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    Phylogenomic analysis of Apoidea sheds new light on the sister group of bees 

    Sann, Manuela; Niehuis, Oliver; Peters, Ralph S; Mayer, Christoph; Kozlov, Alexey; Podsiadlowski, Lars; Bank, Sarah; Meusemann, Karen; Misof, Bernhard; Bleidorn, Christoph; et al.
    Ohl, Michael
    2018; 18(1): Art. 71
    Abstract Background Apoid wasps and bees (Apoidea) are an ecologically and morphologically diverse group of Hymenoptera, with some species of bees having evolved eusocial societies. Major problems for our understanding of the evolutionary history of Apoidea have been the difficulty to trace the phylogenetic origin and to reliably estimate the geological age of bees. To address these issues, we compiled a comprehensive phylogenomic dataset by simultaneously analyzing target DNA enrichment and transcriptomic sequence data, comprising 195 single-copy protein-coding genes and covering all major lineages of apoid wasps and bee families. Results Our compiled data matrix comprised 284,607 nucleotide sites that we phylogenetically analyzed by applying a combination of domain- and codon-based partitioning schemes. The inferred results confirm the polyphyletic status of the former family “Crabronidae”, which comprises nine major monophyletic lineages. We found the former subfamily Pemphredoninae to be polyphyletic, comprising three distantly related clades. One of them, Ammoplanina, constituted the sister group of bees in all our analyses. We estimate the origin of bees to be in the Early Cretaceous (ca. 128 million years ago), a time period during which angiosperms rapidly radiated. Finally, our phylogenetic analyses revealed that within the Apoidea, (eu)social societies evolved exclusively in a single clade that comprises pemphredonine and philanthine wasps as well as bees. Conclusion By combining transcriptomic sequences with those obtained via target DNA enrichment, we were able to include an unprecedented large number of apoid wasps in a phylogenetic study for tracing the phylogenetic origin of bees. Our results confirm the polyphyletic nature of the former wasp family Crabonidae, which we here suggest splitting into eight families. Of these, the family Ammoplanidae possibly represents the extant sister lineage of bees. Species of Ammoplanidae are known to hunt thrips, of which some aggregate on flowers and feed on pollen. The specific biology of Ammoplanidae as predators indicates how the transition from a predatory to pollen-collecting life style could have taken place in the evolution of bees. This insight plus the finding that (eu)social societies evolved exclusively in a single subordinated lineage of apoid wasps provides new perspectives for future comparative studies.
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    High-frequency oscillatory ventilation guided by transpulmonary pressure in acute respiratory syndrome: an experimental study in pigs 

    Klapsing, Philipp; Moerer, Onnen; Wende, Christoph; Herrmann, Peter; Quintel, Michael; Bleckmann, Annalen; Heuer, Jan F
    2018; 22(1): Art. 121
    Abstract Background Recent clinical studies have not shown an overall benefit of high-frequency oscillatory ventilation (HFOV), possibly due to injurious or non-individualized HFOV settings. We compared conventional HFOV (HFOVcon) settings with HFOV settings based on mean transpulmonary pressures (PLmean) in an animal model of experimental acute respiratory distress syndrome (ARDS). Methods ARDS was induced in eight pigs by intrabronchial installation of hydrochloric acid (0.1 N, pH 1.1; 2.5 ml/kg body weight). The animals were initially ventilated in volume-controlled mode with low tidal volumes (6 ml kg− 1) at three positive end-expiratory pressure (PEEP) levels (5, 10, 20 cmH2O) followed by HFOVcon and then HFOV PLmean each at PEEP 10 and 20. The continuous distending pressure (CDP) during HFOVcon was set at mean airway pressure plus 5 cmH2O. For HFOV PLmean it was set at mean PL plus 5 cmH2O. Baseline measurements were obtained before and after induction of ARDS under volume controlled ventilation with PEEP 5. The same measurements and computer tomography of the thorax were then performed under all ventilatory regimens at PEEP 10 and 20. Results Cardiac output, stroke volume, mean arterial pressure and intrathoracic blood volume index were significantly higher during HFOV PLmean than during HFOVcon at PEEP 20. Lung density, total lung volume, and normally and poorly aerated lung areas were significantly greater during HFOVcon, while there was less over-aerated lung tissue in HFOV PLmean. The groups did not differ in oxygenation or extravascular lung water index. Conclusion HFOV PLmean is associated with less hemodynamic compromise and less pulmonary overdistension than HFOVcon. Despite the increase in non-ventilated lung areas, oxygenation improved with both regimens. An individualized approach with HFOV settings based on transpulmonary pressure could be a useful ventilatory strategy in patients with ARDS. Providing alveolar stabilization with HFOV while avoiding harmful distending pressures and pulmonary overdistension might be a key in the context of ventilator-induced lung injury.
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    Locum physicians’ professional ethos: a qualitative interview study from Germany 

