There is growing interest in deoxynivalenol (DON) exposure during puberty because experimental evidence shows that DON-exposed to adolescents are more sensitive to DON and have limited detoxification ability. Nevertheless, there have been few surveys of DON exposure for adolescents in China. Furthermore, little is known about the effects of collection times on risk exposure. In the study, we estimated the risk of DON exposure for adolescents in Shanghai and explore the effects of collection time, areas, sex and BMI on intake estimates. A total of 315 adolescents aged 14–16 years, including 161 boys and 154 girls, were recruited. Urine samples were collected for three consecutive days and digested with β-glucuronidase and then purified using a DON-immunoaffinity column (IAC). Total deoxynivalenol levels were measured using liquid chromatography-tandem mass spectrometry (LC–MS/MS) in combination with a stable isotope dilution assay (SIDA). DON was detected in 945 morning urine samples taken from 315 individuals for three consecutive days. The mean estimated dietary intake of DON did not exceed the tolerable daily intake (TDI) of l μg/kg·bw/day, showing that exposure of adolescents in Shanghai is not of concern. However, 10–20% of probable daily intake (PDI) values exceed the TDI, indicating potential adverse effects. In addition, the DON concentration at the population level did not differ for urine samples collected at different times except for those of overweight adolescents. Therefore, assessment of exposure to DON by monitoring the morning urine of a healthy adolescent, except for overweight people, provides an appropriate estimate of exposure and related risk at the population level, but intake estimates for individuals are uncertain; these could be used to assess exposure of adolescents to DON rapidly and effectively for epidemiological investigations.
In recent years, Pinus sylvestris die-off and mortality events have occurred across all its range of distribution, usually associated with recurrent droughts induced by climate change. A shift in canopy dominance towards other better adapted co-existing species can be expected, especially in populations located close to their climatic tolerance limits. Herein, we tested, along a local elevational gradient, whether canopy opening resulting from die-off and mortality favours the growth of a non-dominant co-existing tree species (Quercus pubescens) established in the sub-canopy, in comparison to P. sylvestris sub-canopy trees. We also tested whether the growth of both species is associated with local climatic suitability for these species (extracted from SDMs) or, alternatively, with direct measures of micro-climatic variables. Finally, the effect on tree growth of other micro-local factors such as competition, canopy closure and micro-topography was also tested. Sub-canopy tree growth was enhanced overall by canopy opening resulting from P. sylvestris canopy die-off, but this response was stronger in P. sylvestris trees, reinforcing the self-replacement of this species after die-off. This higher growth rate is related to modifications in the micro-local climate (higher temperatures in the wettest quarter). Conversely, Q. pubescens is less sensitive to micro-local climate conditions but it can grow faster than P. sylvestris on stands with no canopy die-off or mortality. In contrast, climatic suitability extracted from SDMs was negatively related to sub-canopy P. sylvestris growth and had no effect on Q. pubescens. These contrasting results support observations at plot scale that P. sylvestris self-replacement is better explained by local environmental conditions than by values of climatic suitability obtained from regional-scale data-sets. Nevertheless, these climatic suitability measures remain consistent with the overall pattern of low seedling recruitment observed in previous works at the rear edge of species' distribution. This study reveals that short-term shifts in species dominance at a local scale will not necessarily occur in the studied P. sylvestris forests following die-off. This finding endorses the notion that micro-local environment and species traits (i.e., light and temperature tolerance, life-history strategies) modulate the capacity for resilience in rear-edge populations that would probably be prone to collapse otherwise.
Managing the risk of noncardiac surgery in patients with aortic stenosis is a problem that is frequently confronted in clinical practice. Traditionally, patients with severe aortic stenosis were considered to be at substantial risk during noncardiac surgery, and as such, elective procedures were avoided before intervention on the aortic valve in most patients other than those who were ineligible or refused aortic valve replacement. Recent data suggest that with contemporary anesthesia and surgical techniques, the risk of noncardiac surgery is substantially lower than previously believed. We review the existent literature in the field, and propose a practical approach to complex patients.
