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ZusammenfassungDie biostatistische Bewertung DNA-analytischer Befunde unterstützt Gerichte bei der Einschätzung des Beweiswertes einer Spur. In der Praxis werden dabei zunehmend Spuren mit minimaler DNA-Menge und möglichen „Drop-in“- und „Drop-out“-Ereignissen sowie komplexe Mischspuren analysiert. Solche Spuren sind mit einer klassischen „binären“ Berechnung biostatistisch häufig nicht oder nur eingeschränkt bewertbar.Die Entwicklung vollkontinuierlicher Modelle (VKM) macht eine Vielzahl dieser bisher nicht berechenbaren Spuren einer biostatistischen Bewertung zugänglich. Dabei werden nahezu sämtliche verfügbaren Informationen einer DNA-Spur in die Berechnung einbezogen. Während diese probabilistischen Verfahren international bereits vielfach zum Einsatz kommen, liegen hierzu im deutschsprachigen Raum nur wenige Erfahrungen vor.Um Funktionsweise, Möglichkeiten und Grenzen von VKM-Berechnungen zu erfassen, wurden Mischspuren bekannter Zusammensetzung mit 4 aktuell verfügbaren VKM-Programmen vergleichend analysiert. Bei der Auswertung wurden zentrale Aspekte betrachtet, wie beispielsweise die Konkordanz von Berechnungsergebnissen, der Einfluss von Drop-in- und Drop-out-Ereignissen auf die berechneten vollkontinuierlichen LR-Werte (LRfc) sowie die Ableitung recherchefähiger DNA-Profile mithilfe wahrscheinlichkeitsbasierter Prognosen (Deconvolution).Die im Rahmen dieser Arbeit gewonnenen Erfahrungen bilden, zusammen mit weiteren bereits international publizierten Studien, eine Basis für Empfehlungen zum Einsatz von VKM-basierter Software bei der biostatistischen Bewertung DNA-analytischer Befunde.

ZusammenfassungDie biostatistische Bewertung DNA-analytischer Befunde unterstützt Gerichte bei der Einschätzung des Beweiswertes hinsichtlich einer möglichen Spurenbeteiligung durch eine zu betrachtende Person (engl. „Person Of Interest“; POI). Um die Vergleichbarkeit derartiger Berechnungen auf Grundlage etablierter wissenschaftlicher Standards zu gewährleisten, wurden bereits in der Vergangenheit entsprechende Empfehlungen im nationalen Konsens formuliert.Mit Einführung sog. vollkontinuierlicher Modelle (VKM) für die probabilistische Genotypisierung, die u. a. die Signalintensitäten eines Elektropherogramms berücksichtigen, wurde eine Ergänzung zu den damaligen Empfehlungen erforderlich. VKM erlauben eine biostatistische Bewertung von Spuren mit möglichen Drop-in- und Drop-out-Ereignissen und wahrscheinlichkeitsbasierte Prognosen der zu einer Mischspur beitragenden Genotypen („Deconvolution“).Die vorliegende Veröffentlichung enthält Empfehlungen zum Einsatz VKM-basierter Software und zur Berichterstattung vollkontinuierlicher LR-Werte (engl. „Fully Continuous Likelihood Ratios“; LRfc). Sie empfiehlt bei schwierig zu interpretierenden Befunden eine VKM-Berechnung zur Bewertung einer Spurenlegerschaft. Die VKM-Berechnung ersetzt die bisher in Ausnahmefällen als hinnehmbar erachtete Vorgehensweise einer binären Berechnung unter Ausklammern einzelner Merkmalssysteme. Der Einsatz von VKM erfordert eine umfassende Anwenderschulung sowie eine Validierung und Verifizierung gemäß den Vorgaben der Programmanbieter. Mit der Empfehlung von LRfc-Schwellenwerten soll eine sichere, vergleichbare Anwendung von VKM gewährleistet werden.

