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Human milk, breastfeeding, and early neurodevelopmental outcomes for infants with critical CHD
- Kristin M. Elgersma, Melissa L. Engel, Sara E. Ramel, Jessica A. Davis, Anne C. McKechnie, Katie M. Pfister
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- Journal:
- Cardiology in the Young , First View
- Published online by Cambridge University Press:
- 13 May 2024, pp. 1-9
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Human milk improves neurodevelopment for preterm infants, but relationships between human milk and neurodevelopment for infants with critical CHD are unknown. We aimed to (1) explore associations between human milk/direct breastfeeding and neurodevelopment at 1-year and 2-year follow-up and (2) describe patterns of human milk (maternal, donor) and commercial formula during hospitalisation in the first year of life.
This retrospective cohort study included infants who underwent surgery for CHD < 6 months old. The primary outcome was neurodevelopment via Bayley Scales of Infant Development-IV. Analysis included adjusted linear regression for associations between exclusive human milk while inpatient during the first 6 months or any direct breastfeeding while inpatient during the first year of life and 1-year Bayley-IV scores. Models were adjusted for race, insurance type, genetic diagnosis, and length of stay.
Of 98 eligible infants, 40% followed up at 1 year; 27% at 2 years. There were differences in follow-up related to demographics (race, ethnicity) and social determinants of health (insurance type, distance from clinic). In adjusted models, infants who directly breastfed had 13.18 points higher cognition (95% CI: 0.84–25.53, p = 0.037); 14.04 points higher language (2.55–25.53, p = 0.018); and 15.80 points higher motor scores (3.27–28.34, p = 0.015) at 1-year follow-up. Infants fed exclusive human milk had 12.64 points higher cognition scores (−0.53–25.82, p = 0.059).
Future investigation into nutrition and neurodevelopment in the context of critical CHD is warranted. As neurodevelopmental follow-up becomes standard of care in this population, efforts are needed to mitigate disparities in access to this care.
P01-03 - Biomarkers for Changes in Self-regulation Through Cognitive Behavioral Therapy for Depression
- A. Nocon, K. Keck, H. Pfister, B. Heldmann, M. Rosenhagen, M. Uhr, S. Lucae, M. Ising
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- European Psychiatry / Volume 25 / Issue S1 / 2010
- Published online by Cambridge University Press:
- 17 April 2020, 25-E208
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Depressed patients show a disturbed hypothalamic-pituitary-adrenal (HPA) axis regulation, resulting in increased cortisol levels, inadequate cortisol suppression following a low dose of dexamethasone, increased concentrations of corticotropin releasing hormone (CRH) in the cerebrospinal fluid, and a blunted adrenocorticotropic hormone (ACTH) response following CRH administration. Treatment with antidepressants, but seemingly also cognitive behavioral therapy (CBT), is associated with an improvement of a disturbed HPA-axis regulation, which can be most sensitively evaluated with the combined dexamethasone (dex)/CRH test. Favorable response to antidepressant treatment can be predicted at an early stage by determining the degree of normalization of HPA-axis function under treatment in a second dex/CRH test.
We report about the predictive validity of HPA-axis normalization on the favorable response of CBT in medicated depressed patients.
Medicated depressed patients receiving CBT at the Max-Planck-Institute of Psychiatry in Munich are studied using the State-Trait-Angstinventar (STAI), Beck Depression Inventory (BDI), Volitional-Components-Questionnaire (VCQ-3), Emotion-Regulation Questionnaire (EPQ) and the Self-Control and Self-Management Scale (SCMS). Neuroendocrine parameters including measures of HPA-axis regulation are measured before and after therapy via dex/CRH test.
Up to the present moment data for N=38 depressed patients have been collected (N=21 male, 25-78 years; N=17 female, 21-80 years). The mean level of depression and anxiety showed a significant decrease between pre- and post-treatment measurement. Measures of perceived self-regulation and self-estimation increased and measures of perceived self-inhibition and inhibition of will decreased.
The expected changes in depression, anxiety and self-regulation after treatment with antidepressants and CBT were observed. Endocrine data are currently under analysis.
