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Zusammenfassung Hintergrund Im Zertifizierungssystem der Deutschen Krebsgesellschaft (DKG) sind verschiedene Screenings auf supportiv-therapeutischen Bedarf empfohlen. Die neue Palliativkennzahl „Symptom- und Belastungserfassung mit MIDOS/IPOS“ (Minimales Dokumentationssystem/Integrated Palliative Outcome Scale) wurde 2022 multizentrisch pilotiert, in Würzburg mittels IPOS in einem kombinierten Fragebogen gemeinsam mit dem psychoonkologischen Screening und dem Mangelernährungsscreening im Sarkomzentrum, im Zentrum für endokrine Tumoren und im molekularen Tumorboard. Fragestellung Von Interesse waren neben den berichteten Symptomen und Belastungen auch die Häufigkeit von mehrfacher Positivität im Screening und die Informationswünsche über Unterstützungsangebote in Relation zur Entfernung Wohnort – Behandlungsort. Ergebnisse Den Fragebogen beantworteten 58/118 Zielpatienten (49,1 %). Alle Patienten berichteten über klinisch relevante Symptome oder Belastungen, zumeist im emotionalen Bereich. Im psychoonkologischen Screening waren 56,8 % auffällig, 46,6 % im IPOS-Screening bzgl. spezialisiert-palliativmedizinischer Mitbetreuung und 5,1 % im Mangelernährungsscreening. In 2 Screenings positiv waren 43,4 %, und 4,3 % waren in allen 3 Screenings positiv. Gezielte Informationen über die Unterstützungsangebote wünschten 53,4 %. Dabei kamen 47,6 % der Anfragen von Befragten, die weiter als 50 km entfernt vom Behandlungsort wohnten. Schlussfolgerungen Ein gemeinsames Screening ist umsetzbar und belegt den supportiv-therapeutischen Bedarf. Die bedarfsgerechte Unterstützung von weiter entfernt wohnenden Patienten bedarf innovativer Strategien.

Among Directed Energy Deposition (DED) processes for metallic materials, Wire Laser Additive Manufacturing (WLAM), distinguishes itself by the use of a laser beam to melt a metallic wire and produce beads. Successive depositions of overlapping beads generate volumes to obtain parts. Thus, controlling bead geometries is essential for the additive manufacturing process. Several research works have studied these geometries and the influence of the main manufacturing parameters on their dimensions, but few investigated the effect of feeding direction or wire angle. Moreover, all studies on wire angle were carried out with lateral feeding and a constant laser orientation. This paper focuses on the influence of the deposition head orientation for a coaxial wire feed with 3 laser beams on bead geometries. An experimental campaign is conducted with different orientations relatively to a horizontal substrate and the external profiles are measured using optical instruments in order to extract the average profiles and characteristic dimensions. Results indicate an influence of the head rotation around its axis and lateral tilt on the height, width, and asymmetry of the beads.

Foraging preferences are known to differ among bee taxa, and can also differ between male and female bees of the same species. Similarly, bees can prefer a specific flower sex, particularly if only one sex provides pollen. Such variation in foraging preferences could lead to divergent bee communities visiting different flower sexes of a plant species. We sampled bees visiting sunflowers to characterize bee species richness, abundance, and sex ratios on pollen-fertile and pollen-sterile cultivars. We asked whether female or male bees were more abundant on sunflowers, whether female bees were more abundant on pollen-fertile or pollen-sterile cultivars, and whether pollen presence predicted the sex of sampled bees. We further asked whether the bee community differed between pollen-fertile and pollen-sterile cultivars. Females of most bee species were more abundant on sunflowers compared to males, and females were usually more abundant on pollen-fertile cultivars. In three bee species, pollen presence was predictive of a bee’s sex, with females more abundant on pollen-fertile cultivars than males. Further, the bee community differed significantly between pollen-fertile and pollen-sterile cultivars, with two bee species functioning as indicators for pollen-fertile sunflowers. Our results demonstrate that a bee’s sex shapes foraging associations on sunflowers and influences abundance between pollen-fertile and pollen-sterile cultivars, and that pollen-fertile and pollen-sterile cultivars are visited by different bee communities. Bee sexes and flower pollen presence may be under-appreciated factors shaping pollination services in both agricultural and natural ecosystems, and could be important considerations for pollination of crops with pollen-fertile and pollen-sterile flowers.

