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The effect of spatial dimensionality D on the near-threshold binding of small clusters of identical particles is shown. Estimates of the threshold coupling constants for 2 and N bosons are given for D equal to 1 to 5 and the relation to conditions for the Efimov effect is discussed. Variational trial functions for 4 identical spin-½ fermions in D = 2 are given.
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Indications for TF-TAVI (transfemoral transcatheter aortic valve implantation) are rapidly changing according to increasing evidence from randomized controlled trials. Present trials document the non-inferiority or even superiority of TF-TAVI in intermediate-risk patients (STS-Score 4-8%) as well as in low-risk patients (STS-Score < 4%). However, risk scores exhibit limitations and, as a single criterion, are unable to establish an appropriate indication of TF-TAVI vs transapical TAVI vs SAVR (surgical aortic valve replacement). The ESC (European Society of Cardiology)/EACTS (European Association for Cardio-Thoracic Surgery) guidelines 2017 and the German DGK (Deutsche Gesellschaft für Kardiologie)/DGTHG (Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie) commentary 2018 offer a framework for the selection of the best therapeutic method, but the individual decision is left to the discretion of the heart teams. An interdisciplinary TAVI consensus group of interventional cardiologists of the ALKK (Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte e.V.) and cardiac surgeons has developed a detailed consensus on the indications for TF-TAVI to provide an up-to-date, evidence-based, comprehensive decision matrix for daily practice. The matrix of indication criteria includes age, risk scores, contraindications against SAVR (e.g., porcelain aorta), cardiovascular criteria pro TAVI, additional criteria pro TAVI (e.g., frailty, comorbidities, organ dysfunction), contraindications against TAVI (e.g., endocarditis) and cardiovascular criteria pro SAVR (e.g., bicuspid valve anatomy). This interdisciplinary consensus may provide orientation to heart teams for individual TAVI-indication decisions. Future adaptations according to evolving medical evidence are to be expected. Interdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI).
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Estenosis de la Válvula Aórtica/cirugía , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Consenso , Arteria Femoral , Humanos , Selección de Paciente , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension are also valid for Germany. While the guidelines contain detailed recommendations regarding pulmonary arterial hypertension (PAH), they contain only a relatively short paragraph on other, much more common forms of PH such as PH due to left heart disease. Despite the lack of data, targeted PAH treatments are increasingly being used for PH associated with left heart disease. This development is of concern because of limited ressources and the need to base treatments on scientific evidence. On the other hand, PH is a frequent problem that is highly relevant for morbidity and mortality in patients with left heart disease, representing an unmet need of targeted PH therapies. It that sense, the practical implementation of the European Guidelines in Germany requires the consideration of several specific issues and already existing novel data. This requires a detailed commentary to the guidelines, and in some aspects an update already appears necessary. In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany. This conference aimed to solve practical and controversial issues surrounding the implementation of the European Guidelines in Germany. To this end, several working groups were initiated, one of which was specifically dedicated to PH associated with left heart disease. This article summarizes the results and recommendations of this working group.
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Cardiología/normas , Hipertensión Pulmonar/terapia , Guías de Práctica Clínica como Asunto , Neumología/normas , Disfunción Ventricular Derecha/terapia , Medicina Basada en la Evidencia , Alemania , Humanos , Hipertensión Pulmonar/complicaciones , Hipertensión Pulmonar/diagnóstico , Resultado del Tratamiento , Disfunción Ventricular Derecha/diagnóstico , Disfunción Ventricular Derecha/etiologíaRESUMEN
The physisorption of N2 molecules has long been a model system of molecular adsorption. We present a low-energy electron diffraction (LEED) study of the adsorption structures and thermodynamics of monolayer N2 on Pb(1 1 1). The results indicate that the monolayer structure has a triangular incommensurate center-of-mass lattice, and that the N2-substrate interaction is weaker than that observed on other metal surfaces. The N2 monolayer undergoes a phase transition between an orientationally ordered phase (low-temperature) and an orientationally disordered phase at a temperature of 20 K. Potential energy and quasiharmonic calculations indicate that the weak N2-Pb(1 1 1) interaction is the main contributing factor for the difference in orientational order of incommensurate N2 monolayers on Pb(1 1 1) and other similar metal surfaces.