    Salloch, Sabine; Apitzsch, Birgit; Wilkesmann, Maximiliane; Ruiner, Caroline
    2018; 18(1): Art. 333
    Abstract Background In contrast to other countries, the appearance of locum physicians as independent contractors constitutes a rather new phenomenon in the German health care system and emerged out of a growing economization and shortage of medical staff in the hospital sector. Locums are a special type of self-employed professionals who are only temporally embedded in organisational contexts of hospitals, and this might have consequences for their professional practice. Therefore, questions arise regarding how locums perceive their ethical duties as medical professionals. Methods In this first qualitative study on German locum physicians, the locums’ own perspective is complemented by the viewpoint of permanently employed physician colleagues. Eighteen semi-structured interviews were conducted in 2014 to explore the professional practice of locum physicians from both groups’ perspectives with respect to doctor-patient-relationship, cooperation with colleagues and physicians’ role in society. The data were analysed using qualitative content analysis, including a deductive application and an inductive development of codes. The results were related to key tenets of medical professionalism with respect to the question: how far do locums fulfil their ethical duties towards patients, colleagues and the society? Results The study indicates that although ethical requirements are met broadly, difficulties remain with respect to close doctor–patient contact and the sustainability of hiring locums as a remedy in times of staff shortage. Conclusions Further qualitative and quantitative research on locum physicians’ professional practice, including patient perspectives and economic health care system analyses, is needed to better understand the ethical impact of hiring independent contractors in the hospital sector.
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    Variability and dimensionality of students’ and supervisors’ mini-CEX scores in undergraduate medical clerkships – a multilevel factor analysis 

    Berendonk, Christoph; Rogausch, Anja; Gemperli, Armin; Himmel, Wolfgang
    2018; 18(1): Art. 100
    Abstract Background The mini clinical evaluation exercise (mini-CEX)—a tool used to assess student-patient encounters—is increasingly being applied as a learning device to foster clinical competencies. Although the importance of eliciting self-assessment for learning is widely acknowledged, little is known about the validity of self-assessed mini-CEX scores. The aims of this study were (1) to explore the variability of medical students’ self-assessed mini-CEX scores, and to compare them with the scores obtained from their clinical supervisors, and (2) to ascertain whether learners’ self-assessed mini-CEX scores represent a global dimension of clinical competence or discrete clinical skills. Methods In year 4, medical students conducted one to three mini-CEX per clerkship in gynaecology, internal medicine, paediatrics, psychiatry and surgery. Students and clinical supervisors rated the students’ performance on a 10-point scale (1 = great need for improvement; 10 = little need for improvement) in the six domains history taking, physical examination, counselling, clinical judgement, organisation/efficiency and professionalism as well as in overall performance. Correlations between students’ self-ratings and ratings from clinical supervisors were calculated (Pearson’s correlation coefficient) based on averaged scores per domain and overall. To investigate the dimensionality of the mini-CEX domain scores, we performed factor analyses using linear mixed models that accounted for the multilevel structure of the data. Results A total of 1773 mini-CEX from 164 students were analysed. Mean scores for the six domains ranged from 7.5 to 8.3 (student ratings) and from 8.8 to 9.3 (supervisor ratings). Correlations between the ratings of students and supervisors for the different domains varied between r = 0.29 and 0.51 (all p < 0.0001). Mini-CEX domain scores revealed a single-factor solution for both students’ and supervisors’ ratings, with high loadings of all six domains between 0.58 and 0.83 (students) and 0.58 and 0.84 (supervisors). Conclusions These findings put a question mark on the validity of mini-CEX domain scores for formative purposes, as neither the scores obtained from students nor those obtained from clinical supervisors unravelled specific strengths and weaknesses of individual students’ clinical competence.
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    Genome-wide scan reveals population stratification and footprints of recent selection in Nelore cattle 

