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Background
For supratentorial craniotomy, surgical access, and closure technique, including placement of subgaleal drains, may vary considerably. The influence of surgical nuances on postoperative complications such as cerebrospinal fluid leakage or impaired wound healing overall remains largely unclear. With this study, we are reporting our experiences and the impact of our clinical routines on outcome in a prospectively collected data set.
Method
We prospectively observed 150 consecutive patients undergoing supratentorial craniotomy and recorded technical variables (type/length of incision, size of craniotomy, technique of dural and skin closure, type of dressing, and placement of subgaleal drains). Outcome variables (subgaleal hematoma/CSF collection, periorbital edema, impairment of wound healing, infection, and need for operative revision) were recorded at time of discharge and at late follow-up.
Results
Early subgaleal fluid collection was observed in 36.7% (2.8% at the late follow-up), and impaired wound healing was recorded in 3.3% of all cases, with an overall need for operative revision of 6.7%. Neither usage of dural sealants, lack of watertight dural closure, and presence of subgaleal drains, nor type of skin closure or dressing influenced outcome. Curved incisions, larger craniotomy, and tumor size, however, were associated with an increase in early CSF or hematoma collection (p < 0.0001, p = 0.001, p < 0.01 resp.), and larger craniotomy size was associated with longer persistence of subgaleal fluid collections (p < 0.05).
Conclusions
Based on our setting, individual surgical nuances such as the type of dural closure and the use of subgaleal drains resulted in a comparable complication rate and outcome. Subgaleal fluid collections were frequently observed after supratentorial procedures, irrespective of the closing technique employed, and resolve spontaneously in the majority of cases without significant sequelae. Our results are limited due to the observational nature in our single-center study and need to be validated by supportive prospective randomized design.
Nacre-mimetic nanocomposites based on high fractions of synthetic high-aspect-ratio nanoclays in combination with polymers are continuously pushing boundaries for advanced material properties, such as high barrier against oxygen, extraordinary mechanical behavior, fire shielding, and glass-like transparency. Additionally, they provide interesting model systems to study polymers under nanoconfinement due to the well-defined layered nanocomposite arrangement. Although the general behavior in terms of forming such layered nanocomposite materials using evaporative self-assembly and controlling the nanoclay gallery spacing by the nanoclay/polymer ratio is understood, some combinations of polymer matrices and nanoclay reinforcement do not comply with the established models. Here, we demonstrate a thorough characterization and analysis of such an unusual polymer/nanoclay pair that falls outside of the general behavior. Poly(ethylene oxide) (PEO) and sodium fluorohectorite form nacre-mimetic, lamellar nanocomposites that are completely transparent and show high mechanical stiffness and high gas barrier, but there is only limited expansion of the nanoclay gallery spacing when adding increasing amounts of polymer. This behavior is maintained for molecular weights of PEO varied over four orders of magnitude and can be traced back to depletion forces. By careful investigation via X-ray diffraction and proton low-resolution solid-state NMR, we are able to quantify the amount of mobile and immobilized polymer species in between the nanoclay galleries and around proposed tactoid stacks embedded in a PEO matrix. We further elucidate the unusual confined polymer dynamics, indicating a relevant role of specific surface interactions.
There is a very large number of very important situations which can be modeled with nonlinear parabolic partial differential equations (PDEs) in several dimensions. In general, these PDEs can be solved by discretizing in the spatial variables and transforming them into huge systems of ordinary differential equations (ODEs), which are very stiff. Therefore, standard explicit methods require a large number of iterations to solve stiff problems. But implicit schemes are computationally very expensive when solving huge systems of nonlinear ODEs. Several families of Extrapolated Stabilized Explicit Runge-Kutta schemes (ESERK) with different order of accuracy (3 to 6) are derived and analyzed in this work. They are explicit methods, with stability regions extended, along the negative real semi-axis, quadratically with respect to the number of stages s, hence they can be considered to solve stiff problems much faster than traditional explicit schemes. Additionally, they allow the adaptation of the step length easily with a very small cost.
Two new families of ESERK schemes (ESERK3 and ESERK6) are derived, and analyzed, in this work. Each family has more than 50 new schemes, with up to 84.000 stages in the case of ESERK6. For the first time, we also parallelized all these new variable step length and variable number of stages algorithms (ESERK3, ESERK4, ESERK5, and ESERK6). These parallelized strategies allow to decrease times significantly, as it is discussed and also shown numerically in two problems. Thus, the new codes provide very good results compared to other well-known ODE solvers. Finally, a new strategy is proposed to increase the efficiency of these schemes, and it is discussed the idea of combining ESERK families in one code, because typically, stiff problems have different zones and according to them and the requested tolerance the optimum order of convergence is different.
