Versorgungszeiten von Schwerverletzten im Schockraum der Universitätsklinik Kiel - Eine prospektive Analyse der personellen Besetzung und deren Einfluss auf die Abläufe bei der Versorgung Schwerverletzter

Trotz rückläufiger Zahlen sind schwerverletzte Patienten nach wie vor eine wichtige Entität. Das Ziel dieser Arbeit war die prospektive Dokumentation der Prozessabläufe bei der Behandlung Schwerverletzter im Schockraum des UKSH Kiel. Zentraler Bestandteil dieser Teiluntersuchung ist die Frage nach der Auswirkung auf den Behandlungsablauf durch die Anwesenheit von Oberärzten sowie die Notwendigkeit eines Traumaleaders in der Versorgung von Schwerverletzten

Der "Ausländer"-Diskurs der Kronen Zeitung 2005

Ausgehend von der Frage, ob die Berichterstattung der österreichischen Kronen Zeitung als rassistisch bezeichnet werden kann, untersucht die vorliegende Arbeit den Diskurs der Krone über "Ausländer" im Jahr 2005. Untersuchungsgegenstand sind sämtliche Ausgaben des Jahres von Titel bis TV-Programm, wobei der Hauptfokus auf die Kriminalitätsberichterstattung gerichtet wird: Im Zentrum der Forschung steht die journalistische Praxis, Straftäter anhand ihrer nationalen oder geografischen Herkunft zu beschreiben. In Bezug auf diese Herkunftsnennungen werden mehrere Berichterstattungs-Muster herausgearbeitet, welche einen unterschiedlichen Umgang der Krone-Gestalter mit in- bzw. ausländischen Tätern dokumentieren. Die verschiedenen Muster werden inhaltlich detailliert beschrieben und empirisch erfasst; die quantitative Erfassung wird durchgeführt, um klar belegen zu können, dass die präsentierten Muster in der Tat mit einer gewissen Regelmäßigkeit auftreten. Für die wissenschaftliche Beweisführung werden letztlich allein Inhalte herangezogen, welche tatsächlich mit einer großen Häufigkeit im Jahr 2005 auftreten. Die Analyse der gesammelten Muster wird eine Antwort darauf geben, ob von einem "kronischen" Rassismus gesprochen werden kann

Repetitive application of remote ischemic conditioning (RIC) in patients with peripheral arterial occlusive disease (PAOD) as a non-invasive treatment option: study protocol for a randomised controlled clinical trial

Background The best medical treatment (BMT) for most patients with early stage of peripheral arterial occlusive disease (PAOD) is often limited to gait training and pharmacological therapy besides endovascular surgery. The application of remote ischemic conditioning (RIC) has been described as a promising experimental strategy for the improvement of therapeutic outcome in cardiovascular disease but has not proven beneficial effects in clinical practice and treatment of PAOD yet. Methods Here we describe a prospective, randomized trial for the evaluation of possible effects of repeated application of RIC in patients with PAOD. This monocentric study will enrol 200 participants distributed to an intervention group receiving RIC + BMT and a control group only receiving BMT for four weeks. Patients are at least 18 years of age and have diagnosed PAOD Fontaine stage II b. Pain-free and total walking distance will be measured via treadmill test (primary endpoints). In addition, ankle-brachial index (ABI) and quality of life (QoL) will be assessed using the SF-36 and VascuQoL-6 questionnaire. Moreover, evaluation of markers for atherosclerosis, angiogenic profiling and mononuclear cell characterization will be performed using biochemical assays, proteome profiling arrays and flow cytometry (secondary endpoints). Discussion Our prospective, randomized monocentric trial is the first of its kind to analyse the effects of chronic and repetitive treatment with RIC in patients with PAOD and might provide important novel information on the molecular mechanisms associated with RIC in PAOD patients. Trial registration Prospectively registered in the German Clinical Trials Register (Deutsche Register Klinischer Studien) Registration number: DRKS00025735; Date of registration: 01.07.2021

Area Schedule Based Design of High-Pressure Recovery Radial Diffusion Systems

High-pressure ratio centrifugal compressors require advanced diffusion systems to achieve enhanced efficiencies set by future turbocharger applications. To address the shortcomings of the commonly used channel diffuser and airfoil cascade design perspectives, a streamtube based area schedule is adopted paying special attention to the diffuser entry region. It is shown that the diffusion in the semivaneless space, controlled chiefly by inlet flow angle and the vane suction side geometry, plays a key role in improving diffuser performance. Removing excess thickness from the suction side eliminates flow overspeed, increases effective diffusion length, and leads to higher pressure recovery at reduced stagnation pressure loss. The pressure side thickness distribution controls the channel area schedule. Thin leading edges (LEs) ensure smooth flow area transition into the channel and reduce the vane upstream influence, mitigating high-cycle fatigue related mechanical issues.ABB Turbo Systems A

