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Guenter Weiss, Hans Lippert and Frank Meyer

Successful Management of Non-Occlusive Mesenteric Ischemia (Nomi) - Case Report

Patients with non-occlusive mesenteric ischemia (NOMI) are still confronted with high mortality. The diagnostic is challenging and difficult because of the unspecific symptomatology. The aim of this systematic scientific report on an extraordinary and uncommon single clinical case and its successful course was to demonstrate the great potential of a partially novel non-surgical approach including its periinterventional management.

A 73-year old female is precisely described, who developed an acute abdomen during the postoperative course after cardiosurgical intervention. Only explorative laparotomy clarified the correct diagnosis - NOMI. Despite general intensive care, patient developed multi-organ failure after this second intervention. Using consequently an image-guided minimally invasive radiological approach comprising the introduction of a catheter into the superior mesenteric artery (Seldinger's technique) and the continuous application of vasodilating medication such as alprostadil (prostaglandin) through this catheter enabled us to improve mesenteric perfusion effectively and to overcome multiorgan failure.

In conclusion, specific risk factors may help to focus on the suspicion of NOMI. Diagnostic of choice is the arterial mesentericography, which allows specifically to exclude vascular occlusion including the consequence of a prompt surgical approach. Simultaneously, using the setting of the mesenteric angiography catheter can be placed for initiation of regional vasodilating treatment in case of NOMI. Only this approach may avoid fatal outcome.

Open access

Frank L’Engle Williams

Abstract

Pleistocene Paranthropus robustus fossils from Swartkrans have yielded stable isotope values suggesting some foraging on C4 plants possibly including underground storage organs. Dental microwear texture analysis on P. robustus (SK 6, SK 34 and SK 47) from Swartkrans Member 1 is performed to examine whether tooth surface damage from mastication agrees with prior dietary inferences from carbon isotopes. There is considerable variation in textural characteristics among the P. robustus specimens. Specifically, adult SK 34 stands apart from the two subadult specimens, SK 6 and SK 47, suggesting life history could be reflected in patterns of dental microwear texture characteristics, although seasonality and availability of fallback foods may also explain the variation observed in P. robustus. The fossils all exhibit elevated surface texture complexity, resembling the values for Lophocebus albigena and Cebus apella, and to a lesser extent, Pan troglodytes. Paranthropus robustus is dissimilar to primary folivores, such as Trachypithecus cristatus or folivore- frugivores such as Alouatta palliata suggesting leaves comprised very little of its diet. The textural fill volume of P. robustus differs from that observed in extant primates from tropical forests indicating extreme durophagy, perhaps a function of differences in habitat. Ingestion of extraneous grit on the underground parts of plants and from terrestrial resources, perhaps as fallback foods or as dietary staples, may account for these enamel textural properties and may help explain the mixed C3/C4 isotopic signal in P. robustus.

Open access

Petia Dineva, Frank Wuttke and George Manolis

Elastic Wavefield Evaluation in Discontinuous Poroelastic Media by Bem: Sh-Waves

This work examines the anti-plane strain elastodynamic problem for poroelastic geological media containing discontinuities in the form of cavities and cracks. More specifically, we solve for: (i) a mode III crack; (ii) a circular cylindrical cavity, both embedded in an infinite poroelastic plane; and (iii) a mode III crack in a finite-sized poroelastic block. The source of excitation in all cases are time-harmonic, horizontally polarized shear (SH) waves. These three cases depict a situation whereby propagating elastic waves are diffracted and scattered by the presence of discontinuities in poroelastic soil, and this necessitates the computation of stress concentration factors (SCF) and stress intensity factors (SIF). Thus, the sensitivity of the aforementioned factors to variations in the material parameters of the surrounding poroelastic continuum must be investigated. Bardet's model is introduced by assuming saturated soils as the computationally efficient viscoelastic isomorphism to Biot's equations of dynamic poroelasticity, and stress fields are then evaluated for an equivalent one-phase viscoelastic medium. The computational itool employed is an efficient boundary element method (BEM) defined in terms of the non-hypersingular, traction-based formulation. Finally, the results obtained herein demonstrate a marked dependence of the SIF and the SCF on the mechanical properties of the poroelastic continuum, while the advantages of the proposed method as compared to alternative analytical and/or numerical approaches are also discussed.

Open access

Boštjan Žvanut, Nuša Frank and Irena Trobec

Pomanjkljivosti Poslovnih Procesov v Zdravstvenih Organizacijah: Primer Okulistične Ambulante

Namen: Razumevanje poslovnih procesov je ključni element pri prenovi poslovanja. Kljub temu pa mu v praksi slovenskega zdravstva namenjamo premalo pozornosti. Namen raziskave je pokazati, da je s pomočjo ustreznega popisa poslovnih procesov mogoče prepoznati neučinkovite elemente, ki povzročajo nevidne izgube v poslovanju.