    Cardoso, Diercles F; de Albuquerque, Lucia G; Reimer, Christian; Qanbari, Saber; Erbe, Malena; do Nascimento, André V; Venturini, Guilherme C; Scalez, Daiane C B; Baldi, Fernando; de Camargo, Gregório M F; et al.
    Mercadante, Maria E Zdo Santos Gonçalves Cyrillo, Joslaine NSimianer, HennerTonhati, Humberto
    2018-05-02; 50(1): Art. 22
    Abstract Background This study aimed at (1) assessing the genomic stratification of experimental lines of Nelore cattle that have experienced different selection regimes for growth traits, and (2) identifying genomic regions that have undergone recent selection. We used a sample of 763 animals genotyped with the Illumina BovineHD BeadChip, among which 674 animals originated from two lines that are maintained under directional selection for increased yearling body weight and 89 animals from a control line that is maintained under stabilizing selection. Results Multidimensional analysis of the genomic dissimilarity matrix and admixture analysis revealed a substantial level of population stratification between the directional selection lines and the stabilizing selection control line. Two of the three tests used to detect selection signatures (FST, XP-EHH and iHS) revealed six candidate regions with indications of selection, which strongly indicates truly positive signals. The set of identified candidate genes included several genes with roles that are functionally related to growth metabolism, such as COL14A1, CPT1C, CRH, TBC1D1, and XKR4. Conclusions The current study identified genetic stratification that resulted from almost four decades of divergent selection in an experimental Nelore population, and highlighted autosomal genomic regions that present patterns of recent selection. Our findings provide a basis for a better understanding of the metabolic mechanism that underlies the growth traits, which are modified by selection for yearling body weight.
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    A language-based sum score for the course and therapeutic intervention in primary progressive aphasia 

    Semler, Elisa; Anderl-Straub, Sarah; Uttner, Ingo; Diehl-Schmid, Janine; Danek, Adrian; Einsiedler, Beate; Fassbender, Klaus; Fliessbach, Klaus; Huppertz, Hans-Jürgen; Jahn, Holger; et al.
    Kornhuber, JohannesLandwehrmeyer, BernhardLauer, MartinMuche, RainerPrudlo, JohannesSchneider, AnjaSchroeter, Matthias LLudolph, Albert COtto, Markus
    2018-04-25; 10(1): Art. 41
    Abstract Background With upcoming therapeutic interventions for patients with primary progressive aphasia (PPA), instruments for the follow-up of patients are needed to describe disease progression and to evaluate potential therapeutic effects. So far, volumetric brain changes have been proposed as clinical endpoints in the literature, but cognitive scores are still lacking. This study followed disease progression predominantly in language-based performance within 1 year and defined a PPA sum score which can be used in therapeutic interventions. Methods We assessed 28 patients with nonfluent variant PPA, 17 with semantic variant PPA, 13 with logopenic variant PPA, and 28 healthy controls in detail for 1 year. The most informative neuropsychological assessments were combined to a sum score, and associations between brain atrophy were investigated followed by a sample size calculation for clinical trials. Results Significant absolute changes up to 20% in cognitive tests were found after 1 year. Semantic and phonemic word fluency, Boston Naming Test, Digit Span, Token Test, AAT Written language, and Cookie Test were identified as the best markers for disease progression. These tasks provide the basis of a new PPA sum score. Assuming a therapeutic effect of 50% reduction in cognitive decline for sample size calculations, a number of 56 cases is needed to find a significant treatment effect. Correlations between cognitive decline and atrophy showed a correlation up to r = 0.7 between the sum score and frontal structures, namely the superior and inferior frontal gyrus, as well as with left-sided subcortical structures. Conclusion Our findings support the high performance of the proposed sum score in the follow-up of PPA and recommend it as an outcome measure in intervention studies.
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    Dendrochronologically dated pine stumps document phase-wise bog expansion at a northwest German site between ca. 6700 and ca. 3400 BC 