ZusammenfassungDie forensische DNA-Analyse hat sich in den letzten Jahrzehnten mit zunehmender Sensitivität und gleichzeitiger Standardisierung der Methodik zu einem festen Bestandteilteil der Strafverfolgung entwickelt. Dank der ständigen Verbesserung der Analysemethoden ist es zwischenzeitlich nahezu selbstverständlich, immer kleinere, latente DNA-Spuren erfolgreich zu typisieren. Dies führt mehr und mehr zu einer Verlagerung der Sachverständigentätigkeit in die Bewertung komplexer Spurenszenarien im Rahmen einer Hauptverhandlung: Anstelle der Zuordnung einer Spur zu einer Person rückt die Spurenentstehung bzw. die Möglichkeit eines DNA-Transfers ohne Bezug zu einer strafrechtlich relevanten Handlung in den Fokus der Diskussion. Aus Sicht der Deutschen Spurenkommission erscheint es notwendig, das Bewusstsein für mögliche alternative Szenarien zur Spurenentstehung zu schärfen. Zur Einordnung eines DNA-Ergebnisses in den Kontext der übrigen Sachbeweise eines konkreten Fallszenarios wird im vorliegenden Beitrag das bereits in der internationalen Fachliteratur seit geraumer Zeit etablierte Konzept der „Hierarchie der Hypothesen“ vorgestellt. Darüber hinaus werden die wissenschaftlichen Grundlagen zur Bewertung alternativer Szenarien des DNA-Transfers erläutert und gleichzeitig die Möglichkeiten und Grenzen einer gutachterlichen Stellungnahme dargestellt.

Carbon xerogels were synthesized using a soft-template route with resorcinol as the carbon source and sodium carbonate as the catalyst. The influence of the resorcinol to catalyst ratio in the range of 500–20,000 on pore structure, graphitic domains, and electronic conductivity of as-prepared carbon xerogels, as well as their performance in an aluminium ion battery (AIB), was investigated. After carbonization steps of the polymers up to 800 °C, all carbon samples exhibited similar specific volumes of micropores (0.7–0.8 cm³ g−1), while samples obtained from mixtures with R/C ratios lower than 2000 led to carbon xerogels with significantly higher mesopore diameters up to 6 nm. The best results, in terms of specific surface (1000 m² g−1), average pore size (6 nm) and reversible capacity in AIB cell (28 mAh g−1 @ 0.1 A g−1), were obtained with a carbon xerogel sample synthetized at a resorcinol to catalyst ratio of R/C = 500 (CXG500). Though cyclic voltammograms of carbon xerogel samples did not exhibit any sharp peaks in the applied potential window, the presence of both oxidation and a quite wide reduction peak in CXG500–2000 cyclic voltammograms indicated pseudocapacitance behaviour induced by diffusion-controlled intercalation/de-intercalation of AlCl4− ions into/from the carbon xerogel matrix. This was confirmed by shifting of the (002) peak towards lower 2θ angle values in the XRD pattern of the CXG500 electrode after the charging step in AIB, whereas the contribution of pseudocapacitance, calculated from half-cell measurements, was limited to only 6% of overall capacitance.

BackgroundAugmented reality (AR) is a technology that integrates digital information into the user’s real-world environment. It offers a new approach for treatments and education in medicine. AR aids in surgery planning and patient treatment and helps explain complex medical situations to patients and their relatives. ObjectiveThis systematic and bibliographic review offers an overview of the development of apps in AR with a medical use case from March 2012 to June 2017. This work can aid as a guide to the literature and categorizes the publications in the field of AR research. MethodsFrom March 2012 to June 2017, a total of 1309 publications from PubMed and Scopus databases were manually analyzed and categorized based on a predefined taxonomy. Of the total, 340 duplicates were removed and 631 publications were excluded due to incorrect classification or unavailable technical data. The remaining 338 publications were original research studies on AR. An assessment of the maturity of the projects was conducted on these publications by using the technology readiness level. To provide a comprehensive process of inclusion and exclusion, the authors adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. ResultsThe results showed an increasing trend in the number of publications on AR in medicine. There were no relevant clinical trials on the effect of AR in medicine. Domains that used display technologies seemed to be researched more than other medical fields. The technology readiness level showed that AR technology is following a rough bell curve from levels 4 to 7. Current AR technology is more often applied to treatment scenarios than training scenarios. ConclusionsThis work discusses the applicability and future development of augmented- and mixed-reality technologies such as wearable computers and AR devices. It offers an overview of current technology and a base for researchers interested in developing AR apps in medicine. The field of AR is well researched, and there is a positive trend in its application, but its use is still in the early stages in the field of medicine and it is not widely adopted in clinical practice. Clinical studies proving the effectiveness of applied AR technologies are still lacking.

