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Das Ziel des Beitrags ist, die von uns entwickelten digitalen Materialien einer Ausspracheschulung für den DaF-Unterricht in japanischen Hochschulen vorzustellen. Im Mittelpunkt steht dabei die Diskussion, wie die Ausspracheschulung mit digitalen Medien im Deutschunterricht, vor allem im Online-Unterricht, aussehen soll.
In diesem Beitrag wird ein Lektüreseminar vorgestellt, das curricular im Studiengang Higher Education (M.A.) am Hamburger Zentrum für Universitäres Lehren und Lernen (HUL) verortet ist und das konzeptionell nach dem Vorbild eines literaturwissenschaftlichen Lektüre-Seminars entwickelt wurde. Dort bildet es mit dem Modultitel "Wissenschaftsforschung" eines von vier Pflichtmodulen, die thematisch um ein mehrsemestriges Projektmodul sowie ein einführendes Grundlagenmodul gestaltet sind. Ziel des Lektüreseminars ist es, Orientierungswissen zu Grundlagentexten der Wissenschaftsforschung anhand exemplarischer Detail-Lektüre zu gewinnen, diskursiv zu teilen und kritisch einzuordnen. Im Mittelpunkt steht also die systematische wissenschaftliche Textarbeit.
Im digitalen Sommersemester 2020 hat der Fachschaftsrat des Fachbereichs 02 der Universität Kassel zwei Umfragen unter den Studierenden des Fachbereichs durchgeführt. Während die erste Umfrage vor Beginn des eigentlichen Lehrbetriebs an die Studierenden herangetragen wurde und dabei das Ziel verfolgte, die Erwartungen, Lernvoraussetzungen und Bedenken dieser Gruppe zu erfassen, lag der Fokus der zweiten Befragung, die ca. fünf Wochen nach Semesterbeginn verschickt wurde, mehr auf der Evaluierung der Arbeitsbelastung und der Zufriedenheit mit den digitalen Lehrangeboten am Fachbereich. Aus dem Institut für Germanistik nahmen 318 Studierende an der Umfrage teil, diese bilden damit die größte Gruppe unter den insgesamt 521 Teilnehmer*innen.
Als Lehrbeauftragte des Instituts für Deutsche Sprache und Literatur I habe ich eine Blockveranstaltung zu dem Thema "Was nun? – Literatur der Zwischenkriegszeit 1918–1933" an der Universität zu Köln abgehalten. In diesem Beitrag stelle ich drei Arbeitsaufgaben für dieses Proseminar vor, die Studierende niedriger Semester "abholen" und auf die Voraussetzung eines erfolgreichen (Lehramts-)Studiums vorbereiten sollen. Ziel der vorgestellten Arbeitsaufgaben ist es, den Studierenden eine selbstreflexive Haltung als akademische Schlüsselkompetenz zu vermitteln und ihnen zusätzlich zu verdeutlichen, wie ihre Sprachkompetenz auf akademische Leistungen einwirkt: der Erwerb von Bildungssprache wird neben literaturwissenschaftlichen Grundlagen als ein Lernziel der Veranstaltung präsentiert. Der Erfahrungsbericht ist repräsentativ für Lehrende, die vor den pandemiebedingten Einschränkungen digitale Methoden minimal genutzt haben und begrenzte technische Mittel zur Verfügung haben. Ich präsentiere Arbeitsaufgaben für eine digitale Lehrumgebung, die sich lediglich auf die Software Zoom und andere gängige, leicht zugängliche Software und Programme beschränkt. Es stehen daher nicht die digitalen Mittel im Vordergrund, sondern der Erwerb von Schlüsselkompetenzen während einer online-Veranstaltung.
In den Kursen, die eine Seminararbeit als Prüfungsleistung erfordern, stellt sich folgende Frage für die Lehrenden besonders akut: Wie lassen sich vielfältige Schreibübungen in das Kursprogramm sinnvoll und effizient integrieren, die gleichzeitig als Werkzeuge des Denkens bei der Vermittlung der Seminarinhalte helfen und den Lernprozess insgesamt fördern? Unter den aktuellen Umständen lässt sich die Frage ergänzen: Wie kann die Umstellung auf den digitalen Fernunterricht von der Einführung prozessorientierter Schreibaufgaben profitieren? In meinem Vortrag werde ich einige methodische Vorschläge zum Umgang mit diesen Herausforderungen machen. Dabei werde ich mich auf meine Lehrerfahrungen allgemein sowie speziell auf studentische Rückmeldungen im Rahmen des von mir im SoSe 2020 an der Humboldt-Universität gehaltenen Seminars 'Bild und Körper in der religiösen Literatur des deutschen Mittelalters' im BA Studiengang Deutsche Literatur stützen.
Quenched QCD at zero baryonic chemical potential undergoes a first-order deconfinement phase transition at a critical temperature Tc, which is related to the spontaneous breaking of the global center symmetry. Including heavy, dynamical quarks breaks the center symmetry explicitly and weakens the first-order phase transition. For decreasing quark masses the first-order phase transition turns into a smooth crossover at a Z2-critical point. The critical quark mass corresponding to this point has been examined with Nf=2 Wilson fermions for several Nτ in a recent study within our group. For comparison, we also locate the critical point with Nf=2 staggered fermions on Nτ=8 lattices. For this purpose we perform Monte Carlo simulations for several quark mass values and various aspect ratios in order to extrapolate to the thermodynamic limit. The critical mass is obtained by fitting to a finite size scaling formula of the kurtosis of the Polyakov loop. Our results indicate large discretization effects, requiring simulations on lattices with Nτ>8.
In the strong coupling and heavy quark mass regime, lattice QCD dimensionally reduces to effective theories of Polyakov loops depending on the parameters of the original Wilson action β,κ and Nτ. We apply coarse graining techniques to such theories in 1d and 2d, corresponding to lattice QCD at finite temperature and non-zero chemical potential in 1+1d and 2+1d, respectively. In 1d the method is applied to the effective theories up to O(κ4). Using the transfer matrix, the recursion relations are solved analytically. The thermodynamic limit is taken for some observables. Afterwards, continuum extrapolation is performed numerically and results are discussed. In 2d the coarse graining method is applied in the pure gauge and static quark limit. Running couplings are obtained and the fixed points of the transformations are discussed. Finally, the critical coupling of the deconfinement transition is determined in both limits. Agreement to about 12% with Monte Carlo results of 2+1d Yang-Mills theory from the literature is observed.
The order of the chiral phase transition of lattice QCD with unimproved staggered fermions is known to depend on the number of quark flavours, their masses and the lattice spacing. Previous studies in the literature for Nf∈{3,4} show first-order transitions, which weaken with decreasing lattice spacing. Here we investigate what happens when lattices are made coarser to establish contact to the strong coupling region. For Nf∈{4,8} we find a drastic weakening of the transition when going from Nτ=4 to Nτ=2, which is consistent with a second-order chiral transition reported in the literature for Nf=4 in the strong coupling limit. This implies a non-monotonic behaviour of the critical quark or pseudo-scalar meson mass, which separates first-order transitions from crossover behaviour, as a function of lattice spacing.
Virtuelle statt realer Präsenz : Begriffe und Konzepte für die digitale Lehre in der Germanistik
(2021)
Angesichts der Neuheit und Vielfalt digitaler Lehr-Lernformate im Sommersemester 2020, dem sog. Corona-Semester, zielt der Beitrag auf einen Überblick über Begriffe, Konzepte und Formate von digitaler Lehre, der sowohl aktuelle Erfahrungen als auch frühere Entwicklungen des E-Learnings berücksichtigt und abschließend digitale Gestaltungsoptionen für virtuelle Präsenzphasen empfiehlt.
Veranstalter: Bernadette Biedermann, Universitätsmuseum, Universität Graz; Judith Blume, Universitätsbibliothek J.C. Senckenberg, Goethe-Universität Frankfurt am Main; Franziska Hormuth, Projekt „Digitales Netzwerk Sammlungen“, Berlin University Alliance / Humboldt-Universität zu Berlin
Datum, Ort: 22.04.2021–23.04.2021, digital
Objective: Nationwide data on the epidemiology, treatment characteristics, and long-term outcome of severe traumatic brain injury (TBI) in Germany is not yet existing. Neurosurgeons from the German Neurosurgery Society (DGNC) and traumatologists from the German Trauma Society (DGU), therefore, joined forces in 2016 to conceptualize a TBI module for the well-established Trauma Register of the DGU (TR-DGU). Here, we report how this “German National TBI registry (GNTR)” has been developed, implemented, and tested in a recently completed pilot period.
Methods: The conception and implementation process of the GNTR from August 2016 to February 2019 is described, and results of its 23-months long pilot period from February 2019 to December 2020 are presented. For the pilot period, TBI patients were prospectively enrolled at nine neurosurgical and traumatological hospitals across Germany. Inclusion criteria were treatment on the ICU ≥ 24h, or an ISS score ≥ 16. A variety of clinical, imaging, and laboratory parameters were collected, and the GOSE score was used to assess the outcome at discharge and 6- and 12 months follow-up.
Results: Details on the structure and dataset of the GNTR as well as milestones and pitfalls during its conception and implementation, are outlined. During the pilot period, a total of 264 TBI patients were enrolled. Their demographic characteristics, clinical, imaging, and radiological findings, and their early mortality and functional outcome are described. Furthermore, factors associated with an unfavorable outcome (GOSE 1-4) are assessed using uni- and multivariate regression analyses. Finally, problems and future directions of the GNTR are discussed.
Conclusion: The pilot period of the GNTR offers a first glance at the current epidemiology and treatment characteristics of TBI patients in Germany. More importantly, they show how a national TBI registry yielding high-quality prospective data can be developed, implemented, and tested within four years
Background: To investigate whether patients with critical emergency conditions are seeking or receiving the medical care that they require we characterized the reality of care for patients presenting with Neuro-emergencies during the first phase of the COVID-19 pandemic.
Methods: In this observational, longitudinal cohort study, all neurosurgical admissions that presented to our Department between February 1st and April 15th during the COVID-19 pandemic and during the same time-period in 2019 were identified and categorized according to the presence of a Neuro-emergency, the route of admission, management, and the category of disease. Further, the clinical course of patients with chronic subdural hematoma (cSDH) was investigated as a Neuro-emergency representative for a wide variety of semi-urgent symptoms.