Metode: Uporabili smo so metodo pregleda literature, metodo opazovanja, metodo intervjuja in metodo modeliranja procesov ter v konkretni okulistični ambulanti popisali ključne poslovne procese s pomočjo dogodkovno vodenih procesnih verig ter ugotavljali pomanjkljivosti.

Rezultati: Zaradi pomanjkljivosti v poslovnih procesih v konkretni okulistični ambulanti z dvema zaposlenima neracionalno izrabijo približno 25,5 ur delovnega časa na mesec (15,2 % celotnega delovnega časa na enega zaposlenega).

Zaključek: Na podlagi ugotovitve, da so tolikšne pomanjkljivosti prisotne že v manjši zdravstveni organizaciji z dvema zaposlenima, lahko pričakujemo, da njihov obseg v kompleksnejših organizacijah še bistveno večji. Vodstvom zdravstvenih organizacij priporočamo, da omenjeni problematiki posvetijo posebno pozornost ter izvedejo popis in optimizacijo poslovnih procesov. Omenjene dejavnosti je potrebno izvesti pred uvedbo ali prenovo informacijskega sistema.

Open access

Zdenčk Kučera, Tomáš Vondrák and Daniel Frank

Integrace českého výzkumu a vývoje v oblasti energetiky do meziná-rodních programů otevírá možnosti účasti na finančnč náročných pro-jektech a iniciativách, které nelze realizovat na národní úrovni. Cílem příspčvku je posoudit s využitím kvantitativních indikátorů, jak se ČR zapojuje do mezinárodních projektů VaV a jaká je úroveň výsledků této spolupráce v publikační sféře. Oborová struktura zapojení ČR v meziná-rodním energetickém výzkumu je značnč nevyrovnaná. Celkovč v zapojení v 7. rámcovém programu je ČR na 26. místč z EU-28, avšak v oblasti jaderné energetiky (program EURATOM) je česká účast pomčrnč vyso-ká a v tematické prioritč Jaderné štčpení tohoto programu patří české výzkumné týmy k nejaktivnčjším. Nízká úroveň participace v mezinárodních aktivitách se odráží i v celkovč nízkém podílu českých publikací v energetických oborech vytvořených v mezinárodní spolupráci, v nichž dominují práce zaměřené na oblast jaderné energetiky. Velmi nízké za-stoupení v mezinárodních publikacích má oblast obnovitelných zdrojů.

Open access

Joachim Baumeister, Jochen Reutelshoefer and Frank Puppe

Engineering intelligent systems on the knowledge formalization continuum

In spite of their industrial success, the development of intelligent systems is still a complex and risky task. When building intelligent systems, we see that domain knowledge is often present at different levels of formalization—ranging from text documents to explicit rules. In this paper, we describe the knowledge formalization continuum as a metaphor to help domain specialists during the knowledge acquisition phase. To make use of the knowledge formalization continuum, the agile use of knowledge representations within a knowledge engineering project is proposed, as well as transitions between the different representations, when required. We show that a semantic wiki is a flexible tool for engineering knowledge on the knowledge formalization continuum. Case studies are taken from one industrial and one academic project, and they illustrate the applicability and benefits of semantic wikis in combination with the knowledge formalization continuum.

Open access

David Barney, Robert Christenson and Frank Pleban

Pre-Service Physical Education Teachers' Knowledge of Appropriate Instructional Practices in Secondary School Physical Education

Secondary school can serve as a time for youth to prepare themselves for the ‘real world’, and physical education can play an important role in this preparation. Yet in the past, secondary school physical education has not been very effective in preparing youth for life after secondary school. One area to help improve secondary school physical education is in the preparation of pre-service physical education teachers. It is during the preparation of pre-service physical education teachers that they will be taught and trained regarding appropriate instructional practices in secondary school physical education. The National Association of Sport and Physical Education created a document regarding appropriate educational practices in secondary school physical education. For this study, a survey was adapted from the National Association of Sport and Physical Education appropriate instructional practice document. Three hundred and thirteen pre-service physical education teachers from seven institutions of higher education throughout the United States were surveyed regarding their knowledge of appropriate instructional practices in secondary school physical education. It was found that pre-service physical education teachers inappropriately answered six of the 18 survey statements (33%) regarding appropriate instructional practices in secondary school physical education. When pre-service physical education teachers graduate and expose secondary school pupils to appropriate practices, there is a better chance the pupils will be prepared for the ‘real world’.

Open access

Florin Poenaru

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Open access

Hedda Giertsen, Per-Åke Nylander, Vibeke Asmussen Frank, Torsten Kolind and Jouni Tourunen

Drug Addiction) (2012). Prisons and drugs in Europe: The problem and responses. Luxembourg: Publication Office of the European Union. Farabee, D., Prendergast, M., Cartier, J., Wexler, H., Knight, K., & Anglin M. Y. (1999). Barriers to implementing effective correctional drug treatment programs. The Prison Journal, 79(2), 150-162. Frank, V. A. et al. (2015). Inmates’ perspectives on prison drug treatment. A qualitative study from three prisons in Denmark Probation Journal (forthcoming). Friestad, C., & Hansen, I. L. S