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Summary Management of a mediastinal mass resection remains a challenging anesthetic scenario due to its compression on airway and major cardiovascular structures. In general, anterior mediastinal masses cause the most severe and often life-threatening complications due to the gravity effect leading to high degree of compression on the trachea, the superior vena cava, the pulmonary artery or the right heart. Posterior mediastinal mass is usually considered at lower risk because of its anatomical distance from those vital structures. Here the authors present a case of a large posterior mediastinal mass leading to severe cardiopulmonary compromise, requiring veno-arterial extracorporeal membrane oxygenation (ECMO) for surgical resection and veno-venous ECMO support for postoperative management. Though rare, posterior mediastinal masses can cause cardiopulmonary collapse with anesthesia induction, specifically with a large size tumor. Patient's positioning, physiological state and anesthetic drugs can pose dynamic changes on the severity of airway and vascular compression. It is important to recognize the potential risks of inducing anesthesia and use a multidisciplinary approach with meticulous planning for alternative management strategies that can be applied according to the patient's clinical condition.

Zusammenfassung Hintergrund Durch die neue Datenschutz-Grundverordnung (DS-GVO) sind die Anforderungen an eine sachgerechte Aufklärung der Patienten über die Dokumentation pseudonymisierter, personenbezogener Daten in einem Register enorm gestiegen. Dies betrifft ganz besonders das TraumaRegister DGU®, da eine schriftliche Aufklärung schwer verletzter Patienten in der Akutsituation nicht immer gelingt. Ziel der Untersuchung war es, den Einfluss der infolge fehlender Aufklärung nichtdokumentierten Fälle auf die standardisierte Mortalitätsrate (SMR) zu untersuchen. Material und Methode Im Jahr 2019 wurden 274 Patienten retrospektiv erfasst, die die Kriterien des Basiskollektivs erfüllen. Darunter waren 72 Sekundärverlegungen, die ausgeschlossen wurden. Bei den verbliebenen 197 Patienten konnte in allen Fällen der RISC II Score erhoben werden. Ergebnisse Von den 197 primär (72 % männlich) versorgten Patienten wurden 147 (74,6 %) schriftlich aufgeklärt oder waren verstorben und wurden folglich dokumentiert. Die prognostizierte Letalität, tatsächliche Letalität und SMR betrug 18,5 %, 19,0 % resp. 1,03. Bei den Patienten, die nicht aufgeklärt wurden (n = 50), lagen die prognostizierte Letalität, tatsächliche Letalität und SMR bei 7,0 %, 0 % resp. 0. Bezieht man diese Fälle mit ein, ergibt sich eine deutlich günstigere SMR mit 0,93. Schlussfolgerung Durch die fehlende schriftliche Einwilligung überlebender Patienten konnten nur etwa 75 % aller Patienten der Uniklinik Leipzig für das TraumaRegister DGU® dokumentiert werden. Da die lokale Gesetzeslage andererseits eine Registerdokumentation verstorbener Patienten zulässt, ergibt sich daraus eine nachteilige Beeinflussung der SMR, die in unserem Kollektiv etwa 10 % höher ausfällt, als sie in Realität ist.

NiMn is a collinear antiferromagnet with high magneto crystalline anisotropy ($K_2=-9.7\times10^5\;\text{J m}^{-3}$). Through magnetic annealing of NiMn with excess Ni, strongly pinned magnetic moments emerge due to an imbalance in the distribution of Ni in the antiferromagnetic Mn-sublattices. The results are explained with a model of magnetic-field-biased diffusion, supported by ab initio calculations. Another observation is the oxidation of Mn at the surface, causing an enrichment of Ni in the sub-surface region. This leads to an additional ferromagnetic response appearing in the magnetization measurements, which can be removed by surface polishing.

OA Förderung 2023 The shell-ferromagnetic effect originates from the segregation process in off-stoichiometric Ni–Mn-based Heusler alloys. In this work, we investigate the precipitation process of L21-ordered Ni2MnSn and L10-ordered NiMn in off-stoichiometric Ni50Mn45Sn5 during temper annealing, by X-ray diffraction (XRD) and 119Sn Mössbauer spectroscopy. While XRD probes long-range ordering of the lattice structure, Mössbauer spectroscopy probes nearest–neighbour interactions, reflected in the induced Sn magnetic moment. As shown in this work, the induced magnetic Sn moment can be used as a detector for microscopic structural changes and is, therefore, a powerful tool for investigating the formation of nano-precipitates. Similar research can be performed in the future, for example, on different pinning type magnets like Sm-Co or Nd-Fe-B.

