The Bigger, the Better? The Influence of Urban Green Space Design on Cooling Effects for Residential Areas

It is well known that the cooling effect of an urban green space extends into its surroundings, cooling the immediate environment and mitigating urban heat problems. However, the effects of size, shape, and type of an urban green space on cooling remain uncertain. The objectives of our study were to quantify and compare the strength of the cooling effects of urban parks and forests, to determine how far the cooling effects extend into the surrounding residential environment, and to better understand how temperature gradients are driven by physical characteristics of the green space and the surroundings. Mobile air temperature measurements were performed in 62 urban parks and forests in the city of Leipzig, Germany, in the summer of 2013. Three indicators of cooling were calculated: the change in temperature (ΔT) at the park-width distance, the maximum ΔT, and the cooling distance. The relationships of these variables to the physical characteristics of the green spaces and their surroundings were examined in multiple regression models. Analyzing all three indicators revealed that cooling effects were greater in urban forests than in parks. Cooling increased with increasing size but in a different manner for forests and parks, whereas the influence of shape was the same for forests and parks. Generally, the characteristics of the green spaces were more important than the characteristics of the residential surroundings. These findings have the potential to assist in better planning and designing of urban green spaces to increase their cooling effects.

Surveillance and Outbreak Response Management System (SORMAS) to support the control of the Ebola virus disease outbreak in West Africa

In the context of controlling the current outbreak of Ebola virus disease (EVD), the World Health Organization claimed that 'critical determinant of epidemic size appears to be the speed of implementation of rigorous control measures', i.e. immediate follow-up of contact persons during 21 days after exposure, isolation and treatment of cases, decontamination, and safe burials. We developed the Surveillance and Outbreak Response Management System (SORMAS) to improve efficiency and timeliness of these measures. We used the Design Thinking methodology to systematically analyse experiences from field workers and the Ebola Emergency Operations Centre (EOC) after successful control of the EVD outbreak in Nigeria. We developed a process model with seven personas representing the procedures of EVD outbreak control. The SORMAS system architecture combines latest In-Memory Database (IMDB) technology via SAP HANA (in-memory, relational database management system), enabling interactive data analyses, and established SAP cloud tools, such as SAP Afaria (a mobile device management software). The user interface consists of specific front-ends for smartphones and tablet devices, which are independent from physical configurations. SORMAS allows real-time, bidirectional information exchange between field workers and the EOC, ensures supervision of contact follow-up, automated status reports, and GPS tracking. SORMAS may become a platform for outbreak management and improved routine surveillance of any infectious disease. Furthermore, the SORMAS process model may serve as framework for EVD outbreak modeling.

A quantitative review of urban ecosystem service assessments: concepts, models, and implementation

Although a number of comprehensive reviews have examined global ecosystem services (ES), few have focused on studies that assess urban ecosystem services (UES). Given that more than half of the world's population lives in cities, understanding the dualism of the provision of and need for UES is of critical importance. Which UES are the focus of research, and what types of urban land use are examined? Are models or decision support systems used to assess the provision of UES? Are trade-offs considered? Do studies of UES engage stakeholders? To address these questions, we analyzed 217 papers derived from an ISI Web of Knowledge search using a set of standardized criteria. The results indicate that most UES studies have been undertaken in Europe, North America, and China, at city scale. Assessment methods involve bio-physical models, Geographical Information Systems, and valuation, but few study findings have been implemented as land use policy.

Comparison of Obstetric Efficacy and Safety of the Kiwi OmniCup with Conventional Vacuum Extraction

Purpose: The aim of the present study was to compare the safety and efficacy of the Kiwi OmniCup system with conventional vacuum delivery. Methods: A retrospective study of operative vaginal deliveries was done for 4682 births. The procedures included 217 operative vaginal deliveries (4.6 %), 79 of which were done using conventional vacuum extraction (37 %) and 138 using the Kiwi system (63 %). Results: Use of the Kiwi system was associated with a significant reduction in episiotomies (61 vs. 76 % in the control group; p < 0.05). The rates of successful completion of birth were comparable for the two systems (94 % with the Kiwi system and 99 % with conventional vacuum delivery). Cup detachment occurred significantly more often in the Kiwi group (p < 0.005), requiring a change to a different method of birth significantly more often. It was necessary to change the procedure significantly more often from the mid-pelvis (p < 0.05). The incidence of maternal and foetal injuries was similar for the two systems. Conclusions: With regard to obstetric efficacy and safety and foetal and maternal injuries, the Kiwi system is an acceptable alternative to the conventional vacuum cup. The advantages of the Kiwi system are its significantly lower episiotomy rate and its ease and rapidity of use.

Technical complications during removal of locking screws from locking compression plates: a prospective multicenter study

PURPOSE

To assess the risk for technical complications in patients undergoing removal of locking compression plates (LCP) with head locking screws.

METHODS

A total of 205 patients who were scheduled for implant removal surgery after a healed fracture of the femur, tibia, humerus, distal radius, or clavicle in nine Austrian clinics were prospectively included in the study, all of whom had previously undergone fracture fixation by plates, with titanium implants used in 98 % of the patients. Intraoperative technical complications and the methods used to solve them were documented by the surgeon.

