Predicting concurrent structural mechanical mechanisms during microstructure evolution.

The interdependence between structural mechanics and microstructure solidification has been widely observed experimentally as a factor leading to undesirable macroscopic properties and casting defects. Despite this, numerical modelling of microstructure solidification often neglects this interaction and is therefore unable to predict key mechanisms such as the development of misoriented grains. This paper presents a numerical method coupling a finite volume structural mechanics solver to a cellular automata solidification solver, where gravity or pressure-driven displacements alter the local orientation and thereby growth behaviour of the solidifying dendrites. Solutions obtained using this model are presented which show fundamental behaviours observed in experiments. The results show that small, localized deformations can lead to significant changes in the crystallographic orientation of a dendrite and ultimately affect the overall microstructure development. This article is part of the theme issue 'Transport phenomena in complex systems (part 2)'.

Disability Improvement Is Associated with Less Brain Atrophy Development in Multiple Sclerosis.

BACKGROUND AND PURPOSE: It is unknown whether deceleration of brain atrophy is associated with disability improvement in patients with MS. Our aim was to investigate whether patients with MS with disability improvement develop less brain atrophy compared with those who progress in disability or remain stable. MATERIALS AND METHODS: We followed 980 patients with MS for a mean of 4.8 ± 2.4 years. Subjects were divided into 3 groups: progress in disability (n = 241, 24.6%), disability improvement (n = 101, 10.3%), and stable (n = 638, 65.1%) at follow-up. Disability improvement and progress in disability were defined on the basis of the Expanded Disability Status Scale score change using standardized guidelines. Stable was defined as nonoccurrence of progress in disability or disability improvement. Normalized whole-brain volume was calculated using SIENAX on 3D T1WI, whereas the lateral ventricle was measured using NeuroSTREAM on 2D-T2-FLAIR images. The percentage brain volume change and percentage lateral ventricle volume change were calculated using SIENA and NeuroSTREAM, respectively. Differences among groups were investigated using ANCOVA, adjusted for age at first MR imaging, race, T2 lesion volume, and corresponding baseline structural volume and the Expanded Disability Status Scale. RESULTS: At first MR imaging, there were no differences among progress in disability, disability improvement, and the stable groups in whole-brain volume (P = .71) or lateral ventricle volume (P = .74). During follow-up, patients with disability improvement had the lowest annualized percentage lateral ventricle volume change (1.6% ± 2.7%) followed by patients who were stable (2.1% ± 3.7%) and had progress in disability (4.1% ± 5.5%), respectively (P < .001). The annualized percentage brain volume change values were -0.7% ± 0.7% for disability improvement, -0.8% ± 0.7% for stable, and -1.1% ± 1.1% for progress in disability (P = .001). CONCLUSIONS: Patients with MS who improve in their clinical disability develop less brain atrophy across time compared with those who progress.

Ab initio simulations of complementary K-edges and solvatization effects for detection of proton transfer in aqueous 2-thiopyridone.

The nitrogen and sulfur K-edge X-ray absorption spectra of aqueous 2-thiopyridone, a model system for excited-state proton transfer in several recent time-resolved measurements, have been simulated from ab initio molecular dynamics. Spectral signatures of the local intra- and inter-molecular structure are identified and rationalized, which facilitates experimental interpretation and optimization. In particular, comparison of aqueous and gas phase spectrum simulations assesses the previously unquantified solvatization effects, where hydrogen bonding is found to yield solvatochromatic shifts up to nearly 1 eV of the main peak positions. Thereby, while each K-edge can still decisively determine the local protonation of its core-excited site, only their combined, complementary fingerprints allow separating all of the three relevant molecular forms, giving a complete picture of the proton transfer.

Thermal dependence of large-scale freckle defect formation.