Results: During the pandemic, the percentage of Neuro-emergencies among all neurosurgical admissions remained similar as in 2019 but a larger proportion presented through the emergency department than through the outpatient clinic or by referral (*p=0.009). The total number of Neuro-emergencies was significantly reduced (*p=0.0007) across all types of disease, particularly in severe vascular (*p=0.036) but also in spinal (*p=0.007) and hydrocephalus (*p=0.048) emergencies. Strikingly, elderly patients with cSDH and mild to moderate symptoms presented less frequently, with more severe symptoms (*p=0.046) and were less likely to reach favorable outcome (*p=0.003).
Conclusions: Despite pandemic-related restrictive measures and reallocation of resources, patients with Neuro-emergencies should be encouraged to present regardless of the severity of symptoms because deferred presentation may result in adverse outcome. Thus, conservation of critical healthcare resources remains essential in spite fighting COVID-19.
Background: Epileptic seizures are common clinical features in patients with acute subdural hematoma (aSDH); however, diagnostic feasibility and therapeutic monitoring remain limited. Surface electroencephalography (EEG) is the major diagnostic tool for the detection of seizures but it might be not sensitive enough to detect all subclinical or nonconvulsive seizures or status epilepticus. Therefore, we have planned a clinical trial to evaluate a novel treatment modality by perioperatively implanting subdural EEG electrodes to diagnose seizures; we will then treat the seizures under therapeutic monitoring and analyze the clinical benefit.
Methods: In a prospective nonrandomized trial, we aim to include 110 patients with aSDH. Only patients undergoing surgical removal of aSDH will be included; one arm will be treated according to the guidelines of the Brain Trauma Foundation, while the other arm will additionally receive a subdural grid electrode. The study's primary outcome is the comparison of incidence of seizures and time-to-seizure between the interventional and control arms. Invasive therapeutic monitoring will guide treatment with antiseizure drugs (ASDs). The secondary outcome will be the functional outcome for both groups as assessed via the Glasgow Outcome Scale and modified Rankin Scale both at discharge and during 6 months of follow-up. The tertiary outcome will be the evaluation of chronic epilepsy within 2-4 years of follow-up.
Discussion: The implantation of a subdural EEG grid electrode in patients with aSDH is expected to be effective in diagnosing seizures in a timely manner, facilitating treatment with ASDs and monitoring of treatment success. Moreover, the occurrence of epileptiform discharges prior to the manifestation of seizure patterns could be evaluated in order to identify high-risk patients who might benefit from prophylactic treatment with ASDs.
Trial registration: ClinicalTrials.gov identifier no. NCT04211233.
Background: Research on chronic subdural hematoma (cSDH) management has primarily focused on potential recurrence after surgical evacuation. Herein, we present a novel postoperative/non-invasive treatment that includes a supervised Valsalva maneuver (SVM), which may serve to reduce SDH recurrence. Accordingly, the aims of the study were to investigate the effects of SVM on SDH recurrence rates and functional outcomes.
Methods: A prospective study was conducted from December 2016 until December 2019 at the Goethe University Hospital Frankfurt. Of the 204 adult patients with surgically treated cSDH who had subdural drains placed, 94 patients were assigned to the SVM group and 82 patients were assigned to the control group. The SVM was performed by having patients blow into a self-made SVM device at least two times/h for 12 h/day. The primary end-point was SDH recurrence rate, while secondary outcomes were morbidity and functional outcomes at 3 months of follow-up.
Results: SDH recurrence was observed in 16 of 94 patients (17%) in the SVM group, which was a significant reduction as compared with the control group, which had 24 of 82 patients (29.3%; p = 0.05) develop recurrent SDHs. Further, the infection rate (e.g., pneumonia) was significantly lower in the SVM group (1.1%) than in the control group (13.4%; p < 0.001; odds ratio [OR] 0.1). At the 3-month follow-up, 85 of 94 patients (90.4%) achieved favorable outcomes in the SVM group compared with 62 of 82 patients (75.6%) in the control group (p = 0.008; OR 3.0). Independent predictors for favorable outcome at follow-up were age (OR 0.9) and infection (OR 0.2).
Conclusion: SVM appears to be safe and effective in the post-operative management of cSDHs, reducing both recurrence rates and infections after surgical evacuation, thereby resulting in favorable outcomes at follow-up.
Background: Transfusion of red blood cells (RBC) in patients undergoing major elective cranial surgery is associated with increased morbidity, mortality and prolonged hospital length of stay (LOS). This retrospective single center study aims to identify the impact of RBC transfusions on skull-base and non-skull-base meningioma patients including the identification of risk factors for RBC transfusion.
Methods: From October 2009 - October 2016 we retrospectively analyzed 423 primary meningioma patients undergoing surgery for primary meningioma resection our department.
Results: Of these 423 patients, 68 (16.1%) received RBC transfusion and 355 (83.9%) did not receive RBC units. Preoperative anaemia rate was significantly higher in transfused patients (17.7%) compared to patients without RBC transfusion (6.2%; p = 0.0015). In transfused patients, postoperative complications as well as hospital LOS was significantly higher (p < 00001) compared to non-transfused patients. After multivariate analyses, risk factors for RBC transfusion were preoperative American Society of Anesthesiologists (ASA) physical status score (p = 0.0247), tumor size (p = 0.0006), surgical time (p = 0.0018) and intraoperative blood loss (p < 0.001). Kaplan-Meier curves revealed significant influence on overall survival by preoperative anaemia, RBC transfusion, smoking, cardiovascular disease, preoperative KPS ≤ 60% and age (elderly ≥ 75 years).
Conclusion: We concluded that blood loss due to large tumors or localization near large vessels are the main triggers for RBC transfusion in meningioma patients paired with a potential preselection that masks the effect of preoperative anaemia in multivariate analysis. Further studies evaluating the impact of preoperative anaemia management for reduction of RBC transfusion are needed to improve clinical outcomes of meningioma patients.
Background: Unruptured intracranial aneurysm (UIA) poses a therapeutic dilemma in which the risk-benefit analysis of invasive intervention has to be balanced against the natural history of the disease. To date, there is no medical treatment to prevent aneurysm development and subsequent progression to rupture. We explored the vitamin D system because of its known anti-inflammatory and anti-tissue-remodeling effect as a potential treatment for UIA.
Methods: 25-vitaminD3 levels tested between 2008-2016 and data of SAH patients admitted during the months with a peak versus nadir of VitD3-values were analyzed, retrospectively. We prospectively correlated VitD3 with size and number of aneurysms at the rupture time in patients admitted between 2017-2019. An experimental mice shear stress model and cell culture model were used to investigate the effect of 1,25-dihydroxy-vitaminD3 (1,25-VitD3) and acting mediators in this mechanism.
Results: Based on the retrospective analysis demonstrating an increased frequency of aneurysm rupture rate in patients during the low vitamin D period in winter, we started the prospective study evaluating plasma vitamin D levels at admission. VitD levels were inversely correlated with aneurysm size as well as number of aneurysms. Low number of aneurysms was significantly associated with sufficient plasma Vitamin D level as an independent factor in a multivariate analysis.
From bedside back to bench, active 1,25-VitD3 hormone attenuated the natural history of remodeling in mice basilar artery. Deletion of the vitamin-D-receptor in myeloid cells decreased the protective 1,25-VitD3 effect. Cell-culture of vascular fibroblasts confirmed the anti-tissue remodeling effect of 1,25-VitD3.
Conclusion: 1,25-VitD3 attenuates aneurysm development and subsequent progression to rupture. However, VitD-administration should be tested as optional treatment in management of patients with UIA.
Background: The extent of preoperative peritumoral edema in glioblastoma (GBM) has been negatively correlated with patient outcome. As several ongoing studies are investigating T-cell based immunotherapy in GBM, we conducted this study to assess whether peritumoral edema with potentially increased intracranial pressure, disrupted tissue homeostasis and reduced local blood flow has influence on immune infiltration and affects survival.
Methods: A volumetric analysis of preoperative imaging (gadolinium enhanced T1 weighted MRI sequences for tumor size and T2 weighted sequences for extent of edema (including the infiltrative zone, gliosis etc.) was conducted in 144 patients using the BrainlabÒ software. Immunohistochemical staining was analyzed for lymphocytic- (CD 3+) and myeloid (CD15+) tumor infiltration. A retrospective analysis of patient-, surgical-, and molecular characteristics was performed using medical records.
Results: The edema to tumor ratio was neither associated with progression-free nor overall survival (p=0.90, p=0.74). However, GBM patients displaying IDH-1 wildtype had significantly higher edema to tumor ratio than patients displaying an IDH-1 mutation (p=0.01). Immunohistopathological analysis did not show significant differences in lymphocytic or myeloid tumor infiltration (p=0.78, p=0.74) between these groups.
Conclusion: In our cohort, edema to tumor ratio had no significant correlation with immune infiltration and outcome. However, patients with an IDH-1wildtype GBM had a significantly higher edema to tumor ratio compared to their IDH-1 mutated peer group. Further studies are necessary to elucidate the underlying mechanisms.
Background: Dysphagia is a common and severe symptom of traumatic brain injury (TBI) affecting up to 78% of patients. It is associated with pneumonia, increased morbidity and mortality. Although subdural hematoma (SDH) accounts for over 50% of TBI, the occurrence of dysphagia in this subtype has not been investigated. This study investigates the overall frequency, clinical predictors of dysphagia and functional outcome of patients with SDH associated dysphagia.
Methods: All patients presenting in author ́s institution between 2007 and 2020 with SDH were included in the study. Patients with SDH and clinical suspicion for dysphagia received a clinical swallowing assessment by a speech and language pathologist (SLP). Furthermore the severity of dysphagia was rated according to swallowing disorder scale.Functional outcome was evaluated by Glasgow outcome scale (GOS).
Results: Of 545 patients with SDH, 71 patients had dysphagia (13%). The prevalence of dysphagia was significantly lower in the surgical arm compared to the conservative arm (11.8% vs 21.8%; OR 0.23; p=0.02). Independent predictors for dysphagia were GCS <13 at admission (p<0.001; OR 4.17), cardiovascular disease (p=0.002; OR 2.29) and pneumonia (p=0.002; OR 2.88) whereas operation was a protective factor (p<0.001; OR 0.2). All patients with dysphagia improved significantly under SLP treatment from initial diagnosis to hospital discharge (p<0.01). However, patients with most severe grade of dysphagia showed no significant improvement during the clinical course. Patients with dysphagia had significantly worse outcome (GOS 1-3) compared to those without dysphagia (48.8% vs 26.4%; p<0.001).
