Rechtsmedizinische Begutachtung als Grundlage verbesserter Patientensicherheit : Analyse bestätigter Behandlungsfehler in den Instituten für Rechtsmedizin Bonn und Düsseldorf 1990 - 2006 (2008)

Einleitung: Rechtsmedizinische Begutachtung liefert umfangreiches Datenmaterial zu medizinischen Behandlungsfehlern. In der vorliegenden Arbeit wird untersucht, ob sich durch Analyse der fallbezogenen Unterlagen Zusammenhänge der Fehlerentstehung identifizieren lassen, die für die Fehlerprophylaxe und damit für eine Verbesserung der Patientensicherheit genutzt werden können.Methode: Die Begutachtungsunterlagen bestätigter letaler Behandlungsfehler der Jahre 1990-2006 (2008) in den rechtsmedizinischen Instituten der Universitäten Bonn und Düsseldorf wurden mittels aus der empirischen Sozialforschung abgeleiteter Variabler untersucht. Ergebnisse: Ärzte im stationären Bereich sind eher bereit, ein behördliches Ermittlungsverfahren anzustoßen als ihre niedergelassenen Kollegen. Stationäre Fehler sind Teamfehler, was sich gerade bei Operationen zeigt. Unter den Krankenhäusern weisen Häuser der Schwerpunktversorgung die höchste Fehlerrate auf. Es besteht eine Fehlerhäufung bei Assistenzärzten in Bereitschaftsdiensten. Im niedergelassenen Bereich sind Fehler vor allem ein Problem der Hausärzte. Auch Ärzte im kassenärztlichen Notdienst sind gehäuft für Fehler verantwortlich. Fehler durch nichtärztliches Medizinpersonal betreffen besonders Pflegeheime.Schlussfolgerung: Im stationären Bereich bedürfen die personellen Strukturen vor allem in Bereitschaftsdiensten einer Veränderung. Dies gilt besonders für die wachsende Zahl von Krankenhäusern der Schwerpunktversorgung. Bei Ärzten im niedergelassenen Sektor muss der Qualitätsgedanke wirksam implementiert werden. Die fachübergreifende Organisation des kassenärztlichen Notdienstes ist in Frage zu stellen

Proton-induced fragmentation of carbon at energies below 100 MeV

Radiation effects caused by single cosmic ray particles have been studied for many years in radiobiological experiments for different biological objects and biological end-points. Additionally, single event effects in microelectronic devices have gained large interest. There are two fundamental mechanisms by which a single particle can cause radiation effects. On the one hand, a cosmic ray ion with high linear energy transfer can deposit a high dose along its path. On the other hand, in a nuclear collision, a high dose can be deposited by short range particles emitted from the target nucleus. In low earth orbits a large contribution to target fragmentation events originates from trapped protons which are encountered in the South Atlantic Anomaly. These protons have energies up to a few hundred MeV. We study the fragmentation of C, O and Si nuclei - the target nuclei of biological material and microelectronic devices - in nuclear collisions. Our aim is to measure production cross sections, energy spectra, emission directions and charge correlations of the emitted fragments. The present knowledge concerning these data is rather poor. M. Alurralde et al. have calculated cross sections and average energies of fragments produced from Si using the cascade-evaporation model. D.M. Ngo et al. have used the semiempirical cross section formula of Silberberg and Tsao to calculate fragment yields and the statistical model of Goldhaber to describe the reaction kinematics. Cross sections used in these models have uncertainties within a factor of two. Our data will help to test and improve existing models especially for energies below 300 MeV/nucleon. Charge correlations of fragments emitted in the same interaction are of particular importance, since high doses can be deposited if more than one heavy fragment with a short range is produced

A novel nuclear antigen

The human oestrogen receptor (hER) mediates some effects of the steroid hormone oestrogen and functions as a ligand-dependent transcription factor in the nuclei of oestrogen-sensitive cells. The measurement of hER levels in breast cancer biopsies provides useful clinical information regarding therapy and prognosis. The current study describes a monoclonal antibody raised against hER aa 497-507 which recognises a novel nuclear antigen. Monoclonal antibodies were raised by immunising mice with a synthetic fragment of the hER (aa 497-507) conjugated to keyhole lymphocyte haemocyanin. Thirty antibody secreting hybridomas were identified. Hybridoma supernatants were characterised by enzyme-linked immunosorbent assay (ELISA), immunological staining using MCF-7 cells, binding studies, and SDS-PAGE Western blotting. One supernatant (15F6) displayed nuclear staining in fixed MCF -7 cells. Staining could be abolished by pre-incubation of the supernatant with the aa 497-507 peptide and peptide conjugates, but not with an unrelated hER peptide (aa 256-275). This antibody also stained the nuclei of hER negative breast cell lines MDA-MB-231 and MDA-MB-330, the breast cell line T47D, and liver cell line HepG2. Immunological staining of human tissue sections reveal the antigen to be present in the nuclei of keratocytes in skin and tubule and luminal endothelial cells of the kidney. The antibody identified a 120 kD band on Western blots with cytosols prepared from human breast cell lines and in solubilised cells. The antibody does not precipitate 16a-iodooestradiol-labelled ER from MCF-7 cells. Expression-linked screening of the MCF-7 cDNA library with antibody 15F6 identified nine positive clones. Antibody staining could be blocked by pre-incubating the antibody with hER aa 497-507-BSA conjugate, but not with an unrelated hER peptide conjugate. The (260 bp) clones were found to be identical. Submission of sequence to BLAST protein and nucleotide databases revealed a lack of homology to known proteins and genes. Sequence was matched to expressed sequence tags (ESTs) from brain, liver/spleen, uterus, ovary, colon, heart, and placenta. To further define the epitope of antibody 15F6, the sequence was translated and three peptides containing potential epitopes, comparable to the hER aa 497-507 region, were synthesised and tested by ELISA. The putative epitope was shown to be contained within one of these peptides

