J-2156, a small molecule somatostatin type 4 receptor agonist, alleviated hindpaw hypersensitivity in the streptozotocin-induced rat model of painful diabetic neuropathy but with a 2-fold decrease in potency at an advanced stage in the model, mimicking morphine.

There is a large unmet need for novel pain-killers to improve relief of painful diabetic neuropathy (PDN). Herein, we assessed the efficacy of the somatostatin type 4 (SST4) receptor agonist, J-2156, for relief of PDN in rats. Diabetes was induced with streptozotocin (STZ; 70 mg/kg) and bilateral hindpaw hypersensitivity was fully developed by 8-week post-STZ. In the intervals, 8-12-weeks (morphine-sensitive phase; Phase 1) and 16-18-weeks (morphine-hyposensitive phase; Phase 2) post-STZ, rats received a single dose of intraperitoneal (i.p.) J-2156 (10, 20, 30 mg/kg), gabapentin (100 mg/kg i.p.), subcutaneous morphine (1 mg/kg) or vehicle. Hindpaw withdrawal thresholds (PWTs) were assessed using von Frey filaments pre-dose and at regular intervals over 3-h post-dose. In Phase 1, J-2156 at 30 mg/kg evoked significant anti-allodynia in the hindpaws with maximal effect at 1.5 h compared with 1 h for gabapentin and morphine. The durations of action for all three compounds were greater than 3 h. The corresponding mean (±SEM) extent and duration of anti-allodynia (ΔPWT AUC) for gabapentin did not differ significantly from that for J-2156 (30 mg/kg) or morphine. However, in Phase 2, the ΔPWT AUC for morphine was reduced to approximately 25% of that in Phase 1, mirroring our previous work. Similarly, the mean (±SEM) ΔPWT AUC for J-2156 (30 mg/kg) in Phase 2 was approximately 45% of that for Phase 1 whereas for gabapentin the mean (±SEM) ΔPWT AUCs did not differ significantly (p > 0.05) between the two phases. Our findings further describe the preclinical pain relief profile of J-2156 and complement previous work in rat models of inflammatory pain, neuropathic pain and low back pain. SST4 receptor agonists hold promise as novel therapeutics for the relief of PDN, a type of peripheral neuropathic pain that is often intractable to relief with clinically used drug treatment options.

[On the safe side? Safety culture and patient safety in German anesthesiology clinics-A nationwide survey on the status quo]. / Auf Nummer sicher? Sicherheitskultur und Patientensicherheit an deutschen anästhesiologischen Kliniken ­ Eine deutschlandweite Umfrage zum Status quo.

BACKGROUND: A good safety culture may be predominantly defined by an open and unsanctioned communication about critical and erroneous courses. In an effort to improve patient safety various instruments, such as the critical incident reporting system (CIRS) or in terms of patient handover, the use of the situation, background, assessment, recommendation (SBAR) system patient handover, have been developed and are recommended by the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). This study aimed at identifying how anesthesiologists perceive the safety culture in their current department and whether CIRS or SBAR are already established or not. MATERIAL AND METHODS: All registered members of the DGAI and the Professional Association of German Anaesthesiologists (BDA, n = 19,042) were invited to participate in an online survey on patient safety. In this survey there was a focus on the perceived safety culture and the experience with CIRS and SBAR. RESULTS: Of the participants 76.6% (n = 1372) stated that their department of anesthesiology has a good safety culture, while in 23.4% (n = 419) there was not. For the whole hospital the safety culture was only rated as being positive by 54.3% (n = 949) of the respondents. An open communication about critical and erroneous courses occurred in 76.5% (n = 1375) according to the participants, 23.0% (n = 408) had the impression that in the case of errors the respective person was being denounced. In one third of the participants' departments (n = 630, 36.6%) there were no morbidity and mortality conferences. The acronym CIRS was familiar to 98.9% (n = 1801) of the participants, 84.8% (n = 1544) of the surveyed anesthesiologists reported that CIRS was established in their departments. Critical incidents have been reported via CIRS by 54.4% (n = 839) of the respondents. Only 29.4% (n = 462) of the participants received regular feedback on CIRS reports. The acronym SBAR as a handover tool is unknown to the majority of the surveyed participants (n = 1181, 63.7%) and 86.1% (n = 1554) consider using an instrument in order to improve handover quality as possibly being beneficial. CONCLUSION: Anesthesiologists rate the quality of the safety culture of their own anesthesiology department to be higher compared to their hospital in general. In some hospitals there is denouncement in cases of erroneous courses according to the respondents. In the patients' point of view morbidity and mortality conferences should be established more often. CIRS is known to almost every surveyed anesthetist but feedback on a regular basis is sparse. This contradicts the claims of the German Coalition for Patient Safety. The acronym SBAR is unknown to the majority of surveyed participants despite the recommendation of the DGAI to implement it. There is a wish for tools in order to enhance the quality of handovers.

