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Purpose: The purpose of this paper is to introduce methodology and findings of a trend study in the field of e-learning. The overall interest of the study was the analysis of scientific e-learning discourses. What comes next in the field of academic e-learning? Which e-learning trends dominate the discourse at universities? Answering such questions is the basis for the adaptation of service strategies and IT-infrastructures within institutions of higher education. Design/methodology/approach: Which e-learning formats dominate the current scientific discourse? To answer this question, a trend study based on a content analysis was performed. The abstracts of 427 scientific articles of leading German-speaking e-learning conferences Gesellschaft für Medien in der Wissenschaft and E-Learning-Fachtagungen der Gesellschaft für Informatik e. V. (GMW and DeLFI)--published from 2007 to 2013--were examined. A category scheme was derived from the Horizon Report. The category scheme then was gradually expanded and adapted to the data material during the investigation. Findings: This paper found that the detailed analysis of the frequency distribution over the seven years reflects the intensity of scientific discussion towards e-learning trends within the investigation period, and conclusions about the didactical or technical potentials of innovations can be drawn because both conferences are different in terms of their objective. The authors also classified the life stages of selected innovations based on the Gartner hype cycles, and the striking findings of the study will be formulated in the form of assumptions, which reflect the development potential of learning management, mobile learning, virtual worlds, e-portfolio, social media and Massive Open Online Courses in German Higher Education. Research limitations/implications: Only abstracts of the selected contributions were investigated. Errors in the category allocation due to unclear terminology cannot be excluded. Organisers of the investigated conferences often define the (main) topics. This influenced the spectrum of represented topics overall, as well as the focus of individual contributions. The above-presented study was conducted at German-speaking conferences and, therefore, reflects the situation in Germany, Switzerland and Austria. No conclusions about actors or institutional relationships can be made, in contrast to the original assumptions of discourse analysis. The categorial classification of contributions does not allow any conclusions about the quality of the discourse. Originality/value: The study shows how proceedings of scientific conferences can be used for trend studies. It became clear that discourse analytical studies can be used complementary to other methods of future studies. The advantage of this methodology lies mainly in the easy access to the text material, as conference proceedings are mostly available online. In addition, the analysis of large amounts of data (or texts) can be greatly facilitated by use of digital technologies (e.g. by automatic analysis of keyword). This paper makes an important contribution to the diffusion of digital media in higher education.

Background: The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) pandemic causes a high burden of acute and long-term morbidity and mortality worldwide despite global efforts in containment, prophylaxis, and therapy. With unprecedented speed, the global scientific community has generated pivotal insights into the pathogen and the host response evoked by the infection. However, deeper characterization of the pathophysiology and pathology remains a high priority to reduce morbidity and mortality of coronavirus disease 2019 (COVID-19)., Methods: NAPKON-HAP is a multi-centered prospective observational study with a long-term follow-up phase of up to 36 months post-SARS-CoV-2 infection. It constitutes a central platform for harmonized data and biospecimen for interdisciplinary characterization of acute SARS-CoV-2 infection and long-term outcomes of diverging disease severities of hospitalized patients., Results: Primary outcome measures include clinical scores and quality of life assessment captured during hospitalization and at outpatient follow-up visits to assess acute and chronic morbidity. Secondary measures include results of biomolecular and immunological investigations and assessment of organ-specific involvement during and post-COVID-19 infection. NAPKON-HAP constitutes a national platform to provide accessibility and usability of the comprehensive data and biospecimen collection to global research., Conclusion: NAPKON-HAP establishes a platform with standardized high-resolution data and biospecimen collection of hospitalized COVID-19 patients of different disease severities in Germany. With this study, we will add significant scientific insights and provide high-quality data to aid researchers to investigate COVID-19 pathophysiology, pathology, and chronic morbidity., (© 2023. The Author(s).)

Clinical reactivations of herpes simplex virus or varicella zoster virus occur frequently among patients with malignancies and manifest particularly as herpes simplex stomatitis in patients with acute leukaemia treated with intensive chemotherapy and as herpes zoster in patients with lymphoma or multiple myeloma. In recent years, knowledge on reactivation rates and clinical manifestations has increased for conventional chemotherapeutics as well as for many new antineoplastic agents. This guideline summarizes current evidence on herpesvirus reactivation in patients with solid tumours and hematological malignancies not undergoing allogeneic or autologous hematopoietic stem cell transplantation or other cellular therapy including diagnostic, prophylactic, and therapeutic aspects. Particularly, strategies of risk adapted pharmacological prophylaxis and vaccination are outlined for different patient groups. This guideline updates the guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) from 2015 "Antiviral prophylaxis in patients with solid tumours and haematological malignancies" focusing on herpes simplex virus and varicella zoster virus., (© 2022. The Author(s).)