Superparamagnetic iron oxide nanoparticles (SPION) are extensively used for magnetic resonance imaging (MRI) and magnetic particle imaging (MPI), as well as for magnetic fluid hyperthermia (MFH). We here describe a sequential centrifugation protocol to obtain SPION with well-defined sizes from a polydisperse SPION starting formulation, synthesized using the routinely employed co-precipitation technique. Transmission electron microscopy, dynamic light scattering and nanoparticle tracking analyses show that the SPION fractions obtained upon size-isolation are well-defined and almost monodisperse. MRI, MPI and MFH analyses demonstrate improved imaging and hyperthermia performance for size-isolated SPION as compared to the polydisperse starting mixture, as well as to commercial and clinically used iron oxide nanoparticle formulations, such as Resovist® and Sinerem®. The size-isolation protocol presented here may help to identify SPION with optimal properties for diagnostic, therapeutic and theranostic applications.
SHEMAT-Suite: An open-source code for simulating flow, heat and species transport in porous media
(2020)
SHEMAT-Suite is a finite-difference open-source code for simulating coupled flow, heat and species transport in porous media. The code, written in Fortran-95, originates from geoscientific research in the fields of geothermics and hydrogeology. It comprises: (1) a versatile handling of input and output, (2) a modular framework for subsurface parameter modeling, (3) a multi-level OpenMP parallelization, (4) parameter estimation and data assimilation by stochastic approaches (Monte Carlo, Ensemble Kalman filter) and by deterministic Bayesian approaches based on automatic differentiation for calculating exact (truncation error-free) derivatives of the forward code.
Häufig bremsen geringe IT-Ressourcen, fehlende Softwareschnittstellen oder eine veraltete und komplex gewachsene Systemlandschaft die Automatisierung von Geschäftsprozessen. Robotic Process Automation (RPA) ist eine vielversprechende Methode, um Geschäftsprozesse oberflächenbasiert und ohne größere Systemeingriffe zu automatisieren und Medienbrüche abzubauen. Die Auswahl der passenden Prozesse ist dabei für den Erfolg von RPA-Projekten entscheidend. Der vorliegende Beitrag liefert dafür Selektionskriterien, die aus einer qualitativen Inhaltanalyse von elf Interviews mit RPA-Experten aus dem Versicherungsumfeld resultieren. Das Ergebnis umfasst eine gewichtetet Liste von sieben Dimensionen und 51 Prozesskriterien, welche die Automatisierung mit Softwarerobotern begünstigen bzw. deren Nichterfüllung eine Umsetzung erschweren oder sogar verhindern. Die drei wichtigsten Kriterien zur Auswahl von Geschäftsprozessen für die Automatisierung mittels RPA umfassen die Entlastung der an dem Prozess mitwirkenden Mitarbeiter (Arbeitnehmerüberlastung), die Ausführbarkeit des Prozesses mittels Regeln (Regelbasierte Prozessteuerung) sowie ein positiver Kosten-Nutzen-Vergleich. Praktiker können diese Kriterien verwenden, um eine systematische Auswahl von RPA-relevanten Prozessen vorzunehmen. Aus wissenschaftlicher Perspektive stellen die Ergebnisse eine Grundlage zur Erklärung des Erfolgs und Misserfolgs von RPA-Projekten dar.
Mit finanzieller Unterstützung der Deutschen Gesellschaft für Mauerwerks- und Wohnungsbau e.V. (DGfM) und des Deutschen Instituts für Bautechnik in Berlin (DIBt) wurden zwei aufeinander aufbauende Forschungsvorhaben zur Verbesserung der seismischen Nachweise von Mauerwerksbauten in deutschen Erdbebengebieten durchgeführt. Zunächst wurde das seismische Verhalten von drei modernen unbewehrten Mauerwerksgebäuden in der Region Emilia Romagna in Italien während der Erdbebenserie im Jahr 2012 in Kooperation mit der Universität Pavia eingehend untersucht. Aufbauend auf den Erkenntnissen dieser Untersuchungen wurde ein verbessertes seismisches Bemessungskonzept für unbewehrte Mauerwerksbauten erarbeitet. Der Beitrag stellt die wesentlichen Ergebnisse dieser Forschungsarbeiten und deren Eingang in die Normung vor.
Safety of subjects during radiofrequency exposure in ultra-high-field magnetic resonance imaging
(2020)
Magnetic resonance imaging (MRI) is one of the most important medical imaging techniques. Since the introduction of MRI in the mid-1980s, there has been a continuous trend toward higher static magnetic fields to obtain i.a. a higher signal-to-noise ratio. The step toward ultra-high-field (UHF) MRI at 7 Tesla and higher, however, creates several challenges regarding the homogeneity of the spin excitation RF transmit field and the RF exposure of the subject. In UHF MRI systems, the wavelength of the RF field is in the range of the diameter of the human body, which can result in inhomogeneous spin excitation and local SAR hotspots. To optimize the homogeneity in a region of interest, UHF MRI systems use parallel transmit systems with multiple transmit antennas and time-dependent modulation of the RF signal in the individual transmit channels. Furthermore, SAR increases with increasing field strength, while the SAR limits remain unchanged. Two different approaches to generate the RF transmit field in UHF systems using antenna arrays close and remote to the body are investigated in this letter. Achievable imaging performance is evaluated compared to typical clinical RF transmit systems at lower field strength. The evaluation has been performed under consideration of RF exposure based on local SAR and tissue temperature. Furthermore, results for thermal dose as an alternative RF exposure metric are presented.
Räumliche Transformation
(2020)