Investigating charge-up and fragmentation dynamics of oxygen molecules after interaction with strong X-ray free-electron laser pulses.

During the last decade, X-ray free-electron lasers (XFELs) have enabled the study of light-matter interaction under extreme conditions. Atoms which are subject to XFEL radiation are charged by a complex interplay of (several subsequent) photoionization events and electronic decay processes within a few femtoseconds. The interaction with molecules is even more intriguing, since intricate nuclear dynamics occur as the molecules start to dissociate during the charge-up process. Here, we demonstrate that by analyzing photoelectron angular emission distributions and kinetic energy release of charge states of ionic molecular fragments, we can obtain a detailed understanding of the charge-up and fragmentation dynamics. Our novel approach allows for gathering such information without the need of complex ab initio modeling. As an example, we provide a detailed view on the processes happening on a femtosecond time scale in oxygen molecules exposed to intense XFEL pulses.

Comparison of electrophysiological parameters between perimodiolar and lateral wall electrodes in paediatric cochlear implant users.

PURPOSE: (1) To compare the in vivo impedances of electrical contacts of the Nucleus Contour Advance (CA) perimodiolar electrodes and the Nucleus Slim Straight (SS) lateral wall electrodes. (2) To compare the relation between the electrode contact impedances and the behavioural T-/C-levels for both types of electrodes. METHODS: Retrospective case review in two quaternary otologic referral centres was performed. Data on the impedance of the electrode contacts and the T-/C-levels have been collected from 70 consecutive paediatric CI patients. RESULTS: (1) SS electrodes show significantly higher impedance values of the contacts compared to the CA electrodes. This can be explained by differences in the active surface of the electrode contacts and is true for the whole electrode arrays. (2) There are significant negative correlations observed between the impedances of the electrode contacts and the behaviourally measured T-/C-levels. (3) The strength correlation between the electrode impedances and the behavioural T-/C-levels is significantly higher and the T-/C-level variability is lower for the perimodiolar CA electrodes than for the lateral wall SS electrodes. CONCLUSIONS: There exist significant differences in the contact impedance between different cochlear implant electrode arrays. These differences could influence the implant programming parameters and should be considered in any protocols related to automatic implant programming based on objective measures. The predictive value of the electrode impedances for the behavioural T-/C-levels is higher for the perimodiolar CA electrodes than for the lateral wall SS electrodes.

Cytokine expression in Treponema pallidum infection.

BACKGROUND: Current syphilis tests cannot distinguish between active and past syphilis among patients with serofast rapid plasma reagin (RPR) titers. We investigated whether cytokine profiles might provide insight in the differentiation of active and treated syphilis. METHODS: We collected quarterly serum samples from participants at risk for incident syphilis in a prospective cohort study of men and male-to-female transgender women. We defined incident syphilis as a new RPR titer ≥ 1:8 or a fourfold increase from a prior RPR titer and a positive Treponema pallidum particle agglutination assay. We measured cytokine expression using a 63-multiplex bead-based Luminex assay (eBiosciences/Affymetrix, San Diego, California, USA). We used tertile bins and Chi square tests to identify differences in proportions of cytokines between samples from patients with active and treated syphilis. We constructed a network of cytokine profiles from those findings. We used R software (R version 3.4.1, R, Vienna, Austria) to fit models. RESULTS: We identified 20 pairs of cytokines (out of 1953 possible pairs) that differed between active and treated syphilis. From those, we identified three cytokine networks of interest: an Eotaxin-Rantes-Leptin network, a Mig-IL1ra-Trail-CD40L network, and an IL12p40-IL12p70 network. CONCLUSIONS: Differences in cytokine profiles are present among men and male-to-female transgender women with active and treated syphilis. Cytokine assays may be a potentially useful tool for identifying active syphilis among patients with serologic syphilis reactivity.

Photon-Momentum-Induced Molecular Dynamics in Photoionization of N_{2} at hν=40 keV.

