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Undesired coupling to the surrounding environment destroys long-range correlations in quantum processors and hinders coherent evolution in the nominally available computational space. This noise is an outstanding challenge when leveraging the computation power of near-term quantum processors1. It has been shown that benchmarking random circuit sampling with cross-entropy benchmarking can provide an estimate of the effective size of the Hilbert space coherently available2–8. Nevertheless, quantum algorithms’ outputs can be trivialized by noise, making them susceptible to classical computation spoofing. Here, by implementing an algorithm for random circuit sampling, we demonstrate experimentally that two phase transitions are observable with cross-entropy benchmarking, which we explain theoretically with a statistical model. The first is a dynamical transition as a function of the number of cycles and is the continuation of the anti-concentration point in the noiseless case. The second is a quantum phase transition controlled by the error per cycle; to identify it analytically and experimentally, we create a weak-link model, which allows us to vary the strength of the noise versus coherent evolution. Furthermore, by presenting a random circuit sampling experiment in the weak-noise phase with 67 qubits at 32 cycles, we demonstrate that the computational cost of our experiment is beyond the capabilities of existing classical supercomputers. Our experimental and theoretical work establishes the existence of transitions to a stable, computationally complex phase that is reachable with current quantum processors.

The common whelk Buccinum undatumis of great commercial and ecological importance, but little information is known regarding the gear selectivity of the fishery. Understanding gear selectivity is key for the long‐term sustainability of a stock and has applications in stock assessments and fishery management. We investigated the effect of gear (pots) on the selectivity of catch within the common whelk commercial fishery through a mark–recapture study and comparative gear trials across Wales. The size composition of the population in the water was estimated by dividing the numbers at size brought onboard by the selectivity of the pots. The selectivity of experimental pots (commercial pots that were modified to catch a wider size range) was estimated by comparing the size composition of whelks caught in the experimental gear to the estimated size composition of the population. Peak selectivity of commercial pots occurred around the current minimum landing size (65 mm total shell length) for common whelks, with selectivity sloping off gradually for larger individuals and rapidly for undersized individuals. Across regions, less than 30% of the catch from baited lay‐down pots was discarded. Experimental pots were found to have a more variable but generally dome‐shaped selectivity curve similar to that of the commercial pots. The fishery appears to be well designed, with gear successfully targeting the legal‐sized catch, which is promising for the conservation of the stock if discards have a high survival rate. Experimental gear is ideal for stock assessment purposes, and methods developed to estimate the selectivity of the experimental pots reduce the need for further intensive mark–recapture studies as fishing gear evolves over time. Impact statementThe common whelk is regarded as a data‐poor stock; other than total landings, little information is currently known about the fishery. This study used mark–recapture surveys and comparative gear trials to estimate the selectivity of whelk pots and to determine the composition of whelks in the population. Our findings will facilitate the ongoing development of management strategies for this commercially important species. The common whelk is regarded as a data‐poor stock; other than total landings, little information is currently known about the fishery. This study used mark–recapture surveys and comparative gear trials to estimate the selectivity of whelk pots and to determine the composition of whelks in the population. Our findings will facilitate the ongoing development of management strategies for this commercially important species.

An important measure of the development of quantum computing platforms has been the simulation of increasingly complex physical systems. Before fault-tolerant quantum computing, robust error-mitigation strategies were necessary to continue this growth. Here, we validate recently introduced error-mitigation strategies that exploit the expectation that the ideal output of a quantum algorithm would be a pure state. We consider the task of simulating electron systems in the seniority-zero subspace where all electrons are paired with their opposite spin. This affords a computational stepping stone to a fully correlated model. We compare the performance of error mitigations on the basis of doubling quantum resources in time or in space on up to 20 qubits of a superconducting qubit quantum processor. We observe a reduction of error by one to two orders of magnitude below less sophisticated techniques such as postselection. We study how the gain from error mitigation scales with the system size and observe a polynomial suppression of error with increased resources. Extrapolation of our results indicates that substantial hardware improvements will be required for classically intractable variational chemistry simulations.