Conclusion: Dysphagia is a frequent symptom in SDH and the early identification of dysphagia is crucial regarding initiation of treatment and functional outcome. Surgery is effective in preventing dysphagia and should be considered in high-risked patients.
The magnetic fields generated in non-central heavy-ion collisions are among the strongest fields produced in the Universe, reaching magnitudes comparable to the scale of the strong interactions. Backed by model simulations, the resulting field is expected to be spatially modulated, deviating significantly from the commonly considered uniform profile. To improve our understanding of the physics of quarks and gluons under such extreme conditions, we use lattice QCD simulations with 2+1 staggered fermion flavors with physical quark masses and an inhomogeneous magnetic background for a range of temperatures covering the QCD phase transition. We assume a 1/cosh2 function to model the field profile and vary its strength to analyze the impact on the computed observables and on the transition. We calculate local chiral condensates, local Polyakov loops and estimate the size of lattice artifacts. We find that both observables show non-trivial spatial features due to the interplay between the sea and the valence effects.
According to perturbation theory predictions, QCD matter in the zero-temperature, high-density limits of QCD at nonzero isospin chemical potential is expected to be in a superfluid Bardeen-Cooper-Schrieffer (BCS) phase of u and d¯ Cooper pairs. It is also expected, on symmetry grounds, that such phase connects via an analytical crossover to the phase with Bose-Einstein condensation (BEC) of charged pions at μI≥mπ/2. With lattice results, showing some indications that the deconfinement crossover also smoothly penetrates the BEC phase, the conjecture was made that the former connects continuously to the BEC-BCS crossover. We compute the spectrum of the Dirac operator, and use generalized Banks-Casher relations, to test this conjecture and identify signatures of the superfluid BCS phase.
Background: Dexamethasone (Dex) is the most common corticosteroid to treat edema in glioblastoma (GBM) patients. Recent studies identified the addition of Dex to radiation therapy (RT) to be associated with poor survival. Independently, Tumor Treating Fields (TTFields) provides a novel anti-cancer modality for patients with primary and recurrent GBM. Whether Dex influences the efficacy of TTFields, however, remains elusive.
Methods: Human GBM cell lines MZ54 and U251 were treated with RT or TTFields in combination with Dex and the effects on cell counts and cell death were determined via flow cytometry. We further performed a retrospective analysis of GBM patients with TTFields treatment +/- concomitant Dex and analysed its impact on progression-free (PFS) and overall survival (OS).
Results: The addition of Dex significantly reduced the efficacy of RT in U251 and MZ54 cells. TTFields (200 kHz/250 kHz) induced massive cell death in both cell lines. Concomitant treatment of TTFields and Dex did not reduce the overall efficacy of TTFields. Further, in our retrospective clinical analysis, we found that the addition of Dex to TTFields therapy did not influence PFS nor OS.
Conclusion: Our translational investigation indicates that the efficacy of TTFields therapy in patients with GBM and primary GBM cell lines is not affected by the addition of Dex.
Study Design: Cross-sectional survey
Objective: To determine the influence of surgeons’ level of experience and subspeciality training on the reliability, reproducibility, and accuracy of sacral fracture classification using the AO Spine Sacral Injury Classification System.
Summary of Background Data: An ideal classification system is easily comprehensible and reliable amongst the diverse group of surgeons. A surgeons’ level of experience may have a significant effect on the reliability and accuracy of a classification system. Moreover, surgeons of different subspecialities may have various levels of comfort with imaging assessment of sacral injuries required for accurate diagnosis and classification.
Methods: High-resolution computerized tomography (CT) images from 26 cases were assessed by 172 investigators from a diverse array of surgical subspecialities (general orthopaedics, neurosurgery, orthopaedic spine, orthopaedic trauma) and experience (<5, 5-10, 11-20, >20 years). Validation assessments were performed via web conference using high-resolution images, as well as axial/sagittal/coronal CT scan sequences. Two assessments were performed by each investigator independently three weeks apart in randomized order. Reliability and reproducibility were calculated with cohen’s kappa coefficient (k) and gold standard classification agreement was determined for each fracture morphology and subtype and stratified by experience and subspeciality.
Results: Respondents achieved an overall k = 0.87 for morphology and k = 0.77 for subtype classification, representing excellent and substantial intraobserver reproducibility, respectively. Respondents from all four practice experience groups demonstrated excellent interobserver reliability when classifying overall morphology (k=0.842/0.850, Assessment 1/Assessment 2) and substantial interobserver reliability in overall subtype (k=0.719/0.751) in both assessments. General orthopaedists, neurosurgeons, and orthopaedic spine surgeons exhibited excellent interobserver reliability in overall morphology classification and substantial interobserver reliability in overall subtype classification. Surgeons in each experience category and subspecialty correctly classified fracture morphology in over 90% of cases and fracture subtype in over 80% of cases according to the gold standard. Correct overall classification of fracture morphology (Assessment 1: p= 0.024, Assessment 2: p=0.006) and subtype (p2<0.001) differed significantly with surgeons with >20 years of experience demonstrating increased difficulty correctly classifying all fracture subtypes overall in comparison to the other experience groups. Correct overall classification did not significantly differ by subspecialty.
Conclusions: Overall, the AO Spine Sacral Injury Classification System appears to be universally applicable among surgeons of various subspecialties and levels of experience with acceptable reliability, reproducibility, and accuracy.
Disclosures: author 1: none; author 2: consultant=Medtronic, Nuvasive, ISD, Asutra, Stryker, Bioventus, Zimmer, teledocs, Clinical Spine Surgery, AOSpine ; author 3: none; author 4: grants/research support=AOSpine, consultant=DPS, icotec; author 5: none; author 6: none; author 7: grants/research support=DPS; author 8: none; author 9: grants/research support=NIH, RTI, CSRS, royalties=Inion ; author 10: stock/shareholder=Advanced Spinal Intellectual Properties; Atlas Spine; Avaz Surgical; Bonovo Orthopaedics; Computational Biodynamics; Cytonics; Deep Health; Dimension Orthotics LLC; Electrocore; Flagship Surgical; FlowPharma; Globus; Innovative Surgical Design; Insight Therapeutics; Jushi; Nuvasive; Orthobullets; Paradigm Spine; Parvizi Surgical Innovation; Progressive Spinal Technologies; Replication Medica; Spine Medica; Spineology; Stout Medical; Vertiflex; ViewFi Health, royalties=Aesculap; Atlas Spine; Globus; Medtronics; SpineWave; Stryker Spine,other financial report=AO Spine
We empirically investigate algorithms for solving Connected Components in the external memory model. In particular, we study whether the randomized O(Sort(E)) algorithm by Karger, Klein, and Tarjan can be implemented to compete with practically promising and simpler algorithms having only slightly worse theoretical cost, namely Borůvka’s algorithm and the algorithm by Sibeyn and collaborators. For all algorithms, we develop and test a number of tuning options. Our experiments are executed on a large set of different graph classes including random graphs, grids, geometric graphs, and hyperbolic graphs. Among our findings are: The Sibeyn algorithm is a very strong contender due to its simplicity and due to an added degree of freedom in its internal workings when used in the Connected Components setting. With the right tunings, the Karger-Klein-Tarjan algorithm can be implemented to be competitive in many cases. Higher graph density seems to benefit Karger-Klein-Tarjan relative to Sibeyn. Borůvka’s algorithm is not competitive with the two others.
In this contribution we report the status and plans of the open lattice initiative to generate and share new gauge ensembles using the stabilised Wilson fermion framework. The production strategy is presented in terms of a three stage plan alongside summaries of the data management as well as access policies. Current progress in completing the first stage of generating ensembles at four lattice spacings at the flavor symmetric point is given.
This work is focused on the anomalous skin effect in copper and how it affects the efficiency of copper-cavities in the temperature range 40-50 K. The quality factor Q of three coaxial cavities was measured over the temperature range from 10 K to room temperature in the experiment. The three coaxial cavities have the same structure, but different lengths, which correspond to resonant frequencies: around 100 MHz, 220 MHz and 340 MHz. Furthermore, the effects of copper-plating and additional baking in the vacuum oven on the quality factor Q are studied in the experiment. The motivation is to check the feasibility of an efficient, pulsed, ion linac, operated at cryogenic temperatures.
OPEN SCIENCE, VERSION 3.0: Breaking down barriers for equitable and efficient research communication
(2022)
Propranolol as a potentially novel treatment of arteriovenous malformations: from bench to bedside
(2022)
Background: Propranolol is a non-selective blocker of the β-adrenergic receptor and has been used for treatment of proliferative infantile hemangiomas. The vasoconstrictive and antiangiogenic effects of propranolol led us to explore its potential application for the treatment of AVMs.
Methods: AVM tissue was cultured after surgical resection in the presence of 100μM propranolol or solvent DMSO. After incubation for 72 hours, tissue was harvested for testing. The expression levels of SDF1α, CXCR4, VEGF and HIF-1 was measured by rt-PCR. Furthermore, data of patients in 2 vascular centres harboring AVM was retrospectively interrogated for a time period of 20 years. The database included information about hemorrhage, AVM size and antihypertensive medication. Descriptive analyses were performed, focusing on the risk of hemorrhage, size of the lesion at presentation and clinical follow-up in patients on β-blocker medication versus those who were not.
Results: Among 483 patients, 73 (15%) were under β-blocker-treatment. 48% AVMs presented with hemorrhage at diagnosis. Patients under β-blocker-treatment had a lower risk of hemorrhage at the time of diagnosis in a univariate analysis (p<0,0001;OR13). Patients under β-blocker-treatment showed a significant higher chance for a lower Spetzler-Martin-grade ≤III (p<0,0001;OR6,5) and a lower risk for the presence of an associated aneurysm (p<0,0001;OR3,6).
Multivariate analysis including Spetzler-Martin-Grading, young age ≤50, presence of associated aneurysm and β-blocker-treatment showed reduced risk for hemorrhage under β-blocker-treatment (p<0,01,OR0,2).
The expression of CXCR4 was suppressed by propranolol most likely through the HIF-1-pathways. The gene-expression of vasculogenesis factors was decreased in with propranolol incubated AVMs.