Schock ist definiert als ein Zustand verminderter Gewebsperfusion, der zu einem Missverhältnis zwischen Sauerstoffzufuhr und Sauerststoffbedarf führt und dadurch eine Hypoxie vitaler Organe bewirkt. Schreitet der Prozess weiter fort, kommt es konsekutiv zum Multiorganversagen und schließlich zum Tod des Patienten. Die Sterblichkeit beträgt bei den häufigsten Schockformen immer noch >50%, daher stellt der Schockpatient auch heute noch eine diagnostische und therapeutische Herausforderung für den klinisch tätigen Arzt dar. Mit jeder Therapieverzögerung steigt bei allen Schockformen die Letalität weiter an, daher müssen diagnostische und therapeutische Maßnahmen in schneller Abfolge parallel durchgeführt werden. Dem Kliniker steht dabei eine Reihe von diagnostischen Methoden zur Verfügung, dabei kommt der Echokardiographie als bettseitig einsetzbares Verfahren eine wichtige Rolle sowohl bei der Diagnostik und Differentialdiagnostik des kardialen Schocks als auch anderer Schockformen zu. Der Pathophysiologie folgend werden der kardiale, obstruktive, distributive und der hypovolämische Schock differenziert.
Fine roots serve as the primary interface between trees and the soil, and they are dynamic in their response to environmental conditions. Among many functions, they are principle in gathering nutrients and water, and they constitute a major component of the tree. Their overall contribution to soil carbon flux is not well understood, nor is the effect of site and genotype on their dynamics, and these factors are crucial to understanding nutrient cycles and tree growth under variable conditions. This study evaluated how the fine root dynamics of loblolly pine (Pinus taeda L.) might be different between genotypes and on different sites. Three loblolly pine plantations were established, two in 2009 in North Carolina (NC) and Virginia (VA), and one in 2011 in Brazil (BR). Root biomass was estimated with soil cores across the three sites and between two genotypes in 2020. Seasonal and annual fine root production was measured at the NC and VA sites over the 12th growing season using ingrowth cores. The trees in BR that were two years younger were much larger than those in NC and VA and had more fine root biomass at initial sampling than those in NC, despite similar levels of fertility. Meanwhile, fine root production rates decreased with higher rates of aboveground productivity across all measured plots in NC and VA. These results indicate that (1) standing fine root biomass may be related to environmental conditions that are not easily manipulated, which could inform modeling of carbon cycles, and (2) in these intensively managed plots, sufficient resources were available to allow for increased aboveground growth despite lower rates of fine root production, which supports the employment of these intensive silvicultural practices.
A variety of reactive structures containing chemical reactions in the process of combustion, biochemical frames, and catalysis are homogeneous-heterogeneous (H-HR). Besides, chemical reactions are used as part of applications such as hydrometallurgical industries of food manufacturing, dispersion and forming fog, manufacture of polymers and ceramics. The purpose of the current study is to examine H-HR in the MHD flow of a non-Newtonian Prandtl fluid past a permeable linear horizontal expandable (shrinkable) surface in the Darcy-Forchheimer scheme of porous material. The thermal features under thermal radiation and heat generation (absorption) impact are taken into account. The leading partial-differential equations with appropriate boundary conditions are solved by Chebyshev spectral collection technique (CSCT) and the Runge-Kutta-Fehlberg technique (RKF45). Impacts of some significant parameters on the velocity of the flow, energy, and concentration profiles are graphically measured. Comparing with two techniques and with previous literature, which demonstrates the feasibility of the present numerical solution, are compatible with the findings gained from the restrictive status of the current system. The main outcomes are the heat transport rate at the surface is improved with the higher parameter values of thermal radiation and suction (blowing). The effect of porous Darcy-Forchheimer material is a thermal conductor that disperses the thermal energy of the system more competently.