Systems of correlated particles appear in many fields of modern science and represent some of the most intractable computational problems in nature. The computational challenge in these systems arises when interactions become comparable to other energy scales, which makes the state of each particle depend on all other particles1. The lack of general solutions for the three-body problem and acceptable theory for strongly correlated electrons shows that our understanding of correlated systems fades when the particle number or the interaction strength increases. One of the hallmarks of interacting systems is the formation of multiparticle bound states2–9. Here we develop a high-fidelity parameterizable fSim gate and implement the periodic quantum circuit of the spin-½ XXZ model in a ring of 24 superconducting qubits. We study the propagation of these excitations and observe their bound nature for up to five photons. We devise a phase-sensitive method for constructing the few-body spectrum of the bound states and extract their pseudo-charge by introducing a synthetic flux. By introducing interactions between the ring and additional qubits, we observe an unexpected resilience of the bound states to integrability breaking. This finding goes against the idea that bound states in non-integrable systems are unstable when their energies overlap with the continuum spectrum. Our work provides experimental evidence for bound states of interacting photons and discovers their stability beyond the integrability limit.

A promising approach to study condensed-matter systems is to simulate them on an engineered quantum platform1–4. However, the accuracy needed to outperform classical methods has not been achieved so far. Here, using 18 superconducting qubits, we provide an experimental blueprint for an accurate condensed-matter simulator and demonstrate how to investigate fundamental electronic properties. We benchmark the underlying method by reconstructing the single-particle band structure of a one-dimensional wire. We demonstrate nearly complete mitigation of decoherence and readout errors, and measure the energy eigenvalues of this wire with an error of approximately 0.01 rad, whereas typical energy scales are of the order of 1 rad. Insight into the fidelity of this algorithm is gained by highlighting the robust properties of a Fourier transform, including the ability to resolve eigenenergies with a statistical uncertainty of 10−4rad. We also synthesize magnetic flux and disordered local potentials, which are two key tenets of a condensed-matter system. When sweeping the magnetic flux we observe avoided level crossings in the spectrum, providing a detailed fingerprint of the spatial distribution of local disorder. By combining these methods we reconstruct electronic properties of the eigenstates, observing persistent currents and a strong suppression of conductance with added disorder. Our work describes an accurate method for quantum simulation5,6and paves the way to study new quantum materials with superconducting qubits.

Background: Urinary metanephrine is a reliable method to estimate catecholamine secretion. Traditionally, urinary metanephrines are collected into chilled containers containing hydrochloric acid (HCl) and most laboratories freeze urinary samples before analysis. It is uncertain if these pre-analytic procedures alter metanephrine values. Aim: To evaluate if acidifying and freezing urine samples affect the accuracy of urinary metanephrine measurements. Methods: Random urine samples from healthy individuals were collected. Urine samples were distributed into two containers: with HCl 50% homogenized with urine to obtain pH < 2, and without HCl. Each container was divided again into aliquots for immediate measurement or freezing. One aliquot with acid (group 1) and another without acid (group 2) were sent immediately to the laboratory for testing (HPLC), while the other two aliquots, one with acid (group 3) and another without it (group 4) were frozen for 3 months at − 20 °C. Bland–Altman’s test was used to analyze inter-assay agreement between measurements. Results: A total of 15 individuals were included (mean age 27.5 ± 5.9 years, 8 male and 14 white). No difference was observed on mean urinary metanephrine/creatinine ratio between groups: group 1: 0.23 ± 0.11, group 2: 0.22 ± 0.07, group 3: 0.25 ± 0.13, group 4: 0.25 ± 0.15 mg/g creatinine; P> 0.05 for all the comparisons). Bland–Altman’s analysis showed agreement between the standard method (group 1) and the experimental method (group 4). Conclusion: Measurement of urinary metanephrines by HPLC method is not influenced by sample acidification nor freezing at − 20 °C for 3 months.

Heterochromatin affects genome function at many levels. It enables heritable gene repression, maintains chromosome integrity and provides mechanical rigidity to the nucleus1,2. These diverse functions are proposed to arise in part from compaction of the underlying chromatin2. A major type of heterochromatin contains at its core the complex formed between HP1 proteins and chromatin that is methylated on histone H3, lysine 9 (H3K9me). HP1 is proposed to use oligomerization to compact chromatin into phase-separated condensates3–6. Yet, how HP1-mediated phase separation relates to chromatin compaction remains unclear. Here we show that chromatin compaction by the Schizosaccharomyces pombeHP1 protein Swi6 results in phase-separated liquid condensates. Unexpectedly, we find that Swi6 substantially increases the accessibility and dynamics of buried histone residues within a nucleosome. Restraining these dynamics impairs compaction of chromatin into liquid droplets by Swi6. Our results indicate that Swi6 couples its oligomerization to the phase separation of chromatin by a counterintuitive mechanism, namely the dynamic exposure of buried nucleosomal regions. We propose that such reshaping of the octamer core by Swi6 increases opportunities for multivalent interactions between nucleosomes, thereby promoting phase separation. This mechanism may more generally drive chromatin organization beyond heterochromatin.