BACKGROUND Augmented reality (AR) is a technology that integrates digital information into the user’s real-world environment. It offers a new approach for treatments and education in medicine. AR aids in surgery planning and patient treatment and helps explain complex medical situations to patients and their relatives. OBJECTIVE This systematic and bibliographic review offers an overview of the development of apps in AR with a medical use case from March 2012 to June 2017. This work can aid as a guide to the literature and categorizes the publications in the field of AR research. METHODS From March 2012 to June 2017, a total of 1309 publications from PubMed and Scopus databases were manually analyzed and categorized based on a predefined taxonomy. Of the total, 340 duplicates were removed and 631 publications were excluded due to incorrect classification or unavailable technical data. The remaining 338 publications were original research studies on AR. An assessment of the maturity of the projects was conducted on these publications by using the technology readiness level. To provide a comprehensive process of inclusion and exclusion, the authors adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS The results showed an increasing trend in the number of publications on AR in medicine. There were no relevant clinical trials on the effect of AR in medicine. Domains that used display technologies seemed to be researched more than other medical fields. The technology readiness level showed that AR technology is following a rough bell curve from levels 4 to 7. Current AR technology is more often applied to treatment scenarios than training scenarios. CONCLUSIONS This work discusses the applicability and future development of augmented- and mixed-reality technologies such as wearable computers and AR devices. It offers an overview of current technology and a base for researchers interested in developing AR apps in medicine. The field of AR is well researched, and there is a positive trend in its application, but its use is still in the early stages in the field of medicine and it is not widely adopted in clinical practice. Clinical studies proving the effectiveness of applied AR technologies are still lacking.

Recently, rechargeable aluminum batteries have received much attention due to their low cost, easy operation, and high safety. As the research into rechargeable aluminum batteries with a room-temperature ionic liquid electrolyte is relatively new, research efforts have focused on finding suitable electrode materials. An understanding of the environmental aspects of electrode materials is essential to make informed and conscious decisions in aluminum battery development. The purpose of this study was to evaluate and compare the relative environmental performance of electrode material candidates for rechargeable aluminum batteries with an AlCl3/EMIMCl (1-ethyl-3-methylimidazolium chloride) room-temperature ionic liquid electrolyte. To this end, we used a lifecycle environmental screening framework to evaluate 12 candidate electrode materials. We found that all of the studied materials are associated with one or more drawbacks and therefore do not represent a “silver bullet” for the aluminum battery. Even so, some materials appeared more promising than others did. We also found that aluminum battery technology is likely to face some of the same environmental challenges as Li-ion technology but also offers an opportunity to avoid others. The insights provided here can aid aluminum battery development in an environmentally sustainable direction.