The prognosis of allogeneic stem cell transplant recipients admitted to the intensive care unit (ICU) has improved over the last decades. However, data focusing on patients treated in the ICU during the peri-transplant period are scarce. We therefore conducted an analysis comprising 70 patients who had allogeneic stem cell transplantation at the University Hospital Cologne between 2014 and 2020 and were admitted to the ICU between the initiation of conditioning therapy and day 30 after transplantation. The median age was 59 years (range: 18 - 72 years). 50% of patients were female. Sepsis was the most common cause for ICU admission (49%). Mechanical ventilation (MV) was required in 56% of patients, 27% had renal replacement therapy (RRT), and 64% needed vasopressors. The ICU, hospital, 90-day, and 1-year survival rates were 48.6%, 38.6%, 35.7%, and 16.2%, respectively. MV and/or RRT during the ICU stay were associated with an impaired survival (p < 0.0001). The same was true for the use of vasopressors (p < 0.0001). In contrast, baseline characteristics did not impact the outcome. Cardiopulmonary resuscitation (CPR) was performed in 17% of patients. None of the patients undergoing CPR was alive at 1 year. Among patients who died after discharge from the ICU (n = 23), sepsis and other infectious complications represented the major causes of death (48%). Taken together, the present analysis indicates unfavorable outcomes for allogeneic stem cell transplant recipients admitted to the ICU during the peri-transplant period. The data may help to make informed decisions with patients and their families., (© 2021. The Author(s).)

Objectives: The relevance of candidemia has increased over the last decades due to higher incidence rates in an ageing society. Studies on amphotericin B and fluconazole have shown high attributable mortality rates of 38% and 49% in the United States. Incidence rates and locational factors might have an impact on the mortality rates at the University Hospital of Cologne (UHC), Germany., Methods: We performed a matched case-control study including 57 patients with candidemia, hospitalised at the UHC between 1 July 1997 and 30 June 2001. Controls were matched by age, sex, admission date, treatment on intensive care unit (ICU), number of days at risk, underlying diseases, surgical procedures and the Charlson Comorbidity Index., Results: The incidence of candidemia was 3.5 per 10 000 admissions. For cases and controls, we observed in-hospital-mortality rates of 33.3% and 11.8%, and a 30-day mortality of 23.5% and 7.8% respectively. The attributable mortality rate to candidemia was 21.5%, and at 30 days, it was 15.7%. Underlying conditions were more frequent in cases than in controls, especially central venous catheter (80% vs 33%, P < .001), chronic cardiovascular disease (39.2% vs 25.5%, P = .138), treatment on ICU (31.4% vs 13.7%, P = .033) and chronic liver disease (21.6% vs 0%, P < .001)., Conclusions: The attributable mortality of candidemia at the UHC between 1997 and 2001 was lower compared to studies performed in the United States with a similar design. Contributing factors might be lower incidence rates and less comorbidities in our study., (© 2021 The Authors. Mycoses published by Wiley-VCH GmbH.)

