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Evaluation der Beatmungstherapie mithilfe der elektrischen Impedanztomografie bei Kindern mit schwerem Lungenversagen : Eine prospektive Feasibility-Studie
Get PDFDie vorliegende Arbeit untersucht die Möglichkeiten der EIT zur Evaluation der invasiven Beatmungstherapie bei Kindern mit schwerem Lungenversagen. Dabei zeigt sie, dass EIT Messungen mit absteigenden PEEP Titrationen bei neonatalen und pädiatrischen Patienten mit unterschiedlichsten ARDS Ursachen, unterschiedlichen Schweregraden und sogar unter ECMO Therapie bis 3,5 kg erfolgreich durchgeführt werden können. Die Studie zeigt auf, dass sich der klinisch eingestellte PEEP der nach ARDSNet Tabelle empfohlene PEEP und der via EIT identifizierte optimale PEEP deutlich unterscheiden können. Dabei ist besonders hervorzuheben, dass Kinder mit perinatalen Lungenerkrankungen sowohl klinisch als auch via EIT deutlich niedrigere Druckwerte im Vergleich zu den ARDSNet-Empfehlungen und der pARDS Kohorte aufwiesen. Außerdem kann mithilfe des EIT Index COV gezeigt werden, dass die ventrodorsale Ventilationsverteilung durch Veränderung des PEEPs signifikant beeinflusst werden kann, während die Verteilung von rechts nach links davon unberührt bleibt. Und zuletzt zeigt die Arbeit, dass Patienten mit einem potenziell tödlichen Krankheitsverlauf insgesamt deutlich höhere PEEP-Werte benötigten. Die Ergebnisse schließen an die wenigen bereits bestehenden pädiatrischen Studien und die vielversprechenden Daten aus dem Erwachsenenkollektiv an. Die Arbeit soll Ausgangspunkt für die Entwicklung von größeren prospektiven und longitudinalen Studien in diesem Bereich sein. Zusammenfassend zeigt die Studie, dass EIT die Möglichkeit bietet, die Beatmungsstrategie bei Kindern in unterschiedlichen Altersklassen, Entwicklungs- und Krankheitsstadien zu evaluieren und zu objektivieren und damit wertvolle Zusatzinformationen für die Entscheidungsfindung in der hochkomplexen Intensivtherapie dieses Kollektivs liefern kann. Die sehr einfache, strahlungsfreie und sichere Durchführbarkeit qualifiziert das Verfahren in unseren Augen sehr gut für den Einsatz im pädiatrischen Bereich. Aufgrund der sehr heterogenen Ursachen des ARDS glauben wir, dass insbesondere bei Kindern eine individuelle Beatmungsstrategie notwendig ist. EIT gesteuerte Beatmungsstrategien könnten einen Beitrag zur Verbesserung von Überleben und Entwicklung von beatmungsassoziierten Lungenschäden bei Kindern leisten
Trauma and Memory in Visuality : The Art of Nalini Malani and the Politics of Memory
Get PDFDissertation 'Trauma and Memory in Visuality' examines how contemporary visual art engages with violent legacies of the twentieth and twenty-first centuries, focusing on the political and ethical burden of bearing witness through the means of art. Through the work of the Indian artist Nalini Malani (b. 1946, Karachi), it shows how visuality becomes a site for confronting collective trauma and renegotiating memory. Bringing trauma studies, memory theory, and the French historian Pierre Nora's concept of 'lieux de mémoire' into dialogue, it analyses how Malani's artworks address the aftermath of violence, gendered oppression, and colonial history. While centred on Malani, the work also situates her practice in a broader, transnational context, discussing a selection of artworks by the Colombian artist Doris Salcedo (b. 1958, Bogotá) and the South African artist William Kentridge (b. 1955, Johannesburg), which challenge authorised narratives of the past. The dissertation argues that these contemporary artworks function as sites of political memory, reopening suppressed histories and intervening in dominant structures of remembrance, while demonstrating the important role that visual art plays in shaping how traumatic pasts are recalled and interpreted in the present
Drinking Water and Sanitation Safety Planning for Medical Facilities : An Innovative PoU Approach for a Water System Description Using Ecomaps
Get PDFDrinking Water Safety Plans (DWSP) in buildings serve to identify health hazards associated with the drinking water system. Sanitation Safety Plans (SSP) fulfill the same purpose for the sewage system. Water Safety Plans (WSP) include DWSPs, SSPs, and water systems like gray water and firefighting water. WSPs are based on a high-quality description of the water systems. This paper presents a new methodology for describing water systems. In contrast to previous approaches, the system description begins at the point where the water is consumed. These points of use are described using ecomaps, which are then supplemented with information about the pipe network. This approach makes it possible to fulfill four relevant premises: (1) the system description includes all essential parts of the drinking water installation, (2) the system description is possible with usual equipment, (3) the system description can be carried out with the least possible additional personnel costs, and (4) the system description is controllable, versionable, changeable, and forgery-proof. The ecomaps created in this way are suitable for the next step within the WSP framework, namely hazard and risk assessment. In addition, the ecomaps can be integrated into a quality, occupational safety, or environmental management system. Aspects of water security can be added to enable the ecomaps to be used as the basis for a total integrated water management system
