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Modified scoring system for the quantitative assessment of histological regression in peritoneal carcinomatosis after pressurized intraperitoneal aerosol chemotherapy: A pilot study
No full textPeritoneal carcinomatosis is one of the leading causes of death in patients with gastrointestinal cancer. Newer locoregional treatment concepts include pressurized intraperitoneal aerosol chemotherapy (PIPAC), the regional application of pressurized chemotherapeutic agents to the abdominal cavity, which is usually performed every 4 to 8 weeks. One of the main challenges of PIPAC therapy remains the objective assessment of treatment response. The present study describes a new scoring system to histologically assess the regression of peritoneal cancer following PIPAC therapy, quantitative assessment of histological regression in peritoneal carcinomatosis (QARP). Peritoneal biopsies from 27 patients with peritoneal metastases undergoing PIPAC were obtained and processed in a standardized fashion. Biopsies were scored according to the QARP grading system. The five‑tiered system was graded as follows, Grade 0, no residual tumor cells with regressive changes present; grade 1, 1‑25% viable tumor cells per tumor focus with regressive changes present; grade 2, 26‑50% viable tumor cells per tumor focus with regressive changes present; grade 3, 51‑75% viable tumor cells per tumor focus with few regressive changes; grade 4, >75% viable tumor cells per tumor focus with minimal or no regressive changes. Based on the new grading system, the study cohort was divided into QARP responders and QARP non‑responders following PIPAC treatment. Higher QARP scores were significantly correlated with higher PCI scores (r=0.32; P=0.007). However, no difference in overall survival was detected between QARP responders and QARP non‑responders. Further studies are required to ascertain the reproducibility and prognostic significance of QARP
Moving meaning? The translation of sustainability norms in EU urban mobility governance
No full text‚Moving meaning? The translation of sustainability norms in EU urban mobility governance‘ bietet eine aktuelle Bewertung der Herausforderungen der Transformation zu einer nachhaltigen urbanen Mobilität als Schlüsselsektor für die klima- und umweltpolitischen Ambitionen der Europäischen Union (EU). Konzeptionell vereint die Arbeit Perspektiven aus der EU-Forschung, den Internationalen Beziehungen und Nachhaltigkeitsforschung. Mit Hilfe des Konzepts der Normübersetzung wird eine neue Perspektive auf die komplexe Arena der EU Mehrebenen-Governance eröffnet. Sie erklärt inhaltliche und prozessuale Dynamiken, die politische Räume horizontal und vertikal über Ebenen und Sektoren hinweg überschreiten. Eine umfassende qualitativ-interpretative Studie, basierend auf über 60 Experten- und Stakeholder-Interviews, der Analyse von Policy-Dokumenten und teilnehmenden Beobachtungen, aktualisiert das Wissen über die urbane Mobilitätsgovernance als zentrales Feld der nachhaltigen Transformation in der EU und deckt kritisch verschiedene Wege der ‚Bedeutungswerdung‘ von Nachhaltigkeit sowie die zugrunde liegenden Machtdynamiken auf.‘Moving meaning? The translation of sustainability norms in EU urban mobility governance’ provides a state-of-the-art assessment of the drivers and challenges of the sustainable urban mobility transition as a key sector for the European Union’s (EU) climate and environmental policy ambitions. Conceptually, the thesis brings together perspectives from EU research, International Relations theory and transitional studies. With the use of the norm translation concept, the thesis obtains a novel perspective on the complex EU multilevel governance arena. It explains substantive and processual dynamics that transgress political realms horizontally and vertically across levels and sectors. A comprehensive qualitative-interpretive study building on over 60 expert and stakeholder interviews, policy documents and participatory observations updates the knowledge about urban mobility governance as a critical field of the EU sustainability transition and critically uncovers different avenues of ‘meaning-making’ regarding sustainability as well as underlying power dynamics
Nachhaltigkeitsaktivitäten an den Universitäten und in den Regionen Münster, Osnabrück und Siegen:Eine Inventarisierung im Rahmen des Projekts LATERNE