The Right to Privacy—A Fundamental Right in Search of Its Identity: Uncovering the CJEU’s Flawed Concept of the Right to Privacy
- Valentin M. Pfisterer
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- German Law Journal / Volume 20 / Issue 5 / July 2019
- Published online by Cambridge University Press:
- 04 July 2019, pp. 722-733
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In recent years, the CJEU has impressively brought to bear the protection of the fundamental rights to privacy and protection of personal data as contained in the CFREU. The Court’s decisions in the Digital Rights, Schrems, Tele2, and PNR cases have reshaped the political and legal landscape in Europe and beyond. By restricting the powers of the governments of EU Member States and annulling legislative acts enacted by the EU legislator, the decisions had, and continue to have, effects well beyond the respective individual cases. Despite their strong impact on privacy and data protection across Europe, however, these landmark decisions reveal a number of flaws and inconsistencies in the conceptualization of the rights to privacy and protection of personal data as endorsed and interpreted by the CJEU. This Article identifies and discusses some of the shortcomings revealed in the recent CJEU privacy and data protection landmark decisions and proposes to the CJEU a strategy aimed at resolving these shortcomings going forward.
Walking a Fine Line – A Contextual Perspective on the Purchase of “Stolen” Banking Data by German Authorities
- Valentin M. Pfisterer
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- German Law Journal / Volume 14 / Issue 7 / 01 July 2013
- Published online by Cambridge University Press:
- 06 March 2019, pp. 926-948
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On 14 February 2008, German prosecutors and investigative authorities made a sensational catch. That day, it became public that they had initiated criminal investigations against Klaus Zumwinkel, then head of the DAX-listed corporation Deutsche Post. Additionally, the top manager's villa in Cologne was searched in a dawn raid and, as the media apparently had been tipped off, TV cameras could film the corporate executive while accompanied out of his home by prosecutor Margit Lichtinghagen. About one year later, Zumwinkel, no longer head of Deutsche Post, was convicted of tax evasion to two years of prison placed on probation. Although hailed by many as a triumph for the prosecution of white-collar crimes and the fight against corporate executives' recklessness, some already questioned the approach of prosecutors and investigators in the early stages. This criticism first and foremost referred to the fact that important information used as evidence in the investigations as well as the subsequent criminal court proceedings stemmed from banking data “stolen” by a Liechtenstein banker from his (former) employer Liechtenstein Global Trust, a bank based in Liechtenstein, and subsequently purchased by German authorities. This phenomenon, the purchase of “stolen banking data by German authorities, was not unprecedented as the so called “Liechtenstein tax affair” (“Liechtensteinische Steueraffäre”) had already been going on for some time. Zumwinkel, however, was the first widely known defendant in that context.
A hydrodynamic analysis of self-similar radiative ablation flows
- J.-M. Clarisse, J.-L. Pfister, S. Gauthier, C. Boudesocque-Dubois
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- Journal of Fluid Mechanics / Volume 848 / 10 August 2018
- Published online by Cambridge University Press:
- 05 June 2018, pp. 219-255
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Self-similar solutions to the compressible Euler equations with nonlinear conduction are considered as particular instances of unsteady radiative deflagration – or ‘ablation’ – waves with the goal of characterizing the actual hydrodynamic properties that such flows may present. The chosen family of solutions, corresponding to the ablation of an initially quiescent perfectly cold and homogeneous semi-infinite slab of inviscid compressible gas under the action of increasing external pressures and radiation fluxes, is well suited to the description of the early ablation of a target by gas-filled cavity X-rays in experiments of high energy density physics. These solutions are presently computed by means of a highly accurate numerical method for the radiative conduction model of a fully ionized plasma under the approximation of a non-isothermal leading shock wave. The resulting set of solutions is unique for its high fidelity description of the flows down to their finest scales and its extensive exploration of external pressure and radiative flux ranges. Two different dimensionless formulations of the equations of motion are put forth, yielding two classifications of these solutions which are used for carrying out a quantitative hydrodynamic analysis of the corresponding flows. Based on the main flow characteristic lengths and on standard characteristic numbers (Mach, Péclet, stratification and Froude numbers), this analysis points out the compressibility and inhomogeneity of the present ablative waves. This compressibility is further analysed to be too high, whether in terms of flow speed or stratification, for the low Mach number approximation, often used in hydrodynamic stability analyses of ablation fronts in inertial confinement fusion (ICF), to be relevant for describing these waves, and more specifically those with fast expansions which are of interest in ICF. Temperature stratification is also shown to induce, through the nonlinear conductivity, supersonic upstream propagation of heat-flux waves, besides a modified propagation of quasi-isothermal acoustic waves, in the flow conduction regions. This description significantly departs from the commonly admitted depiction of a quasi-isothermal conduction region where wave propagation is exclusively ascribed to isothermal acoustics and temperature fluctuations are only diffused.
Classifying medulloblastoma into molecular subgroups: Means, motive, and opportunity
- D.J.H. Shih, P.A. Northcott, M. Remke, A. Korshunov, D.T.W. Jones, M. Kool, S.M. Pfister, M.D. Taylor
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 41 / Issue s2 / October 2014
- Published online by Cambridge University Press:
- 30 October 2014, pp. S2-S3
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The clinical application of ABCB1 genotyping in antidepressant treatment: a pilot study
- Barbara Breitenstein, Sandra Scheuer, Hildegard Pfister, Manfred Uhr, Susanne Lucae, Florian Holsboer, Marcus Ising, Tanja M. Brückl
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- Journal:
- CNS Spectrums / Volume 19 / Issue 2 / April 2014
- Published online by Cambridge University Press:
- 23 July 2013, pp. 165-175
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Background
The gene product of the ABCB1 gene, the P-glycoprotein, functions as a custodian molecule in the blood–brain barrier and regulates the access of most antidepressants into the brain. Previous studies showed that ABCB1 polymorphisms predicted the response to antidepressants that are substrates of the P-gp, while the response to nonsubstrates was not influenced by ABCB1 polymorphisms. The aim of the present study was to evaluate the clinical application of ABCB1 genotyping in antidepressant pharmacotherapy.
MethodsData came from 58 depressed inpatients participating in the Munich Antidepressant Response Signature (MARS) project, whose ABCB1 gene test results were implemented into the clinical decision making process. Hamilton Depression Rating Scale (HAM-D) scores, remission rates, and duration of hospital stay were documented with dose and kind of antidepressant treatment.
ResultsPatients who received ABCB1 genotyping had higher remission rates [χ2(1) = 6.596, p = 0.005, 1-sided] and lower Hamilton sores [t(111) = 2.091, p = 0.0195, 1-sided] at the time of discharge from hospital as compared to patients without ABCB1 testing. Among major allele homozygotes for ABCB1 single nucleotide polymorphisms (SNPs) rs2032583 and rs2235015 (TT/GG genotype), an increase in dose was associated with a shorter duration of hospital stay [rho(28) = –0.441, p = 0.009, 1-sided], whereas other treatment strategies (eg, switching to a nonsubstrate) showed no significant associations with better treatment outcome.
DiscussionThe implementation of ABCB1 genotyping as a diagnostic tool influenced clinical decisions and led to an improvement of treatment outcome. Patients carrying the TT/GG genotype seemed to benefit from an increase in P-gp substrate dose.
ConclusionResults suggest that antidepressant treatment of depression can be optimized by the clinical application of ABCB1 genotyping.
Axisymmetric propagating vortices in centrifugally stable Taylor–Couette flow
- C. Hoffmann, S. Altmeyer, M. Heise, J. Abshagen, G. Pfister
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- Journal of Fluid Mechanics / Volume 728 / 10 August 2013
- Published online by Cambridge University Press:
- 11 July 2013, pp. 458-470
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We present numerical as well as experimental results of axisymmetric, axially propagating vortices appearing in counter-rotating Taylor–Couette flow below the centrifugal instability threshold of circular Couette flow without additional externally imposed forces. These propagating vortices are periodically generated by the shear flow near the Ekman cells that are induced by the non-rotating end walls. These axisymmetric vortices propagate into the bulk towards mid-height, where they get annihilated by rotating, non-propagating defects. These propagating structures appear via a supercritical Hopf bifurcation from axisymmetric, steady vortices, which have been discovered recently in centrifugally stable counter-rotating Taylor–Couette flow (Abshagen et al., Phys. Fluids, vol. 22, 2010, 021702). In the nonlinear regime of the Hopf bifurcation, contributions of non-axisymmetric modes also appear.
Co-rotating Taylor–Couette flow enclosed by stationary disks
- M. Heise, Ch. Hoffmann, Ch. Will, S. Altmeyer, J. Abshagen, G. Pfister
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- Journal:
- Journal of Fluid Mechanics / Volume 716 / 10 February 2013
- Published online by Cambridge University Press:
- 28 January 2013, R4
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We report results of a combined numerical and experimental study on axisymmetric and non-axisymmetric flow states in a finite-length, co-rotating Taylor–Couette system in the Taylor vortex regime but also in the Rayleigh stable regime for moderate Reynolds numbers (${\leq }1000$). We found the dominant boundary-driven axisymmetric circulation to play a crucial role in the mode selection and the bifurcation behaviour in this flow. A sequence of partially hysteretic transitions to other axisymmetric multi-cell flow states is observed. Furthermore, we observed spiral states bifurcating via a supercritical Hopf bifurcation out of these multi-cell states which strongly determine the shape of the spiral. Finally, an excellent agreement between experimental and numerical results of the full Navier–Stokes equations is found.
