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Hintergrund: Die Unterschidung von Augen mit frühem Keratokonus (KC) von normalen Augen bereitet nach wie vor Schwierigkeiten. Die vorliegende Untersuchung vergleicht konventionelle keratometrie-basierte mit wellenfront-basierten Maßzahlen hinsichtlich ihrer Eignung, normale Augen von Augen mit sehr frühem Keratokonus zu unterscheiden.
Methoden: Es wurden 17 Augen von 17 Patienten mit frühem KC eingeschlossen. Bei diesen 17 Augen handelt es sich um klinisch unauffällige Partneraugen des stärker betroffenen Auges. 123 Normalaugen von 69 Patienten dienten als Negativkontrolle. Von den axialen Kurvaturdaten wurden folgende Maßzahlen berechnet: zentrale Keratometrie (cK), Astigmatismus (AST), inferior-superiore Brechwertdifferenz (I-S), Verkippung der radialen Achsen (SRAX), KISA% index (eine Maßzahl, die auf cK, AST, I-S und SRAX basiert) und corneale Zernike-Koeffizienten (1.–7. Ordnung, Pupillendurchmesser: 6 mm). Aus Zernike-Koeffizienten wurden Diskriminanzfunktionen konstruiert. Receiver-Operatiing-Charakteristik (ROC)-Kurven wurden erstellt, um die diagnostische Trennschärfe dieser Werte zur Unterscheidung von klinisch unauffälligen Partneraugen von Augen mit frühem Keratokonus und normalen Kontrollen zu evaluieren.
Ergebnisse: Der I-S-Wert (Korrektheit 92,1%, kritischer Wert 0,59 D) und die vertikale Coma (C3-1; 96,7%, –0,2 µm) waren die beiden Einzelwerte mit höchster Trennschärfe. Mit den ursprünglich publizierten kritischen Werten lag der Rabinowitz-McDonnell test (cK und I-S) bei 83,3% (Sensitivität 0%, Spezifität 100%) und der KISA% bei 70,8% (81,3%, 60,3%). In Verbindung mit Diskriminanzanalyse errichten Zernike-Koeffizienten eine Korrektheit von 96,7% (100%, 93,4%).
Schlussfolgerungen: Auf cornealen Zernike-Koeffizienten basierende Maßzahlen erreichte die höchste Trennschärfe bei der Unterscheidung von Augen mit subklinischem KC von Normalaugen. Dennoch konnten konventionelle KC-indices eine ähnlich hohe Trenschärfe wie die Zernike-Methode erreichen, wenn die kritischen Werte entsprechend angepasst werden.
Hintergrund: Im Rahmen der Erforschung von Mechanismen der Presbyopie-Entstehung hat das Interesse an Methoden zur Linsendensitometrie wieder zugenommen. Für spezielle Fragestellungen sind flexible Untersuchungsmethoden notwendig.
Methoden: Basierend auf Aufnahmen mit der Scheimpflug-Kamera Pentacam HR (Oculus, Wetzlar) wurde ein MATLAB-Programm (V7.0, The MathWorks) erstellt, um größere Datenmengen automatisiert auszuwerten. Die Erkennung der Pupillenmitte als Referenzpunkt erfolgt mittels eines Randerkennungsalgorithmus. Als Kennzahlen dienen klassische Parameter der beschreibenden Statistik (Mittel, Minimum, Maximum, Standardabweichung und Variationskoeffizient) für einen definierten rechteckigen Bereich und für die zentrale vertikale Achse.
Ergebnisse: In einer Präliminarserie von 18 Augen war eine automatisierte Messung mit korrekter Pupillenerkennung in 80% der Fälle möglich. Verglichen mit der hersteller-eigenen Software (Pentacam 6.03r11) besitzt das eigene Programm eine erweiterte Spannweite der Messwerte. Die Messwerte können automatisch nach Excel (Microsoft) exportiert werden. Ein modularer Aufbau ermöglicht eine flexible Erweiterung für weitere Fragestellungen (z.B. Quantifizierung von Kern- und Rindentrübungen).
Schlussfolgerungen: Mittels eines selbst programmierten MATLAB-basierten Programmes kann eine automatisierte Messung und Analyse von linsndensitometrischen Parametern durchgeführt werden.
Direct photon emission in heavy-ion collisions is calculated within a relativistic micro+macro
hybrid model and compared to the microscopic transport model UrQMD. In the hybrid approach,
the high-density part of the collision is calculated by an ideal 3+1-dimensional hydrodynamic
calculation, while the early (pre-equilibrium-) and late (rescattering-) phase are calculated with
the transport model. Different scenarios of the transition from the macroscopic description to
the transport model description and their effects are studied. The calculations are compared to
measurements by the WA98-collaboration and predictions for the future CBM-experiment are
made.
We present unambiguous evidence from lattice simulations of Nf = 3 QCD for two tricritical points in the (T;m) phase diagram at fixed imaginary m=T = ip=3 mod. 2p=3, one in the light and one in the heavy quark regime. Together with similar results in the literature for Nf = 2 this implies the existence of a chiral and of a deconfinement tricritical line at those values of imaginary chemical potentials. These tricritical lines represent the boundaries of the analytically continued chiral and deconfinement critical surfaces, respectively, which delimit the parameter space with first order phase transitions. It is demonstrated that the shape of the deconfinement critical surface is dictated by tricritical scaling and implies the weakening of the deconfinement transition with real chemical potential. A qualitatively similar effect holds for the chiral critical surface.
