OptiScreen – ein Schulungskonzept für Pflegekräfte zur Durchführung des psychosozialen Distress-Screenings

Hintergrund

Eine angemessene, bedarfsgerechte psychoonkologische Versorgung reduziert Depressivität und Ängste von Krebserkrankten sowie ihren Angehörigen und erhöht die Lebensqualität. Psychisch belastete Krebserkrankte werden jedoch nicht flächendeckend identifiziert, um ihnen psychoonkologische Unterstützung anzubieten. Screeningfragebögen haben sich zur Identifikation bewährt, allerdings bestehen bei der Anwendung im klinischen Alltag Hürden. Pflegekräfte haben durch ihren kontinuierlichen Kontakt zu Patient_innen, die vielfältigen klinischen Eindrücke und ihre Verbindung zu anderen Berufsgruppen eine Schlüsselrolle.

Ziele

Die OptiScreen-Schulung soll Pflegekräfte in der Onkologie zur Durchführung des Distress-Screenings befähigen, entsprechendes Expert_innenwissen vermitteln und Hürden sowie Unsicherheiten im Screeningprozess abbauen, um somit belastete Erkrankte zielgerichtet identifizieren und einer psychoonkologischen Versorgung zuführen zu können.

Das Training

Die OptiScreen-Schulung gliedert sich in drei Module à 1,5–2 h zu den Themen psychische Störungen bei Krebs, psychoonkologische Versorgung, psychische Belastung, Distress-Screening, Kommunikation im Screeningprozess und Psychohygiene (vermittelt durch Vorträge, Videos, Rollenspiele, Übungen).

Ergebnisse und Diskussion

Erste praktische Erfahrungen weisen auf eine erfolgreiche Umsetzung des Schulungskonzepts hin. Weitere Ziele sind es, den Wissenszuwachs und die zunehmende Sicherheit der Pflegekräfte im Screeningprozess zu stärken sowie die Effekte langfristig aufrechtzuerhalten. Zusätzlich soll die Schulung in verschiedenen Settings etabliert und die Auswirkungen der Schulung in Bezug auf die Informiertheit und Zufriedenheit der Patient_innen mit dem Screeningprozess untersucht werden.

Selective Separation of Lithium, Magnesium and Calcium using 4-Phosphoryl Pyrazolones as pH-Regulated Receptors

Ensuring continuous and sustainable lithium supply requires the development of highly efficient separation processes such as LLE (liquid-liquid extraction) for both primary sources and certain waste streams. In this work, 4-phosphoryl pyrazolones are used in an efficient pH-controlled stepwise separation of Li⁺ from Ca²⁺ , Mg²⁺ , Na⁺ and K⁺ . The factors affecting LLE process, such as the substitution pattern of the extractant, diluent/water distribution, co-ligand, pH, and speciation of the metal complexes involved, were systematically investigated. The maximum extraction efficiency of Li⁺ at pH 6.0 was 94 % when Mg²⁺ and Ca²⁺ were previously separated at pH<5.0, proving that the separation of these ions is possible by simply modulating the pH of the aqueous phase. Our study points a way to separation of lithium from acid brine or from spent lithium ion battery leaching solutions, which supports the future supply of lithium in a more environmentally friendly and sustainable manner.

Highly Tunable 4-Phosphoryl Pyrazolone Receptors for Selective Rare-Earth Separation

Highly selective rare-earth separation has become increasingly important due to the indispensable role of these elements in various cutting-edge technologies including clean energy. However, the similar physicochemical properties of rare-earth elements (REEs) render their separation very challenging, and the development of new selective receptors for these elements is potentially of very considerable economic and environmental importance. Herein, we report the development of a series of 4-phosphoryl pyrazolone receptors for the selective separation of trivalent lanthanum, europium, and ytterbium as the representatives of light, middle, and heavy REEs, respectively. X-ray crystallography studies were employed to obtain solid-state structures across 11 of the resulting complexes, allowing comparative structure-function relationships to be probed, including the effect of lanthanide contraction that occurs along the series from lanthanum to europium to ytterbium and which potentially provides a basis for REE ion separation. In addition, the influence of ligand structure and lipophilicity on lanthanide binding and selectivity was systematically investigated via n-octanol/water distribution and liquid-liquid extraction (LLE) studies. Corresponding stoichiometry relationships between solid and solution states were well established using slope analyses. The results provide new insights into some fundamental lanthanide coordination chemistry from a separation perspective and establish 4-phosphoryl pyrazolone derivatives as potential practical extraction reagents for the selective separation of REEs in the future.