Conclusion: β-Blocker medication seems to be associated with a decreased risk of AVM-related hemorrhage and AVM-size at presentation or during follow-up. Propranolol inhibits SDF1α-induced vasculogenesis by suppressing the expression of CXCR4 most likely through the HIF-1-pathways. Therefore, SDF1α/CXCR4 axis plays an important role in the vasculogenesis and migration of inflammatory cells in AVM lesions.
Background: During the COVID-19 pandemic, decreased volumes of acute stroke admissions were reported. We aimed to examine whether subarachnoid hemorrhage (SAH) volumes demonstrated similar declines in our department. Furthermore, the impact of pandemic on disease progression should be analyzed.
Methods: We conducted a retrospective study in neurosurgical department of university hospital Frankfurt including patients with the diagnosis of aneurysmal SAH during the first year of COVID-pandemic. One year cumulative volume for SAH hospitalization procedures were compared to the one-year period before (03/2020–02/2021 versus 03/2019–02/2020) and the last 5 pre-COVID-pandemic years (2015-2020). All relevant patient characteristics concerning family history, disease history, clinical condition at admission, active/past COVID-infection, treatment management, complications and outcome were analyzed.
Results: There was a decline in SAH hospitalizations, with 84 admissions in the year immediately before and 56 admissions during the pandemic, without reaching a significance. No significant difference in analyzed patient characteristics including clinical condition at onset, treatment, complications and outcome, between 56 SAH patients admitted during COVID pandemic and treated patients in the last 5 years in pre-COVID period were found. Using a multivariable analysis, we detected young age (p<0.05;OR4,2) and no existence of early hydrocephalus (p<0.05;OR0,13) as important factors for a favorable outcome (mRS≤0-2) after aSAH during the COVID-pandemic. A past COVID-infection was detected in young patients suffering from aSAH (Age< 50years, p<0.05;OR10,5) with increased rate of cerebral vasospasm after SAH onset (p<0.05;OR26). Nevertheless, past COVID-infection did not reach a significance as a high risk factor for unfavorable outcome.
Conclusion: There was a relative decrease in the volume of SAH during the COVID-19 pandemic. Despite of extremely different conditions of hospitalization, there was no impairing significant effect on treatment and outcome of admitted SAH patients. A past COVID-infection seemed not to be a relevant limiting factor concerning favorable outcome.
Background: Following elective craniotomy patients routinely receive monitoring on ICU. However, the benefit of ICU monitoring in these patients is discussed controversially. Due to the current COVID-19 pandemic, there are further limitations of ICU capacities. This study aimed to compare this strategy with a standardized management of post-craniotomy patients on ICU.
Methods: Two postoperative strategies were compared in a matched-pair analysis: The first cohort included patients treated between May-August 2021 according to the “No ICU – unless” concept (NIU group), where patients were managed on the normal ward postoperatively. The second cohort contained patients routinely admitted to the ICU between February-April 2021 (control group). Outcome parameters contained complications, length of stay, duration to first postoperative mobilization, number of unplanned imaging, number/type of ICU interventions and pre- and postoperative mRS. Patient characteristics were analyzed using electronic medical records.
Results: The NIU group consisted of 96 patients, the control group of 75 patients. Complication rates were comparable in both cohorts (16% in NIU vs. 17% in control; p=0.123). Groups did not differ significantly in the number of imaging (10% in NIU vs. 13% in control; p=0.67), in the type of interventions on ICU (antihypertensive therapy 5% (NIU) vs. 6% (control); p=0.825) or in the time to first postoperative mobilization (average 1.1± 1.6 days vs. 0.9± 1.2 days; p=0.402). Length of hospital stay was shorter in the NIU group without reaching statistical significance (average 5.8 vs. 6.8 days; p=0.481). There was no significant change in the distribution of preoperative (p=0.960) and postoperative (p=0.425) mRS scores.
Conclusion: Postoperative ICU management does not reduce postoperative complications and has no effect on the surgical outcome of elective craniotomies. The majority of postoperative complications are detected after a 24-hour observation period. This approach may represent a potential strategy to prevent overutilization of ICU capacities while maintaining sufficient postoperative care for neurosurgical patients.
Background: A growing interest exists in using polymeric nanoparticles (NPs) especially functionalized with surface-active substances as carriers across the blood brain barrier (BBB) for potentially effective drugs in traumatic brain injury (TBI). However, the organ distribution of intravenous administrated biodegradable and non-biodegradable NPs coated with different surfactants, how much of the administrated dose reach the brain parenchyma in areas with intact and opened BBB after trauma, as well as whether they elicit an inflammatory response is still to be clarified.
Methods: The organ distribution, brain penetration and eventual inflammatory activation of polysorbate-80 (Tw80) and sodium-lauryl-sulfate (SDS) coated poly l-lactide (PLLA) and perfluorodecyl acrylate (PFDL) nanoparticles were evaluated after intravenous administration in rats prior and after undergoing controlled cortical impact (CCI).
Results: A significant highest NP uptake at 4 and 24 hs was observed in the liver and spleen, followed by the brain and kidney, with minimal concentrations in the lungs and heart for all NPs. After CCI, a significant increase of NP uptake at 4 hs and 24 hs was observed within the traumatized hemisphere, especially in the perilesional area, although NPs were still found in areas away from CCI and the contralateral hemisphere in similar concentrations as in non-CCI subject. NPs were localized in neurons, glial and endovascular cells. Immunohistochemical staining against GFAP, Iba1, TNFα and IL1β demonstrated no glial activation or neuroinflamatory changes.
Conclusions: Tw80 and SDS coated biodegradable (PLLA) and non-biodegradrable (PFDL) NPs reach the brain parenchyma in both areas of traumatized and undamaged brain with disrupted and intact BBB, even though a high amount of them are retained in the liver and the spleen. No inflammatory reaction is elicited by these NPs within 24 hs after application. These preliminary promising results postulate the effectiveness and safety of these NPs as drug-carriers for the treatment of TBI.
Background: The most frequent therapy of hydrocephalus is the implantation of ventriculoperitoneal shunts for diverting cerebrospinal fluid from the ventricles into the peritoneum. We compared two adjustable valves, the proGAV and proGAV 2.0, for complications which resulted in revision operations.
Methods: Four hundred patients who underwent primary shunt implantation between 2014 and 2020 were analyzed for overall revision rate, one-year revision rate, revision free survival and overall survival observing patient age group, gender, etiology of hydrocephalus, implantation site, prior diversion of cerebrospinal fluid and cause of revision.
Results: All data were available of all 400 patients (female/male 208/192). Overall, 99 patients underwent revision surgery after primary implantation. ProGAV valve was implanted in 283 patients, proGAV 2.0 in 117 patients. There was no significant difference between the two shunt valves concerning revision rate (p=0.8069), one-year revision rate (p=0.9077), revision free survival (p=0.6921) and overall survival (p=0.3232). Furthermore, regarding one-year revision rate, we observed no significant difference between the two shunt valves in pediatric patients (40.7% vs 27.6%; p=0.2247). Revision operation had to be performed more frequently in pediatric patients (46.6% vs 24.8%; p=0.0093) with a significant higher number of total revisions with proGAV than proGAV 2.0 (55.9% vs. 27.6%; p=0.0110) most likely due to longer follow up in the proGAV -group.
Conclusion: According to the target variables we analyzed, aside from lifetime revision rate in pediatric patients there is no significant difference between the two shunt valves. From our subjective point of view, implantation of the newer proGAV 2.0 valve is preferable due to higher adjustment comfort for both patients and physicians.
In this work we study the 3+1-dimensional Nambu-Jona-Lasinio (NJL) model in the mean field-approximation. We carry out calculations using five different regularization schemes (two continuum and three lattice regularization schemes) with particular focus on inhomogeneous phases and condensates. The regularization schemes lead to drastically different inhomogeneous regions. We provide evidence that inhomogeneous condensates appear for all regularization schemes almost exclusively at values of the chemical potential and with wave numbers, which are of the order of or even larger than the corresponding regulators. This can be interpreted as indication that inhomogeneous phases in the 3+1-dimensional NJL model are rather artifacts of the regularization and not a consequence of the NJL Lagrangian and its symmetries.
We refine our previous study of a udb¯b¯ tetraquark resonance with quantum numbers I(JP)=0(1−), which is based on antiheavy-antiheavy lattice QCD potentials, by including heavy quark spin effects via the mass difference of the B and the B∗ meson. This leads to a coupled channel Schrödinger equation, where the two channels correspond to BB and B∗B∗, respectively. We search for T matrix poles in the complex energy plane, but do not find any indication for the existence of a tetraquark resonance in this refined coupled channel approach. We also vary the antiheavy-antiheavy potentials as well as the b quark mass to further understand the dynamics of this four-quark system.
Effective three-dimensional Polyakov loop theories derived from QCD by strong coupling and hopping expansions are valid for heavy quarks and can also be applied to finite chemical potential μ, due to their considerably milder sign problem. We apply the Monte-Carlo method to the Nf=1,2 effective theories up to O(κ4) in the hopping parameter at μ=0 to determine the critical quark mass, at which the first-order deconfinement phase transition terminates. The critical end point obtained from the effective theory to order O(κ2) agrees well with 4-dimensional QCD simulations with a hopping expanded determinant by the WHOT-QCD collaboration. We also compare with full QCD simulations and thus obtain a measure for the validity of both the strong coupling and the hopping expansion in this regime.
The STAR experiment provides a perfect machinery for studying strange matter for more than two decades. Recently, we developed the express procedure, which allows online monitoring of the collected physics data. The high quality of express calibration and reconstruction provides a unique possibility to run the express production and observe almost in real time strange particles including mesons, hyperons, resonances and even hypernuclei.
The STAR Beam Energy Scan II program, including fixed target Au+Au collisions taken in 2018–2021, is particularly suited to study hypernuclei. Light hypernuclei are expected to be abundantly produced in low energy heavy-ion collisions. Measurements of hypernuclei production and their properties will provide information on the hyperon-nucleon interactions, which are essential ingredients for understanding nuclear matter equation of state at high net-baryon densities, such as inside neutron stars.
With the heavy fragment trigger introduced for the 2021 data taking, we were able to run the express production at the STAR High Level Trigger farm. The collected data were suffcient to observe the decay process of Λ5He →4Hepπ− with more than 11σ significance, measure binding energy as a function of hypernuclei mass, and study hypernuclei decay properties with the Dalitz plot technique.
