Chemotherapy-Induced Ischemic Colitis in a Patient with Jejunal Lymphoma

The occurrence of acute ischemic colitis may be associated with the intake of various drugs. However, colitis during antineoplastic chemotherapy usually is due to toxic effects or neutropenia and not caused by ischemia. We describe a 51-year-old man with jejunal B-cell lymphoma who developed recurrent episodes of ischemic colitis following chemotherapy with cyclophosphamide, vincristine, doxorubicine and prednisolone plus rituximab (R-CHOP). After switching chemotherapy to bendamustin plus rituximab no further episodes of colonic ischemia occurred during the following cycles of chemotherapy. In conclusion, chemotherapy of lymphoma using a standard protocol with CHOP and rituximab may cause ischemic colitis

Cardiac output states in patients with severe functional tricuspid regurgitation: impact on treatment success and prognosis

Aims To investigate whether there is evidence for distinct cardiac output (CO) based phenotypes in patients with chronic right heart failure associated with severe tricuspid regurgitation (TR) and to characterize their impact on TR treatment and outcome. Methods and results A total of 132 patients underwent isolated transcatheter tricuspid valve repair (TTVR) for functional TR at two centres. Patients were clustered according to k-means clustering into low [cardiac index (CI)  2.6 L/min/m2) clusters. All-cause mortality and clinical characteristics during follow-up were compared among different CO clusters. Mortality rates were highest for patients in a low (24%) and high CO state (42%, log-rank P < 0.001). High CO state patients were characterized by larger inferior vena cava diameters (P = 0.003), reduced liver function, higher incidence of ascites (P = 0.006) and markedly reduced systemic vascular resistance (P < 0.001) as compared to TTVR patients in other CO states. Despite comparable procedural success rates, the extent of changes in right atrial pressures (P = 0.01) and right ventricular dimensions (P < 0.001) per decrease in regurgitant volume following TTVR was less pronounced in high CO state patients as compared to other CO states. Successful TTVR was associated with the smallest prognostic benefit among low and high CO state patients. Conclusions Patients with chronic right heart failure and severe TR display distinct CO states. The high CO state is characterized by advanced congestive hepatopathy, a substantial decrease in peripheral vascular tone, a lack of response of central venous pressures to TR reduction, and worse prognosis. These data are relevant to the pathophysiological understanding and management of this important clinical syndrome. Graphical Abstract Proposed mechanism of hypercirculatory tricuspid regurgitation. Tricuspid regurgitation related backward failure causes liver congestion and dysfunction with portal hypertension and reduced washout of vasoactive substances. Consequent splanchnic and peripheral vasodilatation alongside with reduced renal blood flow results in renin–angiotensin–aldosterone system (RAAS) activation and sympathetic overactivation. The sympathetic drive and volume retention lead to further capacitance depletion and volume overload, eventually resulting in a high cardiac output state, with limited preload reduction and prognostic benefit following transcatheter tricuspid valve repair. The alterations in the graph should be interpreted as simultaneous interaction rather than a timeline. Continuous lines indicate findings in the present study. Dashed lines express currently accepted mechanistical considerations. AP, alkaline phosphatase; γGT, gamma-glutamyl-transferase; RA, right atrium; RV, right ventricle

Nutritional status in tricuspid regurgitation: implications of transcatheter repair

Aims To characterize the prevalence and clinical relevance of malnutrition in patients undergoing transcatheter tricuspid valve edge-to-edge repair (TTVR). Methods and results Overall, 86 consecutive patients (mean age 78 ± 7 years) with moderate-to-severe tricuspid regurgitation (TR) at prohibitive surgical risk were analysed. Mini Nutritional Assessment (MNA), quality of life assessment, 6-min walk test distance and laboratory analyses were performed before and 1 month after TTVR. A total of 43 patients (50%) underwent concomitant transcatheter mitral valve repair. According to MNA, 81 patients (94%) were malnourished or at risk of malnutrition before TTVR. Following TTVR, MNA improved in 64 patients (74%). As compared to patients without MNA improvement, patients with increased MNA score had greater reductions in TR [regurgitation volume −17.0 (interquartile range, IQR −25.0; −7.0) mL vs. −26.4 (IQR −40.3; −14.5) mL, P < 0.001] and inferior vena cava diameter. Only patients with increased MNA score displayed a decrease in N-terminal pro-brain natriuretic peptide levels [−320 (IQR −1294; 105) pg/mL vs. +708 (IQR −342; 2708) pg/mL, P = 0.009], improvements in cholinesterase levels (0.0 ± 11.9 μmoL/L vs. +10.9 ± 16.7 μmoL/L, P < 0.001) and renal function during follow-up. Beneficial effects on quality of life scores and 6-min walk test distance following TTVR were observed exclusively in patients with improvement in MNA. During a median follow-up of 6 months, patients with worsened MNA had an increased risk of death and rehospitalization for heart failure. Conclusion Nutritional impairment is common and of prognostic importance in patients undergoing TTVR. Hepatorenal function modestly improves after successful TTVR. Further study of extracardiac implications of TR-associated right heart failure is warranted to improve care in this vulnerable patient population