Oral semaglutide is the first oral formulation of a glucagon-like peptide-1 (GLP-1) receptor agonist developed for the treatment of type 2 diabetes. We aimed to compare the efficacy and safety of flexible dose adjustments of oral semaglutide with sitagliptin 100 mg.

ObjectivesIn 2007, the International Agency for Research on Cancer classified shift work involving circadian disruption (CD) as probably carcinogenic to humans. Circadian disruption could be conceptualised as the overlap of activity, such as work, with an individual’s biological night. The latter can be approximated from a worker’s chronotype (or morning/evening preference). Few previous studies have taken chronotype into account when assessing CD caused by shift work. Our objective was to test the hypothesis that women working during their biological night would be at increased risk of breast cancer.MethodsWe used data from our case–control study of breast cancer to investigate associations between shift work involving CD and breast cancer risks. Previously, we had assumed that everyone working in jobs which involved work for two or more shifts between midnight and 05:00 hours was equally exposed to CD. In the present analyses, we reclassified as unexposed those who had a late chronotype in which their preferred bedtime was 2 hours after the end of their shift.ResultsOnly 30 of 1385 night jobs changed classification and the overall finding (OR 1.17, 95% CI 0.98 to 1.41) was not different to the original finding when chronotype was not considered.ConclusionsWe found virtually no difference between our new and old classifications of exposure. However, we were not able to calculate the total number of chronodisrupted shifts over a lifetime in order to assess dose and nor were we able to determine how many women were exposed to CD when doing shifts which began before midnight. Our first practical application highlights challenges for future chronobiology-based research.

Les fractures de l’extrémité proximale du tibia représentent 1 % des fractures de l’adulte. Parmi ces lésions, les fractures complexes Schatzker V et VI représentent une menace pour la structure et la fonction du genou. Leur traitement est difficile et source de complications fréquentes. Si l’ostéosynthèse par plaques reste la référence, le taux d’infections en résultant, nous fait préférer le fixateur hybride. Les objectifs de ce travail étaient d’étudier les résultats radiographiques et fonctionnels, ainsi que le taux de complications obtenus par cette technique et de les comparer avec ceux obtenus par plaques.

Dans les arthroplasties totales de hanche, la taille et le positionnement de la cupule comme de la tige fémorale doivent être parfaitement adaptés afin d’éviter les complications per- et postopératoires, et pour obtenir une bonne évolution fonctionnelle et assurer la survie de la prothèse à long terme. Les techniques actuelles de planification deux dimensions (2D) ne fournissent pas une précision suffisante. Le but de cette étude était d’évaluer : (1) la précision d’une nouvelle méthode de planification trois dimensions (3D) (radiographie par balayage linéaire biplan et modélisation 3D) pour la détermination de la taille de la cupule et la tige fémorale, en comparaison à la planification radiographique traditionnelle 2D utilisant des calques et (2) la précision et la reproductibilité de cette technique 3D pour la planification préopératoire d’arthroplastie totale de hanche.