    Achterberg, Inke Elisabeth Maike; Eckstein, Jan; Birkholz, Bernhard; Bauerochse, Andreas; Leuschner, Hanns Hubert
    Climate of the Past 2018; 14(1) p.85-100
    The investigated northwest German mire site at "Totes Moor" is densely covered with subfossil pine stumps (Pinus sylvestris L.) from the fen–bog transition. This facilitates the spatio-temporal reconstruction of mire development, which is based on 212 in situ tree stumps in the case study presented here. Six dendrochronologically dated site chronologies together cover 2345 years between 6703 and 3403 BC. The gaps in between are 6 to 550 years long. Additionally, a floating chronology of 309 years, containing 30 trees, was radiocarbon-dated to the beginning of the 7th millennium cal BC. Peat-stratigraphical survey was carried out additionally, and elevations a.s.l. were determined at several locations. Tree dying-off phases, which indicate water level rise at the site, mostly in context of the local fen–bog transition, are evident for ca. 6600–6450, ca. 6350–5750, ca. 5300–4900, ca. 4700–4550, ca. 3900–3850, ca. 3700–3600, ca. 3500–3450 and ca. 3400 BC. The spatial distribution of the dated in situ trees illustrates the phase-wise expansion of raised bog over fen peat at the site. The documented bog expansion pulses likely correspond to climatic wet sifts.
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    Next-Generation Theranostic Agents Based on Polyelectrolyte Microcapsules Encoded with Semiconductor Nanocrystals: Development and Functional Characterization 

    Nifontova, Galina; Zvaigzne, Maria; Baryshnikova, Maria; Korostylev, Evgeny; Ramos-Gomes, Fernanda; Alves, Frauke; Nabiev, Igor; Sukhanova, Alyona
    2018-01-25; 13(1): Art. 30
    Abstract Fabrication of polyelectrolyte microcapsules and their use as carriers of drugs, fluorescent labels, and metal nanoparticles is a promising approach to designing theranostic agents. Semiconductor quantum dots (QDs) are characterized by extremely high brightness and photostability that make them attractive fluorescent labels for visualization of intracellular penetration and delivery of such microcapsules. Here, we describe an approach to design, fabricate, and characterize physico-chemical and functional properties of polyelectrolyte microcapsules encoded with water-solubilized and stabilized with three-functional polyethylene glycol derivatives core/shell QDs. Developed microcapsules were characterized by dynamic light scattering, electrophoretic mobility, scanning electronic microscopy, and fluorescence and confocal microscopy approaches, providing exact data on their size distribution, surface charge, morphological, and optical characteristics. The fluorescence lifetimes of the QD-encoded microcapsules were also measured, and their dependence on time after preparation of the microcapsules was evaluated. The optimal content of QDs used for encoding procedure providing the optimal fluorescence properties of the encoded microcapsules was determined. Finally, the intracellular microcapsule uptake by murine macrophages was demonstrated, thus confirming the possibility of efficient use of developed system for live cell imaging and visualization of microcapsule transportation and delivery within the living cells.
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    Serum chloride levels in critical illness—the hidden story 

    Pfortmueller, Carmen A; Uehlinger, Dominik; von Haehling, Stephan; Schefold, Joerg C
    2018-04-13; 6(1): Art. 10
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    A Simple Method for Predicting Distributions by Means of Covariates with Examples from Poverty and Health Economics 

    Dai, Jing; Sperlich, Stefan; Zucchini, Walter
    Summary We present an integration based procedure for predicting the distribution f of an indicator of interest in situations where, in addition to the sample data, one has access to covariates that are available for the entire population. The proposed method, based on similar ideas that have been used in the literature on policy evaluation, provides an alternative to existing simulation and imputation methods. It is very simple to apply, flexible, requires no additional assumptions, and does not involve the inclusion of artificial random terms. It therefore yields reproducible estimates and allows for valid inference. It also provides a tool for future predictions, scenarios and ex-ante impact evaluation. We illustrate our procedure by predicting income distributions in a case with sample selection, and both current and future doctor visits. We find our approach outperforms other commonly used procedures substantially.
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    Trachyte weathering in the urban built environment related to air quality 