Zusammenfassung Hintergrund „Qualitätsverbesserung im konservativen Schmerzmanagement“ (QUIKS), das Modul für nichtoperative Patienten welches an das „QUIPS“-Projekt angelehnt ist, wurde an einer Kohorte Tumorpatienten auf Anwendbarkeit getestet. Material und Methoden Prospektiv wurden stationär konservativ behandelte Patienten am Universitätsklinikum Würzburg (UKW) anhand des Ergebnisfragebogens QUIKS zur Qualität der Schmerztherapie befragt (AZ 129/17, Ethikkommission am UKW). Informationen zur Therapie und Demografie wurden dem klinikinternen Dokumentationssystem entnommen. Ergebnisse Im Erfassungszeitraum konnten 100 Tumorpatienten aus verschiedenen Kliniken eingeschlossen werden. 74 % der Patienten benötigten Unterstützung bei der Beantwortung des Fragebogens. Funktionelle Einschränkungen oder schmerztherapiebedingte Nebenwirkungen lagen bei 77 % der Patienten vor, im Durchschnitt lagen Schmerzen von 6 auf der numerischen Rating-Skala vor. Die am häufigsten benannten Schmerzentitäten waren Rücken- und Kopfschmerzen. 18 % der Patienten erhielten eine Schmerztherapie mit Opioiden, 26 % mit Nichtopioiden, eine Anpassung der Schmerztherapie erfolgte in 5 % mit Opioiden und in 44 % mit Nichtopioiden, ein Einbezug schmerzmedizinischer Spezialisten erfolgte in 9 %. Fazit Die Anwendung des Fragebogens wurde von den Patienten gut akzeptiert, war jedoch mit einem großen Maß an Unterstützung beim Ausfüllen verbunden. Es zeigte sich ein hohes Schmerzniveau während des Krankenhausaufenthalts. Eine Anpassung der Schmerztherapie oder ein Einbezug schmerzmedizinischer Spezialisten erfolgte selten. Die Interpretation bzgl. Aussagen zur Qualität des Schmerzmanagements könnte eingeschränkt sein, da andere (vorbestehende) Schmerzentitäten, wie nichttumorassoziierter Schmerz oder chronischer Tumorschmerz, nicht eindeutig abgrenzbar sind.

Hintergrund Das deutsche Gesundheitssystem steht aufgrund der SARS-CoV-2-Pandemie vor bisher nicht gekannten Herausforderungen. Auch die Palliativversorgung schwerkranker Patient*innen und deren Angehörigen war vor allem während der ersten Welle der Pandemie im stationären und ambulanten Setting stark beeinträchtigt. Das betrifft auch palliativ behandelte Krebspatient*innen. Material und Methoden Die Arbeit beschreibt – basierend auf Teilergebnissen einer Studie, die im Rahmen des Verbundprojekts „Nationale Strategie für Palliativversorgung in Pandemiezeiten“ (PallPan) durchgeführt wurde, sowie aus eigenen Erfahrungen aus der stationären Versorgung von Patient*innen, die unter einer schweren oder lebenslimitierenden Erkrankung leiden, – Best-Practice-Beispiele zur Verbesserung bzw. Aufrechterhaltung der Palliativversorgung. Ergebnisse Eingeschränkte Besucherregelungen, Kommunikationsbarrieren und unzureichende Möglichkeiten zur Begleitung sterbender Patient*innen bzw. trauernder Angehöriger stellen nach wie vor große Herausforderungen in der allgemeinen wie spezialisierten stationären Palliativversorgung dar. Hier bedarf es der Schaffung von Strukturen, um z. B. innovative Kommunikationswege mittels Videotelefonie oder individuelle Ausnahmeregelungen von Besuchsverboten bei Therapiezielgesprächen oder Sterbebegleitungen möglich zu machen, um eine qualitativ hochwertige Palliativversorgung aufrechtzuerhalten. Schlussfolgerungen Eine adäquate Versorgung schwerkranker und sterbender Patient*innen sowie deren Angehörigen muss auch in der Pandemie gewährleistet werden. Individuelle Maßnahmen können abgesprochen und durchgeführt werden. Eine frühzeitige Einbindung spezialisierter Palliativteams kann von Vorteil sein.