Porphyromonas gingivalis and Tannerella forsythia secrete proteases, gingipains and KLIKK-proteases. In addition, T. forsythia produces a serpin (miropin) with broad inhibitory spectrum. The aim of this pilot study was to determine the level of expression of miropin and individual proteases in vivo in periodontal and peri-implant health and disease conditions. Biofilm and gingival crevicular fluid (GCF)/ peri-implant sulcular fluid (PISF) samples were taken from healthy tooth and implant sites (n = 10), gingivitis and mucositis sites (n = 12), and periodontitis and peri-implantitis sites (n = 10). Concentration of interleukin-8 (IL-8), IL-1β and IL-10 in GCF was determined by enzyme-linked immunosorbent assay. Loads of P. gingivalis and T. forsythia and the presence of proteases and miropin genes were assessed in biofilm by quantitative PCR, whereas gene expression was estimated by quantitative RT-PCR. The presence of P. gingivalis and T. forsythia, as well as the level of IL-8 and IL-1β, were associated with disease severity in the periodontal and peri-implant tissues. In biofilm samples harboring T. forsythia, genes encoding proteases were found to be present at 72.4% for karilysin and 100% for other KLIKK-protease genes and miropin. At the same time, detectable mRNA expression of individual genes ranged from 20.7% to 58.6% of samples (for forsylisin and miropsin-1, respectively). In comparison with the T. forsythia proteases, miropin and the gingipains were highly expressed. The level of expression of gingipains was associated with those of miropin and certain T. forsythia proteases around teeth but not implants. Cumulatively, KLIKK-proteases and especially miropin, might play a role in pathogenesis of both periodontal and peri-implant diseases.

Ist die Ausblendung von Menschen mit Behinderung aus der Wirtschaftswerbung noch zeitgemas oder ist es an der Zeit, die Chancen und Risiken dieser umstrittenen Kommunikationsstrategie neu zu bewerten? Im Rahmen einer von der Universitat Trier durchgefuhrten Studie wurden die Teilnehmer u. a. gebeten, einige eigens fur diese Untersuchung konzipierte (also fiktive) Werbeanzeigen zur vorliegenden Thematik zu bewerten. Die in diesem Beitrag diskutierten Ergebnisse legen nahe, dass die Urteile der behinderten versus nicht behinderten Befragten weit ahnlicher ausfielen, als im Vorfeld zu erwarten war. Dies konnte zwar dafur sprechen, die Bedenken Werbender (das heist die Angst vor negativen Zuschauerreaktionen) zu relativieren. Doch so lange dies angesichts der Fast-Unsichtbarkeit des Phanomens nur auf der theoretischen Ebene der Fall sein kann, gestalten sich konkrete Erfolgsprognosen zu Werbung mit Behinderung nach wie vor schwierig. English Michael Jackel/Martin Eckert: Provocative, Stigmatizing – or Simply Normal? In advertising disabilities are hardly existent. Fictional examples explain the effect. Is the invisibility of persons with disabilities in commercial advertising still in keeping with the times or has the time come to re-assess the opportunities and risks of this controversial communication strategy? In the course of a study conducted by the University Trier, the participants were asked to evaluate promotional advertisements specially designed for this research project (thereby fictional), featuring disabled persons. The results discussed in this article reveal that the preferences of disabled and non-disabled respondents were remarkably more similar than expected. These findings may suggest that the main concerns of some advertisers (for example the fear of negative consumer reactions) may have to be reconsidered. However, currently these conclusions are primarily restricted to a theoretical level due to the lack of real ads dealing with disabilities. Thus, further statements concerning the general prospects of success of this marketing strategy may still prove difficult.

Periodontal inflammation is one of the most common chronic inflammatory conditions in humans. Despite recent advances in identifying and characterizing oral microbiota dysbiosis in the pathogenesis of gum disease, just how host factors maintain a healthy homeostatic oral microbial community or prevent the development of a pathogenic oral microbiota remains poorly understood. An important determinant of microbiota fate is local antimicrobial proteins. Here, we report that chemoattractant protein chemerin, which we recently identified as a potent endogenous antimicrobial agent in body barriers such as the skin, is present in the oral cavity under homeostatic and inflammatory conditions. Chemerin and a chemerin-derived antimicrobial peptide are bactericidal against select bacteria strategically positioned in dental biofilm. Gingival crevicular samples from patients with gingivitis but not periodontitis contain abundant bioactive chemerin capable of inducing CMKLR1-dependent leukocyte migration. Gingipains secreted by the periodontopathogen P. gingivalis inactivate chemerin. Together, these data suggest that as an antimicrobial agent and leukocyte chemoattractant, chemerin likely contributes to antimicrobial immune defense in the oral cavity.