Surface ion-imprinted brewer's spent grain with low template loading for selective uranyl ions adsorption from simulated wastewater

Efficient removal of uranyl ions from wastewater requires excellent selectivity of the adsorbents. Herein, we report a new strategy using a high monomer/template molar ratio of 500:1 to prepare surface ion-imprinted brewer's spent grain (IIP-BSG) for selective U(VI) removal using binary functional monomers (2-hydroxyethyl methacrylate and diethyl vinylphosphonate) with high site accessibility and easy template removal. IIP-BSG exhibits a maximum U(VI) adsorption capacity of 165.7 mg/g, a high selectivity toward U(VI) in the presence of an excess amount of Eu(III) (Eu/U molar ratio = 20), a good tolerance of salinity, and a high reusability. In addition, mechanism studies have revealed electrostatic interaction and a coordination of uranyl ions by carboxyl and phosphoryl groups, the predominant contribution of high-energy (specific) sites during selective adsorption, and internal mass transfer as the rate-controlling step of U(VI) adsorption. Furthermore, IIP-BSG shows great potentials to separate U(VI) from lanthanides in simulated nuclear wastewater (pH₀ = 3.5) and selectively concentrate U(VI) from simulated mine water (pH₀ = 7.1). This study proves that the ion-imprinting effect can be achieved using a very low template amount with reduced production cost and secondary pollution, which benefits large-scale promotion of the ion-imprinted materials for selective uranyl ions removal.

One-pot synthesis of brewer's spent grain-supported superabsorbent polymer for highly efficient uranium adsorption from wastewater

High-efficient and fast adsorption of uranium is important to reduce the hazards caused by the uranium contamination of water environment due to the increased human activities. Herein, brewer's spent grain (BSG)-supported superabsorbent polymers (SAP) with different cross-linking densities are prepared as cheap and eco-friendly adsorbents for the first time via one-pot swelling and graft polymerization. A 7 wt% NaOH solution is used to swell BSG before grafting and subsequently neutralize the acrylic acid to control the reaction rate without producing alkaline wastewater. Compared with the traditional methods, swelling improves the grafting density and the utilization of raw materials due to the increased disorder degree of the BSG fibers. This results in the grafting of abundant carboxyl and amide groups onto the BSG backbone, forming a strongly hydrophilic polymer network of the BSG-SAP. Compared with the reference polymers without BSG, BSG-SAP presents higher adsorption capacity and enhanced reusability. The highly cross-linked BSG-SAP (BSG-SAP-H) shows an outstanding adsorption capacity of U(VI) (1465 mg/g at pH₀ = 4.6), a fast adsorption rate (81% of equilibrium adsorption capacity in 15 min), and a high selectivity in the presence of competing ions. Adsorption mechanism studies reveal the involvement of amide groups, a bidentate binding structure between UO₂²⁺ and the carboxyl groups, and a cation exchange between Na⁺ and UO₂²⁺. More importantly, the adsorption capacity of BSG-SAP-H reaches 254.4 mg/g in the fixed-bed column experiment at a low initial concentration (c₀(U) = 30 mg/L) and keeps 80% of the adsorption capacity after four cycles, indicating a great potential for uranium removal from wastewater. This work shows a suitable approach to explore the untreated biomass to prepare SAP with enhanced adsorption performance via a general and low-cost strategy.

[Removal of a bent femoral nail : Case report: treatment strategy of a complex femoral deformity with a bent femoral nail in situ since 36 years]

To remove a bent femoral nail is always a challenging task for a surgeon. In the last 20 years several case reports and descriptions of techniques are to be found in literature, the goal being to weaken the nail at the apex and then straightening it in situ in most cases. Those reports all have one parameter in common: the necessity to remove the nail relates to a refracture of the femur.We report the case of a patient who presented with the explicit wish to have a bent femoral nail removed and a femoral angulation corrected because of pain in the ipsilateral hip. A femoral fracture had been treated by a Küntscher nail in 1982. A refracture with severe bending of the nail had occurred a short time later, which was treated conservatively without a second surgical procedure.We can show that a planned removal of a bent and well-osseointegrated Küntscher nail can be achieved without complications and that thereby a multiplane angulation in the femur can be corrected, paving the way for a future arthroplasty in this specific case.