We investigate K-shell ionization of N_{2} at 40 keV photon energy. Using a cold target recoil ion momentum spectroscopy reaction microscope, we determine the vector momenta of the photoelectron, the Auger electron, and both N^{+} fragments. These fully differential data show that the dissociation process of the N_{2}^{2+} ion is significantly modified not only by the recoil momentum of the photoelectron but also by the photon momentum and the momentum of the emitted Auger electron. We find that the recoil energy introduced by the photon and the photoelectron momentum is partitioned with a ratio of approximately 30∶70 between the Auger electron and fragment ion kinetic energies, respectively. We also observe that the photon momentum induces an additional rotation of the molecular ion.

Recoil-Induced Asymmetry of Nondipole Molecular Frame Photoelectron Angular Distributions in the Hard X-ray Regime.

We investigate angular emission distributions of the 1s photoelectrons of N_{2} ionized by linearly polarized synchrotron radiation at hν=40 keV. As expected, nondipole contributions cause a very strong forward-backward asymmetry in the measured emission distributions. In addition, we observe an unexpected asymmetry with respect to the polarization direction, which depends on the direction of the molecular fragmentation. In particular, photoelectrons are predominantly emitted in the direction of the forward nitrogen atom. This observation cannot be explained via asymmetries introduced by the initial bound and final continuum electronic states of the oriented molecule. The present simulations assign this asymmetry to a novel nontrivial effect of the recoil imposed to the nuclei by the fast photoelectrons and high-energy photons, which results in a propensity for the ions to break up along the axis of the recoil momentum. The results are of particular importance for the interpretation of future experiments at x-ray free electron lasers operating in the few tens of keV regime, where such nondipole and recoil effects will be essential.

Breakdown of the Spectator Concept in Low-Electron-Energy Resonant Decay Processes.

We suggest that low-energy electrons, released by resonant decay processes, experience substantial scattering on the electron density of excited electrons, which remain a spectator during the decay. As a result, the angular emission distribution is altered significantly. This effect is expected to be a common feature of low-energy secondary electron emission. In this Letter, we exemplify our idea by examining the spectator resonant interatomic Coulombic decay of Ne dimers. Our theoretical predictions are confirmed by a corresponding coincidence experiment.

Illness perception is significantly determined by depression and anxiety in systemic lupus erythematosus.

Objectives Illness perception is a cognitive representation influencing physical and psychological functioning and adherence in patients with rheumatic disease. Studies exploring illness perception in systemic lupus erythematosus (SLE) are still scarce and none of them have investigated factors determining illness perception. We aimed to assess illness perception and to identify psychological, clinical and sociodemographic factors that might influence illness perception in SLE. Methods The study involved 80 patients with SLE (87.5% women, mean age 41.56 years). The Brief Illness Perception Questionnaire, State Trait Anxiety Inventory, Beck Depression Inventory, Pittsburgh Sleep Quality Index, Visual Analogue Scale-Pain and Fatigue Severity Scale were used. Clinical and sociodemographic data were collected via structured interview and medical files review. Results Illness perception was significantly positively correlated with anxiety, depression, sleep quality, fatigue and pain while it was not related to age, education, steroid treatment, disease duration and activity (SLEDAI) or organ damage (SLICC/ACR). Regression analysis revealed that state anxiety and depression explained 43% of illness perception variance. Cluster analysis identified three patient groups among which the middle-aged group had the most negative illness perception, the highest levels of anxiety, depression, pain and fatigue, and the poorest sleep quality. Conclusions The study has proved a significant relationship between negative illness perception and anxiety and depression. Patients reporting fatigue, poor sleep and pain might have special needs in terms of psychological intervention focused on negative illness perception and distress symptoms. Multidisciplinary care in managing SLE seems to be of great importance.

Participation and health care provision of statutory skin cancer screening in Germany - a secondary data analysis.

