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Unsubstituted and methylated polycyclic aromatic hydrocarbons (22 PAHs and 17 Me-PAHs) were examined in surface sediments collected from the Red River and four inner-city rivers of Hanoi City, Vietnam. Concentrations of total PAHs and Me-PAHs ranged from 52 to 920 (median 710) and from 70 to 2600 (median 1000) ng/g dry weight in samples of dry and wet seasons, respectively. Significant correlation was observed between total PAHs and organic carbon contents (Spearman's ρ = 0.782; p  less then  0.05). PAHs were more abundant than Me-PAHs in all samples and dominated by 4-6 ring compounds. The most predominant PAHs were benzo[ghi]perylene, benzo[b/j]fluoranthene, chrysene, pyrene, fluoranthene, and phenanthrene. Methylated derivatives of naphthalene, phenanthrene, anthracene, and benz[a]anthracene were frequently detected. The patterns of PAHs indicated principal pyrogenic sources (notably gasoline exhaust) in this highly urbanized area. The occurrence of several PAHs were occasionally associated with adverse effects on benthic organisms of the inner-city rivers.As part of the national influenza pandemic preparedness, surveillance systems have been established in Germany in addition to the mandatory notifications according to the Protection Against Infection Act. The aim of these systems is the description, analysis, and evaluation of the epidemiology of acute respiratory infections (ARIs), the identification of the circulating viruses, and the trend. Since the beginning of the COVID-19 pandemic, the systems have been expanded to enable monitoring of infections with SARS-CoV‑2.Three systems are presented GrippeWeb, the primary care sentinel Arbeitsgemeinschaft Influenza with its electronic reporting module SEEDARE, and the ICD-10-based hospital sentinel ICOSARI. With these systems, ARIs can be monitored at the population, outpatient, and inpatient levels. In combination with the monitoring of mortality, these systems provide important information on the frequency of different stages of disease severity in the population. In order to expand the systems to SARS-CoV‑2, only a few adjustments were needed.As the case definitions for ARIs were preserved, historical baselines of the systems can still be used for comparison. All systems are structured in such a way that stable and established reference values are available for calculating weekly proportions and rates.This is an important addition to the mandatory reporting system of infectious diseases in Germany, which depends on the particular testing strategy, the number of tests performed, and on specific case definitions, which are adapted as required.The surveillance systems have proven to be feasible and efficient in the COVID-19 pandemic, even when compared internationally.Real-time data from medical care settings play an increasing role in guiding public health action. The COVID-19 pandemic is a good example; public health decisions depend on current data from the various clinical care settings. The automated processing and communication of health-related data is essential to ensure continuity of reporting and safe resources. So far, various technical, formal, and organizational challenges help back the development of digitally automated real-time systems with scientific quality standards. The COVID-19 pandemic pushed sustainable system developments since it began in early 2020.This article describes how a real-time data system should be structured so that automated data processing is possible. Important aspects in the consolidation of the data and their preparation and communication are presented. The processes implemented for handling routine data from emergency departments in real time and making it available to public health actors is described. As an example, we present the cooperation between the emergency admission registry of the Aktionsbündnis für Informations- und Kommunikationstechnologie in Intensiv- und Notfallmedizin (AKTIN), the Universität Magdeburg, and the RWTH Aachen as well as the Surveillance Monitor (SUMO) hosted at the Robert Koch Institute.The development of modern systems for processing research data in real-time from medical care settings can only succeed through the cooperation of a wide variety of actors. find more An important basis for long-term success is the development of a legal framework.Data normalization is an essential part of a large-scale untargeted mass spectrometry metabolomics analysis. Autoscaling, Pareto scaling, range scaling, and level scaling methods for liquid chromatography-mass spectrometry data processing were compared with the most common normalization methods, including quantile normalization, probabilistic quotient normalization, and variance stabilizing normalization. These methods were tested on eight datasets from various clinical studies. The efficiency of the data normalization was assessed by the distance between clusters corresponding to batches and the distance between clusters corresponding to clinical groups in the space of principal components, as well as by the number of features with a pairwise statistically significant difference between the batches and the number of features with a pairwise statistically significant difference between clinical groups. Autoscaling demonstrated the most effective reduction in interbatch variation and can be preferable to probabilistic quotient or quantile normalization in liquid chromatography-mass spectrometry data.

Anatomical restoration of the function and anatomy of the talocrural joint, anatomical reduction of fractures of the lateral and medial malleoli and to address ligamentous instability when achieving exercise stability.

Dislocated and intra-articular fractures of the lateral and medial malleoli.

Infections, peripheral arterial occlusive disease, critical soft tissue conditions.

Placement in a supine position, lateral and medial access, reduction of the fractures by manipulation of the fragments with Kirschner wires or use of reduction clamps, control of the joint reduction, definitive fixation with traction screws and plate osteosynthesis of the distal fibula, screw, tension-band or plate osteosynthesis of the medial malleolus, in cases of syndesmosis instability exact restoration of the talocrural joint by implantation of adjusting screws, alternatively dynamic fixation with a suture-button system.

Movement exercises of the talocrural joint after postoperative day 1, mobilization with partial weight-bearing of the affected leg with 20kg postoperatively for 6-8 weeks, with implantation of adjusting screws removal after 8 weeks and staged increase of weight-bearing, if necessary postoperative insertion of an orthesis.