Untersuchung zum Einfluss der ACD-CPR mit während der Dekompressionsphase blockiertem Gasfluss (ITD) im Vergleich zur Standard-Reanimationstechnik auf die Kurzzeit-Überlebensrate von Patienten mit präklinisch aufgetretenem Herzkreislaufstillstand

Untersuchung zum Einfluss der ACD-CPR (Aktive Kompressions- Dekompressions-Reanimation) mit während der Dekompressionsphase blockiertem Gasfluss (Impedance-Threshold-Device) im Vergleich zur Standardreanimationsrechnik auf die Kurzzeit-Überlebensrate von Patienten mit präklinisch aufgetretenem Herzkreislaufstillstand. Die Studie vergleicht die ACD-ITD-CPR gegen die Standard-CPR bei Patienten mit präklinischem Herkreislaufstillstand. Primär untersuchter Parameter war die Ein-Stunden-Überlebensrate nach Krankenhausaufnahme. Sekundär wurden die Tastbarkeit eines Pulses unter CPR, die Wiederkehr des Spontankreislaufs (ROSC), die Rate an Krankenhausaufnahmen, 24-Stunden-Überleben und Krankenhausentlassungen untersucht. Außerdem wurde das neurologische Outcome evaluiert. Die Studie fand in Mainz statt; Mainz bietet sich für die Durchführung notfallmedizinischer Studien in besonderem Maße an. Der Rettungsdienst der Stadt arbeitet nach dem in Deutschland üblichen zweigliedrigen System mit RA/RS auf RTWs und NA auf NAW/NEF. Die Studie wurde nach einer fünfmonatigen Pilotphase und extensivem Training beider Verfahren durchgeführt. Zusätzlich bestanden bei einigen der Beteiligten schon Erfahrungen mit ACD-CPR. Es ergaben sich signifikante Vorteile der ACD-ITD-CPR gegenüber der Standard-CPR hinsichtlich des primär untersuchten Parameters (51% vs. 32% p=0,006), außerdem statistisch auffällige Vorteile hinsichtlich der Pulstastbarkeit unter CPR (85% vs. 69%, p=0,008), der Wiederkehr des Spontankreislaufs (55% vs. 37%, p=0,016), der Rate der Krankenhausaufnahmen (52% vs. 36%, p=0.023) und des 24-Stunden-Überlebens (37% vs. 22%, p=0,033). Es ergaben sich keine statistisch auffälligen Unterschiede hinsichtlich der Rate an Krankenhausentlassungen und im neurologischen Outcome. Die Ergebnisse lassen den Schluss zu, dass die ACD-ITD die Kurzzeitüberlebensrate der Patienten mit außerklinischem Herzkreislaufstillstand verbessern kann. Eine Voraussetzung hierfür ist eine ausreichende und andauernde Ausbildung der beteiligten Helfer und/oder die Verfügbarkeit technisch verbesserter Lösungen. Weitere Untersuchungen zum Einfluss auf die Langzeitüberlebensraten und das neurologische Outcome scheinen angezeigt.

