Rolle des Transplantationsbeauftragten

Alle Krankenhäuser, die nach dem Sozialgesetzbuch V als Entnahmekrankenhäuser definiert sind, sind verpflichtet, einen Transplantationsbeauftragten (TxB) zu stellen. Das Aufgabenfeld des TxB beinhaltet nicht nur die Spendererkennung, die Diagnose eines irreversiblen Hirnfunktionsausfalls sowie die Spenderevaluation und Organprotektion, sondern er begleitet den gesamten Organspendeprozess. Er verantwortet die Festlegung von innerklinischen Standards sowie die Organisation von Fort- und Weiterbildungen und ist Ansprechpartner rund um das Thema Organspende. Darüber hinaus fungiert er als Bindeglied zwischen der Koordinierungs- (Deutsche Stiftung Organtransplantation) und der Vermittlungsstelle (Eurotransplant). Seine Tätigkeit unterliegt dem Transplantationsgesetz und dessen Ausführungsgesetzen; er benötigt aber auch entsprechende Kenntnisse der verschiedenen Richtlinien zu Organspende bzw. -transplantation. Letztendlich ist der TxB auch für die Qualitätssicherung des Organspendeprozesses verantwortlich

IoT Middleware Platforms for Smart Energy Systems: An Empirical Expert Survey

Middleware platforms are key technology in any Internet of Things (IoT) system, considering their role in managing the intermediary communications between devices and applications. In the energy sector, it has been shown that IoT devices enable the integration of all network assets to one large distributed system. This comes with significant benefits, such as improving energy efficiency, boosting the generation of renewable energy, reducing maintenance costs and increasing comfort. Various existing IoT middlware solutions encounter several problems that limit their performance, such as vendor locks. Hence, this paper presents a literature review and an expert survey on IoT middleware platforms in energy systems, in order to provide a set of tools and functionalities to be supported by any future efficient, flexible and interoperable IoT middleware considering the market needs. The analysis of the results shows that experts currently use the IoT middleware mainly to deploy services such as visualization, monitoring and benchmarking of energy consumption, and energy optimization is considered as a future application to target. Likewise, non-functional requirements, such as security and privacy, play vital roles in the IoT platforms’ performances

Do drivers of biodiversity change differ in importance across marine and terrestrial systems — Or is it just different research communities' perspectives?

Cross-system studies on the response of different ecosystems to global change will support our understanding of ecological changes. Synoptic views on the planet's two main realms, the marine and terrestrial, however, are rare, owing to the development of rather disparate research communities.We combined questionnaires and a literature review to investigate howthe importance of anthropogenic drivers of biodiversity change differs amongmarine and terrestrial systems and whether differences perceived by marine vs. terrestrial researchers are reflected by the scientific literature. This included asking marine and terrestrial researchers to rate the relevance of different drivers of global change for either marine or terrestrial biodiversity. Land use and the associated loss of natural habitatswere rated as most important in the terrestrial realm,while the exploitation of the sea by fishing was rated as most important in the marine realm. The relevance of chemicals, climate change and the increasing atmospheric concentration of CO2 were rated differently for marine and terrestrial biodiversity respectively. Yet, our literature review provided less evidence for such differences leading to the conclusion that while the history of the use of land and sea differs, impacts of global change are likely to become increasingly similar

A proposal for early dosing regimens in heart transplant patients receiving thymoglobulin and calcineurin inhibition

There is currently no consensus regarding the dose or duration of rabbit antithymocyte globulin (rATG) induction in different types of heart transplant patients, or the timing and intensity of initial calcineurin inhibitor (CNI) therapy in rATG-treated individuals. Based on limited data and personal experience, the authors propose an approach to rATG dosing and initial CNI administration. Usually rATG is initiated immediately after exclusion of primary graft failure, although intraoperative initiation may be appropriate in specific cases. A total rATG dose of 4.5 to 7.5 mg/kg is advisable, tailored within that range according to immunologic risk and adjusted according to immune monitoring. Lower doses (eg, 3.0 mg/kg) of rATG can be used in patients at low immunological risk, or 1.5 to 2.5 mg/kg for patients with infection on mechanical circulatory support. The timing of CNI introduction is dictated by renal recovery, varying between day 3 and day 0 after heart transplantation, and the initial target exposure is influenced by immunological risk and presence of infection. Rabbit antithymocyte globulin and CNI dosing should not overlap except in high-risk cases. There is a clear need for more studies to define the optimal dosing regimens for rATG and early CNI exposure according to risk profile in heart transplantation

Cross-realm assessment of climate change impacts on species' abundance trends

Climate change, land-use change, pollution and exploitation are among the main drivers of species' population trends; however, their relative importance is much debated. We used a unique collection of over 1,000 local population time series in 22 communities across terrestrial, freshwater and marine realms within central Europe to compare the impacts of long-term temperature change and other environmental drivers from 1980 onwards. To disentangle different drivers, we related species' population trends to species- and driver-specific attributes, such as temperature and habitat preference or pollution tolerance. We found a consistent impact of temperature change on the local abundances of terrestrial species. Populations of warm-dwelling species increased more than those of cold-dwelling species. In contrast, impacts of temperature change on aquatic species' abundances were variable. Effects of temperature preference were more consistent in terrestrial communities than effects of habitat preference, suggesting that the impacts of temperature change have become widespread for recent changes in abundance within many terrestrial communities of central Europe.Additionally, we appreciate the open access marine data provided by the International Council for the Exploration of the Sea. We thank the following scientists for taxonomic or technical advice: C. Brendel, T. Caprano, R. Claus, K. Desender, A. Flakus, P. R. Flakus, S. Fritz, E.-M. Gerstner, J.-P. Maelfait, E.-L. Neuschulz, S. Pauls, C. Printzen, I. Schmitt and H. Turin, and I. Bartomeus for comments on a previous version of the manuscript. R.A. was supported by the EUproject LIMNOTIP funded under the seventh European Commission Framework Programme (FP7) ERA-Net Scheme (Biodiversa, 01LC1207A) and the long-term ecological research program at the Leibniz-Institute of Freshwater Ecology and Inland Fisheries (IGB). R.W.B. was supported by the Scottish Government Rural and Environment Science and Analytical Services Division (RESAS) through Theme 3 of their Strategic Research Programme. S.D. acknowledges support of the German Research Foundation DFG (grant DO 1880/1-1). S.S. acknowledges the support from the FP7 project EU BON (grant no. 308454). S.K., I.Kü. and O.S. acknowledge funding thorough the Helmholtz Association’s Programme Oriented Funding, Topic ‘Land use, biodiversity, and ecosystem services: Sustaining human livelihoods’. O.S. also acknowledges the support from FP7 via the Integrated Project STEP (grant no. 244090). D.E.B. was funded by a Landes–Offensive zur Entwicklung Wissenschaftlich–ökonomischer Exzellenz (LOEWE) excellence initiative of the Hessian Ministry for Science and the Arts and the German Research Foundation (DFG: Grant no. BO 1221/23-1).Peer Reviewe

Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe