[Skill-grade mix and shared governance in the intensive care unit: development of a management triangle and the advancement of nursing roles].

Background: In the Federal Republic of Germany, it has been possible for some years to study (intensive) nursing care alongside further training in intensive care and anaesthesia. This results in a nursing skill-grade mix in the intensive care unit (ICU), which nursing management must consider.

Objectives: The aim is to show the development and implementation of a new nursing management structure in the ICU and also provide an overview of the parallel role development with preliminary results at a university hospital.

[Diagnosis and Treatment of Hypersensitivity Pneumonitis - S2k Guideline of the German Respiratory Society and the German Society for Allergology and Clinical Immunology].

Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) in sensitized individuals caused by a large variety of inhaled antigens. The clinical form of acute HP is often misdiagnosed, while the chronic form, especially the chronic fibrotic HP, is difficult to differentiate from other fibrotic ILDs. The present guideline for the diagnosis and treatment of HP replaces the former German recommendations for the diagnosis of HP from 2007 and is amended explicitly by the issue of the chronic fibrotic form, as well as by treatment recommendations for the first time.

Performance of cut-offs of the ASAS Health Index to discriminate between treatment groups in patients with axial spondyloarthritis in the TICOSPA trial.

Objective: To test trial and longitudinal known group discrimination of thresholds of meaning for improvement and health states of the ASAS Health Index (ASAS HI) in patients with active axSpA treated in a randomized study.

Methods: Data from baseline and week 48 from the tight-controlled, treat-to-target trial TICOSPA study were used. The performance of different thresholds to assess change or health states of the ASAS HI were evaluated between arms and against changes in patients' relevant outcomes and various external responder criteria.

Metal-ligand delocalization of iron and cobalt porphyrin complexes in aqueous solutions probed by soft X-ray absorption spectroscopy.

Metal-ligand delocalization of metal porphyrin complexes in aqueous solutions was investigated by analyzing the electronic structure of both the metal and ligand sides using soft X-ray absorption spectroscopy (XAS) at the metal L-edges and nitrogen K-edge, respectively. In the N K-edge XAS spectra of the ligands, the energies of the CN π* peaks of cobalt protoporphyrin IX (CoPPIX) are higher than iron protoporphyrin IX (FePPIX). The energy difference between the two lowest peaks in the XAS spectrum of CoPPIX is also larger than that of FePPIX.

Perioperative outcome of left atrial appendage amputation in coronary artery bypass grafting.

Background: Left atrial appendage (LAA) amputation performed alongside cardiac surgery has become an increasingly established procedure to reduce stroke risk in patients with atrial fibrillation. As the recommendation levels for LAA amputation continue to rise, ample evidence assessing its perioperative safety and risk factors is of utmost interest.

Methods: All patients who underwent isolated coronary artery bypass grafting (CABG) between 2018 and 2021 at two high-volume centers were retrospectively included in the study.

Direct observation of a few-photon phase shift induced by a single quantum emitter in a waveguide.

Realizing a sensitive photon-number-dependent phase shift on a light beam is required both in classical and quantum photonics. It may lead to new applications for classical and quantum photonics machine learning or pave the way for realizing photon-photon gate operations. Nonlinear phase-shifts require efficient light-matter interaction, and recently quantum dots coupled to nanophotonic devices have enabled near-deterministic single-photon coupling.

Inhibition of myeloperoxidase to treat left ventricular dysfunction in non-ischaemic cardiomyopathy.

Aims: Non-ischaemic cardiomyopathy (NICMP), an incurable disease terminating in systolic heart failure (heart failure with reduced ejection fraction [HFrEF]), causes immune activation, however anti-inflammatory treatment strategies so far have failed to alter the course of this disease. Myeloperoxidase (MPO), the principal enzyme in neutrophils, has cytotoxic, pro-fibrotic and nitric oxide oxidizing effects. Whether MPO inhibition ameliorates the phenotype in NICMP remains elusive.

Inverse Method to Determine Parameters for Time-Dependent and Cyclic Plastic Material Behavior from Instrumented Indentation Tests.