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AIM OF THE STUDY: How can 2 pseudonymised data sets be linked? Using the example of data from the Berlin Myocardial Infarction Registry and from a German sickness fund (AOK Nordost) we will demonstrate how record linkage can be achieved without personal identifiers. METHODS: In different steps the method of deterministic record linkage with indirect identifiers: age, sex, hospital admission date and time, will be explained. RESULTS: We were able to show that 80.6% of the expected maximum number of patients were matched with our approach. As a result we had no duplicate matches in the linkage process, where one AOK patient was linked to 2 or more BMIR patients or vice versa. The matching variables produced enough uniqueness to be used as indirect patient identifiers. CONCLUSION: Deterministic record linkage with the following indirect indicators: age, sex, hospital admission date and time was possible in our study of patients with myocardial infarction in a circumscribed geographical region, which limited the number of cases and avoided mismatches.
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Anonimización de la Información , Sistemas de Información en Hospital/estadística & datos numéricos , Registro Médico Coordinado/métodos , Infarto del Miocardio/epidemiología , Programas Nacionales de Salud/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Adulto , Exactitud de los Datos , Femenino , Alemania/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Almacenamiento y Recuperación de la Información/métodos , Almacenamiento y Recuperación de la Información/estadística & datos numéricos , Masculino , Uso Significativo/estadística & datos numéricos , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/terapiaAsunto(s)
Diagnóstico por Imagen , Hipertensión Pulmonar/diagnóstico , Hipertensión Pulmonar/terapia , Ecocardiografía , Humanos , Hipertensión Pulmonar/genética , Imagen por Resonancia Magnética , Imagen Multimodal , Tomografía de Emisión de Positrones , Valores de Referencia , Sensibilidad y Especificidad , Tomografía Computarizada de Emisión de Fotón Único , Tomografía Computarizada por Rayos X , Disfunción Ventricular Derecha/diagnóstico , Disfunción Ventricular Derecha/genética , Disfunción Ventricular Derecha/terapiaRESUMEN
Diffraction and one-phonon inelastic scattering of a thermal energy helium atomic beam are evaluated in the situation that the target monolayer lattice is so dilated that the atomic beam penetrates to the interlayer region between the monolayer and the substrate. The scattering is simulated by propagating a wavepacket and including the effect of a feedback of the inelastic wave onto the diffracted wave, which represents a coherent re-absorption of the created phonons. Parameters are chosen to be representative of an observed p(1 × 1) commensurate monolayer solid of H2/NaCl(001) and a conjectured p(1 × 1) commensurate monolayer solid of H2/KCl(001). For the latter, there are cases where part of the incident beam is trapped in the interlayer region for times exceeding 50 ps, depending on the spacing between the monolayer and the substrate and on the angle of incidence. The feedback effect is large for cases of strong transient trapping.
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The one-phonon inelastic low energy helium atom scattering theory is adapted to cases where the target monolayer is a p(1 × 1) commensurate square lattice. Experimental data for para-H(2)/NaCl(001) are re-analyzed and the relative intensities of energy loss peaks in the range 6 to 9 meV are determined. The case of the H(2)/NaCl(001) monolayer for 26 meV scattering energy is computationally challenging and difficult because it has a much more corrugated surface than those in the previous applications for triangular lattices. This requires a large number of coupled channels for convergence in the wave-packet-scattering calculation and a long series of Fourier amplitudes to represent the helium-target potential energy surface. A modified series is constructed in which a truncated Fourier expansion of the potential is constrained to give the exact value of the potential at some key points and which mimics the potential with fewer Fourier amplitudes. The shear horizontal phonon mode is again accessed by the helium scattering for small misalignment of the scattering plane relative to symmetry axes of the monolayer. For 1° misalignment, the calculated intensity of the longitudinal acoustic phonon mode frequently is higher than that of the shear horizontal phonon mode in contrast to what was found at scattering energies near 10 meV for triangular lattices of Ar, Kr, and Xe on Pt(111).