Workplaces are changing rapidly, with an increasingly diverse workforce and a lack of talent to fill all the roles, which is why companies across all industries are tackling Diversity & Inclusion within their organisations.

Introduction: The effectiveness and safety of romiplostim were evaluated by immune thrombocytopenia (ITP) phase (newly diagnosed/persistent/chronic) at romiplostim initiation. Methods: This is a post hoc analysis of a prospective, German, multicentre, observational study in adults with ITP who received ≥1 dose of romiplostim. Follow-up data were collected for ≤2 years. Outcomes included overall platelet response (≥1 platelet count ≥50 × 109/L at 2–24 weeks after romiplostim initiation) or durable platelet response (≥75% of measurements ≥50 × 109/L at 14–24 weeks) and adverse drug reactions (ADRs), evaluated by ITP phase. Results: Data from 96 patients were analysed (newly diagnosed, n = 18; persistent, n = 25; chronic, n = 53). During the 2- to 24-week follow-up, overall platelet response was achieved in 100% (95% confidence interval: 81.5–100), 100% (86.3–100), and 96.2% (87.0–99.5) of patients with newly diagnosed, persistent, or chronic ITP, respectively, and platelet responses were durable in 88.2% (63.6–98.5), 65.0% (40.8–84.6), and 69.4% (54.6–81.7) of patients. During the 2-year follow-up, ADRs occurred in 24.0–35.8% of patients across phases. Two patients with chronic ITP experienced bone marrow ADRs; no thrombotic ADRs occurred. Conclusion: Romiplostim was effective and well tolerated in patients with newly diagnosed, persistent, or chronic ITP in routine clinical practice.

Lantibiotics are post-translationally modified antibiotic peptides with lanthionine thioether bridges that represent potential alternatives to conventional antibiotics. The lantibiotic pseudomycoicidin is produced by Bacillus pseudomycoides DSM 12442 and is effective against many Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. While prior work demonstrated that pseudomycoicidin possesses one disulfide bridge and four thioether bridges, the ring topology has so far remained unclear. Here, we analyzed several pseudomycoicidin analogues that are affected in ring formation via MALDI-TOF-MS and tandem mass spectrometry with regard to their dehydration and fragmentation patterns, respectively. As a result, we propose a bridging pattern involving Thr8 and Cys13, Thr10 and Cys16, Ser18 and Cys21, and Ser20 and Cys26, thus, forming two double ring systems. Additionally, we localized the disulfide bridge to connect Cys3 and Cys7 and, therefore, fully elucidated the bridging pattern of pseudomycoicidin.

As bit rates of optical interconnects increase, a large amount of complicated signal conditioning is needed to compensate for the insufficient bandwidth of current modulators. In this paper, we evaluate the reduced equalization requirements of high-bandwidth plasmonic modulators in short-reach transmission experiments. It is shown that transmission of 100 Gbit/s non-return-to-zero (NRZ) and 112 Gbit/s pulse-amplitude modulation-4 over 1 km and 2 km distance is possible without any receiver equalization. At higher bit-rates, such as 120 Gbit/s NRZ, data transmission is demonstrated over 500 m with reduced receiver equalization requirements. Transmission up to 200 Gbit/s over 1 km is also shown with more complex receiver equalization. The reduced complexity of the receiver digital signal processing is attributed to a flat frequency response of at least 108 GHz of the plasmonic modulators. All single wavelength transmissions have been performed at 1540 nm in standard single mode fiber.

A new plasmonic Mach-Zehnder modulator is demonstrated at a bit rate of 120 Gb/s NRZ-OOK with low peak-to-peak driving voltages of 178 mVpp below the HD-FEC limit. Such record low driving voltage requirements potentially translate into an electrical drive power consumption of 862 aJ/bit. The low drive voltages have been made possible by a new differential Mach-Zehnder modulator electrode design. The differential electrode design is optimized for the balanced driving circuitry and reduces the effectively required driving voltage by a factor of four (Vπ/4). The potential of the transmitter scheme is further demonstrated by a transmission experiment over 500 m of single mode fiber at the C-band with a BER performance below the KP4 FEC limit.