Objectives: To investigate the diagnosis and treatment standards at the University Hospital of Cologne, Germany, by applying the EQUAL Aspergillosis Score to invasive pulmonary aspergillosis (IPA) patients., Methods: The charts of 103 patients with probable or proven IPA at the University Hospital of Cologne were reviewed and the score retrospectively applied to all patients., Results: Patients were stratified into two groups according to the underlying disease: a haematology group (n = 76, 73.8%) and a non-haematology group (n = 27, 26.2%). While the haematology group attained 67.8% of achievable score points (median: 15; IQR: 13-18; range: 8-25), the non-haematology group reached 48.4% (median: 12 points; IQR: 9-14; range: 4-18) (P < 0.001). Regarding diagnostics, haematological patients achieved 81.3% of achievable points (median: 7; IQR: 8-10; range: 3-13) and non-haematological 56.3% (median: 7; IQR: 5-9; range: 3-11). Concerning treatment, haematological patients gained 86.3% (median: 5; IQR: 5-5; range: 0-5) and non-haematological 68.1% (median: 5; IQR: 0-5; range: 0-5) of achievable points. Among the haematological patients with versus those without mould-active prophylaxis, 90 day mortality was 46.0% and 59.3% (P = 0.004), respectively. Guideline adherent management of IPA was observed in 31.1% of cases (39.5% in haematological patients and 7.4% in non-haematological)., Conclusions: The EQUAL Aspergillosis Score is more suitable for evaluation of management of haematological patients compared with those without such underlying disease. In both groups there was no correlation between score points and survival. Larger prospective studies may be suitable to correlate outcome and score. A revision of the score should be considered based on the data presented., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objectives: Candidemia is among the most frequent nosocomial bloodstream infections. Landmark case-control studies on amphotericin B and fluconazole estimated attributable mortality rates of 38% and 49%, respectively. After introduction of echinocandins, these may have decreased., Methods: In a case-control design, 100 consecutive, hospitalised patients with candidemia were enrolled at the University Hospital of Cologne, Germany between 2014 and 2017. Controls were patients without candidemia matched for age, sex, year and duration of hospitalisation, main admission diagnosis and Patient Clinical Complexity Level (PCCL). Main data captured were risk factors for candidemia, attributable mortality rates and diagnostic and therapeutic adherence according to the EQUAL Candida score., Results: Overall mortality rates for cases and controls were 43% and 17% (P < .001), respectively; day 30 mortality rates were 38% and 11% (P = .03), accounting for an attributable mortality of 26% and 27%. Guideline adherence was higher in surviving vs non-surviving patients: while survivors reached a median of 17 (IQR: 16-19) points, non-surviving cases reached a median 16 (IQR: 14-18) points out of 22 maximum achievable points (P = .028). Risk factors for candidemia were more frequent in cases compared to control patients, especially chronic pulmonary disease (25% vs 16%; P = n.s.), chronic liver disease (21% vs 6%; P = .002), stay on intensive care unit (70% vs 64%; P = n.s.), respiratory failure (56% vs 50%; P = n.s.) and central venous catheter (97% vs 35%; P < .001)., Conclusions: Attributable mortality of nosocomial candidemia is still substantial but has decreased compared to previous studies with similar design., (© 2020 Wiley-VCH GmbH.)

Amylase/trypsin inhibitors (ATIs) are major wheat allergens and they are also implicated in causing non-celiac gluten sensitivity and worsening other inflammatory conditions. With only few studies on ATI contents in different Triticum species available so far, we developed a targeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) method based on stable isotope dilution assays to quantitate the 13 most important ATIs in a well-defined sample set of eight cultivars of common wheat and durum wheat (modern species), as well as spelt, emmer and einkorn (ancient species) grown at three locations in Germany, respectively. Only few ATIs with low contents were detected in einkorn. In contrast, spelt had the highest total ATI contents. Emmer and common wheat had similar total ATI contents, with durum wheat having lower contents than common wheat. Due to the lack of correlation, it was not possible to estimate ATI contents based on crude protein contents. The wheat species had a higher influence on ATI contents than the growing location and the heritability of this trait was high. Despite comparatively low intra-species variability, some cultivars were identified that may be promising candidates for breeding for naturally low ATI contents.

Objectives: Patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications like invasive aspergillosis. Our study evaluates coronavirus disease 19 (COVID-19) associated invasive aspergillosis at a single centre in Cologne, Germany., Methods: A retrospective chart review of all patients with COVID-19 associated ARDS admitted to the medical or surgical intensive care unit at the University Hospital of Cologne, Cologne, Germany., Results: COVID-19 associated invasive pulmonary aspergillosis was found in five of 19 consecutive critically ill patients with moderate to severe ARDS., Conclusion: Clinicians caring for patients with ARDS due to COVID-19 should consider invasive pulmonary aspergillosis and subject respiratory samples to comprehensive analysis to detect co-infection., (© 2020 The Authors. Mycoses published by Blackwell Verlag GmbH.)

