German Total Ankle Replacement Register of the German Foot and Ankle Society (D. A. F.) - presentation of design and reliability of the data as well as first results

INTRODUCTION Even though arthroplasty of the ankle joint is considered to be an established procedure, only about 1,300 endoprostheses are implanted in Germany annually. Arthrodeses of the ankle joint are performed almost three times more often. This may be due to the availability of the procedure - more than twice as many providers perform arthrodesis - as well as the postulated high frequency of revision procedures of arthroplasties in the literature. In those publications, however, there is often no clear differentiation between revision surgery with exchange of components, subsequent interventions due to complications and subsequent surgery not associated with complications. The German Orthopaedic Foot and Ankle Association's (D. A. F.) registry for total ankle replacement collects data pertaining to perioperative complications as well as cause, nature and extent of the subsequent interventions, and postoperative patient satisfaction. MATERIAL AND METHODS The D. A. F.'s total ankle replacement register is a nation-wide, voluntary registry. After giving written informed consent, the patients can be added to the database by participating providers. Data are collected during hospital stay for surgical treatment, during routine follow-up inspections and in the context of revision surgery. The information can be submitted in paper-based or online formats. The survey instruments are available as minimum data sets or scientific questionnaires which include patient-reported outcome measures (PROMs). The pseudonymous clinical data are collected and evaluated at the Institute for Evaluative Research in Medicine, University of Bern/Switzerland (IEFM). The patient-related data remain on the register's module server in North Rhine-Westphalia, Germany. The registry's methodology as well as the results of the revisions and patient satisfaction for 115 patients with a two year follow-up period are presented. Statistical analyses are performed with SAS™ (Version 9.4, SAS Institute, Inc., Cary, NC, USA). RESULTS About 2½ years after the register was launched there are 621 datasets on primary implantations, 1,427 on follow-ups and 121 records on re-operation available. 49 % of the patients received their implants due to post-traumatic osteoarthritis, 27 % because of a primary osteoarthritis and 15 % of patients suffered from a rheumatic disease. More than 90 % of the primary interventions proceeded without complications. Subsequent interventions were recorded for 84 patients, which corresponds to a rate of 13.5 % with respect to the primary implantations. It should be noted that these secondary procedures also include two-stage procedures not due to a complication. "True revisions" are interventions with exchange of components due to mechanical complications and/or infection and were present in 7.6 % of patients. 415 of the patients commented on their satisfaction with the operative result during the last follow-up: 89.9 % of patients evaluate their outcome as excellent or good, 9.4 % as moderate and only 0.7 % (3 patients) as poor. In these three cases a component loosening or symptomatic USG osteoarthritis was present. Two-year follow-up data using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Scale (AOFAS-AHS) are already available for 115 patients. The median AOFAS-AHS score increased from 33 points preoperatively to more than 80 points three to six months postoperatively. This increase remained nearly constant over the entire two-year follow-up period. CONCLUSION Covering less than 10 % of the approximately 240 providers in Germany and approximately 12 % of the annually implanted total ankle-replacements, the D. A. F.-register is still far from being seen as a national registry. Nevertheless, geographical coverage and inclusion of "high-" (more than 100 total ankle replacements a year) and "low-volume surgeons" (less than 5 total ankle replacements a year) make the register representative for Germany. The registry data show that the number of subsequent interventions and in particular the "true revision" procedures are markedly lower than the 20 % often postulated in the literature. In addition, a high level of patient satisfaction over the short and medium term is recorded. From the perspective of the authors, these results indicate that total ankle arthroplasty - given a correct indication and appropriate selection of patients - is not inferior to an ankle arthrodesis concerning patients' satisfaction and function. First valid survival rates can be expected about 10 years after the register's start.

