken from submicrometric single crystals, allowed for direct ab initio structure solution and the unbiased determination of the internal molecular conformation. Detailed synthetic routes and spectroscopic analyses are also discussed. Based on many-body perturbation theory simulations, benzo[e]dinaphtho[2,3-a;1′,2′,3′,4′-ghi]fluoranthene may be a promising candidate for triplet–triplet annihilation and 7,14-diphenylnaphtho[1,2,3,4-cde]bisanthene may be a promising candidate for intermolecular singlet fission in the solid state.

Abstract Background The interest in non-intubated video-assisted thoracic surgery (NIVATS) has risen over the last decade and numerous terms have been used to describe this technique. They all have in common, that the surgical procedure is performed in a spontaneously breathing patient under locoregional anaesthesia in combination with intravenous sedation but have also been performed on awake patients without sedation. Evidence has been generated favouring NIVATS compared to one-lung-ventilation under general anaesthesia. Main body We want to give an overview of how NIVATS is performed, and which different techniques are possible. We discuss advantages such as shorter length of hospital stay or (relative) contraindications like airway difficulties. Technical aspects, for instance intraoperative handling of the vagus nerve, are considered from a thoracic surgeon’s point of view. Furthermore, special attention is paid to the cohort of patients with interstitial lung diseases, who seem to benefit from NIVATS due to the avoidance of positive pressure ventilation. Whenever a new technique is introduced, it must prove noninferiority to the state of the art. Under this aspect current literature on NIVATS for lung cancer surgery has been reviewed. Conclusion NIVATS technique may safely be applied to minor, moderate, and major thoracic procedures and is appropriate for a selected group of patients, especially in interstitial lung disease. However, prospective studies are urgently needed.

Digital Twins are digital models of Cyber-Physical Systems to enable not only continuous monitoring but also active functional improvement of networked services, physical products, machines and devices. This capacity is of utmost importance when recognizing and exploring business opportunities in terms of organizational and technology innovations, as well as enriching the scope of system-relevant applications. Before being operated in their target ecosystems, such as smart cities, Cyber-Physical Systems can be validated and be run as Digital Twin through executable behavior models. The development of these models captures both, the horizontal, and the vertical integration of CPS components, thus allowing to consider specific system qualities, such as pollution effects of traffic. This article investigates methodological and technological aspects of developing and operating Digital Twins along system transformation processes. We consider integration depth and breadth, connectivity, organizational intelligence, validation, and implementation variability in the context of human-centered modeling and development. The approach enriches the understanding of digital twins towards digital representation of Cyber-Physical Systems allowing for dynamic allocation of physical and digital parts according to operational conditions. An exemplary case study in traffic management demonstrates the feasibility and practicability of the communication-centered approach.

In this observational prospective multicenter study conducted between October 2016 and October 2018, we tested the hypothesis that the use of prehospital non-invasive ventilation (phNIV) to treat patients with acute respiratory insufficiency (ARI) caused by severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and acute cardiopulmonary oedema (ACPE) is effective, time-efficient and safe. The data were collected at four different physician response units and three admitting hospitals in a German EMS system. Patients with respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease and acute cardiopulmonary oedema were enrolled. A total of 545 patients were eligible for the final analysis. Patients were treated with oxygen supplementation, non-invasive ventilation or invasive mechanical ventilation. The primary outcomes were defined as changes in the clinical parameters and the in-hospital course. The secondary outcomes included time efficiency, peri-interventional complications, treatment failure rate, and side-effects. Oxygenation under phNIV improved equally to endotracheal intubation (ETI), and more effectively in comparison to standard oxygen therapy (SOT) (paO2 SOT vs. non-invasive ventilation (NIV) vs. ETI: 82 mmHg vs. 125 mmHg vs. 135 mmHg, p-value SOT vs. NIV < 0.0001). In a matched subgroup analysis phNIV was accompanied by a reduced time of mechanical ventilation (phNIV: 1.8 d vs. ETI: 4.2 d) and a shortened length of stay at the intensive care unit (3.4 d vs. 5.8 d). The data support the hypothesis that the treatment of severe AECOPD/ACPE-induced ARI using prehospital NIV is effective, time efficient and safe. Compared to ETI, a matched comparison supports the hypothesis that prehospital implementation of NIV may provide benefits for an in-hospital course.