Aim The aim of this study was to evaluate the suitability and comprehensibility of the integrated palliative care outcome scale for the evaluation of palliative care needs in patients with heart failure. Methods and results This cross-sectional study investigated 100 heart failure patients (40 women, 60 men; median age 79 years) within the first few days of their hospitalisation by applying the integrated palliative care outcome scale (3-day recall period) and two additional self-developed questions about the suitability and comprehensibility of the integrated palliative care outcome scale. Clinically relevant somatic and psycho-emotional symptoms were reported very frequently (approximately 75% each), followed by communicational needs or practical issues. Ninety-five per cent of patients thought the integrated palliative care outcome scale very easy to understand, and 91% judged the integrated palliative care outcome scale suitable to assess palliative care needs. Conclusion The integrated palliative care outcome scale was well accepted by hospitalised patients with heart failure and identified a high burden of both physical and psycho-emotional symptoms. Screening for palliative care has to consider patients and their relatives alike, and should be part of a comprehensive care concept jointly integrated into clinical routine by primary and specialised palliative care teams.

Um Patienten mit lebenslimitierenden Erkrankungen proaktiv eine adaquate palliative Mitbetreuung anzubieten, mussen diese Patienten zunachst erkannt werden. Dabei mussen patienten- wie arztseitige Barrieren uberwunden werden, wobei ein Screening auf Palliativbedarf sinnvoll ist. Hierfur wird eine Kombination aus Fremd- und Selbsteinschatzung empfohlen. Es gibt viele Instrumente, die die Symptomlast und/oder die psychische Belastetheit des Patienten und seiner Angehorigen erheben. Bisher gibt es jedoch noch kein Screeninginstrument, aus dem ein direkter palliativer Mitbetreuungsbedarf direkt abgelesen werden kann. Fur das stationare Setting schlagen wir ein abgestuftes Vorgehen vor, in dem prognoserelevante Daten aus der (Pflege‑)Anamnese automatisiert ausgelesen und mit einer strukturierten Arzteinschatzung sowie einer Selbsteinschatzung des Patienten kombiniert werden. Abgestufte und multiprofessionelle Screeningmodelle konnen das gemeinsame Engagement der Onkologen und Palliativmediziner unterstutzen, Patienten mit lebenslimitierender Erkrankung bestmoglich palliativmedizinisch mitzubetreuen.

In the partnership between the medical departments of Würzburg University, Germany, and Nagasaki University, Japan, palliative care is a relevant topic. The aim of the study was to perform a comparative analysis of the hospital-based palliative care teams in Würzburg (PCT-W) and Nagasaki (PCT-N). Survey of staff composition and retrospective analysis of PCT patient charts in both PCTs were conducted. Patients self-assessed their symptoms in PCT-W and in Radiation Oncology Würzburg (RO-W). The (negative) quality indicator ‘percentage of deceased hospitalised patients with PCT contact for less than 3 days before death’ (Earle in Int J Qual Health Care 17(6):505–509, 2005) was analysed. Both PCTs follow a multidisciplinary team approach. PCT-N saw 410 cancer patients versus 853 patients for PCT-W (22.8% non-cancer patients). The Eastern Cooperative Oncology Group Performance Status at first contact with PCT-N was 3 or 4 in 39.3% of patients versus 79.0% for PCT-W. PCT-N was engaged in co-management longer than PCT-W (mean 20.7 days, range 1–102 versus mean 4.9 days, range 1–48). The most frequent patient-reported psychological symptom was anxiety (family anxiety: 98.3% PCT-W and 88.7% RO-W, anxiety 97.9% PCT-W and 85.9% RO-W), followed by depression (98.2% PCT-W and 80.3% RO-W). In 14 of the 148 deceased patients, PCT-N contact was initiated less than 3 days before death (9.4%) versus 121 of the 729 deceased PCT-W patients (16.6%). Psychological needs are highly relevant in both Germany and Japan, with more than 85% anxiety and depression in patients in the Japanese IPOS validation study (Sakurai in Jpn J Clin Oncol 49(3):257–262, 2019). This should be taken into account when implementing PCTs.

Bei der Behandlung von Tumorschmerzen sind Opioide oft unverzichtbar. Was aber ist zu tun, wenn diese Substanzen nicht mehr ausreichend wirken oder zu unertraglichen Nebenwirkungen fuhren?