BACKGROUND: In Germany, skin cancer screening was introduced nationwide in July 2008. From the age of 35 years, members of the statutory health insurance are eligible for screening every 2 years. OBJECTIVE: The aim of this study is to calculate the participation rates and the proportions of health care providers of statutory skin cancer screening in Germany on a population-based level. METHODS: Data were provided by a nationwide German statutory health insurance, approximately 6.1 million members, covering the years 2008/2009. Participation rates were calculated per yearly quarter and were adjusted for age, gender and federal state. RESULTS: Approximately 920,000 insurants were screened from the third quarter of 2008 until the last quarter of 2009. Mean participation rate of skin cancer screening was 30.8%. Women had higher participation rates (31.9%) than men (29.7%). After adjusting for gender and federal state, high rates for pensioners at the age of 65-74 were confirmed at 39.4% on average for all yearly quarters. One of the highest gender- and age-adjusted rates was observed in the state of Schleswig-Holstein, where a population based pilot project had been implemented before the start of the nationwide screening programme. In general, without taking into account Berlin, former East Germany had a much lower gender- and age-adjusted participation rate (23.9%) than West Germany (33.3%). At the first quarter after implementation of screening, 58.5% of the screenings were provided by dermatologists and 41.5% by general practitioners. CONCLUSION: Participation rates and health care providers of skin cancer screening can be calculated from secondary data and contribute to identify group- and region-specific participation patterns in order to improve early detection of skin cancer.

[Structural lag and room for possibilities in old age exemplified by central transitions. Initial results of a novel discipline trialogue between diaconal studies, psychology and theology]. / "Structural Lag" und Möglichkeitsräume des Alterns am Beispiel zentraler Transitionen. Erste Befunde eines neuartigen Disziplinentrialogs zwischen Diakoniewissenschaft, Psychologie und Theologie.

BACKGROUND: Although the need for interdisciplinary research is generally accepted in gerontology, such interdisciplinary communication is often limited to various combinations of psychological, sociological and biomedical scientific approaches. We argue that gerontology requires a continuous examination of novel disciplinary constellations to obtain a better understanding of aging in its complexity and to further develop this scientific field in its entirety. OBJECTIVE: The present study introduced and tested for the first time an innovative disciplinary trialogue, i.e. the combination of psychology, theology and diaconal studies. In particular, it is assumed that this combination can contribute to a more profound interpretation of the prominent concept of structural lag which is underresearched in gerontology. MATERIAL AND METHODS: The analysis of structural lag with another overarching concept, "room for possibilities", can provide a synergy-rich interpretation category for a range of challenges connected with old age. In this respect, three major transitions were selected to shed light on these concepts and examined by means of three focus group interviews: transition to retirement, need for long-term care in the private home context and transition to nursing home life. The data were evaluated using qualitative content analysis. RESULTS: The interdisciplinary-oriented evaluation of the interviews and the qualitative data analysis revealed the relevance of different perceptions of time in all three transitions. In addition, different dynamics in terms of the interplay of gains and losses as well as participation were found to be important for a better understanding of the three transitions. In particular, the subjective interpretation of the time remaining for living and the predetermined or self-selected time structuring of the daily routine were important factors for the perception of one's own potential. The results also underline a range of unused room for possibilities and the existence of structural lag for each transition. CONCLUSION: By the cooperation of the participating disciplines aspects of aging and their interdependence became visible. At the same time this pilot-like disciplinary trialogue revealed the challenges in combining interdisciplinary perspectives by the combination of empirical and hermeneutical methods.

Why do rough surfaces appear glossy?

