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Manas K Akmatov,* Jakob Holstiege,* Lotte Dammertz, Joachim Heuer, Claudia Kohring, Jörg Bätzing Department of Epidemiology and Health Care Atlas, Central Research Institute of Ambulatory Health Care, Berlin, Germany*These authors contributed equally to this workCorrespondence: Manas K Akmatov; Jakob Holstiege, Tel +49 3040052414 ; +49 3040052467, Fax +49 304005272414 ; +49304005272467, Email makmatov@zi.de; jholstiege@zi.dePurpose: We aimed to examine possible variations in diagnostic prevalence of hay fever between urban and rural regions as well as in age-specific temporal developments.Patients and Methods: We used nationwide outpatient claims data from the years 2010 to 2019. The data contain information for all individuals with statutory health insurance (SHI) in Germany who were treated at least once in respective years (n = 71,410,121 in 2019). Individuals with a confirmed diagnosis of hay fever were defined as prevalent cases. We examined the association between the degree of urbanization and age- and sex-standardized prevalence of hay fever. We used the age- and sex-structure of SHI insurees in the year 2010 as a reference population for direct standardization.Results: The standardized prevalence of hay fever increased from 6.2% in 2010 to 7.2% in 2019, corresponding to a relative increase of 16%. However, we observed a clear decrease in prevalence among children, with the strongest relative reduction in young children (0– 2 years: − 53%). The standardized prevalence in the total population in 2019 was lowest in rural areas with a low population density (6.6%) and highest in big urban municipalities (7.8%). In stark contrast, prevalence in 0– 14-year-olds was lowest in big urban municipalities (4.3%).Conclusion: We observed a decrease in the prevalence of hay fever in children and increase in the older age groups. A clear urban–rural association observed over years may be explained by environmental factors. Deviations from this general regional pattern in children of the age group 0– 14 years may be explained by differing age-specific risk factors of hay fever.Keywords: diagnostic prevalence, hay fever, urban–rural differences, statutory health insurance, temporal trends, Germany

Introduction Evidence of nationwide and regional morbidity of Lyme borreliosis (LB) in Germany is lacking. Aims We calculated the total number of incident LB cases in Germany in 2019, compared regional variations, investigated the extent of possible under-reporting in notification data and examined the association between high incidence areas and land cover composition. Methods We used outpatient claims data comprising information for people with statutory health insurance who visited a physician at least once between 2010 and 2019 in Germany (n = 71,411,504). The ICD-10 code A69.2 was used to identify incident LB patients. Spatial variations of LB were assessed by means of Global and Local Moran’s Index at district level. Notification data were obtained for nine federal states with mandatory notification from the Robert Koch Institute (RKI). Results Of all insured, 128,177 were diagnosed with LB in 2019, corresponding to an incidence of 179 per 100,000 insured. The incidence varied across districts by a factor of 16 (range: 40–646 per 100,000). We identified four spatial clusters with high incidences. These clusters were associated with a significantly larger proportion of forests and agricultural areas than low incidence clusters. In 2019, 12,264 LB cases were reported to the RKI from nine federal states, while 69,623 patients with LB were found in claims data for those states. This difference varied considerably across districts. Conclusions These findings serve as a solid basis for regionally tailored population-based intervention programmes and can support modelling studies assessing the development of LB epidemiology under various climate change scenarios.