Human monocytes subjected to ischaemia/reperfusion inhibit angiogenesis and wound healing in vitro

Objectives The sequence of initial tissue ischaemia and consecutive blood flow restoration leads to ischaemia/reperfusion (I/R) injury, which is typically characterized by a specific inflammatory response. Migrating monocytes seem to mediate the immune response in ischaemic tissues and influence detrimental as well as regenerative effects during I/R injury. Materials and methods To clarify the role of classical monocytes in I/R injury, isolated human monocytes were subjected to I/R in vitro (3 hours ischaemia followed by 24 hours of reperfusion). Cellular resilience, monocyte differentiation, cytokine secretion, as well as influence on endothelial tube formation, migration and cell recovery were investigated. Results We show that I/R supported an enhanced resilience of monocytes and induced intracellular phosphorylation of the prosurvival molecules Erk1/2 and Akt. FACS analysis showed no major alteration in monocyte subtype differentiation and surface marker expression under I/R. Further, our experiments revealed that I/R changes the cytokine secretion pattern, release of angiogenesis associated proteins and MMP-9 activity in supernatants of monocytes exposed to I/R. Supernatants from monocytes subjected to I/R attenuated endothelial tube formation as indicator for angiogenesis as well as endothelial cell migration and recovery. Conclusion In summary, monocytes showed no significant change in cellular integrity and monocyte subtype after I/R. Functionally, monocytes might have a rather detrimental influence during the initial phase of I/R, suppressing endothelial cell migration and neoangiogenesis

Strategies to Overcome the Barrier of Ischemic Microenvironment in Cell Therapy of Cardiovascular Disease

The transplantation of various immune cell types are promising approaches for the treatment of ischemic cardiovascular disease including myocardial infarction (MI) and peripheral arterial disease (PAD). Major limitation of these so-called Advanced Therapy Medicinal Products (ATMPs) is the ischemic microenvironment affecting cell homeostasis and limiting the demanded effect of the transplanted cell products. Accordingly, different clinical and experimental strategies have been evolved to overcome these obstacles. Here, we give a short review of the different experimental and clinical strategies to solve these issues due to ischemic cardiovascular disease

Area-Schedule Based Design of High Pressure Recovery Radial Diffusion Systems

High-pressure ratio centrifugal compressors require advanced diffusion systems to achieve enhanced efficiencies set by future turbocharger applications. To address the shortcomings of the commonly used channel diffuser and airfoil cascade design perspectives, a streamtube based area-schedule is adopted paying special attention to the diffuser entry region. It is shown that the diffusion in the semi-vaneless-space, controlled chiefly by inlet flow angle and the vane suction side geometry, plays a key role in improving diffuser performance. Removing excess thickness from the suction side eliminates flow overspeed, increases effective diffusion length, and leads to higher pressure recovery at reduced stagnation pressure loss. The pressure side thickness distribution controls the channel area schedule. Thin leading edges ensure smooth flow area transition into the channel and reduce the vane upstream influence, mitigating high-cycle fatigue related mechanical issues.ABB Turbo Systems A

An investigation of the stability enhancement of a centrifugal compressor stage using a porous throat diffuser

The stable operating range of a centrifugal compressor stage of an engine turbocharger is limited at low mass flow rates by aerodynamic instabilities which can lead to the onset of rotating stall or surge. There have been many techniques employed to increase the stable operating range of centrifugal compressor stages. The literature demonstrates that there are various possibilities for adding special treatments to the nominal diffuser vane geometry, or including injection or bleed flows to modify the diffuser flow field in order to influence diffuser stability. One such treatment is the porous throat diffuser (PTD). Although the benefits of this technique have been proven in the existing literature, a comprehensive understanding of how this technique operates is not yet available. This paper uses experimental measurements from a high pressure ratio (PR) compressor stage to acquire a sound understanding of the flow features within the vaned diffuser which affect the stability of the overall compression system and investigate the stabilizing mechanism of the porous throat diffuser. The nonuniform circumferential pressure imposed by the asymmetric volute is experimentally and numerically examined to understand if this provides a preferential location for stall inception in the diffuser. The following hypothesis is confirmed: linking of the diffuser throats via the side cavity equalizes the diffuser throat pressure, thus creating a more homogeneous circumferential pressure distribution, which delays stall inception to lower flow rates. The results of the porous throat diffuser configuration are compared to a standard vaned diffuser compressor stage in terms of overall compressor performance parameters, circumferential pressure nonuniformity at various locations through the compressor stage and diffuser subcomponent analysis. The diffuser inlet region was found to be the element most influenced by the porous throat diffuser, and the stability limit is mainly governed by this element.</jats:p