Insights at the molecular level into the formation of oxo-bridged trinuclear uranyl complexes

Reaction of 1,3,4,6-tetra-O-acetyl-N-(2-hydroxy)-naphthylidene glucosamine (HL(Ac)) with uranyl acetate in ethanol leads to formation of dinuclear [(UO₂)₂(L)₂] (1). In a second step 1 is quantitatively transferred into the trinuclear oxo-bridged complex [(UO₂)₃(μ₃-O)(L)₃]^2- (2^2-) via deprotonation and coordination of a water molecule. This transformation was followed by NMR and UV/Vis spectroscopy and it proved possible to selectively introduce ¹⁸O into the μ₃-bridge.

4-Phosphoryl Pyrazolones for Highly Selective Lithium Separation from Alkali Metal Ions

Effective receptors for the separation of Li⁺ from a mixture with other alkali metal ions under mild conditions remains an important challenge that could benefit from new approaches. In this study, it is demonstrated that the 4-phosphoryl pyrazolones, HL² -HL⁴ , in the presence of the typical industrial organophosphorus co-ligands tributylphosphine oxide (TBPO), tributylphosphate (TBP) and trioctylphosphine oxide (TOPO), are able to selectively recognise and extract lithium ions from aqueous solution. Structural investigations in solution as well as in the solid state reveal the existence of a series of multinuclear Li⁺ complexes that include dimers (TBPO, TBP) as well as rarely observed trimers (TOPO) and represent the first clear evidence for the synergistic role of the co-ligands in the extraction process. Our findings are supported by detailed NMR, MS and extraction studies. Liquid-liquid extraction in the presence of TOPO revealed an unprecedented high Li⁺ extraction efficiency (78 %) for HL⁴ compared to the use of the industrially employed acylpyrazolone HL¹ (15 %) and benzoyl-1,1,1-trifluoroacetone (52 %) extractants. In addition, a high selectivity for Li⁺ over Na⁺ , K⁺ and Cs⁺ under mild conditions (pH ∼8.2) confirms that HL² -HL⁴ represent a new class of ligands that are very effective extractants for use in lithium separation.

Recovering valuable metals from spent hydrodesulfurization catalyst via blank roasting and alkaline leaching

Spent hydrodesulfurization (HDS) catalysts, containing considerable amount of pollutants and metals including vanadium (V), molybdenum (Mo), aluminum (Al), and nickel (Ni), are considered as hazardous wastes which will result in not only ecosystem damage but also squandering resource. Herein, a process featuring blank roasting-alkaline leaching is proposed to recover spent HDS catalyst. During roasting, low-valence compounds convert to high-valence oxides which can be leached out by NaOH solution. Afterwards, leaching solution is subjected to crystallization to separate metals. The results show that for samples roasted at 650 °C, 97% V, 96% Mo, and 88% Al are leached out at optimal condition; for samples roasted at 1000 °C, selective leaching of 91% V and 96% Mo respectively, are realized, with negligible Al being dissolved. NiO is insoluble in strong alkali leaving in residue. The advantages of this process are that first, the leaching of V, Mo, and Al can be manipulated by controlling roasting conditions, providing flexible process design. Second, leaching solution can be fully recycled. Finally, mild leaching condition and clean separation of V, Mo, and Al is achieved, proving fundamental information for peer researches to facilitate their future research on the development of more efficient and cleaner technologies.