Emerging symmetric strain response and weakening nematic fluctuations in strongly hole-doped iron-based superconductors.

Electronic nematicity is often found in unconventional superconductors, suggesting its relevance for electronic pairing. In the strongly hole-doped iron-based superconductors, the symmetry channel and strength of the nematic fluctuations, as well as the possible presence of long-range nematic order, remain controversial. Here, we address these questions using transport measurements under elastic strain. By decomposing the strain response into the appropriate symmetry channels, we demonstrate the emergence of a giant in-plane symmetric contribution, associated with the growth of both strong electronic correlations and the sensitivity of these correlations to strain. We find weakened remnants of the nematic fluctuations that are present at optimal doping, but no change in the symmetry channel of nematic fluctuations with hole doping. Furthermore, we find no indication of a nematic-ordered state in the AFe2As2 (A = K, Rb, Cs) superconductors. These results revise the current understanding of nematicity in hole-doped iron-based superconductors.

Dominant In-Plane Symmetric Elastoresistance in CsFe_{2}As_{2}.

We study the elastoresistance of the highly correlated material CsFe_{2}As_{2} in all symmetry channels. Neutralizing its thermal expansion by means of a piezoelectric-based strain cell is demonstrated to be essential. The elastoresistance response in the in-plane symmetric channel is found to be large, while the response in the symmetry-breaking channels is weaker and provides no evidence for a divergent nematic susceptibility. Rather, our results can be interpreted naturally within the framework of a coherence-incoherence crossover, where the low-temperature coherent state is sensitively tuned by the in-plane atomic distances.

[Continuous lateral rotational bed therapy in patients with traumatic lung injury: an analysis from the TraumaRegister DGU®]. / Die kontinuierliche laterale Rotationstherapie bei Patienten mit Thoraxtrauma: eine Analyse aus dem TraumaRegister DGU®.

BACKGROUND: Patients with severe thoracic trauma often receive continuous lateral rotational bed therapy (CLRT) for the treatment of lung contusions. In this study, the effects of CLRT on mortality, morbidity and length of stay (LOS) in the intensive care unit (ICU) and in the hospital were evaluated. METHODS: Retrospective data from the TraumaRegister DGU® were analysed, focusing on patients with severe thoracic trauma. Patients treated with CLRT were compared to a control group with comparable trauma severity who had received conventional therapy. RESULTS: A total of 1476 patients (239 with CLRT, 1237 without CLRT) were included in this study. Both groups were similar for demographic characteristics. The median CLRT duration was 6 (4-10) days. Patients receiving CLRT were ventilated for 17 (10-26) days compared to 14 (8-22) days (p = 0.001) in the control group. The ICU length of stay differed significantly (CLRT: 23 [14-32] days; control: 19 [13-28] days; p = 0.002). Also, organ failure occurred more frequently in patients treated with CLRT (CLRT: 76.6%, control: 67.6%; p = 0.006). No differences could be detected regarding mortality rates, multiple organ failure and hospital LOS. CONCLUSIONS: The results of this retrospective analysis fail to detect a benefit for CLRT therapy in trauma patients. Considering inherent limitations of retrospective studies, caution should be exerted when interpreting these results. Further research is warranted to confirm these findings in a prospective trial.

