Untersuchungen zur Wundheilung unter Verwendung von Wundauflagen aus Polyhydroxykieselsäureethylester

Die Firma Bayer hat resorbierbare Wundauflagen zur Untersuchung auf deren Wirksamkeit vorgestellt. Das Material besteht aus Polyhydroxykieselsäureethylester, anorganischen Kieselgelfasern. Der deutlichste Effekt, der sich im Wundmodell verglichen mit Wundauflagen aus Kollagen-Elastin-Verbänden sowie Fett-Gaze als Negativkontrolle darstellen ließ, war eine Verzögerung der Wundkontraktion. Wurden Wundauflagen in vierfacher Stärke aufgebracht, zeigten sich Verzögerungen der Wundkontraktion noch deutlicher und in geringerer Ausprägung auch bei Wundauflagen aus Kollagen-Elastin. Bei dieser Überdosierung zeigten sich unter den Kieselgelwundauflagen auch Wundheilungsstörungen mit Epitheldefekten, Fremdkörpergranulomen und Nekrosen. Die Fremdkörperriesenzellen ließen sich mit Antikörpern gegen Cathepsin-K darstellen. Vorteile gegenüber den etablierten Materialien besonders für die Therapie menschlicher mangeldurchbluteter Wunden können aus dieser Studie nicht abgeleitet werden

(Un)Specific advices. Reconstructing interactional patterns of instructors in school composition settings

Im aktuellen Diskurs um das Musik-Erfinden in pädagogischen Kontexten wird in Bezug auf die Initiierung und angemessene Begleitung dieser Prozesse ein grundlegendes Spannungsfeld thematisiert, in dem sich Anleitende zwischen der Notwendigkeit von Anleitung einerseits und der Wahrung der Eigenständigkeit der Schüler*innen andererseits verorten müssen. Wie genau eine Begleitung von Prozessen des Musik-Erfindens in der Praxis aussieht, stellt allerdings ein international konstatiertes Forschungsdesiderat dar. Das Projekt LinKo1 (BMBF 2016–2019) widmete sich diesem Desiderat und untersuchte Lehrendeninterventionen in schulischen und außerschulischen Prozessen des Musik-Erfindens in Kleingruppen. Im vorliegenden Beitrag sollen exemplarisch Interventionen in den Blick genommen werden, in denen Anleitende Anregungen geben. Dabei konnte ein fallübergreifendes Handlungsmuster des (Un-)Eindeutig-Bleibens rekonstruiert werden, in dem sich das beschriebene Spannungsverhältnis zeigt. (DIPF/Orig.)Music education research concerning composition has frequently discussed the instructor’s role of supporting and facilitating the learning process. Current publications have singled out the conflicting interests of necessary teacher guidance, on the one hand, and retaining learner autonomy, on the other hand, as a central dichotomy. Our empirical research in the project LinKo (BMBF 2016–2019) shows interactional patterns that correspond to this conflict focusing on the roles of teachers’ interventions in formal and informal group composition processes. This article will focus on the phenomenon of being “(un)specific,” which we illustrate with a videographical case study. (DIPF/Orig.

The impact of multivisceral liver resection on short- and long-term outcomes of patients with colorectal liver metastasis: A systematic review and meta-analysis

The impact of Multivisceral Liver Resection (MLR) on the outcome of patients with Colorectal Liver Metastasis (CRLM) is unclear. The present systematic review aimed to compare patients with CRLM who underwent MLR versus standard hepatectomy regarding short- and long-term outcomes. MLR is a feasible procedure but has a higher risk of major complications. MLR did not negatively affect long-term survival, suggesting that an extended resection is an option for potentially curative treatment for selected patients with CRLM

Two decades of liver resection with a multidisciplinary approach in a single institution: What has changed? Analysis of 1409 cases