Recycling of Brewer's Spent Grain as a Biosorbent by Nitro-Oxidation for Uranyl Ion Removal from Wastewater

Developing biosorbents derived from agro-industrial biomass is considered as an economic and sustainable method for dealing with uranium-contaminated wastewater. The present study explores the feasibility of oxidizing a representative protein-rich biomass, brewer's spent grain (BSG), to an effective and reusable uranyl ion adsorbent to reduce the cost and waste generation during water treatment. The unique composition of BSG favors the oxidation process and yields in a high carboxyl group content (1.3 mmol/g) of the biosorbent. This makes BSG a cheap, sustainable, and suitable raw material independent from pre-treatment. The oxidized brewer's spent grain (OBSG) presents a high adsorption capacity of U(VI) of 297.3 mg/g (c 0(U) = 900 mg/L, pH = 4.7) and fast adsorption kinetics (1 h) compared with other biosorbents reported in the literature. Infrared spectra (Fourier transform infrared), 13C solid-state nuclear magnetic resonance spectra, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and thermogravimetric analysis were employed to characterize the biosorbents and reveal the adsorption mechanisms. The desorption and reusability of OBSG were tested for five cycles, resulting in a remaining adsorption of U(VI) of 100.3 mg/g and a desorption ratio of 89%. This study offers a viable and sustainable approach to convert agro-industrial waste into effective and reusable biosorbents for uranium removal from wastewater.

Saccharified Uranyl Ions: Self-Assembly of UO2 2+ into Trinuclear Anionic Complexes by the Coordination of Glucosamine-Derived Schiff Bases

The reaction of UO2 (OAc)2  ⋅ 2H2 O with the biologically inspired ligand 2-salicylidene glucosamine (H2 L1 ) results in the formation of the anionic trinuclear uranyl complex [(UO2 )3 (μ3 -O)(L1 )3 ]2- (12- ), which was isolated in good yield as its Cs-salt, [Cs]2 1. Recrystallization of [Cs]2 1 in the presence of 18-crown-6 led to formation of a neutral ion pair of type [M(18-crown-6)]2 1, which was also obtained for the alkali metal ions Rb+ and K+ (M=Cs, Rb, K). The related ligand, 2-(2-hydroxy-1-naphthylidene) glucosamine (H2 L2 ) in a similar procedure with Cs+ gave the corresponding complex [Cs(18-crown-6)]2 [(UO2 )3 (μ3 -O)(L2 )3 ([Cs(18-crown-6)]2 2). From X-ray investigations, the [(UO2 )3 O(Ln )3 ]2- anion (n=1, 2) in each complex is a discrete trinuclear uranyl species that coordinates to the alkali metal ion via three uranyl oxygen atoms. The coordination behavior of H2 L1 and H2 L2 towards UO2 2+ was investigated by NMR, UV/Vis spectroscopy and mass spectrometry, revealing the in situ formation of the 12- and 22- dianions in solution.

Coordination of trivalent lanthanum and cerium, and tetravalent cerium and actinides (An = Th(IV), U(IV), Np(IV)) by a 4-phosphoryl 1H-pyrazol-5-olate ligand in solution and the solid state

Structural investigations of three actinide(iv) 4-phosphoryl 1H-pyrazol-5-olate complexes (An = Th(iv), U(iv), Np(iv)) and their cerium(iv) analogue display the same metal coordination in the solid state. The mononuclear complexes show the metal centre in a square antiprismatic coordination geometry composed by the two O-donor atoms of four deprotonated ligands. Detailed solid state analysis of the U(iv) complex shows that dependent on the solvent used altered arrangements are observable, resulting in a change in the coordination polyhedron of the U(iv) metal centre to bi-capped trigonal prismatic. Further, single crystal analyses of the La(iii) and Ce(iii) complexes show that the ligand can also act as a neutral ligand by protonation of the pyrazolyl moiety. All complexes were comprehensively characterized by NMR, IR and Raman spectroscopy. A single resonance in each of the 31P NMR spectra for the La(iii), Ce(iii), Ce(iv), Th(iv) and Np(iv) complex indicates the formation of highly symmetric complex species in solution. Extended X-ray absorption fine structure (EXAFS) investigations provide evidence for the same local structure of the U(iv) and Np(iv) complex in toluene solution, confirming the observations made in the solid state.

[Movember health care initiative 2019: prostate cancer screening at the University Hospital Frankfurt]

Hintergrund

Männer in Deutschland sterben früher als Frauen und nehmen weniger häufig Krebsvorsorgeuntersuchungen wahr.

Fragestellung

Ziel war die prospektive Evaluation einer „Movember-Gesundheitsinitiative“ am Universitätsklinikum Frankfurt (UKF) im November 2019.