    Germinario, Luigi; Siegesmund, Siegfried; Maritan, Lara; Simon, Klaus; Mazzoli, Claudio
    2017-10-25; 5(1): Art. 44
    Abstract Decay of trachyte used as building stone in urban environment was investigated through the analysis of crusts and patinas found on trachyte of the Euganean Hills in the Renaissance city walls of Padua, northeastern Italy. Mineralogical and microstructural characteristics of the alteration products, as well as major- and trace-element chemical composition, were determined by optical microscopy, SEM–EDS and X-ray mapping, XRPD, and LA-ICPMS. The results are discussed referring to environmental parameters, in particular concerning air quality and anthropic pollution sources. The influence of composition of the stone and other neighboring materials on specific weathering processes is also debated. The formation of crusts and patinas turns out to be mainly due to exogenous processes. Enrichment in heavy metals and carbonaceous matter derives from the deposition of particulate emitted during fuel combustion by road vehicles, domestic heating and, secondarily, industrial activities. The particulate is typically cemented by calcite, mainly mobilized after dissolution from nearby mortar joints, or iron, released by leaching from iron-bearing minerals, reprecipitated according to pH fluctuations. Gypsum layers were rarely observed. Generally, composition of the weathering crusts and patinas of Euganean trachyte proves to be an informative marker for the relevant environmental conditions and their evolution.
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    Effects of regional perfusion block in healthy and injured lungs 

    Cambiaghi, Barbara; Vasques, Francesco; Mörer, Onnen; Ritter, Christian; Mauri, Tommaso; Kunze-Szikszay, Nils; Holke, Karin; Collino, Francesca; Maiolo, Giorgia; Rapetti, Francesca; et al.
    Schulze-Kalthoff, EliasTonetti, TommasoHahn, GünterQuintel, MichaelGattinoni, Luciano
    2017-10-13; 5(1): Art. 46
    Abstract Background Severe hypoperfusion can cause lung damage. We studied the effects of regional perfusion block in normal lungs and in the lungs that had been conditioned by lavage with 500 ml saline and high V T (20 ml kg−1) ventilation. Methods Nineteen pigs (61.2 ± 2.5 kg) were randomized to five groups: controls (n = 3), the right lower lobe block alone (n = 3), lavage and high V T (n = 4), lung lavage, and high V T plus perfusion block of the right (n = 5) or left (n = 4) lower lobe. Gas exchange, respiratory mechanics, and hemodynamics were measured hourly. After an 8-h observation period, CT scans were obtained at 0 and 15 cmH2O airway pressure. Results Perfusion block did not damage healthy lungs. In conditioned lungs, the left perfusion block caused more edema in the contralateral lung (777 ± 62 g right lung vs 484 ± 204 g left; p < 0.05) than the right perfusion block did (581 ± 103 g right lung vs 484 ± 204 g left; p n.s.). The gas/tissue ratio, however, was similar (0.5 ± 0.3 and 0.8 ± 0.5; p n.s.). The lobes with perfusion block were not affected (gas/tissue ratio right 1.6 ± 0.9; left 1.7 ± 0.5, respectively). Pulmonary artery pressure, PaO2/FiO2, dead space, and lung mechanics were more markedly affected in animals with left perfusion block, while the gas/tissue ratios were similar in the non-occluded lobes. Conclusions The right and left perfusion blocks caused the same “intensity” of edema in conditioned lungs. The total amount of edema in the two lungs differed because of differences in lung size. If capillary permeability is altered, increased blood flow may induce or increase edema.
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    Positional effects on the distributions of ventilation and end-expiratory gas volume in the asymmetric chest—a quantitative lung computed tomographic analysis 