Background: Cardiac manifestation of COVID-19 has been reported during the COVID pandemic. The role of cardiac arrhythmias in COVID-19 is insufficiently understood. This study assesses the incidence of cardiac arrhythmias and their prognostic implications in hospitalized COVID-19-patients. Methods: A total of 166 patients from eight centers who were hospitalized for COVID-19 from 03/2020–06/2020 were included. Medical records were systematically analyzed for baseline characteristics, biomarkers, cardiac arrhythmias and clinical outcome parameters related to the index hospitalization. Predisposing risk factors for arrhythmias were identified. Furthermore, the influence of arrhythmia on the course of disease and related outcomes was assessed using univariate and multiple regression analyses. Results: Arrhythmias were detected in 20.5% of patients. Atrial fibrillation was the most common arrhythmia. Age and cardiovascular disease were predictors for new-onset arrhythmia. Arrhythmia was associated with a pronounced increase in cardiac biomarkers, prolonged hospitalization, and admission to intensive- or intermediate-care-units, mechanical ventilation and in-hospital mortality. In multiple regression analyses, incident arrhythmia was strongly associated with duration of hospitalization and mechanical ventilation. Cardiovascular disease was associated with increased mortality. Conclusions: Arrhythmia was the most common cardiac event in association with hospitalization for COVID-19. Older age and cardiovascular disease predisposed for arrhythmia during hospitalization. Whereas in-hospital mortality is affected by underlying cardiovascular conditions, arrhythmia during hospitalization for COVID-19 is independently associated with prolonged hospitalization and mechanical ventilation. Thus, incident arrhythmia may indicate a patient subgroup at risk for a severe course of disease.

In order to directly involve stakeholders in socio-technical system design, we argue for streamlining executable process specifications with business process modeling. Due to current agility requirements of organizations, socio-technical system development is considered one of the key activities of members of the organizations. Dynamic process adaptation enable handling the volatility of business operation and IT infrastructure. Subject-oriented process representations are key enablers to dynamic adaptation due to their capability for stakeholders to create directly executable models. In this way stakeholder can be involved in change management pro-actively. Subject-oriented models (i) represent all relevant features required for system control and decision making, and (ii) are executable on demand. This effectiveness enables organizational change in a creative and efficient way, while establishing innovative design and change management tools. Subject-oriented Business Process Management capabilities are reflected in this realm revealing benefits and potential for further research.

Abstract Surface decoration of support structures by physical vapor deposition (PVD) of small molecular building blocks offers a versatile platform to realize functional supramolecular nanofibers in a controlled manner and with tailored properties. Here, details on the preparation of surface‐decorated polyamide fabrics by PVD using N1,N3,N5‐tris[2‐(diisopropylamino)‐ethyl]‐1,3,5‐benzenetricarboxamide (1) as a molecular building block are reported. It is shown that a defined morphology with uniform nanofiber length can be achieved, which is controlled by the PVD conditions. The functional periphery of supramolecular nanofibers of 1 allows the immobilization of gold nanoparticles (AuNPs). This results in AuNP‐loaded nanostructures with a high surface area, which can be used as a heterogenous catalyst for the reduction of 4‐nitrophenol in aqueous media. The surface‐decorated support structures with firmly deposited AuNPs also provide the opportunity to conveniently reuse these structures without compromising the catalytic performance. This approach provides fabrication strategies for the controlled surface decoration of macroscopic support structures with small molecular building blocks by PVD with the potential to realize functional robust supramolecular nanofibers for various catalytic or filtration applications.