Methoden

Im Rahmen der „Movember-Gesundheitsinitiative“ wurde allen männlichen Mitarbeitern des UKF ab dem 45. Lebensjahr und bei erstgradiger familiärer Vorbelastung eines Prostatakarzinoms ab dem 40. Lebensjahr im November 2019 gemäß S3-Leitlinien der Deutschen Gesellschaft für Urologie (DGU) eine Prostatakarzinom-Vorsorgeuntersuchung angeboten.

Ergebnisse

Insgesamt nahmen 14,4 % der Mitarbeiter teil. Eine familiäre Vorbelastung gaben insgesamt 14,0 % Teilnehmer an. Das mediane Alter betrug 54 Jahre. Der mediane PSA(prostataspezifisches Antigen)-Wert lag bei 0,9 ng/ml, der mediane PSA-Quotient bei 30 %. Bei 5 % (n = 6) zeigte sich ein suspekter Tastbefund in der DRU (digital-rektale Untersuchung). Nach Altersstratifizierung (≤ 50 vs. > 50 Lebensjahre) zeigten sich signifikante Unterschiede im medianen PSA-Wert (0,7 ng/ml vs. 1,0 ng/ml, p < 0,01) und der bereits zuvor durchgeführten urologischen Vorsorge (12,1 vs. 42,0 %, p < 0,01). Vier Teilnehmer (3,3 %) zeigten erhöhte Gesamt-PSA-Werte. Bei 32,2 % der Teilnehmer zeigte sich mindestens ein kontrollbedürftiger Befund. Insgesamt wurden 6 Prostatabiopsien durchgeführt. Hierbei zeigte sich in einem Fall ein intermediate-risk Prostatakarzinom (Gleason 3 + 4, pT3a, pPn1, pNx, R0).

Schlussfolgerungung

Im Rahmen der UKF-Movember-Gesundheitsinitiative 2019 konnten durch ein Vorsorgeangebot 121 Männer für eine Prostatakrebs-Vorsorge inklusive PSA-Testung gewonnen werden. Auffällige/kontrollbedürftige Befunde zeigten sich bei 32,2 %. Bei einem Mitarbeiter wurde ein therapiebedürftiges Prostatakarzinom entdeckt und therapiert.

Mild hydrothermally treated brewer's spent grain for efficient removal of uranyl and rare earth metal ions

The increasing concerns on uranium and rare earth metal ion pollution in the environment require sustainable strategies to remove them from wastewater. The present study reports an eco-friendly approach to convert a kind of protein-rich biomass, brewer's spent grain (BSG), into effective biosorbents for uranyl and rare earth metal ions. The employed method reduces the energy consumption by performing the hydrothermal treatment at a significantly lower temperature (150 °C) than conventional hydrothermal carbonization. In addition, with the aid of the Maillard reaction between carbohydrates and proteins forming melanoidins, further activation processes are not required. Treatment at 150 °C for 16 h results in an altered biosorbent (ABSG) with increased content of carboxyl groups (1.46 mmol g⁻¹) and a maximum adsorption capacity for La³⁺, Eu³⁺, Yb³⁺ (pH = 5.7) and UO₂²⁺ (pH = 4.7) of 38, 68, 46 and 221 mg g⁻¹, respectively. Various characterization methods such as FT-IR, ¹³C CP/MAS NMR, SEM-EDX and STA-GC-MS analysis were performed to characterize the obtained material and to disclose the adsorption mechanisms. Aside from oxygen-containing functional groups, nitrogen-containing functional groups also contribute to the adsorption. These results strongly indicate that mild hydrothermal treatment of BSG could be applied as a greener, low-cost method to produce effective adsorbents for uranyl and rare earth metal ion removal.

Effective biosorbent ABSG is obtained via hydrothermal treatment of BSG at low temperature without activation, minimizing energy consumption and environmental impact.