Mapping Cloud-Edge-IoT opportunities and challenges in Europe

While current data processing predominantly occurs in centralized facilities, with a minor portion handled by smart objects, a shift is anticipated, with a surge in data originating from smart devices. This evolution necessitates reconfiguring the infrastructure, emphasising computing capabilities at the cloud's "edge" closer to data sources. This change symbolises the merging of cloud, edge, and IoT technologies into a unified network infrastructure - a Computing Continuum - poised to redefine tech interactions, offering novel prospects across diverse sectors. The computing continuum is emerging as a cornerstone of tech advancement in the contemporary digital era. This paper provides an in-depth exploration of the computing continuum, highlighting its potential, practical implications, and the adjustments required to tackle existing challenges. It emphasises the continuum's real-world applications, market trends, and its significance in shaping Europe's tech future

Single-Source Bismuth (Transition Metal) Polyoxovanadate Precursors for the Scalable Synthesis of Doped BiVO4 Photoanodes.

Single-source precursors are used to produce nanostructured BiVO4 photoanodes for water oxidation in a straightforward and scalable drop-casting synthetic process. Polyoxometallate precursors, which contain both Bi and V, are produced in a one-step reaction from commercially available starting materials. Simple annealing of the molecular precursor produces nanocrystalline BiVO4 films. The precursor can be designed to incorporate a third metal (Co, Ni, Cu, or Zn), enabling the direct formation of doped BiVO4 films. In particular, the Co- and Zn-doped photoanodes show promise for photoelectrochemical water oxidation, with photocurrent densities >1 mA cm-2 at 1.23 V vs reversible hydrogen electrode (RHE). Using this simple synthetic process, a 300 cm2 Co-BiVO4 photoanode is produced, which generates a photocurrent of up to 67 mA at 1.23 V vs RHE and demonstrates the scalability of this approach.We thank the following for financial support: China Scholarship Council (H.L.), the Cambridge Trusts (Vice Chancellor’s Award) and the Winton Programme for the Physics of Sustainability (V.A.), A*STAR Graduate Scholarship (Overseas) (N.L.), Imperial College Research Fellowship (A.R.), Christian Doppler Research Association and the OMV Group (E.R), Herchel Smith Research Fund (S.D.P

Open Surgical versus Minimal Invasive Necrosectomy of the Pancreas-A Retrospective Multicenter Analysis of the German Pancreatitis Study Group

Background Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. Methods The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014. Data were analysed for the primary endpoints "severe complications" and "mortality" as well as secondary endpoints including "length of hospital stay", "follow up", and predisposing or prognostic factors. Results Of all patients 13.6% were treated primarily with surgery and 86.4% underwent a step-up approach. More men (71.8%) required intervention for necrotising pancreatitis. The most frequent etiology was biliary (41.4%) followed by alcohol (29.1%). Compared to open necrosectomy, the step-up approach was associated with a lower number of severe complications (primary composite endpoint including sepsis, persistent multiorgan dysfunction syndrome (MODS) and erosion bleeding: 44.7% vs. 73.3%), lower mortality (10.5% vs. 33.3%) and lower rates of diabetes mellitus type 3c (4.7% vs. 33.3%). Low hematocrit and low blood urea nitrogen at admission as well as a history of acute pancreatitis were prognostic for less complications in necrotising pancreatitis. A combination of drainage with endoscopic necrosectomy resulted in the lowest rate of severe complications. Conclusion A step-up approach starting with minimal invasive drainage techniques and endoscopic necrosectomy results in a significant reduction of morbidity and mortality in necrotising pancreatitis compared to a primarily surgical intervention