Defining the concept of ‘tick repellency’ in veterinary medicine
- L. HALOS, G. BANETH, F. BEUGNET, A. S. BOWMAN, B. CHOMEL, R. FARKAS, M. FRANC, J. GUILLOT, H. INOKUMA, R. KAUFMAN, F. JONGEJAN, A. JOACHIM, D. OTRANTO, K. PFISTER, M. POLLMEIER, A. SAINZ, R. WALL
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- Journal:
- Parasitology / Volume 139 / Issue 4 / April 2012
- Published online by Cambridge University Press:
- 05 January 2012, pp. 419-423
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Although widely used, the term repellency needs to be employed with care when applied to ticks and other periodic or permanent ectoparasites. Repellency has classically been used to describe the effects of a substance that causes a flying arthropod to make oriented movements away from its source. However, for crawling arthropods such as ticks, the term commonly subsumes a range of effects that include arthropod irritation and consequent avoiding or leaving the host, failing to attach, to bite, or to feed. The objective of the present article is to highlight the need for clarity, to propose consensus descriptions and methods for the evaluation of various effects on ticks caused by chemical substances.
Individualized Catheter Surveillance among Neonates: A Prospective, 8-Year, Single-Center Experience
- Walter Zingg, Klara M. Posfay-Barbe, Riccardo E. Pfister, Sylvie Touveneau, Didier Pittet
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 32 / Issue 1 / January 2011
- Published online by Cambridge University Press:
- 02 January 2015, pp. 42-49
- Print publication:
- January 2011
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Objective.
To monitor trends in central line-associated bloodstream infections and clinical sepsis (CLABICS) among neonates and to determine risk factors for infection, especially dwell time.
Design.Prospective, single-center cohort study conducted from 2001 through 2008.
Setting.University-affiliated tertiary care center.
Methods.Individualized surveillance of catheter use and CLABICS episodes was conducted. Data were obtained via regular on-site visits made 3 times a week. Trends over time were estimated by Poisson regression, and risk factor analysis was conducted using a Cox proportional hazards model and logistic regression.
Results.In all, 1,124 neonates were exposed to 2,210 central lines for a total of 12,746 catheter-days and 11,467 catheter-days at risk. The median duration of catheter use was 8 (interquartile range, 5–11) days for peripherally inserted central catheters (PICCs) and 4 (interquartile range, 2-6) days for umbilical catheters; 102 CLABICS episodes were detected. The median time to infection was 7 days. Incidence densities were 8.5 CLABICS episodes per 1,000 catheter-days at risk and 8.0 CLABICS episodes per 1,000 catheter-days. The highest rates were identified among neonates weighing 750 g or lower (14.9 CLABICS episodes per 1,000 catheter days at risk) and for PICCs (13.2 CLABICS episodes per 1,000 catheter days at risk). Catheter dwell time was associated with CLABICS for all umbilical catheters (odds ratio [OR], 1.2 per day of use [95% confidence interval {CI}, 1.1–1.3] P< .001) and for PICCs for up to 7 days (OR, 1.2 [95% CI, 1.1–1.4]; P = .041), but not thereafter (OR, 1.0 [95% CI, 0.9–1.1]; P = .90).
