[Hemorrhage of the innominate artery during percutaneous dilatation tracheotomy]. / Blutung des Truncus brachiocephalicus während perkutaner Dilatationstracheotomie.

The report describes the rare case of a periprocedural hemorrhage during percutaneous dilatation tracheotomy. In the final analysis, the innominate artery could be identified as the source of the hemorrhage. Particular attention must be paid to preprocedural evaluation of the puncture site and the procedure following unexpected hemorrhage. Continuation of the percutaneous tracheotomy, with only a clinical suspicion of a vascular injury while the bleeding source remained undetectable, seemed to be the most reasonable option. In this case the potentially life-threatening hemorrhage could be stopped and the elective treatment was completed. Therefore, because palpation of the neck cannot exclude life-threatening vascular aberrations with certainty, a preprocedural ultrasound examination of the anatomical features should be performed before carrying out a dilatation tracheotomy.

Decisions in motion: vestibular contributions to saccadic target selection.

The natural world continuously presents us with many opportunities for action, and thus a process of target selection must precede action execution. While there has been considerable progress in understanding target selection in stationary environments, little is known about target selection when we are in motion. Here we investigated the effect of self-motion signals on saccadic target selection in a dynamic environment. Human subjects were sinusoidally translated (f = 0.6 Hz, 30-cm peak-to-peak displacement) along an interaural axis with a vestibular sled. During the motion two visual targets were presented asynchronously but equidistantly on either side of fixation. Subjects had to look at one of these targets as quickly as possible. With an adaptive approach, the time delay between these targets was adjusted until the subject selected both targets equally often. We determined this balanced time delay for different phases of the motion in order to distinguish the effects of body acceleration and velocity on saccadic target selection. Results show that acceleration (or position, as these are indistinguishable during sinusoidal motion), but not velocity, affects target selection for saccades. Subjects preferred to look at targets in the direction of the acceleration-the leftward target was preferred when the sled accelerated to the left, and vice versa. Saccadic reaction times mimicked this selection bias by being reliably shorter to targets in the direction of acceleration. Our results provide evidence that saccade target selection mechanisms are modulated by self-motion signals, which could be derived directly from the otolith system.

Domestic Violence During the Corona Pandemic: A Comparison of Pre-Pandemic and Pandemic Incidents of Domestic Violence in the Netherlands.

There is a widespread fear that the measures as a consequence of the worldwide corona pandemic have led to a significant increase in domestic violence and child abuse. The current study uses criminal files from all incidents of domestic violence that were reported to the police in a relatively large city in the Netherlands during 3.5 months before the pandemic and the first 3.5 months from the start of the nationwide shutdown, to compare the characteristics of the incident, the suspect and victim, how the case was handled and the involvement of minors. Results show that levels of domestic violence during the Covid-19-related restrictions did not increase compared to before the pandemic. During the pandemic, suspects were relatively more often men, the violence was less often reciprocal, more often took place inside the homes of suspects and victims, and was more often reported to the police by a witness than before the pandemic. Before and during the pandemic, minors were involved in respectively 34% and 43% of the incidents, mainly as witnesses of the violence between their parents. The results of the study may ease the concerns about the potential threat of domestic violence levels going through the roof during isolating measures such as during a shutdown. Limitations of the study are that official data from a single, but large, city were used and that we were not able to control for seasonal effects.

Cooperative regulation of AJM-1 controls junctional integrity in Caenorhabditis elegans epithelia.

The function of epithelial cell sheets depends on the integrity of specialized cell-cell junctions that connect neighbouring cells. We have characterized the novel coiled-coil protein AJM-1, which localizes to an apical junctional domain of Caenorhabditis elegans epithelia basal to the HMR-HMP (cadherin-catenin) complex. In the absence of AJM-1, the integrity of this domain is compromised. Proper AJM-1 localization requires LET-413 and DLG-1, homologues of the Drosophila tumour suppressors Scribble and Discs large, respectively. DLG-1 physically interacts with AJM-1 and is required for its normal apical distribution, and LET-413 mediates the rapid accumulation of both DLG-1 and AJM-1 in the apical domain. In the absence of both dlg-1 and let-413 function AJM-1 is almost completely lost from apical junctions in embryos, whereas HMP-1 (alpha-catenin) localization is only mildly affected. We conclude that LET-413 and DLG-1 cooperatively control AJM-1 localization and that AJM-1 controls the integrity of a distinct apical junctional domain in C. elegans.