Технология зачистки резервуаров от донных отложений в зимнее время

Объектом исследования являются современные технологии удаления твердых отложений из нефтяных резервуаров. Цель работы – анализ современных методов очистки резервуаров вертикальных стальных от донных отложений с технико-экономическим обоснованием наиболее оптимального метода. В процессе исследования проводилось изучение причин и процессов осадконакопления в нефтяных резервуарах, изучались возможности современных мобильных комплексов для очистки нефтяных резервуаров, выявлялись их достоинства и недостатки, а также проводилось их сравнение с такими традиционными методами очистки как ручной и механизированный. Степень внедрения: реальная. Область применения:резервуарные парки нефтеперекачивающих станций с резервуарами типа РВС объёмом до 30000 м3.The object of the study is the modern technology of removal of solid deposits from oil tanks. The purpose of the work is to analyze modern methods of cleaning vertical steel tanks from bottom sediments with a feasibility study of the most optimal method. In the course of the study, the causes and processes of sedimentation in oil tanks were studied, the possibilities of modern mobile systems for cleaning oil tanks were studied, their advantages and disadvantages were revealed, and they were compared with traditional methods of cleaning such as manual and mechanized. Degree of implementation: real. Field of application: tank farms of oil pumping stations with tanks of PBC type up to 30,000 m3

Green transformations in Vietnam's energy sector

Vietnam has experienced rapid economic growth over the past few decades, as well as growing environmental pressures. The country is therefore pursuing strategies for green transformations, which are the processes of restructuring to bring economies and societies within the planetary boundaries. This article addresses the opportunities, barriers, and trade‐offs for green transformations in Vietnam's energy sector and examines them from an energy justice perspective. The article draws on in‐depths expert interviews with representatives from government agencies, private firms, academic institutions, and multilateral institutions in Vietnam. The article finds that Vietnam is undergoing efforts to move away from business as usual by promoting renewable energy and energy efficiency, as well as aligning energy and climate plans with national development priorities such as energy security and economic growth. Yet there is a need for more coordinated, integrated approaches and policies that span across the 3 areas that address green transformations in Vietnam: green growth, sustainable development, and climate change. Finally, although key actors seem to be aware and may be critical of major trade‐offs such as land grabs for energy projects, the impacts on affected people need to be better understood and mitigated

Constructing living buildings: a review of relevant technologies for a novel application of biohybrid robotics

Biohybrid robotics takes an engineering approach to the expansion and exploitation of biological behaviours for application to automated tasks. Here, we identify the construction of living buildings and infrastructure as a high-potential application domain for biohybrid robotics, and review technological advances relevant to its future development. Construction, civil infrastructure maintenance and building occupancy in the last decades have comprised a major portion of economic production, energy consumption and carbon emissions. Integrating biological organisms into automated construction tasks and permanent building components therefore has high potential for impact. Live materials can provide several advantages over standard synthetic construction materials, including self-repair of damage, increase rather than degradation of structural performance over time, resilience to corrosive environments, support of biodiversity, and mitigation of urban heat islands. Here, we review relevant technologies, which are currently disparate. They span robotics, self-organizing systems, artificial life, construction automation, structural engineering, architecture, bioengineering, biomaterials, and molecular and cellular biology. In these disciplines, developments relevant to biohybrid construction and living buildings are in the early stages, and typically are not exchanged between disciplines. We, therefore, consider this review useful to the future development of biohybrid engineering for this highly interdisciplinary application.publishe

Mutational Analysis of the SOX9 Gene in Campomelic Dysplasia and Autosomal Sex Reversal: Lack of Genotype/Phenotype Correlations

It has previously been shown that, in the heterozygous state, mutations in the SOX9 gene cause campomelic dysplasia (CD) and the often associated autosomal XY sex reversal. In 12 CD patients, 10 novel mutations and one recurrent mutation were characterized in one SOX9 allele each, and in one case, no mutation was found. Four missense mutations are all located within the high mobility group (HMG) domain. They either reduce or abolish the DNA-binding ability of the mutant SOX9 proteins. Among the five nonsense and three frameshift mutations identified, two leave the C-terminal transactivation (TA) domain encompassing residues 402-509 of SOX9 partly or almost completely intact. When tested in cell transfection experiments, the recurrent nonsense mutation Y440X, found in two patients who survived for four and more than 9 years, respectively, exhibits some residual transactivation ability. In contrast, a frameshift mutation extending the protein by 70 residues at codon 507, found in a patient who died shortly after birth, showed no transactivation. This is apparently due to instability of the mutant SOX9 protein as demonstrated by Western blotting. Amino acid substitutions and nonsense mutations are found in patients with and without XY sex reversal, indicating that sex reversal in CD is subject to variable penetrance. Finally, none of 18 female patients with XY gonadal dysgenesis (Swyer syndrome) showed an altered SOX9 banding pattern in SSCP assays, providing evidence that SOX9 mutations do not usually result in XY sex reversal without skeletal malformation