The fundamental mechanisms governing macroscopic freckle defect formation during directional solidification are studied experimentally in a Hele-Shaw cell for a low-melting point Ga-25 wt.% In alloy and modelled numerically in three dimensions using a microscopic parallelized Cellular Automata Lattice Boltzmann Method. The size and distribution of freckles (long solute channels, or chimneys) are shown to be strongly dependent on the thermal profile of the casting, with flat, concave and convex isotherms being considered. For the flat isotherm case, no large-scale freckles form, while for concave or convex isotherms, large freckles appear but in different locations. The freckle formation mechanism is as expected buoyancy-driven, but the chimney stability, its long-term endurance and its location are shown to depend critically on the detailed convective transport through the inter-dendritic region. Flow is generated by curved isopleths of solute concentration. As solute density is different from that of the bulk fluid, gravity causes 'uphill' or 'downhill' lateral flow from the sample centre to the edges through the mush, feeding the freckle. An excellent agreement is obtained between the numerical model and real-time X-ray observations of a solidifying sample under strictly controlled temperature conditions. This article is part of the theme issue 'Heterogeneous materials: metastable and non-ergodic internal structures'.

Infectious exposure, antibiotic use, and multiple sclerosis: A population-based incident case-control study.

BACKGROUND: The existing reports regarding the potential role of infections as well as antibiotic use in multiple sclerosis (MS) etiology are inconclusive. OBJECTIVES: We aimed to investigate the association of viral infections as well as antibiotic use and the risk of developing MS. MATERIALS & METHODS: This was a population-based incident case-control study of 547 incident cases and 1057 general population controls obtained from 22 municipality areas of Tehran (7/8/2013-17/2/2015). Multiple logistic regression models were used to determine the adjusted associations. RESULTS: Overall antibiotic use for ≥14 days during 3 years before the index date, significantly decreased the odds of MS OR 0.69 (95%CI: 0.53-0.91, P = .008). The results were consistent for different types of antibiotics, including penicillin OR 0.50 (95%CI: 0.34-0.75, P = .001) and cephalosporins OR 0.25 (95%CI: 0.12-0.50, P < .001). History of IM was associated with a more than 5fold increased risk of MS OR = 5.7 (95%CI, 1.28-25.37). There was no statistically significant association between any other single or cumulative number of viral infections with subsequent risk of MS (P > .05). CONCLUSIONS: Considering the possibility of reverse causation, the results of this large case-control study suggest that use of antibiotics may be associated with a decreased risk of MS. However, viral disease other than infectious mononucleosis was not associated with MS risk.

Exploratory study on the presence of GM oilseed rape near German oil mills.

Seed losses from imported oilseed rape (OSR) and the genetically modified (GM) admixtures therein may potentially lead to the establishment of transgenic plants and their hybridization with wild crucifers. The post-market environmental monitoring (PMEM) must therefore also address problems related to seed spillages of GM OSR. Since detailed information on imported commodity flows, GM contents, means of transport, downstream users and efficient containment of GM OSR was lacking, we performed a field study in the vicinity of large oil mills and seed processing industries at the harbours along the river Rhine. One hundred thirty-six composite samples taken from one to 20 plants per site were collected near roads, railways and waterways. Individuals or large groups of feral OSR plants were detected in all of the nine study areas, but only one plant out of 1918 tested was confirmed to be transgenic (GT73). The results suggest that a spread of herbicide tolerant GM OSR has not occurred to date. In order to confirm the absence of GM feral OSR and potentially adverse effects of GM plants in the future, we recommend monitoring feral OSR on a routine basis. We present an approach for the sampling and testing of feral OSR that is based on floristic mapping and rapid tests for the determination of herbicide tolerances.

Pan-atlantic analysis of the overlap of a highly migratory species, the leatherback turtle, with pelagic longline fisheries.