MED13L-related intellectual disability: involvement of missense variants and delineation of the phenotype

Molecular anomalies in MED13L, leading to haploinsufficiency, have been reported in patients with moderate to severe intellectual disability (ID) and distinct facial features, with or without congenital heart defects. Phenotype of the patients was referred to "MED13L haploinsufficiency syndrome." Missense variants in MED13L were already previously described to cause the MED13L-related syndrome, but only in a limited number of patients. Here we report 36 patients with MED13L molecular anomaly, recruited through an international collaboration between centers of expertise for developmental anomalies. All patients presented with intellectual disability and severe language impairment. Hypotonia, ataxia, and recognizable facial gestalt were frequent findings, but not congenital heart defects. We identified seven de novo missense variations, in addition to protein-truncating variants and intragenic deletions. Missense variants clustered in two mutation hot-spots, i.e., exons 15-17 and 25-31. We found that patients carrying missense mutations had more frequently epilepsy and showed a more severe phenotype. This study ascertains missense variations in MED13L as a cause for MED13L-related intellectual disability and improves the clinical delineation of the condition.

Social Discrimination and Tolerance in Intergroup Relations: Reactions to Intergroup Difference

In this article, we present a theoretical approach to social discrimination on the one hand and intergroup relations characterized by tolerance and plurality on the other hand. Central to the analysis is the question of how members deal with intergroup difference. If the outgroup's difference is judged to be nonnormative and inferior, devaluation, discrimination, and hostility are likely responses toward the outgroup. Judging the outgroup's difference to be normative or positive leads to acceptance and appreciation of this group. Following self-categorization theory, the criteria—being norms and values for judging intergroup differences—are derived from the superordinate category that is perceived to include both groups. More specifically, they are derived from the prototype, or representation, of this inclusive category. Social discrimination results from the generalization of ingroup attributes to the inclusive category, which then become criteria for judging the outgroup. Tolerance, on the other hand, is conceptualized as either a lack of inclusion of both groups in a higher order category or as the representation of the inclusive category in such a way as to also include the other group and designate it as normative.

Exciton dynamics in perturbed vibronic molecular aggregates

A site specific perturbation of a photo-excited molecular aggregate can lead to a localization of excitonic energy. We investigate this localization dynamics for laser-prepared excited states. Changing the parameters of the electric field significantly influences the exciton localization which offers the possibility for a selective control of this process. This is demonstrated for aggregates possessing a single vibrational degree of freedom per monomer unit. It is shown that the effects identified for the molecular dimer can be generalized to larger aggregates with a high density of vibronic states.

Piperazine linked salicylaldoxime and salicylaldimine-based dicopper(ii) receptors for anions

The syntheses and single crystal X-ray analyses of five strapped salicylaldoxime/salicylaldimine based dicopper(ii) receptors utilising a new piperazine linker are described. The complexes form 2 + 2 metallocycles and the molecular structures of all four complexes possess a small internal cavity with the utilisation of a short piperazine linker. The molecular structures of complexes [Cu2(L(4) - H)(L(4) - 2H) ⊂ DMF]BF4·DMF, and [Cu2(L(4) - H)2Br]Br·1.25DMSO·H2O·MeOH, show that intramolecular H-bonding interactions due to the presence of -OH (oxime moiety) groups lead to a Pacman-like cleft arrangement of the two metal coordinating subunits in the metallo-macrocycle. The geometrical constraints brought about by this constrained cleft make the receptor coordinate strongly to a bromide anion involving both metal centres as evidenced by whereas in the larger tetrafluroborate anion is excluded. Absence of the oxime moiety around the metal coordination site of the ligand as demonstrated in the complexes [Cu2(L(5))2BF4](BF4)3, and [Cu2(L(5))2Br]Br3·2MeOH, resulted in less constrained dicopper(ii) helicate forms. For these complexes no anion size discrimination was observed. The addition of pyridine solvent to a slightly modified piperazine-linked ligand produces an expanded 3 + 3 tube-like tricopper complex [Cu3(L(4a) - H)3Py3](BF4)2·(MeOH)3·PF6·(H2O)3, , with two coordinated pyridine molecules occupying the newly formed cavity.

[Trabeculotomy Combined with Cataract Surgery in Glaucoma: Outcome in a Rural Setting]

Purpose: Intensive postoperative care is essential for the outcome of trabeculectomy. However, in a rural setting, repeated visits to the operating theatre are often not requested or possible. The objective of this study was to examine the outcome of trabeculotomy combined with cataract surgery in patients with glaucoma. Patients and Methods: 142 patients with glaucoma and cataract were included in a retrospective clinical study. All patients were operated on from November 2005 to December 2008 by a single surgeon and with a minimum follow-up of 2 months. Intraocular pressure (IOP), number of antiglaucomatous medications and surgical success rate were assessed at 2 months and at the longest follow-up (at least 1 year). Results: IOP was significantly reduced from 24.1 ± 8.3 mmHg preoperatively to 14.9 ± 3.3 mmHg at 2 months (p < 0.0001) and to 15.1 ± 3 mmHg at the longest follow-up (3.71 ± 1.5 years). The number of IOP-lowering medications was lowered from 1.35 ± 1 preoperatively to 0.73 ± 1 at the longest follow-up. Complete surgical success (no IOP-lowering medications, longest follow-up) was achieved in 51.3 % (IOP < 22 mmHg) and 47.5 % (IOP < 19 mmHg) of patients, respectively. Conclusions: Trabeculotomy combined with cataract surgery is a safe and effective surgical option to treat combined cataract and glaucoma without the need of intensified postoperative treatment.

Toward anticancer gold-based compounds targeting PARP-1: a new case study

A new gold(iii) complex bearing a 2-((2,2′-bipyridin)-5-yl)-1H-benzimidazol-4-carboxamide ligand has been synthesized and characterized for its biological properties in vitro.

Unique Occurrence of Cationic and Anionic Bis-1,2-diaminocyclohexane Copper(II) Units in a Double Complex Salt

The reaction of (±)-trans-diaminocyclohexane (dach) with copper(ii) sulfate in water resulted in the spontaneous formation of a double complex salt of type [Cu(dach)2(H2O)2][Cu(dach)2(SO4)2]·6H2O, whose X-ray structure confirmed the presence of the same square-planar Cu(dach)22+ coordination motif in both the complex cation and anion. Each copper centre adopts a Jahn–Teller-distorted octahedral geometry. Both axial positions of the metal centre in the complex cation are occupied by water molecules, whereas two monodentate sulfato ions occupy the corresponding sites in the complex anion, leading to a trans N4O2-donor coordination environment in each ion.

Which colours are seen by the patient during cataract surgery? Results of an intraoperative interview

PURPOSE

To discover what cataract patients see during phacoemulsification and if these light phenomena influence their anxiety levels during surgery.

METHODS

In all, 200 patients were interviewed intraoperatively at the Eye Hospital, Petrisberg, Trier, Germany. The quality of the visual experiences was described and if these were pleasant, neutral or unpleasant. Systemic sedation was noted.

RESULTS

Among 200 patients (209 eyes): 88 were men (91 eyes; 44%) and 112 were women (118 eyes; 56%). Median age (years): men (71), women (70). Mean operating time was 8 min. 49/209 (23%) were not anxious before and during surgery. 110/209 (52%) were more anxious before than during surgery, 50/209 (24%) were still anxious during surgery, 27/209 (13%) got sedation with midazolam (1-5 mg). Colours in descending order seen: blue, red, pink, yellow, green, purple, turquois, and orange. The most dominant colour combination was red/blue. Structures were seen by 162/209 (78%). Most (61%) intraoperative visual experiences were pleasant, 38% were neutral, and 1% found them transiently unpleasant. Three patients felt blinded by the light of the operating microscope.

CONCLUSIONS

The experience of colours and other light phenomena was pleasant for most patients during phacoemulsification under topical anaesthesia. They occur spontaneously when the patient is fixating on the operating light. They are not dependent on the individual or environment. Sedation only in 13%. Direct questioning for visual sensations by the operating surgeon may lead to less need for sedation and lead to less side effects for elderly and multimorbidity people postoperatively. The surgeon can use this knowledge to reassure patients during surgery.

Emergence of Chaotic Scattering in Ultracold Er and Dy

We show that for ultracold magnetic lanthanide atoms chaotic scattering emerges due to a combination of anisotropic interaction potentials and Zeeman coupling under an external magnetic field. This scattering is studied in a collaborative experimental and theoretical effort for both dysprosium and erbium. We present extensive atom-loss measurements of their dense magnetic Feshbach-resonance spectra, analyze their statistical properties, and compare to predictions from a random-matrix-theory-inspired model. Furthermore, theoretical coupled-channels simulations of the anisotropic molecular Hamiltonian at zero magnetic field show that weakly bound, near threshold diatomic levels form overlapping, uncoupled chaotic series that when combined are randomly distributed. The Zeeman interaction shifts and couples these levels, leading to a Feshbach spectrum of zero-energy bound states with nearest-neighbor spacings that changes from randomly to chaotically distributed for increasing magnetic field. Finally, we show that the extreme temperature sensitivity of a small, but sizable fraction of the resonances in the Dy and Er atom-loss spectra is due to resonant nonzero partial-wave collisions. Our threshold analysis for these resonances indicates a large collision-energy dependence of the three-body recombination rate.

