bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing ‘Buttonhole’ Complications
Authors: Wilson Nicole A. , Shenoy Surendra
Published: November 2014

Cannulation problems in vascular access can be a cause for significant morbidity, mortality and risk loss of access site. Buttonhole cannulation has been promoted as a method of arteriovenous fistula (AVF) cannulation that has fewer complications and is more patient friendly ( 1 , 2 ). Widespread use of this technique has resulted in several publications raising concerns about the complications associated with this technique. This article attempts to understand the anatomic and physiologic basis for this technique and may provide explanations for some of these complications. A clear understanding of the mechanism of function of this technique might help mitigate some of the complications and help devise techniques to reduce others. It focuses on evaluation of the buttonhole to identify the infectious problems that may predispose to bleeding and their management.
Alternative Tests to Psa for Prostate Cancer Diagnosis
Authors: Defilippi Elio , Zitella Andrea , Tizzani Alessandro
Published: November 2014

Prostate specific antigen (PSA) is still the most useful tool to select the population requiring prostate biopsy. The main downsides of PSA are an inadequate sensitivity to be used in screening and a low specificity for cancer detection.

So far, a limited value for PSA derivates (velocity, density, free, proisoforms and doubling time) has been recognised.

We present a short review of the literature describing a selection of the most promising alternatives to PSA being studied currently: PCA3, serum kallikreins, serum detectable prostate specific membrane antigen, the nuclear matrix protein EPCA, EPCA-2, prostatic acid phosphatase, urine detectable GSTP1, anti-AMACR antibodies, sarcosine, plasminogen activating urokinase, IGFBP, TGF beta 1, PSP94, IL6, plasmatic DNA, serum autoantibodies, neuroendocrine markers, proteomic analysis.
The Endovision Technique in Renal Percutaneous Lithotripsy
Authors: Serra Simona , Corona Andrea , Caddeo Giacomo , De Lisa Antonello
Published: November 2014

Introduction

In order to achieve a safer percutaneous access to the kidney, even if not systematically, it is possible to combine the use of eco-fluoro-guided puncture with the endoscopic retrograde vision through flexible ureteroscopy Our experience has been conducted in order to standardize the technique and highlight advantages and limitations.

Materials and Methods

26 patients (15 M-11 F), mean age 46 years, underwent flexible ureterorenoscopy as first percutaneous access for pyelic or pyelocaliceal stones. 20 cases were conducted in the prone and 6 in the supine position. We proceeded with the study of the caliceal topography and the choice of the calyx suitable for puncture, studying the orientation of the main axis of the papilla of the lower or middle group. Leaving the endoscopic instrument in place, we proceeded with the contrast injection and the eco-fluoro-guided puncture. The retrograde instrument followed the puncture and access dilatation.

Results

In 16 cases we identified a papilla of the lower caliceal group with a correct orientation for the renal puncture; in the other 10, we chose a papilla of the middle group, because it was more favorable. In 10 cases the puncture was made at the center of the papilla with its axis in favor; in 16 it was necessary to correct the puncture because the needle had penetrated the fornix (no. 14) or had punctured the other side of the calyx (no. 2). In 10 cases the puncture correction caused some bleeding, which required a careful washing in order to clear the field of vision and repeat the procedure; in other 6 cases, this was not possible: the Endovision procedure was interrupted and completed according to the conventional method. There was no difference in technique between the supine and the prone position.

Discussion

It is not always likely to find a papilla of lower calyx suitable to correct puncture. The Endovision technique is related to an inevitably blind moment linked to the displacement of the kidney, which is not followed by the flexible instrument, and to the limitations related to the visibility. The technique can be used both in the prone and supine position; chances are that it might not always be completed.
Sostenibilidad de Bancos Comunitarios de Semillas Criollas y Acriollas en el norte de Nicaragua
Authors: Vílchez Ponce Leonel Aarón , González Benavidez Jonny Antonio , Lanuza Morales Eveling Giomar , Lanuza Lanuza Oscar Rafael
Published: November 2014

La presente investigación es untrabajo monográfico para optar al titulo de Lic. En Ciencias Ambientales. Esta investigación se realizo dentro del convenio de la FAREM Estelí y la UNAG. En el artículo se encontrará información relacionada sobre el contexto geográfico de los departamentos estudiados, objetivos, metodología utilizada, caracterización de los Bancos, nivel de sostenibilidad y alternativas de solución. La metodologia aplicada en esta investigacion, fue mediante fases de estudio: Fase 1: Revision documental, fase 2: Definicion de la muestra, fase 3: Recoleccion de la informacion de campo, fase 4: Analisis de la información recolectada. En la primera etapa se realizo una caracterización general de los bancos comunitarios, para conocer el estado actual. A continuación se determino el nivel de sostenibilidad de los bancos con la “Metodología para estimar el nivel de desarrollo Sostenible de los territorios rurales”. (Sepúlveda Sergio, et al 2005). Para finalizar se formularon alternativas de solución para mejorar el funcionamiento de los bancos comunitarios. DOI: http://dx.doi.org/10.5377/farem.v0i11.1602 Revista Científica de FAREM-Estelí No.11 2014: 27-38
Herstelgerichte praktijken, berouw en vergeving in het islamitische strafrecht
Authors: Claessen Jacques
Published: November 2014