In recent years, Pinus sylvestris die-off and mortality events have occurred across all its range of distribution, usually associated with recurrent droughts induced by climate change. A shift in canopy dominance towards other better adapted co-existing species can be expected, especially in populations located close to their climatic tolerance limits. Herein, we tested, along a local elevational gradient, whether canopy opening resulting from die-off and mortality favours the growth of a non-dominant co-existing tree species (Quercus pubescens) established in the sub-canopy, in comparison to P. sylvestris sub-canopy trees. We also tested whether the growth of both species is associated with local climatic suitability for these species (extracted from SDMs) or, alternatively, with direct measures of micro-climatic variables. Finally, the effect on tree growth of other micro-local factors such as competition, canopy closure and micro-topography was also tested. Sub-canopy tree growth was enhanced overall by canopy opening resulting from P. sylvestris canopy die-off, but this response was stronger in P. sylvestris trees, reinforcing the self-replacement of this species after die-off. This higher growth rate is related to modifications in the micro-local climate (higher temperatures in the wettest quarter). Conversely, Q. pubescens is less sensitive to micro-local climate conditions but it can grow faster than P. sylvestris on stands with no canopy die-off or mortality. In contrast, climatic suitability extracted from SDMs was negatively related to sub-canopy P. sylvestris growth and had no effect on Q. pubescens. These contrasting results support observations at plot scale that P. sylvestris self-replacement is better explained by local environmental conditions than by values of climatic suitability obtained from regional-scale data-sets. Nevertheless, these climatic suitability measures remain consistent with the overall pattern of low seedling recruitment observed in previous works at the rear edge of species' distribution. This study reveals that short-term shifts in species dominance at a local scale will not necessarily occur in the studied P. sylvestris forests following die-off. This finding endorses the notion that micro-local environment and species traits (i.e., light and temperature tolerance, life-history strategies) modulate the capacity for resilience in rear-edge populations that would probably be prone to collapse otherwise.
In recent years, Pinus sylvestris die-off and mortality events have occurred across all its range of distribution, usually associated with recurrent droughts induced by climate change. A shift in canopy dominance towards other better adapted co-existing species can be expected, especially in populations located close to their climatic tolerance limits. Herein, we tested, along a local elevational gradient, whether canopy opening resulting from die-off and mortality favours the growth of a non-dominant co-existing tree species (Quercus pubescens) established in the sub-canopy, in comparison to P. sylvestris sub-canopy trees. We also tested whether the growth of both species is associated with local climatic suitability for these species (extracted from SDMs) or, alternatively, with direct measures of micro-climatic variables. Finally, the effect on tree growth of other micro-local factors such as competition, canopy closure and micro-topography was also tested. Sub-canopy tree growth was enhanced overall by canopy opening resulting from P. sylvestris canopy die-off, but this response was stronger in P. sylvestris trees, reinforcing the self-replacement of this species after die-off. This higher growth rate is related to modifications in the micro-local climate (higher temperatures in the wettest quarter). Conversely, Q. pubescens is less sensitive to micro-local climate conditions but it can grow faster than P. sylvestris on stands with no canopy die-off or mortality. In contrast, climatic suitability extracted from SDMs was negatively related to sub-canopy P. sylvestris growth and had no effect on Q. pubescens. These contrasting results support observations at plot scale that P. sylvestris self-replacement is better explained by local environmental conditions than by values of climatic suitability obtained from regional-scale data-sets. Nevertheless, these climatic suitability measures remain consistent with the overall pattern of low seedling recruitment observed in previous works at the rear edge of species' distribution. This study reveals that short-term shifts in species dominance at a local scale will not necessarily occur in the studied P. sylvestris forests following die-off. This finding endorses the notion that micro-local environment and species traits (i.e., light and temperature tolerance, life-history strategies) modulate the capacity for resilience in rear-edge populations that would probably be prone to collapse otherwise.