In addition to question prompts for information transfer, we also used prompts to facilitate the expression of emotions. Our aim was to investigate how a question prompt list (QPL) is accepted by patients and whether it enhances interactional empowerment of the patients in the consultation with the radio-oncological treatment team before the beginning of radiotherapy. Adult cancer patients before the beginning of radiotherapy were randomly assigned to the intervention group (IG) or control group (CG). The patients in the IG received a QPL with predefined subsets and subject areas. After the physician’s consultation, both groups completed a self-developed, content validated questionnaire on interactional empowerment. The IG evaluated the QPL using a self-developed instrument. A total of 279 adult cancer patients participated in the study (IG n = 139/CG n = 140). The participants of the IG reported a significantly higher interactional empowerment compared with those of the CG (t(277) = − 2.71, p = .007, 95% CI [− 1.61, − 0.26], d = 0.29). 60.4% of the IG agreed “rather” or “very” that they used the QPL in consultation with the medical team. The QPL used in the consultation improved the self-assessed competence for interaction with the medical team and strengthened the interactional empowerment. The QPL was well accepted by the patients and is to be introduced into a routine as a practicable and simple instrument in the future. The support of patients in addressing concerns and fears is an important innovation.

PURPOSE: Guidelines recommend several screening tools to identify patients with complex palliative needs. This diversity and lack of structural recommendations offer a wide scope for implementing screening. Against this background, the current status of implementation at German Comprehensive Cancer Centers (CCCs) funded by the German Cancer Aid has not yet been investigated. METHODS: e-mail survey of the 17 hospital sites of the 13 CCCs. The questionnaire asked for structural characteristics of the centers as well as preconditions of the screening process. Structurally established screening procedures (one item) and standardized workflows, modes of performance, screening tools (four items), modes of training how to screen, and responsibilities (two items) were assessed. RESULTS: In a 2-month period, 15 hospital sites responded; seven hospital sites conducted a palliative care needs (PCN) screening. Only one hospital site carried out PCN screening in almost all oncology departments, but only with the distress thermometer. Other hospital sites determined palliative needs by assessing physical symptoms using the Integrated Palliative Care Outcome Scale or the Minimal Documentation System, and two hospital sites combined tools to determine both physical and psychological stress. The type of screening varied from paper-pencil–based to tablet computer–based documentation. The main barriers to implementation were identified as a lack of human resources and a lack of structural conditions. CONCLUSION: There is a lack of consensus among palliative care specialists and oncologists in the CCCs supported by the German Cancer Aid in PCN screening as well as of structured guidelines and the professional association. Structural requirements should be adapted to these needs, which include both technical and human resources. A combined psycho-oncologic and palliative care screening might help to formulate best practice recommendations.

This qualitative phenomenology investigates the acquisition of intercultural competencies during international service-learning experiences. Additionally, the authors of this article examine the impact of intercultural competencies on subsequent coursework. The findings of this study indicate that international service-learning experiences result in the acquisition of multiple intercultural competencies. Participants of this study were able to make their experiences more meaningful through the practice of purposeful reflection. Despite a lack of institutional preparedness, participants of this study unanimously acquired intercultural competencies that were used to contextualize the learning process in a more meaningful way.

Purpose Examine the effects of an 8-week yoga therapy on fatigue in patients with different types of cancer. Methods A total of 173 cancer patients suffering from mild to severe fatigue were randomly allocated to yoga intervention (n = 84) (IG) versus waitlist control group (CG) (n = 88). Yoga therapy consisted of eight weekly sessions with 60 min each. The primary outcome was self-reported fatigue symptoms. Secondary outcomes were symptoms of depression and quality of life (QoL). Data were assessed using questionnaires before (T0) and after yoga therapy for IG versus waiting period for CG (T1). Results A stronger reduction of general fatigue (P = .033), physical fatigue (P = .048), and depression (P < .001) as well as a stronger increase in QoL (P = .002) was found for patients who attended 7 or 8 sessions compared with controls. Within the yoga group, both higher attendance rate and lower T0-fatigue were significant predictors of lower T1-fatigue (P ≤ .001). Exploratory results revealed that women with breast cancer report a higher reduction of fatigue than women with other types of cancer (P = .016) after yoga therapy. Conclusion The findings support the assumption that yoga therapy is useful to reduce cancer-related fatigue, especially for the physical aspects of fatigue. Women with breast cancer seem to benefit most, and higher attendance rate results in greater reduction of fatigue. Trial registration German Clinical Trials Register DRKS00016034