Restorative practices, remorse and forgiveness in Islamic criminal law

Since Islam stands for a total way of life, it also includes a vision on crime and punishment. According to several (Muslim)scholars the Sharia contains not so much a message of revenge and retribution but rather one of compassion, forgiveness and mercy. Much depends on which sections of the holy sources of Islam are read and subsequently how these sections are interpreted. However, fact is that – in the context of quite a number of criminal offences – Islamic criminal law gives room for restorative practices. These practices prove to be more beneficial with regard to the realization of remorse, forgiveness and reconciliation than the regular criminal process. Since restorative practices form an intrinsic part of (pre-modern) Islamic criminal law and since more and more initiatives are being developed nowadays to incorporate such practices in (modern) Western criminal law, it is of fundamental importance to take note of Islamic criminal law. Before focusing in this contribution on the role of restorative practices, remorse and forgiveness in Islamic criminal law, first the position of victims in criminal law under influence of Islam and Christianity will be discussed on the basis of the ideas of the Dutch victimologist Jan van Dijk. Furthermore, attention will be paid to the decline of mysticism in Islam and to the possible consequences and risks thereof – also for the role of restorative practices, remorse and forgiveness in Islamic criminal law.
Cultura Brasileira e Marketing de Relacionamento: Um Estudo Etnográfico no Varejo
Authors: Lourenço Cléria Donizete da Silva
Published: November 2014

O presente estudo foi realizado com o objetivo de compreender como os traos culturais brasileiros se manifestam nas relaes de troca comercial entre funcionrios de micro e pequenas empresas varejistas e seus consumidores. Como, na rea de marketing, uma das perspectivas tericas que buscam dar conta das relaes entre empresas e consumidores o marketing de relacionamento, procurou-se compreender as trocas tendo tambm esta perspectiva como suporte. Partindo do pressuposto de que a relao de troca comercial tambm uma relao humana e social, procurou-se tratar a troca como um fenmeno social. A pesquisa, de natureza qualitativa, foi realizada em cinco empresas varejistas de um municpio de pequeno porte no Sul de Minas Gerais um supermercado, uma farmcia, uma panificadora, um posto de combustveis e uma loja de hortifrutigranjeiros durante o perodo de um ano (dez/2008 a dez/2009) utilizando-se como mtodo a etnografia. A observao participante e a entrevista em profundidade foram utilizadas como tcnica de coleta de dados. Quanto aos resultados, evidenciou-se como o personalismo, a cordialidade, a no valorizao do trabalho manual, a averso ao conflito, a malandragem e o jeitinho se manifestaram nas relaes comerciais. A principal concluso a que se chegou a de que a realidade das trocas comerciais no varejo complexa e multifacetada tanto quanto o a cultura brasileira. No final deste trabalho, so apresentadas as implicaes tericas e metodolgicas para a rea acadmica de marketing e as implicaes gerenciais, especialmente para as empresas varejistas.
Impacto da Extensão e Interação de Serviços nas Vendas B2B: Uma Investigação Temporal na Categoria de Combustíveis
Authors: Almeida Marcos Inacio Severo de , Porto Rafael Barreiros , Isidro-Filho Antonio , Coelho Ricardo Limongi França
Published: November 2014

O escopo do marketing de servios possui uma lacuna terico-emprica que se refere ao impacto que a oferta de servios promove nas vendas. Essa oportunidade de pesquisa rotineiramente destacada em propostas tericas como a do Aumento da Oferta de Servios (ASO), da Inovao nos Servios (IS) e da Lgica Dominante dos Servios (SDL), que demandam investigaes alternativas de mensurao das combinaes entre produto e servio e os possveis efeitos que esses arranjos possam provocar. Este artigo apresenta uma pesquisa cujo principal objetivo foi investigar o impacto da extenso e interao de servios em um recorte especfico das vendas, as vendas B2B. Trs hipteses foram testadas com dados provenientes da categoria de combustveis: a investigao foi operacionalizada a partir de dados secundrios, cedidos por uma empresa de energia, que compreendem dados de venda de gasolina comum e gasolina aditivada dessa empresa para 19 postos de combustveis, ao longo de 27 meses, totalizando 513 observaes. O estudo compreendeu a construo de um modelo linear generalizado, baseado em uma regresso em estrutura de painel balanceado, longo e de efeito aleatrio. As trs hipteses foram suportadas, permitindo identificar que o princpio extensivo do servio contribui para o aumento do desempenho e concluir a existncia de um impacto direto, linear e positivo da extenso e interao de servios nas vendas B2B.
Comunicação Digital e a Preocupação com a Comunidade: Um Estudo de Caso em uma Cooperativa de Crédito de Araguaína
Authors: Santos Rumeninng Abrantes , Carvalho Adriano Dias de , Pitombo Teresa Dias de Toledo , Zaccaria Rosana Borges
Published: November 2014

Este artigo busca abordar os atributos da Comunicao Digital utilizados por uma cooperativa de Crdito para atender ao stimo princpio cooperativista, da Preocupao com a Comunidade. O mesmo ocorreu em uma cooperativa de crdito no municpio de Araguana, Tocantins, com o objetivo de identificar as aes de comunicao digital desenvolvidas pela cooperativa. O artigo inicia-se com uma reviso literria sobre o surgimento do cooperativismo, depois a conceituao do cooperativismo de crdito e a sua histria no Brasil, em seguida os princpios cooperativistas e sua evoluo, conceituaes sobre a preocupao com a comunidade, a comunicao digital, o marketing social e a apresentao e anlise dos resultados. A metodologia adotada foi embasada no estudo de caso, que segundo Yin (2001) o mesmo importante por se tratar da realidade pesquisada. A pesquisa demonstrou que a atuao da cooperativa voltada inteiramente para os cooperados e no tem muito foco relacionado s aes sociais, mas a mesma promove aes para atrair os cooperados e promover o desenvolvimento da comunidade por meio de mdias digitais. Outro resultado importante da pesquisa foi o de que o princpio abordado um dos objetivos da cooperativa que visa atender os interesses, promover o bem-estar dos cooperados e de toda a comunidade em que a cooperativa est inserida.
Species of Erysiphales, Uredinales and Ustilaginales rare or new in Poland
Authors: Majewski Tomasz
Published: November 2014

