Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery

Minimally invasive techniques to access subcutaneous adipose tissue for glucose monitoring are successfully applied in type1 diabetic and critically ill patients. During critical illness, the addition of a lactate sensor might enhance prognosis and early intervention. Our objective was to evaluate SAT as a site for lactate measurement in critically ill patients. In 40 patients after major cardiac surgery, arterial blood and SAT microdialysis samples were taken in hourly intervals. Lactate concentrations from SAT were prospectively calibrated to arterial blood. Analysis was based on comparison of absolute lactate concentrations (arterial blood vs. SAT) and on a 6-hour lactate trend analysis, to test whether changes of arterial lactate can be described by SAT lactate. Correlation between lactate readings from arterial blood vs. SAT was highly significant (r2 = 0.71, P < .001). Nevertheless, 42% of SAT lactate readings and 35% of the SAT lactate trends were not comparable to arterial blood. When a 6-hour stabilization period after catheter insertion was introduced, 5.5% of SAT readings and 41.6% of the SAT lactate trends remained incomparable to arterial blood. In conclusion, replacement of arterial blood lactate measurements by readings from SAT is associated with a substantial shortcoming in clinical predictability in patients after major cardiac surgery

NSCLC molecular testing in Central and Eastern European countries

Background: The introduction of targeted treatments for subsets of non-small cell lung cancer (NSCLC) has highlighted the importance of accurate molecular diagnosis to determine if an actionable genetic alteration is present. Few data are available for Central and Eastern Europe (CEE) on mutation rates, testing rates, and compliance with testing guidelines. Methods: A questionnaire about molecular testing and NSCLC management was distributed to relevant specialists in nine CEE countries, and pathologists were asked to provide the results of EGFR and ALK testing over a 1-year period. Results: A very high proportion of lung cancer cases are confirmed histologically/cytologically (75-100%), and molecular testing of NSCLC samples has been established in all evaluated CEE countries in 2014. Most countries follow national or international guidelines on which patients to test for EGFR mutations and ALK rearrangements. In most centers at that time, testing was undertaken on request of the clinician rather than on the preferred reflex basis. Immunohistochemistry, followed by fluorescent in situ hybridization confirmation of positive cases, has been widely adopted for ALK testing in the region. Limited reimbursement is a significant barrier to molecular testing in the region and a disincentive to reflex testing. Multidisciplinary tumor boards are established in most of the countries and centers, with 75-100% of cases being discussed at a multidisciplinary tumor board at specialized centers. Conclusions: Molecular testing is established throughout the CEE region, but improved and unbiased reimbursement remains a major challenge for the future. Increasing the number of patients reviewed by multidisciplinary boards outside of major centers and access to targeted therapy based on the result of molecular testing are other major challenges

Comics and Truth : Why Non-Fiction Comics need Rules

A comic can tell the story of almost anything: a single atom, the entire solar system, the past, future events, dreams and thoughts. All this, and more, can be depicted. When presenting facts, a certain artistic licence can be deployed if, for instance, the author wants to emphasise important details; likewise, aspects he or she deems irrelevant can be left out. Moreover, questions and issues can be laid out that are difficult or even impossible to portray photographically or cinematically. However, when the cartoon strip sets out its version of information, events, objects and people, it can also result in a distortion of reality. The graphic may not always make clear exactly how something looks or the precise way in which something happened. And even where documentary images exist, the comic strip representation of the non-fictional is always coloured by artistic interpretation

Kleingedrucktes mit großem Effekt

Der 3D‐Druck von geometrisch komplexen Nanostrukturen ist auf dem Weg zu ersten Anwendungen. Die Auswahl an geeigneten Materialien ermöglicht metallische, halbleitende, isolierende, supraleitende und exotische magnetische Eigenschaften. Das 3D‐FEBID‐Verfahren schreibt mit dem Elektronenstrahl eines Raster‐Elektronenmikroskops wie mit einem Nanostift. Das Material wird als Gasstrom von Precursor‐Molekülen über eine Hohlnadel zugeführt. Der Elektronenstrahl ermöglicht die hochlokale Fragmentierung dieser Moleküle, die meist metallische Zielatome enthalten. Die lokale Verweildauer des Strahls steuert den Strukturaufbau in der Vertikalen, während seine seitliche Bewegung zu geneigten, freistehenden Strukturen führt. Eine Herausforderung ist die definierte Strahlsteuerung, um ein CAD‐Modell möglichst präzise in ein reales 3D‐Nanoobjekt zu überführen. Für die Zukunft soll eine simulationsgestützte Software zur Steuerung des Elektronenstrahls auch Laien die Anwendung erleichtern. 3D‐FEBID ist bereits heute ein zuverlässiges und in vielerlei Hinsicht einzigartiges Verfahren zur Direktabscheidung funktionaler Nanostrukturen

Thermoelektrische Wärmepumpe - Messmethoden zur Bestimmung der thermoelektrischen Gürezahl anhand von marktreifen Modulen

Energie-Umweltmanagemen

PELTIER HEAT PUMP- Test methods and results of thermoelectric modules

Forschung Burgenlan