    Cortes-Puentes, Gustavo A; Gard, Kenneth E; Adams, Alexander B; Dries, David J; Quintel, Michael; Oeckler, Richard A; Gattinoni, Luciano; Marini, John J
    2018-04-10; 6(1): Art. 9
    Abstract Background Body positioning affects the configuration and dynamic properties of the chest wall and therefore may influence decisions made to increase or decrease ventilating pressures and tidal volume. We hypothesized that unlike global functional residual capacity (FRC), component sector gas volumes and their corresponding regional tidal expansions would vary markedly in the setting of unilateral pleural effusion (PLEF), owing to shifting distributions of aeration and collapse as posture changed. Methods Six deeply anesthetized swine underwent tracheostomy, thoracostomy, and experimental PLEF with 10 mL/kg of radiopaque isotonic fluid randomly instilled into either pleural space. Animals were ventilated at VT = 10 mL/kg, frequency = 15 bpm, I/E = 1:2, PEEP = 1 cmH2O, and FiO2 = 0.5. Quantitative lung computed tomographic (CT) analysis of regional aeration and global FRC measurements by nitrogen wash-in/wash-out technique was performed in each of these randomly applied positions: semi-Fowler’s (inclined 30° from horizontal in the sagittal plane); prone, supine, and lateral positions with dependent PLEF and non-dependent PLEF. Results No significant differences in total FRC were observed among the horizontal positions, either at baseline (p = 0.9037) or with PLEF (p = 0.58). However, component sector total gas volumes in each phase of the tidal cycle were different within all studied positions with and without PLEF (p = < .01). Compared to other positions, prone and lateral positions with non-dependent PLEF had more homogenous VT distributions among quadrants (p = .051). Supine position was associated with most dependent collapse and greatest tendency for tidal recruitment (48 vs ~ 22%, p = 0.0073). Conclusions Changes in body position in the setting of effusion-caused chest asymmetry markedly affected the internal distributions of gas volume, collapse, ventilation, and tidal recruitment, even though global FRC measurements provided little indication of these potentially important positional changes.
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    The influence of surface texture and wettability on initial bacterial adhesion on titanium and zirconium oxide dental implants 

    Wassmann, Torsten; Kreis, Stefan; Behr, Michael; Buergers, Ralf
    2017-07-17; 3(1): Art. 32
    Abstract Background This study aims to investigate bacterial adhesion on different titanium and ceramic implant surfaces, to correlate these findings with surface roughness and surface hydrophobicity, and to define the predominant factor for bacterial adhesion for each material. Methods Zirconia and titanium specimens with different surface textures and wettability (5.0 mm in diameter, 1.0 mm in height) were prepared. Surface roughness was measured by perthometer (R a ) and atomic force microscopy, and hydrophobicity according to contact angles by computerized image analysis. Bacterial suspensions of Streptococcus sanguinis and Staphylococcus epidermidis were incubated for 2 h at 37 °C with ten test specimens for each material group and quantified with fluorescence dye CytoX-Violet and an automated multi-detection reader. Results Variations in surface roughness (R a ) did not lead to any differences in adhering S. epidermidis, but higher R a resulted in increased S. sanguinis adhesion. In contrast, higher bacterial adhesion was observed on hydrophobic surfaces than on hydrophilic surfaces for S. epidermidis but not for S. sanguinis. The potential to adhere S. sanguinis was significantly higher on ceramic surfaces than on titanium surfaces; no such preference could be found for S. epidermidis. Conclusions Both surface roughness and wettability may influence the adhesion properties of bacteria on biomaterials; in this context, the predominant factor is dependent on the bacterial species. Wettability was the predominant factor for S. epidermidis and surface texture for S. sanguinis. Zirconia did not show any lower bacterial colonization potential than titanium. Arithmetical mean roughness values R a (measured by stylus profilometer) are inadequate for describing surface roughness with regard to its potential influence on microbial adhesion.
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    Accounting of GHG emissions and removals from forest management: a long road from Kyoto to Paris 