Display Omitted Tool that bridges the gap between different domains.Clinical trial centred search with simplified access and reduced search time.Intuitive and can be used by researchers without prior training.Access multiple data sources via one graphical interface. For research in biomedical sciences, cross-domain searches through several different databases are an increasingly necessary task that often becomes a time consuming and labour-intense process. This is especially the case when different domain databases have to be combined, for example combined searches in clinical trials registries, publication databases and research databases. The Clinical Trial Information Mediator (CTIM) addresses this problem and offers a novel way for the combined search in ClinicalTrials.gov, PubMed and BioSamples.CTIM was developed based on a requirements analysis and implemented using open source technology. A search engine with a graphical user interface was developed in order to search linked data in the three databases ClinicalTrials.gov, PubMed and BioSamples; thereby enabling CTIM to bridge the gap between different knowledge domains of clinical trials, publications of research results and biosamples/genetic information. CTIM was applied in three use cases demonstrating that information retrieval could be considerably improved in sense for complex queries. These use cases show that more relevant results were obtained and more associated publications and biosamples could be retrieved in comparison to a separate single search.Main advantages of CTIM are identifying related information between clinical trials and publications employing a clinical trial centred kind of search, simplified access to its databases and thus reduced search time. In addition it can be used by researchers without prior training because of the intuitive usage.

This work reports on the synthesis of layered manganese oxides (&delta, MnO2) and their possible application as cathode intercalation materials in Al-ion and Zn-ion batteries. By using a one-pot microwave-assisted synthesis route in 1.6 M KOH (MnVII:MnII = 0.33), a pure layered &delta, MnO2 birnessite phase without any hausmannite traces was obtained after only a 14 h reaction time period at 110 &deg, C. Attempts to enhance crystallinity level of as-prepared birnessite through increasing of reaction time up to 96 h in 1.6 M KOH failed and led to decreases in crystallinity and the emergence of an additional hausmannite phase. The influence of MnII:OH&minus, ratio (1:2 to 1:10) on phase crystallinity and hausmannite phase formation for 96 h reaction time was investigated as well. By increasing alkalinity of the reaction mixture up to 2.5 M KOH, a slight increase in crystallinity of birnessite phase was achieved, but hausmannite formation couldn&rsquo, t be inhibited as hoped. The as-prepared layered &delta, MnO2 powder material was spray-coated on a carbon paper and tested in laboratory cells with Al or Zn as active materials. The Al-ion tests were carried out in EMIMCl/AlCl3 while the Zn-Ion experiments were performed in water containing choline acetate (ChAcO) or a ZnSO4 solution. Best performance in terms of capacity was yielded in the Zn-ion cell (200 mWh g&minus, 1 for 20 cycles) compared to about 3 mAh g&minus, 1 for the Al-ion cell. The poor activity of the latter system was attributed to low dissociation rate of tetrachloroaluminate ions (AlCl4&minus, ) in the EMIMCl/AlCl3 mixture into positive Al complexes which are needed for charge compensation of the oxide-based cathode during the discharge step.

Menschen mit Behinderungen kommen in kommerziellen Werbeanzeigen nur selten vor. Dies kann aus Sicht Betroffener als Akt der Stigmatisierung empfunden werden, ist aus der Perspektive der Werbenden jedoch mit der Angst vor negativen Konsumentenreaktionen begründet. Doch inwieweit sind diese Bedenken noch zeitgemäß? Martin Eckerts soziologische Studie zu dieser hierzulande innovativen Thematik stellt sich der Herausforderung, ein nahezu unsichtbares Phänomen empirisch zu analysieren. Er verknüpft hierbei die Perspektiven der Werbung und der Medienwirkungsforschung mit (in der Wissenschaft wie in der Gesellschaft) hochaktuellen Fragestellungen der Disability Studies.