Zusammenfassung Hintergrund Nicht nur im Kontext der Neuordnung der Notfallversorgung in Deutschland besteht derzeit ein hoher Bedarf an Daten aus Notaufnahmen. Für die Versorgungsforschung bieten sich Daten an, welche auf gesetzlicher Grundlage generiert werden. Unterschiedliche Kostenträger und Abrechnungsmodi stellen eigene Anforderungen an die Dokumentation dieser Routinedaten. Methodische Herausforderungen Aufgrund der sektoralen Trennung gibt es keinen Datensatz oder Datenhalter, der Auskunft über alle Notaufnahmebehandlungen geben kann. Aus administrativer Sicht gilt die gesamte Notaufnahmebehandlung als ambulant oder stationär, tatsächlich wird die Entscheidung darüber erst während der Versorgung getroffen. Für die stationäre Versorgung existiert ein administratives Notfallkennzeichen, allerdings kein direktes Merkmal für Notaufnahmebehandlungen. Bei Abrechnung ambulanter Fälle über die kassenärztlichen Vereinigungen ist mindestens eine Diagnose (ICD-10-Kode) zu erfassen, versehen mit einem Kennzeichen zur Diagnosesicherheit. Es können mehrere ICD-10-Kodes ohne Hierarchie angegeben werden. Bei stationär behandelten Patienten ist eine Aufnahmediagnose und nach Behandlungsende die Hauptdiagnose und ggf. Nebendiagose(n) an die zuständige Krankenkasse zu übermitteln. Die gesetzliche Unfallversicherung hat eigene Dokumentationsanforderungen. Lösungsansätze Je nach Forschungsfrage und Studiendesign sind unterschiedliche Vorgehensweisen erforderlich. Stammen die Daten unmittelbar aus Notaufnahmen bzw. Kliniken ist eine Information über den Kostenträger und den Abrechnungsmodus hilfreich. Bei Nutzung von Krankenkassendaten muss die Identifikation von stationär behandelten Patienten in einer Notaufnahme aktuell indirekt erfolgen. Dazu können unter anderem die Parameter Aufnahmegrund und definierte „eindeutige“ Notfall-Diagnosen herangezogen werden. Die fallpauschalenbezogene Krankenhausstatistik hat eigene Limitationen, enthält dafür aber die stationären Fälle aller Kostenträger. Diskussion Die divergierenden Anforderungen an die administrative Dokumentation verursachen einen hohen Aufwand in den Kliniken. Perspektivisch ist eine Vereinheitlichung der Leistungserfassung und Dokumentation von Notfallbehandlungen aller Kostenarten auch zur Generierung von validen, vergleichbaren und repräsentativen Daten für die Versorgungsforschung erstrebenswert. Die Einführung eines eigenen Fachabteilungsschlüssels würde zur Identifikation von Notaufnahmebehandlungen beitragen.

Zusammenfassung Ziel der Studie Niedergelassene Haus- und Fachärzte behandeln ein breites Spektrum an Erkrankungen. Das Kodieren von Diagnosen erfolgt mittels der jahresaktuellen Version der Internationalen statistischen Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification (ICD-10-GM). Das Ziel dieser Studie war, die aktuelle Breite und Tiefe der Diagnosendokumentation in der vertragsärztlichen Versorgung zu beschreiben. Unter den gegebenen Rahmenbedingungen konnte diese in einer Nutzung unterschiedlichster aber vielfach nicht-terminaler ICD-10-GM-Kodes erwartet werden. Methodik Der retrospektiven Studie lagen Abrechnungsdatensätze von 900 Praxen aus 13 Arztgruppen der KV-Regionen Brandenburg und Nordrhein aus dem Abrechnungszeitraum Oktober 2014 – September 2015 zu Grunde. Eingeschlossen wurden 22 287 583 Datensätze. Der normierte Gini-Koeffizient wurde als Maß zur Darstellung der Konzentration verwendet. Ergebnisse Der Anteil terminaler ICD-10-GM-Kodes an der Gesamtheit der Datensätze lag bei 97,6 %. Hierbei verzeichneten die HNO-Ärzte den größten Anteil (99,6 %), den geringsten Anteil die Orthopäden und Kardiologen (jeweils 94,0 %). Die größte Breite an unterschiedlichen ICD-10-GM-Kodes zeigte sich bei den Hausärzten (71,1 % aller terminalen Kodes), die geringste Breite bei den Augenärzten (22,9 %). Die geringste Konzentration von ICD-10-GM-Kodes zeigte sich bei den Hausärzten (Gini-Koeffizient: 0,56), die größte Konzentration bei den Augenärzten (0,93). Schlussfolgerung Die Fachärzte nutzten hauptsächlich ein umschriebenes Set an ICD-10-GM-Kodes. Hausärzte nutzten nicht nur eine sehr weite Palette von ICD-10-GM-Kodes sondern kodierten diese sehr häufig terminal. Dies spricht für eine hohe Kodierqualität.