We study the high temperature transition in pure SU(3) gauge theory and in full QCD with 3D-convolutional neural networks trained as parts of either unsupervised or semi-supervised learning problems. Pure gauge configurations are obtained with the MILC public code and full QCD are from simulations of Nf=2+1+1 Wilson fermions at maximal twist. We discuss the capability of different approaches to identify different phases using as input the configurations of Polyakov loops. To better expose fluctuations, a standardized version of Polyakov loops is also considered.
We present SU(3) lattice Yang-Mills data for hybrid static potentials from five ensembles with different small lattice spacings and the corresponding parametrizations for quark-antiquark separations 0.08fm≤r≤1.12fm. We remove lattice discretization errors at tree level of perturbation theory and partly at order a2 as well as the a-dependent self energy. In particular the tree-level improvement of static potentials is discussed in detail and two methods are compared. The resulting parametrizations are expected to represent continuum limit results for hybrid static potentials within statistical errors.
Gravitational-wave cosmology with dark sirens: state of the art and perspectives for 3G detectors
(2022)
A joint fit of the mass and redshift distributions of the population of Binary Black Holes detected with Gravitational-Wave observations can be used to obtain constraints on the Hubble parameter and on deviations from General Relativity in the propagation of Gravitational Waves. We first present applications of this technique to the latest catalog of Gravitational-Wave events, focusing on the comparison of different parametrizations for the source-frame mass distribution of Black Hole Binaries. We find that models with more than one feature are favourite by the data, as suggested by population studies, even when varying the cosmology. Then, we discuss perspectives for the use of this technique with third generation Gravitational-Wave detectors, exploiting the recently developed Fisher information matrix Python code GWFAST.
Study of I = 0 bottomonium bound states and resonances based on lattice QCD static potentials
(2022)
We investigate I=0 bottomonium bound states and resonances in S, P, D and F waves using lattice QCD static-static-light-light potentials. We consider five coupled channels, one confined quarkonium and four open B(∗)B¯(∗) and B(∗)sB¯(∗)s meson-meson channels and use the Born-Oppenheimer approximation and the emergent wave method to compute poles of the T matrix. We discuss results for masses and decay widths and compare them to existing experimental results. Moreover, we determine the quarkonium and meson-meson composition of these states to clarify, whether they are ordinary quarkonium or should rather be interpreted as tetraquarks.
The OpenLat initiative presents its results of lattice QCD simulations using Stabilized Wilson Fermions (SWF) using 2+1 quark flavors. Focusing on the SU(3) flavor symmetric point mπ=mK=412 MeV, four different lattice spacings (a=0.064,0.077,0.094,0.12 fm) are used to perform the continuum limit to study cutoff effects. We present results on light hadron masses; for the determination we use a Bayesian analysis framework with constraints and model averaging to minimize the bias in the analysis.
The thermodynamics of QCD with sufficiently heavy dynamical quarks can be described by a three-dimensional Polyakov loop effective theory, obtained after a truncated character and hopping expansion. We investigate the resulting phase diagram for low temperatures by mean field methods. Taking into account chemical potentials for both baryon number and isospin, we obtain clear signals for a liquid-gas type transition to baryon matter at μI=0 and a Bose-Einstein condensation transition at μB=0, as well as for their connection when both chemical potentials are non-zero.
Computation of masses of quarkonium bound states using heavy quark potentials from lattice QCD
(2022)
We compute masses of bottomonium and charmonium bound states using a Schrödinger equation with a heavy quark-antiquark potential including 1/m and 1/m2 corrections previously derived in potential Non-Relativistic QCD and computed with lattice QCD. This is a preparatory step for a future project, where we plan to take into account similar corrections to study quarkonium resonances and tetraquarks above the lowest meson-meson thresholds.
The global center symmetry of quenched QCD at zero baryonic chemical potential is broken spontaneously at a critical temperature Tc leading to a first-order phase transition. Including heavy dynamical quarks breaks the center symmetry explicitly and weakens the first-order phase transition for decreasing quark masses until it turns into a smooth crossover at a Z(2)-critical point. We investigate the Z(2)-critical quark mass value towards the continuum limit for Nf=2 flavors using lattice QCD in the staggered formulation. As part of a continued study, we present results from Monte-Carlo simulations on Nτ=8,10 lattices. Several aspect ratios and quark mass values were simulated in order to obtain the critical mass from a fit of the Polyakov loop to a kurtosis finite size scaling formula. Moreover, the possibility to develop a Ginzburg-Landau effective theory around the Z(2)-critical point is explored.
For the exploration of the phase diagram of QCD, effective Polyakov loop theories derived from lattice QCD provide a valuable tool in the heavy quark mass regime. In practice, the evaluation of these theories is complicated by the appearance of long-range and multipoint interaction terms. On the other hand, it is well known that for theories with such kind of interactions mean field approximations can be expected to yield reliable results. Here, we apply this framework to the critical endpoint of the deconfinement transition and results are compared to the literature. This treatment can also be used to investigate the phase diagram at non-zero baryon and isospin chemical potential.
Approaching the continuum limit of the deconfinement critical point for Nf=2 staggered fermions
(2022)
Quenched QCD at zero baryonic chemical potential undergoes a first-order deconfinement phase transition at a critical temperature Tc, which is related to the spontaneous breaking of the global center symmetry. The center symmetry is broken explicitly by including dynamical quarks, which weaken the first-order phase transition for decreasing quark masses. At a certain critical quark mass, which corresponds to the Z(2)-critical point, the first-order phase transition turns into a smooth crossover. We investigate the Z(2)-critical quark mass for Nf=2 staggered fermions on Nτ=8,10 lattices, where larger Nτ correspond to finer lattices. Monte-Carlo simulations are performed for several quark mass values and aspect ratios in order to extrapolate to the thermodynamic limit. We present final results for Nτ=8 and preliminary results for Nτ=10 for the critical mass, which are obtained from fitting to a kurtosis finite size scaling formula of the absolute value of the Polyakov loop.
The so-called Columbia plot summarises the order of the QCD thermal transition as a function of the number of quark flavours and their masses. Recently, it was demonstrated that the first-order chiral transition region, as seen for Nf∈[3,6] on coarse lattices, exhibits tricritical scaling while extrapolating to zero on sufficiently fine lattices. Here we extend these studies to imaginary baryon chemical potential. A similar shrinking of the first-order region is observed with decreasing lattice spacing, which again appears compatible with a tricritical extrapolation to zero.
In an ideal world, extraction of machine-readable data and knowledge from natural-language biodiversity literature would be done automatically, but not so currently. The BIOfid project has developed some tools that can help with important parts of this highly demanding task, while certain parts of the workflow cannot be automated yet. BIOfid focuses on the 20th century legacy literature, a large part of which is only available in printed form. In this workshop, we will present the current state of the art in mobilisation of data from our corpus, as well as some challenges ahead of us. Together with the participants, we will exercise or explain the following tasks (some of which can be performed by the participants themselves, while other tasks currently require execution by our specialists with special equipment): Preparation of text files as an input; pre-processing with TextImager/TextAnnotator; semiautomated annotation and linking of named entities; generation of output in various formats; evaluation of the output. The workshop will also provide an outlook for further developments regarding extraction of statements from natural-language literature, with the long-term aim to produce machine-readable data from literature that can extend biodiversity databases and knowledge graphs.
Recently, an approximate SU(4) chiral spin-flavour symmetry was observed in multiplet patterns of QCD meson correlation functions, in a temperature range above the chiral crossover. This symmetry is larger than the chiral symmetry of massless QCD, and can only arise effectively when colour-electric quark-gluon interactions dynamically dominate the quantum effective action. At temperatures about three times the crossover temperature, these patterns disappear again, indicating the screening of colour-electric interactions, and the expected chiral symmetry is recovered. In this contribution we collect independent evidence for such an intermediate temperature range, based on screening masses and the pion spectral function. Both kinds of observables behave non-perturbatively in this window, with resonance-like peaks for the pion and its first excitation disappearing gradually with temperature. Using symmetry arguments and the known behaviour of screening masses at small densities, we discuss how this chiral spin symmetric band continues into the QCD phase diagram.
n this joint contribution we announce the formation of the "OPEN LATtice initiative", this https URL, to study Stabilised Wilson Fermions (SWF). They are a new avenue for QCD calculations with Wilson-type fermions and we report results on our continued study of this framework: Tuning the clover improvement coefficient, and extending the reach of lattice spacings to a=0.12 fm. We fix the flavor symmetric points mπ=mK=412 MeV at a=0.055,0.064,0.077,0.094,0.12 fm and define the trajectories to the physical point by fixing the trace of the quark mass matrix. Currently our pion mass range extends down to mπ∼200 MeV. We outline our tuning goals and strategy as well as our future planned ensembles. First scaling studies are performed on fπ and mπ. Additionally results of a preliminary continuum extrapolation of mN at the flavor symmetric point are presented. Going further a first determination of the light and strange hadron spectrum chiral dependence is shown, which serves to check the quality of the action for precision measurements. We also investigate other quantities such as flowed gauge observables to study how the continuum limit is approached. Taken together we observe the SWF enable us to perform stable lattice simulations across a large range of parameters in mass, volume and lattice spacing. Pooling resources our new initiative has made our reported progress possible and through it we will share generated gauge ensembles under an open science philosophy.
We compute the equation of state of isospin asymmetric QCD at zero and non-zero temperatures using direct simulations of lattice QCD with three dynamical flavors at physical quark masses. In addition to the pressure and the trace anomaly and their behavior towards the continuum limit, we will particularly discuss the extraction of the speed of sound. Furthermore, we discuss first steps towards the extension of the EoS to small non-zero baryon chemical potentials via Taylor expansion.
The interrelation between quantum anomalies and electromagnetic fields leads to a series of non-dissipative transport effects in QCD. In this work we study anomalous transport phenomena with lattice QCD simulations using improved staggered quarks in the presence of a background magnetic field. In particular, we calculate the conductivities both in the free case and in the interacting case, analysing the dependence of these coefficients with several parameters, such as the temperature and the quark mass.
Stabilized Wilson fermions are a reformulation of Wilson clover fermions that incorporates several numerical stabilizing techniques, but also a local change of the fermion action - the original clover term being replaced with an exponentiated version of it. We intend to apply the stabilized Wilson fermions toolbox to the thermodynamics of QCD, starting on the Nf=3 symmetric line on the Columbia plot, and to compare the results with those obtained with other fermion discretizations.