New therapeutic modalities enable good treatment options for patients with advanced and metastatic head and neck cancer. In this context, discussions about the end of life, advance care planning, and palliative concepts are often eclipsed.Analysis of symptom burden and advance directives of palliatively comanaged inpatients using a palliative care self-assessment questionnaire. Based on the Earle quality indicator (QI), the integration of specialized palliative care in deceased inpatients was examined.Retrospective analysis of head and neck cancer patients cotreated by the palliative care service. Patients were surveyed using the Integrated Palliative Care Outcome Scale (IPOS) questionnaire.The most frequent physical symptoms were weakness (77%), loss of appetite (65%), and poor mobility (65%). Pain was reported by 41% of patients. The most frequent emotional and psychosocial burdens were depression (97%) and worries about illness or treatment (94%), lack of ability to share feelings (77%), lack of information (85%), and organizational problems (77%). In 23% of patients, advanced directives were available. The Earle QI was not achieved.Patients report a high degree of symptoms and stress, most often in emotional areas and in terms of communicative and practical needs. This may reflect a need to talk about wishes and expectations concerning the end of life. Palliative care services should aim to address psychosocial needs in particular.HINTERGRUND: Neue Therapieformen ermöglichen auch bei Patienten mit fortgeschrittenen und metastasierten Kopf-Hals-Tumoren gute Behandlungsansätze. Gespräche über das Lebensende, vorausschauende Versorgungsplanung und auch palliativmedizinische Konzepte geraten dadurch oft in den Hintergrund.Analyse von Symptomen, Belastungen sowie dem Vorliegen von Vorsorgedokumenten, von stationär palliativmedizinisch mitbetreuten Patienten durch Selbsteinschätzung. Erhebung der Integration der spezialisierten Palliativversorgung in die Versorgung stationär verstorbener Patienten anhand des Qualitätsindikators nach Earle.Retrospektive Analyse der vom Palliativdienst mitbetreuten Patienten mit Kopf-Hals-Tumoren durch Nutzung des standardisierten IPOS Fragebogens.Die häufigsten physischen Symptome waren „Schwäche“ (77 %), „Appetitlosigkeit“ (65 %) und „eingeschränkte Mobilität“ (65 %). „Schmerzen“ wurden von 42 % der Patienten angegeben. Die häufigsten emotionalen und psychosozialen Belastungen waren „Traurigkeit“ (97 %) und „Sorgen des Patienten“ (94 %), die „fehlende Möglichkeit Gefühle“ zu teilen (77 %), „unzureichende Informiertheit“ (85 %) und „organisatorische Probleme“ (77 %). Bei 23 % der Patienten lagen Vorsorgedokumente vor. Das Qualitätsziel nach Earle wurde nicht erreicht.Die Patienten berichten in der Auswertung in hohem Maß Symptome und Belastungen, am häufigsten im emotionalen Bereich und bezüglich kommunikativer und praktischer Bedürfnisse. Hier zeigt sich möglicherweise auch ein Gesprächsbedarf über Wünsche und Vorstellungen im Hinblick auf das Lebensende. Palliativdienste sollten deshalb besonders auf die psychosozialen Bedürfnisse einzugehen.

Neue Therapieformen ermoglichen auch bei Patienten mit fortgeschrittenen und metastasierten Kopf-Hals-Tumoren gute Behandlungsansatze. Gesprache uber das Lebensende, vorausschauende Versorgungsplanung und auch palliativmedizinische Konzepte geraten dadurch oft in den Hintergrund. Analyse von Symptomen, Belastungen sowie dem Vorliegen von Vorsorgedokumenten, von stationar palliativmedizinisch mitbetreuten Patienten durch Selbsteinschatzung. Erhebung der Integration der spezialisierten Palliativversorgung in die Versorgung stationar verstorbener Patienten anhand des Qualitatsindikators nach Earle. Retrospektive Analyse der vom Palliativdienst mitbetreuten Patienten mit Kopf-Hals-Tumoren durch Nutzung des standardisierten IPOS Fragebogens. Die haufigsten physischen Symptome waren „Schwache“ (77 %), „Appetitlosigkeit“ (65 %) und „eingeschrankte Mobilitat“ (65 %). „Schmerzen“ wurden von 42 % der Patienten angegeben. Die haufigsten emotionalen und psychosozialen Belastungen waren „Traurigkeit“ (97 %) und „Sorgen des Patienten“ (94 %), die „fehlende Moglichkeit Gefuhle“ zu teilen (77 %), „unzureichende Informiertheit“ (85 %) und „organisatorische Probleme“ (77 %). Bei 23 % der Patienten lagen Vorsorgedokumente vor. Das Qualitatsziel nach Earle wurde nicht erreicht. Die Patienten berichten in der Auswertung in hohem Mas Symptome und Belastungen, am haufigsten im emotionalen Bereich und bezuglich kommunikativer und praktischer Bedurfnisse. Hier zeigt sich moglicherweise auch ein Gesprachsbedarf uber Wunsche und Vorstellungen im Hinblick auf das Lebensende. Palliativdienste sollten deshalb besonders auf die psychosozialen Bedurfnisse einzugehen.