Currently, there is a big need for data on emergency department (ED) utilization in Germany. One reason is the ongoing reorganisation of emergency care. Possible sources are routine data that are being collected based on legal regulations. Different payers and compensation systems have their own requirements for data collection.Due to the sectoral separation of health care services, there is no dataset or data holder to provide information on all ED treatments in Germany. From an administrative point of view, emergency care in Germany is considered ambulatory outpatient or inpatient care from the time point of admission to the ED. In contrast, clinical decision about inpatient admission can sometimes only be made towards the end of emergency care. EDs themselves cannot be identified in claims data; only the medical discipline (e. g. surgery) is classified. In the case of outpatient treatment, reimbursed by the Association of Statutory Health Insurance Physicians, at least one coded diagnosis (ICD) has to be recorded, accompanied by an additional code for the likelihood of this diagnosis. In case of multiple ICDs, a primary diagnosis cannot be specified. In the case of in-hospital treatment, an admission diagnosis must be recorded. After completion of hospital treatment, the main diagnosis and possibly secondary diagnoses are transferred to the respective health insurance fund. The statutory occupational accident insurance has its own requirements.Depending on the research question and study design, different approaches are required. If data are queried directly in emergency departments or hospitals, additional information on the designated data holder and billing mode is crucial. When using health insurance data from inpatient care, the identification of emergency departments can be estimated on the basis of the reason for hospital admission and defined "unique" emergency ICDs. The case-related hospital statistics has its own limitations, but includes inpatients of all payers.Differing requirements for the administrative documentation cause a high workload in emergency departments. A standardised data collection system for all payers for inpatient and outpatient emergency care is recommended. This would contribute to the creation of valid and comparable datasets. The introduction of a particular identifier for EDs in claims data would enhance health services research.Nicht nur im Kontext der Neuordnung der Notfallversorgung in Deutschland besteht derzeit ein hoher Bedarf an Daten aus Notaufnahmen. Für die Versorgungsforschung bieten sich Daten an, welche auf gesetzlicher Grundlage generiert werden. Unterschiedliche Kostenträger und Abrechnungsmodi stellen eigene Anforderungen an die Dokumentation dieser Routinedaten.Aufgrund der sektoralen Trennung gibt es keinen Datensatz oder Datenhalter, der Auskunft über alle Notaufnahmebehandlungen geben kann. Aus administrativer Sicht gilt die gesamte Notaufnahmebehandlung als ambulant oder stationär, tatsächlich wird die Entscheidung darüber erst während der Versorgung getroffen. Für die stationäre Versorgung existiert ein administratives Notfallkennzeichen, allerdings kein direktes Merkmal für Notaufnahmebehandlungen. Bei Abrechnung ambulanter Fälle über die kassenärztlichen Vereinigungen ist mindestens eine Diagnose (ICD-10-Kode) zu erfassen, versehen mit einem Kennzeichen zur Diagnosesicherheit. Es können mehrere ICD-10-Kodes ohne Hierarchie angegeben werden. Bei stationär behandelten Patienten ist eine Aufnahmediagnose und nach Behandlungsende die Hauptdiagnose und ggf. Nebendiagose(n) an die zuständige Krankenkasse zu übermitteln. Die gesetzliche Unfallversicherung hat eigene Dokumentationsanforderungen. LöSUNGSANSäTZE: Je nach Forschungsfrage und Studiendesign sind unterschiedliche Vorgehensweisen erforderlich. Stammen die Daten unmittelbar aus Notaufnahmen bzw. Kliniken ist eine Information über den Kostenträger und den Abrechnungsmodus hilfreich. Bei Nutzung von Krankenkassendaten muss die Identifikation von stationär behandelten Patienten in einer Notaufnahme aktuell indirekt erfolgen. Dazu können unter anderem die Parameter Aufnahmegrund und definierte „eindeutige“ Notfall-Diagnosen herangezogen werden. Die fallpauschalenbezogene Krankenhausstatistik hat eigene Limitationen, enthält dafür aber die stationären Fälle aller Kostenträger.Die divergierenden Anforderungen an die administrative Dokumentation verursachen einen hohen Aufwand in den Kliniken. Perspektivisch ist eine Vereinheitlichung der Leistungserfassung und Dokumentation von Notfallbehandlungen aller Kostenarten auch zur Generierung von validen, vergleichbaren und repräsentativen Daten für die Versorgungsforschung erstrebenswert. Die Einführung eines eigenen Fachabteilungsschlüssels würde zur Identifikation von Notaufnahmebehandlungen beitragen.