No full textDieses Arbeitspapier gibt einen Überblick über die Nachhaltigkeitsbemühungen der Universitäten Münster, Osnabrück und Siegen entlang der Dimensionen des Whole Institution Approach (WIA) – Forschung, Lehre, Transfer, Betrieb, Governance. Das Projekt LATERNE beschäftigt sich mit Hochschulen als Treiber der Nachhaltigkeitstransformation und in diesem Kontext mit der Rolle von Leuchtturmprojekten. Der vorliegende Überblick über den Status Quo an den drei Universitäten dient der Analyse des Potenzials sowie der Identifikation von Bereichen, in denen die gegenwärtigen Aktivitäten weiterentwickelt werden könnten. Darüber hinaus nimmt es den regionalen Kontext der Hochschulen in den Blick und ermöglicht einen Vergleich der drei Standorte. Die Inventarisierung basiert auf einer umfassenden Desktoprecherche. Beim Vergleich der drei Standorte fällt auf, dass an jeder der drei Universitäten in jedem der WIA-Bereiche das Thema Nachhaltigkeit eine Rolle spielt, die Präsenz des Themas in den verschiedenen Bereichen jedoch unterschiedlich stark ausgeprägt ist. Hinsichtlich der regionalen Kontexte ist auffällig, dass ein beachtlicher Teil der Verknüpfungen von Hochschule und Region über Forschungsprojekte hergestellt wird. Festgestellte Unterschiede in der Inzidenz und Intensität von regionaler Kooperation sind vermutlich auf die unterschiedlichen Größen und Charaktere der Städte und Regionen um Münster, Osnabrück und Siegen zurückzuführen. An allen drei Universitäten kann die koordinierte Zusammenarbeit über die Grenzen der WIA-Bereiche hinweg ausgebaut werden. Es wird außerdem deutlich, dass die Mehrheit der identifizierten Projekte und Initiativen einen Schwerpunkt auf ökologischer Nachhaltigkeit haben. Zurückgeführt wird diese Limitation auf das angelegte Auswahlkriterium für Projekte und Initiativen, welches verlangt, dass diese sich selbst als "nachhaltig" bezeichnen. Dies lässt allerdings auch den Schluss zu, dass die in den Projekten vorherrschenden Nachhaltigkeitsverständnisse an den Universitäten primär von ökologischen Anliegen geprägt sind
The Influence of Different Sera on the Anti-Infective Properties of Silver Nitrate in Biopolymer Coatings
No full textThe widespread prevalence of periprosthetic joint infections (PJIs) poses significant challenges in orthopedic surgeries, with pathogens such as Staphylococcus epidermidis being particularly problematic due to their capability to form biofilms on implants. This study investigates the efficacy of an innovative silver nitrate-embedded poly-L-lactide biopolymer coating designed to prevent such infections. The methods involved applying varying concentrations of silver nitrate to in vitro setups and recording the resultant bacterial growth inhibition across different serum environments, including human serum and various animal sera. Results highlighted a consistent and significant inhibition of S. epidermidis growth at all tested concentrations in each type of serum without adverse interactions with serum proteins, which commonly compromise antimicrobial efficacy. This study concludes that the silver nitrate-embedded biopolymer coating exhibits potent antibacterial properties and has potential for use in clinical settings to reduce the incidence of PJIs. Furthermore, the findings underscore the importance of considering serum interactions in the design and testing of antimicrobial implants to ensure their effectiveness in actual use scenarios. These promising results pave the way for further research to validate and refine this technology for clinical application, focusing on optimizing silver ion release and assessing biocompatibility in vivo
Two-Stage Revision Arthroplasty for Resistant Gram-Positive Periprosthetic Joint Infections Using an Oral Linezolid-Based Antibiotic Regime
No full textBackground: Increasing antibiotic resistance has been reported as an issue in the systemic treatment of periprosthetic joint infection (PJI). Linezolid offers the advantages of high oral bioavailability and little resistance; however, efficacy in the treatment of PJI varies considerably, and studies reporting consistent surgical treatment are scarce. Methods: This is a retrospective, single-center analysis of two-stage revisions performed between 2008 and 2017. We identified 111 patients who met the inclusion criteria. Oral linezolid was given for 28 days following 14 days of intravenous tailored antibiotics in resistant gram-positive PJI. A total of 64% of the patients had methicillin-resistant coagulase-negative staphylococci. The median follow-up was 43 (interquartile range (IQR) 30–57) months. Results: 22% (24/111) of the patients underwent surgery for subsequent infection. The 5-year infection-free survival probability was 77% (95% confidence interval (CI) 69–85). A total of 5% of the patients (6/111) had the same organism at the time of reinfection. The patients with infections caused by other organisms than Coagulase-negative staphylococci tended to have a worse reinfection-free survivorship at five years (70% vs. 81%, p = 0.09). Furthermore, the patients with obesity tended to have reduced reinfection-free survivorship at five years (69% vs. 84%, p = 0.08). Overall, 5% (6/111) of the patients had blood count abnormalities with no treatment discontinuations. Conclusion: Two-stage revision arthroplasty with systemic oral linezolid treatment for resistant gram-positive PJI results in an infection control of 77% at the mid-term