Ferroelasticity, anelasticity and magnetoelastic relaxation in Co-doped iron pnictide: Ba(Fe0.957Co0.043)2As2.

The hypothesis that strain has a permeating influence on ferroelastic, magnetic and superconducting transitions in 122 iron pnictides has been tested by investigating variations of the elastic and anelastic properties of a single crystal of Ba(Fe0.957Co0.043)2As2 by resonant ultrasound spectroscopy as a function of temperature and externally applied magnetic field. Non-linear softening and stiffening of C 66 in the stability fields of both the tetragonal and orthorhombic structures has been found to conform quantitatively to the Landau expansion for a pseudoproper ferroelastic transition which is second order in character. The only exception is that the transition occurs at a temperature (T S ≈ 69 K) ~10 K above the temperature at which C 66 would extrapolate to zero ([Formula: see text] ≈ 59 K). An absence of anomalies associated with antiferromagnetic ordering below T N ≈ 60 K implies that coupling of the magnetic order parameter with shear strain is weak. It is concluded that linear-quadratic coupling between the structural/electronic and antiferromagnetic order parameters is suppressed due to the effects of local heterogeneous strain fields arising from the substitution of Fe by Co. An acoustic loss peak at ~50-55 K is attributed to the influence of mobile ferroelastic twin walls that become pinned by a thermally activated process involving polaronic defects. Softening of C 66 by up to ~6% below the normal-superconducting transition at T c ≈ 13 K demonstrates an effective coupling of the shear strain with the order parameter for the superconducting transition which arises indirectly as a consequence of unfavourable coupling of the superconducting order parameter with the ferroelastic order parameter. Ba(Fe0.957Co0.043)2As2 is representative of 122 pnictides as forming a class of multiferroic superconductors in which elastic strain relaxations underpin almost all aspects of coupling between the structural, magnetic and superconducting order parameters and of dynamic properties of the transformation microstructures they contain.

Strain relaxation behaviour of vortices in a multiferroic superconductor.

The elastic and anelastic properties of a single crystal of Co-doped pnictide Ba(Fe0.957Co0.043)2As2 have been determined by resonant ultrasound spectroscopy in the frequency range 10-500 kHz, both as a function of temperature through the normal-superconducting transition (T c ≈ 12.5 K) and as a function of applied magnetic field up to 12.5 T. Correlation with thermal expansion, electrical resistivity, heat capacity, DC and AC magnetic data from crystals taken from the same synthetic batch has revealed the permeating influence of strain on coupling between order parameters for the ferroelastic (Q E) and superconducting (Q SC) transitions and on the freezing/relaxation behaviour of vortices. Elastic softening through T c in zero field can be understood in terms of classical coupling of the order parameter with the shear strain e 6, λe 6 [Formula: see text], which means that there must be a common strain mechanism for coupling of the form λ [Formula: see text] Q E. At fields of ~5 T and above, this softening is masked by Debye-like stiffening and acoustic loss processes due to vortex freezing. The first loss peak may be associated with the establishment of superconductivity on ferroelastic twin walls ahead of the matrix and the second is due to the vortex liquid-vortex glass transition. Strain contrast between vortex cores and the superconducting matrix will contribute significantly to interactions of vortices both with each other and with the underlying crystal structure. These interactions imply that iron-pnictides represent a class of multiferroic superconductors in which strain-mediated coupling occurs between the multiferroic properties (ferroelasticity, antiferromagnetism) and superconductivity.

Hedgehog Spin-Vortex Crystal Antiferromagnetic Quantum Criticality in CaK(Fe_{1-x}Ni_{x})_{4}As_{4} Revealed by NMR.