Wasseroxidationskatalysatoren : Mechanismus und Wechselwirkung an der Halbleiter-Elektrolyt Grenzfläche

Climate change has been widely recognized as a major environmental problem facing the world today. According to IPCC, this is related to the increase in greenhouse gas concentrations, mainly as a result of the combustion of fossil-fuels. To reconcile this, a transition from fossil-fuels to renewable-based energy sources is unavoidable. Solar water splitting has attracted significant attention to convert the abundant solar energy to chemical energy. It uses a semiconductor to convert sunlight into electron-hole pairs, which then split water into hydrogen and oxygen. Hereby metal oxides have emerged as attractive candidates for photoelectrochemical water splitting, mainly due to their good stability in aqueous solutions, easy synthesis, and low cost. However, to achieve a high efficiency, the semiconductor alone is usually not enough; co-catalysts need to be implemented to address the low charge injection efficiency that most metal oxides are suffering from. This thesis consists of three parts: (i) development and characterization of an oxygen evolution reaction (OER) catalyst, (ii) investigations on the fundamental processes involved in the OER, and (iii) studies on the interaction between semiconductor, catalyst and electrolyte. In the first part, the performance of NixMnyOz over a broad stoichiometry range as alternative catalysts for the OER—either as counter electrode or co-catalyst on top of a photoanode in PEC cells—is analyzed. The films were synthesized by pulsed laser deposition using a combinatorial approach that allows scanning over the complete stoichiometry range. Electrochemical as well as spectroscopic methods were used to understand the catalysts’ working principle and the relations between its composition and OER activity. The introduction of Ni into the MnOx catalyst is found to reduce the overpotential significantly. A further increase in Ni concentration in the films results in even further decrease of overpotentials. This shows that pure NiOx still performs best for the OER within this composition range, as well as in terms of stability and transparency. The next paragraph addresses the understanding of the fundamental processes taking place in a cobalt phosphate (CoPi) catalyst during water oxidation. CoPi is a well-known electrocatalyst, which has already been studied extensively in the literature. However, there are still some open questions on the exact processes taking place during the water oxidation reaction. To get a better insight into those mechanisms, in-situ UV-Vis studies were performed as a function of potential to investigate the working principle of a CoPi OER catalyst. Our measurements reveal a sequential oxidation from CoII --> CoIII --> CoIV, and we show that the film does not need to be completely oxidized to CoIII before CoIV can be formed. The oxidation from CoII to CoIII is also found to be the slowest amongst the two oxidation steps. Finally, the processes at the semiconductor/electrolyte and the semiconductor/co-catalyst/electrolyte interface are discussed to understand the role of a co-catalyst layer and its relation to the semiconductor’s limitation. On that account, BiVO4 photoanodes were used as model system and were investigated by intensity modulated photocurrent spectroscopy (IMPS). With this method one can distinguish the recombination and charge transfer at the surface of the working electrode. By comparing the bare and the co-catalyzed photoanode system, it is shown that an effective co-catalyst deposited onto BiVO4 does not enhance the charge transfer, as one would expect intuitively, but reduces the surface recombination instead.Der Klimawandel wurde mittlerweile weltweit als gigantisches Umweltproblem anerkannt. Gemäß dem IPCC, wird der Klimawandel durch den Anstieg der Treibhausgase vorangetrieben, welche hauptsächlich durch den Verbrauch von fossilen Brennstoffen verursacht werden. Um diesen Prozess aufzuhalten, ist ein Übergang von fossilen Brennstoffen zu erneuerbaren Energieträgern unvermeidbar. In diesem Zusammenhang hat solare Wasserspaltung große Aufmerksamkeit auf sich gezogen um die reichlich vorhandene Solarenergie in chemische Energie umzuwandeln. Hierbei werden im Halbleiter