    Krug, Joachim H A
    2018-01-03; 13(1): Art. 1
    Abstract Background Forests have always played an important role in agreeing on accounting rules during the past two decades of international climate policy development. Starting from activity-based gross–net accounting of selected forestry activities to mandatory accounting against a baseline—rules have changed quite rapidly and with significant consequences for accounted credits and debits. Such changes have direct consequences on incentives for climate-investments in forestry. There have also been strong arguments not to include forests into the accounting system by considering large uncertainties, procedural challenges and a fear of unearned credits corrupting the overall accounting system, among others. This paper reflects the development of respective accounting approaches and reviews the progress made on core challenges and resulting incentives. Main text The historic development of forest management accounting rules is analysed in the light of the Paris Agreement. Pros and cons of different approaches are discussed with specific focus on the challenge to maintain integrity of the accounting approach and on resulting incentives for additional human induced investments to increase growth for future substitution and increased C storage by forest management. The review is solely based on scientific publications and official IPCC and UNFCC documents. Some rather political statements of non-scientific stakeholders are considered to reflect criticism. Such sources are indicated accordingly. Remaining and emerging requirements for an accounting system for post 2030 are highlighted. Conclusions The Paris Agreement is interpreted as a “game changer” for the role of forests in climate change mitigation. Many countries rely on forests in their NDCs to achieve their self-set targets. In fact, the agreement “to achieve a balance between anthropogenic emissions by sources and removals by sinks of greenhouse gases in the second half of this century” puts pressure on the entire land sector to contribute to overall GHG emission reductions. This also concerns forests as a resource for the bio-based economy and wood products, and for increasing carbon reservoirs. By discussing the existing elements of forest accounting rules and conditions for establishing an accounting system post 2030, it is concluded that core requirements like factoring out direct human-induced from indirect human-induced and natural impacts on managed lands, a facilitation of incentives for management changes and providing safeguards for the integrity of the accounting system are not sufficiently secured by currently discussed accounting rules. A responsibility to fulfil these basic requirements is transferred to Nationally Determined Contributions. Increased incentives for additional human induced investments are not stipulated by the accounting approach but rather by the political decision to make use of the substitution effect and potential net removals from LULUCF to contribute to self-set targets.
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    Thromboelastography-based anticoagulation management during extracorporeal membrane oxygenation: a safety and feasibility pilot study 

    Panigada, Mauro; E. Iapichino, Giacomo; Brioni, Matteo; Panarello, Giovanna; Protti, Alessandro; Grasselli, Giacomo; Occhipinti, Giovanna; Novembrino, Cristina; Consonni, Dario; Arcadipane, Antonio; et al.
    Gattinoni, LucianoPesenti, Antonio
    2018-01-16; 8(1): Art. 7
    Abstract Background There is no consensus on the management of anticoagulation during extracorporeal membrane oxygenation (ECMO). ECMO is currently burdened by a high rate of hemostatic complications, possibly associated with inadequate monitoring of heparin anticoagulation. This study aims to assess the safety and feasibility of an anticoagulation protocol for patients undergoing ECMO based on thromboelastography (TEG) as opposed to an activated partial thromboplastin time (aPTT)-based protocol. Methods We performed a multicenter, randomized, controlled trial in two academic tertiary care centers. Adult patients with acute respiratory failure treated with veno-venous ECMO were randomized to manage heparin anticoagulation using a TEG-based protocol (target 16–24 min of the R parameter, TEG group) or a standard of care aPTT-based protocol (target 1.5–2 of aPTT ratio, aPTT group). Primary outcomes were safety and feasibility of the study protocol. Results Forty-two patients were enrolled: 21 were randomized to the TEG group and 21 to the aPTT group. Duration of ECMO was similar in the two groups (9 (7–16) days in the TEG group and 11 (4–17) days in the aPTT group, p = 0.74). Heparin dosing was lower in the TEG group compared to the aPTT group (11.7 (9.5–15.3) IU/kg/h vs. 15.7 (10.9–21.3) IU/kg/h, respectively, p = 0.03). Safety parameters, assessed as number of hemorrhagic or thrombotic events and transfusions given, were not different between the two study groups. As for the feasibility, the TEG-based protocol triggered heparin infusion rate adjustments more frequently (p < 0.01) and results were less frequently in the target range compared to the aPTT-based protocol (p < 0.001). Number of prescribed TEG or aPTT controls (according to study groups) and protocol violations were not different between the study groups. Conclusions TEG seems to be safely used to guide anticoagulation management during ECMO. Its use was associated with the administration of lower heparin doses compared to a standard of care aPTT-based protocol. Trial registration ClinicalTrials.gov, October 22,2014. Identifier: NCT02271126.
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    Transcatheter atrial septal defect closure in an infant (body weight 6.4 kg) using the GORE CARDIOFORM septal occluder (GCSO) 