Conclusion.Catheter dwell time is a risk factor for CLABICS during the first 7 days, irrespective of catheter type. After 7 days, PICCs are less likely to become infected.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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CRESST
- E. Pécontal, T. Buchert, Ph. Di Stefano, Y. Copin, G. Angloher, M. Bauer, I. Bavykina, A. Bento, A. Brown, C. Bucci, C. Ciemniak, C. Coppi, G. Deuter, F. von Feilitzsch, D. Hauff, S. Henry, P. Huff, J. Imber, S. Ingleby, C. Isaila, J. Jochum, M. Kiefer, M. Kimmerle, H. Kraus, J.-C. Lanfranchi, R.F. Lang, B. Majorovits, M. Malek, R. McGowan, V.B. Mikhailik, E. Pantic, F. Petricca, S. Pfister, W. Potzel, F. Pröbst, W. Rau, S. Roth, K. Rottler, C. Sailer, K. Schäffner, J. Schmaler, S. Scholl, W. Seidel, L. Stodolsky, A.J.B. Tolhurst, I. Usherov, W. Westphal
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- European Astronomical Society Publications Series / Volume 36 / 2009
- Published online by Cambridge University Press:
- 30 May 2009, pp. 231-236
- Print publication:
- 2009
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The CRESST-II direct Dark Matter search is located in the Gran Sasso underground laboratories, Italy. CaWO4 crystals are used as scintillating targets for WIMP (weakly interacting massive particle) interactions. They are operated as cryogenic calorimeters in combination with a second cryogenic detector used to measure the scintillation light produced in the target crystal. For each particle interaction, the combination of phonon and light signals provides an event by event discrimination which allows to distinguish known particles (alphas, betas, gammas, neutrons) from the expected signal of WIMPs. A major upgrade of the setup comprises modifications of the shielding, installation of a muon-veto, and new read out electronics, as well as a new detector-support structure to accommodate up to 33 detector modules, i.e. 10 kg of target mass. The experiment was thereafter successfully commissioned in 2007. Data obtained during this commissioning phase from 2 detector modules are presented here. Combining the data collected with these two detector modules with data from one single module obtained during the CRESST-I phase, the experiment could already place a limit of ~6 × 10-7 pb for the spin independent WIMP-nucleon scattering cross section at a WIMP mass of ~60 GeV/c2.
Characterization of the CRESST detectors by neutron induced nuclear recoils
- E. Pécontal, T. Buchert, Ph. Di Stefano, Y. Copin, C. Coppi, C. Ciemniak, F. von Feilitzsch, A. Gütlein, H. Hagn, C. Isaila, J. Jochum, M. Kimmerle, J.-C. Lanfranchi, S. Pfister, W. Potzel, W. Rau, S. Roth, K. Rottler, C. Sailer, S. Scholl, I. Usherov, W. Westphal
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- Journal:
- European Astronomical Society Publications Series / Volume 36 / 2009
- Published online by Cambridge University Press:
- 30 May 2009, pp. 315-317
- Print publication:
- 2009
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CRESST is an experiment for the direct detection of dark matter particles via nuclear recoils. The CRESST detectors, based on CaWO4 scintillating crystals, are able to discriminate γ and β background by simultaneously measuring the light and phonon signals produced by particle interactions. The discrimination of the background is possible because of the different light output (Quenching Factor, QF) for nuclear and electron recoils. In this article a measurement is shown, aimed at the determination of the QFs of the different nuclei (O, Ca, W) of the detector crystal at 40–60 mK using an 11 MeV neutron beam produced at the Maier-Leibnitz-Laboratorium in Garching (MLL).
EURECA – The Future of Cryogenic Dark Matter Detection in Europe
- E. Pécontal, T. Buchert, Ph. Di Stefano, Y. Copin, H. Kraus, E. Armengaud, M. Bauer, I. Bavykina, A. Benoit, A. Bento, J. Blümer, L. Bornschein, A. Broniatowski, G. Burghart, P. Camus, A. Chantelauze, M. Chapellier, G. Chardin, C. Ciemniak, C. Coppi, N. Coron, O. Crauste, F.A. Danevich, M. De Jésus, P. de Marcillac, E. Daw, X. Defay, G. Deuter, J. Domange, P. Di Stefano, G. Drexlin, L. Dumoulin, K. Eitel, F. von Feilitzsch, D. Filosofov, P. Gandit, E. Garcia, J. Gascon, G. Gerbier, J. Gironnet, H. Godfrin, S. Grohmann, M. Gros, M. Hannewald, D. Hauff, F. Haug, S. Henry, P. Huff, J. Imber, S. Ingleby, C. Isaila, J. Jochum, A. Juillard, M. Kiefer, M. Kimmerle, H. Kluck, V.V. Kobychev, V. Kozlov, V.M. Kudovbenko, V.A. Kudryavtsev, T. Lachenmaier, J.-C. Lanfranchi, R.F. Lang, P. Loaiza, A. Lubashevsky, M. Malek, S. Marnieros, R. McGowan, V. Mikhailik, A. Monfardini, X.-F. Navick, T. Niinikoski, A.S. Nikolaiko, L. Oberauer, E. Olivieri, Y. Ortigoza, E. Pantic, P. Pari, B. Paul, G. Perinic, F. Petricca, S. Pfister, C. Pobes, D.V. Poda, R.B. Podviyanuk, O.G. Polischuk, W. Potzel, F. Pröbst, J. Puimedon, M. Robinson, S. Roth, K. Rottler, S. Rozov, C. Sailer, A. Salinas, V. Sanglard, M.L. Sarsa, K. Schäffner, S. Scholl, S. Scorza, A. Smolnikov, W. Seidel, S. Semikh, M. Stern, L. Stodolsky, M. Teshima, V. Tomasello, A. Torrento, L. Torres, V.I. Tretyak, J.A. Villar, M.A. Verdier, I. Usherov, J. Wolf, E. Yakushev