Elektron-Loch Paare mittels Sonnenenergie erzeugt, die dann Wasser in Wasserstoff und Sauerstoff spalten. Metalloxide haben sich aufgrund ihrer guten Stabilität in wässriger Lösung, einfacher Synthesemöglichkeiten und geringer Kosten als attraktive Kandidaten für die elektrochemische Wasserspaltung herauskristallisiert. Nichtsdestotrotz, ist der Halbleiter allein normalerweise nicht ausreichend um hohe Effizienzen zu erreichen; die Anwendung von Co-Katalysatoren ist notwendig um die geringe Ladungsinjektion (typisch für ein Großteil der Metalloxide) zu behandeln. Diese Arbeit setzt sich aus drei Teilen zusammen: (i) Entwicklung und Charakterisierung von Katalysatoren für die Sauerstoffentwicklung, (ii) Untersuchungen der fundamentalen Prozesse der Sauerstoffentwicklung, und (iii) des Zusammenspiels zwischen Halbleiter, Katalysator und Elektrolyt. Im ersten Abschnitt wird die Aktivität von NixMnyOz mit unterschiedlichen Zusammensetzungen als alternativer Katalysator für die Wasseroxidation untersucht. Die Schichten werden mittels eines kombinatorischen Ansatzes beim Laserstrahlverdampfen hergestellt. Elektrochemische sowie spektroskopische Methoden werden genutzt um die Arbeitsweise der Katalysatoren und den Zusammenhang zwischen der Zusammensetzung und der Aktivität für die Wasseroxidation zu verstehen. Hierbei hat sich gezeigt, dass die Einbringung von Ni in MnOx die Überpotentiale signifikant reduziert. Mit steigendem Ni-Gehalt in den Filmen sinkt das Überpotential kontinuierlich. Gleiche Tendenzen lassen sich auch für die Stabilität und die Transparenz der Schichten erkennen. Der zweite Abschnitt beschäftigt sich mit den fundamentalen Prozessen während der Wasseroxidation mit einem Kobaltphosphat-Katalysator (CoPi). CoPi ist ein weitverbreiteter Elektrokatalysator, der bereits intensiv in der Literatur untersucht wurde. Nichtsdestotrotz, gibt es immer noch offene Fragen zu den genauen Abläufen während der Wasseroxidation. Um einen besseren Einblick in diese Mechanismen zu erhalten, wurden in-situ UV-Vis-Messungen als Funktion des angelegten Potentials durchgeführt. Die Messungen zeigen eine schrittweise Oxidation von CoII --> CoIII --> CoIV. Außerdem müssen die Schichten nicht vollständig zu CoIII oxidiert werden bevor CoIV geformt werden kann. Abschließend werden die Prozesse an der Halbleiter/Elektrolyt- und der Halbleiter/Elektrolyt/Co-Katalysator-Grenzfläche beschrieben um die Funktion von Co-Katalysatorschichten besser zu verstehen. Aus diesem Grund wurden BiVO4 Photoanoden als Modelsysteme genutzt und mittels intensitätsmodulierter Photostrom-Spektroskopie (IMPS) untersucht. Mit Hilfe dieser Methode kann zwischen Rekombination und Ladungstransfer an der Oberfläche der Arbeitselektrode unterschieden werden. Es wurde gezeigt, dass die Auftragung eines effektiven Co-Katalysators auf BiVO4 entgegen den Erwartungen nicht zu einer Steigerung des Ladungstransfers, sondern vielmehr zu einer Verringerung der Oberflächenrekombinationen führt

Arbeitswelten, Migration, sozialer Protest und Globalisierung im Kupferbergbau zur Mitte des 19. Jahrhunderts: Der chilenische Kleine Norden im Vergleich mit dem Mansfelder Land

In the middle of the 19th century, miners and smelters in the Central German copper region Mansfeld lived in the corporative world of the Prussian mining industry. At the same time, Europe’s growing demand for copper and silver contributed to the rise of in the Chilean Northern provinces Atacama and Coquimbo, the so-called Norte Chico, as the leading supplier worldwide. The region was able to maintain this position between 1840 and 1870. The long running boom generated a new multicultural working class in the mining regions in the Norte Chico. Whereas Mansfeld’s mineworkers in Germany did neither participate in the hunger riots of 1847 nor the revolutionary actions of 1848, workers from the mining districts in Chile’s Norte Chico belonged to the most radical groups during the revolutions against President Manuel Montt in 1851 and 1858–9. On the basis of these two examples, this comparative study challenges some general claims of the Dependencia theory, according to which economically advanced regions in 19th century Chile had lacked the more progressive social structures of highly industrialised regions in Europe at that time