Multifunctional Coordination Compounds: Design and Properties

Cleverly designed molecular building blocks provide chemists with the tools of a powerful molecular-scale construction set. They enable them to engineer materials having a predictable order and useful solid-state properties. Hence, it is in the realm of supramolecular chemistry to follow a strategy for synthesizing materials which combine a selected set of properties, for instance from the areas of magnetism, photophysics and electronics. As a successful approach, host/guest solids which are based on extended anionic, homo- and bimetallic oxalato-bridged transition-metal compounds with two-and three-dimensional connectivities have been investigated. In this report, a brief review is given on the structural aspects of this class of compounds followed by a presentation of a thermal and magnetic study for two distinct, heterometallic oxalato-bridged layer compounds.

The ring vaccination trial: a novel cluster randomised controlled trial design to evaluate vaccine efficacy and effectiveness during outbreaks, with special reference to Ebola

A World Health Organization expert meeting on Ebola vaccines proposed urgent safety and efficacy studies in response to the outbreak in West Africa. One approach to communicable disease control is ring vaccination of individuals at high risk of infection due to their social or geographical connection to a known case. This paper describes the protocol for a novel cluster randomised controlled trial design which uses ring vaccination.In the Ebola ça suffit ring vaccination trial, rings are randomised 1:1 to (a) immediate vaccination of eligible adults with single dose vaccination or (b) vaccination delayed by 21 days. Vaccine efficacy against disease is assessed in participants over equivalent periods from the day of randomisation. Secondary objectives include vaccine effectiveness at the level of the ring, and incidence of serious adverse events.Ring vaccination trials are adaptive, can be run until disease elimination, allow interim analysis, and can go dormant during inter-epidemic periods.

Planning and reporting of quality-of-life outcomes in cancer trials.

BACKGROUND Information about the impact of cancer treatments on patients' quality of life (QoL) is of paramount importance to patients and treating oncologists. Cancer trials that do not specify QoL as an outcome or fail to report collected QoL data, omit crucial information for decision making. To estimate the magnitude of these problems, we investigated how frequently QoL outcomes were specified in protocols of cancer trials and subsequently reported. DESIGN Retrospective cohort study of RCT protocols approved by six research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003. We compared protocols to corresponding publications, which were identified through literature searches and investigator surveys. RESULTS Of the 173 cancer trials, 90 (52%) specified QoL outcomes in their protocol, 2 (1%) as primary and 88 (51%) as secondary outcome. Of the 173 trials, 35 (20%) reported QoL outcomes in a corresponding publication (4 modified from the protocol), 18 (10%) were published but failed to report QoL outcomes in the primary or a secondary publication, and 37 (21%) were not published at all. Of the 83 (48%) trials that did not specify QoL outcomes in their protocol, none subsequently reported QoL outcomes. Failure to report pre-specified QoL outcomes was not associated with industry sponsorship (versus non-industry), sample size, and multicentre (versus single centre) status but possibly with trial discontinuation. CONCLUSIONS About half of cancer trials specified QoL outcomes in their protocols. However, only 20% reported any QoL data in associated publications. Highly relevant information for decision making is often unavailable to patients, oncologists, and health policymakers.

Design and Implementation of a Laparoscope Calibration Method for Augmented Reality Navigation

Intraoperative laparoscopic calibration remains a challenging task. In this work we present a new method and instrumentation for intraoperative camera calibration. Contrary to conventional calibration methods, the proposed technique allows intraoperative laparoscope calibration from single perspective observations, resulting in a standardized scheme for calibrating in a clinical scenario. Results show an average displacement error of 0.52 ± 0.19 mm, indicating sufficient accuracy for clinical use. Additionally, the proposed method is validated clinically by performing a calibration during the surgery.

Na 1 Nachlass Max Horkheimer, 270 - Korrespondenzen mit Ludwig von Friedeburg (p. V 71, 45-218)

58 Briefe zwischen dem Professor Ludwig von Friedeburg (Kultusminister) und Max Horkheimer, 1953-1973; Gutachten über die Habilitationsschrift von Friedeburg 1959 (Blatt 53-66); Antrittsvorlesung von Friedeburg: "Universität und Öffentlichkeit" 1967 (Blatt 159-173); Sonderdrucke und Fragebogen;