We discuss results for the Roberge Weiss (RW) phase transition at nonzero imaginary baryon and isospin chemical potentials, in the plane of temperature and quark masses. Our study focuses on the light tricritical endpoint which has already been used as a starting point for extrapolations aiming at the chiral limit at vanishing chemical potentials. In particular, we are interested in determining how imaginary isospin chemical potential shifts the tricritical mass with respect to earlier studies at zero imaginary isospin chemical potential. A positive shift might allow one to perform the chiral extrapolations from larger quark mass values, therefore making them less computationally expensive. We also present results for the dynamics of Polyakov loop clusters across the RW phase transition.
We present first results of a recently started lattice QCD investigation of antiheavy-antiheavy-light-light tetraquark systems including scattering interpolating operators in correlation functions both at the source and at the sink. In particular, we discuss the importance of such scattering interpolating operators for a precise computation of the low-lying energy levels. We focus on the b¯b¯ud four-quark system with quantum numbers I(JP)=0(1+), which has a ground state below the lowest meson-meson threshold. We carry out a scattering analysis using Lüscher's method to extrapolate the binding energy of the corresponding QCD-stable tetraquark to infinite spatial volume. Our calculation uses clover u, d valence quarks and NRQCD b valence quarks on gauge-link ensembles with HISQ sea quarks that were generated by the MILC collaboration.
In this work, the phase diagram of the 2+1-dimensional Gross-Neveu model is investigated with baryon chemical potential as well as chiral chemical potential in the mean-field approximation. We study the theory using two lattice discretizations, which are both based on naive fermions. An inhomogeneous chiral phase is observed only for one of the two discretizations. Our results suggest that this phase disappears in the continuum limit.
Nitrogen pollution is a major constituent of global change, threatening local biodiversity, ecosystem services, and causing serious environmental damage. Specifically, in areas with heavy agricultural soil-use, excessive use of nitrogen fertilizer pollutes the groundwaters with nitrates, but also with ammonia and nitrites. Freshwater fish and other aquatic fauna are especially vulnerable to nitrites, which can cause massive mortalities at even low concentrations < 0.1 mg/l NO2- - N. Adaptation of fish to environments with relatively high concentrations of chemicals has occurred throughout the history of life, although contemporary evolution acts at a much more rapid pace. The growing use of land for mass agriculture and livestock industries in the last 50 years in Florida has dramatically increased the nutrient loading into the groundwaters that feed the springs. Nitrite poses a serious threat for freshwater fauna as it is rapidly up taken and disturbs ion homeostasis and blood gas transport in fish. In this study, we evaluated, by means of a common-garden experiment, the tolerance of fish to nitrite using three different populations of eastern mosquitofish (Gambusia holbrooki) with different background nitrogen pollution histories. Mosquitofish females were exposed to nitrite in the lab, to either < 0.005 mg/l NO2- (control) or 0.3 mg/l NO2- for ten days and we assessed at the end of the exposure period their blood O2 transport capacity by measuring the concentration of four different types of hemoglobin, their total hematocrit, and their respiratory rates. Preliminary results show slight but significant varying patterns in the response of the exposed fish, depending on the population source, as evidenced by their respiratory rates and the blood erythrocyte counts. Mortality was very low, and hemoglobin profiles indicate high tolerance of G. holbrooki to nitrite contamination – a factor supporting their invasion success in agriculturally dominated regions around the world.
Introduction: The influence of our diet on mental health is of increasing importance in current research. Study results on the gut-brain axis suggest that the gut microbiome can influence mental processes via neuronal, hormonal and immune signaling pathways [1]. The gut microbiome is largely influenced by our diet. Some studies provide evidence that a "Western diet" rich in saturated fat and sugar may promote mental disorders [2]. There is evidence, that dietary behaviour in individuals with Attention Deficit Hyperactivity Disorder (ADHD) is characterized by an increased intake of sugar and saturated fat [3]. So far, it is unclear whether this dietary pattern contributes to ADHD symptoms such as impulsivity. The aim of this study is to investigate the influence of certain macronutrients such as fats and mono/disaccharides on impulsivity in individuals with ADHD. Using our APPetite-mobile-app [4] enabled us to study dietary behaviour and momentary impulsiveness in everyday life of our participants.
Methods: 43 participants with ADHD (mean age 36.0 ± 12.3 years, 21 females) and 186 healthy controls (mean age 28.5 ± 7.7 years, 133 females) without any psychiatric condition were included into the study. Food intake was recorded over a period of three days using the APPetite-mobile-app via a 6 step process: (1) Selection of meal type, (2) Entry of time of meal, (3) Selection of consumed foods and drinks, (4) Specification of consumed amounts, (5) Presentation of reminder for commonly forgotten foods, and (6) Indication of predominant reason for eating. In addition to entering consumed foods in the APPetite-mobile-app, subjects completed an online food log for the last 24 hours (myfood 24) at the beginning of the study. After the data collection period, a detailed analysis of the ingested nutrients was performed for each subject. Trait impulsivity was assessed using the UPPS-P, a self-assessment questionnaire. Momentary impulsiveness was assessed via the mHealth APP by means of the Momentary Impulsiveness scale (MIS). The MIS consists of 4 questions capturing different aspects of impulsivity. The participants were prompted to answer these questions at 8 semi-random times per day between 8 AM and 10 PM. The minimum time between 2 prompts was 1 hour. Thereby participants could not predict the exact time of the next prompt and the assessed situations are a better reflection of the participant’s real life.
Results: ANOVA revealed higher levels of both, trait and momentary impulsivity in individuals with ADHD compared to controls (p < 0,01). After preprocessing of data that was sampled via the mHealth APP is completed, a regression analysis with different macronutrients as predictors and impulsivity as dependent variable will be computed. To assess the association between momentary impulsiveness and dietary intake, generalized linear multilevel modelling will be used. Results of these analyses will be presented.
Sulfur in the slab: a sulfur-isotopes and thermodynamic-modeling perspective from exhumed terranes
(2022)
Sulfur is a key element in the subduction zone-volcanic arc system; however, the mechanism(s) that recycle sulfur from the slab into the overlying volcanic arc are debated. Here we summarize recent advances in quantifying this component of the deep sulfur cycle. First, primary metamorphic or inherited sulfides in oceanic-type eclogites are only rarely observed as inclusions and are typically absent from the rock matrix. Additionally, sulfides are relatively common in rocks metasomatized at the slab-mantle interface by slab-derived fluids during exhumation. Combined, these two observations suggest that sulfur loss from subducted mafic crust is relatively efficient. Thermodynamic modeling in Perple_X using the Holland and Powell (2011) database combined with the Deep Earth Water model suggests that the efficiency and speciation of sulfur loss varies depending on the degree of seafloor alteration prior to subduction and the geothermal gradient of the slab. In relatively cold subduction zones, such as Honshu, slab-fluids derived from subducted mafic crust are predicted to exhibit elevated concentrations of HSO4-, SO42-, HSO3-, and CaSO4(aq), whereas hot subduction zones, such as Cascadia, are predicted to produce slab fluids enriched in HS- and H2S at lower pressures. The oxidation of sulfur expelled from subducted pyrite is balanced by the reduction of Fe3+ to Fe2+, consistent with the low Fe3+/SFe of exhumed eclogites relative to blueschists and altered oceanic crust. Where oxidized S-bearing fluids are produced, they are anticipated to interact with more reduced rocks at the slab-mantle interface and within the mantle wedge, resulting in sulfide precipitation and significant isotopic fractionation. The δ34S values of slab fluids are estimated to fall between -11 and +8 ‰. Rayleigh fractionation during progressive fluid-rock interaction results in fractionations of tens of per mil as oxidized species are depleted and sulfides are precipitated, resulting in δ34S values of sulfides that easily span the -21.7 to +13.9 ‰ range observed in metasomatic sulfides in exhumed high-pressure rocks. However, in subduction zones where reduced species prevail, the S isotopic signature of slab fluids is expected to reflect their source and will exhibit a narrower range in δ34S values. As a result, the δ34S values measured in arc magmas may not always be a reliable indicator of the contribution of different components of the slab, such as sediments vs. AOC. Additionally, the impact of S recycling on the oxygen fugacity of arc magmas is expected to vary both spatially and temporally throughout Earth history.
Differential invariant cross sections of light neutral mesons in p-Pb collisions at √sNN = 8.16 TeV and in pp collisions at √s = 8 TeV have been measured up to very high transverse momentum (pT). By combining independent reconstruction techniques available in ALICE using the EMCal and PHOS calorimeters as well as the central barrel tracking detectors, the combined spectra cover almost two orders of magnitude in pT for the π0 meson. The nuclear modification factor RpPb has been measured for the π0 and η mesons and is found to be consistent with NLO pQCD, CGC and energy loss calculations. Comparisons to the RpPb of π0 measured in √sNN = 5.02 TeV hint at a stronger suppression at low pT with increasing collision energy.
Oral e-Poster Presentations - Booth 1: Vascular 3, September 27, 2023, 10:00 AM - 10:40 AM
Background: Despite current clinical guidelines recommending suboccipital decompressive craniectomy (SDC) in patients with space-occupying cerebellar infarction when neurological deterioration occurs, the precise definition of such deterioration remains unclear. The current study aimed at characterizing whether clinical outcomes can be predicted by the GCS score immediately prior to SDC, and whether higher GCS scores are associated with better clinical outcomes. We aimed to characterize whether clinical outcomes can be predicted by the GCS score immediately prior to SDC, and if higher GCS scores are associated with better clinical outcomes.
Methods: In a single-center, retrospective analysis of 51 patients treated with SDC for space-occupying cerebellar infarction clinical and imaging data were evaluated at the timepoints of symptom onset, hospital admission and preoperatively. Clinical outcome was measured by mRS at the last available follow-up. Preoperative GCS scores were stratified into three groups (GCS 3-8, 9-11 and 12-15). Univariate and multivariate Cox regression analyses were performed using clinical and radiological parameters as predictors of clinical outcome.
