IFU (Germany)

Neurological recovery following spinal cord injury (SCI) is commonly studied through changes in high-level descriptors of injury severity, such as the American Spinal Injury Association Impairment Scale (AIS) grade, or total upper and/or lower extremity motor scores. More recently, the analysis of segmental motor scores has attracted interest as it provides a more detailed understanding of the exact location and extent of changes occurring during recovery. We propose to augment the analysis of segmental motor recovery with a qualitative descriptor of local motor score patterns, which is defined for all upper and lower extremity myotomes below the neurological level of injury (NLI) and based on a categorization of the changes along the rostrocaudal motor score sequence. Our hypothesis is that recovery of segmental motor scores depends on the residual function as described by the newly proposed descriptors of local motor score patterns. Using data of 1385 patients from the European Multicenter Study about SCI, we analyze differences in recovery at approximately 6 months after injury between local motor score patterns and find an increased probability of full motor recovery for myotomes associated with increased motor scores in the caudal direction. We further use an aggregated descriptor of motor score patterns focusing on increases of motor scores in the caudal direction as an alternative or complementary feature to the AIS grade in prediction models for segmental motor scores at recovery. We observe equivalent predictive performance as measured by the root mean square error between actual and predicted motor scores below the NLI for models using the same set of features and additionally either the AIS grade (median = 0.79) or local pattern (median = 0.80). This is noteworthy as the definition of local motor score patterns requires only the examination of the 10 key muscles of the International Standards for Neurological Classification of SCI on each side of the body, while the AIS grade can only be reliably determined if extensive sensory testing is performed in addition. These results indicate the potential benefits of considering information inherent to the rostrocaudal sequence of motor scores for a better understanding of motor recovery. Furthermore, it supports the development and use of abbreviated sensorimotor examinations specifically in the early phase after SCI.

Spinal cord injury (SCI) incidence is rising among the elderly, yet the relationship between age and recovery remains controversial. The aim of this study was to evaluate the relationship between age and neurologic and functional outcomes and to identify an age cutoff associated with a decline in recovery. We conducted a prospective cohort study using data from patients with traumatic and ischemic SCI enrolled in the European Multicenter Study about Spinal Cord Injury between 2001 and 2022. Linear regression models assessed the relationship between age and changes from baseline to 1 year after SCI in the total motor score (TMS) of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and in the Spinal Cord Independence Measure (SCIM) total score. Additional analyses examined the relationship between age and the evolution of ISNCSCI light-touch and pinprick scores, as well as ambulation parameters (6-minute walking test, 10-meter walking test, and Walking Index for Spinal Cord Injury). Models were adjusted for baseline scores, sex, year of injury, American Spinal Injury Association Impairment Scale (AIS) grade, and level of injury. The age cutoff was determined using a change-point model. A total of 2,171 patients (median age 47 years, 77.9% male, 51.9% injured at the cervical level, and 50.0% with a motor complete injury [AIS-A and AIS-B]) were included in the analysis. Increased age was not associated with changes in TMS (p = 0.896) but was significantly associated with reduced SCIM improvement (p < 0.001), with an estimated decline of 4.3 SCIM points per decade of age. Sensory outcomes were not significantly affected by age (Δlight-touch: p = 0.273; Δpinprick: p = 0.520) while ambulation recovery declined with increasing age (all outcomes p < 0.01). A noticeable reduction in functional recovery was observed in patients older than 70 years. Older age does not seem to affect neurologic recovery but is linked to poorer functional and ambulation outcomes. These findings, including the identified age cutoff, should inform future clinical trial design and guide tailored care strategies for older adults with SCI. ClinicalTrials.gov Identifier NCT01571531.

Heart sounds classification plays an important role in cardiovascular disease detection. Currently, deep learning methods for heart sound classification with heavy parameters consumption cannot be deployed in environments with limited memory and computational budgets. Besides, de-noising of heart sound signals (HSSs) can affect accuracy of heart sound classification, because erroneous removal of meaningful components may lead to heart sound distortion. In this paper, an automated heart sound classification method using adaptive wavelet threshold and 1D LDCNN (One-dimensional Lightweight Deep Convolutional Neural Network) is proposed. In this method, we exploit WT (Wavelet Transform) with an adaptive threshold to de-noise heart sound signals (HSSs). Furthermore, we utilize 1D LDCNN to realize automatic feature extraction and classification for de-noised heart sounds. Experiments on PhysioNet/CinC 2016 show that our proposed method achieves the superior classification results and excels in consumption of parameter comparing to state-of-the-art methods.