The coronavirus disease (COVID-19) pandemic has caused tremendous pressure on hospital infrastructures such as emergency rooms (ER) and outpatient departments. To avoid malfunctioning of critical services because of large numbers of potentially infected patients seeking consultation, we established a COVID-19 rapid response infrastructure (CRRI), which instantly restored ER functionality. The CRRI was also used for testing of hospital personnel, provided epidemiological data and was a highly effective response to increasing numbers of suspected COVID-19 cases.

Objectives: Mucormycosis is a difficult-to-diagnose life-threatening disease with high morbidity and mortality. Adherence to guidelines that lead through complex management and support clinical decisions is however rarely reported. By applying the EQUAL Score, our study evaluates the management of mucormycosis at the University Hospital of Cologne, Germany., Methods: We performed a retrospective chart review of patients with mucormycosis at the University Hospital of Cologne. Data collection comprised items for quality assessment in mucormycosis management according to the EQUAL Mucormycosis Score and economics., Results: Of 29 patients identified, 27 were documented retrospectively. Eight patients of 18 with neutropenia (>10 days) or receiving allogeneic stem cell transplantation (44.4%) received mould active prophylaxis. Chest CT was done in 21 patients (77.8%), while BAL and direct microscopy of BAL fluid was performed in 22 patients (81.5%), culture in 22 (81.5%) and fungal PCR in 24 (88.9%). First-line treatment was liposomal amphotericin B in 19 patients (70.4%). Isavuconazole or posaconazole with therapeutic drug monitoring was used in four (14.8%) and in one patient (3.7%), respectively. In our cohort, crude mortality was 51.9% (n = 14) with a median survival time of 113 days. During the management of the 27 patients, 450 points (53.8%) of the maximum EQUAL Mucormycosis Score were achieved (median 15 points, range 6-30)., Conclusions: We observed management of mucormycosis aligning with current guidelines and hope to encourage other groups to use the EQUAL Score in routine clinical settings. Future studies will evaluate whether guideline adherence in mucormycosis management improves patient outcome., (© 2019 The Authors. Mycoses published by Blackwell Verlag GmbH.)

Introduction: Staphylococcus aureus frequently causes infections in outpatient and hospital settings and can present as a highly variable entity. Typical manifestations are endocarditis, osteoarticular infections or infection of implanted prostheses, intravascular devices or foreign bodies. A thorough diagnostic evaluation with early focus identification is mandatory to improve patient outcome., Case Report: We report a case of a 68-year old patient with a history of double allogeneic stem cell transplant for acute myeloid leukemia who developed a S. aureus bacteremia with dissemination, severe sepsis and lethal outcome due to nasal handkerchief packing after nose bleeding., Conclusion: A thorough medical examination with further diagnostic work-up is most important in S. aureus blood stream infection to identify and eradicate the portal(s) of entry, to rule out endocarditis, to search for spinal abscesses, osteomyelitis or spondylodiscitis. Adherence to management guides for clinicians must be of major importance to achieve optimal quality of clinical care, and thus improve patient outcome.

As a basis for sodium reduction, interactions between sodium and wheat bread ingredients and their impact on salt perception in bread crumb were examined. The theoretical sodium binding capacities of wheat proteins revealed that a maximum amount of 0.24% NaCl (based on flour) could be bound in bread crumb by ionic interactions between sodium ions and acidic amino acid side chains. However, the sodium binding capacities of wheat proteins, determined by a magnetic beads assay and a sodium-selective electrode, were only about 0.002% NaCl. They were negligible concerning the sensory perception of saltiness, as 0.075 and 0.3% NaCl were the lowest noticeable differences using bread containing 0 and 1% NaCl as a reference, respectively. Extracting bread crumb in a mastication simulator with ultrapure water, buffer solutions, and artificial and human saliva revealed that interactions between sodium and wheat bread ingredients were sufficiently weak to enable complete sodium extraction during simulated mastication.

In this article it is argued that Heinrich Irenäus Quincke who should be credited with the discovery of lumbar puncture. Although some authors mention the names of James Leonard Corning and Walter Essex Wynter as well, it is demonstrated, by comparing the relevant publications, that the discovery, the application for diagnostic purposes and the introduction in clinical practice of the lumbar puncture were done by Quincke. At first, the purposes for performing a lumbar puncture were purely therapeutic, for instance CSF-drainage in hydrocephalus and meningitis. But, soon after, it was applied for diagnostic aims as well.