Various Arabidopsis thaliana mutants with defects in phytohormone signal transduction or the reception of light were analysed with regard to their stomatal response in a red, red/blue light irradiation programme. Stomatal response to light was detected with a customized gas exchange measurement device, optimized for the small model plant. Small transpiration-kinetic variations of the two wild-type lines Columbia (Col) and Landsberg erecta (Ler) were observed. A comparison of the mutant lines to the respective wild type revealed significant differences for the phytochrome A (phyA-103), the abscisic acid insensitive (aba3-2) and the auxin resistant (axr1-3) mutant. Furthermore, the zeaxanthin-less mutant line npq1-2 showed no alterations in stomatal response to light.

meability of these channel proteins for water (Preston et al., 1992). Recent findings concerning the sensitivity of aqua- For a long time, plant physiologists, on the other hand, porins to heavy metal ions and their possible con- have not accepted the requirement of these molecules for sequences to plant physiology are discussed. the simple reason that the majority of plants do not Furthermore, results obtained from heterologous possess organs or sites where comparable tremendous expression of plant aquaporin cRNAs in Xenopus amounts of water are transported through living cells. It oocytes are related to the situation in the plant. An was assumed that the water permeability of a biomemassessment of the significance of water flux regulation brane itself is suYcient for the requirements of plant by modification of the aquaporin protein or change cellular water movement (Fettiplace and Haydon, 1980; of gene activity is given and new data concerning Cullis et al., 1996). Since the counterparts of AQP1 were the selectivity of plasma membrane aquaporins are identified in the plant plasma membrane and tonoplast, presented. this opinion is questioned. To date the existence of aquaporins in virtually all living organisms, including

Membrane intrinsic proteins (MIPs) that facilitate water transport across biological membranes have been identified in many single- and multi-cellular organisms. Starting from an overview about the MIP protein family, common structures of aquaporins are described. A detailed report about tonoplast- and plasma-membrane-located plant aquaporins is given and several aspects about regulation of the corresponding genes, with emphasis on light-induced expression, are discussed. After reviewing techniques and results about the functional analysis of these proteins by heterologous and homologous expression systems, the plant-specific attributes of aquaporin regulation are considered, including a discussion about the use of solutions containing heavy-metal ions for inhibition of aquaporin-mediated water transport.

Due to manifold and complex interactions in a clinical laboratory, it is difficult to assess how organizational changes or new equipment may affect overall performance. We present a simulation system that is able to model arbitrary configurations of clinical laboratories. Drawing on the experience of a fixed configuration model we have developed a flexible simulation model. This model has been validated by several laboratories of different size and organizational structure. Using the model the laboratory management is able to judge whether the additional cost for new equipment may be justified by better performance or whether performance can be maintained when measures of cost-cutting are taken.

An important objective of laboratory management is to adjust the laboratory's capability to the needs of patients' care as well as economy. The consequences of management may be changes in laboratory organization, equipment, or personnel planning. At present only one's individual experience can be used for making such decisions. We have investigated whether the techniques of operations research could be transferred to a clinical laboratory and whether an adequate simulation model of the laboratory could be realized. First we listed and documented the system design and the process flow for each single laboratory request. These input data were linked by the simulation model (programming language SIMSCRIPT II.5). The output data (turnaround times, utilization rates, and analysis of queue length) were validated by comparison with the current performance data obtained by tracking specimen flow. Congruence of the data was excellent (within +/- 4%). In planning experiments we could study the consequences of changes in order entry, staffing, and equipment on turnaround times, utilization, and queue lengths. We conclude that simulation can be a valuable tool for better management decisions.

Increasing demand for parallelism due to out-of-order and multi-threading computation requires fast and dense arrays with multi-port capabilities. The load-store-unit (LSU) of the POWER7™ microprocessor core has a 32kB L1 data cache composed of four 8kB blocks. In a two-cycle back-to-back operation it supports concurrently two independent read and one write operations. Organized in banks of 16 cells each, the two reads operate independently in any of these banks, including two reads within the same bank, even the same cell. A bank selected for write is blocked for any read operation. If read and write collide within the same bank, collision-control circuitry provides write-over-read priority. Each read port provides 4B from 1 of 256 locations, whereas the double-bandwidth write operation provides individual control of 8B to 128 locations.