The database presented in this study has been acquired during the SOuth west FOGs 3D (SOFOG3D) experiment for processes study. This international campaign led by Météo-France during the winter 2019–2020 aimed at deploying a unique network of both in situ and remote sensing measurements in order to document spatial and temporal variabilities of fog events. To support this scientific objective but also to conduct first data assimilation experiments within the French convective scale model AROME, an un-precedented network of 8 ground-based microwave radiometers (MWR) has been deployed in 7 different locations known to be prone to fog occurrences. The database gives access to vertical profiles of temperature and humidity (both absolute and relative) from the surface up to 10 km altitude as well as integrated water vapor and liquid water path estimates. The retrieved profiles offer a very large database that can be exploited for several scientific purposes: fog process studies at specific location, documentation on the variability of fog properties at the regional scale, better understanding of the atmospheric boundary layer (ABL) height and dynamics during wintertime conditions, development of nowcasting products dedicated to fog alerts, data assimilation experiments to improve fog forecasts, development of synergetical advanced products, and evaluation of new model configurations with advanced parameterization or resolutions.

Inadequate treatment of aerosol scattering can be a significant source of error when retrieving column‐averaged dry‐air mole fractions of CO2 (XCO2) from space‐based measurements of backscattered solar shortwave radiation. We have developed a retrieval algorithm, RemoTeC, that retrieves three aerosol parameters (amount, size, and height) simultaneously with XCO2. Here we evaluate the ability of RemoTeC to account for light path modifications by clouds, subvisual cirrus, and aerosols when retrieving XCO2 from Greenhouse Gases Observing Satellite (GOSAT) Thermal and Near‐infrared Sensor for carbon Observation (TANSO)‐Fourier Transform Spectrometer (FTS) measurements. We first evaluate a cloud filter based on measurements from the Cloud and Aerosol Imager and a cirrus filter that uses radiances measured by TANSO‐FTS in the 2 micron spectral region, with strong water absorption. For the cloud‐screened scenes, we then evaluate errors due to aerosols. We find that RemoTeC is well capable of accounting for scattering by aerosols for values of aerosol optical thickness at 750 nm up to 0.25. While no significant correlation of errors is found with albedo, correlations are found with retrieved aerosol parameters. To further improve the XCO2 accuracy, we propose and evaluate a bias correction scheme.Measurements from 12 ground‐based stations of the Total Carbon Column Observing Network (TCCON) are used as a reference in this study. We show that spatial colocation criteria may be relaxed using additional constraints based on modeled XCO2 gradients, to increase the size and diversity of validation data and provide a more robust evaluation of GOSAT retrievals. Global‐scale validation of satellite data remains challenging and would be improved by increasing TCCON coverage.

Generally spine injured persons without neurological deficits can--as long as the principles of industrial medicine are observed--be occupationally integrated without any particular rehabilitation measures within the limits of their remaining capacity. Spine injured persons, however, with remaining instabilities, serious static deficiencies and/or neurological deficits need further rehabilitation after their in-patient and immediate posthospital treatment. Spinal cord injured patients usually have to accept serious changes and limitation in all spheres of life. Rehabilitation measure in work, school and the social field are vital. Despite all efforts at rehabilitation limitations do remain among other things in work, mobility and social contacts. The preceding paper presents the tasks and results of rehabilitation of spinal cord injured persons, special consideration being given to spinal cord injured persons with supporting facts from long term studies.