[The Influence of Intravitreal Injections on Outpatient Cataract Operations in Germany]

PURPOSE

The number of outpatient operations in Germany is not registered in a centralised manner. To estimate the development of the outpatient intraocular surgery especially since the implementation of the intravitreal injections, surveys among ophthalmic surgeons were analysed.

METHODS

Between 2006 and 2013 surveys were done among ophthalmic surgeons in Germany using questionnaires. An average of 318 completed questionnaires were sent back. The mean participation ratio was 37 %.

RESULTS

Between 2006 and 2013 an extrapolated mean of 347 564 cataract operations and 139 946 intravitreal injections were reported. Whereas the number of cataract operations was constant in the observation period, the number of injections increased considerably from 35 135 in 2006 to 274 714 in 2013.

CONCLUSION

A saturation in the development of the numbers of the intravitreal injections could not yet be observed. Other outpatient operations, especially cataract procedures were not replaced by the increase of the injections in the recent years.

Selective Solvent Extraction of Silver(I) by Tris-Pyridyl Tripodal Ligands and X-Ray Structure of a Silver(I) Coordination Polymer Incorporating One Such Ligand

Two tripodal ligands, each derived from 1,1,1-tris(hydroxymethyl)ethane and terminated respectively by 4-pyridyl (L1) and 2-pyridyl groups (L2), have been synthesised. Competitive seven-metal extraction studies (H2O/CHCl3) incorporating equal concentrations of cobalt(ii), nickel(ii), copper(ii), zinc(ii), silver(i), cadmium(ii), and lead(ii) in the aqueous phase and L1 or L2 in the organic phase showed selective extraction of silver(i) in each case. A parallel solvent extraction experiment involving a related tripodal tris-pyridyl ligand (L3) based on a 1,3,5-substituted aryl ring scaffold and incorporating thioether sulfurs in each tripod arm also showed extraction selectivity for silver(i); extraction efficiencies towards this metal ion fall in the order L3 > L1 > L2. Physical data are in accord with L1 forming a capsule-like complex of type [Ag3L12]3+ in which silver ions link pairs of pyridyl groups from different ligands. In contrast, L2 yields a complex of type [Ag2L2(NO)3]n whose X-ray structure showed it to be a two-dimensional coordination polymer in which the three pyridyl donors of each L2 coordinate to three silver(i) centres, two of which are crystallographically distinct, with the centres also bonded to bidentate and/or bridging bidentate nitrato groups.

[Systematic analysis of the annual quality reports of the Federal Joint Committee with regard to cataract surgery]

BACKGROUND

Cataract is one of the most common diseases in ophthalmology. Up to now the only way to estimate the total number of carried out surgeries in Germany were the surveys done by DOG, BVA, DGII and BDOC or reports of the federal statistical office.

OBJECTIVES

Objective of this paper is to evaluate the annual quality reports of the Federal Joint Committee with a view to how the hospitals are participating in the nationwide comprehensive coverage concerning cataract surgery and if there is a continuing trend to more outpatient cataract surgeries in German eye hospitals.

MATERIAL AND METHODS

The number of outpatient and inpatient cataract surgeries included in the annual quality reports of 2006, 2008 and 2010 were put into relation with population density for every provincial state.

RESULTS

In 2006, 2008 and 2010 a total of 765,179 cataract surgeries were recorded. Median number of cataract surgeries per 1000 inhabitants showed an only slight increase (2006: 2.8; 2008 and 2010: 3.0; p = 0.82). The ratio of outpatient to inpatient surgeries showed only a slight increase from 0.84 (2006) to 0.86 (2010).

CONCLUSIONS

Lack of spatial and temporal variations imply that hospitals take a part in supplying the population with cataract surgery. There is no trend to more outpatient cataract surgeries at the moment. This implies that there might be a stable patient population that is not suitable for outpatient care.