In addition to question prompts for information transfer, we also used prompts to facilitate the expression of emotions. Our aim was to investigate how a question prompt list (QPL) is accepted by patients and whether it enhances interactional empowerment of the patients in the consultation with the radio-oncological treatment team before the beginning of radiotherapy.Adult cancer patients before the beginning of radiotherapy were randomly assigned to the intervention group (IG) or control group (CG). The patients in the IG received a QPL with predefined subsets and subject areas. After the physician's consultation, both groups completed a self-developed, content validated questionnaire on interactional empowerment. The IG evaluated the QPL using a self-developed instrument.A total of 279 adult cancer patients participated in the study (IG n = 139/CG n = 140). The participants of the IG reported a significantly higher interactional empowerment compared with those of the CG (t(277) = - 2.71, p = .007, 95% CI [- 1.61, - 0.26], d = 0.29). 60.4% of the IG agreed "rather" or "very" that they used the QPL in consultation with the medical team.The QPL used in the consultation improved the self-assessed competence for interaction with the medical team and strengthened the interactional empowerment. The QPL was well accepted by the patients and is to be introduced into a routine as a practicable and simple instrument in the future. The support of patients in addressing concerns and fears is an important innovation.

Eine 34-jahrige Patientin mit multiplen Vorerkrankungen prasentierte sich zur medikamentosen schmerztherapeutischen Neueinstellung. Eine Vordiagnose war ein Gitelman-Syndrom mit negativem Gentest. Wiederkehrende Hypokaliamien auf Normalstation fuhrten zur Uberwachung auf Intensivstation. Mit Einverstandnis der Patientin sichteten wir die mitgefuhrten Medikamente. Hierbei fanden sich grose Mengen an Diuretika und Laxanzien. Die Patientin gab eine unkontrollierte Selbstmedikation zu. Die Erkrankung des Gitelman-Syndroms erschien somit als artifizielle Storung.

Mixed ammonium-transition metal salts with formula of (NH4)xMyHzPMo12O40 (M = Ni2+, Co2+ or Fe3+) denoted as MPMo12 have been investigated for the oxidation of propane, with molecular oxygen, at temperature range between 380 °C and 420 °C after in-situ pre-treatment performed at two heating rate of 5 or 9 °C/min. They were characterized by BET method, XRD, UV-Vis and IR techniques. The catalysts were found to be active in the propane oxidation and selective to propene or acrolein, in particular for samples pre-treated with the heating rate of 9 °C/min. FePMo12 was found to be a more active catalyst for propene (17.2% yield) with minimal over deep oxidation (0.3% yield in COx).

Ammonium salts, (NH4)6HPMo11MO40 (M = Ni, Co, Fe), have been investigated for the oxidation of propane, with molecular oxygen, at temperature ranging between 380 °C and 420 °Cafter in-situ pre-treatment performed at two heating rate of 5 or 9 °C/min. They were characterized by BET method, XRD, 31P NMR, UV-Vis and IR techniques. The catalysts were found active in the propane oxidation and selective to propene or acrolein, in particular for samples pre-treated with the heating rate of 9 °C/min.

International audience; In this letter, we experimentally demonstrate Brillouin echoes-based distributed optical fiber sensing with centimeter spatial resolution. It is based on a differential phase-shift-keying technique using a single Mach-Zehnder modulator to generate a pump pulse and a pi-phase-shifted pulse with an easy and accurate adjustment of delay. The results are compared to those obtained in standard Brillouin echo-distributed sensing system with two optical modulators and clearly show a resolution of 5 cm in a spliced segment between two fibers by applying a pi-phase-shifted pulse of 500 ps.