Vibration measurements of a cryocooled double-crystal monochromator are presented. The origins of the vibrations are identified. The minimum achieved vibration of the relative pitch between the two crystals is 48 nrad RMS and the minimum achieved absolute vibration of the second crystal is 82 nrad RMS., The requirement for vibrational stability of beamline optics continues to evolve rapidly to comply with the demands created by the improved brilliance of the third-generation low-emittance storage rings around the world. The challenge is to quantify the performance of the instrument before it is installed at the beamline. In this article, measurement techniques are presented that directly and accurately measure (i) the relative vibration between the two crystals of a double-crystal monochromator (DCM) and (ii) the absolute vibration of the second-crystal cage of a DCM. Excluding a synchrotron beam, the measurements are conducted under in situ conditions, connected to a liquid-nitrogen cryocooler. The investigated DCM utilizes a direct-drive (no gearing) goniometer for the Bragg rotation. The main causes of the DCM vibration are found to be the servoing of the direct-drive goniometer and the flexibility in the crystal cage motion stages. It is found that the investigated DCM can offer relative pitch vibration down to 48 nrad RMS (capacitive sensors, 0–5 kHz bandwidth) and absolute pitch vibration down to 82 nrad RMS (laser interferometer, 0–50 kHz bandwidth), with the Bragg axis brake engaged.

Primary care physicians and specialists deal with a wide range of diseases. The diagnoses are coded by using the annual version of the International Statistical Classification of Diseases and Related Health Problems, 10th revised version, German modification (ICD-10-GM). The aim of this study was to describe the current spectrum of documented diagnoses by physicians. Based on the underlying conditions, a broad variety of ICD-10-GM codes could be expected, which in many cases would not be coded to the final character (terminal).22,287,583 data sets of 900 medical practices of 13 various physician groups were included in this retrospective study. The data originate from the regions Brandenburg and North Rhine and the accounting period October 2014 - September 2015. The normalized Gini coefficient was applied as a measure for inequality.97.6 % of the total data set were coded to the final character using the ICD-10-GM. ENT physicians used the highest rate of terminal codes (99.6 %), whereas orthopedists and cardiologists used the lowest rate (94.0 %). The broadest variety of different ICD-10-GM codes was used by primary care physicians (71.1 % of all possible terminal codes), the smallest variety was used by ophthalmologists (22.9 %). The lowest inequality of using ICD-10-GM codes could be detected for primary care physicians (Gini coefficient: 0.56), the highest inequality could be shown for ophthalmologists (Gini coefficient: 0.93).The specialists mainly use a circumscribed set of ICD-10-GM codes, whereas primary care physicians not only use a broad variety of different ICD-10-GM codes, but very often code them to their final character. This indicates a high quality of coding.Niedergelassene Haus- und Fachärzte behandeln ein breites Spektrum an Erkrankungen. Das Kodieren von Diagnosen erfolgt mittels der jahresaktuellen Version der Internationalen statistischen Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification (ICD-10-GM). Das Ziel dieser Studie war, die aktuelle Breite und Tiefe der Diagnosendokumentation in der vertragsärztlichen Versorgung zu beschreiben. Unter den gegebenen Rahmenbedingungen konnte diese in einer Nutzung unterschiedlichster aber vielfach nicht-terminaler ICD-10-GM-Kodes erwartet werden.Der retrospektiven Studie lagen Abrechnungsdatensätze von 900 Praxen aus 13 Arztgruppen der KV-Regionen Brandenburg und Nordrhein aus dem Abrechnungszeitraum Oktober 2014 – September 2015 zu Grunde. Eingeschlossen wurden 22 287 583 Datensätze. Der normierte Gini-Koeffizient wurde als Maß zur Darstellung der Konzentration verwendet.Der Anteil terminaler ICD-10-GM-Kodes an der Gesamtheit der Datensätze lag bei 97,6 %. Hierbei verzeichneten die HNO-Ärzte den größten Anteil (99,6 %), den geringsten Anteil die Orthopäden und Kardiologen (jeweils 94,0 %). Die größte Breite an unterschiedlichen ICD-10-GM-Kodes zeigte sich bei den Hausärzten (71,1 % aller terminalen Kodes), die geringste Breite bei den Augenärzten (22,9 %). Die geringste Konzentration von ICD-10-GM-Kodes zeigte sich bei den Hausärzten (Gini-Koeffizient: 0,56), die größte Konzentration bei den Augenärzten (0,93).Die Fachärzte nutzten hauptsächlich ein umschriebenes Set an ICD-10-GM-Kodes. Hausärzte nutzten nicht nur eine sehr weite Palette von ICD-10-GM-Kodes sondern kodierten diese sehr häufig terminal. Dies spricht für eine hohe Kodierqualität.