ABSTRACTIn mammals, excess energy is stored primarily as triglycerides, which are mobilized when energy demands arise and cannot be covered by feed intake. This review mainly focuses on the role of long chain fatty acids in disturbed energy metabolism of the bovine species. Long chain fatty acids regulate energy metabolism as ligands of peroxisome proliferator-activated receptors. Carnitine acts as a carrier of fatty acyl groups as long-chain acyl-CoA derivatives do not penetrate the mitochondrial inner membrane. There are two different types of disorders in lipid metabolism which can occur in cattle, namely the hypoglycaemic-hypoinsulinaemic and the hyperglycaemic-hyperinsulinaemic type with the latter not always associated with ketosis. There is general agreement that fatty acid β-oxidation capability is limited in the liver of (ketotic) cows. In accord, supplemental L-carnitine decreased liver lipid accumulation in periparturient Holstein cows. Of note, around parturition concurrent oxidation of fatty acids in skeletal muscle is highly activated. Also peroxisomal β-oxidation in liver of dairy cows may be part of the hepatic adaptations to a negative energy balance (NEB) to break down fatty acids. An elevated blood concentration of nonesterified fatty acids is one of the indicators of NEB in cattle among others like increased β-hydroxy butyrate concentration, and decreased concentrations of glucose, insulin, and insulin-like growth factor-I. Assuming that liver carnitine concentrations might limit hepatic fatty acid oxidation capacity in dairy cows, further study of the role of acyl-CoA dehydrogenases and/or riboflavin in bovine ketosis is warranted.

G Protein Signaling Modulator-3 (GPSM3) is a leukocyte-specific regulator of G protein-coupled receptors (GPCRs), which binds inactivated Gαi·GDP subunits and precludes their reassociation with Gβγ subunits. GPSM3 deficiency protects mice from inflammatory arthritis and, in humans, GPSM3single-nucleotide polymorphisms (SNPs) are inversely associated with the risk of rheumatoid arthritis development; recently, these polymorphisms were linked to one particular SNP (rs204989) that decreases GPSM3transcript abundance. However, the precise role of GPSM3 in leukocyte biology is unknown. Here, we show that GPSM3 is induced in the human promyelocytic leukemia NB4 cell line following retinoic acid treatment, which differentiates this cell line into a model of neutrophil physiology (NB4*). Reducing GPSM3 expression in NB4* cells, akin to the effect ascribed to the rs204989 C>T transition, disrupts cellular migration toward leukotriene B4 (LTB4) and (to a lesser extent) interleukin-8 (a.k.a.IL-8 or CXCL8), but not migration toward formylated peptides (fMLP). As the chemoattractants LTB4 and CXCL8 are involved in recruitment of neutrophils to the arthritic joint, our results suggest that the arthritis-protective GPSM3SNP rs204989 may act to decrease neutrophil chemoattractant responsiveness.

One of the most prominent physiological responses to stressors is the activation of the hypothalamic–pituitary–adrenocortical (HPA) axis, currently assessed by measuring cortisol concentration in blood plasma. To reduce animal discomfort during sampling, which negatively affects stress biomarkers, current research focuses on noninvasive sampling of media other than blood, for example, saliva. The aim of this study was to assess the suitability of saliva cortisol as a biomarker under different physiological and immunological states in dairy cows. Our objectives were to 1) evaluate the relationship between HPA axis activation and saliva cortisol concentration, 2) investigate effects of some feeding action (as influenced by feed and water consumption) on saliva cortisol concentration, and 3) evaluate the time lag between plasma and saliva cortisol during induced inflammatory conditions by intramammary lipopolysaccharide (LPS) and lipoteichoic acid (LTA) injection. During a specific activation of the HPA axis, a positive correlation (r= 0.75, P< 0.0001) between saliva and blood cortisol concentrations was observed with increased (P< 0.01) plasma cortisol concentrations following ACTH administration. Saliva and blood samples were taken before, during, and after drinking, feeding, and ruminating. Only a low correlation between saliva and plasma cortisol concentrations (r= 0.03, P= 0.83) but no significant effects of the different feeding actions on saliva cortisol were observed. When compared with basal concentrations, cortisol concentrations in plasma significantly increased during inflammatory responses following LPS and LTA injection. Compared with plasma cortisol, changes in saliva cortisol concentrations occurred at a much lower level within a narrow range and did not necessarily follow changes in plasma. In conclusion, the positive correlation between saliva and plasma cortisol concentration in response to ACTH and inflammation suggests the suitability of saliva cortisol measurement for the HPA axis activation assessment. However, changes in saliva cortisol concentration occur within a very narrow range. Furthermore, not only must variation among individual animals be considered but also variation within the same animal. Only with additional knowledge of the concomitant physiological status of the cow it is possible to correctly evaluate saliva and blood cortisol samples.