The majority of work on the perception of gloss has been performed using smooth surfaces (e.g., spheres). Previous studies that have employed more complex surfaces reported that increasing mesoscale roughness increases perceived gloss [Psychol. Sci.19, 196 (2008), J. Vis.10(9), 13 (2010), Curr. Biol.22, 1909 (2012)]. We show that the use of realistic rendering conditions is important and that, in contrast to [Psychol. Sci.19, 196 (2008), J. Vis.10(9), 13 (2010)], after a certain point increasing roughness further actually reduces glossiness. We investigate five image statistics of estimated highlights and show that for our stimuli, one in particular, which we term "percentage of highlight area," is highly correlated with perceived gloss. We investigate a simple model that explains the unimodal, nonmonotonic relationship between mesoscale roughness and percentage highlight area.

Molecular confirmation of nine cases of Cornelia de Lange syndrome diagnosed prenatally.

OBJECTIVES: Cornelia de Lange syndrome (CdLS) is characterized by distinct facial features, growth retardation, upper limb reduction defects, hirsutism, and intellectual disability. NIPBL mutations have been identified in approximately 60% of patients with CdLS diagnosed postnatally. Prenatal ultrasound findings include upper limb reduction defects, intrauterine growth restriction, and micrognathia. CdLS has also been associated with decreased PAPP-A and increased nuchal translucency (NT). We reviewed NIPBL sequence analysis results for 12 prenatal samples in our laboratory to determine the frequency of mutations in our cohort. METHODS: This retrospective study analyzed data from all 12 prenatal cases with suspected CdLS, which were received by The University of Chicago Genetic Services Laboratories. Diagnostic NIPBL sequencing was performed for all samples. Clinical information was collected from referring physicians. RESULTS: NIPBL mutations were identified in 9 out of the 12 cases prenatally (75%). Amongst the NIPBL mutation-positive cases with clinical information available, the most common findings were upper limb malformations and micrognathia. Five patients had NT measurements in the first trimester, of which four were noted to be increased. CONCLUSION: We demonstrate that prenatally-detected phenotypes of CdLS, particularly severe micrognathia and bilateral upper limb defects, are associated with an increased frequency of NIPBL mutations.

Residual antimicrobial effect of chlorhexidine digluconate and octenidine dihydrochloride on reconstructed human epidermis.

The objective of the present investigation was to examine the residual antimicrobial activity after a topical exposure of reconstructed human epidermis (RHE) to equimolar solutions of either chlorhexidine digluconate (CHG, 0.144% w/v) or octenidine dihydrochloride (OCT, 0.1% w/v) for 15 min. RHE-associated antiseptic agents were more effective on Staphylococcus aureus than on Pseudomonas aeruginosa. S. aureus was not detected after 24 h of contact, which demonstrated a microbicidal efficacy of greater than 5-log10 reduction. In contrast, P. aeruginosa was reduced by approximately 2 log10 at the same incubation time, which parallels the growth of the initial inoculum. This result could be interpreted either as a microbiostatic effect or as an adherence of P. aeruginosa to a low positively charged surface. Small amounts of CHG and OCT can penetrate the stratum corneum. Using these antiseptic agents, the viability of keratinocytes was reduced to 65-75% of that of the untreated RHE control following 24 h incubation in the presence of test microorganisms. With consideration of antimicrobial activity and cytotoxic effect, OCT corresponds better to a biocompatible antiseptic agent than CHG.

Three-dimensional assessment of facial appearance following surgical repair of unilateral cleft lip and palate.

BACKGROUND AND OBJECTIVE: Objective assessment of postsurgical facial asymmetry can be difficult, but three-dimensional (3D) imaging techniques have made this possible. The objective of this study was to assess residual asymmetry in surgically repaired unilateral cleft lip (UCL) and unilateral cleft lip and palate (UCLP) patients and to compare this with noncleft controls. DESIGN: Retrospective multicohort comparative study. PATIENTS AND METHODS: Fifty-one 10-year-old children with surgically managed UCLP and 44 children with UCL were compared with a control group of 68 ten-year-olds. The 3D facial models at rest and with maximum smile were created using a 3D imaging system. Asymmetry scores were produced using both anatomical landmarks and a novel method of facial curve analysis. RESULTS: Asymmetry for the whole face was significantly higher in both cleft groups compared with controls (P < .001). UCLP asymmetry was higher than UCL (P < .001). In cleft patients, the upper lip and nasal rim were the most asymmetric (P < .001 to .05). Control subjects also displayed a degree of facial asymmetry. Maximum smile did not significantly affect the symmetry of the whole face, but it increased asymmetry of the vermillion border and nasal rim in all three groups (P < .001). CONCLUSIONS: Despite surgical intervention at an early age, asymmetry remains significant in cleft patients at 10 years of age. Three-dimensional imaging is a noninvasive objective assessment tool that identifies specific areas of the face responsible for asymmetry. Facial curve analysis describes the face more comprehensively and characterizes soft tissue contours.

