Bilomas are defined collections of bile fluids mainly caused by iatrogenic injuries of the bile duct system. Owing to the infrequency of this disease, studies addressing bilomas are rare.
By using an ...endoscopic database, this retrospective study identified 32 patients with bilomas treated between 2004 to 2015, in order to analyse aetiology, clinical presentation, spectrum of pathogens, and resolution rate of bilomas.
65.6% of the study population (21/32) developed bilomas after surgery and 21.9% (7/32) after endoscopic retrograde cholangiography (ERC). Icterus, fever, and abdominal pain were the leading symptoms. 93.9% (46/49) of microbiological bile cultures revealed a positive microbiology. The predominant microorganisms were the group of Enterobacteriaceae (43.0%, 52/121), followed by Enterococcus spp. (32.2%, 39/121), and Candida spp. (9.1%, 11/121). Multiresistant bacteria like Enterobacteriaceae were isolated from one quarter of all patients. Single or multimodal treatment resulted in an overall complication rate of 4.8% (9/188). Clinical follow-up analysis showed a complete resolution rate of 78.3% for interventional therapy and 80% in the non-interventional group.
Pathogen spectrum of bilomas mainly comprises the group of Enterobacteriacae and Enterococcus spp., with a high proportion of multiresistant bacteria. Different interventional approaches are available for biloma drainage, which seem to be safe and effective for most patients.
German Clinical Trials Register DRKS00015208 , retrospectively registered.
Since May 2011 the AMS-02 experiment is installed on the International Space Station and is observing cosmic radiation. It consists of several state-of-the-art sub-detectors, which redundantly ...measure charge and energy of traversing particles. Due to the long exposure time of AMS-02 of many years the measurement of momentum for protons and ions is limited systematically by the spatial resolution and magnetic field strength of the silicon tracker. The maximum detectable rigidity for protons is about 1.8TV, for helium about 3.6TV. We investigate the possibility to extend the range of the energy measurement for heavy nuclei (Z⩾2) with the transition radiation detector (TRD). The response function of the TRD shows a steep increase in signal from the level of ionization at a Lorentz factor γ of about 500 to γ≈20,000, where the transition radiation signal saturates. For heavy ions the signal fluctuations in the TRD are sufficiently small to allow an energy measurement with the TRD beyond the limitations of the tracker. The energy resolution of the TRD is determined and reaches a level of about 20% for boron (Z=5). After adjusting the operational parameters of the TRD a measurement of boron and carbon could be possible up to 5TeV/nucleon.
The carbon flux due to land-use and land-cover change (net LULCC flux) historically contributed to a large fraction of anthropogenic carbon emissions while at the same time being associated with ...large uncertainties. This study aims to compare the contribution of several sensitivities underlying the net LULCC flux by assessing their relative importance in a bookkeeping model (Bookkeeping of Land Use Emissions, BLUE) based on a LULCC dataset including uncertainty estimates (the Land-Use Harmonization 2 (LUH2) dataset). The sensitivity experiments build upon the approach of Hurtt et al. (2011) and compare the impacts of LULCC uncertainty (a high, baseline and low land-use estimate), the starting time of the bookkeeping model simulation (850, 1700 and 1850), net area transitions versus gross area transitions (shifting cultivation) and neglecting wood harvest on estimates of the net LULCC flux. Additional factorial experiments isolate the impact of uncertainty from initial conditions and transitions on the net LULCC flux. Finally, historical simulations are extended with future land-use scenarios to assess the impact of past LULCC uncertainty in future projections.
Aim of the present study is the evaluation of ultrasound as a physical method for virus inactivation in human plasma products prior to transfusion. Our study is focused on achieving a high level of ...virus inactivation simultaneously leaving blood products unaltered, measured by the level of degradation of coagulation factors, especially in third world countries where virus contamination of blood products poses a major problem. Virus inactivation plays an important role, especially in the light of newly discovered or unknown viruses, which cannot be safely excluded via prior testing.
Taking into account the necessary protection of the relevant coagulation activity for plasma, the basis for a sterile virus inactivation under shielding gas insufflation was developed for future practical use. Influence of frequency and power density in the range of soft and hard cavitation on the inactivation of transfusion-relevant model viruses for Hepatitis-(BVDV = bovine diarrhea virus), for Herpes-(SFV = Semliki Forest virus, PRV = pseudorabies virus) and Parvovirus B19 (PPV = porcine parvovirus) were examined. Coagulation activity was examined via standard time parameters to minimize reduction of functionality of coagulation proteins. A fragmentation of coagulation proteins via ultrasound was ruled out via gel electrophoresis. The resulting virus titer was examined using end point titration.
Through CO
shielding gas insufflation-to avoid radical emergence effects-the coagulation activity was less affected and the time window for virus inactivation substantially widened. In case of the non-lipidated model virus (AdV-luc = luciferase expressing adenoviral vector), the complete destruction of the virus capsid through hard cavitation was proven via scanning electron microscopy (SEM). This can be traced back to microjets and shockwaves occurring in hard cavitation. The degree of inactivation seems to depend on size and compactness of the type of viruses. Using our pre-tested and subsequently chosen process parameters with the exception of the small PPV, all model viruses were successfully inactivated and reduced by up to log 3 factor. For a broad clinical usage, protection of the coagulation activities may require further optimization.