Results: In Cox-regression analysis using mRS of 1-2 as a positive clinical outcome we found a significant increase in the proportional hazard ratio (HR) of 6.581 [CI 1.839-36.414]; p=0.031 for GCS scores of 12-15 prior to SDC. Clinical outcomes (mRS 3-6) were associated with infarct volume above 6.0 cm3 (HR 2.473 [CI 1.209-5.057]; p=0.013), tonsillar herniation (HR: 0.279 [CI 0.083-0.933]; p=0.038), brainstem compression (HR 0.304 [CI 0.123-0.749]; p=0.010) and a preoperative GCS score of 3-8 (HR 2.386 [CI 1.160-4.906]; p=0.018).
Conclusions: SDC should be considered in patients with infarct volumes above 6.0 cm3 with GCS scores higher than previously described in the literature, as these patients may show better long-term outcome than those in which surgery is delayed until a GCS score of 11 or lower.
Garnet xenocrysts from kimberlites provide unique insights into the composition, structure and evolution of the subcontinental lithospheric mantle (SCLM). For example, different metasomatic events in the SCLM are reflected in compositional differences between garnet xenocrysts. As mantle metasomatism largely controls the physical and chemical properties of the SCLM, it exerts first order control over the genesis of kimberlitic magmas and diamond formation. However, dating mantle lithologies and processes is complicated by high ambient temperatures that allow the equilibration of most isotopic systems up to the time of kimberlite eruption. As a consequence, the temporal connection between metasomatic events in the mantle and kimberlite genesis is commonly ambiguous.
In this study, we applied LA-ICPMS U-Pb dating to 43 harzburgitic, lherzolithic and megacrystic garnet xenocrysts from the ~376 Ma diamondiferous V. Grib kimberlite, Russia, in order to investigate the link between different types of mantle metasomatism and kimberlite genesis.
Our results indicate that, with two possible exceptions, only harzburgitic garnet overlaps in age with the kimberlite eruption, whereas lherzolitic and megacrystic garnet crystals are ~20 to 130 million years older. Furthermore, garnet U-Pb ages and Ni-in-garnet temperatures of ~820 to 1200 °C do not correlate. This, and the high closure temperature of U-Pb in garnet (≥900 °C) suggests that the garnet U-Pb ages indeed reflect metasomatic events in the SCLM. However, the U-Pb ages could also reflect cooling ages. In this case, the metasomatic events recorded in the garnet crystals must still have occurred up to ~130 million years prior to the eruption of the V. Grib kimberlite.
These findings have far-reaching implications for the genesis of (diamondiferous) kimberlites, as they clearly show that the time lag between metasomatic events in the SCLM, as recorded in kimberlitic garnet xenocrysts, and kimberlite eruption may extend to tens of millions of years.
Oral e-Poster Presentations - Booth 3: Spine 2 (Tumors), September 26, 2023, 4:10 PM - 4:50 PM
Background: Spinal metastasis remains a persistent and oftentimes urgent challenge in the neurosurgical operating room. We aim to understand metastatic spread to the spinal bone on a molecular level in endothelial cells and tumor cells to facilitate improved therapeutic approaches and diagnostics.
Methods: We established a murine syngeneic spinal bone metastasis model. In vivo dissemination was first evaluated using fluorescent beads, followed by murine cancer cell lines (B16, LLC1). We investigated short-term seeding and long-term growth to identify correlations between seeding and tumor formation. EphrinB2-Eph4 interaction has been described as a crucial mediator of spinal bone metastasis. Transient (pharmacological) and permanent (genetical) ephrinB2-Eph4 interventions were performed.
Results: Dissemination of microbeads to distinct spinal segments depended on segment and particle size. Disseminated tumor cells on the contrary showed less frequent arrest in the bone and equal distribution among segments. EphrinB2 intervention changed the dissemination behavior towards the lumbar segment. Interestingly, only transient intervention retained this distribution, permanent ephrinB2 depletion on endothelial cells (efnb2iΔEC) resulted in equal dispersion of metastases. Histological staining revealed a reduction of Endomucin (Emcn) positive structures in combination with a reduction of Type H (Emcn high/CD31 high) endothelial cells in naïve efnb2iΔEC animals. In tumor tissue, these Type H endothelial cells were unaffected. However, an increase in CD31-expressing endothelial cells was observed under endothelial ephrinB2 depletion. These CD31-expressing endothelial cells have been recently described as Type E (Emcn low/CD31 high) and implicated in angiogenesis and osteogenesis.
Conclusions: We here describe a subpopulation of endothelial cells in efnb2iΔEC mice that seems to resemble pro-angiogenic and possibly pro-adhesive type E endothelial cells. Based on these finding we propose a compensatory pro-angiogenic mechanism in efnb2iΔEC mice that is highjacking pre-existing developmental pathways, which is critical for late-stage spinal metastatic growth independent of the initial seeding and extravasation of metastatic cells.
Oral e-Poster Presentations - Booth 2: Neuro-Oncology C (Imaging&Monitoring), September 27, 2023, 1:00 PM - 2:30 PM
Background: Repetitive TMS (rTMS) can be used to non-invasively map cortical language areas. Commonly, frequencies of 5-10 Hz are used to induce speech errors. We could recently show that frequencies of 30 and 50 Hz are advantageous to achieve higher reliability. However, high-frequent rTMS applied over perisylvian regions still suffer from limited tolerability. Using short-train or paired-pulse TMS (pp-TMS) might offer a good alternative to rTMS to interfere with speech production. In this study, we, therefore, compared 30 Hz rTMS to pp-TMS aiming at improved language mapping.
Methods: 13 healthy, right-handed subjects (f=6, 25-41 years) were investigated using two different rTMS protocols: (i) 30 Hz rTMS and (ii) pp-TMS. TMS protocols were applied in a pseudo-randomized order during a picture naming task (picture-to-trigger interval: 0 ms) over cortical language areas. In a subsequent study, we compared pp-TMS also to short trains of three TMS pulses and repetitive paired pulse TMS. Language errors were post-hoc analysed by two independent raters and were assigned to eight different error categories. The level of pain was assessed on a subjective 0-10 numeric rating scale (NRS). Moreover, language error distribution was analysed using a cortical parcellation system.
Results: 30 Hz rTMS evoked a significantly higher number of errors than the pp-protocol, i.e., 18 ± 12 % vs. 10 ± 7 % (p<0.05). However, pp-TMS was significantly better tolerated with a mean NRS of 2.3 ± 1.6 vs. 3.4 ± 1.5 (p<0.05, FDR-corrected). Of note, pp-TMS could induce a higher number of anomias (15 ± 15 %) than repetitive TMS protocols (4 ± 7 %; p<0.1, FDR-corrected), but less dysarthria. The cortical distribution of errors differed between the two protocols. The results of train-of-three TMS were similar to the pp-TMS protocol.
Conclusions: Due to its better tolerability, pp-TMS might offer the possibility to stimulate regions which are particularly prone to direct facial / trigeminal nerve stimulation, e.g., the inferior frontal gyrus. Moreover, pp-TMS seems advantageous for mapping patients who are comparatively susceptible to rTMS side effects and with regard to safety in general.
Introduction: Lumbosacral fixation is a common procedure in primary and revision spine surgery but leads to high biomechanical stress on adjacent segments and the SIJ, resulting in implant failure such as breakage and loosening and pain. This frequently results in further surgery. For patients showing clinical and radiological signs of SIJ affection/arthrosis who fail conservative therapy, transarticular lumbopelvic fusion via the SIJ may be considered. The Bedrock™ technique has been described as a new option for reinforced lumbopelvic fixation, fusing the SIJ with additional triangular titanium implants, thereby reducing biomechanical loads off the S2AI screws. We share our experiences with 19 patients treated with this technique since January 2019.
Materials and Methods: 19 patients suffering from persisting low back pain (LBP) with indication for reinforced lumbopelvic fixation and SIJ fusion were treated with reinforced lumboplevic fixation with S2AI screw and a triangular titanium implant. 14 cases were revisions. All surgeries were carried out by a single surgeon at a orthopedic university hospital. Data was gathered retrospectively.
Results: From 1/2019 - 9/2021 19 patients (11f, 8m) were treated with reinforced lumbopelvic fixation and SIJ fusion with a mean follow up of 18,2 months. Mean age 68 years (range 62-78y). Preop. walking distance was reduced to an average <100 m. Standard treatment involved S2AI screws and triangular titanium implants (SIBone, iFuse 3D™). 14 revision cases split into 5 low grade infections with screw loosening, 3 cases with rod breakage, 5 cases of painful lumbopelvic screw prominence, 7 cases with proximal junctional kyphosis, 2 cases with misplaced implants, 8 cases of poor bone mineral density. 5 patients without prior spine surgery. All patients were treated bilaterally using freehand technique. Average implant length was 65 mm. There were no intraoperative or implant associated adverse events (AE) or serious adverse events (SAE). Postoperative imaging demonstrated good implant positioning and function. All patients regained walking ability for distances > 1000 m and were satisfied with the result. All patients reported significant reduction of SIJ pain.
Conclusion: We report results of 19 patients with a reinforced lumbopelvic fixation and fusion by S2AI screws augmented by one parallelly placed triangular titanium implant fusing the SIJ bilaterally with a mean follow-up of 18.2 months. Intra- and postoperatively we experienced no implant associated adverse event. Patients regained significant walking ability and significant reduction of SIJ pain. Radiologically no signs of implant loosening or failure were detected at the end of follow-up. Our results demonstrate a safe and efficacious surgical technique for reinforced lumbopelvic fixation with fusion of SIJ with significant improvement of the health care related quality of life. Further studies need to be conducted in order to obtain additional evidence.
This article summarizes some of the current theoretical developments and the experimental status of hypernuclei in relativistic heavy-ion collisions and elementary collisions. In particular, the most recent results of hyperhydrogen of mass A = 3 and 4 are discussed. The highlight at SQM2022 in this perspective was the discovery of the anti-hyperhydrogen-4 by the STAR Collaboration, in a large data set consisting of different collision systems. Furthermore, the production yields of hyperhydrogen-4 and hyperhelium-4 from the STAR Collaboration can be described nicely by the thermal model when the excited states of these hypernuclei are taken into account. In contrast, the production measurements in small systems (pp and p–Pb) from the ALICE Collaboration tends to favour the coalescence model over the thermal description. New measurements from STAR, ALICE and HADES Collaborations of the properties, e.g. lifetime, of A = 3 and 4 hypernuclei give similar results of these properties. Also the anti-hyperhydrogen-4 lifetime is in rather good agreement with previous measurements. Interestingly, the new STAR measurement on the R3 value, that is connected to the branching ratio, points to a Λ separation energy that is below 100 keV but definitely consistent with the value of 130 keV assumed since the 70s.
