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After an introduction describing the significance and a short history of catalysis at Ciba-Geigy, the present role of the Catalysis Section within the Central Research Services is outlined. Its main activities are preparative services for the synthetic chemists in the fields of hydrogenation and high-pressure reactions, the development of catalytic processes and a research program in the fields of enantioselective catalysis, the modification of heterogeneous catalytic systems, acid-base catalysis and catalytic C–C-bond forming reactions. Because catalysis is considered by Ciba-Geigy to be a key technology, the main goal of its R+D program in catalysis is to create and maintain a reliable scientific and technical foundation for the optimal application of catalytic reactions throughout the company. Some results are presented that illustrate the work described above and an outlook on the opportunities of catalytic technologies in the fine chemicals industry is given.

Medical data registers are a key instrument of medical care research and a valuable tool for medical quality assurance. The structured plausibility tested documentation of large case numbers on a longitudinally oriented time axis with different points in time of data acquisition enables statements to be made on numerous relevant outcomes, not only the mortality of patients. For incidents outside the daily routine care in trauma surgery, such as natural disasters, accidents with multiple casualties and nonmilitary treatment of the domestic population in defence situations, such registers can provide data-based recommendations for action. These data, mainly obtained from routine traumatological treatment, enable a targeted resource management in the abovenamed incidents, which are associated with mass casualties. Due to the utilization of registers from the military field or from international registers, the perspective is additionally extended with respect to treatment strategies and injury patterns. Whether data can also be generated in a suitable manner for the abovenamed registers in specific disaster situations and can provide a direct gain of knowledge from the incident, must be critically discussed. The maintenance of the register datasets is time-consuming and has been subjected to a more stringent regulation at least since May 2018, when the European Union General Data Protection Regulation (EU-GDPR) came into force. The future Register Act in Germany will hopefully achieve greater simplification in the documentation of routine data., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: S. Imach ist der Sprecher des Arbeitskreises TraumaRegister der Sektion Notfallmedizin, Intensivmedizin und Schwerverletztenversorgung der Deutschen Gesellschaft für Unfallchirurgie. R. Lefering ist der leitende Statistiker des TraumaRegister der Deutschen Gesellschaft für Unfallchirurgie. D. Bieler ist der 1. Vorsitzende der Sektion Notfallmedizin, Intensivmedizin und Schwerverletztenversorgung der Deutschen Gesellschaft für Unfallchirurgie. B. Kölbel, M. Wolf und L. Hackenberg geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Competing Interests: Einhaltung ethischer Richtlinien Interessenkonflikt T. Knoll, C. Hohmann, O. Kemper und R. Dembinski geben an, dass kein Interessenkonflikt besteht.Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patient/-innen zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern/Vertreterinnen eine schriftliche Einwilligung vor.

Background: Renal cell carcinoma (RCC) accounts for about 13.5% of all urological tumors. Healthcare research analyzes whether treatment recommendations from controlled studies or guidelines are being implemented in routine care. A prerequisite for the assessment and scientific study of the quality of care in the treatment of urological tumors is standardized documentation., Objectives: This article illustrates healthcare research in RCC by presenting current data from the prospective of the VERSUS study (VERSorgUngsStudie) by d‑uo (Deutsche Uro-Onkologen)., Materials and Methods: The VERSUS study is a noninterventional, prospective, multicentric study for the documentation and descriptive statistical analysis of the diagnosis, treatment, and aftercare of uro-oncological patients., Results: Of 25,065 patients currently included in the VERSUS study, 1976 have a diagnosis of RCC. Data regarding stage distribution, reason leading to initial diagnosis, distribution of symptomatic vs. asymptomatic patients as well as surgical margins from surgical treatment of RCC are presented., Conclusions: Despite providing interesting results, the VERSUS study remains limited with regard to the depth of the data, since it relies on the same dataset as the German cancer registry. In order to provide more comprehensive healthcare research, organ-related cancer registries like the Urothelial Cancer National Registry (UroNAT) and the Prostate Cancer National Registry (ProNAT) by d‑uo are necessary. These national cancer registries by d‑uo are unique in that they comprise all tumor stages. The Renal Cancer National Registry (ReNAT) by d‑uo is in preparation and will be a valuable contribution to quality assurance of oncological care in Germany., Competing Interests: Einhaltung ethischer Richtlinien Interessenkonflikt M. Johannsen, R. Eichenauer, J. Klier, F. König, R. Schönfelder, J. Schröder, E. Hempel und C. Doehn geben an, dass kein Interessenkonflikt besteht.Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Competing Interests: Rolf Janka gibt an Honorare für Fortbildungen und Vorträge von der Siemens-Healthineers AG Erlangen erhalten zu haben.