Structuring of polymer surface by evaporation of sessile microdrops

In this thesis, we investigated the evaporation of sessile microdroplets on different solid substrates. Three major aspects were studied: the influence of surface hydrophilicity and heterogeneity on the evaporation dynamics for an insoluble solid substrate, the influence of external process parameters and intrinsic material properties on microstructuring of soluble polymer substrates and the influence of an increased area to volume ratio in a microfluidic capillary, when evaporation is hindered. In the first part, the evaporation dynamics of pure sessile water drops on smooth self-assembled monolayers (SAMs) of thiols or disulfides on gold on mica was studied. With increasing surface hydrophilicity the drop stayed pinned longer. Thus, the total evaporation time of a given initial drop volume was shorter, since the drop surface, through which the evaporation occurs, stays longer large. Usually, for a single drop the volume decreased linearly with t1.5, t being the evaporation time, for a diffusion-controlled evaporation process. However, when we measured the total evaporation time, ttot, for multiple droplets with different initial volumes, V0, we found a scaling of the form V0 = attotb. The more hydrophilic the substrate was, the more showed the scaling exponent a tendency to an increased value up to 1.6. This can be attributed to an increasing evaporation rate through a thin water layer in the vicinity of the drop. Under the assumption of a constant temperature at the substrate surface a cooling of the droplet and thus a decreased evaporation rate could be excluded as a reason for the different scaling exponent by simulations performed by F. Schönfeld at the IMM, Mainz. In contrast, for a hairy surface, made of dialkyldisulfide SAMs with different chain lengths and a 1:1 mixture of hydrophilic and hydrophobic end groups (hydroxy versus methyl group), the scaling exponent was found to be ~ 1.4. It increased to ~ 1.5 with increasing hydrophilicity. A reason for this observation can only be speculated: in the case of longer hydrophobic alkyl chains the formation of an air layer between substrate and surface might be favorable. Thus, the heat transport to the substrate might be reduced, leading to a stronger cooling and thus decreased evaporation rate. In the second part, the microstructuring of polystyrene surfaces by drops of toluene, a good solvent, was investigated. For this a novel deposition technique was developed, with which the drop can be deposited with a syringe. The polymer substrate is lying on a motorized table, which picks up the pendant drop by an upward motion until a liquid bridge is formed. A consecutive downward motion of the table after a variable delay, i.e. the contact time between drop and polymer, leads to the deposition of the droplet, which can evaporate. The resulting microstructure is investigated in dependence of the processes parameters, i.e. the approach and the retraction speed of the substrate and the delay between them, and in dependence of the intrinsic material properties, i.e. the molar mass and the type of the polymer/solvent system. The principal equivalence with the microstructuring by the ink-jet technique was demonstrated. For a high approach and retraction speed of 9 mm/s and no delay between them, a concave microtopology was observed. In agreement with the literature, this can be explained by a flow of solvent and the dissolved polymer to the rim of the pinned droplet, where polymer is accumulated. This effect is analogue to the well-known formation of ring-like stains after the evaporation of coffee drops (coffee-stain effect). With decreasing retraction speed down to 10 µm/s the resulting surface topology changes from concave to convex. This can be explained with the increasing dissolution of polymer into the solvent drop prior to the evaporation. If the polymer concentration is high enough, gelation occurs instead of a flow to the rim and the shape of the convex droplet is received. With increasing delay time from below 0 ms to 1s the depth of the concave microwells decreases from 4.6 µm to 3.2 µm. However, a convex surface topology could not be obtained, since for longer delay times the polymer sticks to the tip of the syringe. Thus, by changing the delay time a fine-tuning of the concave structure is accomplished, while by changing the retraction speed a principal change of the microtopolgy can be achieved. We attribute this to an additional flow inside the liquid bridge, which enhanced polymer dissolution. Even if the pendant drop is evaporating about 30 µm above the polymer surface without any contact (non-contact mode), concave structures were observed. Rim heights as high as 33 µm could be generated for exposure times of 20 min. The concave structure exclusively lay above the flat polymer surface outside the structure even after drying. This shows that toluene is taken up permanently. The increasing rim height, rh, with increasing exposure time to the solvent vapor obeys a diffusion law of rh = rh0  tn, with n in the range of 0.46 ~ 0.65. This hints at a non-Fickian swelling process. A detailed analysis showed that the rim height of the concave structure is modulated, unlike for the drop deposition. This is due to the local stress relaxation, which was initiated by the increasing toluene concentration in the extruded polymer surface. By altering the intrinsic material parameters i.e. the polymer molar mass and the polymer/solvent combination, several types of microstructures could be formed. With increasing molar mass from 20.9 kDa to 1.44 MDa the resulting microstructure changed from convex, to a structure with a dimple in the center, to concave, to finally an irregular structure. This observation can be explained if one assumes that the microstructuring is dominated by two opposing effects, a decreasing solubility with increasing polymer molar mass, but an increasing surface tension gradient leading to instabilities of Marangoni-type. Thus, a polymer with a low molar mass close or below the entanglement limit is subject to a high dissolution rate, which leads to fast gelation compared to the evaporation rate. This way a coffee-rim like effect is eliminated early and a convex structure results. For high molar masses the low dissolution rate and the low polymer diffusion might lead to increased surface tension gradients and a typical local pile-up of polymer is found. For intermediate polymer masses around 200 kDa, the dissolution and evaporation rate are comparable and the typical concave microtopology is found. This interpretation was supported by a quantitative estimation of the diffusion coefficient and the evaporation rate. For a different polymer/solvent system, polyethylmethacrylate (PEMA)/ethylacetate (EA), exclusively concave structures were found. Following the statements above this can be interpreted with a lower dissolution rate. At low molar masses the concentration of PEMA in EA most likely never reaches the gelation point. Thus, a concave instead of a convex structure occurs. At the end of this section, the optically properties of such microstructures for a potential application as microlenses are studied with laser scanning confocal microscopy. In the third part, the droplet was confined into a glass microcapillary to avoid evaporation. Since here, due to an increased area to volume ratio, the surface properties of the liquid and the solid walls became important, the influence of the surface hydrophilicity of the wall on the interfacial tension between two immiscible liquid slugs was investigated. For this a novel method for measuring the interfacial tension between the two liquids within the capillary was developed. This technique was demonstrated by measuring the interfacial tensions between slugs of pure water and standard solvents. For toluene, n-hexane and chloroform 36.2, 50.9 and 34.2 mN/m were measured at 20°C, which is in a good agreement with data from the literature. For a slug of hexane in contact with a slug of pure water containing ethanol in a concentration range between 0 and 70 (v/v %), a difference of up to 6 mN/m was found, when compared to commercial ring tensiometry. This discrepancy is still under debate.

The electron antineutrino angular correlation coefficient a in free neutron decay: Testing the standard model with the aSPECT-spectrometer

The beta-decay of free neutrons is a strongly over-determined process in the Standard Model (SM) of Particle Physics and is described by a multitude of observables. Some of those observables are sensitive to physics beyond the SM. For example, the correlation coefficients of the involved particles belong to them. The spectrometer aSPECT was designed to measure precisely the shape of the proton energy spectrum and to extract from it the electron anti-neutrino angular correlation coefficient "a". A first test period (2005/ 2006) showed the “proof-of-principles”. The limiting influence of uncontrollable background conditions in the spectrometer made it impossible to extract a reliable value for the coefficient "a" (publication: Baessler et al., 2008, Europhys. Journ. A, 38, p.17-26). A second measurement cycle (2007/ 2008) aimed to under-run the relative accuracy of previous experiments (Stratowa et al. (1978), Byrne et al. (2002)) da/a =5%. I performed the analysis of the data taken there which is the emphasis of this doctoral thesis. A central point are background studies. The systematic impact of background on a was reduced to da/a(syst.)=0.61 %. The statistical accuracy of the analyzed measurements is da/a(stat.)=1.4 %. Besides, saturation effects of the detector electronics were investigated which were initially observed. These turned out not to be correctable on a sufficient level. An applicable idea how to avoid the saturation effects will be discussed in the last chapter.