New localities are reported of rare species of Erysiphaceae, Uredinales and Ustilaginales Eleven species, marked are new in the flora of Poland, plant marked are new hosts of fungi in Poland. The more noteworthy new hosts are: Sphaerotheca delphinii (Delphinium exysepalum), Urocystis poae (Poa angustifolia) and Ustilago lolii (Lolium remotum). The perithecia of Erysiphe galii on Asperula odorata have been recorder in Poland for the first time.
Rare and new Laboulbeniales from Poland
Authors: Majewski Tomasz
Published: November 2014

In this work new species parasitizing on Coleoptera (Cucujomyces rotundatus sp. n. on Silvanus unidentatus, Hydrophilomyces gracilis sp. n. and H. hamatus sp. n. on Cercyon spp.), Dermaptera (Hesperomyces forficulae sp. n.) and Acarina (Rickia polonica sp. n.) are described. The localities of four species new for Poland are given.
Fungi of the genera Pseudovalsa, Melanconis et Cryptospora in Poland
Authors: Truszkowska Wanda
Published: November 2014

The author presents results of investigations on some specie~ of the genera Pseudovalsa, Melanconis and Cryptospora collected since 1955 in Poland. Samples found in herbaries in Poland were examined. Descriptions of perfect and accompanying imperfect forms were made.
Record on a new species of epiphytic fungus Aegeritella lenkoi sp.nov. (Mycophyta, Hyphomycetales) from the Brasilian ant Camponotus sericeiventris (Guerin)
Authors: Bałazy Stanisław , Wiśniewski Jerzy
Published: November 2014

Within the genus Aegeritella Bał. et Wiś. the occurrence of the only one described hitherto fungus spedes A. superficialis Bał. et Wiś. was found exclusively on species from the genus Formica L. (W i ś n i e w s k i 1967; B a ł a z y, W i ś n i e w s k i 1974; W i ś n i e w s k i 1976). Several years ago dr. Karol Lenko from the Instituto Biologico in Sao Paulo sent us a collection of Brasilian ants. In the course of studies about a dozen workers of the species Camponotus sericeiventris (Guerin) were found to have fungal wens, reminding much the mentioned above fungus.
Fungi of Mount Babia Eastern. I. Mycoflora of forests
Authors: Bujakiewicz Anna
Published: November 2014

The author gives a list of 617 taxons of fungi (macromycetes) recorded in the forests of Mt. Babia Góra in the Western Carpathians.
Low adverse event rates following voluntary medical male circumcision in a high HIV disease burden public sector prevention programme in South Africa
Authors: Phili Rogerio , Abdool‐Karim Quarraisha , Ngesa Oscar
Published: November 2014

Introduction

The provision of voluntary medical male circumcision (VMMC) services was piloted in three public sector facilities in a high HIV disease burden, low circumcision rate province in South Africa to inform policy and operational guidance for scale‐up of the service for HIV prevention. We report on adverse events (AEs) experienced by clients following the circumcision procedure.

Methods

Prospective recruitment of HIV‐negative males aged 12 and older volunteering to be circumcised at three select public health facilities in KwaZulu‐Natal between November 2010 and May 2011. Volunteers underwent standardized medical screening including a physical assessment prior to the surgical procedure being performed. AEs were monitored at three time intervals over a 21‐day period post‐operatively to determine safety outcomes in this pilot demonstration programme.

Results

A total of 602 volunteers participated in this study. The median age of the volunteers was 22 years (range 12–56). Most participants (75.6%) returned for the 48‐hour post‐operative visit; 51.0% for day seven visit and 26.1% for the 21st day visit. Participants aged 20–24 were most likely to return. The AE rate was 0.2% intra‐operatively. The frequency of moderate AEs was 0.7, 0.3 and 0.6% at 2‐, 7‐ and 21‐day visits, respectively. The frequency of severe AEs was 0.4, 0.3 and 0.6% at 2‐, 7‐ and 21‐day visits, respectively. Swelling and wound infection were the most common AEs with mean appearance duration of seven days. Clients aged between 35 and 56 years presented with most AEs (3.0%).

Conclusions

VMMC can be delivered safely at resource‐limited settings. The intensive three‐visit post‐operative review practice may be unfeasible due to high attrition rates over time, particularly amongst older men.
О задачах и методах словообразовательной разметки в корпусе текстов
(Word-formation annotation of the Russian National Corpus – aims and methods)
Authors: Lyashevskaya Olga , Grishina Elena , Itkin Ilya , Tagabileva Maria
Published: November 2014

This article reports on a project aimed at creating a full-fledged word- formation annotation of the Russian National Corpus (http: //rus- corpora.ru). In the article we outline the goals of the first stage of our work - compiling a word-formation database suitable for corpus an- notation. We furthermore discuss some important theoretical problems of Russian word-formation, describe stipulated searching possibilities and the annotation format, and outline possible approaches to automation of the annotation process.
Schwa in Contemporary Standard Russian
Authors: Nesset Tore
Published: November 2014

This article explores a number of generalizations regarding the distribution of schwa in Russian and outlines an analysis in terms of Optimality Theory.
Effectiveness of Non-Traditional Activities to Develop the Mathematical Higher Order Thinking Skills of Grade-Seven Students
Authors: Abuzo Emmanuel P.
Published: November 2014

Developing critical thinking and problem solving skills of students are some of the important goals that every school must set. This study determined the effectiveness of non-traditional activities to develop mathematical higher order thinking skills of grade seven students. This study employed the non-equivalent control group experimental design, which involved 83 grade 7 students of Sawata National High School. There were two sections used in this study, the control group which the researcher used the traditional lecture activity and the experimental group, were the students exposed to non-traditional activities: manipulative activities, computer-aided activities, and reflective writing activities. The specific subject matters covered were the second-grading mathematics seven topics which are measurement and measuring of length, measuring mass/weight and volume, and measuring angles, time and temperature. The data were gathered using the multiple choice teacher's made test in the pre-test and post-test. Prior to the study, the higher order thinking skills of the two groups had no significant difference. The result changed after the treatment was given. The study concludes that the used of non-traditional activities were effective over the traditional activity in the development of the higher order thinking skills of the students. The study recommends integration of non-traditional activities to develop the higher order thinking skills of the students.
Effect of Cooperative Learning Method Anchored on Multiple Intelligence Theory on Students' Achievement in Mathematics
Authors: Valencerina May Ann Bague
Published: November 2014