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It is shown that a commensurate square monolayer solid of Kr/NaCl(001) can be stabilized with a model incorporating a rather large energy corrugation amplitude. Then a square bilayer is formed under a compression and preempts the formation of an incommensurate triangular monolayer lattice. The lattice dynamics of the commensurate monolayer may be complex, because the modeling admits the possibility that it has a (2 × 2) unit cell with four Kr atoms.
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The 2009 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension (PH) have been adopted for Germany. Invasive hemodynamic data obtained by right heart catheterization are essential to confirm the diagnosis, test vasoreactivity, assess severity and guide therapy in PH patients. The definition of PH is resting on a mean pulmonary artery pressure ≥ 25 mm Hg obtained by right heart catheterization. Furthermore, a pulmonary capillary wedge pressure > 15 mm Hg excludes pre-capillary PH. Vasoreactivity testing is part of the diagnostic work-up in pulmonary arterial hypertension. Recent data on the use of inhaled iloprost update these guidelines and are of special importance due to the frequent diagnostic use of iloprost in Germany. Other aspects of invasive hemodynamic data in certain PH subgroups as well as their measurement and interpretation in children are discussed. Several aspects of right heart catheterization in PH justify a detailed commentary, and in some areas an update already appears necessary. In June 2010, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Paediatric Cardiology (DGPK) was held in Cologne, Germany. This conference aimed to solve practical and controversial issues surrounding the implementation of the European Guidelines in Germany. To this end, a number of working groups were initiated, one of which was specifically addressing the invasive hemodynamic evaluation of patients with PH. This commentary summarizes the results and recommendations of this working group.
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Medicina Basada en la Evidencia , Hemodinámica/fisiología , Hipertensión Pulmonar/diagnóstico , Administración por Inhalación , Cateterismo de Swan-Ganz , Niño , Alemania , Humanos , Hipertensión Pulmonar/fisiopatología , Iloprost , Presión Esfenoidal Pulmonar/fisiología , Resistencia Vascular/efectos de los fármacos , Resistencia Vascular/fisiología , VasodilatadoresRESUMEN
The behavior of gases physically adsorbed on graphene might be expected to be similar to that of ones adsorbed on graphite. Here, three kinds of phase transitions are examined for gases adsorbed on suspended, free-standing graphene. In one case, the quasi-two-dimensional condensation of a van der Waals fluid is evaluated, using perturbation theory. In a second case, changes are discussed for contributions to the ground state energies of monolayer solid and liquid phases of quantum adsorbates (especially He) on graphene. This includes a determination of the leading perturbation terms in the adsorption-mediated (McLachlan) dispersion energy for two adatoms on a graphene sheet. The third problem is the wetting transition of water and other fluids on graphene. In each case, the relevant energies are somewhat different from those for adsorption on graphite.
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The ordering in a higher-order-commensurate monolayer solid of Pt(111)- (3 × 3)-4 N(2), which has coexisting physisorbed and weakly chemisorbed N(2) species, is analyzed with model calculations. Density functional theory calculations are also used to evaluate properties of chemisorbed N(2) in a (2 × 2) unit cell on Pt(111). The relation of these results to the orientational ordering of N(2) on other metal surfaces is discussed.