Hintergrund: Medizinischer Fortschritt und Veränderungen in den ärztlichen Versorgungsstrukturen ziehen eine veränderte Arbeitsteilung zwischen niedergelassenen Ärzten und akutstationären Krankenhäusern nach sich. Zunehmend erbringen auch ambulant tätige Ärzte[zum vollständigen Text gelangen Sie über die oben angegebene URL], 16. Deutscher Kongress für Versorgungsforschung (DKVF)

There is limited availability of reliable and valid information on alternative methods to the use of experimental animals from open access data banks. In 1989, the Centre for Documentation and Evaluation of Alternative Methods to Animal Experiments (ZEBET) at the German Federal Health Office started a data bank to meet requirements of the German Animal Protection Act. In comparison with other data banks in this field, ZEBET's data bank comprises two types of evaluation: firstly, whether a specific method contributes to the Three Rs concept of Russell & Burch, i.e. replacement, reduction and refinement, and secondly, whether the method meets the criteria of validation as outlined in the report of the Amden workshop on validation of toxicity test procedures. This information is primarily available to the scientific and ethical commissions which have been introduced by the Animal Protection Act in order to reduce the numbers of animals used in experiments in Germany. However, other users of the ZEBET data bank are also welcome, e.g. local animal protection officers, interested scientists and the public. Although the language of ZEBET's data bank is German, the documentation also contains English summaries, key words, and updated lists of references. Here, the concept of ZEBET's data bank and its scientific background are described and compared with other alternatives data banks.

Wird „Rechtsextremismus“ und „Fremdenfeindlichkeit“ in den Kontext mit polizeilichem Handeln gestellt und anschliesend analysiert, wachsen Erklarungsund Bewertungsmuster auf, die immer noch nicht frei von Tabus und Peinlichkeitsempfindungen sind. Das scheint auch damit zusammen zu hangen, dass noch immer nicht die Rolle der Polizei im „Dritten Reich“ so hinreichend bearbeitet ist, dass das Phanomen „Fremdenfeindlichkeit in der Polizei“ sowohl bei den Kritikern als auch bei den Leitungsebenen der Polizeien ohne diesen historischen Bezug auskommen kann. Das Bundeskriminalamt (BKA) hat dieses Hindernis aktuell erkannt und mit drei wissenschaftlichen Kolloquien versucht, die frei zuganglich fur die Offentlichkeit waren, die „braunen Wurzeln des Amtes“ frei zu legen. Das BKA mochte damit auch erreichen, dass aktuelle rechtspolitische Diskussionen frei von nationalsozialistischen Bezugen gefuhrt werden konnen und plant jetzt, zur Geschichte der Behorde ein Forschungsprojekt zu vergeben. Seit Mitte der 90er Jahre gibt es eine gewisse Anzahl nicht selbststandig erschienener Publikationen die das Thema „Fremdenfeindlichkeit und Polizei“

Das gesellschaftliche Produkt einer Inneren Sicherheit1 wird durch politische, rechtliche und tatsachliche Rahmenbedingungen konstruiert und strukturiert. Spezifische Organisationen reprasentieren die Innere Sicherheit auf der Ebene der staatlichen Institutionen; die Polizei steht hier an prominenter Stelle. In den Bundeslandern, die nach dem Grundgesetz die „Polizeihoheit“ besitzen, gibt es ganz unterschiedliche Organisationsformen2 der Polizei. Die „Bundespolizei“ wird durch das Bundeskriminalamt in Wiesbaden und durch den Bundesgrenzschutz reprasentiert, beide Organisationen werden vom Bundesinnenministerium gesteuert. Die Angehorigen dieser Polizeien werden in den Landern und durch den Bund auf internen Polizeischulen, Bildungsinstituten (z.B. Niedersachsen), durch eine Akademie der Polizei (z.B. Baden-Wurttemberg) und an Polizei-Fachhochschulen (Verwaltungsfachhochschulen, Fachbereich Polizei) ausgebildet. 1997 wurden ca. 221.500 Planstellen fur Beamte im Vollzugsdienst (ohne BKA und BGS) ausgewiesen, davon betrug der Anteil des hoheren Dienstes ca. 3.300 Stellen (ca. 1,5%) (fur 1993 vgl. Winter 1998, S. 91; Behr 2000, S. 13). Diese Bildungseinrichtungen qualifizieren ihre Absolventen und Absolventinnen sowohl fur den mittleren als auch fur den gehobenen Dienst. Zu Beginn der 90er Jahre begann zuerst das Bundesland Hessen die so genannte zweigeteilte Laufbahn einzufuhren. Hier werden die Berufsanfanger als Kommissarsanwarter bzw. -anwarterin eingestellt und sie qualifizieren sich fur die Berufstatigkeit durch ein sechssemestriges Fachhochschulstudium; dies wird mit einer Diplomprufung und dem Erwerb eines akademischen Grades (Dipl.-Verwaltungswirt/FH) abgeschlossen. Diesem Beispiel sind andere Bundeslander wie Niedersachsen, Bremen, Hamburg und Rheinland-Pfalz gefolgt, auch hier werden Berufsanfanger fur die polizeiliche Ausfuhrungsebene durch ein Fachhochschulstudium vorbereitet. Ausbildung und Sozialisation der Polizeibeamten und — beamtinnen sind also landerspezifisch.