Introduction: Based on the cases in which assisted suicide (AS) has taken place in Switzerland in the context of a mental disorder or dementia, we discuss whether the slippery slope argument often brought up by opponents of assisted dying is justified. Long-term data from the Swiss Federal Statistical Office shows that while the number of cases with these «indications» is increasing (1999-2017: on average 21 cases/year vs. 2018-2022: n = 73 cases/year), the percentage share of these diseases in the total number of all AS cases has remained unchanged at around 5 %. Opponents of assisted dying believe that the slippery slope argument is already fulfilled by the fact that these cases occur at all. However, the still limited prevalence of these specific indications which still represent only a minority of assisted suicide cases over time, may be used by advocates of assisted dying to weaken the opposing viewpoint., Competing Interests: Die Autoren bestätigen, dass kein Interessenkonflikt besteht. Keiner der Autoren ist Mitglied in einer der Schweizer Sterbe­hilfeorganisationen., (© 2024 Aerzteverlag medinfo AG.)

In the observation period between 1999 and 2022, the Swiss Federal Statistical Office recorded 14 170 assisted suicide (AS) cases. During this 24-year period, the annual number of cases increased significantly: While only 63 cases were observed in 1999, the number of cases in 2022 amounted to almost 1600, corresponding to 2.1 % of all deaths in Switzerland. The most common underlying disease group for AS was cancer, accounting for 40 % of cases. AS is mainly chosen by women (unchanged over time at 58 % of cases) and is primarily a geriatric phenomenon: In 2022, the median age of those who opted for assisted dying was 81 years; the median age of those who chose AS due to cancer was 77 years, while the median age of those who died with non-cancer-related AS was 84 years., Competing Interests: Die Autoren bestätigen, dass kein Interessenkonflikt besteht. Keiner der Autoren ist Mitglied in einer der Schweizer Sterbehilfe-Organisationen. Für unser Forschungsprojekt erfolgte keine finanzielle Unterstützung., (Thieme. All rights reserved.)

Background:  Job-related limitations of earning capacity are eligible for recognition under social legislation and may be subject to compensation (see Part 1)., Method:  For the recognition of an occupational disease (BK), diagnostic imaging is required as part of the legal determination procedure for occupational diseases 2108/2110 ("occupational disc disease"). The focus is on image criteria on X-ray images and MRI examinations. In a consensus paper under the guidance of the German Social Accident Insurance Institutions from 2005, the characteristic patterns are defined and explained extensively and summarized in typical occupation-related constellations. This article presents representative image examples as a reference system for expert reporting as far as the typical patterns from the consensus paper are concerned., Conclusion:  In Part 2, comparison images with the typical findings of the vertebral bodies and intervertebral discs according to occupational diseases are systematically presented, explained, and offered as a reference system for expert assessment. The image criteria can be used as "evidence by eye" (Heuck) in the recognition procedure., Key Points: · Occupational diseases are defined by the legislator in the "List of Occupational Diseases".. · For occupational intervertebral disc diseases (OD nos. 2108/2110), constellations of findings are defined.. · Within the scope of diagnostic imaging, a large number of image criteria are used.. · Part 1 explains the basics and the legal background.. · Part 2 provides the image criteria on the basis of "comparison images" as a reference catalog.., Citation Format: · Braunschweig R, Kildal D, Meyer-Clement M et al. Structured image diagnosis of vertebral body degeneration and intervertebral disc damage - Binary image criteria and comparison for systematic image analysis for occupational diseases 2108 and 2110. Fortschr Röntgenstr 2024; 196: 912 - 920., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Background: Magnetic resonance (MRI) imaging of the skeletal muscles (muscle MRI for short) is increasingly being used in clinical routine for diagnosis and longitudinal assessment of muscle