Large oceanic migrants play important roles in ecosystems, yet many species are of conservation concern as a result of anthropogenic threats, of which incidental capture by fisheries is frequently identified. The last large populations of the leatherback turtle, Dermochelys coriacea, occur in the Atlantic Ocean, but interactions with industrial fisheries could jeopardize recent positive population trends, making bycatch mitigation a priority. Here, we perform the first pan-Atlantic analysis of spatio-temporal distribution of the leatherback turtle and ascertain overlap with longline fishing effort. Data suggest that the Atlantic probably consists of two regional management units: northern and southern (the latter including turtles breeding in South Africa). Although turtles and fisheries show highly diverse distributions, we highlight nine areas of high susceptibility to potential bycatch (four in the northern Atlantic and five in the southern/equatorial Atlantic) that are worthy of further targeted investigation and mitigation. These are reinforced by reports of leatherback bycatch at eight of these sites. International collaborative efforts are needed, especially from nations hosting regions where susceptibility to bycatch is likely to be high within their exclusive economic zone (northern Atlantic: Cape Verde, Gambia, Guinea Bissau, Mauritania, Senegal, Spain, USA and Western Sahara; southern Atlantic: Angola, Brazil, Namibia and UK) and from nations fishing in these high-susceptibility areas, including those located in international waters.

Structure-function relationship of the foam-like pomelo peel (Citrus maxima)-an inspiration for the development of biomimetic damping materials with high energy dissipation.

The mechanical properties of artificial foams are mainly determined by the choice of bulk materials and relative density. In natural foams, in contrast, variation to optimize properties is achieved by structural optimization rather than by conscious substitution of bulk materials. Pomelos (Citrus maxima) have a thick foam-like peel which is capable of dissipating considerable amounts of kinetic energy and thus this fruit represents an ideal role model for the development of biomimetic impact damping structures. This paper focuses on the analysis of the biomechanics of the pomelo peel and on its structure-function relationship. It deals with the determination of the onset strain of densification of this foam-like tissue and on how this property is influenced by the arrangement of vascular bundles. It was found here that the vascular bundles branch in a very regular manner-every 16.5% of the radial peel thickness-and that the surrounding peel tissue (pericarp) attains its exceptional thickness mainly by the expansion of existing interconnected cells causing an increasing volume of the intercellular space, rather than by cell division. These findings lead to the discussion of the pomelo peel as an inspiration for fibre-reinforced cast metallic foams with the capacity for excellent energy dissipation.

Two-dimensional ultrasound Doppler velocimeter for flow mapping of unsteady liquid metal flows.

We present a novel pulsed-wave ultrasound Doppler system for fluid flow investigations being able to determine two-dimensional vector fields of flow velocities. Electromagnetically-driven liquid metal flows appear as an attractive application field for such a measurement system. Two linear ultrasound transducer arrays each equipped with 25 transducer elements are used to measure the flow field in a square plane of 67×67 mm(2). The application of advanced processing methods as a multi-beam operation, an interlaced echo signal acquisition and a segmental array technique enable high data acquisition rates and concurrently a high spatial resolution, which have not been obtained so far for flow measurements in liquid metals. The extended pulsing strategy and essential operation principles such as the multiplexing electronic concept will be presented within this paper. The capabilities of the measuring system make it suitable for investigations of non-transparent, turbulent flows. Here, we present measurements of liquid metal flows driven by a rotating magnetic field for demonstration purposes. The measuring setup realized here reveals details of the swirling fluid motion in a horizontal section of a cube. Frame acquisition rates up to 30 fps were achieved for a complete two-dimensional flow mapping.

Self-esteem among German nurses: does academic education make a difference?

Self-esteem is not typically associated with the nursing profession. However, the concept is indispensible for job satisfaction and good-quality patient care. Many healthcare systems are confronted with declining numbers of qualified nurses, and desperately seek suitable strategies to recruit and retain sufficient trainees and junior staff. This investigation examined self-esteem in 212 German nurses using the Rosenberg Self-Esteem Scale. Nurses with an academic degree displayed a statistically significant higher level of self-esteem than nurses without academic education (P < 0.01). The type of professional training may therefore have a direct effect on the self-esteem, thus offering a myriad of potential benefits to both nurses and patients. Self-esteem is a quality relevant to this profession and, as such, the findings of research in this area should be reflected in the design of nurse training curricula.