In order to utilize the full potential of high power wiggler beam lines with heat loads up to several kW and large white beam cross sections, a variety of monochromator crystal designs are in use. Either the crystal is efficiently cooled or the unwanted distortions are compensated by different means which require external control mechanisms. Based on the self-adapting crystal design developed at the Advanced Photon Source, we present a new Si-monochromator crystal and matching support structure. This design makes use of forces inside the crystal which are generated by the heat load hitting the crystal. The heat load induced distortions of the reflecting surface are compensated by these forces. Finite element calculations are the basis for the tested components. The design of the support structure, which provides the necessary mechanical and thermal boundary conditions to the crystal is shown. The present setup allows to measure and adjust the force between crystal and support.

BackgroundMusculoskeletal disorders particularly in the back and lower extremities are common among marines. Here, movement-control tests are considered clinically useful for screening and follow-up evaluation. However, few studies have addressed the reliability of clinical tests, and no such published data exists for marines. The present aim was therefore to determine the inter- and intra-observer reliability of clinically convenient tests emphasizing movement control of the back and hip among marines. A secondary aim was to investigate the sensitivity and specificity of these clinical tests for discriminating musculoskeletal pain disorders in this group of military personnel.MethodsThis inter- and intra-observer reliability study used a test-retest approach with six standardized clinical tests focusing on movement control for back and hip. Thirty-three marines (age 28.7 yrs, SD 5.9) on active duty volunteered and were recruited. They followed anin-vivoobservation test procedure that covered both low- and high-load (threshold) tasks relevant for marines on operational duty. Two independent observers simultaneously rated performance as “correct” or “incorrect” following a standardized assessment protocol. Re-testing followed 7–10 days thereafter. Reliability was analysed using kappa (κ) coefficients, while discriminative power of the best-fitting tests for back- and lower-extremity pain was assessed using a multiple-variable regression model.ResultsInter-observer reliability for the six tests was moderate to almost perfect with κ-coefficients ranging between 0.56-0.95. Three tests reached almost perfect inter-observer reliability with mean κ-coefficients > 0.81. However, intra-observer reliability was fair-to-moderate with mean κ-coefficients between 0.22-0.58. Three tests achieved moderate intra-observer reliability with κ-coefficients > 0.41. Combinations of one low- and one high-threshold test best discriminated prior back pain, but results were inconsistent for lower-extremity pain.ConclusionsOur results suggest that clinical tests of movement control of back and hip are reliable for use in screening protocols using several observers with marines. However, test-retest reproducibility was less accurate, which should be considered in follow-up evaluations. The results also indicate that combinations of low- and high-threshold tests have discriminative validity for prior back pain, but were inconclusive for lower-extremity pain.