Synthesis, functionalisation and post-synthetic modification of bismuth metal-organic frameworks.

Two new bismuth metal-organic frameworks (Bi-MOFs) were discovered using high throughput experiments employing bismuth(iii) nitrate pentahydrate and triazine-2,4,6-triyl-tribenzoic acid (H3TATB). The reaction was carried out for long reaction times (∼5 d) in a water/DMF-mixture and resulted in the formation of [Bi2(O)(OH)(TATB)]·H2O (denoted as CAU-35). By switching to short reaction times and a methanol/DMF-mixture as the solvent, an analogue of CAU-7-BTB with the composition [Bi(TATB)]·DMF·6H2O (denoted as CAU-7-TATB) was obtained. The use of the amino-functionalised H3TATB linker (H3TATB-NH2) resulted in the formation of a functionalised porous Bi-MOF with the composition [Bi(TATB-NH2)]·5H2O·0.5DMF (CAU-7-TATB-NH2). The structures of CAU-35 and CAU-7-TATB were successfully solved and refined from the PXRD data. CAU-7-TATB-NH2 was post-synthetically modified using anhydrides (acetic anhydride and valeric anhydride), cyclic anhydrides (succinic anhydride and phthalic anhydride), and 1,3-propane sultone. The degree of conversion ranged from 33% to 79%.

A multi-purpose reaction cell for the investigation of reactions under solvothermal conditions.

A new versatile and easy-to-use remote-controlled reactor setup aimed at the analysis of chemical reactions under solvothermal conditions has been constructed. The reactor includes a heating system that can precisely control the temperature inside the reaction vessels in a range between ambient temperature and 180 °C. As reaction vessels, two sizes of commercially available borosilicate vessels (Vmax = 5 and 11 ml) can be used. The setup furthermore includes the option of stirring and injecting of up to two liquid additives or one solid during the reaction to initiate very fast reactions, quench reactions, or alter chemical parameters. In addition to a detailed description of the general setup and its functionality, three examples of studies conducted using this setup are presented.

Hydrogen retention in beryllium: concentration effect and nanocrystalline growth.

We herein report on the formation of BeD2 nanocrystalline domes on the surface of a beryllium sample exposed to energetic deuterium ions. A polycrystalline beryllium sample was exposed to D ions at 2 keV/atom leading to laterally averaged deuterium areal densities up to 3.5 10(17) D cm(-2), and studied using nuclear reaction analysis, Raman microscopy, atomic force microscopy, optical microscopy and quantum calculations. Incorporating D in beryllium generates a tensile stress that reaches a plateau at ≈1.5 10(17) D cm(-2). For values higher than 2.0 10(17) cm(-2), we observed the growth of ≈90 nm high dendrites, covering up to 10% of the surface in some zones of the sample when the deuterium concentration was 3 × 10(17) D cm(-2). These dendrites are composed of crystalline BeD2, as evidenced by Raman microscopy and quantum calculations. They are candidates to explain low temperature thermal desorption spectroscopy peaks observed when bombarding Be samples with D ions with fluencies higher than 1.2 10(17) D cm(-2).

[Kirlian photography: accidental or person-specific pattern?]. / Kirlian-Fotografie: Zufälliges oder personenspezifisches Entladungsmuster?

OBJECTIVE: Is the corona electrography of Kirlian photography an accidental pattern or an individual specific discharge pattern? PATIENTS: 30 patients of the Stauferklinik Schwäbisch Gmünd, suffering from a great variety of diseases. STUDY DESIGN: At intervals of 10-15 min 10 Kirlian photos each of all fingers and toes were taken from each patient. Out of this material, from 8 patients 4 Kirlian photos each with evident similarity of the discharge radiographs of 3 fingers were selected. These images were scanned for mathematical procedures, and heuristic measurements of the histograms were evaluated by a genetic algorithm. RESULTS: Three pattern groups showed different heuristic measurements: accidental pattern 0.28 +/- 0.01, Kirlian pattern in general 0.3 +/- 0.02, and Kirlian pattern of the same person 0.44 +/- 0.05. CONCLUSIONS: The mathematical objectivation of the Kirlian photographs confirm the visual impression of strong similarity. Because of the lack of anatomical irregularities and since, due to new positioning, physical and chemical surface characteristics were changed in the single Kirlian photographs, the identification of the basic pattern stresses the existence of an individual discharge pattern and thus of an individual electromagnetic field.

