A multilevel, multi-mode framework for standardization in digital B2B platform eco-systems in international cargo transportation-A multiple case study.

Unlabelled: Standardization is gaining importance for digital platform eco-systems as they try to balance both stability and flexibility of their core as well as their boundary resources. Our knowledge on which factors influence standardization processes in business-to-business (B2B) focused digital platform eco-systems remains limited. Using three B2B platform eco-systems from the cargo transportation and seaport eco-system context, we apply a multiple case study to investigate which factors affect the standardization mode and the standard adoption.

Multi-sided platforms in competitive B2B networks with varying governmental influence - a taxonomy of Port and Cargo Community System business models.

Our knowledge on differences in business model characteristics of thriving and failing Multi-Sided Platforms in competitive B2B networks (B2B-MSP) and potential influences of increasing governmental involvement remains fragmented. This study develops a taxonomy to classify special B2B-MSP with varying governmental influence in the supply chain and transportation context, viz. Port and Cargo Community Systems (CS).

Evaluation of a Clinical Decision Support System for the most evidence-based approach to managing perioperative anticoagulation.

Study Objective: We explored the feasibility of a Clinical Decision Support System (CDSS) to guide evidence-based perioperative anticoagulation.

Design: Prospective randomised clinical management simulation multicentre study.

Setting: Five University and 11 general hospitals in Germany.

First Implantation of a Novel Left Ventricular Assist Device: The ReliantHeart aVAD.

aVAD (ReliantHeart Inc, Houston, TX) is a new, compact, axial flow left ventricular assist device with novel features including real flow measurement, remote device monitoring, and a miniaturized pump housing. The aVAD received Conformité Européenne marking in August 2016. The use of this device was performed in a 61-year-old woman with severe heart failure.

Carbapenem-resistant Gram-negative bacteria - analysis of the data obtained through a mandatory reporting system in the Rhine-Main region, Germany, 2012-2015.

Background: Multidrug-resistant Gram-negative bacteria (MRGN) and the infections they cause are a serious threat and a challenge to the healthcare system. This particularly applies to carbapenem-resistant Gram-negative bacteria (CRGN). Currently, the introduction of a nationwide mandatory notification system for CRGN in Germany is under consideration.

Peripheral nerve blocks on the upper extremity: Technique of landmark-based and ultrasound-guided approaches.

The German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin, DGAI) established an expert panel to develop preliminary recommendations for the application of peripheral nerve blocks on the upper extremity. The present recommendations state in different variations how ultrasound and/or electrical nerve stimulation guided nerve blocks should be performed. The description of each procedure is rather a recommendation than a guideline.

Obesity in regional anesthesia--a risk factor for peripheral catheter-related infections.

Background: Obesity is believed to increase the risk of surgical site infections and possibly increase the risk of catheter-related infections in regional anesthesia. We, therefore, analyzed the influence of obesity on catheter-related infections defined within a national registry for regional anesthesia.

Methods: The German Network for Regional Anesthesia database with 25 participating clinical centers was analyzed between 2007 and 2012.

[Infection control measures and surveillance of patients with ventricular assist devices].

Ventricular assist devices (VAD) are a new routine therapy option for end-stage heart failure. However, the incidence of VAD-related infections varies between 20 and 188% and makes a major contribution to VAD-related morbidity. Therefore, optimised infection control policies should be applied to prevent VAD-related infections.

Creatine kinase isoenzyme MB relative index as predictor of mortality on extracorporeal membrane oxygenation support for postcardiotomy cardiogenic shock in adult patients.

Objective: Extracorporeal membrane oxygenation (ECMO) has been used as initial, biventricular circulatory support for patients with severe postcardiotomy cardiogenic shock (PCS). Due to its aggressiveness and limited weaning quote, concerns have been raised about maintenance of ECMO support regarding duration. However, it is frequently hazardous for physicians to make an individualized decision, whether and when discontinuation of ECMO support should be considered.

Bridge to lung transplantation with the novel pumpless interventional lung assist device NovaLung.

Background: Worsening of lung failure in patients awaiting a lung transplantation might lead to ventilation-refractory hypercapnia and respiratory acidosis. Most transplant centers consider pretransplantation extracorporeal membrane oxygenation as a contraindication for lung transplantation because of the poor outcome. We have, for the first time, applied the novel pumpless interventional lung assist NovaLung for bridge to lung transplantation in patients with severe ventilation-refractory hypercapnia.

Adhesive functions of both chains of VLA-integrins are not fully conserved across the human-porcine species barrier: implications for xenotransplantation.

Background: A possible solution to the shortage of organs for transplantation would be the use of swine as source animals. As current immunosuppressive protocols cannot prevent rejection of these organs, super-selective immunosuppression or the induction of donor-specific central tolerance represent two promising approaches. Central tolerance induction involves bone marrow transplantation, and depends on intrathymic deletion of donor reactive host cells by donor antigen-presenting cells.

Outcome following single vs bilateral lung transplantation in recipients 60 years of age and older.

Aims: The significant shortage of donor organs in lung transplantation necessitates a careful selection of lung transplant recipients. The outcome of lung transplant recipients aged 60 years and older has not been analyzed systematically.

Methods: We retrospectively reviewed our experience with older recipients.

No evidence for productive PERV infection of baboon cells in in vivo infection model.

Objectives: The discovery that pig endogenous retroviruses are infectious for human cells in vitro lead to vehement discussions about the possible risk of infection after clinical xenotransplantation. Since PERV transmission to non-human primate cells in vitro has been observed, similar to human cells, infection studies in non-human primates should represent the best model to analyze a potential PERV transmission after xenotransplantation. However, it is still open to discussion, whether non-human primate cells can be infected productively-similar to human cells- and whether those species are suitable to analyze PERV infection risks in vivo.

Induction of long-term peripheral microchimerism in non-human primates in a model of xenogeneic peripheral tolerance induction.

Xenotransplantation represents a promising solution to the ever increasing shortage of donor organs in allotransplantation. However, due to different and stronger modes of rejection, successful xenotransplantation will require different organ-protective regimes from those used in allogeneic transplantation today. Since one can not simply increase the dosage of the drugs used, immunomodulation or tolerance induction of the recipient would be the most desirable approach.

[Removal of lepirudin used as an anticoagulant in mechanical autotransfusion with Cell-Saver 5].

Unlabelled: Former studies demonstrated that small amounts of heparin might remain in the prepared retransfusion blood during intraoperative autotransfusion. This could lead to serious complications in patients suffering from heparin-induced-thrombocytopenia type II (HIT II). Lepirudin is an approved anticoagulant in HIT II-patients.

[Danaparoid (Orgaran) as an antiocoagulant for mechanical autotransfusion with Cell Saver 5 (Hemonetics)].

We investigated Danaparoid Sodium (Orgaran) as anticoagulant using three different concentrations (9, 4,5 or 3 U/ml anticoagulant solution) for the use in the autotransfusion device Cell Saver 5 (Haemonetics). Fresh units of whole blood packs were mixed in the reservoir in a proportion of 5:1 with the anticoagulant solution. Having started the Cell Saver 5 in the automatic mode, the amount of Danaparoid in the retransfusion blood was determined (chromogenic Antifactor-Xa test).

[Fiber optic intubation using a modified laryngeal mask. Report of experiences with use in 105 patients].

Purpose: This study was made to investigate the suitability of a modified laryngeal mask airway as an aid for fibreoptic endotracheal intubation in patients with a difficult airway. We used a laryngeal mask airway split lengthwise on its convex site, the incision going from a point corresponding to the teeth down to the base of the cuff. The cuff remains uncut.