We show examples of the impact of the Maxwellian averaged capture cross sections determined at n_TOF over the past 20 years on AGB stellar nucleosynthesis models. In particular, we developed an automated procedure to derive MACSs from evaluated data libraries, which are subsequently used as input to stellar models computed by means of the FuNS code. In this contribution, we present a number of s-process abundances obtained using different data libraries as input to stellar models, with a focus on the role of n_TOF data.
Lattice QCD and functional methods are making significant progress in constraining the QCD phase diagram. As an important milestone, the chiral phase transition with massless u, d-quarks at zero density is now understood to be of second order for all strange quark masses, and a smooth crossover as soon as mu,d, ≠ 0. Together with information on fluctuations and refined reweighted simulations, this bounds a possible critical point to be at µB/T ≲3. On the other hand, an approximately chiral-spin symmetric temperature window has been discovered above the chiral crossover, Tch<T ≳3Tch, with distinct correlator multiplet patterns and a pion spectral function suggesting resonance-like degrees of freedom, which dissolve graduallly with temperature.
Prediction for hyper nuclei multiplicities from GSI to LHC energies from the Ultra-relativistic Quantum Molecular Dynamics (UrQMD) model combined with a final state coalescence approach is presented and compared to the thermal model. The influence of the coalescence radius on the collision energy and centrality dependence of the Λ3H/ΛΛ3H/Λ ratio is discussed.
Present nuclear reaction network computations for astrophysical simulations involve many different types of rates, including neutron-capture reactions of interest for the modeling of heavy-element nucleosynthesis. While for many of them we still have to rely on theoretical calculations, an increasing number of experimentally-determined cross sections have now become available. In this contribution, we present “ASTrophysical Rate and rAw data Library” (ASTRAL), a new online database for neutron-capture cross sections based on experimental results, mainly obtained through activation and timeof-flight measurements. For the evaluation process, cross sections were re-calculated starting from raw data and by considering recent changes in physical properties of the involved isotopes (e.g., half-life and γ-ray intensities). We show the current status of the database, the techniques adopted to derive the recommended Maxwellian-averaged cross sections, and future developments.
Phase transitions in a non-perturbative regime can be studied by ab initio Lattice Field Theory methods. The status and future research directions for LFT investigations of Quantum Chromo-Dynamics under extreme conditions are reviewed, including properties of hadrons and of the hypothesized QCD axion as inferred from QCD topology in different phases. We discuss phase transitions in strong interactions in an extended parameter space, and the possibility of model building for Dark Matter and Electro-Weak Symmetry Breaking. Methodological challenges are addressed as well, including new developments in Artificial Intelligence geared towards the identification of different phases and transitions.
We study threshold testing, an elementary probing model with the goal to choose a large value out of n i.i.d. random variables. An algorithm can test each variable X_i once for some threshold t_i, and the test returns binary feedback whether X_i ≥ t_i or not. Thresholds can be chosen adaptively or non-adaptively by the algorithm. Given the results for the tests of each variable, we then select the variable with highest conditional expectation. We compare the expected value obtained by the testing algorithm with expected maximum of the variables. Threshold testing is a semi-online variant of the gambler’s problem and prophet inequalities. Indeed, the optimal performance of non-adaptive algorithms for threshold testing is governed by the standard i.i.d. prophet inequality of approximately 0.745 + o(1) as n → ∞. We show how adaptive algorithms can significantly improve upon this ratio. Our adaptive testing strategy guarantees a competitive ratio of at least 0.869 - o(1). Moreover, we show that there are distributions that admit only a constant ratio c < 1, even when n → ∞. Finally, when each box can be tested multiple times (with n tests in total), we design an algorithm that achieves a ratio of 1 - o(1).
The Ethics of Waiting lists and Rationing access to care (Ethics Parallel Session), September 26, 2023, 4:50 PM - 6:20 PM
Background: There has been a fivefold increase of neurosurgeons over the last three decades in Germany, despite a lesser increase in operations. Currently, there are approximately 1000 neurosurgical residents employed at training hospitals. Little is known about the overall training experience and career opportunities for these trainees.
Methods: In our role as resident representatives, we implemented a mailing list for interested German neurosurgical trainees. Thereafter, we created a survey including 25 items to assess the trainees’ satisfaction with their training and their perceived career prospects, which we then distributed through the mailing list. The survey was open from 1st April until 31st May 2021.
Results: 90 trainees were enrolled in the mailing list and we received 81 completed responses to our survey. Overall, 47% of trainees were very dissatisfied or dissatisfied with their training. 62% of trainees reported a lack of surgical training. 58% of trainees found it difficult to attend courses or classes and only 16% had consistent mentoring. There was an expressed desire for a more structured training programme and mentoring projects. In addition, 88% of trainees were willing to relocate for fellowships outside their current hospitals.
Conclusions: Half of the responders were dissatisfied with their neurosurgical training. There are various aspects that require improvement, such as the training curriculum, the lack of structured mentoring and the amount of administrative work. We propose the implementation of a modernized structured curriculum, which addresses the mentioned aspects, in order to improve neurosurgical training and, consecutively, patient care.
In QCD at large enough isospin chemical potential Bose-Einstein Condensation (BEC) takes place, separated from the normal phase by a phase transition. From previous studies the location of the BEC line at the physical point is known. In the chiral limit the condensation happens already at infinitesimally small isospin chemical potential for zero temperature according to chiral perturbation theory. The thermal chiral transition at zero density might then be affected, depending on the shape of the BEC boundary, by its proximity. As a first step towards the chiral limit, we perform simulations of 2+1 flavors QCD at half the physical quark masses. The position of the BEC transition is then extracted and compared with the results at physical masses.
In this work we study the 3+1-dimensional Nambu-Jona-Lasinio (NJL) model in the mean field-approximation. We carry out calculations using five different regularization schemes (two continuum and three lattice regularization schemes) with particular focus on inhomogeneous phases and condensates. The regularization schemes lead to drastically different inhomogeneous regions. We provide evidence that inhomogeneous condensates appear for all regularization schemes almost exclusively at values of the chemical potential and with wave numbers, which are of the order of or even larger than the corresponding regulators. This can be interpreted as indication that inhomogeneous phases in the 3+1-dimensional NJL model are rather artifacts of the regularization and not a consequence of the NJL Lagrangian and its symmetries.
In this work, inhomogeneous chiral phases are studied in a variety of Four-Fermion and Yukawa models in 2+1 dimensions at zero and non-zero temperature and chemical potentials. Employing the mean-field approximation, we do not find indications for an inhomogeneous phase in any of the studied models. We show that the homogeneous phases are stable against inhomogeneous perturbations. At zero temperature, full analytic results are presented.
Oral e-Poster Presentations - Booth 2: Spine 1 (Trauma&Misc), September 25, 2023, 10:00 AM - 10:40 AM
Background: Spondylodiscitis is a prevalent type of spinal infection, with pyogenic spondylodiscitis being the most common subtype. While antibiotic therapy is the standard treatment, some argue that early surgery can aid in infection clearance, improve survival rates, and prevent long-term complications such as deformities. However, others view early surgery as excessively risky. Due to the high mortality rate of up to 20%, it is crucial to determine the most effective treatment.
Methods: The primary objective of this study was to compare the mortality rate, relapse rate, and length of hospital stay for conservative and early surgical treatments of pyogenic spondylodiscitis, including determinants of outcomes. The study was registered on PROSPERO with the registration number CRD42022312573. The databases MEDLINE, Embase, Scopus, PubMed, and JSTOR were searched for original studies comparing conservative and early surgical treatments of pyogenic spondylodiscitis. The included studies were assessed using the ROBINS-1 tool, and eligible studies were evaluated using meta-analyses, influence, and regression analyses.
Results: The systematic review included 31 studies. The meta-analysis, which had a pooled sample size of 10,954 patients from 21 studies, found that the pooled mortality rate among patients treated with early surgery was 8%, while the rate was 13% for patients treated conservatively. The mean proportion of relapse/failure was 15% for patients treated with early surgery and 21% for those treated conservatively. Furthermore, the analysis concluded that early surgical treatment is associated with a 40% and 39% risk reduction in relapse/failure and mortality rates, respectively, when compared to conservative management. Additionally, early surgical treatment resulted in a 7.75-day reduction in length of hospital stay per patient (p<0.01). The most highly significant predictors of treatment outcome were found to be intravenous drug use, diabetes, the presence of an epidural abscess, positive cultures, location of infection, and age (p<0.001).
Conclusions: Overall, early surgical management was found to be consistently significantly more effective than conservative management in terms of relapse/failure and mortality rates when treating pyogenic spondylodiscitis, particularly for non-spinal epidural abscess spondylodiscitis.
Introduction: Spondylodiscitis is the commonest form of infectious disease of the spine and harbours a high mortality rate of up to 20%. Recent demographic trends in Germany, such as an aging population, immunosuppression, and intravenous drug use, suggest that the incidence of spondylodiscitis may be on the rise. However, the exact epidemiological development of the disease remains uncertain. This study aims to analyse the burden on the tertiary healthcare system in Germany using data from the Federal Statistical Office of Germany (FSOG) database.
Materials and Methods: All cases of spondylodiscitis diagnosed between 2005 and 2021 were identified from the FSOG database. The study characterised the mean duration of hospital stays, total and population-adjusted number of diagnoses made, age-stratified incidence, and outcomes of hospitalised patients.
Results: A total of 131,982 diagnoses for spondylodiscitis were identified between 2005 and 2021. The number of diagnoses for spondylodiscitis has doubled during this period, from 5.4/100,000 population in 2005 to 11/100,000 population in 2021. The highest increase in admissions was recorded for those aged 90 years and above (+1307%), 80-89 (+376%) and 70-79 (+99%). Hospital discharges to rehabilitation facilities have increased by 160%, and discharges against medical advice by 91%. On the other hand, during the analysed period, the in-hospital mortality rate has decreased by 52%.
Conclusion: The population-adjusted incidence of spondylodiscitis in Germany has more than doubled between 2005 and 2021, highlighting the clinical relevance of this disease. During the same period, in-hospital mortality dropped by half. These findings suggest the need for further investigation into optimal therapy, particularly the role and timing of surgical treatment.