Two ordering states, antiferromagnetism and nematicity, have been observed in most iron-based superconductors (SCs). In contrast to those SCs, the newly discovered SC CaK(Fe_{1-x}Ni_{x})_{4}As_{4} exhibits an antiferromagnetic (AFM) state, called hedgehog spin-vortex crystal (SVC) structure, without nematic order, providing the opportunity for the investigation into the relationship between spin fluctuations and SC without any effects of nematic fluctuations. Our ^{75}As nuclear magnetic resonance studies on CaK(Fe_{1-x}Ni_{x})_{4}As_{4} (0≤x≤0.049) revealed that CaKFe_{4}As_{4} is located close to a hidden hedgehog SVC AFM quantum-critical point (QCP). The magnetic QCP without nematicity in CaK(Fe_{1-x}Ni_{x})_{4}As_{4} highlights the close connection of spin fluctuations and superconductivity in iron-based SCs. The advantage of stoichiometric composition also makes CaKFe_{4}As_{4} an ideal platform for further detailed investigation of the relationship between magnetic QCP and superconductivity in iron-based SCs without disorder effects.

Spectral Evidence for Emergent Order in Ba_{1-x}Na_{x}Fe_{2}As_{2}.

We report an angle-resolved photoemission spectroscopy study of the iron-based superconductor family, Ba_{1-x}Na_{x}Fe_{2}As_{2}. This system harbors the recently discovered double-Q magnetic order appearing in a reentrant C_{4} phase deep within the underdoped regime of the phase diagram that is otherwise dominated by the coupled nematic phase and collinear antiferromagnetic order. From a detailed temperature-dependence study, we identify the electronic response to the nematic phase in an orbital-dependent band shift that strictly follows the rotational symmetry of the lattice and disappears when the system restores C_{4} symmetry in the low temperature phase. In addition, we report the observation of a distinct electronic reconstruction that cannot be explained by the known electronic orders in the system.

Imaging orbital-selective quasiparticles in the Hund's metal state of FeSe.

Strong electronic correlations, emerging from the parent Mott insulator phase, are key to copper-based high-temperature superconductivity. By contrast, the parent phase of an iron-based high-temperature superconductor is never a correlated insulator. However, this distinction may be deceptive because Fe has five actived d orbitals while Cu has only one. In theory, such orbital multiplicity can generate a Hund's metal state, in which alignment of the Fe spins suppresses inter-orbital fluctuations, producing orbitally selective strong correlations. The spectral weights Zm of quasiparticles associated with different Fe orbitals m should then be radically different. Here we use quasiparticle scattering interference resolved by orbital content to explore these predictions in FeSe. Signatures of strong, orbitally selective differences of quasiparticle Zm appear on all detectable bands over a wide energy range. Further, the quasiparticle interference amplitudes reveal that [Formula: see text], consistent with earlier orbital-selective Cooper pairing studies. Thus, orbital-selective strong correlations dominate the parent state of iron-based high-temperature superconductivity in FeSe.

[Anesthesia problem cards-indispensable yet problematic : Nationwide survey on experiences from clinical practice]. / Der Anästhesieausweis ­ unverzichtbar, aber problematisch : Deutschlandweite Umfrage zu Erfahrungen aus der klinischen Anwendung.

BACKGROUND: Anesthetic procedures may lead to severe and potentially life-threatening complications (e. g. difficult airway, allergic reactions, malignant hyperthermia). Most complications can be avoided in future anesthetic procedures with adequate preparation (e. g. awake intubation, trigger-free anesthesia). In Germany, anesthesia problem cards were introduced two decades ago to identify patients at risk and to increase patient safety by creating a standardized documentation system for anesthesia-related complications. The purpose of our study was to evaluate the utility and problems of anesthesia problem cards in clinical practice. MATERIAL AND METHODS: All registered members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Professional Association of German Anesthesiologists (BDA) (n = 19,042) were invited to participate in an online survey on patient safety. A subsection of the survey focused specifically on anesthesia problem cards and their utility in clinical practice (e. g. field of application, issuing procedures, benefits and problems). RESULTS: The survey subsection on anesthesia problem cards was completed by 1783 participants. Most agreed that anesthesia problem cards are a useful tool to increase patient safety (n = 1502; 84.2%) and that they are routinely issued after the occurrence of anesthesia-related complications (n = 1664, 93.4%). One of the major problems noted was that patients frequently forget to bring their anesthesia problem cards when presenting for the preanesthetic assessment. This was observed by 1457 participants (81.7%). Furthermore, the information provided on anesthesia problem cards may be inadequately phrased (n = 874; 49.0%) or illegible (n = 833; 46.7%). In addition, the space for individual comments or problem solutions is insufficient (n = 811; 45.5%). Replacements for lost anesthesia problem cards with identical informational content can be issued in only 41.9% (n = 747) of the participants' departments. CONCLUSION: Anesthesia problem cards are considered a useful tool to increase patient safety and are frequently issued in clinical practice; however, in the document's current form its full potential for risk minimization cannot be exploited. Structural changes are required to increase documentation quality and reproducibility. Concerning its informational content, the spectrum of included complications and their individual solutions need to be expanded to meet the requirements of modern anesthetic practice.

