Watkinsbinderup0023

As soon as there are occupational safety violations, superiors are obliged to intervene. In general, they should intervene as early as possible in the case of irregularities caused by alcohol consumption. In the case of high-risk drug use and risk of addiction, the procedure is based on a tiered sequence of interviews. Support offers from internal or external advice centres are recommended.Alcohol and addiction prevention is part of occupational health management. It has a particularly lasting effect where the program has been written in a company or service agreement and is implemented in a binding manner.Alcohol prevention in municipalities is an important and complex aspect of drug prevention in Germany. Based on the principle of subsidiarity, prevention measures are characterised by different legal requirements and prevailing conditions. On the one hand, the federal government set a legal framework with the law of prevention (PrävG) in 2015 and established the national strategy of drug policy and prevention in 2012. On the other hand, municipalities are responsible for the detailed design of local drug policy and interventions together with federal states. Furthermore, preventive measures need to fit local challenges and conditions.Hence, we discuss different strategies of alcohol prevention in municipalities and explain how these strategies fit in administrative frameworks. We also look critically at specific local situations and challenges but also at conditions and possibilities to establish a quality-assured local alcohol policy. Promising approaches from pilot projects are contributed to the discussion.Political decisionmakers, scientists and skilled workers accord that alcohol prevention needs to be implemented in municipal settings and that it is a field of growing importance. We conclude that there is a need to improve local prevention measures by creating better access to qualification programs for skilled workers in combination with a constant transfer between science and pratice of current research results and best practices by providing consultation and support from coordinating institutions for local interventions, especially for the identification of challenges and conditions. Local initiatives should receive better access to interventions that are proven to be effective, and these interventions should be sustainable anchored and evaluated in their municipal settings.

The aim of this study was to compare the effect of the change in TTA protocol from a two-tier to one-tier, with focus on undertriage and mortality.

A before-after observational cohort study based on data extracted from the Stavanger University Hospital Trauma registry in the transition period from two-tier to a one-tier TTA protocol over two consecutive 1-year periods (2017-2018). Comparative analysis was done between the two time-periods for descriptive characteristics and outcomes. The main outcomes of interest were undertriage and mortality.

During the study period 1234 patients were included in the registry, of which 721 (58%) were in the two-tier and 513 (42%) in the one-tier group. About one in five patients (224/1234) were severely injured (ISS > 15). Median age was 39 in the two-tier period and 43years in the one-tier period (p = 0.229). Median ISS was 5 for the two-tier period vs 9, in the one-tier period (p = 0.001). The undertriage of severely injured patients in the two-tier period was 18l for better patient care.Isopropylamine dodecylbenzene sulfonate (IDS) is a new kind of anionic surfactant (ANS). To preliminarily evaluate the aquatic toxicity of IDS, this study took gibel carp (Carassius auratus gibelio) as the research object. The well-acclimatized fish were divided into six groups and exposed to 0 mg/L, 0.5 mg/L, 1.0 mg/L, 2.0 mg/L, 4.0 mg/L, or 8.0 mg/L of IDS for 7, 14, 21 or 28 days. Our results showed that the superoxide dismutase (SOD) activity and malondialdehyde (MDA) content of the liver were unaffected by IDS exposure, while glutathione peroxidase (GSH-Px) activity was significantly inhibited. Hepatic tissue exhibited pathological damage, characterized by nuclear migration and dissolution and cell boundary blurring. The results suggest that IDS does not cause oxidative stress in the liver, but cause hepatic histopathological damage. GSH-Px can be considered as a biomarker of IDS exposure in gibel carp.Proper development of the O2-sensing system is essential for survival. Here, we characterized the development of the O2-sensing system in the mangrove rivulus (Kryptolebias marmoratus), an amphibious fish that transitions between hypoxic aquatic environments and O2-rich terrestrial environments. We found that NECs formed in the gills and skin of K. marmoratus during embryonic development and that both NEC populations are retained from the embryonic stage to adulthood. check details We also found that the hyperventilatory response to acute hypoxia was present in embryonic K. marmoratus, indicating that functional O2-sensing pathways are formed during embryonic development. We then exposed embryos to aquatic normoxia, aquatic hyperoxia, aquatic hypoxia, or terrestrial conditions for the first 30 days of embryonic development and tested the hypothesis that environmental O2 availability during embryonic development modulates the development of the O2-sensing system in amphibious fishes. Surprisingly, we found that O2 availability during embryonic development had little impact on the density and morphology of NECs in the gills and skin of K. marmoratus. Collectively, our results demonstrate that, unlike the only other species of fish in which NEC development has been studied to date (i.e., zebrafish), NEC development in K. marmoratus is largely unaffected by environmental O2 levels during the embryonic stage, indicating that there is interspecies variation in O2-induced plasticity in the O2-sensing system of fishes.