disorders. However, cross-centre standards for measurement protocol and radiological assessment are still lacking., Objectives: The aim of this expert recommendation is to present standards for the application and interpretation of muscle MRI in hereditary and inflammatory muscle disorders., Methods: This work was developed in collaboration between neurologists, neuroradiologists, radiologists, neuropaediatricians, neuroscientists and MR physicists from different university hospitals in Germany. The recommendations are based on expert knowledge and a focused literature search., Results: The indications for muscle MRI are explained, including the detection and monitoring of structural tissue changes and oedema in the muscle, as well as the identification of a suitable biopsy site. Recommendations for the examination procedure and selection of appropriate MRI sequences are given. Finally, steps for a structured radiological assessment are presented., Conclusions: The present work provides concrete recommendations for the indication, implementation and interpretation of muscle MRI in muscle disorders. Furthermore, it provides a possible basis for the standardisation of the measurement protocols at all clinical centres in Germany., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Every year, thousands of people in Germany succumb to severe injuries. But what causes the death of these patients? In addition to the trauma, pre-traumatic health status, age, and other influencing factors play a role in the outcome after trauma. This study aims to answer the question of what causes the death of a severely injured patient.For this publication, in addition to previously published results, we examined current data from patients in German hospitals from the years 2015-2022 (8 years) documented in the TraumaRegister DGU®. The feature "Presumed Cause of Death", introduced in 2015, was considered. Patients transferred out early (< 48 h) as well as patients with minor injuries were excluded from this analysis.The number of fatalities decreases over time and does not correspond to a traditionally postulated tri-modal mortality distribution. Instead, over time, the distribution of causes of death shows significant variation. In over half of the cases (54%), traumatic brain injury (TBI) was the presumed cause of death, followed by organ failure (24%) and haemorrhage (9%). TBI dominates, especially in the first week, haemorrhage in the first 24 h, and organ failure as a cause steadily increases over time.In summary, it can be observed that the risk of death due to trauma-related consequences is highest in the first minutes, hours, and days, decreasing steadily over time. Particularly, the extent of injuries, head injuries, and significant blood loss are early risk factors., Competing Interests: RL gibt an, das seine Universität ein Service Agreement mit der Akademie der Unfallchirurgie (AUC GmbH) hat, dem Eigner des TR-DGU. DB gibt an, dass kein Interessenskonflikt besteht., (Thieme. All rights reserved.)

In recent years, reports of health problems associated with nitrous oxide consumption have significantly increased. In Germany, nitrous oxide (N 2 O) is easily available in cartridges without legal restrictions. The main reason for its popularity in the party scene are the euphoric, psychedelic effects of the gas. In addition to severe and sometimes irreversible health problems associated with long-term use of nitrous oxide, e.g., anemia and nerve damage, life-threatening or fatal consequences of acute nitrous oxide consumption can also occur: accidents under the influence of nitrous oxide, pneumothorax, pneumopericardium and shock due to an explosive increase in airway pressure when inhaled directly from the cartridge. But the most common cause of severe complications is asphyxia as the gas is usually inhaled pure from large balloons and without oxygen. The resulting hypoxia during use may be perpetuated by the diffusion hypoxia that occurs during the reoxygenation period. Nitrous oxide as a cause in accidental or intoxication events is usually not detectable but can only be identified as a trigger based on the patient's history or the circumstances. Acute medical treatment is symptomatic., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Competing Interests: The authors declare that they have no conflict of interest.