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- European Astronomical Society Publications Series / Volume 36 / 2009
- Published online by Cambridge University Press:
- 30 May 2009, pp. 249-255
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- 2009
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EURECA (European Underground Rare Event Calorimeter Array) is an astro-particle physics facility aiming to directly detect galactic dark matter. The Laboratoire Souterrain de Modane has been selected as host laboratory. The EURECA collaboration unites CRESST, EDELWEISS and the Spanish-French experiment ROSEBUD, thus concentrating and focussing effort on cryogenic detector research in Europe into a single facility. EURECA will use a target mass of up to one ton, enough to explore WIMP – nucleon scalar scattering cross sections in the region of 10-9 – 10-10 picobarn. A major advantage of EURECA is the planned use of more than just one target material (multi target experiment for WIMP identification).
Bursting dynamics due to a homoclinic cascade in Taylor–Couette flow
- J. ABSHAGEN, J. M. LOPEZ, F. MARQUES, G. PFISTER
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- Journal:
- Journal of Fluid Mechanics / Volume 613 / 25 October 2008
- Published online by Cambridge University Press:
- 01 October 2008, pp. 357-384
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Transitions between regular oscillations and bursting oscillations that involve a bifurcational process which culminates in the creation of a relative periodic orbit of infinite period and infinite length are investigated both experimentally and numerically in a short-aspect-ratio Taylor–Couette flow. This bifurcational process is novel in that it is the accumulation point of a period-adding cascade at which the mid-height reflection symmetry is broken. It is very rich and complex, involving very-low-frequency states arising via homoclinic and heteroclinic dynamics, providing the required patching between states with very different dynamics in neighbouring regions of parameter space. The use of nonlinear dynamical systems theory together with symmetry considerations has been crucial in interpreting the laboratory experimental data as well as the results from the direct numerical simulations. The phenomenon corresponds to dynamics well beyond the first few bifurcations from the basic state and so is beyond the reach of traditional hydrodynamic stability analysis, but it is not fully developed turbulence where a statistical or asymptotic approach could be employed. It is a transitional phenomenon, where the phase dynamics of the large-scale structures (jets of angular momentum emanating from the boundary layer on the rotating inner cylinder) becomes complicated. Yet the complicated phase dynamics remains accessible to an analysis of its space–time characteristics and a comprehensive mechanical characterization emerges. The excellent agreement between the experiments and the numerical simulations demonstrates the robustness of this complex bifurcation phenomenon in a physically realized system with its inherent imperfections and noise. Movies are available with the online version of the paper.
Direction reversal of a rotating wave in Taylor–Couette flow
- J. ABSHAGEN, M. HEISE, Ch. HOFFMANN, G. PFISTER
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- Journal:
- Journal of Fluid Mechanics / Volume 607 / 25 July 2008
- Published online by Cambridge University Press:
- 30 June 2008, pp. 199-208
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In Taylor–Couette systems, waves, e.g. spirals and wavy vortex flow, typically rotate in the same direction as the azimuthal mean flow of the basic flow which is mainly determined by the rotation of the inner cylinder. In a combined experimental and numerical study we analysed a rotating wave of a one-vortex state in small-aspect-ratio Taylor–Couette flow which propagates either progradely or retrogradely in the inertial (laboratory) frame, i.e. in the same or opposite direction as the inner cylinder. The direction reversal from prograde to retrograde can occur at a distinct parameter value where the propagation speed vanishes. Owing to small imperfections of the rotational invariance, the curves of vanishing rotation speed can broaden to ribbons caused by coupling between the end plates and the rotating wave. The bifurcation event underlying the direction reversal is of higher codimension and is unfolded experimentally by three control parameters, i.e. the Reynolds number, the aspect ratio, and the rotation rate of the end plates.