To investigate the formation and the propagation of relativistic shock waves in viscous gluon matter we solve the relativistic Riemann problem using a microscopic parton cascade. We demonstrate the transition from ideal to viscous shock waves by varying the shear viscosity to entropy density ratio n/s. Furthermore we compare our results with those obtained by solving the relativistic causal dissipative fluid equations of Israel and Stewart (IS), in order to show the validity of the IS hydrodynamics. Employing the parton cascade we also investigate the formation of Mach shocks induced by a high-energy gluon traversing viscous gluon matter. For n/s = 0.08 a Mach cone structure is observed, whereas the signal smears out for n/s >=0.32.
A lot of effort in lattice simulations over the last years has been devoted to studies of the QCD deconfinement transition. Most state-of-the-art simulations use rooted staggered fermions, while Wilson fermions are affected by large systematic uncertainties, such as coarse lattices or heavy sea quarks. Here we report on an ongoing study of the transition, using two degenerate flavours of nonperturbatively O(a) improved Wilson fermions. We start with Nt = 12 and 16 lattices and pion masses of 600 to 450 MeV, aiming at chiral and continuum limits with light quarks.
Meeting Abstract : Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 17. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Osnabrück, 25.-26.11.2010.
ntroduction: Several drugs require dose adjustment in patients with impaired renal function, which however, often goes undetected. Serum creatinine may be normal in patients while renal function is already reduced. The estimated GFR (eGFR) allows a more precise evaluation of the renal function. This study was carried out in a group practice for family medicine, in Frankfurt/ Main, Germany. The exploration aimed at investigating if patients with renal insufficiency were recognised and if their prescriptions were appropriate in terms of dose adjustment or contra-indications.
Methods: In patients (>65yrs) with renal insufficiency (creatinine clearance <60 ml/min), their prescribed medication was retrospectively explored (Observation period 1.1.2008 to 1.4.2009). The Cockroft-Gault formula was used as estimate for the eGFR, using a creatinine value from the patient’s charts. In 90 patients, a second eGFR could be estimated from a second creatinine value obtained within 3-6 months. The recommended dose of each prescription in the SmPC (Fachinformation“) was compared to the dose that had been actually prescribed.
Results: Out of 232 consecutively patients >65 yrs, 102 had an eGFR <60 ml/min, 16 of these had an eGFR <30 ml/min. The eGFR was closely correlated (r2=0.81) with an independent second eGFR. Out of these 102 patients, 48 had a serum creatinine level within the normal range. Renal adjustment was required in 263 of a total of 613 prescriptions. 72 prescriptions in a total of 45 patients were not appropriately adjusted (32) or prescribed despite a contraindication (40). For chronic prescriptions, metformin, ramipril, enalapril, HCTZ, and spironolactone accounted for 70% of inappropriate dosing; the magnitude of misdosing was 1.5 to 4 fold (median 2). 9 temporary prescriptions (of a total of 60 prescriptions) in 8 patients were not adjusted (cefuroxim, cefpodoxim, levofloxacin). We could not prove that patients with normal serum creatinine had a higher rate of inappropriate dosing than those with already elevated creatinine.
Discussion and conclusion: In this GP practice, we have demonstrated a considerable prevalence of inappropriate dosing in patients with impaired renal function. It remains to be elucidated whether surveillance of appropriate dosing in renal impairment can be optimized e.g. with CPOE.
The KADoNiS (Karlsruhe Astrophysical Database of Nucleosynthesis in Stars) project is an online
database (www.kadonis.org) for cross sections relevant to the s-process and the p-process.
The first version was an updated sequel to the previous Bao et al. [1] compilations from 1987
and 2000 for (n; g) cross sections relevant to Big Bang and s-process nucleosynthesis. The first
update, KADoNiS v0.2, was published in 2006 [2]. It contained mainly Maxwellian averaged
(n; g) cross sections relevant to the s-process, and some experimental charged particle induced
reaction relevant to the p-process. After that a second update was presented in 2009 [3].
Recently, we started to collect and review all existing experimental data relevant for p-process
nucleosynthesis and to provide a user-friendly database based on the KADoNiS framework. The
p-process part of the KADoNiS database is currently being extended and will include all available
experimental data from (p; g), (p;n), (p;a), (a,g), (a;n) and (a; p) reactions in or close to the
respective Gamow window.
The CBM experiment will investigate heavy-ion collisions at beam energies from 8 to 45 AGeV at the future accelerator facility FAIR. The goal of the experiment is to study the QCD phase diagram in the vincinity of the QCD critical point. To do so, CBM aims at measuring rare probes among them open charm. In order to identify those rare and short lived particles despite the rich combinatorial background generated in heavy ion collisions, a micro vertex detector (MVD) providing an unprecedented combination of high rate capability and radiation hardness, very light material budget and excellent granularity is required. In this work, we will discuss the concept of this detector and summarize the status of the R&D.