Common variants in DLG1 locus are associated with non-syndromic cleft lip with or without cleft palate.

Non-syndromic cleft lip with or without cleft palate (nsCL/P) is a common craniofacial anomaly with a complex and heterogeneous aetiology. Knowledge regarding specific genetic factors underlying this birth defect is still not well understood. Therefore, we conducted an independent replication analysis for the top-associated variants located within the DLG1 locus at chromosome 3q29, which was identified as a novel cleft-susceptibility locus in our genome-wide association study (GWAS). Mega-analysis of the pooled individual data from the GWAS and replication study confirmed that common DLG1 variants are associated with the risk of nsCL/P. Two single nucleotide polymorphisms (SNPs), rs338217 and rs7649443, were statistically significant even at the genome-wide level (Ptrend = 9.70E-10 and Ptrend = 8.96E-09, respectively). Three other SNPs, rs9826379, rs6805920 and rs6583202, reached a suggestive genome-wide significance threshold (Ptrend < 1.00E-05). The location of the strongest individual SNP in the intronic sequence of the gene encoding DLG1 antisense RNA suggests that the true causal variant implicated in the risk of nsCL/P may affect the DLG1 gene expression level rather than structure of the encoded protein. In conclusion, we identified a novel cleft-susceptibility locus at chromosome 3q29 with a DLG1 as a novel candidate gene for this common craniofacial anomaly.

Candidate Genes for Nonsyndromic Cleft Palate Detected by Exome Sequencing.

Nonsyndromic cleft palate only (nsCPO) is a facial malformation that has a livebirth prevalence of 1 in 2,500. Research suggests that the etiology of nsCPO is multifactorial, with a clear genetic component. To date, genome-wide association studies have identified only 1 conclusive common variant for nsCPO, that is, a missense variant in the gene grainyhead-like-3 ( GRHL3). Thus, the underlying genetic causes of nsCPO remain largely unknown. The present study aimed at identifying rare variants that might contribute to nsCPO risk, via whole-exome sequencing (WES), in multiply affected Central European nsCPO pedigrees. WES was performed in 2 affected first-degree relatives from each family. Variants shared between both individuals were analyzed for their potential deleterious nature and a low frequency in the general population. Genes carrying promising variants were annotated for 1) reported associations with facial development, 2) multiple occurrence of variants, and 3) expression in mouse embryonic palatal shelves. This strategy resulted in the identification of a set of 26 candidate genes that were resequenced in 132 independent nsCPO cases and 623 independent controls of 2 different ethnicities, using molecular inversion probes. No rare loss-of-function mutation was identified in either WES or resequencing step. However, we identified 2 or more missense variants predicted to be deleterious in each of 3 genes ( ACACB, PTPRS, MIB1) in individuals from independent families. In addition, the analyses identified a novel variant in GRHL3 in 1 patient and a variant in CREBBP in 2 siblings. Both genes underlie different syndromic forms of CPO. A plausible hypothesis is that the apparently nonsyndromic clefts in these 3 patients might represent hypomorphic forms of the respective syndromes. In summary, the present study identified rare variants that might contribute to nsCPO risk and suggests candidate genes for further investigation.

Discovery of orbital-selective Cooper pairing in FeSe.