Right-angled buildings and locally compact groups
No full textUniversal groups are certain automorphism groups of right-angled buildings, that are defined via prescribed local actions. Equipped with the topology of pointwise convergence, these groups are second countable and totally disconnected locally compact groups. We present conditions that lead to a concrete description of the identity neighbourhoods, and topologically isomorphic universal groups that are associated to different right-angled buildings. Furthermore, we describe a finite presentation for discrete chamber-transitive universal groups. Automatic continuity asks for the continuity of abstract group homomorphisms between topological groups. We study this question for group homomorphisms from Polish or locally compact groups to universal groups and present conditions on the local actions that ensure continuity of abstract surjective group homomorphisms. Additionally, we obtain the uniqueness of the group topology in most cases.Universelle Gruppen sind bestimmte Automorphismengruppen rechtwinklige Gebäude, die durch vorgegebene lokale Wirkungen definiert sind. Versehen mit der Topologie der punktweisen Konvergenz, sind sie zweitabzählbare, total unzusammenhängende lokalkompakte Gruppen. Neben Bedingungen, die uns eine konkrete Beschreibung der Einsumgebungen ermöglichen, präsentieren wir universelle Gruppen, die topologisch isomorph und assoziiert zu verschiedenen rechtwinkligen Gebäuden sind. Außerdem geben wir eine endliche Präsentierung für diskrete Kammern-transitive universelle Gruppen an. Automatische Stetigkeit fragt nach der Stetigkeit abstrakter Gruppenhomomorphismen zwischen topologischen Gruppen. Wir studieren diese Frage für Gruppenhomomorphismen von polnischen oder lokalkompakten Gruppen zu universellen Gruppen und geben Voraussetzungen an die lokalen Wirkungen an, sodass abstrakte surjektive Gruppenhomomorphismen stetig sind. Zusätzlich erhalten wir in den meisten Fällen die Eindeutigkeit der Gruppentopologie
Search for Dark Matter and other beyond the Standard Model physics with XENON1T and XENONnT
No full textTrotz zahlreicher Hinweise für die Existenz der Dunklen Materie, bleiben ihre Eigenschaften ein Rätsel und bildeen eines der Hauptthemen der modernen Teilchenphysik. Das XENON Dark Matter Projekt beabsichtigt den direkten Nachweis dieser hypothetischen Dunklen Materie mit immer empfindlicheren Detektoren. In dieser Arbeit wird untersucht ob der Überschuss an Elektron-Rückstößen in XENON1T auf inelastische Streuung von Dunkler Materie an Elektronen in der Xenon Detektromasse zurückzuführen ist. Frühere Analysen wurden nur mit der Energieinformation der Rückstöße durchgeführt, wobei die Zeitinformationen vernachlässigt wurden. Eine Analyse mit der Zeitinformation führt zu verschiedenen Verbesserungen gegenüber vorheriger Veröffentlichung. Die Dicke der PTFE-Detektorwand von XENONnT wurde hinsichtlich ihrer Lichtdichtigkeit und Massenreduzierung optimiert. Diese Arbeit stellt ein Modell für die Lichtdurchlässigkeit bei Xenon-Szintillationslicht und die optimale Detektorwandstärke vor.Despite numerous evidence for the existence of Dark Matter, its nature remains a mystery and is one of the main topics of modern particle physics. The XENON Dark Matter project is aiming for the direct detection of the hypothetical Dark Matter particles with increasingly sensitive detectors. This work investigates the possibility that the excess of electronic recoil events in XENON1T originates from inelastic scattering of Dark Matter off electrons in the xenon target. Previous analyses were only performed by investigating the electronic recoil energy spectra, neglecting most of the time information. This work describes the re-analysis focusing on the time information leading to various improvements over the previous analyses. The thickness of the XENONnT PTFE detector wall is optimized for light tightness and mass reduction. This work presents a modell for the light transmission at xenon scintillation light wavelengths and the optimal detector wall thickness
Second-Generation Wide-Field Visualization Devices for 5-ALA–Induced Fluorescence and Concepts for Validation in Neurosurgery—A Systematic Review
No full textBACKGROUND AND OBJECTIVES: Fluorescence-guided resection (FGR) of malignant gliomas with five-aminolevulinic acid (5-ALA) is an established method using surgical microscopes equipped with filter systems for observing fluorescence. Over the past decade, new technologies have been introduced for the same purpose, with available publications evaluating their clinical efficacy based on varying criteria. This study aims to review technologies and concepts of validation in the context of 5-ALA–mediated FGR. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was performed to identify devices capable of detecting 5-ALA–induced fluorescence. Articles found eligible for this review were analyzed, focusing on the methods of validation used for novel devices. A qualitative analysis is presented. RESULTS: Using predefined eligibility criteria, 22 studies were analyzed. Publications on the following visualization devices were reviewed: FL400 (Leica Microsystems), Aeos (Aesculap), BLUE400 and BLUE400 AR Filter System (Carl Zeiss Meditec AG), Endoscope with D-Light C (Karl Storz), Fiberscope N-4L (Machida), ORBEYE 4K 3D Digital Video Microscope (Olympus), and several customized surgical loupe systems. In many cases, validation seemed unstandardized, with inherent biases and limited reproducibility. CONCLUSION: This review illustrates the significance of device validation within the framework of FGR. It emphasizes the criticality of validating devices in accordance with established standard, i.e. the BLUE400 filter system, which was employed in the approval studies of 5-ALA. Furthermore, standardized concepts of validation are required to assess whether new devices are, in fact, a reliable or superior alternative in the field of FGR. Published guidelines should be considered when performing future studies
Submacular Hemorrhages Show No Significant Seasonal Variations in a European Cohort
No full textThe aim of the article is to investigate the seasonality of acute submacular hemorrhages (SMHs) in a European population and analyze the influence of the seasons, arterial hypertension, and intake of anticoagulatory/antiplatelet (AC/AP) medication on hemorrhage size. This retrospective, monocentric study included 164 eyes of 164 patients treated for acute SMH at the University Hospital Münster, Germany, between 1 January 2016 and 31 December 2021. Data on the day of occurrence, hemorrhage size, and general patient characteristics were recorded. “Test for cyclic trends in incidence data” and the Chi-Square Test were applied to investigate seasonal variations in SMH incidence. Fisher’s exact test was used to investigate the influence of the seasons, arterial hypertension, and intake of AC/AP medication on hemorrhage size. A statistical analysis did not reveal significant seasonal variations in the occurrence of SMHs (p = 0.81). While the seasons and the presence of systemic arterial hypertension did not exert a significant influence, the intake of AC/AP medication significantly affected the size of SMH (p = 0.03). In this European cohort, no significant seasonal variations of SMHs were observed. However, in patients with risk factors, such as neovascular age-related macular degeneration (nAMD), the chance of an increase in hemorrhage size should be considered when initiating AC/AP therapy
Visualization of the Postoperative Position of the Hydrus® Microstent Using Automatic 360° Gonioscopy
No full textIntroduction: Glaucoma, one leading cause of irreversible vision loss worldwide, is primarily caused by elevated intraocular pressure (IOP). Recently, minimally invasive glaucoma surgeries (MIGSs) have become popular due to their shorter surgical times, tissue-sparing nature, and faster recovery. One such MIGS, the Hydrus® nickel–titanium alloy Microstent, helps lower IOP by improving aqueous humor outflow. The NIDEK GS-1 automated 360° gonioscope provides advanced imaging of the chamber angle for evaluation and documentation. The aim of this study was to test automated 360° gonioscopy for the detection of postoperative positional variations after Hydrus® Microstent implantation. This study is the largest to date to evaluate post-op positioning of the Hydrus® Microstent using the NIDEK GS-1. Materials and Methods: This study analyzed postoperative outcomes and stent location in eyes diagnosed with mild to moderate glaucoma that underwent Hydrus® Microstent implantation with or without phacoemulsification. Patients with prior IOP-lowering surgery or vitrectomy were excluded. Analyses of the postoperative Hydrus® Microstent position were based on the evaluation of automated 360° gonioscopy images. Results: Twenty-three eyes were included in the study, and all showed a reduction in IOP and a decrease in antiglaucomatous drop use postoperatively. Postoperative gonoscopic images showed variations in implant position. In all cases, the proximal inlet was clearly visible in the anterior chamber. The degree of protrusion into the anterior chamber was variable. The distal tip of the stent was visible behind the trabecular meshwork in Schlemm’s canal in five cases, in the anterior chamber in one case, and not visible in seven cases. In no case did postoperative alterations in the position of the implant lead to explantation. Conclusions: This study demonstrated that the Hydrus® Microstent can effectively lower IOP even in the presence of postoperative positional variations. Automated 360° gonioscopy was found to be a useful tool to verify and document the postoperative position of the implant. Positional changes did not require device explantation in any of the cases evaluated