In recent years, Pinus sylvestris die-off and mortality events have occurred across all its range of distribution, usually associated with recurrent droughts induced by climate change. A shift in canopy dominance towards other better adapted co-existing species can be expected, especially in populations located close to their climatic tolerance limits. Herein, we tested, along a local elevational gradient, whether canopy opening resulting from die-off and mortality favours the growth of a non-dominant co-existing tree species (Quercus pubescens) established in the sub-canopy, in comparison to P. sylvestris sub-canopy trees. We also tested whether the growth of both species is associated with local climatic suitability for these species (extracted from SDMs) or, alternatively, with direct measures of micro-climatic variables. Finally, the effect on tree growth of other micro-local factors such as competition, canopy closure and micro-topography was also tested. Sub-canopy tree growth was enhanced overall by canopy opening resulting from P. sylvestris canopy die-off, but this response was stronger in P. sylvestris trees, reinforcing the self-replacement of this species after die-off. This higher growth rate is related to modifications in the micro-local climate (higher temperatures in the wettest quarter). Conversely, Q. pubescens is less sensitive to micro-local climate conditions but it can grow faster than P. sylvestris on stands with no canopy die-off or mortality. In contrast, climatic suitability extracted from SDMs was negatively related to sub-canopy P. sylvestris growth and had no effect on Q. pubescens. These contrasting results support observations at plot scale that P. sylvestris self-replacement is better explained by local environmental conditions than by values of climatic suitability obtained from regional-scale data-sets. Nevertheless, these climatic suitability measures remain consistent with the overall pattern of low seedling recruitment observed in previous works at the rear edge of species' distribution. This study reveals that short-term shifts in species dominance at a local scale will not necessarily occur in the studied P. sylvestris forests following die-off. This finding endorses the notion that micro-local environment and species traits (i.e., light and temperature tolerance, life-history strategies) modulate the capacity for resilience in rear-edge populations that would probably be prone to collapse otherwise.
Fine roots serve as the primary interface between trees and the soil, and they are dynamic in their response to environmental conditions. Among many functions, they are principle in gathering nutrients and water, and they constitute a major component of the tree. Their overall contribution to soil carbon flux is not well understood, nor is the effect of site and genotype on their dynamics, and these factors are crucial to understanding nutrient cycles and tree growth under variable conditions. This study evaluated how the fine root dynamics of loblolly pine (Pinus taeda L.) might be different between genotypes and on different sites. Three loblolly pine plantations were established, two in 2009 in North Carolina (NC) and Virginia (VA), and one in 2011 in Brazil (BR). Root biomass was estimated with soil cores across the three sites and between two genotypes in 2020. Seasonal and annual fine root production was measured at the NC and VA sites over the 12th growing season using ingrowth cores. The trees in BR that were two years younger were much larger than those in NC and VA and had more fine root biomass at initial sampling than those in NC, despite similar levels of fertility. Meanwhile, fine root production rates decreased with higher rates of aboveground productivity across all measured plots in NC and VA. These results indicate that (1) standing fine root biomass may be related to environmental conditions that are not easily manipulated, which could inform modeling of carbon cycles, and (2) in these intensively managed plots, sufficient resources were available to allow for increased aboveground growth despite lower rates of fine root production, which supports the employment of these intensive silvicultural practices.
Cumulative distribution functions and probability density functions for the minimum and maximum seek distances in disk systems with two independent arms are derived. Comparison is made with conventional one-arm systems. Different effects on the average seek distance and the average seek time due to the availability of the extra arm are discussed. In particular, a realistic example showing the marked difference for the impacts on the average seek distance and average seek time is given. Practical usage of these probability density functions in conjunction with actual measurement data are demonstrated. Efficient formulas for computing the average seek time from measurement data are given. Experimental results for validating the proposed cumulative distribution functions are reported.