    Scheidmann, Roman; Paul, Thomas; Sigler, Matthias
    2017-11-03; 4(1): Art. 9
    Abstract Introduction Transcatheter closure has become the treatment of choice for secundum atrial septal defects (ASD II), but particularly in small children, there is concern regarding procedure-related complications. Case description We report on a 10-month-old infant, body weight of 6.4 kg, with a large ASD who was referred for failure to thrive and dyspnea on exertion. Echocardiography showed two neighboring ASDs centrally located within an atrial septum with a length of 27 mm resulting in significant left-to-right shunting. During cardiac catheterization, hemodynamic significance of the defect as well as normal pulmonary vascular resistance was demonstrated. Balloon sizing of the central ASD showed a stretched defect diameter of 12 × 11 mm. A 20-mm GORE CARDIOFORM septal occluder (GCSO; Goremedical, W. L. Gore & Associates, Inc., Newark, DE, USA) was implanted without any complications. Initial trivial residual shunting resolved during 4 months of follow-up. Right ventricular dimensions declined significantly, and the boy gained body weight properly. Discussion, evaluation and conclusion As demonstrated in our report, even large ASDs can be closed safely by catheter intervention in small infants. Selection of implant device and optimal sizing is of paramount importance. The size of the delivery sheath (11 French in our patient) is a potential limitation for the GCSO in smaller infants.
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    Predictability of properties of a fractured geothermal reservoir: the opportunities and limitations of an outcrop analogue study 

    Bauer, Johanna F; Krumbholz, Michael; Meier, Silke; Tanner, David C
    2017-11-09; 5(1): Art. 24
    Abstract Minimizing exploration risk in deep geothermics is of great economic importance. Especially, knowledge about temperature and permeability of the reservoir is essential. We test the potential of an outcrop analogue study to minimize uncertainties in prediction of the rock properties of a fractured reservoir in the Upper Rhine Graben. Our results show that although mineralogical composition, clay content, grain size, and fabric type are basically comparable, porosity and quartz cementation are not. Young’s modulus, as observed in the outcrop closest to the reservoir is about twice as high (~ 64 GPa) as observed in the reservoir (~ 34 GPa). Most importantly, however, the parameters that describe the fracture system, which are essential to predict reservoir permeability, differ significantly. While the outcrops are dominated by perpendicular fracture sets (striking NE–SW and NW–SE), two different conjugate fracture sets (striking NW–SE and N–S) occur in the reservoir. Fracture apertures, as reported from the FMI, are one order of magnitude wider than in the outcrop. We conclude that our outcrop analogue study fails to predict important properties of the reservoir (such as permeability and porosity). This must be in part because of the tectonically complex setting of the reservoir. We propose that analogue studies are important, but they must be treated with care when attempting to predict the controlling parameters of a fractured reservoir.
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    Genome sequence of Planktotalea frisia type strain (SH6-1T), a representative of the Roseobacter group isolated from the North Sea during a phytoplankton bloom 

    Bakenhus, Insa; Voget, Sonja; Poehlein, Anja; Brinkhoff, Thorsten; Daniel, Rolf; Simon, Meinhard
    2018-04-11; 13(1): Art. 7
    Abstract Planktotalea frisia SH6-1T Hahnke et al. (Int J Syst Evol Microbiol 62:1619–24, 2012) is a planktonic marine bacterium isolated during a phytoplankton bloom from the southern North Sea. It belongs to the Roseobacter group within the alphaproteobacterial family Rhodobacteraceae. Here we describe the draft genome sequence and annotation of the type strain SH6-1T. The genome comprises 4,106,736 bp and contains 4128 protein-coding and 38 RNA genes. The draft genome sequence provides evidence for at least three extrachromosomal elements, encodes genes for DMSP utilization, quorum sensing, photoheterotrophy and a type IV secretion system. This indicates not only adaptation to a free-living lifestyle of P. frisia but points also to interactions with prokaryotic or eukaryotic organisms.
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    Martin Baethge Obituary 

    Seeber, Susan
    2018-03-01; 52(1): Art. 2
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