[Expert consensus statement on interventional renal sympathetic denervation for hypertension treatment]. / Interventionelle renale Sympathikusdenervation zur Behandlung der therapieresistenten Hypertonie.

This commentary summarizes the expert consensus and recommendations of the working group 'Herz und Niere' of the German Society of Cardiology (DGK), the German Society of Nephrology (DGfN) and the German Hypertension League (DHL) on renal denervation for antihypertensive treatment. Renal denervation is a new, interventional approach to selectively denervate renal afferent and efferent sympathetic fibers. Renal denervation has been demonstrated to reduce office systolic and diastolic blood pressure in patients with resistant hypertension, defined as systolic office blood pressure ≥ 160 mm Hg and ≥ 150 mm Hg in patients with diabetes type 2, which should currently be used as blood pressure thresholds for undergoing the procedure. Exclusion of secondary hypertension causes and optimized antihypertensive drug treatment is mandatory in every patient with resistant hypertension. In order to exclude pseudoresistance, 24-hour blood pressure measurements should be performed. Preserved renal function was an inclusion criterion in the Symplicity studies, therefore, renal denervation should be only considered in patients with a glomerular filtration rate > 45 ml/min. Adequate centre qualification in both, treatment of hypertension and interventional expertise are essential to ensure correct patient selection and procedural safety. Long-term follow-up after renal denervation and participation in the German Renal Denervation (GREAT) Registry are recommended to assess safety and efficacy after renal denervation over time.

[Epidural spinal cord stimulation for therapy of chronic pain. Summary of the S3 guidelines]. / Epidurale Rückenmarkstimulation zur Therapie chronischer Schmerzen. Zusammenfassung der S3-Leitlinie.

Epidural spinal cord stimulation (SCS) is a reversible but invasive procedure which should be used for neuropathic pain, e.g. complex regional pain syndrome I (CRPS) and for mostly chronic radiculopathy in connection with failed back surgery syndrome following unsuccessful conservative therapy. Epidural SCS can also successfully be used after exclusion of curative procedures and conservative therapy attempts for vascular-linked pain, such as in peripheral arterial occlusive disease stages II and III according to Fontaine and refractory angina pectoris. Clinical practice has shown which clinical symptoms cannot be successfully treated by epidural SCS, e.g. pain in complete paraplegia syndrome or atrophy/injury of the sensory pathways of the spinal cord or cancer pain. A decisive factor is a critical patient selection as well as the diagnosis. Epidural SCS should always be used within an interdisciplinary multimodal therapy concept. Implementation should only be carried out in experienced therapy centers which are in a position to deal with potential complications.

[Validation of continuous blood pressure measurements by pulse transit time: a comparison with invasive measurements in a cardiac intensive care unit]. / Validierung der kontinuierlichen nicht-invasiven Blutdruckmessung mittels Puls-Transit-Zeit: Ein Vergleich mit der invasiven Blutdruckmessung bei Patienten einer kardiologischen Intensivstation.

BACKGROUND AND OBJECTIVE: Arterial blood pressure measured by pulse transit time (PTT) can be used as an alternative to the gold standard of invasive measurement. It was the aim of this study to compare these two methods in order to validate PTT in patients with cardiac diseases. PATIENTS AND METHODS: In 40 patients (29 males; mean age 68.7 ± 15 years) in a cardiac intensive care unit, blood pressures were continuously measured by PTT and the standardized invasive method for one hour. Values were analysed and compared in 30-second intervals (9,600 values for each method). RESULTS: Blood pressures obtained with either method were not statistically different, neither in the whole group nor in subgroups. However, the number of analysable data was significantly higher using the invasive method, by which appropriate signals were obtained in 99.2 % of systolic and in 99.1 % of diastolic blood pressure measurements. In contrast, using the PTT-method, appropriate signals were seen in 85.8 % of systolic and 85.9 % of diastolic pressure measurements. CONCLUSION: Blood pressures measured by PTT in patients in cardiac intensive care units provide reliable values over a period of at least one hour. However, the PTT method seems to be more susceptible to errors as evidenced by the number of failed measurements.

