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Here, we describe the surgical technique for implanting a new, active, transcutaneous bone conduction hearing aid. The implant technology is based on a system that has been in use reliably since 2012. The geometry of the new implant has been adapted based on experience with previously introduced implants. The surgery was feasible, standardized, and safe. Due to the optimized geometric design that improved the bone fit, it is not necessary to use specialized, detailed preoperative planning, except in challenging anatomical conditions; e.g., in young children, malformations, poor pneumatization, or after a canal wall down mastoidectomy.The number of operations for tonsillectomy have been significantly decreasing for many years in Germany. In children the number of adenotonsillectomies has decreased by two thirds within a decade. This phenomenon is mirrored by a significant increase in the number of annually performed tonsillotomies, a surgical procedure which is preferably performed for volume reduction in cases of tonsillar hypertrophy. The aim of this article is to elucidate the different interventional procedures, their typical indications and risks.Toxoplasma gondii is a widespread protozoan parasite that infects one third of the global human population. Very little information is known about the impact of T. gondii on patients with heart disease. The aim of the present study was to determine the association between T. gondii exposure and patients suffering from myocardial infarction.The infection rate of anti-Toxoplasma IgG antibodies in 86 patients with myocardial infarction (troponin‑T positive) and 86 age and gender-matched controls (troponin‑T negative) was examined using enzyme-linked immunoassays. The DNA extraction was performed on separated buffy coats of serologically positive blood samples (32 samples with high titer of anti-Toxoplasma IgG). The GRA6 gene of T. gondii was amplified using PCR. The existence of polymorphic restriction sites for endonuclease MseI was used with the PCR-RFLP method and the bases of GRA6 gene were sequenced to determine the type of strains (I, II and III).A positive anti-Toxoplasma IgG level was found in 61.6% of the myocardial infarction samples and in 24.4% of the healthy controls (P- value less then 0.05). The PCR results showed that only 3 of the anti-Toxoplasma IgG positive patients were found to be positive with GRA6 gene for T. gondii. The PCR-RFLP results showed that 2 of the 3 positive sample had 75bp and 623 bp DNA fragments belonging to type II genotype. The sequencing result confirmed the genotype II of T. gondii. Toxoplasma infection should be considered in myocardial infarction cases.Bone loss of the distal tibia represents a major challenge for the treating surgeons and the reconstruction technique. This is particularly true for septic bone loss. Several techniques are available, ranging from callus distraction of Ilizarov frames and monorail techniques as well as transport with plates and nails; however, implants for internal segmental transport for bone defects have so far not been available. This case report describes worldwide the first reconstruction of a distal tibial defect by reconstruction of the major arterial flow path with flap coverage and all inside segmental transport using a motorized segmental transport nail without additional osteosynthesis or add-on module.Arginine, homoarginine (hArg), asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) affect nitric oxide metabolism and altered concentrations are associated with cardiovascular morbidity and mortality. We analyzed these metabolites using liquid chromatography-tandem mass spectrometry in patients with atrial fibrillation (AF) (n = 241) with a focus on heart rhythm at blood withdrawal, AF progression phenotypes, and successful sinus rhythm (SR) restoration (n = 22). AF progression phenotypes were defined as paroxysmal AF with/without low voltage areas (LVA) and persistent AF with/without LVA. While arginine, ADMA, and hArg were within reference limits for healthy controls, SDMA was higher in the AF cohort (0.57 ± 0.12 vs. 0.53 μmol/L (97.5th percentile in reference cohort)). SR restoration in AF patients resulted in normalization of SDMA concentrations (0.465 ± 0.082 vs. 0.570 ± 0.134 μmol/L at baseline, p less then 0.001). Patients with AF at the time of blood sampling had significantly lower hArg (1.65 ± 0.51 vs. 1.85 ± 0.60 μmol/L, p = 0.006) and higher ADMA concentrations (0.526 ± 0.08 vs. 0.477 ± 0.08 μmol/L, p less then 0.001) compared with AF patients in SR. hArg concentrations were lower in patients with advanced AF progression phenotypes (persistent AF with LVA (p = 0.046)) independent of heart rhythm at blood sampling. Summarizing, arginine metabolism imbalance is associated with AF in general and AF progression and may contribute to associated risk. KEY MESSAGES • Heart rhythm at blood withdrawal affects ADMA and hArg level in AF patients. • SDMA is higher in AF patients. • SDMA levels normalize after sinus rhythm restoration. • hArg levels decrease in advanced AF progression phenotypes.In the original publication of the article, Fig. 3 is incorrect.Growing evidence suggests that global climate change promotes the dominance of mixotrophic algae especially in oligotrophic aquatic ecosystems. While theory predicts that mixotrophy increases trophic transfer efficiency in aquatic food webs, deleterious effects of some mixotrophs on consumers have also been reported. Niacinamide Here, using a widespread mixotrophic algal genus Dinobryon, we aimed to quantify how colonial taxa contribute to secondary production in lakes. We, therefore, studied the dietary effects of Dinobryon divergens on Cladocera (Daphnia longispina) and Copepoda (Eudiaptomus gracilis), representing two main taxonomic and functional groups of zooplankton. In