Cooperative learning is defined as a category of instructional strategies that place students in mixed-ability groups in which students work together to achieve a common academic goal. This type of learning has become more desirable as researchers study individual learning differences and styles as well as multiple intelligences. The theory of multiple intelligences suggests that there are number of distinct forms of intelligence that each individual possesses in varying degrees and that the implication of the theory is that learning and teaching should focus on the particular intelligences of each person. This study was conducted to provide empirical facts on the effect of cooperative learning method supported by multiple intelligence theory on students' achievement in mathematics. This study used the nonequivalent control group design. The instruments used were the 90-item adopted Multiple Intelligence test and the 40-item teacher-made test for the topics Fundamental Operations on Rational Algebraic Expressions, Positive Integral Exponents, and Zero and Negative Exponents. The data gathered were summarized, translated, and analyzed using the mean scores for both pre-test and post-test. The difference between the post-test mean scores of the experimental and control group is statistically significant, which means that students' achievement in mathematics is greatly affected when cooperative learning methods were used as teaching strategies compared to the traditional method. Furthermore, it is strongly recommended that cooperative learning method supported with multiple intelligence theory should be used in teaching mathematical concepts and even in other fields of study.
Effect of Multimedia Teaching to the Achievement of Junior High School Students in Trigonometry
Authors: Zacal Steve G.
Published: November 2014

Modernization means advancement of technology. Since technology is now fast growing in any instance, it also affects student's behavior in their studies. This study was conducted to determine the effect of interactive multimedia instruction on the achievement of junior-high-school students in the subject Trigonometry. Design 10, the non-equivalent control-group format was used to conduct the experiment during the fourth quarter of school year 2010-2011. The section, third-year Mayon with 35 students made up the experimental group, while that of third-year Apo with 35 students became the control group comprising of 70 third-year students of Daniel R. Aguinaldo National High School as the subjects of the study. The experimental group was evaluated based on treatment X, which used the interactive multimedia instruction. The traditional method of teaching was used by control group and isolated from the experimental intervention and was evaluated during the pre-test and post-test periods. Data were retrieved using the test made by the investigator. It came out that both groups displayed learning improvement at the end of the study, but the magnitude of an increase significantly differed. The study concludes that interactive multimedia instruction led to higher improvement of teaching trigonometry than the conventional method adopted by the control group.
Logical Intelligence as Correlates of Academic Achievement in Advanced Algebra of Fourth Year High School Students
Authors: Callaman Roar
Published: November 2014

Mathematics serves as the basis of modern innovations, discoveries and research studies. Students nowadays tend not to apply the concepts of Mathematics in the solution of meaningful problems since they were bombarded with the different factors affecting their academic achievement in mathematics. This study was conducted to determine the relationship between intellective and non-intellective factors and the academic achievement of students in advanced algebra. The descriptive - correlational method was used to determine the relationship between the achievement test in advanced algebra and the intellective and non-intellective factors which include logical intelligence, family income, number of years spent in school of the head of the family, time allotted in studying mathematics and interest in mathematics. Cluster Sampling Design was used as sampling design; that is, 217fourth-year high school students of F. Bustamante National High School, School Year 2011-2012 were taken as respondents. Pearson Product Coefficient of Correlation was used to determine the relationship between the variables. While the logical intelligence of senior students was satisfactory, relationship with the academic achievement of students was established in the findings at 0.05 level of significance, specifically in the domains of understanding, applying, analyzing and evaluating.
Keine Auswirkungen der neuen Verlustnutzungssperre in § 2 Abs. 4 Sätze 3 ff. UmwStG auf die Ermittlung des Gewerbeertrags
Authors: Dodenhoff Jan , Hannover M.
Published: November 2014

Im Rahmen des Amtshilferichtlinie-Umsetzungsgesetzes hat der Gesetzgeber mit § 2 Abs. 4 Sätze 3 bis 6 UmwStG eine neue Verlustnutzungsbeschränkung eingeführt. Diese Neuregelung wirft aufgrund Ihrer Komplexität vielfältige Zweifelsfragen auf. Einer dieser Streitpunkte betrifft den sachlichen Anwendungsbereich der Vorschrift und insbesondere die Frage, inwieweit sich die Neuregelung auf die Gewerbesteuer auswirkt. Dieser Frage soll im folgenden Beitrag nachgegangen werden.
US Copyright Infringement by File “Sharing”: Statutory Damage(s)
Authors: Kuppers Martin Arthur
Published: November 2014

For the sake of argument, not that this is something that you would necessarily do, picture yourself living in the USA, finally getting hold that elusive song you have been wanting for so long - via an unlicensed file sharing service. Your initial feeling of euphoria would rather quickly give way to that of concern since you are now liable for at least 750 USD in ‘regular’ statutory damages for copyright infringement - were the plaintiff copyright holder to elect to recover this statutory minimum amount from you. It would most likely cross your mind that that level of recovery alone by the plaintiff is not entirely compensatory.