The superconductor iron selenide (FeSe) is of intense interest owing to its unusual nonmagnetic nematic state and potential for high-temperature superconductivity. But its Cooper pairing mechanism has not been determined. We used Bogoliubov quasiparticle interference imaging to determine the Fermi surface geometry of the electronic bands surrounding the Γ = (0, 0) and X = (π/aFe, 0) points of FeSe and to measure the corresponding superconducting energy gaps. We show that both gaps are extremely anisotropic but nodeless and that they exhibit gap maxima oriented orthogonally in momentum space. Moreover, by implementing a novel technique, we demonstrate that these gaps have opposite sign with respect to each other. This complex gap configuration reveals the existence of orbital-selective Cooper pairing that, in FeSe, is based preferentially on electrons from the d yz orbitals of the iron atoms.

Effect of Biaxial Strain on the Phase Transitions of Ca(Fe_{1-x}Co_{x})_{2}As_{2}.

We study the effect of applied strain as a physical control parameter for the phase transitions of Ca(Fe_{1-x}Co_{x})_{2}As_{2} using resistivity, magnetization, x-ray diffraction, and ^{57}Fe Mössbauer spectroscopy. Biaxial strain, namely, compression of the basal plane of the tetragonal unit cell, is created through firm bonding of samples to a rigid substrate via differential thermal expansion. This strain is shown to induce a magnetostructural phase transition in originally paramagnetic samples, and superconductivity in previously nonsuperconducting ones. The magnetostructural transition is gradual as a consequence of using strain instead of pressure or stress as a tuning parameter.

Insights into the genetics of gastroesophageal reflux disease (GERD) and GERD-related disorders.

Gastroesophageal reflux disease (GERD) is associated with obesity and hiatal hernia, and often precedes the development of Barrett's esophagus (BE) and esophageal adenocarcinoma (EA). Epidemiological studies show that the global prevalence of GERD is increasing. GERD is a multifactorial disease with a complex genetic architecture. Genome-wide association studies (GWAS) have provided initial insights into the genetic background of GERD. The present review summarizes current knowledge of the genetics of GERD and a possible genetic overlap between GERD and BE and EA. The review discusses genes and cellular pathways that have been implicated through GWAS, and provides an outlook on how future molecular research will enhance understanding of GERD pathophysiology.

Origin of the Resistivity Anisotropy in the Nematic Phase of FeSe.

The in-plane resistivity anisotropy is studied in strain-detwinned single crystals of FeSe. In contrast to other iron-based superconductors, FeSe does not develop long-range magnetic order below the tetragonal-to-orthorhombic transition at T_{s}≈90 K. This allows for the disentanglement of the contributions to the resistivity anisotropy due to nematic and magnetic orders. Comparing direct transport and elastoresistivity measurements, we extract the intrinsic resistivity anisotropy of strain-free samples. The anisotropy peaks slightly below T_{s} and decreases to nearly zero on cooling down to the superconducting transition. This behavior is consistent with a scenario in which the in-plane resistivity anisotropy is dominated by inelastic scattering by anisotropic spin fluctuations.

Strong cooperative coupling of pressure-induced magnetic order and nematicity in FeSe.

A hallmark of the iron-based superconductors is the strong coupling between magnetic, structural and electronic degrees of freedom. However, a universal picture of the normal state properties of these compounds has been confounded by recent investigations of FeSe where the nematic (structural) and magnetic transitions appear to be decoupled. Here, using synchrotron-based high-energy x-ray diffraction and time-domain Mössbauer spectroscopy, we show that nematicity and magnetism in FeSe under applied pressure are indeed strongly coupled. Distinct structural and magnetic transitions are observed for pressures between 1.0 and 1.7 GPa and merge into a single first-order transition for pressures ≳1.7 GPa, reminiscent of what has been found for the evolution of these transitions in the prototypical system Ba(Fe1-xCox)2As2. Our results are consistent with a spin-driven mechanism for nematic order in FeSe and provide an important step towards a universal description of the normal state properties of the iron-based superconductors.