[The assessment and course of development of cognitive abilities in the elderly]. / Diagnostik und Verlauf von kognitiven Fähigkeiten bei älteren Menschen.

BACKGROUND: The assessment of the appropriate level of development in children belongs to the standard duties of physicians in the public health system. Due to a steady increase of dementia in Germany the assessment of cognitive abilities of the elderly is becoming more and more the focus of future activities. Such an assessment of cognitive functioning reveals whether the respective person is aging normally or whether the impaired cognitive functioning is probably based on a pathological process. OBJECTIVE: The aim of the present study is to present cognitive changes in the aged and 2 psychometric tests for the assessment of cognitive functioning: the Wechsler Adult Intelligence Scale (WAIS-IV) and the Short Cognitive Performance Test (SKT), a test for the assessment of memory impairments and impairment of attention. In addition, similarities and dissimilarities are presented. METHODS: As part of a multi-centre study in German-speaking countries the data of 504 cognitively healthy persons between the age of 60 and 90 were tested with the WAIS-IV and the SKT. RESULTS AND CONCLUSION: The results revealed a significant cognitive decline in the fluid and crystal intelligence depending on age. Only 2 subtests of the WAIS-IV (General Information and Block Design) showed no significant variation due to age. The SKT scores of memory and attention correlated significantly with almost all subtests of the WAIS-IV. The highest correlations were between the SKT attention score and the WAIS-IV subtests for processing speed, perceptual reasoning and working memory. The decline in cognitive abilities is mainly due to reduced capacities in speed of information processing and working memory.

Neuropsychological assessment in mixed connective tissue disease: comparison with systemic lupus erythematosus.

OBJECTIVE: The aims of the study were to assess cognitive functions (CF) in patients with mixed connective tissue disease (MCTD) and to compare MCTD patients with systemic lupus erythematosus patients with and without neuropsychiatric manifestations (NP-SLE and non-NP-SLE, respectively) in terms of CF. METHODS: Neuropsychological examination was performed in 141 patients: 30 with MCTD (24 women, 6 men), mean age: 48.07 years, 37 with non-NP-SLE (36 women, 1 man), mean age: 40.76 years and 74 with NP-SLE (68 women, 6 men), mean age: 41.97 years. Neuropsychological tests and structured interview were used. Emotional state was assessed by Hospital Anxiety and Depression Scale and clinical review. RESULTS: We observed cognitive impairment in six MCTD patients (20%); in one (3%) the impairment was severe. MCTD patients achieved significantly higher results in seven out of 11 tests compared with patients with NP-SLE. MCTD and non-NP-SLE patients did not differ significantly. The differences were irrespective of premorbid IQ, education, disease duration and steroid treatment. CONCLUSIONS: In the majority of MCTD patients, CF were not impaired and severe impairment was unusual. Cognitive functioning was most disturbed in NP-SLE. The cognitive deficits observed in connective tissue diseases can be connected with nervous system involvement.

The HLA-B 3906 allele imparts a high risk of diabetes only on specific HLA-DR/DQ haplotypes.