Previous studies showed that pre-incisional administration of dextromethorphan (DM), a weak N-methyl-D-aspartic (NMDA) acid antagonist, reduces postoperative pain after epidural as well as general anesthesia. Aim of this study was therefore to proof the effects of DM on postoperative pain in patients undergoing orthopedic surgery under spinal anesthesia. Forty-five patients undergoing elective orthopedic surgery were enrolled in this prospective, double-blinded and randomized study. Patients were randomly assigned to three groups (n = 15) and received either placebo or dextromethorphan (45 or 90 mg) p.o. Afterwards, a spinal catheter was inserted at the L2/3 or L3/4 interspace and spinal anesthesia with bupivacaine was induced and maintained at a level between Th 10 and Th 12. After completion of surgery patient controlled analgesia (PCA) with piritramide was started. Visual analogue pain scales (VAS) and analgesic requirements were assessed before surgery (control) as well as during the first 48 hours. The three groups were comparable with respect to biometric data, distribution of surgery as well as preoperative pain levels. VAS scores were not different between the three groups within 48 hours postoperatively. Furthermore, administration of pre-incisional DM had no influence on postoperative requirements of opioids (group D90: 59.5 ± 37.5 mg; group D45: 56.2 ± 37.1 mg piritramide; and group P: 49.3 ± 29.2 mg piritramide) within 48 hours. In this study DM enables neither reduction of postoperative pain intensity nor analgesic- or opioid-sparing effects. Further studies to find out ideal dosage, way of administration and applicable kind of surgery should be implemented. Zahlreiche Untersuchungen konnten die analgetische Wirksamkeit des NMDA-Rezeptor-Antagonisten Dextromethorphan (DM) bei präoperativer Verabreichung bei Eingriffen sowohl in Allgemeinanästhesie, als auch unter Epiduralanästhesie zeigen. Ziel dieser Studie war es, die analgetischen Effekte von DM bei orthopädischen Eingriffen in Spinalanästhesie zu überprüfen. In diese prospektive, randomisierte, doppelblinde Studie wurden 45 Patienten vor einem orthopädischen Gelenkersatz der Hüfte oder des Knies eingeschlossen. Die Patienten wurden in drei gleich große Gruppen (n = 15) randomisiert und erhielten neben der oralen Prämedikation (Midazolam 7,5 mg) ebenfalls oral entweder Placebo oder 45 bzw. 90 mg Dextromethorphan. Die Spinalanästhesie mit Bupivacain wurde in Kathetertechnik durchgeführt und über Nachinjektionen von Bupivacain auf einem Anästhesieniveau zwischen Th10 und Th12 gehalten. Nach Beendigung des operativen Eingriffs erfolgte die weitere Analgesie patientenkontrolliert (PCA) mit Piritramid intravenös. Der Analgetikabedarf wurde bis 48 Stunden postoperativ erfasst. Ebenso wurde in diesem Zeitraum zu definierten Messzeitpunkten die Schmerzstärke mittels VAS (mm) in Ruhe und unter Belastung erhoben. Die drei Gruppen waren hinsichtlich der biometrischen Daten, der operativen Eingriffe und der präoperativen Schmerzlevel vergleichbar. Die Schmerzscores (VAS) unterschieden sich im Beobachtungszeitraum nicht signifikant. Ebenso hatte die präoperative Gabe von DM keine Effekte auf den postoperativen Piritramidbedarf (Gruppe D90: 59.5 ± 37.5 mg; Gruppe D45: 56.2 ± 37.1 mg Piritramid und Gruppe Placebo: 49.3 ± 29.2 mg Piritramid). In dieser Untersuchung konnte keine Reduktion der postoperativen Schmerzintensität oder des Analgetikabedarfs durch präoperative Verabreichung von DM nachgewiesen werden. Dennoch sollten aufgrund der positiven Effekte aus anderen Studien weitere Untersuchungen zur optimalen Dosierung, Darreichungsform von DM und zur Identifikation geeigneter operativer Eingriffe durchgeführt werden.
Das geänderte deutsche Gesundheitssystem bringt für die Leistungserbringer neue Herausforderungen sowohl in Bezug auf Behandlungsqualität und –kosten als auch in Bezug auf Mitarbeiterzufriedenheit und –ausbildung mit sich. Dieser Herausforderung wird häufig mit dem Instrument des Klinischen Behandlungspfades begegnet. Als klinische Behandlungspfade werden detaillierte Behandlungsplanungen angesehen, die konkrete Handlungsanweisungen zu jedem einzelnen Behandlungszeitpunkt definieren.