Criteria for assessment of the significance of scientific articles are presented. The focus is on research design and methodology, illustrated by the classical study on prehospital volume treatment of severely injured individuals with penetrating torso injuries by Bickell et al. (1994). A well-thought out research design is crucial for the success of a scientific study and is documented in a study protocol beforehand. A hypothesis is a provisional explanation or prediction and must be testable, falsifiable, precise, and relevant. There are various types of randomization methods, with the randomized controlled trial being the gold standard for clinical interventional studies. When reading a scientific article it is important to verify whether the research design and setting align with the research question and whether potential sources of error have been considered and controlled. Critical scrutiny should also be applied to references, the funding and expertise of the researchers., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objective: The results of this study describe the relationship between the body condition of dairy cows and selected metabolic parameters during the peri- and post-partum period with special consideration of 3 local dairy cow breed in Upper Bavaria and the Allgau., Material and Methods: Three local dairy cattle breeds (Swiss Brown (BV), Simmental (FL), Holstein Friesian (HF)) were examined on 68 farms in southern Germany for 7 consecutive weeks. In dry cows as well as lactating cows (5.-65. day in milk), following blood parameters were investigated: beta-hydroxybutyrate (BHB), non-esterified fatty acids (NEFA), creatinine, aspartate aminotransferase, gamma-glutamyltransferase, glutamate dehydrogenase, total protein, albumin, creatine kinase. In addition, body condition (body condition score [BCS] and back fat thickness [BFT]) were recorded. Exploratory and descriptive statistics were used for data analysis., Results: Concerning the difference in condition before and after calving, the FL showed the smallest difference in RFD. For FL and BV a trend towards higher BFT values could be seen in first lactating cows. For FL and HF, the NEFA values of the later lactating cows were below those of the first lactating cows. The higher lactating cows of BV and FL had higher BHB values. The correlation between BFT and BCS showed the highest R2 (0.53) in the HF cows. BV and FL were below at 0.42 and 0.37. BCS and BFT could not be predicted by the variables NEFA, BHB and liver enzymes. BHB levels of all 3 breeds increased at weeks 2-4 post-partum. The NEFA values for all 3 breeds increased primarily in the 1st-3rd week p.p. in parallel to when the BFT p.p. decreased. NEFA values were highest when body condition declined and therefore when fat mobilization peaked. In BV and HF, there was a constant increase in GLDH when the p.p. BCS difference was there., Conclusion and Clinical Relevance: Body condition assessment (BCS at herd and animals` level, BFT at animal level) is an important tool for animal health monitoring. Due to the recognizable breed specificity, the dairy herds can be dealt with more explicitly. The aim is to optimally influence the energy balance of the cow during early lactation in order maintain the health of the animal and its organ systems., Competing Interests: Die Autor*innen bestätigen, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Isthmic spondylolysis represents the most common cause of spinal pain in adolescent athletes. This article provides an overview of the classification, diagnosis, and treatment options for these conditions, including conservative and operative measures. It also provides a treatment pathway to how young athletes with spondylolysis should be treated., Diagnostics: Diagnostic imaging techniques are essential for an accurate diagnosis, with CT scans providing additional information for surgical planning., Treatment: Conservative treatment focuses on activity modification and physiotherapy, with a phased approach tailored to individual patient needs. Operative intervention may be considered if conservative measures fail, with minimally invasive techniques such as Buck's screw fixation showing promising results. The decision between conservative and operative management should consider factors of the patients' individual profile. In this paper, we present the first treatment algorithm for the treatment of isthmic spondylolysis. Long-term prognosis varies, with most athletes able to return to sport following treatment., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Introduction: As with other chronic diseases, the course of chronic obstructive pulmonary disease (COPD) can be expected to be positively influenced if patients are well informed about their disease and undertake appropriate self-management. Assessments of the level of knowledge and management that are comparable should benefit from structured, systematically developed questionnaires. These, however, have not been published in Germany., Methods: A total of 310 patients with COPD were recruited from three pneumological practices and one hospital to develop the questionnaires. Based on statistical criteria and content assessments by medical specialists, two questionnaires on knowledge (17 questions) and self-management (25 questions) were developed by selecting and modifying questions from published studies and training programs. In addition, two short versions with 5 and 3 questions were created to enable a quick assessment of the patients' knowledge and self-management. All questionnaires also included a visual analogue scale for self-assessment of knowledge and self-management. The statistical procedures for systematically guided selection comprised correlation and regression analyses., Results: The questionnaires revealed considerable knowledge deficits in many patients and remarkably unsystematic, incoherent knowledge. The extent of