Almost all land plants have developed a symbiosis with arbuscular mycorrhizal fungi. Establishment of the association is accompanied by structural changes in the plant root. During arbuscule formation fungal hyphae penetrate the root apoplast and install highly specialized interfaces for solute transport between plant and fungus. The periarbuscular membrane which is part of the plant plasma membrane surrounding arbuscular structures was shown to harbour a high density of different transport systems. Among these also expression of aquaporins was described, which potentially can act as a low affinity transport system for ammonia or ammonium. The present study provides data for expression, localization and function of plant aquaporins in the periarbuscular membrane of mycorrhizal Medicago truncatula plants.

Es kommt zu unaufloslichen Widerspruchen. Letztlich beruhen diese Widerspruche auf dem wohl unuberbruckbaren Gegensatz von verstandnisbezogener und handlungsanweisungsgebender Weltsicht, d.h. dass hier das Problem besteht, dass eine verstandnisbezogene Sicht letztlich in ihren Ergebnissen nicht „eindeutig genug“ erscheint, um Grundlage fur eine direkt auf Handlungsanweisungen ausgerichtete Sicht zu sein.

Bei der Gegenuberstellung der linguistischen Analyse und der juristischen Analyse ist grds. zu beachten, dass eine linguistische Analyse primar das Verstehen eines Textes als Ziel hat, wahrend eine juristische Analyse primar auf eine Handlungsanweisung ausgerichtet ist. Dadurch ergeben sich schon im vorhinein gewisse Kompatibilitatsprobleme, die unter Umstanden den Eindruck entstehen lassen, die juristischen Methoden zur Ermittlung der tatsachlichen Aussage einer Auserung seien „oberflachlich“.

Background: Low-molecular-weight heparin (LMWH) is supposed to be advantageous compared to unfractionated heparin for chronic hemodialysis (HD) with respect to lipid and bone metabolism, polymorphonuclear cell stimulation, induction of antibody-mediated thrombocytopenia, and aldosterone suppression. Due to longer biological half-life, LMWH offers the possibility of single bolus administration. Methods: To assess safety and efficacy of single bolus anticoagulation with enoxaparin for chronic HD, 781 stable HD patients from 79 German dialysis centers (mean age 62 years; 31% ESRD due to diabetes mellitus) were monitored by clinical and laboratory parameters for 32 weeks. Additionally, in a single dialysis center, 22 chronic HD patients were investigated by molecular markers of coagulation during chronic HD under conditions of single bolus or continuous anticoagulation regimens. Anti-Xa activity and the thrombin- antithrombin-III complex (TAT) were determined before the enoxaparin bolus, after 15 min, 2 h, and at the end of HD in venous and arterial blood lines. Results: Chronic HD was performed in 24,117 HD treatments with enoxaparin at a median dose of 70.1 IU/kg (5,000 IU median total dose) for single bolus anticoagulation. In 83.0% of HD treatments, enoxaparin was given as single bolus. In 98.3% of patients no adverse event was reported. No drug-related severe adverse event occurred. Significant clotting problems were observed in only 0.3% of HD treatments with single bolus anticoagulation. As assessed in 257 HD treatments, essentially identical anti-Xa levels were detected at the end of HD with single bolus (50 IU/kg) or continuous (mean total dose 43 IU/kg) anticoagulation regimens. Bolus anticoagulation resulted in higher TAT generation at the end of HD. However, this was not associated with increased macroscopic clot formation. Conclusion: Single bolus anticoagulation with enoxaparin was safe and effective for chronic HD. For a duration of 4 h HD, a median dose of 70 IU/kg can be recommended for regular use, which is in accordance with the manufacturer’s instructions for use of enoxaparin recommending a range of 50–100 IU/kg.