FEI Titan 80-300 TEM

The FEI Titan 80-300 TEM is a high-resolution transmission electron microscope equipped with a field emission gun and a corrector for the spherical aberration (CS) of the imaging lens system. The instrument is designed for the investigation of a wide range of solid state phenomena taking place on the atomic scale, which requires true atomic resolution capabilities. Under optimum optical settings of the image CS-corrector (CEOS CETCOR) the point-resolution is extended up to the information limit of well below 100 pm with 200 keV and 300 keV electrons. A special piezo-stage design allows ultra-precise positioning of the specimen in all 3 dimensions. Digital images are acquired with a Gatan 2k x 2k slow-scan charged coupled device camera

Praktische Empfehlungen zum Screening und Management von Funktionsstörungen der Nebennierenrinde bei einer akuten SARS-CoV-2-Infektion

Erkrankungen der Nebennierenrinde erfordern im Rahmen der Severe-acute-respiratory-syndrome-coronavirus-2(SARS-CoV-2)-Pandemie eine besondere Aufmerksamkeit. Zum einen können SARS-CoV-2-Infektionen sich auch extrapulmonal manifestieren und endokrine Störungen – insbesondere im Bereich der Nebennierenrinde – verursachen. Zum anderen sind Patienten mit einer vorbestehenden Nebennierenrindeninsuffizienz oder einem Hyperkortisolismus durch eine schwerwiegende Infektion wie etwa mit SARS-CoV‑2 besonders gefährdet, zusätzliche Komplikationen oder einen schwerwiegenderen Verlauf einer akuten SARS-CoV-2-Infektion mit erhöhter Mortalität zu erleiden. Insbesondere bei hämodynamisch instabilen Patienten mit SARS-CoV-2-Infektion müssen deshalb auch Erkrankungen der Nebennieren differenzialdiagnostisch erwogen und gegebenenfalls abgeklärt werden, falls diese nicht bereits anamnestisch bekannt sind. Weiterhin kann auch die Therapie einer SARS-CoV-2-Infektion mit hohen Glukokortikoiddosen über einen längeren Zeitraum eine sekundäre Nebennierenrindeninsuffizienz verursachen. Wir stellen hier deshalb eine Praxisempfehlung zur Erkennung und Therapie von Nebennierenfunktionsstörungen bei Patient*innen mit SARS-CoV-2-Infektion vor. = Diseases of the adrenal cortex require particular attention during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Firstly, SARS-CoV‑2 infections can give rise to extrapulmonary manifestations and cause endocrine disorders, particularly in the adrenal cortex. Furthermore, patients with pre-existing insufficiency of the adrenal cortex or hypercortisonism are particularly at risk from a severe infection such as SARS-CoV‑2, to suffer from additional complications or a more severe course of a SARS-CoV‑2 infection with a higher mortality. Especially in hemodynamically unstable patients with a SARS-CoV‑2 infection, diseases of the adrenal glands should also be considered in the differential diagnostics and if necessary clarified, if this is not already known. Prolonged treatment of patients with a SARS-CoV‑2 infection with regimens containing high doses of glucocorticoids can also result in a secondary adrenal insufficiency. In order to address these special aspects, some practical recommendations for the diagnostic and therapeutic management of functional disorders of the adrenal glands in patients with a SARS-CoV‑2 infection are therefore presented

Costs of air pollutants from shipping: a meta-regression analysis

This study estimated the external cost of air pollution from shipping by means of a meta-regression analysis, which has not been made before. Three pollutants, which were included in most of the primary studies, were considered: nitrogen oxides (NOx), sulphur dioxides (SO2) and particulate matters with a diameter of max 2.5 micrometres (PM2.5). All primary studies included damages of health and a majority added impacts on agriculture and estimated the cost of air pollutants by transferring cost estimates from studies on costs of air emissions from transports in Europe. Different regression models and estimators were used and robust results were found of statistically significant emission elasticities of below one, i.e. total external costs increase by less than 1% when emissions increase by 1%. There was a small variation between the pollutants, with the highest elasticity for PM2.5 and lowest for NOx. Calculations of the marginal external cost of the pollutants showed the same pattern, with this cost being approximately six times higher for PM2.5 than for the other pollutants. Common to all pollutants was that the marginal external cost decreases when emission increases. Another robust result was a significant increase in the cost of studies published in journals compared with other publication outlets. These findings point out some caution when transferring constant external unit cost of air pollutant from shipping, which is much applied in the literature, and the cost functions estimated in this study could thus provide a complementary transfer mechanism