During the airborne CONTRACE field experiment carried out in November 2001 a number of polluted layers of North American (NA) origin were observed in the free troposphere over Europe. For the first time, forecasts from a Lagrangian particle dispersion model were used to predict the NA pollution events and to direct a research aircraft very precisely into these polluted layers above Europe. Two of the NA pollution events are investigated here: one in detail (case 19 November) and a second more briefly (case 22 November). An exceptional result was that the first pollution plume could be traced with the model and trace gas measurements (airborne and surface) for a period of one week, from the source region over the eastern United States to its decay over the Alps. On 14–15 November a warm conveyor belt lifted the leading edge of the pollution plume over the eastern United States to the mid troposphere where it remained during the transport over the Atlantic. On 19 November the plume was intersected with the research aircraft over Scandinavia at an altitude between 2 and 4 km. Elevated CO (170), O3 (53), NOy (1.1), acetone (5.0), and SO2 (2.6) mixing ratios (nmol mol−1) were measured. A positive O3‐CO correlation was observed in the plume. The observations indicate that the enhanced levels of ozone were already produced near the source region over the eastern United States and not during the transit. In the next days one branch of the plume then turned to the south and descended to ground level over the Alpine region. Elevated O3 (54 nmol mol−1) and CO (168 nmol mol−1) were observed at the mountain site Zugspitze (southern Germany) during two days. At the Arosa Alpine site in Switzerland the highest daily ozone means of November 2001 were observed during this event.

Sonographic examination can yield additional information free of radiation in the course of corticotomy/callus distraction. The echogenic structures of the cortical structure and the callus between can be scanned at the area of the callus distraction by ultrasound examination. Individual sectional planes are focussed. They are different from the standardized ultrasound examination. Depending on when the corticotomy was performed, the callus between the cortical structures can be visualized sonographically. First it is echo poor, and then it becomes more and more echogenic. The ultrasound examination can give additional information during the first 4 weeks after corticotomy/callus distraction. A deviation of the axis in the area of callus distraction cannot be judged reliably. A sonographically guided division into three stages is possible.

Die verschiedensten klinischen Zeichen können auf eine Hüftluxation hinweisen, wobei deren Wert in Abhängigkeit vom Alter und vom Schweregrad der Dislokation gesehen werden muß. Alle klinischen Untersuchungstechniken beschränken sich aber im wesentlichen auf das Erkennen von Stellungsveränderungen des Hüftkopfes zur Hüftgelenkpfanne; den Pfannenfehlbau bei zentriertem Hüftgelenk können sie nicht erkennen. Es muß daher festgehalten werden, daß es keine klinischen Untersuchungstechniken zur Diagnostik des Pfannenfehlbaues gibt, so daß der Pfannenfehlbau, der für den Betroffenen unter Umständen auch dramatische Folgen hat, durch eine klinische Untersuchung allein nicht entdeckt werden kann (Tschauner 1997) (siehe Kapitel 4). Als bildgebende Diagnosemittel stehen, neben der Sonographie, das Röntgenbild, die Computertomographie und MRT, die letzteren kombiniert mit Kontrastmitteldarstellungen, zur Verfügung. Hinsichtlich der Gewichtung steht die Sonographie im 1. Lebensjahr zur Diagnostik von Hüftreifungsstörungen als reproduzierbares, beliebig oft einsetzbares und nichtinvasives Verfahren ohne jegliche Strahlenbelastung an erster Stelle (Niethard 1997).

Die Sonographie des Sauglingshuftgelenkes nach Graf (1986a,b,c) ist eine etablierte Methode zur Fruherkennung von Huftreifungsstorungen und seit dem 1. Januar 1996 in der Bundesrepublik Deutschland in das Screening-programm der Krankenkassen bei der U3 integriert. Die seit langem diskutierte Abhangigkeit der Huftreifungsstorung von diversen anamnestischen und klinischen Risikofaktoren hat unter anderem dazu gefuhrt, das manche Autoren, vornehmlich aus dem angloamerikanischen Raum, die sonographische Untersuchung der Neugeborenenhuftgelenke vom Vorhandensein solcher Risikofaktoren abhangig machen und ein generelles Screening fur nicht erforderlich halten (Clarke u. Mitarb. 1989; Jones 1989; Jones u. Mitarb. 1990). Die im Huftgelenk-Screening an zwei Universitatskliniken gewonnenen Daten einer grosen Anzahl Neugeborener ermoglichen die Uberprufung der Korrelation von Huftreifungsstorung und den anamnestischen Risikofaktoren: familiare Belastung, Geburt aus Beckenend- oder Steislage bzw. per Sectio, Fruh- oder Spatgeburt und Zwillingsgraviditat.