During the last months, the number of reports on Holstein calves suffering from incurable idiopathic diarrhea dramatically increased. Affected calves showed severe hypocholesterolemia and mostly died within days up to a few months after birth. This new autosomal monogenic recessive inherited fat metabolism disorder, termed cholesterol deficiency (CD), is caused by a loss of function mutation of the bovine APOBgene. The objective of the present study was to investigate specific components of lipid metabolism in 6 homozygous for the APOBmutation (CDS) and 6 normal Holstein calves with different APOBgenotypes. Independent of sex, CDS had significantly lower plasma concentrations of total cholesterol (TC), free cholesterol (FC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C), triacylglycerides (TAG), and phospholipids (PL) compared with homozygous wild-type calves (P< 0.05). Furthermore, we studied the effect of the APOBgenotype on cholesterol metabolism in adult Holstein breeding bulls of Swissgenetics. Among a total of 254 adult males, the homozygous mutant genotype was absent, 36 bulls were heterozygous carriers (CDC), and 218 bulls were homozygous wild-type (CDF). In CDC bulls, plasma concentrations of TC, FC, HDL-C, LDL-C, VLDL-C, TAG, and PL were lower compared with CDF bulls (P< 0.05). The ratios of FC:cholesteryl esters (CE) and FC:TC were higher in CDC bulls compared with CDF bulls, whereas the ratio of CE:TC was lower in CDC bulls compared with CDF bulls (P< 0.01). In conclusion, the CD-associated APOBmutation was shown to affect lipid metabolism in affected Holstein calves and adult breeding bulls. Besides cholesterol, the concentrations of PL, TAG, and lipoproteins also were distinctly reduced in homozygous and heterozygous carriers of the APOBmutation. Beyond malabsorption of dietary lipids, deleterious effects of apolipoprotein B deficiency on hepatic lipid metabolism, steroid biosynthesis, and cell membrane function can be expected, which may result in unspecific symptoms of reduced fertility, growth, and health.

Colostrum IgG concentration and yield vary tremendously among farms and cows and among quarters within cows. The present study quantified changes in quarter colostrum characteristics up to 3 successive lactations. First colostrum was quarter collected within 4 h after parturition in the first 2 consecutive lactations from 12 cows, and colostrum was obtained from 14 multiparous dairy cows in 2 consecutive lactations and 8 cows thereof in 3 consecutive lactations. Colostrum yield per quarter showed a high variation in both primiparous and multiparous dairy cows during consecutive lactations. Percentage distribution of colostrum yield among quarters within cows was similar from parity to parity. The differences in colostrum yield within the same quarter were higher in cows from the first to the second lactation compared with the differences within quarters of multiparous cows in consecutive lactations (P< 0.05). The intraclass correlation coefficient (ICC) for quarter colostrum yield was found to be similar in cows from the first to the second parity (ICC = 0.42) and within consecutive lactations of multiparous cows (ICC = 0.44). Whereas the position of the quarter did not influence colostrum yield in cows from the first to the second lactation, quarter colostrum yield in multiparous cows was higher in rear quarters than in front quarters (P< 0.05) with fewer changes in successive lactations. Concentration and mass of IgG in quarter-milked colostrum distinctly varied among quarters and cows in both primiparous and multiparous cows. In multiparous cows, higher values for quarter concentration and mass of IgG were observed when compared with primiparous cows, in particular in the rear quarters (P< 0.05). Relative differences of IgG concentration and mass within quarters were higher in consecutive lactations of multiparous cows compared with differences within quarters of cows in the first 2 lactations (P< 0.05). The ICC of colostral IgG concentration and mass within quarters of cows from the first to the second lactation was 0.52 and 0.67, respectively, and lower compared with the ICC of IgG concentration and mass within quarters during consecutive lactations of multiparous cows. In conclusion, IgG concentration and mass were shown to be more repeatable within quarters of multiparous dairy cows compared with the first 2 lactations of dairy cows. Contrarily, colostrum yield within quarters in consecutive lactations had only a moderate repeatability and seemed to be affected by factors other than genetics.