Fractures of the metatarsal bones are common injuries of the foot and particularly occur in patients aged 40-50years. Especially multiple metatarsal fractures can lead to permanent limitations. Therefore, the aim of this study was to investigate the functional outcome of metatarsal fractures after conservative and surgical treatment using avalidated self-reported patient-based outcome questionnaire.

All patients suffering from metatarsal fractures between 2003 and 2015 were enrolled in this retrospective analysis. The following data were collected demographic data, AO classification, treatment, reoperation rate and the foot and ankle outcome score (FAOS). For outcome analysis, the nonparametric Mann-Whitney U‑test and Fisher's exact test were performed.

In total the functional outcome of 111patients with metatarsal fractures were analyzed, 81patients suffered of an isolated metatarsal fracture and 30of multiple fractures. The mean age of the patients was 45 ± 15.2years with atotal of 48men (43%) and 63ws can be successfully treated conservatively and complex multifragment fractures can be safely managed surgically. If more than one metatarsal bone is fractured, the functional outcome is significantly worse with patients reporting lasting limitations involving the range of motion and stiffness.A young man suffered the fatal combination of burn injuries and acute kidney failure caused by substantial rhabdomyolysis after lying on the floor in a somnolent condition for 12 h. This symptom constellation should always make physicians aware of a potential compartment syndrome.

Transosseous reconstruction of the triceps tendon.

All tears of the triceps tendon that allow atension-free reconstruction.

Retracted triceps tendon tears that do not allow atension-free reconstruction after mobilization.

Two nonabsorbable sutures are threaded through two crossing transosseous canals. In addition, an anchor is placed directly in the footprint. Using the first nonabsorbable suture the tendon is sutured using the Krackow technique and subsequently shuttled transosseously distally and knotted there with its other part. Using the first suture pair of the anchor the tendon is sutured in asimilar manner and knotted within the tendon. With the second pair pressure to the avulsion fragment can be increased by knotting it distally to the first knot. Alternatively, sutures of the suture anchor can be used with aMason-Allen technique.

For the first 6weeks aROM brace is applied with gradual release of flexion. Free flexion after 6weeks is allowed. Beginning of strengthening exercises after 12weeks.

Authors have reported good results after surgical treatment of triceps tendon ruptures. Regardless of possible extension deficits described in the literature, in the case presented an excellent postoperative outcome with afree range of motion was achieved.

Authors have reported good results after surgical treatment of triceps tendon ruptures. Regardless of possible extension deficits described in the literature, in the case presented an excellent postoperative outcome with a free range of motion was achieved.2-Methyl-2-butene has recently been reported to be a quorum-based volatile self-inhibitor of spore germination and growth in pathogenic Mucorale Rhizopus arrhizus. The present study aimed to elucidate if this compound can influence R. arrhizus biofilm formation and interspecies interaction. The compound was found to significantly decrease R. arrhizus biofilm formation (p  less then  0.001), with nearly 25% and 50% lesser biomass in the biofilms cultured with exposure to 4 and 32 µg/ml of 2-methyl-2-butene, respectively. The growth of pre-formed biofilms was also impacted, albeit to a lesser extent. Additionally, 2-methyl-2-butene was found to self-limit R. arrhizus growth during interspecies interaction with Staphylococcus aureus and was detected at a substantially greater concentration in the headspace of co-cultures (2338.75 µg/ml) compared with monocultures (69.52 µg/ml). Some of the C5 derivatives of this compound (3-methyl-1-butanol, 2-methyl-2-butanol, and 3-methyl-1-butyne) were also observed to partially mimic its action, such as inhibition of spore germination, but did not impact R. arrhizus biofilm formation. Finally, the treated R. arrhizus displayed changes in fungal morphology suggestive of cytoskeletal alterations, such as filopodia formation, blebs, increased longitudinal folds and/or corrugations, and finger-like and sheet-like surface protrusions, depending upon the concentration of the compound(s) and the planktonic or biofilm growth mode.

Cricothyroidotomy and surgical tracheostomy are methods to secure airway patency. In emergency surgery, these methods are nowadays mostly reserved for patients unsuited for percutaneous procedures. Detailed description of complications and functional outcomes following both procedures is underreported in current literature. The aim of this study was to evaluate outcomes following cricothyroidotomy and tracheostomy in this presumed complex population.

In this retrospective cohort study, adult emergency surgical patients treated with cricothyroidotomy and/or surgical tracheostomy were included. Postoperative complications and functional outcomes in trauma and non-trauma patients were evaluated.

Forty-one trauma patients and 11 non-trauma emergency surgical patients (mainly after elective onco-abdominal or vascular surgery) were included. Of 52 patients, seven underwent cricothyroidotomy pre-tracheostomy. Mortality was higher in non-trauma patients (p = 0.04) following both procedures. Over half of patients (56%, n = 29) regained unsupported airway patency with a tendency toward increased tracheostomy removal in trauma patients.