RESULTS

During the course of this study, a total of 1,462 locking screws were removed from 204 LCPs. While 95 % of these screws could be removed without difficulties, technical complications were reported for 41 patients with 78 screws which could not be removed with standard screwdrivers and required the use of additional instruments. The estimated risk for the occurrence of at least one technical complication during implant removal surgery was 20.1 %. The most frequently observed complications were screws that could not be loosened because they were jammed in the LCP, screws with a damaged recess in which the screwdriver turned freely, as well as a combination of both events. The majority of these screws could be removed with the use of a conical extraction screw or by drilling off the screw head. In one patient, an intraoperative refracture of the humerus occurred during plate removal. Even though there is a rate of 20 % for technical complications when removing the implants, only a few patients experience a clinical impact.

CONCLUSIONS

Titanium LCPs are prone to technical complications during implant removal, but the majority of the issues can be solved using special techniques.

Simulating Demography and Housing Demand in an Urban Region under Scenarios of Growth and Shrinkage

After the fall of the Berlin wall in 1989, demographic decline and urban shrinkage brought massive changes in the housing stock in East German cities. Urban planners and policy makers face complex problems caused by the resulting vacancies and demolitions and the handling of urban brownfields in the inner city. At the same time, cities are under ongoing pressure of suburbanisation. Because existing models focus mainly on demographic and urban growth and their impact on housing stocks, we present a simulation model that is able to compute both growth and shrinkage processes. We uncover nonlinear dynamics and feedbacks between demography, housing preference, and supply of housing space. The simulation results show that, despite population decline, the increasing number of single households leads to a growing total housing demand in the central parts of the study area. Beyond this area, residential vacancies in multistorey housing segments will remain regardless of population growth. At the same time, the simulations show that, despite population shrinkage and an overall oversupply of flats, there is a negative net demand for flats in affordable prefabricated housing estates as the percentage of low-income households increases. These findings will help planners modify or adapt their visions of the residential function in shrinking cities and to adjust current programmes of renewal and restructuring.

[Cognitive deterioration after cardiosurgery]

Over 100,000 heart surgeries are performed in Germany annually. Although severe neurological complications like ischaemic strokes have meanwhile become rare occurrences, subtle neuropsychological changes are still frequently recognized after major heart surgeries. The hitherto unsolved problem of postoperative cognitive decline (POCD) is portrayed in this article. Multifactorial aetiologies including microembolism and preoperative risk factors are supposed to play a significant role in POCD. A variety of neuroprotective strategies such as intraoperative microemboli filtration have been suggested to minimize cerebral risks. The utility of neuroprotective methods has recently been verified in randomized studies.

Omnipresent Sprawl? A Review of Urban Simulation Models with Respect to Urban Shrinkage

Simulation models on urban land-use change help in understanding urban systems and assist in urban planning. One of the challenges of simulating urban regions in Europe as well as in North America or Japan is urban shrinkage, where deindustrialisation, massive population losses, and ageing cause unforeseen (or unexpected) commercial and housing vacancies in cities. In order to set up a conceptual framework for model improvement to assist such challenges, we review recent urban land-use-change simulation models, using four different modelling approaches: system dynamics, linked transport — urban models, cellular automata, and agent-based modelling. The focus of the review is to assess the causalities and feedback mechanisms that were implemented in these models. The results show that simulation models are very heterogeneous in implemented mechanisms leading to urban land-use dynamics. No single model fulfils all of the criteria required to model urban shrinkage in a spatially explicit way. However, system-dynamic models that are documented in the literature can serve as a good starting point for spatially nonexplicit simulation, and one example was found for linked transport — urban models which encompasses aspects of urban shrinkage. The potential of cellular automata is unclear as spatially explicit data on vacancies to feed this class of models is usually not available. Agent-based models appear to be the most promising approach for spatially explicit modelling of urban shrinkage.

[Trauma hospital. Knee arthroplasty as primary therapy for proximal tibial fracture]

Ten patients aged 55-85 years with a tibial head fracture AO B3 or C3 were treated primarily by implantation of an endoprosthesis. There were one unilateral, three superficial, and six revision-type prostheses. Follow-up was 6 months to 3 years; two patients were lost to follow-up. There were no intra- or postoperative complications except one deep infection which could be cured by repeated arthroscopic lavage. At last follow-up all eight patients were completely or almost pain free; the extension deficit was less than 10 degrees , and flexion was 100 degrees or more. Primary endoprosthetic replacement of the knee joint is a valuable procedure for the treatment of complex tibial head fractures in elderly patients.

[Acute headache in a case of cerebral cavernomas]

We report a case of a 52-year-old female patient with known cerebral cavernomas and acute headache. A cranial CT scan excluded an intracranial bleeding. Cavernomas are rare vascular malformations of the venous blood system (synon. cavernous angiomas) with a slow blood flow. Clinical manifestation is presented between an age of 30-50 years with mostly unspecific neurological symptoms like headache, nausea, vomiting and dizziness, but also epileptic seizures and bleedings may occur. In general, therapy is symptomatic. In cases of seizures, however, anticonvulsive treatment is indicated. Operation can be discussed for peripheral localized cavernomas with bleeding or for refractory seizures. If antiplatelet or anticoagulation therapy is necessary due to other diseases (coronary heart disease, atrial fibrillation, thrombosis, pulmonary embolism), cerebral cavernomas are not considered as an absolute contraindication. The risk for an ischemic stroke under atrial fibrillation (5-20%), for example, is higher than the risk for bleeding of a cerebral cavernoma under anticoagulation therapy.