This article will thus seek to examine problems associated with statutory damages in US copyright law for copyright infringement by file sharing, in particular their punitive character. In order to facilitate a close and comprehensive examination of the issues involved, relevant provisions in US copyright law will be briefly highlighted. This will provide the context for an analysis and application of US Supreme Court jurisprudence relating to punitive damages, which will summarily be followed by a call to action and recommendations in this regard.
New Approaches to Network and Information Security Regulation: The EU Telecoms Package
Authors: Feiler Lukas
Published: November 2014

The ePrivacyDirective and the FrameworkDirective as amended by the EU Telecoms Package introduce, for the first time, obligations for providers of public communications networks and for providers of publicly available electronic communications services to notify certain personal data security breaches and certain network security breaches to subscribers, individuals concerned, and/or the competent national (regulatory) authority. This paper analyzes the conditions under which different types of security breaches will have to be notified and to whom this notification will have to be addressed. The paper will conclude with a riskbased assessment of these new security breach notification requirements, examining to what extent they not only allow users to take corrective security measures and regulators to make informed policy choices, but also to what extent the new policies address the fundamental problem of the misalignment of risk and risk mitigation capability.
Gewerbesteuerzerlegung bei mehrgemeindlichen Betriebstätten am Beispiel eines Großflughafens
Authors: Offerhaus Klaus , Althof Michael
Published: November 2014

Die Belastung durch Lärmemissionen im unmittelbaren Umfeld von Großflughäfen gewinnen in Anbetracht der stark zunehmenden Zahl der Flugbewegungen sowie der immer dichter werdenden Besiedelung im Umfeld von Ballungsräumen zunehmend an Bedeutung. Um die vom Flughafen ausgehende Lärmbelästigung und den Erfolg von Lärmschutzmaßnahmen messen zu können, unterhalten Großflughäfen heutzutage ein Netz von Lärmmessstationen, die in den besonders lärmbelasteten Gebieten rund um den Flughafen aufgestellt werden. Hierzu sind die Betreiber von Verkehrsflughäfen nach § 19a des Luftverkehrsgesetzes (LuftVG) sogar verpflichtet. Der nachfolgende Beitrag befasst sich mit der Einordnung derartiger festinstallierter Lärmmessstationen im Lichte des Betriebstättenbegriffs sowie mit den möglichen Folgewirkungen für die Zerlegung der Gewerbesteuer. Der Betriebstättenbegriff wird insbesondere relevant, wenn es um die räumliche Zuordnung von Einkünften geht. Bei der Frage, welche Gemeinde (Gewerbesteuer-) hebeberechtigt ist, kommt es darauf an, ob der Gewerbebetrieb eine Betriebstätte in der betreffenden Gemeinde unterhält (§ 4 GewStG).
Die Zulässigkeit der Präimplantationsdiagnostik de lege lata
Authors: Seibl Maximilian
Published: November 2014

Die Entwicklung in der medizinischen Forschung schreitet rasch voran. Behandlungsmethoden, die vor kurzem noch als unmöglich und nicht zu verwirklichen galten, werden unter Umständen bald realisierbar sein. Der nachfolgende Beitrag setzt sich mit der höchst umstrittenen Frage der rechtlichen Zulässigkeit der Präimplantationsdiagnostik (PID) auseinander. Kernproblem hierbei ist, ob die Durchführung der PID oder sogar schon die In-Vitro-Fertilisation mit anschließender PID gegen die Strafrechtsnormen des Embryonenschutzgesetzes verstößt.
Der neue § 127 SGB V oder: Das Gesetz zur Stärkung des Wettbewerbsrechts?
Authors: Steiner Michael
Published: November 2014

Es kann nicht überraschen, dass die letzte Gesundheitsreform erneut eine fast unüberschaubare Zahl neuer rechtlicher Fragen aufwirft. Eine dieser Fragen ist das nunmehr wieder neu zu bestimmende Verhältnis zwischen den gesetzlichen Krankenversicherungen und den Leistungserbringern im Hilfsmittelbereich.
Die Finanzierung von Krankenhäusern in öffentlich-rechtlicher Trägerschaft aus EG-beihilfenrechtlicher Perspektive
Authors: Koenig Christian , Vorbeck Philipp
Published: November 2014

Betriebsverluste von Krankenhäusern in öffentlich-rechtlicher Trägerschaft werden durch ihre Träger häufig ausgeglichen. Dieser Defizitausgleich war bereits Gegenstand eines konkreten Kommissionsverfahrens: Die Asklepios GmbH, ein privater Krankenhausträger, hatte gegen derartige Zahlungen der öffentlichen Hand im Januar 2003 Beschwerde vor der Europäischen Kommission mit der Begründung eingelegt, der Defizitausgleich stelle eine verbotene Beihilfe i.S.d. Art. 87 Abs. 1 EG dar. Da die Europäische Kommission trotz der Beschwerde nach Auffassung der Asklepios GmbH untätig geblieben war, erhob das Unternehmen im Mai 2004 Untätigkeitsklage vor dem Gericht erster Instanz der Europäischen Gemeinschaften (EuG). Die mündliche Verhandlung vor dem EuG in dieser Sache fand im März 2007 statt.

Die anstehende Entscheidung des EuG in dieser Frage wird zum Anlass genommen, die Frage nach der Vereinbarkeit des Defizitausgleichs mit dem EG-Beihilfenrecht unter besonderer Beachtung der Freistellungsentscheidung der Kommission näher zu beleuchten.
Neuregelungen im Leistungserbringerrecht der GKV durch das GKV-OrgWG
Authors: Knispel Ulrich
Published: November 2014