A 34-year-old woman presented with a complex pain disorder and a previous diagnosis of the rare Gitelman syndrome but with a negative genetic test. The patient was admitted to a routine ward for treatment of the pain but was transferred to the intensive care unit after suffering severe hypokalemia and a narcoleptic attack. In the period of intensive care all blood parameters were stable but on release to the normal ward severe hypokalemia immediately reoccurred. With consent the patient's belongings were inspected and many diuretics and laxatives were found. The patient admitted to uncontrolled self-medication so that the diagnosis of Gitelman syndrome also appeared to be an artificial disorder.

We present in this work the results of a Raman spectroscopy study on the plasmon–phonon coupling in Ge‐doped p‐type gallium arsenide. A series of polarized Raman scattering experiments were carried out on epitaxial films grown by liquid‐phase epitaxy on (100) GaAs substrates at 20, 100, and 300 K. The films were p type with free hole densities varying in the range of 5×1017–1×1020 cm−3. Under the scattering configurations employed, the longitudinal optical (LO) mode is forbidden for crossed polarization while the transverse optical (TO) mode is forbidden for both parallel and crossed polarizations. However, all the polarized Raman spectra showed two peaks with frequencies close to the TO and LO phonons of semi‐insulating GaAs. The appearance of such forbidden modes was accounted for with a theoretical model which considers phonon–plasmon coupled modes with wave vectors much larger than those given by the regular q≊0 wave vector transferred by photons. Ionized acceptor impurities provide such additional wa...

The optical and electrical properties of hydrogenated amorphous silicon (a-Si:H) thin films, prepared by plasma deposition, were studied as a function of r.f. power in the range from 12.5 to 200 mW/cm 2 . Film analysis performed included spectroellipsometry, FT-IR absorption spectroscopy, photothermal deflection spectroscopy, and dark and photoelectrical conductivity measurements. The initial effect of increasing r.f. power is characterized by a decrease in material density and an increase in film microstructure and structural disorder, resulting in a deterioration of a-Si:H optoelectronic properties. In contrast, at higher r.f. power, film density is hardly affected and microstructure is reduced, as well as the structural disorder. As a consequence, a-Si:H films were obtained at high deposition rate (1 nm/s) with optoelectronic properties comparable with that obtained at low r.f. power (

Silicon nitride thin films were prepared by plasma-enhanced chemical vapor deposition with nitrogen, ammonia, silane and helium gas mixtures. Increasing the [N 2 ] [NH 3 + N 2 ] ratio from 0.75 to 1 resulted in a decrease in the hydrogen content in the films down to 8%. These films were annealed up to 1000°C. Using IR spectroscopy measurements we studied the evolution of the chemical bonds, while the evolved hydrogen was measured upon thermal effusion in an ultrahigh vacuum cell by a mass spectrometer. We discuss the thermal stability of these films and we show that internal chemical reordering is favored with regard to the effusion of hydrogen. This effect is larger in low hydrogen content than in high hydrogen content silicon nitride.

Thin films of hydrogenated amorphous silicon ( a - Si : H ) were grown on different substrates by r.f. glow discharge decomposition of silane gas. Hydrogen content and structural properties of films, determined by IR spectroscopy, have photothermal deflection measurements respectively. New evidence about the influence of the deposition temperature on the structure and properties of a-Si:H, through its action during the growth process, have been analysed. Some effects induced by deposition temperature on a-Si:H films are the linear decrease in both the hydrogen content and the gap energy as the deposition temperature rises to 400°C as well as the decrease in the density of localized states and the Urbach edge as the temperature increases to 350°C. Moreover, changes in deposition temperature induce changes in hydrogen incorporation, as has been evidenced through a microstructural parameter calculated from IR absorption peaks at 2000 and 2090 cm -1 . These results suggest that the main mechanism operating in the growth process is thermal activation of the surface mobility which is limited by the hydrogen surface desorption. Above 350 °C, a lower hydrogen coverage arises during the a-Si:H deposition process.