this knowledge was negatively correlated with higher age and positively correlated with participation in training programs; this also applied to self-management. Correlations between the answers to the knowledge questions were higher in patients who had participated in training programs. The visual analogue scales for self-assessment of knowledge and management always correlated with the total number of correct answers., Discussion: The questionnaires on knowledge and self-management in patients with COPD could be used in outpatient settings, including by non-medical staff, in order to quickly identify and correct deficits or as a reason to recommend training programs. The short versions and the analogue scales for self-assessment can give at least first hints. Potentially, training programs should focus more on promoting the coherence of knowledge through better understanding, as this presumably favors long-term knowledge. Older patients and those with a low level of education appear to be particularly in need of specially adapted training programs., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective: Four parameters of a decision tree for Selective Dry Cow Treatment (SDCT), examined in a previous study, were analyzed regarding their efficacy in detecting cows for dry cow treatment (DCT, use of intramammary antimicrobials). This study set out to review wether all parameters (somatic cell count [SCC≥ 200 000 SC/ml 3 months' milk yield recordings prior dry off (DO)], clinical mastitis history during lactation [≥1 CM], culturing [14d prior DO, detection of major pathogens] and California-Mastitis-Test [CMT, > rate 1/+ at DO]) are necessary for accurate decision making, whether there are possible alternatives to replace culturing, and whether a simplified model could replace the decision tree., Material and Methods: Records of 18 Bavarian dairy farms from June 2015 to August 2017 were processed. Data analysis was carried out by means of descriptive statistics, as well as employing a binary cost sensitive classification tree and logit-models. For statistical analyses the outcomes of the full 4-parameter decision tree were taken as ground truth., Results: 848 drying off procedures in 739 dairy cows (C DO ) were included. SCC and CMT selected 88.1%, in combination with CM 95.6% of the cows that received DCT (n=494). Without culturing, 22 (4.4%) with major pathogens (8x Staphylococcus [ S. ] aureus ) infected C DO would have been misclassified as not needing DCT. The average of geometric mean SCC (within 100 d prior DO) for C DO with negative results in culturing was<100 000 SC/ml milk, 100 000-150 000 SC/ml for C DO infected with minor pathogens, and ≥ 150 000 SC/ml for C DO infected with major pathogens (excluding S.aureus ). Using SCC during lactation (at least 1x > 200 000 SC/ml) and positive CMT to select C DO for DCT, contrary to the decision tree, 37 C DO (4.4%) would have been treated "incorrectly without" and 43 C DO (5.1%) "unnecessarily with" DCT. Modifications were identified, such as SCC<131 000 SC/ml within 100 d prior to DO for detecting C DO with no growth or minor pathogens in culturing. The best model for grading C DO for or against DCT (C DO without CM and SCC<200 000 SC/ml [last 3 months prior DO]) had metrics of AUC=0.74, Accuracy=0.778, balanced Accuracy=0.63, Sensitivity=0.92 and Specificity=0.33., Conclusions: Combining the decision tree's parameters SCC, CMT and CM renders suitable selection criteria under the conditions of this study. When omitting culturing, lower thresholds for SCC should be considered for each farm individually to select C DO for DCT. Nonetheless, the most accurate model could not replace the full decision tree., Competing Interests: Es besteht kein Interessenkonflikt., (Thieme. All rights reserved.)

Background:  Occupationally related limitations of earning capacity can be recognized under social legislation and may be subject to compensation ("reduction in earning capacity"). For this purpose, legislators have defined a list of occupational diseases ("BK list"). Recognition of an occupational disease requires a legal assessment procedure based on a medical appraisal. The aim of the assessment is to prove the "causality" and the "causality giving rise to liability"., Method: In addition to clinical findings and workplace analyses, imaging methods (projection radiography, MRI) are primarily used to substantiate liability. These methods enable proof of load-conforming damage patterns for occupational diseases 2108/2110 (damage to intervertebral discs)., Results and Conclusion:  In addition to the legal background, the following review article primarily presents the image criteria for load-conforming damage patterns of the spine. On the basis of the consensus paper on the "Assessment of occupational disc diseases of the lumbar spine", image criteria are assigned to age-atypical grades of findings, and "typical constellations of findings" are defined for vibration (BK 2108) or lifting (BK 2110) loads. The aim of Part 1 is to explain the image criteria of the comparative images presented as image plates in Part 2 and thus to present a reference catalog of findings., Key Statements:   · Occupational diseases are defined by legislators in the "List of Occupational Diseases".. · For occupational intervertebral disc diseases (BK 2108/2110), constellations of findings are defined.. · In the context of imaging diagnostics, a large number of image criteria are used.. · Part 1 explains the basics.. · Part 2 provides the image criteria on the basis of "comparative images" as a reference catalog.., Citation Format: · Braunschweig R, Kildal D, Meyer-Clement M et al. Structured image diagnosis of vertebral body degeneration and disc damage - Binary image criteria and comparison for systematic image analysis in occupational diseases 2108/2110. Fortschr Röntgenstr 2024; 196: 347 - 353., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.