Current Aspects in the Pathophysiology and Treatment of Chronic Wounds in Diabetes Mellitus

Impaired wound healing is a frequent and very severe problem in patients with diabetes mellitus, yet little is known about the underlying pathomechanisms. In this paper we review the biology of wound healing with particular attention to the pathophysiology of chronic wounds in diabetic patients. The standard treatment of diabetic ulcers includes measures to optimize glycemic control as well as extensive debridement, infection elimination by antibiotic therapy based on wound pathogen cultures, the use of moisture dressings, and offloading high pressure from the wound bed. In this paper we discuss novel adjuvant therapies with particular reference to the use of autologous skin transplants for the treatment of diabetic foot ulcers which do not respond to standard care

The Potential of Electrical Stimulation and Smart Textiles for Patients with Diabetes Mellitus

Diabetes mellitus is one of the most frequent diseases in the general population. Electrical stimulation is a treatment modality based on the transmission of electrical pulses into the body that has been widely used for improving wound healing and for managing acute and chronic pain. Here, we discuss recent advancements in electroceuticals and haptic/smart devices for quality of life and present in which patients and how electrical stimulation may prove to be useful for the treatment of diabetes-related complications

Heidelberg coping scales for delusions: psychometric evaluation of an expert rating instrument

Background: Coping is of substantial relevance in the treatment and course of psychiatric disorders. Standardized instruments to assess coping with psychotic symptoms, particularly delusions, are rare. The aim of this study was to develop and evaluate the psychometric properties of a new instrument to assess coping strategies in the context of delusional experiences: the Heidelberg Coping Scales for Delusions (HCSD). Methods: Two hundred and twelve inpatients with schizophrenia spectrum disorders and affective disorders currently experiencing delusions were interviewed with the HCSD and other coping assessment instruments. Psychometric properties and factor structure were analyzed. Results: The HCSD showed good inter-rater reliability and convergent validity. Factor analysis yielded an interpretable structure with five factors: resource-oriented coping, medical care, distraction, cognitive coping, and depressive coping. Symptomatic behavior, due to its particular characteristics, was considered apart. Conclusion: The HCSD is a reliable and valid instrument for the assessment of coping strategies in patients with delusions. Further research is needed to evaluate coping changes over time and their influence on treatment and clinical outcomes. Copyright (C) 2012 S. Karger AG, Base

Structured health care for subjects with diabetic foot ulcers results in a reduction of major amputation rates

OBJECTIVE: We tested the effects of structured health care for the diabetic foot in one region in Germany aiming to reduce the number of major amputations. RESEARCH DESIGN AND METHODS: In a prospective study we investigated patients with diabetic foot in a structured system of outpatient, in-patient and rehabilitative treatment. Subjects were recruited between January 1(st), 2000 and December 31, 2007. All participants underwent a two-year follow-up. The modified University of Texas Wound Classification System (UT) was the basis for documentation and data analysis. We evaluated numbers of major amputations, rates of ulcer healing and mortality. In order to compare the effect of the structured health care program with usual care in patients with diabetic foot we evaluated the same parameters at another regional hospital without interdisciplinary care of diabetic foot (controls). RESULTS: 684 patients with diabetic foot and 508 controls were investigated. At discharge from hospital 28.3% (structured health care program, SHC) vs. 23.0% (controls) of all ulcers had healed completely. 51.5% (SHC) vs. 49.8% (controls) were in UT grade 1. Major amputations were performed in 32 subjects of the structured health care program group (4.7%) vs. 110 (21.7%) in controls (p<0.0001). Mortality during hospitalization was 2.5% (SHC) vs. 9.4% in controls (p<0.001). CONCLUSIONS: With the structured health care program we achieved a significant reduction of major amputation rates by more than 75% as compared to standard care