Fragm. lat. V 27 - Liber sex principiorum

Trägerbände: Inc. fol. 173 Bd. 6, Inc. qu. 1250, Inc. oct. 29 Bd. 1, Inc. oct. 238; Vorbesitzer: Dominikanerkloster Frankfurt am Main

La planificación ambiental estratégica en los instrumentos de ordenamiento territorial. Caso de estudio: el Plan Regulador Intercomunal del Alto Aconcagua (PRIAA), provincias de San Felipe y Los Andes, V Región, Valparaíso, Chile

El artículo presenta la aplicación de un modelo de Planificación Ambiental Estratégica al diseño de un Plan de Ordenamiento Territorial en la zona de estudio, cuyo territorio se caracteriza por poseer un significativo patrimonio ambiental en términos de recursos naturales, paisaje, historia, etc. Junto a lo anterior, muestra un fuerte dinamismo económico por su localización en relación a la Macrozona Central de Chile, el Mercosur y el futuro corredor bioceánico. El objetivo fue diseñar una metodología que permitiera incorporar la dimensión ambiental en cada en cada una de las etapas características de elaboración de un Plan Regulador. El estudio ambiental se baso en tres etapas: diagnóstico ambiental, evaluación ambiental de alternativas y definición del proyecto, para lo cual se desarrollaron metodologías especificas apoyadas en sistemas de información geográfica (SIG) y modelos de simulación. La aplicación del modelo de planificación ambiental estratégica permitió obtener un Plan territorial con zonas y ordenanzas que protejan el patrimonio ambiental existente y aminore los impactos ambientales negativos de futuras actividades que se instalen en un territorio.

Manganese nodules recovered by R/V Vityaz expedition

Uranium, radium, thorium and ionium were determined directly on seven concretions from three stations in the Indian Ocean, and on two concretions and a manganese-rich crust from two stations in the Pacific Ocean. The uranium content averages 3 to 5 gamma/g and the thorium content varies only slightly, but the Th/U ratio in the concretions is typically 2 to 5 in the Indian Ocean and 5 to 15.5 in the Pacific. The ionium content ranges from 1.0 x 10-9 to 3.6 10**-9 g/g in concretions from both oceans. Radium is more abundant in specimens from the Pacific Ocean (Ra = 3 - 12.7 x 10**-11 g/g) than from the Indian Ocean (1.5 - 5.2 x 10**-11 g/g). Analyses for Ca, Mn, Fe, Si, Ni, P, and ignition loss are also given. Radioactive equilibria between uranium, ionium, and radium are strongly disturbed throughout the concretions, and the RA/U and lo/U ratios generally exceed equilibrium ratios. Migration of radium from interior layers was established, so that neither determination of the ages of the concretions nor of their rates of growth can be considered reliable. The age of the concretions cannot exceed 800,000 years, and all grew within relatively short periods of time; there may have been "dormant" periods during growth. Estimates of growth rates are calculated from the radium and ionium contents; they show marked discordance.

Whole-rock geochemistry of amphibolites and metagabbros from ODP Holes 173-1067A and 173-1068A

The Leg 173 Site 1067 and 1068 amphibolites and metagabbros from the west Iberia margin exhibit variable whole-rock compositions from primitive to more evolved (Mg numbers = 49-71) that are generally incompatible trace and rare earth element enriched (light rare earth element [LREE] = 11-89 x chondrite). The Site 1067 amphibolites are compositionally similar to the basalts reported at Site 899 from this same region, based on trace and rare earth element contents. The Site 1068 amphibolites and metagabbros are similar to the Site 899 diabases but are more LREE enriched. However, the Sites 1067 and 1068 amphibolites and metagabbros are not compositionally similar to the Site 900 metagabbros, which are from the same structural high as the Leg 173 samples. The Leg 173 protoliths may be represented by basalts, diabases, and/or fine-grained gabbros that formed from incompatible trace element-enriched liquids.

Natural fluctuations and gradients in the experimental design:research bias in the field of ocean acidification

These data form the basis of an analysis of a prevalent research bias in the field of ocean acidification, notably the ignoring of natural fluctuations and gradients in the experimental design. The data are extracted from published work and own experiments.