Reconstructive surgery after burns: a 10-year follow-up study.

BACKGROUND: There is minimal insight into the prevalence of reconstructive surgery after burns. The objective of this study was to analyse the prevalence, predictors, indications, techniques and medical costs of reconstructive surgery after burns. METHODS: A retrospective cohort study was conducted in the three Dutch burn centres. Patients with acute burns, admitted from January 1998 until December 2001, were included. Data on patient and injury characteristics and reconstructive surgery details were collected in a 10-year follow-up period. RESULTS: In 13.0% (n=229/1768) of the patients with burns, reconstructive surgery was performed during the 10-year follow-up period. Mean number of reconstructive procedure per patient were 3.6 (range 1-25). Frequently reconstructed locations were hands and head/neck. The most important indication was scar contracture and the most applied technique was release plus random flaps/skin grafting. Mean medical costs of reconstructive surgery per patient over 10-years were €8342. CONCLUSIONS: With this study we elucidated the reconstructive needs of patients after burns. The data presented can be used as reference in future studies that aim to improve scar quality of burns and decrease the need for reconstructive surgery.

Dynamic changes in CD4+ CD25+(high) T cell apoptosis after the diagnosis of type 1 diabetes.

Because type 1 diabetes (T1D) is a chronic, autoimmune, T cell-mediated disease, interventions affecting T cells are expected to modulate the immune cascade and lead to disease remission. We propose that increased CD4(+) CD25(+high) T cell apoptosis, a trait we discovered in recent-onset T1D subjects, reflects T1D partial remission within the first 6 months after diagnosis. Apoptosis of forkhead box P3 (FoxP3)(+) CD4(+) CD25(+high) T cells, in addition to total daily doses of insulin (TDD), blood glucose, HbA1c and age, were measured in 45 subjects with T1D at various times after diagnosis. Sixteen healthy control subjects were also recruited to the study. Higher CD4(+) CD25(+high) T cell apoptosis levels were detected within the first 6 months of diagnosis (odds ratio = 1.39, P = 0.009), after adjustment for age, TDD and HbA1c. A proportional hazards model confirmed that the decline of apoptosis after diagnosis of T1D was related significantly to survival time (hazards ratio = 1.08, P = 0.014), with TDD and age also contributing to survival. During this time there was an inverse relationship between CD4(+) CD25(+high) T cell apoptosis with TDD (r = -0.39, P = 0.008). The CD4(+) CD25(+high) T cell apoptosis levels decline significantly after the first 6 months from diagnosis of T1D and may help in the close monitoring of autoimmunity. In parallel, there is an increase in TDD during this time. We also propose that CD4(+) CD25(+high) T cell apoptosis assay can be used to gauge the efficacy of the several immune tolerance induction protocols, now under way.

Laparoscopic treatment of colonic perforations related to colonoscopy.

BACKGROUND: Colonic perforations associated with colonoscopy are rare but major complications. Conservative treatment is less invasive than major surgery, but any case of failure leads to more extensive surgical procedures with a higher morbidity and mortality than the immediate operative repair. To reduce the invasiveness of major surgery and avoid the risk of failure, we introduced laparoscopic techniques to deal with iatrogenic colonic perforations. METHODS: Each colonic perforation was identified by diagnostic laparoscopy. The perforation was then characterized by size and extent of thermal damage into one of three types, followed by type-dependent treatment (suture, tangential resection, segmental resection, or open procedure). Operative time, complications, clinical outcome, and patient satisfaction were recorded. RESULTS: Seven patients underwent diagnostic laparoscopy for colonic perforations. Laparoscopic treatment was performed on five patients (one simple closure by suture, three tangential resections, and one segmental resection). Two cases required open procedures. There was one intraoperative complication that necessitated conversion. There were no postoperative complications. All laparoscopically treated patients were satisfied with their clinical outcome and cosmetic results. CONCLUSIONS: Laparoscopic treatment seems to reduce the invasiveness and morbidity of major surgery. At the same time, it is more definitive than conservative treatment, so that we now prefer to use laparoscopic techniques to treat colonic perforations related to colonoscopy.