Building upon the information gained, an optimum inactivation can be reached via raising of power density up to 1200 W and simultaneous lowering of frequency down to 27 kHz. In addition, the combination of the two physical methods UV treatment and ultrasound may yield optimum results without the need of substance removal after the procedure.
Measurements of cosmic-ray abundances on balloons are affected by interactions in the residual atmosphere above the balloon. Corrections for such interactions are particularly important for ...observations of rare secondary particles such as boron, antiprotons, and positrons. These corrections either can be calculated if the relevant cross sections in the atmosphere are known or may be empirically determined by extrapolation of the "growth curves," i.e., the individual particle intensities as functions of atmospheric depth. The growth-curve technique is particularly attractive for long-duration balloon flights where the periodic daily altitude variations permit rather precise determinations of the corresponding particle intensity variations. We determine growth curves for nuclei from boron (Z = 5) to iron (Z = 26) using data from the 2006 Arctic balloon flight of the TRACER detector for cosmic-ray nuclei, and we compare the growth curves with predictions from published cross section values. In general, good agreement is observed. We then study the boron/carbon abundance ratio and derive a simple and energy-independent correction term for this ratio. We emphasize that the growth-curve technique can be developed further to provide highly accurate tests of published interaction cross section values.
Biological soil crusts (BSC) encompassing green algae, cyanobacteria, lichens, bryophytes, heterotrophic bacteria and microfungi are keystone species in arid environments because of their role in ...nitrogen- and carbon-fixation, weathering and soil stabilization, all depending on the photosynthesis of the BSC. Despite their importance, little is known about the BSCs of the Atacama Desert, although especially crustose chlorolichens account for a large proportion of biomass in the arid coastal zone, where photosynthesis is mainly limited due to low water availability. Here, we present the first hyperspectral reflectance data for the most wide-spread BSC species of the southern Atacama Desert. Combining laboratory and field measurements, we establish transfer functions that allow us to estimate net photosynthesis rates for the most common BSC species. We found that spectral differences among species are high, and differences between the background soil and the BSC at inactive stages are low. Additionally, we found that the water absorption feature at 1420 nm is a more robust indicator for photosynthetic activity than the chlorophyll absorption bands. Therefore, we conclude that common vegetation indices must be taken with care to analyze the photosynthesis of BSC with multispectral data.
The serine/threonine kinase p21‐activated kinase (PAK) has been implicated as a downstream effector of the small GTPases Rac and Cdc42. While these GTPases evidently induce a variety of morphological ...changes, the role(s) of PAK remains elusive. Here we report that overexpression of βPAK in PC12 cells induces a Rac phenotype, including cell spreading/membrane ruffling, and increased lamellipodia formation at growth cones and shafts of nerve growth factor‐induced neurites. These effects are still observed in cells expressing kinase‐negative or Rac/Cdc42 binding‐deficient PAK mutants, indicating that kinase‐ and p21‐binding domains are not involved. Furthermore, lamellipodia formation in all cell lines, including those expressing Rac binding‐deficient PAK, is inhibited significantly by dominant‐negative RacN17. Equal inhibition is achieved by blocking PAK interaction with the guanine nucleotide exchange factor PIX using a specific N‐terminal PAK fragment. We conclude that PAK, via its N‐terminal non‐catalytic domain, acts upstream of Rac mediating lamellipodia formation through interaction with PIX.
Projected population growth and climate change will make it inevitable to convert neglected and marginal land into productive arable land. We investigate the influence of agricultural management ...practices on nutrient stocks and soil functions during the conversion of former extensively used grassland to arable land. Effects of grassland removal, tillage, intercropping with faba bean (Vicia faba) and its later incorporation were studied with respect to soil properties and bacterial community structure. Therefore, composite samples were collected with a core sampler from the topsoil (0–20 cm) in (a) the initial grassland, (b) the transitional phase during the vegetation period of V. faba, (c) after ploughing the legume in, and (d) untreated controls. In all samples, nitrate-N, ammonium-N, dissolved organic carbon (DOC) and total nitrogen bound (TNb) were analyzed and comparisons of the bacterial community structure after 16S-amplicon sequencing were performed to assess soil functions. Mineralization after grassland conversion followed by the biological nitrogen fixation of broad beans enhanced the nitrate-N content in bulk soil from 4 to almost 50 μg N g−1dw. Bacterial community structure on phylum level in bulk soil was dominated by Proteobacteria, Actinobacteria, Acidobacteria, Chloroflexi, and Bacteroidetes and remained almost stable. However, alpha and beta-diversity analysis revealed a change of the bacterial composition at the final state of the conversion. This change was primarily driven by increasing abundances of the genera Massilia and Lysobacter, both members of the Proteobacteria, after the decay of the leguminous plant residues. Furthermore, increasing abundances of the family Gaiellaceae and its genus Gaiella fostered this change and were related to the decreasing carbon to nitrogen ratio. In short, gentle management strategies could replace the input of mineral fertilizer with the aim to contribute to future sustainable and intensified production even on converted grassland.
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•Strong increase of nitrate-N due to mineralization and biological nitrogen fixation•Bacterial composition on phylum level and bacterial richness remain quite stable.•Beta-diversity analysis indicates changes due to the management practices.•High abundance of Massilia and Lysobacter after incorporation and decay of V. faba•Gentle management strategies can replace the input of mineral fertilizer.
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