feeding experiments, we showed that Dinobryon was largely grazing resistant and even inhibited the uptake of the high-quality reference food in Daphnia. Eudiaptomus could to some extent compensate with selective feeding, but a negative long-term food quality effect was also evident. Besides, Eudiaptomus was more sensitive to the pure diet of Dinobryon than Daphnia. Low lipid content and high CP elemental ratio further supported the low nutritional value of the mixotroph. In a stable isotope approach analysing a natural plankton community, we found further evidence that carbon of Dinobryon was not conveyed efficiently to zooplankton. link2 Our results show that the increasing dominance of colonial mixotrophs can result in reduced dietary energy transfer to consumers at higher trophic levels. In a wider perspective, global climate change favours the dominance of some detrimental mixotrophic algae which may constrain pelagic trophic transfer efficiency in oligotrophic systems, similarly to cyanobacteria in eutrophic lakes.Mercury as the 3rd most toxic, non-biodegradable, and carcinogenic pollutant can adversely affect the ecosystem and health of living species through its bioaccumulation within the nature that can affect the top consumer in the food chain; therefore, it is vital to sense/remove Hg2+ within/from aqueous media using practical approaches. To address this matter, we modified the glassy carbon electrode (GCE) with ultra-sensitive, interconnected, sulfurized, and porous nanostructure consisted of polyaniline-Fe3O4-silver diethyldithiocarbamate (PANi-F-S) to enhance the sensitivity, selectivity, and limit of detection (LOD) of the sensor. Obtained results showed that at optimum conditions (i.e., pH value of 7, deposition potential of - 0.8 V, and accumulation time of 120 s), for Hg2+ concentration ranging from 0.4 to 60 nM, the modified electrode showing linear relative coefficient of 0.9983, LOD of 0.051 nM, LOQ of 0.14 nM, and sensitivity of 1618.86 μA μM-1 cm-2 highlights superior sensitivity of the developed platform until picomolar level. Additionally, the modified electrode showed ideal repeatability, stability, reproducibility, and selectivity (by considering Zn2+, Cd2+ Pb2+, Cu2+, Ni2+, and Co2+ as metal interferences) and recovered more than 99% of the Hg2+ ions within non-biological (mineral, tap, and industrial waters) and biological (blood plasma sample) fluids. Graphical abstract.DNA methylation is one of the best studied epigenetic modifications. Alteration of the global DNA methylation level occurs in abnormal cells, such as those associated with cancers and Alzheimer's disease. Several assays are used to determine the global DNA methylation level, including the bisulfite-based assay, high-performance liquid chromatography (HPLC)-based assay, enzyme-linked immunosorbent assay (ELISA), and methyl acceptance assay. However, these assays require several cumbersome steps to detect methylation levels. link3 We developed a simpler enzymatic assay for the quantification of the global DNA methylation level using the Ten-eleven translocation (TET) protein. TET proteins mediate DNA demethylation through the oxidation of 5-methylcytosine (5mC) in CpG in mammalian cells. Succinate is produced during this oxidation reaction, and the amount of succinate produced correlates to the global DNA methylation level. The catalytic domain of the TET2 was expressed in Escherichia coli (E. coli), and the purified TET2 catalytic domain was reacted with human genomic DNA. The reaction solution was used for enzymatic succinate quantification with no purification step. The results showed that the succinate produced through TET-mediated oxidation increased with increasing global DNA methylation levels in human genomic DNA, which was determined using the bisulfite method. These results show that the global DNA methylation level is quantifiable by measuring the amount of succinate produced by the TET2-mediated 5mC oxidation reaction. Graphical abstract.Background The incidence of deep vein thrombosis (DVT) in CoViD-19 patients in intensive care units (ICU) has so far been investigated in only a few studies. Prospective comparative studies with non-CoViD-19 ICU patients are completely lacking. Objective Evaluation of the incidence of DVT in ICU patients with CoViD-19 compared to non-CoViD-19 ICU patients who were treated in the University Hospital Augsburg during the same period. In addition, the aim was to investigate what type of anticoagulation was present in CoViD-19 patients at the time the DVT occurred and to what extent DVT is associated with increased mortality in this patient population. Material and methods In this prospective single center study, which was conducted between 18 April 2020 and 30 April 2020, 20 SARS-CoV2 positive patients were compared with 20 non-CoVid-19 patients in the ICU with respect to the occurrence of DVT. For this purpose, demographic data, laboratory parameters, and clinical outcomes were recorded and evaluated. Results The rate of DVT in the investigated patient collective was markedly higher in patients with SARS-CoV2 (CoViD-19 patients 20% vs. non-CoViD-19 patients 5%). Both DVT and elevated D‑dimer levels were associated with increased mortality in the present study. Conclusion We recommend the determination of D‑dimer levels and, in the case of elevated levels, the broad indication for compression sonography of the deep leg veins on admission of patients with suspected or confirmed SARS-CoV2. In this way DVT in the setting of CoViD-19 can be recognized early and therapeutic anticoagulation can be started. All inpatient CoViD-19 patients should receive thrombosis prophylaxis with low molecular weight heparin. Further studies on point of care methods (TEG®, ROTEM®) for the detection of hypercoagulability in SARS-CoV2 are necessary.

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