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Conditions likely to lead to enhanced inelastic atomic scattering that creates shear horizontal (SH) and longitudinal acoustic (LA) monolayer phonons are identified, specifically examining the inelastic scattering of (4)He atoms by a monolayer solid of XePt(111) at incident energies of 2-25 meV. There is strong inelastic scattering for both dispersive phonon branches (SH and LA) of the monolayer at incident energies below 8 meV. Several improvements enable more complete wave packet calculations of the inelastic scattering than in previous work. Long propagation times are made feasible by adding an absorbing potential at large distance. The times now extend to beyond 100 ps and enable a clarification of processes involving transient trapping of the He atoms. The wave packet is made more monochromatic by significantly increasing the spatial width of the initial Gaussian shape. The narrower energy distribution in the incident beam then enables a demonstration of strong energy dependence of the scattering over a scale of less than 0.3 meV.
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Inelastic scattering of a low-energy atomic helium beam (HAS) by a physisorbed monolayer is treated in the one-phonon approximation using a time-dependent wave packet formulation. The calculations show that modes with shear horizontal polarization can be excited near high symmetry azimuths of the monolayer, in agreement with recent experiments. The parameters of the calculations are chosen to match the conditions of HAS experiments for triangular incommensurate monolayer solids of xenon, krypton, and argon adsorbed on the (111) face of platinum, and the results show many of the systematic experimental trends for relative excitation probability of the shear horizontal and longitudinal acoustic phonon branches. The inelastic scattering at beam energies near 8 meV is exceedingly sensitive to small misalignment between the scattering plane and the high symmetry directions of the monolayer solid. The diffraction and inelastic processes arise from a strong coupling of the incident atom to the target and the calculated results show large departures from expectations based on analogies to inelastic thermal neutron scattering.
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BACKGROUND: Cytogenetic studies of malignant peripheral nerve sheath tumours (MPNSTs) and malignant triton tumours (MTTs) are rare. AIMS: To undertake cytogenetic analysis of these tumours. METHODS: Conventional cytogenetic analysis of 21 MPNSTs and MTTs from 17 patients (nine with peripheral neurofibromatosis (NF1)) was carried out using standard culture and harvesting procedures. For a more precise identification of composite structural rearrangements and marker chromosomes, spectral karyotypic analysis (SKY) was applied to a subset of cases. In addition, EGFR gene copy number was assessed by fluorescence in situ hybridisation (FISH) analysis in a subset of cases. RESULTS: Cytogenetic analysis revealed predominantly complex karyotypes. SKY analysis was useful in further defining many structural anomalies. Structural aberrations most frequently involved chromosomal bands or regions 1p31-36, 4q28-35, 7p22, 11q22-23, 19q13, 20q13, and 22q11-13. Overall, loss of chromosomal material was much more common than gain. Loss of chromosomes or chromosomal regions 1p36 (48%), 3p21-pter (52%), 9p23-pter (57%), 10 (48%), 11q23-qter (48%), 16/16q24 (62%), 17(43%), and 22/22q (48%), and gains of 7/7q (29%) and 8/8q (29%) were most prominent. These gains and losses were distributed equally between MPNST and MTT, demonstrating that these entities are similar with respect to recurrent genomic imbalances. Similarly, none of the recurrent chromosomal breakpoints or imbalances was restricted to either NF1 associated or sporadic MPNSTs. FISH analysis was negative for amplification. CONCLUSIONS: These cytogenetic and molecular cytogenetic findings expand the knowledge of chromosomal alterations in MPNST and MTT, and point to possible recurring regions of interest.