There is growing interest in deoxynivalenol (DON) exposure during puberty because experimental evidence shows that DON-exposed to adolescents are more sensitive to DON and have limited detoxification ability. Nevertheless, there have been few surveys of DON exposure for adolescents in China. Furthermore, little is known about the effects of collection times on risk exposure. In the study, we estimated the risk of DON exposure for adolescents in Shanghai and explore the effects of collection time, areas, sex and BMI on intake estimates. A total of 315 adolescents aged 14–16 years, including 161 boys and 154 girls, were recruited. Urine samples were collected for three consecutive days and digested with β-glucuronidase and then purified using a DON-immunoaffinity column (IAC). Total deoxynivalenol levels were measured using liquid chromatography-tandem mass spectrometry (LC–MS/MS) in combination with a stable isotope dilution assay (SIDA). DON was detected in 945 morning urine samples taken from 315 individuals for three consecutive days. The mean estimated dietary intake of DON did not exceed the tolerable daily intake (TDI) of l μg/kg·bw/day, showing that exposure of adolescents in Shanghai is not of concern. However, 10–20% of probable daily intake (PDI) values exceed the TDI, indicating potential adverse effects. In addition, the DON concentration at the population level did not differ for urine samples collected at different times except for those of overweight adolescents. Therefore, assessment of exposure to DON by monitoring the morning urine of a healthy adolescent, except for overweight people, provides an appropriate estimate of exposure and related risk at the population level, but intake estimates for individuals are uncertain; these could be used to assess exposure of adolescents to DON rapidly and effectively for epidemiological investigations.
There is growing interest in deoxynivalenol (DON) exposure during puberty because experimental evidence shows that DON-exposed to adolescents are more sensitive to DON and have limited detoxification ability. Nevertheless, there have been few surveys of DON exposure for adolescents in China. Furthermore, little is known about the effects of collection times on risk exposure. In the study, we estimated the risk of DON exposure for adolescents in Shanghai and explore the effects of collection time, areas, sex and BMI on intake estimates. A total of 315 adolescents aged 14–16 years, including 161 boys and 154 girls, were recruited. Urine samples were collected for three consecutive days and digested with β-glucuronidase and then purified using a DON-immunoaffinity column (IAC). Total deoxynivalenol levels were measured using liquid chromatography-tandem mass spectrometry (LC–MS/MS) in combination with a stable isotope dilution assay (SIDA). DON was detected in 945 morning urine samples taken from 315 individuals for three consecutive days. The mean estimated dietary intake of DON did not exceed the tolerable daily intake (TDI) of l μg/kg·bw/day, showing that exposure of adolescents in Shanghai is not of concern. However, 10–20% of probable daily intake (PDI) values exceed the TDI, indicating potential adverse effects. In addition, the DON concentration at the population level did not differ for urine samples collected at different times except for those of overweight adolescents. Therefore, assessment of exposure to DON by monitoring the morning urine of a healthy adolescent, except for overweight people, provides an appropriate estimate of exposure and related risk at the population level, but intake estimates for individuals are uncertain; these could be used to assess exposure of adolescents to DON rapidly and effectively for epidemiological investigations.
Chirurgische Wunden heilen gewöhnlich primär. Postoperative Wundinfektionen stellen jedoch die dritthäufigste nosokomiale Infektion dar. Für die Wundbehandlung gibt es derzeit keinen einheitlichen Standard. Zur Risikoabschätzung wird teilweise das deutsche Krankenhaus-Infektions-Surveillance-System genutzt. Der beste verfügbare Evidenzlevel zur Empfehlung der Behandlung einer kompliziert-heilenden oder chronischen Wunde ist Level II. Die Behandlungsstrategien werden am ehesten aufgrund eigener Erfahrungswerte festgelegt.