Im GKV-OrgWG ist in § 69 SGB V klargestellt worden, dass bei Vorliegen der tatbestandlichen Voraussetzungen das Vergaberecht der §§ 97 ff. GWB im Leistungserbringerrecht der GKV Anwendung findet. Zugleich ist der Rechtsweg für Streitigkeiten aus diesem Bereich gesetzlich geregelt worden: Zuständig für die Überprüfung von Entscheidungen der Vergabekammern, die auch bei die GKV betreffenden Vergabestreitigkeiten zunächst zur Entscheidung berufen sind, sind die Landessozialgerichte. Für Hilfsmittellieferanten soll ein sog. Präqualifizierungsverfahren etabliert werden, in dem vorab über die Eignung zur Teilnahme an der Versorgung entschieden wird. Allerdings ist die Einrichtung eines solchen Prüfungsverfahrens dem GKV-Spitzenverband und den Spitzenorganisationen der Leistungserbringer übertragen worden; zudem stellen sich zahlreiche Fragen, zu denen sowohl das Gesetz als auch die Gesetzesbegründung schweigen. Da es für den Fall einer Nichteinigung der Partner keine Konfliktlösungsregelung gibt, liegt es nicht fern, dass es nicht zu einer Regelung kommt. Im Vertragssystem der Hilfsmittelleistungserbringer ist der Vorrang für die im Wege einer Ausschreibung zu schließenden Verträge nach § 127 Abs. 1 SGB V, die dem Ausschreibungsgewinner eine Exklusivverssorgungsberechtigung vermitteln, abgeschwächt worden. Zugleich soll die Zweckmäßigkeit solcher Ausschreibungen durch gemeinsame Empfehlungen des GKVSpitzenverbandes und der Spitzenorganisationen der Leistungserbringer, an deren Stelle ggf. eine Schiedsperson entscheidet, festgelegt werden. Parallel zu dem Zurücktreten der Ausschreibungsverträge nach § 127 Abs. 1 SGB V wird allen geeigneten Leistungserbringern ein Beitrittsrecht zu den nach § 127 Abs. 2 SGB V geschlossenen Verträgen eingeräumt und so ihre Teilnahme an der Versorgung sichergestellt. Die Verlängerung der Versorgungsberechtigung der am 1.4.2007 zugelassenen Leistungserbringer bis zum 31.12.2009 hat angesichts dieses Beitrittsrechts kaum praktische Bedeutung, da gesetzlich klargestellt worden ist, dass im Bereich der nach § 127 Abs. 1 SGB V geschlossenen Verträge diese Übergangsbestimmung nicht gilt.

Schon kurz nach dem seit 1.4.2007 geltenden GKVWSG2 hat sich der Gesetzgeber in dem zum 1.1.2009 in Kraft getretenen GKV-OrgWG einerseits im Leistungserbringerrecht zu Klarstellungen und andererseits im Bereich der Hilfsmittellieferanten, der durch das GKVWSG einem ausschließlichen Vertragsregime unterstellt worden ist, zu Ergänzungen und Änderungen veranlasst gesehen. Inhalt und Reichweite dieser Neuregelungen, die während der Gesetzesberatung durch den Ausschuss für Gesundheit vorgenommen worden sind,3 sollen im Folgenden näher betrachtet werden.
Verordnungsfähigkeit von arzneimittelähnlichen Medizinprodukten zulasten der gesetzlichen Krankenkassen
Authors: Spiegel Jan-Peter , Jäkel Christian
Published: November 2014

Bis zum 30.6.2008 waren arzneimittelähnliche Medizinprodukte gem. § 3 Nr. 1 oder Nr. 2 MPG in Form von Stoffen bzw. Stoffzubereitungen zur Anwendung am oder im menschlichen Körper automatisch in den Leistungskatalog der gesetzlichen Krankenkassen einbezogen. Voraussetzung für die Leistungspflicht der Krankenkassen war allerdings, dass die Medizinprodukte apothekenpflichtig waren und vor Inkrafttreten des MPG als Arzneimittel i.S.d. § 2 Abs. 1 AMG eingestuft worden wären. Da in der Praxis vielfach Rechtsunsicherheit darüber bestand, ob ein Medizinprodukt diese Kriterien tatsächlich erfüllte, ist § 31 Abs. 1 S. 2 SGB V durch das Gesetz zur Änderung medizinprodukterechtlicher und anderer Vorschriften mit Wirkung zum 1.7.2008 geändert worden. Der Gemeinsame Bundesausschuss hat nun nach § 31 Abs. 1 S. 2 Nr. 2 SGB V in den Arzneimittel-Richtlinien festzulegen, in welchen medizinisch notwendigen Fällen arzneimittelähnliche Medizinprodukte ausnahmsweise in die Arzneimittelversorgung einbezogen werden. Die Aufnahme in die Positivliste ist für die Kostentragungspflicht der gesetzlichen Krankenkassen konstitutiv; die Leistungspflicht folgt nicht mehr direkt aus § 31 Abs. 1 SGB V. Das wesentliche Aufnahmekriterium ist die medizinische Notwendigkeit der Versorgung mit dem arzneimittelähnlichen Medizinprodukt. Darauf, ob das Produkt apothekenpflichtig ist und vor Inkrafttreten des MPG als Arzneimittel zu qualifizieren gewesen wäre, kommt es bei der Beurteilung der Aufnahmefähigkeit in die Positivliste hingegen nicht an. Zur Bewertung und zum Nachweis der Aufnahmefähigkeit von arzneimittelähnlichen Medizinprodukten in die Arzneimittel-Richtlinien (Anlage 12 - verordnungsfähige Medizinprodukte) hat der Gemeinsame Bundesausschuss Entscheidungsgrundlagen entwickelt, die auch das - gebührenpflichtige - Aufnahmeverfahren regeln. Es sind bereits mehrere Beschlüsse des Gemeinsamen Bundesausschuss über die Aufnahme von arzneimittelähnlichen Medizinprodukten in die Positivliste ergangen.
Rechte und Pflichten des pharmazeutischen Unternehmens bei der frühen Nutzenbewertung
Authors: Maassen Bernhard
Published: November 2014

Mit dem Gesetz zur Neuordnung des Arzneimittelmarktes in der gesetzlichen Krankenversicherung (Arzneimittelmarktneuordnungsgesetz - AMNOG) hat der Gesetzgeber einen völlig neuen Rechtsrahmen für Bewertung und Preise von Arzneimittelinnovationen geschaffen. Eine der zentralen Säulen des Gesetzes ist die sog. frühe Nutzenbewertung von Arzneimitteln. Der vorliegende Beitrag befasst sich mit den Rechten und Pflichten des pharmazeutischen Unternehmers bei der frühen Nutzenbewertung. Wesentlichste Pflicht des pharmazeutischen Unternehmers ist die zeitgerechte Vorlage eines vollständigen Dossiers für die frühe Nutzenbewertung. Wesentlichstes Recht des pharmazeutischen Unternehmers ist das Recht auf ein faires Bewertungsverfahren und auf eine faire Nutzenbewertung in der Sache. Entscheidend hierfür ist insbesondere der richtige Gebrauch der internationalen Standards der evidenzbasierten Medizin.
Aktuelle Rechtsprechung des BGH zum Arzthaftungsrecht Schwerpunkt: Notfall- und Intensivmedizin
Authors: Diederichsen Angela
Published: November 2014