Amtliche Bekanntmachungen, 55. Jahrgang, Nr. 81
No full textÄnderung und zugleich Neubekanntmachung der Ordnung für die Wahl zum Fakultätsrat der Evangelisch-Theologischen Fakultät der Rheinischen Friedrich-Wilhelms-Universität Bonn vom 4. November 202
Trajectories of Mental Distress and Resilience During the COVID-19 Pandemic Among Healthcare Workers
Get PDFBackground/Objectives: The recent COVID-19 pandemic posed a significant psychological challenge for healthcare workers. Resilience and the extent of psychological stress varied across professional groups and individual circumstances. This study aims to longitudinally capture the trajectories of psychological stress and resilience among medical personnel during the pandemic and identify various contributing factors. Methods: Over a period of three years, healthcare workers from five locations (Bonn, Cologne, Ulm, Erlangen, and Dresden) were surveyed regarding their psychological stress (PHQ-4) and other aspects of mental health. Data were collected at five different points during the pandemic. Using Growth Mixture Modeling (GMM), various stress trajectories during the crisis were modeled without initial adjustment for covariates to allow for an unbiased identification of latent classes. Differences in demographic and occupational factors (e.g., age, gender, profession) were analyzed across the identified trajectory groups in subsequent steps. Results: The application of GMM revealed three distinct profiles of psychological stress and resilience among the respondents, largely consistent with the literature. The largest group was the 'resilience' group (81%), followed by the 'recovery' (10%) and 'delayed' groups (9%). Group membership was consistent with self-reported trajectories over the course of the pandemic. It was not possible to predict individual trajectories based on the results of a short resilience questionnaire (RS-5). Conclusions: The COVID-19 pandemic had multiple psychological impacts on healthcare workers, manifesting in clearly differentiated group trajectories of distress over time. While a majority of respondents in this sample exhibited a stable trajectory with low distress, other groups showed varying stress responses over time. These findings highlight the necessity of longitudinal approaches to understand the complex interplay of stressors and coping mechanisms during prolonged crises
Sensory Organs of Eunicida (Annelida) : Implications for Neuronal Brain Architecture and Phylogenetic Significance
Get PDFThe taxon Eunicida comprise marine annelids exhibiting a remarkable variation in the number and morphology of prostomial sensory organs. Currently seven different families of Eunicida are accepted: Eunicidae, Onuphidae, Dorvilleidae, Oenonidae, Lumbrineridae, Histriobdellidae, and Hartmaniella. Most representatives of Eunicida are highly mobile predators with a complex nervous system, showing significant interspecific and interfamilial variations in the number and morphology of antennae, palps, buccal lips, eyes, and nuchal organs. This diversity makes Eunicida an ideal model to study the following key questions: (1) To what extent is the brain morphology affected by the presence and variation of prostomial sensory organs? and (2) Do differences in the number and shape of these sensory organs reflect phylogenetic relationships and ecological adaptations? It could be assumed that different brain morphologies become apparent between the families, that deliver not only insight into the different processing of sensory information but also help to provide clues about phylogenetic relationships and ecological adaptation. Further, the lateral organs were investigated to gather information, if they can be used as supporting character in assessing phylogenies. Using a comparative morphological approach - including immunohistochemistry, µCT, TEM, SEM, paraffin histology, and semi-thin sectioning techniques - we show that while the gross morphology of the central nervous system is largely conserved, the brain's microanatomy varies in association with the presence or absence of sensory organs. In Eunicidae and Onuphidae (Eunicoidea), many well-developed sensory appendages are present correlating with distinct commissural and tract arrangements in the brain. In contrast, Oenonidae and Lumbrineridae (Oenonoidea) exhibit reduced prostomial sensory structures but share unique neuroanatomical features such as lateral neuropils, a dorsoventrally extended brain and similar nuchal organs, supporting a sister-group relationship.