G protein signaling modulator 3 (GPSM3) is a regulator of G protein-coupled receptor signaling, with expression restricted to leukocytes and lymphoid organs. Previous genome-wide association studies have highlighted single-nucleotide polymorphisms (SNPs; rs204989 and rs204991) in a region upstream of the GPSM3transcription start site as being inversely correlated to the prevalence of rheumatoid arthritis (RA)—this association is supported by the protection afforded to Gpsm3-deficient mice in models of inflammatory arthritis. Here, we assessed the functional consequences of these polymorphisms. We collected biospecimens from 50 volunteers with RA diagnoses, 50 RA-free volunteers matched to the aforementioned group and 100 unmatched healthy young volunteers. We genotyped these individuals for GPSM3(rs204989, rs204991), CCL21(rs2812378) and HLAgene region (rs6457620) polymorphisms, and found no significant differences in minor allele frequencies between the RA and disease-free cohorts. However, we identified that individuals homozygous for SNPs rs204989 and rs204991 had decreased GPSM3transcript abundance relative to individuals homozygous for the major allele. In vitropromoter activity studies suggest that SNP rs204989 is the primary cause of this decrease in transcript levels. Knockdown of GPSM3in THP-1 cells, a human monocytic cell line, was found to disrupt ex vivomigration to the chemokine MCP-1.

Cortisol in dairy cows is released in an episodic manner underlying a circadian rhythm. The involvement of cortisol in numerous adaptive processes to cope with adverse conditions such as pain and inflammation is well characterized. Recent studies described contradictory effects of nutrition and metabolism on the secretory pattern of cortisol. However, up to now, the direct effects of single metabolites during various metabolic conditions without the profound endocrine changes around parturition on the glucocorticoid secretion in dairy cows have not been described. The objective of this study was to investigate the effects of long-term (56-h) manipulated metabolic states, that is, manipulated plasma concentrations of glucose and β-hydroxybutyrate (BHBA), on the release of cortisol in midlactation dairy cows. Besides the concentration of cortisol at defined time points, its pulsatile secretory pattern was studied in combination with an acute immune challenge through an intramammary lipopolysaccharide (LPS) challenge. Twenty-five midlactation dairy cows were randomly assigned to 1 of 4 treatments (hyperinsulinemic hypoglycemic clamp [HypoG], hyperinsulinemic–euglycemic clamp [EuG], continuous infusion of BHBA [HyperB], or infusion of saline solution for the control group [Control). Different metabolic states induced by infusion treatments affected the characteristics of cortisol secretion (elevation of baseline [the HypoG and HyperB treatments] and decreased peak length [the HypoG treatment]; P< 0.05), whereas amplitude, peak interval, height, peak area, area under the curve (AUC) above the baseline cortisol concentration (AUCb), and the total AUC (AUCt) were not different between infusion treatments. The induced inflammatory response due to the intramammary LPS challenge at simultaneously maintained infusion treatments diminished the pulsatile nature of cortisol release, whereas AUCb(and AUCt, respectively) was lowest for the HypoG treatment compared with the HyperB and Control treatments (P< 0.05). This study indicates that single metabolites (glucose and BHBA) and their availability or turnover (in case of glucose) have a different impact on the regulation of cortisol secretion resulting in changes of its pulsatile release. Furthermore, cortisol release during intramammary inflammation was found to be greater in the HyperB, EuG, and Control treatments compared with the HypoG treatment (P< 0.05). This finding emphasizes the regulatory role of the current metabolic status on the cortisol release during inflammation.

Zusammenfassung: Die Konfrontation mit ethischen Problemen wie z. B. Entscheidungen am Lebensende oder Maßnahmen zur Therapiebegrenzung gehören zum Alltag auf einer Intensivstation. Im Folgenden wird die Ethikvisite als ein mögliches Instrument bei der Standortbestimmung klinisch-ethischer Probleme in der Intensivmedizin vorgestellt. Grundlage der ethischen Standortbestimmung während der Ethikvisite sind Überlegungen aus der prinzipienorientierten Medizinethik. Neben organisatorischen Aspekten einer Ethikvisite wird die Rolle des Ethikmoderators im Visitenteam dargelegt. Es werden die wichtigsten klinisch-ethischen Analysenschritte während der Ethikvisite präsentiert. Gegenüber dem klassischen ethischen Konsil ist der Ethikmoderator im Rahmen der Ethikvisite fest im Team der Intensivstation integriert. Dadurch ist es möglich, ethische Probleme frühzeitig zu identifizieren und Lösungsmöglichkeiten aufzuzeigen, bevor der Konflikt eskaliert. Diese präventive Strategie macht die Ethikvisite zu einer hilfreichen und sinnvollen Institution auf der Intensivstation.