Der Beitrag basiert auf einem Vortrag der Verfasserin im Rahmen einer Tagung des Versicherungsforums am 3. Februar 2011 in Köln. Unter Intensivmedizin wird in der medizinischen Fachliteratur Notfallmedizin, aber auch die medizinische Versorgung am Ende des Lebens verstanden.1 Der Beitrag befasst sich mit den Fragen der ärztlichen Haftung im Bereich der Notfallmedizin. Berichtet werden außerdem neue Entscheidungen des VI. Zivilsenats des BGH zur ärztlichen Aufklärung, zum Diagnoseirrtum und zur Befunderhebung sowie zum Einsichtsrecht des Sozialversicherungsträgers in die Pflegedokumentation.
Earth's Climate Sensitivity: Apparent Inconsistencies in Recent Assessments
Authors: Schwartz Stephen E. , Charlson Robert J. , Kahn Ralph , Rodhe Henning
Published: November 2014

Earth's equilibrium climate sensitivity (ECS) and forcing of Earth's climate system over the industrial era have been re‐examined in two new assessments: the Fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change (IPCC), and a study by Otto et al. (2013). The ranges of these quantities given in these assessments and also in the Fourth (2007) IPCC Assessment are analyzed here within the framework of a planetary energy balance model, taking into account the observed increase in global mean surface temperature over the instrumental record together with best estimates of the rate of increase of planetary heat content. This analysis shows systematic differences among the several assessments and apparent inconsistencies within individual assessments. Importantly, the likely range of ECS to doubled CO2 given in AR5, 1.5–4.5 K/(3.7 W m−2) exceeds the range inferred from the assessed likely range of forcing, 1.2–2.9 K/(3.7 W m−2), where 3.7 W m−2 denotes the forcing for doubled CO2. Such differences underscore the need to identify their causes and reduce the underlying uncertainties. Explanations might involve underestimated negative aerosol forcing, overestimated total forcing, overestimated climate sensitivity, poorly constrained ocean heating, limitations of the energy balance model, or a combination of effects.
Sensitivity experiments on True Polar Wander
Authors: Greff‐Lefftz Marianne , Besse Jean
Published: November 2014

Using sensitivity experiments based on the position of subductions and of superplumes, we derive models for the temporal evolution of 3‐D mass anomalies in the mantle and compute the associated inertia perturbations and polar wander. We show that although the large length‐scale mantle dynamics during the Earth's history may have been dominated by coupled supercontinent‐superplume cycles, subductions alone are sufficient to trigger major True Polar Wander (TPW) episodes, or rotation of the whole lithosphere and mantle with respect to the Earth's rotation axis. We present two examples. We speculate that the distribution of continents with respect to the equator on the Earth's surface is driven by episodic subductions during the Wilson cycle: alternating fast subduction girdles around continents and upwellings during the divergence phases, with both reduced or stopped subductions activity around continents and moderate inter‐continental subductions during the convergence phases, lead to successive equatorial or polar distributions of continents, both configurations being separated by strong episodes of TPW. Finally, using plate reconstructions and geologic maps, over the period 1100–720 Ma, the period of amalgamation and destruction of the Rodinia supercontinent, we explain with our model the observed large eastward/westward and poleward/equatorward motions of the rotation axis.
Ein gemischtes Arsen‐Phosphor‐zentriertes Biradikaloid
Authors: Hinz Alexander , Schulz Axel , Villinger Alexander
Published: November 2014

Singulett‐Biradikaloide der Hauptgruppenelemente wurden in den letzten 20 Jahren gründlich untersucht, insbesondere Derivate des Cyclobutan‐1,3‐diyls. Jedoch sind in jedem der bekannten Beispiele die Radikalzentren äquivalent. Daher wollten wir ein gemischtes Dipniktadiazandiyl herstellen, in dem P und As den Radikalcharakter tragen. Um das Ziel zu erreichen, musste zunächst das Dichlorcycloarsaphosphadiazan [ClP(μ‐NTer)2AsCl] synthetisiert werden. Durch Chloridabstraktion von [ClP(μ‐NTer)2AsCl] wurde das cyclische Kation [P(μ‐NTer)2AsCl]+ erhalten, während die Reduktion mit Magnesium zum Arsaphosphadiazandiyl [P(μ‐NTer)2As] führte.
Copper‐Catalyzed Stereoselective Aminoboration of Bicyclic Alkenes
Authors: Sakae Ryosuke , Hirano Koji , Satoh Tetsuya , Miura Masahiro
Published: November 2014

A copper‐catalyzed aminoboration of bicyclic alkenes, including oxa‐ and azabenzonorbornadienes, has been developed. With this method, amine and boron moieties are simultaneously introduced at an olefin with exo selectivity. Subsequent stereospecific transformations of the boryl group can provide oxygen‐ and nitrogen‐rich cyclic molecules with motifs that may be found in natural products or pharmaceutically active compounds. Moreover, a catalytic asymmetric variant of this transformation was realized by using a copper complex with a chiral bisphosphine ligand, namely (R,R)‐Ph‐BPE.
Ligand‐Detected Relaxation Dispersion NMR Spectroscopy: Dynamics of preQ1–RNA Binding
Authors: Moschen Thomas , Wunderlich Christoph Hermann , Spitzer Romana , Levic Jasmin , Micura Ronald , Tollinger Martin , Kreutz Christoph
Published: November 2014