These findings align with recent phylogenetic hypotheses and suggest a secondary reduction of antennae in several lineages. Furthermore, the sensory organ morphology reflects ecological adaptation: Species in epibenthic, light-rich habitats retain complex sensory structures, while endobenthic taxa show reductions consistent with life in low-light environments. This study provides new insights into the evolution of sensory systems, nervous system plasticity, and phylogenetic relationships within Eunicida and Annelida
Overconfidence and Prejudice
Get PDFWe develop a model of multi-dimensional misspecified learning in which an overconfident agent learns about groups in society from observations of his and others' successes. We show that the average person sees his group relative to other groups too positively, and this in-group bias exhibits systematic comparative-statics patterns. First, a person is most likely to have negative opinions about other groups he competes with. Second, while information about another group's achievements does not lower a person’s prejudice, information about economic or social forces affecting the group can, and personal contact with group members has a beneficial effect that is larger than in classical settings. Third, the agent's beliefs are subject to "bias substitution", whereby forces that decrease his bias regarding one group tend to increase his biases regarding unrelated other groups
Biografías de mujeres negras en el sur brasileño : la interseccionalidad como herramienta de emancipación del Otro
Get PDFEl presente artículo analiza, desde una perspectiva microsociológica, la biografía de una mujer negra en la sociedad contemporánea en el sur brasileño, en la ciudad de Pelotas, localizada en el estado de Rio Grande do Sul. A partir del concepto de interseccionalidad, se examina cómo su trayectoria de vida está atravesada por múltiples formas de opresión en una ciudad que se desarrolló, en gran medida, bajo el trabajo esclavista y cuya estructura social aún reproduce las desigualdades heredadas de ese período. A pesar de haber transcurrido más de un siglo y medio desde la abolición de la esclavitud, la sociedad postabolición no ha generado mecanismos efectivos para la inclusión igualitaria de la población negra, promoviendo distintos tipos de desigualdades en la vida de esas personas. Basándose en el concepto de interseccionalidad como herramienta teórico-analítica, a partir de las autoras María Lugones, Patrícia Hill Collins y Silma Bilge, este estudio busca identificar los sistemas de opresión que marcan estas trayectorias, las formas de percibirlos y las estrategias desarrolladas para enfrentarlos. En este sentido, se analiza cómo, históricamente, la sociedad brasileña ha fallado en promover acciones efectivas para la inserción y emancipación de las mujeres negras, manteniéndolas, aún en la contemporaneidad, en la posición de 'Otro'.Biographies of black women in the Brazilian South : intersectionality as a tool for the emancipation of the 'Other'From a micro-sociological perspective, this article analyzes the biography of a Black Woman in contemporary society in southern Brazil, in the city of Pelotas, located in the state of Rio Grande do Sul. Based on the concept of intersectionality, it examines how her life trajectory is traversed by multiple forms of oppression in a city that developed primarily under slave labor and whose social structure still reproduces the inequalities inherited from that period. Despite the passage of more than a century and a half since the abolition of slavery, post-abolition society has not generated effective mechanisms for the egalitarian inclusion of the Black population, promoting different types of inequalities in the lives of these people. Based on the concept of intersectionality as a theoretical-analytical tool, from the authors Maria Lugones, Patricia Hill Collins and Silma Bilge, this study seeks to identify the systems of oppression that mark these trajectories, the ways of perceiving them and the strategies developed to confront them. In this sense, it analyzes how, historically, Brazilian society has failed to implement practical actions for the insertion and emancipation of Black Women, keeping them, even in contemporary times, in the position of 'Other'
Global China : Epistemic Traps and Analytical Registers
Get PDFThe contributions to The Routledge Handbook on Global China highlight the diverse and dynamic relations between Global China and multiple actors, contexts and agencies. The relationship between China's international outreach and the effects of Global China is not straightforward, and understanding the nature and implications of China's rise requires acknowledging the multiple sites, voices and faces of Global China. The Handbook reveals epistemic traps that hinder the understanding of Global China, such as othering and strategic narcissism. It argues for a more nuanced approach that embraces alternative perspectives and challenges existing binaries. The Handbook also emphasizes the importance of accounting for positionality and recognizing different perceptions of China as a global actor. It suggests analytical registers of relationality, global capitalist processes, language and discourse power, and planetary scale modernization to guide future research on Global China. By adopting these registers, researchers can better understand the multifaceted factors shaping Global China within the broader global context of competition and crisis
Thermalization of matter decay products and non-thermal dark matter production in the early universe
Get PDFHeavy, out-of-equilibrium, decaying particles appear in many cosmological histories in the early universe. Our understanding of the late-time universe dictates that the energy injected into the radiation component of the energy budget of the universe should for the most part be thermalized and absorbed into the thermal radiation bath of particles. In this thesis we study the process of thermalization of these highly energetic decay products, dominated by the near-collinear splitting processes; the long quantum formation time in the latter calls for the inclusion of coherence effects, in the form of the LPM suppression. We introduce the main theoretical tools necessary for the study of the thermalization cascade of near-collinear splittings, and then move on to study this cascade for scenarios with a single species of non-Abelian gauge bosons, as well as all non-scalar particles of the Standard Model