Indentation is a versatile method to assess the hardness of different materials along with their elastic properties. Recently, powerful approaches have been developed to determine further material properties, like yield strength, ultimate tensile strength, work-hardening rate, and even cyclic plastic properties, by a combination of indentation testing and computer simulations. The basic idea of these approaches is to simulate the indentation with known process parameters and to iteratively optimize the initially unknown material properties until just a minimum error between numerical and experimental results is achieved.

The Neuroprotective Effect of Neural Cell Adhesion Molecule L1 in the Hippocampus of Aged Alzheimer's Disease Model Mice.

Alzheimer's disease (AD) is a severe neurodegenerative disorder and the most common form of dementia, causing the loss of cognitive function. Our previous study has shown, using a doubly mutated mouse model of AD (APP/PS1), that the neural adhesion molecule L1 directly binds amyloid peptides and decreases plaque load and gliosis when injected as an adeno-associated virus construct (AAV-L1) into APP/PS1 mice. In this study, we microinjected AAV-L1, using a Hamilton syringe, directly into the 3-month-old APP/PS1 mouse hippocampus and waited for a year until significant neurodegeneration developed.

Enhancing Forensic Diagnostics: Structured Reporting of Post-Mortem CT versus Autopsy for Laryngohyoid Complex Fractures in Strangulation.

Background: The purpose of this study was to establish a standardized structured workflow to compare findings from high-resolution, optimized reconstructions from post-mortem computed tomography (pmCT) with autopsy results in the detection of fractures of the laryngohyoid complex in strangulation victims.

Method: Forty-two strangulation cases were selected, and pmCT scans of the laryngohyoid complex were obtained. Both pmCT scans and autopsy reports were analyzed using a structured template and compared using Cohen's kappa coefficient (κ) and the McNemar test.

Impact of COVID-19 infection on lung function and nutritional status amongst individuals with cystic fibrosis: A global cohort study.

Background: Factors associated with severe COVID-19 infection have been identified; however, the impact of infection on longer-term outcomes is unclear. The objective of this study was to examine the impact of COVID-19 infection on the trajectory of lung function and nutritional status in people with cystic fibrosis (pwCF).

Methods: This is a retrospective global cohort study of pwCF who had confirmed COVID-19 infection diagnosed between January 1, 2020 and December 31, 2021.

Increased resting lactate levels and reduced carbohydrate intake cause νLa.max underestimation by reducing net lactate accumulation-A pilot study in young adults.

Modulation of testing conditions such as resting lactate (La) levels or carbohydrate intake may affect the calculation of the maximal glycolytic rate (νLa.max). To evaluate the impact of elevated La as well as reduced and increased carbohydrate availability on νLa.

[German expert consensus on programmed cell death ligand 1 (PD-L1) testing in perioperative systemic therapy of muscle invasive bladder cancer].

The risk of recurrence in patients with muscle invasive bladder cancer (MIBC) after radical cystectomy depends on the pathological tumor stage. In particular, patients with lymph node metastasis (pN+), locally advanced (≥pT3), or residual muscle invasive tumor despite neoadjuvant chemotherapy are at high risk. Currently, the importance of adjuvant therapy with immune checkpoint inhibitors is increasing in the context of perioperative systemic therapeutic concepts.

Time to assess more than prognosis: advancements and challenges in transcatheter tricuspid valve interventions.

We provide an overview about the current landscape of transcatheter tricuspid valve interventions (TTVI) and summarize recent findings from trials including TRILUMINATE, TRILUMINATE Pivotal, bRIGHT, TRICLASP, TRISCEND, TRISCEND II, TRICUS, and Cardioband TR EFS. These studies have demonstrated the safety and efficacy of TTVI. Yet, they have failed to show a prognostic benefit over conservative treatment.

[Prehospital analgesia with nalbuphine and paracetamol compared to piritramide by paramedics-A multicenter observational study].

Objective: Following recent changes to the German Narcotics Act, this article examines prehospital analgesia by paramedics using piritramide vs. nalbuphine + paracetamol.

Material And Methods: Prehospital analgesia administered by paramedics from the Fulda (piritramide) and Gütersloh (nalbuphine + paracetamol) emergency services was compared regarding pain intensity at the beginning and end of the mission, measured using the numeric rating scale (NRS).