Carbon and water fluxes from ponderosa pine forests disturbed by wildfire and thinning.

Disturbances alter ecosystem carbon dynamics, often by reducing carbon uptake and stocks. We compared the impact of two types of disturbances that represent the most likely future conditions of currently dense ponderosa pine forests of the southwestern United States: (1) high-intensity fire and (2) thinning, designed to reduce fire intensity. High-severity fire had a larger impact on ecosystem carbon uptake and storage than thinning. Total ecosystem carbon was 42% lower at the intensely burned site, 10 years after burning, than at the undisturbed site. Eddy covariance measurements over two years showed that the burned site was a net annual source of carbon to the atmosphere whereas the undisturbed site was a sink. Net primary production (NPP), evapotranspiration (ET), and water use efficiency were lower at the burned site than at the undisturbed site. In contrast, thinning decreased total ecosystem carbon by 18%, and changed the site from a carbon sink to a source in the first posttreatment year. Thinning also decreased ET, reduced the limitation of drought on carbon uptake during summer, and did not change water use efficiency. Both disturbances reduced ecosystem carbon uptake by decreasing gross primary production (55% by burning, 30% by thinning) more than total ecosystem respiration (TER; 33-47% by burning, 18% by thinning), and increased the contribution of soil carbon dioxide efflux to TER. The relationship between TER and temperature was not affected by either disturbance. Efforts to accurately estimate regional carbon budgets should consider impacts on carbon dynamics of both large disturbances, such as high-intensity fire, and the partial disturbance of thinning that is often used to prevent intense burning. Our results show that thinned forests of ponderosa pine in the southwestern United States are a desirable alternative to intensively burned forests to maintain carbon stocks and primary production.

[Effectiveness and relevance of laser trabeculoplasty: treatment of open-angle glaucoma]. / Effektivität und Stellenwert der Lasertrabekuloplastik : Behandlung von Offenwinkelglaukomen.

Laser trabeculoplasty is a common glaucoma therapy that is safe and effective for reducing intraocular pressure. It was developed as a treatment for open-angle glaucoma in the 1970s, and larger studies proved its effectiveness in the years that followed. In recent years, through the implementation of newer processes such as selective laser trabeculoplasty, laser trabeculoplasty has experienced further developments. Because it causes less damage to the trabecular meshwork, it should have fewer adverse effects, making it a repeatable treatment. Studies on the indications, contraindications, and effectiveness of this method in lowering intraocular pressure are reviewed.

[Laser trabeculoplasty: therapeutic options and adverse effects]. / Behandlungsmethoden und Komplikationen der Lasertrabekuloplastik.

Laser trabeculoplasty is a simple method for treating glaucoma and ocular hypertension and has few adverse effects. There are different laser systems for reducing the intraocular pressure of patients with glaucoma and ocular hypertension. Complications include transient intraocular pressure elevation, iritis, and anterior synechiae.

[Available laser systems and mechanism of action in laser trabeculoplasty]. / Verfügbare Lasersysteme und Wirkprinzip der Lasertrabekuloplastik.

Intraocular pressure-lowering laser procedures such as argon laser trabeculoplasty and selective laser trabeculoplasty are nowadays an essential part of glaucoma therapy. This article presents the currently most popular laser systems. These various laser procedures are based on the physical structure of the different lasers and on variable generation of laser light. They vary in their effect on the trabecular meshwork on a histopathological level, as well as in the active principles of intraocular pressure reduction. The mechanical, biological, and repopulation theories are currently used to explain the intraocular pressure-lowering effect of the different laser systems; these are discussed in detail.