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Aberraciones Cromosómicas , Neoplasias de la Vaina del Nervio/genética , Adolescente , Adulto , Anciano , Transformación Celular Neoplásica/genética , Deleción Cromosómica , Femenino , Amplificación de Genes/genética , Humanos , Hibridación Fluorescente in Situ/métodos , Cariotipificación/métodos , Masculino , Persona de Mediana Edad , Neurofibromatosis 1/genética , Rabdomiosarcoma/genética , Translocación Genética/genéticaRESUMEN
The formation of dimers in a free jet cryogenic expansion of 4He gas has been studied by measuring mole fractions as a function of source temperature and pressure using diffraction from a nanostructured transmission grating. The data sets are limited to low source pressures for which dimers and trimers are the only appreciable cluster populations in the beam. The final cluster mole fractions are corrected for residual gas attenuation in the source chamber by an extrapolation over several residual gas pressures. A set of rate equations used to model the cluster formation in a free jet expansion has been extended to include the departure of the ambient translational temperature from the isentropic-equilibrium values as the density decreases with increasing distance. The effect of collisions in restoring the equilibrium temperature is treated with a relaxation time approximation. There are distinct distance ranges where the dimer and trimer mole fractions and the ambient temperature near their asymptotic values. The present modeling reproduces the apparent threshold observed at low source pressures for the survival of dimers in the asymptotic beam. Except for these low source pressures, there are only small changes relative to results based on the isentropic temperature.
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The energy barrier for sliding of octane on Cu(111) is estimated from an experimental datum for the Brillouin-zone-center gap for translation of a monolayer solid of the octane.
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BACKGROUND: An adapted system of 'Diagnosis Related Groups' (DRG's) will be introduced for Germany at the beginning of 2003. This article focuses on the structure of the Australian DRG system (AR-DRG 4.1) regarding the diseases of the cardiovascular system and corresponding cost weights in Germany (G-DRG 1.0). METHODS: Cardiac diagnoses, procedures and cost weights (with a different base rate) were compared between the Australian and German DRG's. RESULTS: Categories and procedures for diagnostics and therapies are shown regarding coronary interventions, electrophysiological strategies including implantation of pacemakers and cardioverter/ defibrillators, hybrid treatment modalities, transcatheter closure of interatrial/-ventricular communications as well as interventions during intensive care treatment.
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Enfermedades Cardiovasculares/economía , Grupos Diagnósticos Relacionados/economía , Angioplastia Coronaria con Balón/economía , Australia , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/terapia , Ablación por Catéter/economía , Control de Costos , Costos y Análisis de Costo , Desfibriladores Implantables/economía , Tabla de Aranceles , Honorarios Médicos , Alemania , Implantación de Prótesis de Válvulas Cardíacas/economía , Costos de Hospital , Humanos , Tiempo de Internación/economía , Marcapaso Artificial/economía , Stents/economíaRESUMEN
Composite extrarenal rhabdoid tumors (CERTs) represent a diverse group of neoplasms with rhabdoid shape in combination with one of several distinctive tumor types. Like the classic renal and extrarenal malignant rhabdoid tumor (MRT), as well as the atypical teratoid/rhabdoid tumor (AT/RT) of the central nervous system, CERTs typically show aggressive clinical behavior. Deletions and mutations of the INII gene on 22q11.2 have been identified in most classic MRTs and AT/RTs; however, it is not known whether the rhabdoid components in CERTs have similar genetic abnormalities. Using fluorescence in situ hybridization (FISH) on archival, paraffin-embedded tissue with a commercially available probe in close proximity to the INII locus (bcr), as well as other chromosome 22 probes, we studied 4 cases of MRT, 13 of AT/RT, and 16 of CERT (3 melanoma, 4 meningioma, 7 carcinoma, 1 rhabdomyosarcoma, and 1 neuroblastoma). Deletion of the 22q11.2 locus was demonstrated in 10 (77%) of 13 AT/RTs and 3 (75%) of 4 MRT, including 1 congenital MRT. Of the 16 CERTs, only 2 (a rhabdoid meningioma and a carcinoma with rhabdoid features; 13%) harbored a deletion at this locus. This difference was statistically significant (P <.001). We conclude that deletion of 22q11.2, typical of most classic MRTs and AT/RTs, is infrequently seen in CERTs. This suggests that the rhabdoid component of CERTs does not evolve by way of the genetic alteration characteristic of MRTs or AT/RTs, but represents instead a distinct phenotype shared by a number of tumors as they undergo anaplastic progression.