The surface structure and chemistry of polymers affect their functionality for a great range of applications in areas as diverse as biosensors, corrosion protection, semiconductor processing, biofouling, tissue engineering and biomaterials technology. Some of those applications require purposeful tailoring of laterally differentiated regions (e.g., array structures for multi-channel/multi-analyte biosensors and patterning for promotion of selective adhesion of cells/proteins). While such tailoring is currently taking place on the μm-scale, it is likely in the future to progress into the nm-regime. Attachment of biological moieties at surfaces and interfaces has been shown to be highly dependant on local chemistry at the intended site of attachment. Additionally, the local molecular-scale geometry may promote or hinder attachment events, as in the case of biofilms. To date, however, the effect of frictional properties of surfaces for chemical and biomolecular attachment is a much less understood phenomenon. In this study we show controlled patterning of a polymer surface (polydimethylsiloxane (PDMS)) arising from manipulation by Atomic Force Microscopy (AFM). PDMS is a bio-active/selective polymer having a broad range of applications, such as biomedical devices, molecular stamps, hydraulic fluid devices and in soft lithography. The polymer surface has been selectively altered by high speed scanning in order to generate regions on the surface that exhibit differentiated frictional properties. By altering the loading force, scan width, and area of the AFM probe-to-polymer contact it is possible to produce a variety of detailed and complex patterns with frictional contrast, including anisotropic frictional gradients on the polymer surface. The controlled manipulation of the polymer surface can be carried out on the micro-, meso- and nano-scale.

A review of patient confidentiality issues was commissioned and its findings published as the Caldicott Report in December 1997. It made 16 recommendations and formulated six principals. To help in remembering these principles the mnemonic FIONA C can be used: Formal justification of purpose; Information transferred only when absolutely necessary; Only the minimum required; Need to know access controls; All to understand their responsibilities; Comply with and understand the law. Since the Caldicott Report in 1997 the following acts have become law. Data Protection Act 1998, Human Rights Act 1998, Public Interest Disclosure Act 1998, Audit Commission Act 1998, Terrorism Act 2000, section 60 of the Health and Social Care Act 2001 and Regulation of Investigatory Powers Act 2000, and by 2005 The Freedom of Information Act 2000 will become law and affect the NHS. Consequently it can be seen that the role and responsibility of Caldicott guardians has grown significantly into what is now known as information governance.

Hydrogenated amorphous silicon (a‐Si:H) thin films have been obtained from pure SiH4 rf discharges by using the square wave modulation (SQWM) method. Film properties have been studied by means of spectroellipsometry, thermal desorption spectrometry, photothermal deflection spectroscopy and electrical conductivity measurements, as a function of the modulation frequency of the rf power amplitude (0.2–4000 Hz). The films deposited at frequencies about 1 kHz show the best structural and optoelectronic characteristics. Based upon the experimental results, a qualitative model is presented, which points up the importance of plasma negative ions in the deposition of a‐Si:H from SQWM rf discharges through their influence on powder particle formation.Hydrogenated amorphous silicon (a‐Si:H) thin films have been obtained from pure SiH4 rf discharges by using the square wave modulation (SQWM) method. Film properties have been studied by means of spectroellipsometry, thermal desorption spectrometry, photothermal deflection spectroscopy and electrical conductivity measurements, as a function of the modulation frequency of the rf power amplitude (0.2–4000 Hz). The films deposited at frequencies about 1 kHz show the best structural and optoelectronic characteristics. Based upon the experimental results, a qualitative model is presented, which points up the importance of plasma negative ions in the deposition of a‐Si:H from SQWM rf discharges through their influence on powder particle formation.

The phonon‐plasmon coupling of p‐type, Ge‐doped gallium arsenide films have been study using Raman spectroscopy. The films were grown epitaxially on (100) GaAs substrates by liquid phase epitaxy employing Ge as dopant at various concentrations, which resulted in films with hole densities in the range of 5×1017−5×1020 cm−3. The Raman experiments were performed at near backscattering geometry at room temperature, 100 and 20 K. In the configuration employed only the LO mode is allowed. The intensity, frequency and linewidth of this mode have been discussed in terms of LO phonon‐plasmon coupling due to impurity‐induced Frohlich interaction and or deformation potential mechanisms.

The metastable defects of a-Si:H samples annealed at temperatures in the 300–550°C range have been studied by photothermal deflection spectroscopy (PDS). The light-soaked samples show an increase in optical absorption in the 0.8 to 1.5 eV range. The metastable defect density decreases when the annealing temperature increases, while the defect density increases. This decrease in the metastable defect density shows an almost linear correlation with the decrease in the hydrogen content of the samples, determined by IR transmission spectroscopy and thermal desorption spectroscopy.