Flow in a small annulus between concentric cylinders
- M. Lücke, M. Mihelcic, K. Wingerath, G. Pfister
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- Journal:
- Journal of Fluid Mechanics / Volume 140 / March 1984
- Published online by Cambridge University Press:
- 20 April 2006, pp. 343-353
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Rotationally symmetric vortex flows between concentric cylinders with the inner one rotating and the outer one at rest have been investigated by numerical simulation and by laser-Doppler velocimetry for an annulus of aspect ratio Γ = 1.05 with a radius ratio η = 0.5066. Stationary states and relaxation towards them were explored close to the transition from the primary flow, which is mirror symmetric with respect to the midplane of the annulus, to a flow which gradually loses the symmetry. Detailed comparison of numerically simulated and measured velocity fields is made.
Model-based control of neuromuscular block using mivacurium: design and clinical verification
- P. M. Schumacher, K. S. Stadler, R. Wirz, D. Leibundgut, C. A. Pfister, A. M. Zbinden
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- Journal:
- European Journal of Anaesthesiology / Volume 23 / Issue 8 / August 2006
- Published online by Cambridge University Press:
- 04 April 2006, pp. 691-699
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- August 2006
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Summary
Background: Short-acting agents for neuromuscular block (NMB) require frequent dosing adjustments for individual patient's needs. In this study, we verified a new closed-loop controller for mivacurium dosing in clinical trials. Methods: Fifteen patients were studied. T1% measured with electromyography was used as input signal for the model-based controller. After induction of propofol/opiate anaesthesia, stabilization of baseline electromyography signal was awaited and a bolus of 0.3 mg kg−1 mivacurium was then administered to facilitate endotracheal intubation. Closed-loop infusion was started thereafter, targeting a neuromuscular block of 90%. Setpoint deviation, the number of manual interventions and surgeon's complaints were recorded. Drug use and its variability between and within patients were evaluated. Results: Median time of closed-loop control for the 11 patients included in the data processing was 135 [89–336] min (median [range]). Four patients had to be excluded because of sensor problems. Mean absolute deviation from setpoint was 1.8 ± 0.9 T1%. Neither manual interventions nor complaints from the surgeons were recorded. Mean necessary mivacurium infusion rate was 7.0 ± 2.2 μg kg−1 min−1. Intrapatient variability of mean infusion rates over 30-min interval showed high differences up to a factor of 1.8 between highest and lowest requirement in the same patient. Conclusions: Neuromuscular block can precisely be controlled with mivacurium using our model-based controller. The amount of mivacurium needed to maintain T1% at defined constant levels differed largely between and within patients. Closed-loop control seems therefore advantageous to automatically maintain neuromuscular block at constant levels.
Mode competition of rotating waves in reflection-symmetric Taylor–Couette flow
- J. ABSHAGEN, J. M. LOPEZ, F. MARQUES, G. PFISTER
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- Journal:
- Journal of Fluid Mechanics / Volume 540 / 10 October 2005
- Published online by Cambridge University Press:
- 27 September 2005, pp. 269-299
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We report on the results of a combined experimental and numerical study on mode interactions of rotating waves in Taylor–Couette flow. Our work shows that rotating waves which originate at a Hopf bifurcation from the steady axisymmetric Taylor vortex flow interact with this axisymmetric flow in a codimension-two fold-Hopf bifurcation. This interaction gives rise to an (unstable) low-frequency modulated wave via a subcritical Neimark–Sacker bifurcation from the rotating wave. At higher Reynolds numbers, a complicated mode interation between stable modulated waves originating at a different Neimark–Sacker bifurcation and a pair of symmetrically related rotating waves that originate at a cyclic pitchfork bifurcation is found to organize complex $Z_2$-symmetry breaking of rotating waves via global bifurcations. In addition to symmetry breaking of rotating waves via a (local) cyclic pitchfork bifurcation, we found symmetry breaking of modulated waves via a saddle-node-infinite-period (SNIP) global bifurcation. Tracing these local and global bifurcation curves in Reynolds number/aspect ratio parameter space toward their apparant merging point, unexpected complexity arises in the bifurcation structure involving non-symmetric two-tori undergoing saddle-loop homoclinic bifurcations. The close agreement between the numerics and the experiment is indicative of the robustness of the observed complex dynamics.