[A Germany-wide survey on anaesthesia in thoracic surgery]. / Deutschlandweite Umfrage zur Thoraxanästhesie.

BACKGROUND/OBJECTIVE: This study's objective was to evaluate current thoracic anaesthesia practice in Germany and to quantify potential differences depending on the hospital's level of care. MATERIALS AND METHODS: A four-part online survey containing 28 questions was mailed to all anaesthesiology department chairs (n = 777) registered with the German Society of Anaesthesiology and Intensive Care Medicine. RESULTS: The general response rate was 31.5 % (n = 245). High monthly volumes (>50 operations/month) of intrathoracic procedures, performed by specialized thoracic surgeons are mostly limited to hospitals of maximum care, university hospitals, and specialized thoracic clinics. In hospitals with a lower level of care, intrathoracic operations occur less frequently (1-5/month) and are commonly performed by general (69.3 %) rather than thoracic surgeons (15.4 %). Video-assisted thoracic surgeries are the most invasive intrathoracic procedures for most hospitals with a low level of care (61.5 %). Extended resections and pneumonectomies occur mainly in hospitals of maximum care and university hospitals. Thoracic anaesthesia is primarily performed by consultants or senior physicians (59.9 %). The double lumen tube (91.4 %) is the preferred method to enable one-lung ventilation (bronchial blockers: 2.7 %; missing answer: 5.9 %). A bronchoscopic confirmation of the correct placement of a double lumen tube is considered mandatory by 87.7 % of the respondents. Bronchial blockers are available in 64.7 % of all thoracic anaesthesia departments. While CPAP-valves for the deflated lung are commonly used (74.9 %), jet-ventilators are rarely accessible, especially in hospitals with a lower level of care (15.4 %). Although general algorithms for a difficult airway are widely available (87.7 %), specific recommendations for a difficult airway in thoracic anaesthesia are uncommon (4.8 %). Laryngeal mask airways (90.9 %) and videolaryngoscopy (88.8 %) are the primary adjuncts in store for a difficult airway. While hospitals with a lower level of care admitted patients routinely (92.3 %) to an intensive care unit after thoracic surgery, larger clinics used the postanaesthesia recovery room (12.5 %) and intermediate care units (14.6 %) more frequently for further surveillance. Thoracic epidural catheters (85.6 %) are predominantly chosen for peri- and postoperative analgesia, in contrast to paravertebral blockade (single shot: 8.6 %; catheter: 8.0 %) (multiple answers possible). Ultrasound is generally accessible (84.5 %) and mostly employed for the placement of central venous (81.3 %) and arterial (43.9 %) lines as well as a diagnostic tool for pulmonary pathology (62.0 %). CONCLUSION: The study reveals considerable differences in the anaesthetic practice in thoracic surgery. These focus mostly on the postoperative surveillance, the availability of bronchial blockers, and the use of regional anaesthetic techniques. Furthermore, it is evident that specific algorithms are needed for the difficult airway in thoracic anaesthesia. A recommendation for the high-tech work environment of thoracic anaesthesia could enhance the structural quality and optimize patient outcomes. Independent of a hospital's level of care, uniform requirements could help establish national quality standards in thoracic anaesthesia.

Superconductivity-induced re-entrance of the orthorhombic distortion in Ba1-xKxFe2As2.

Detailed knowledge of the phase diagram and the nature of the competing magnetic and superconducting phases is imperative for a deeper understanding of the physics of iron-based superconductivity. Magnetism in the iron-based superconductors is usually a stripe-type spin-density-wave, which breaks the tetragonal symmetry of the lattice, and is known to compete strongly with superconductivity. Recently, it was found that in some systems an additional spin-density-wave transition occurs, which restores this tetragonal symmetry, however, its interaction with superconductivity remains unclear. Here, using thermodynamic measurements on Ba1-xKxFe2As2 single crystals, we show that the spin-density-wave phase of tetragonal symmetry competes much stronger with superconductivity than the stripe-type spin-density-wave phase, which results in a novel re-entrance of the latter at or slightly below the superconducting transition.