An NMR‐based approach to characterizing the binding kinetics of ligand molecules to biomolecules, like RNA or proteins, by ligand‐detected Carr‐Purcell‐Meiboom‐Gill (CPMG) relaxation dispersion experiments is described. A 15N‐modified preQ1 ligand is used to acquire relaxation dispersion experiments in the presence of low amounts of the Fsu class I preQ1 aptamer RNA, and increasing ligand concentrations to probe the RNA small molecule interaction. Our experimental data strongly support the conformational selection mechanism postulated. The approach gives direct access to two parameters of a ligand–receptor interaction: the off rate and the population of the small molecule–receptor complex. A detailed description of the kinetics underlying the ligand binding process is of crucial importance to fully understanding a riboswitch’s function and to evaluate potential new antibiotics candidates targeting the noncoding RNA species. Ligand‐detected NMR relaxation dispersion experiments represent a valuable diagnostic tool for the characterization of binding mechanisms.
DEPLETION OF AUTOPHAGY‐RELATED GENES ATG3 AND ATG5 IN Tenebrio molitor LEADS TO DECREASED SURVIVABILITY AGAINST AN INTRACELLULAR PATHOGEN, Listeria monocytogenes
Authors: Tindwa Hamisi , Jo Yong Hun , Patnaik Bharat Bhusan , Noh Mi Young , Kim Dong Hyun , Kim Iksoo , Han Yeon Soo , Lee Yong Seok , Lee Bok Luel , Kim Nam Jung
Published: November 2014

Macroautophagy (autophagy) is an evolutionarily conserved catabolic process involved in physiological and developmental processes including cell survival, death, and innate immunity. Homologues of most of 36 originally discovered autophagy‐related (ATG) genes in yeast have been characterized in higher eukaryotes including insects. In this study, the homologues of ATG3 (TmATG3) and ATG5 (TmATG5) were isolated from the coleopteran beetle, Tenebrio molitor by expressed sequence tag and RNAseq approaches. The cDNA of TmATG3 and TmATG5 comprise open‐reading frame sizes of 963 and 792 bp encoding polypeptides of 320 and 263 amino acid residues, respectively. TmATG3 and TmATG5 mRNA are expressed in all developmental stages, and mainly in fat body and hemocytes of larvae. TmATG3 and TmATG5 showed an overall sequence identity of 58–95% to other insect Atg proteins. There exist clear one‐to‐one orthologs of TmATG3 and TmATG5 in Tribolium and that they clustered together in the gene tree. Depletion of TmATG3 and TmATG5 by RNA interference led to a significant reduction in survival ability of T. molitor larvae against an intracellular pathogen, Listeria monocytogenes. Six days post‐Listeria challenge, the survival rate in the dsEGFP‐injected (where EGFP is enhanced green fluorescent protein) control larvae was significantly higher (55%) compared to 4 and 3% for TmATG3 and TmATG5 double‐stranded RNA injected larvae, respectively. These data suggested that TmATG3 and TmATG5 may play putative role in mediating autophagy‐based clearance of Listeria in T. molitor model.
ZnAl2O4:Eu novel phosphor: SEM and mechanoluminescence characterization synthesized by solution combustion technique
Authors: Satapathy Kabita K. , Mishra G. C. , Khan F.
Published: November 2014

Eu doped ZnAl2O4 phosphors were synthesized by the solution combustion technique using carbohydrazide as a fuel. Mechanoluminescence (ML) was excited impulsively by dropping a piston of 0.7 kg onto the phosphors. Two distinct peaks were observed in the ML glow curve of the γ‐ray irradiated ZnAl2O4:Eu phosphors. Dependence of ML on various parameters as impact velocity of the piston dropped on to it, mass of the sample, gamma ray doses given to the sample and ML spectra have been studied. ML emission spectrum showed the characteristic emission of Eu3+ ion in this system. ML is observed to be optimum for the sample having 0.2 mol% of Eu in the ZnAl2O4 phosphor. XRD result confirms formation of the phosphors. SEM characterization shows its surface morphology. This novel phosphor may be a potential candidate for dosimetric use due to its linear dose response. Copyright © 2014 John Wiley & Sons, Ltd.
Unexpected Carbon Dioxide Inclusion in Water‐Saturated Pores of Metal–Organic Frameworks with Potential for Highly Selective Capture of CO2
Authors: Kim Daeok , Lim Hyung‐Kyu , Ro Hyeyoon , Kim Hyungjun , Lee Huen
Published: November 2014

Unusual CO2 storage in water‐saturated MOFs was investigated by combining experiment and simulation. It was found that the micropores of HKUST‐1 saturated with water provide an environment that is thermodynamically and kinetically favorable for CO2 capture, but not for N2 and H2 capture. We expect that this phenomenon have potential to be used for successful separation of CO2 from versatile flue streams and pre‐combustion gas.
113Cd Solid‐State NMR for Probing the Coordination Sphere in Metal–Organic Frameworks
Authors: Kuttatheyil Anusree Viswanath , Handke Marcel , Bergmann Jens , Lässig Daniel , Lincke Jörg , Haase Jürgen , Bertmer Marko , Krautscheid Harald
Published: November 2014

Spectroscopic techniques are a powerful tool for structure determination, especially if single‐crystal material is unavailable. 113Cd solid‐state NMR is easy to measure and is a highly sensitive probe because the coordination number, the nature of coordinating groups, and the geometry around the metal ion is reflected by the isotropic chemical shift and the chemical‐shift anisotropy. Here, a detailed investigation of a series of 27 cadmium coordination polymers by 113Cd solid‐state NMR is reported. The results obtained demonstrate that 113Cd NMR is a very sensitive tool to characterize the cadmium environment, also in non‐single‐crystal materials. Furthermore, this method allows the observation of guest‐induced phase transitions supporting understanding of the structural flexibility of coordination frameworks.