AIMS/HYPOTHESIS: We investigated the risk associated with HLA-B*39 alleles in the context of specific HLA-DR/DQ haplotypes. METHODS: We studied a readily available dataset from the Type 1 Diabetes Genetics Consortium that consists of 2,300 affected sibling pair families genotyped for both HLA alleles and 2,837 single nucleotide polymorphisms across the major histocompatibility complex region. RESULTS: The B*3906 allele significantly enhanced the risk of type 1 diabetes when present on specific HLA-DR/DQ haplotypes (DRB1 0801-DQB1 0402: p = 1.6 × 10(-6), OR 25.4; DRB1 0101-DQB1 0501: p = 4.9 × 10(-5), OR 10.3) but did not enhance the risk of DRB1 0401-DQB1 0302 haplotypes. In addition, the B 3901 allele enhanced risk on the DRB1 1601-DQB1 0502 haplotype (p = 3.7 × 10(-3), OR 7.2). CONCLUSIONS/INTERPRETATION: These associations indicate that the B 39 alleles significantly increase risk when present on specific HLA-DR/DQ haplotypes, and HLA-B typing in concert with specific HLA-DR/DQ genotypes should facilitate genetic prediction of type 1 diabetes, particularly in a research setting.

Neuropsychological assessment in systemic lupus erythematosus patients: clinical usefulness of first-choice diagnostic tests in detecting cognitive impairment and preliminary diagnosis of neuropsychiatric lupus.

OBJECTIVES: To evaluate the usefulness of neuropsychological tests in order to distinguish the first-choice methods useful in quick detection of cognitive impairment in SLE and preliminary diagnosis of neuropsychiatric manifestation. Study aimed at assessment of the prevalence and severity of cognitive deficits in SLE patients and comparison between SLE patients with neuropsychiatric manifestations (NP-SLE) and without ones (non-NP-SLE). METHODS: 93 out of 104 SLE patients, 57 with NP-SLE and 36 with non-NP-SLE underwent comprehensive neuropsychological examination. Tailor-made structured interview for neuropsychological assessment in SLE (SISLE) was used. Patients' emotional state was assessed by clinical interview and HADS. RESULTS: Cognitive dysfunction was identified in 57% of SLE patients, 48.4% in 1-3 tests, 8.6% (8 patients) in 4 or more tests (severe decline). Among impaired patients 15% had severe decline. In NP-SLE group 63.2% were impaired vs. 47.2% in non-NP-SLE group. All 8 patients with severe decline were NP-SLE. The dysfunction was irrespective of premorbid intellectual level, age, education, disease duration and steroid treatment. In NP-SLE significantly lower scores were observed in 8 tests (10 parameters). CONCLUSIONS: Cognitive dysfunction is frequent in SLE patients. The majority of patients has mild deficits, but severe decline is also observed. The dysfunction is more frequent and more pronounced in NP-SLE. The study distinguished 8-test-first-choicebattery useful in detecting cognitive impairment in SLE and in case of severe decline - in preliminary differentiating NP-SLE and non-NP-SLE. Structured interview for psychological/neuropsychological examination of SLE patients is a useful and required tool for a standard patients' assessment.

Three-dimensional assessment of early surgical outcome in repaired unilateral cleft lip and palate: Part 1. Nasal changes.

OBJECTIVE: To evaluate three-dimensional nasal morphology following primary reconstruction in children with unilateral cleft lip and palate relative to contemporaneous noncleft data. DESIGN: Prospective, cross-sectional, controlled study. SETTING: Glasgow Dental Hospital and School, Faculty of Medicine, Glasgow University. PATIENTS AND PARTICIPANTS: Two groups of 3-year-old children (21 with unilateral cleft lip and palate and 96 controls) with facial images taken using a three-dimensional, vision-based capture technique. METHODS: Three-dimensional images of the face were reflected so the cleft was on the left side to create a homogeneous group for statistical analysis. Three-dimensional coordinates of anthropometric landmarks were extracted from facial images by a single operator. A set of linear measurements was used to compare cleft and control subjects on right and left sides, adjusting for sex differences. RESULTS: The mean nasal base width and the width of the nostril floor on right and left sides differed significantly between control and unilateral cleft lip and palate groups. The measurements were greater in children with unilateral cleft lip and palate. The differences in the mean nasal height and mean nasal projection between the groups were not statistically significant. Mean columellar lengths were different between the left and right sides in children with unilateral cleft lip and palate. CONCLUSIONS: There were significant nasal deformities following the surgical repair of unilateral cleft lip and palate.