A position-sensitive 1D x-ray detector with large dynamic range (> 214:1) for high photon fluxes with fast image recording sequence has been developed for noninvasive subtraction coronary angiography. Detailed investigations of the basic physical processes in the detector allow the quantitative description of the important detector performance parameters. As an example a detector with a position resolution of 430 micrometers FWHM and a detective quantum efficiency (DQE) of at least 58% (for 20,000 photons/pixel) for 33 keV photons in a XeCO2 gas mixture at 20 bars is described. A procedure has been developed for determination of the DQE from the data. Investigations at high beam intensities showed that only at a flux above 2.4 1010 photons/s pixel saturation effects become apparent. These observations are quantitatively explained by a newly developed dynamic ion chamber model. Recently a number of noninvasive angiographies from patients of diagnostic quality were obtained at HASYLAB, DESY.© (1994) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Mit diesem Beitrag werden einige Strukturprinzipien des flexiblen Planens, Denkens und Handelns in der Unterwelt (Untergrundorganisationen) beschrieben, um so Einblick in deren „Betriebswirtschaft“ zu erhalten. Der Beitrag untersucht als Schwerpunkt typische Kommunikations-, Verflechtungs- und Fuhrungsstrukturen, wobei Aspekte der Existenz- und der Uberlebenssicherung besonders hervorgehoben werden. Die Ergebnisse dieser Strukturanalyse werden dann in den Kontext von organisations- bzw. betriebswirtschaftlichen Konzepten gestellt, danach stellt sich die Betriebsform der Unterwelt als „Adhocracy“ dar.

This contribution describes the development of a fast two line scan detector for digital subtraction angiography (DSA). For each line an input phosphor screen, an image intensifier and a photodiode array are successively coupled by a special fiber optic. A line comprises 250 pixels having a size of 0.5 .0.5mm 2 each. The vertical center to center distance of the two input lines is 2mm. Different materials for the phosphor lines such as Gd 2 O 2 S : Tb and CdWO 4 were tested. The 3 stage proximity focusing image intensifiers have a light intensity amplification of 120W/W. Fast readout electronics enable a minimum integration time of 2ms for the photodiode array. For this time the measured dynamic range of the detector is 3000. It can be improved by increasing the readout time. Details of the existing detector will be given. The tested detector was optimized for the application in non-invasive coronary angiography with synchrotron radiation (System NIKOS II). However, its modular design permits an optimization for other applications as well. By individual selection of the detector components, for example the spatial resolution and the shape of the input line can be adapted to specific problems.

Three bovine serum albumin-specific Lyt-2+ T suppressor (Ts) cell clones from CBA/J mice have been analyzed with regard to expression of L3T4 molecules. All three Ts-cell clones can be stained with monoclonal antibodies (mAb) to L3T4. Tested for the two clones restricted to recognition of Ek determinants, antigen-specific proliferation on antigen-presenting cells, but not the proliferation induced by conditioned medium can be inhibited by L3T4-specific mAb. In a similar way, Ts-cell cytolytic effector functions can be blocked by L3T4-specific mAb. Thus L3T4 structures seem to play a role in Ts-cell functions. Furthermore, the data support the view that L3T4 expression can be a property of class II-restricted T cells irrespective of their Lyt phenotype.

Two major alternative models, clonal deletion and suppression, have been proposed as possible explanations for immunological tolerance1,2. We have now isolated a functional T suppressor (Ts) cell clone to analyse the role of Ts cells in the induction and maintenance of tolerance. This cloned, long-term cultured Ts cell line (HF1) was derived from CBA/J mice (H–2k) in which low-zone tolerance (LZT)3 had been induced by sub-immunogenic doses of bovine serum albumin (BSA). HF1 cells show BSA-specific suppressor activity in two in vitro suppressor assays. HF1 Ts cells and a factor derived from them suppress imprinted, carrier-specific T helper (Th) cells in an assay measuring IgG antibody production against fluorescein-conjugated BSA (Flu-BSA). Furthermore, they block DNA synthesis in an antigen-specific in vitro T-cell proliferation assay. Their proliferation in the presence of antigen-presenting cells is antigen specific and shows restriction to the I–Ak region of the major histocompatibility complex (MHC). In addition, HF1 Ts cells have a characteristic cytotoxic activity. The data reported suggest that clonal deletion and suppression models are not necessarily mutually exclusive. Clonal deletion could manifest itself by the action of Ts cells.

A cloned, antigen-specific T suppressor cell line derived from a CBA mouse expresses large amounts of I-A and I-E antigens. Comparative two-dimensional polyacrylamid gel electrophoresis of biosynthetically labeled I-A antigens immunoprecipitated with a variety of monoclonal I-Ak-specific antibodies suggested that alpha, beta and Ii polypeptide chains are identical with B-cell-derived I-A. Dimeric complexes formed by I-A chains derived from B or T suppressor cells were also similar with two major exceptions. Pulse-labeled T-cell-derived Ia antigen was complexed with two additional unknown components of about 31K. These components were not visible in pulse-chased (processed) materials. In addition, T suppressor-cell-derived I-A antigens did not contain S-S linked dimers consisting of processed alpha and beta chains, which are usually formed during solubilization of B cells. We consider the possibility that in T cells these chains are associated with other structures, thus preventing S-S linkage between alpha and beta chains.