Objectives: To evaluate results of patients undergoing liver resection in a single center over the past two decades with a particular look at Colorectal Liver Metastasis (CRLM) and Hepatocellular Carcinoma (HCC). Method: Patients were divided into two eras, from 2000 to 2010 (Era 1) and 2011 to 2020 (Era 2). The most frequent diagnosis was CRLM and HCC, with 738 (52.4%) and 227 (16.1%) cases respectively. An evaluation of all liver resection cases and a subgroup analysis of both CRLM and HCC were performed. Preoperative and per operative variables and long-term outcomes were evaluated. Results: 1409 liver resections were performed. In Era 2 the authors observed higher BMI, more: minimally invasive surgeries, Pringle maneuvers, and minor liver resections; and less transfusion, less ICU necessity, and shorter length of hospital stay. Severe complications were observed in 14.7% of patients, and 90-day mortality was 4.2%. Morbidity and mortality between eras were not different. From 738 CRLM resections, in Era 2 there were significantly more patients submitted to neoadjuvant chemotherapy, bilateral metastases, and smaller sizes with significantly less transfusion, the necessity of ICU, and shorter length of hospital stay. More pedicle clamping, minimally invasive surgeries, and minor resections were also observed. From 227 HCC resections, in Era 2 significantly more minimally invasive surgeries, fewer transfusions, less necessity of ICU, and shorter length of hospital stay were observed. OS was not different between eras for CRLM and HCC. Conclusions: Surgical resection in a multidisciplinary environment remains the cornerstone for the curative treatment of primary and metastatic liver tumors

Preoperative Inflammatory Markers as Prognostic Predictors After Hepatocellular Carcinoma Resection: Data From a Western Referral Center

BACKGROUND: Recent studies from eastern centers have demonstrate an association between inflammatory response and long-term outcomes after hepatocellular carcinoma (HCC) resection. However, the prognostic impact of inflammatory markers in western patients, with distinct tumor and epidemiologic features, is still unknown. AIM: To evaluate the prognostic impact of preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as well as their impact according to tumor size (\u3c 5 cm, 5-10 cm, \u3e 10 cm) in patients undergoing HCC resection with curative intent. METHODS: Optimal cut-off values for NLR, PLR, and MLR were determined by plotting the receiver operator curves. Overall survival (OS) and disease-free survival (DFS) curves were calculated using the Kaplan-Meier method and compared using the log-rank test. The Cox method was used to identify independent predictors of OS and DFS. RESULTS: In total, 161 consecutive adult patients were included. A high NLR (\u3e 1.715) was associated with worse OS (P = 0.018). High NLR (\u3e 2.475; P = 0.047) and PLR (\u3e 100.25; P = 0.028) were predictors of short DFS. In HCC \u3c 5 cm, MLR (\u3e 1.715) was associated with worse OS (P = 0.047). In the multivariate analysis, high PLR was an independent predictor of worse DFS [hazard ratio (HR) 3.029; 95%CI 1.499-6.121; P = 0.002]. CONCLUSION: Inflammatory markers are useful tools to predict long-term outcomes after liver resection in western patients, high NLR was able to stratify subgroups of patients with short OS and DFS, an increased PLR was an independent predictor of short DFS, while high MLR was associated with short OS in patients with early HCC

Modern secondary education and economic performance: the introduction of the Gewerbeschule and Realschule in nineteenth-century Bavaria

Do new school types focusing on practical and business-related knowledge lead to increased economic performance? To analyze this question, this paper examines the introduction of two types of modern secondary education, the Gewerbeschule and its successor, the Realschule, in nineteenth-century Bavaria. Since opening of these schools is arguably endogenous – as it were mainly the prosperous, big cities that opened one – the estimated treatment effect capturing the economic influence of the Gewerbeschule/Realschule will lead to biased results. To alleviate this bias, I adopt propensity score matching to compare relatively alike counties with and without these schools. Using historical county-level data on business formations, tax revenues, employment structure, and patent holdings, OLS regression analysis shows that the opening of a modern secondary school is in general positively associated with economic performance several years later

Education policy and its international dimension: theoretical approaches

The international dimension of education policies has been widely discussed in the last couple of years. This article argues that the activities of international agents involved in education policy formulation cannot be entirely and exclusively understood from a national perspective and, thus, should be studied as a discrete level of analysis. Questioning how we might best conceptualize this field of study, this paper presents three theoretical approaches - neoinstitutionalism/isomorphism, externalization, and the international regime theory. The focus here is laid on the analysis of international education policy based on international regime theory.A dimensão internacional das políticas públicas de educação tem sido bastante discutida nos últimos anos. Este artigo argumenta que as atividades dos agentes internacionais no domínio das políticas da educação não podem ser compreendidas inteira e exclusivamente a partir da perspectiva nacional e, por isso, devem ser estudadas em um nível distinto de análise. Questionando como melhor conceituar teoricamente esse campo de estudo, o artigo apresenta três abordagens teóricas: neoinstitucionalismo/ isomorfia, externalização e teoria do regime internacional. O foco dessa contribuição está centrado na análise da política internacional da educação a partir do último conceito indicado