Three-dimensional assessment of early surgical outcome in repaired unilateral cleft lip and palate: Part 2. Lip changes.

OBJECTIVE: To evaluate three-dimensional lip morphology, following primary reconstruction in children with unilateral cleft lip and palate relative to contemporaneous noncleft data. DESIGN: Prospective, cross-sectional, controlled study. SETTING: Glasgow Dental Hospital and School, University of Glasgow, U.K. PATIENTS AND PARTICIPANTS: Two groups of 3-year-old children (21 with unilateral cleft lip and palate and 96 controls) with facial images taken using a three-dimensional vision-based capture technique. METHODS: Three-dimensional images of the face were reflected so the cleft was on the left side to create a homogeneous group for statistical analysis. Three-dimensional coordinates of anthropometric landmarks were extracted from facial images. Three-dimensional, generalized Procrustes superimposition was implemented and a set of linear measurements were used to compare cleft and control subjects for right and left sides, adjusting for sex differences. RESULTS: Crista philtri on both the cleft and noncleft sides were displaced laterally and posteriorly; there was also a statistically significant increase in philtrum width. No significant differences between cleft and control regarding the cutaneous height of the upper lip. The lip in the cleft patients was flatter than in the noncleft individuals, with less prominence of labialis superioris. CONCLUSIONS: Stereophotogrammetry allows detection of residual dysmorphology following cleft repair. There was significant increase of the philtrum width. The lip appeared flatter and more posterior displaced in unilateral cleft lip and palate patients compared with controls.

Standardized comparison of antiseptic efficacy of triclosan, PVP-iodine, octenidine dihydrochloride, polyhexanide and chlorhexidine digluconate.

BACKGROUND: This study presents a comparative investigation of the antimicrobial efficacy of the antiseptics PVP-iodine, triclosan, chlorhexidine, octenidine and polyhexanide used for pre-surgical antisepsis and antiseptic treatment of skin, wounds and mucous membranes based on internationally accepted standards. METHODS: MICs and MBCs were determined in accordance with DIN 58940-7 and 58940-8 using Staphylococcus aureus (including methicillin-resistant Staphylococcus aureus), Enterococcus faecalis (including vancomycin-resistant Enterococcus), Streptococcus pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Clostridium perfringens, Haemophilus influenzae and Candida albicans. The microbicidal efficacy was determined in accordance with DIN EN 1040 and 1275 using S. aureus, P. aeruginosa and C. albicans. RESULTS: For chlorhexidine, octenidine and polyhexanide, MIC(48) and MBC(24) ranged from 16 to 32 mg/L. Maximum values for triclosan ranged from 256 to 512 mg/L, with an efficacy gap against P. aeruginosa, while the maximum values of PVP-iodine were 1024 mg/L, with a gap against S. pneumoniae. Comparing the minimal effective concentrations, octenidine was most effective. After 1 min, only octenidine and PVP-iodine fulfil the requirements for antiseptics. CONCLUSIONS: Tests under standardized and harmonized conditions help to choose the most efficacious agent. When a prolonged contact time is feasible, ranking of agents would be polyhexanide = octenidine > chlorhexidine > triclosan > PVP-iodine. This is consistent with the recommendations for antisepsis of acute wounds. Polyhexanide seems to be preferable for chronic wounds due to its higher tolerability. If an immediate effect is required, ranking would be octenidine = PVP-iodine>> polyhexanide > chlorhexidine > triclosan.