The suppressive activity of two bovine serum albumin-specific class II-restricted T suppressor cell clones (BVI/5 and 83/2-Dl 1) was compared to that of a feeder cell-independent, IL 2-dependent subline (HF1.IL-2) of an originally antigen-dependent class II-restricted Ts cell clone (HF1). No soluble suppressor factors can be found in BVI/5 and 83/2-D11 Ts cell extracts or culture supernatants under conditions where an unspecific factor can be derived from HFLIL-2 cells. This factor, when isolated from cell extracts in the presence of n-octyl-pD-glycopyranoside, has a molecular weight of 70-80 kD. In absence of this non-ionic detergent, it has a high affinity to membrane fragments and is associated with a molecular weight of 300 kD or more. The data are discussed in connection with recent findings of direct T suppressor to T helper interaction by cell-cell contact.

An antigen-specific T suppressor cell clone isolated from a CBA/J mouse tolerized to low doses of bovine serum albumin (BSA) has previously been analyzed with regard to its effector functions. The T suppressor cell clone HF1 specifically inhibits T helper cell responses to the antigen. It also has characteristic cytolytic activity which can neither be classified as cytotoxic T cell nor as natural killer cell activity. Since this lytic capacity might be of relevance in immunoregulation, it has now been studied in more detail. For that purpose BSA-specific T cell lines have been isolated from immune CBA/J mice in order to test them in 51Cr-release assays as possible targets for HF1 T suppressor cells. Two T cell lines, both BSA specific and restricted to recognition of I-Ek major histocompatibility complex determinants, have been selected for the studies because one is a helper cell (83/1), the other a suppressor cell type (83/2). HF1 T cells are able to lyse cells of line 83/1 but not those of line 83/2. Control experiments show that 83/1 cells are not a natural killer cell target and that on the other hand 83/2 cells are susceptible to lysis in an alloreactive BALB/c anti-CBA/J cytotoxic T cell response. The extent of lysis of 83/1 T cells by HF1 T cells changes with time after antigenic stimulation. The lysis is based on direct effector: target cell interaction and not caused by soluble mediators. The data are discussed with regard to the effector function of a type of T suppressor cells which expresses I-A and I-E molecules and whose proliferation is restricted to the recognition of I-A or I-E determinants.

The antigen-specific T suppressor cell clone HF1 isolated from a CBA/J mouse made tolerant by low doses of bovine serum albumin has suppressive and cytolytic activity. The analysis of the latter gave the following results. Natural killer (NK)-sensitive YAC-1 (H-2a) and RBL-5 (H-2b) target cells are lysed whereas other NK targets, like EL4 (H-2b) or the human K562 cell line are resistant. Cytolytic activity is not antibody mediated. Its inhibition by sugar phosphate or monoclonal antibodies against LFA-1 antigens is such that HF1 can neither by typed as T killer nor as NK cells. It seems to represent a distinct T lymphocyte type.

Metabolomics, the comprehensive analysis of metabolites in a biological system, provides detailed information about the biochemical/physiological status of a biological system, and about the changes caused by chemicals. Metabolomics analysis is used in many fields, ranging from the analysis of the physiological status of genetically modified organisms in safety science to the evaluation of human health conditions. In toxicology, metabolomics is the -omics discipline that is most closely related to classical knowledge of disturbed biochemical pathways. It allows rapid identification of the potential targets of a hazardous compound. It can give information on target organs and often can help to improve our understanding regarding the mode-of-action of a given compound. Such insights aid the discovery of biomarkers that either indicate pathophysiological conditions or help the monitoring of the efficacy of drug therapies. The first toxicological applications of metabolomics were for mechanistic research, but different ways to use the technology in a regulatory context are being explored. Ideally, further progress in that direction will position the metabolomics approach to address the challenges of toxicology of the 21st century. To address these issues, scientists from academia, industry, and regulatory bodies came together in a workshop to discuss the current status of applied metabolomics and its potential in the safety assessment of compounds. We report here on the conclusions of three working groups addressing questions regarding 1) metabolomics for in vitro studies 2) the appropriate use of metabolomics in systems toxicology, and 3) use of metabolomics in a regulatory context.