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In the 1970s and 1980s the course of rheumatoid arthritis (RA) could be defined as fateful despite the introduction of methotrexate as well as other immunosuppressive treatments. In most patients at this time RA was combined with an early disability due a progressive destruction of joints. In addition, comorbidity was known to be one of the major causes for a decreased life expectancy. These less than optimal options for treating RA patients led to intensive research in the pathogenesis with the aim to develop new treatment principles. Based on the increasing knowledge of pathogenically important mechanisms, so-called biologicals were developed targeting T and B cells and proinflammatory cytokines, such as tumor necrosis factor alpha. Over the past 10 years the repertoire of biologicals for treating RA has steadily and significantly increased, which was necessary especially for those patients classified as non-responders to available biological compounds. In the present overview cellular structures, T and B cells as well as cells of the monocyte/macrophage system are discussed as targets for immune interventions.

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Following similar examples for diabetes mellitus and hypertension an attempt was made to establish a treat-to-target (T2T) program for rheumatic diseases in order to improve the course of the disease. Nevertheless, it is a factum that rheumatology, a recognized discipline in internal medicine, was not represented in university clinics corresponding to its scientific, clinical and socioeconomic importance. On the question how rheumatology in university clinics can contribute to the implementation of a T2T program, several aspects have to be considered. These include improvement in training and further education, establishment of clinical scientific core topics, formulation of guidelines, initiation of controlled studies, establishment of long-term cohorts and the incorporation of pathogenetic and therapeutic information in international networks and national symposia.

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New therapeutic principles and considerable diagnostic advances have made it possible to define different rheumatic diseases and especially rheumatoid arthritis (RA) at an early stage and by starting an early and aggressive medication a considerable proportion of patients with RA will reach the status of low disease activity or even remission. With the additional development of composite measures to estimate the disease activity of RA, it was the goal of an international working group consisting of rheumatologists and patients to develop recommendations for treating rheumatoid arthritis in a similar way as for patients with hypertension or diabetes, with the aim to achieve remission as often as possible. This treat-to-target initiative has taken off in quite a number of different countries including Germany leading to discussions on how this initiative can be integrated into the specific national healthcare systems and what possibilities would exist for its implementation. To develop strategies for an improved healthcare of people suffering from rheumatic diseases and using RA as an example, action elements and postulates were developed which will be discussed in more detail in the present manuscript.

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We report on the fabrication of a light-emitting diode based on GaN nanorods containing InGaN quantum wells. The unique system consists of tilted N-polar nanorods of high crystalline quality. Photoluminescence, electroluminescence, and spatially resolved cathodoluminescence investigations consistently show quantum well emission around 2.6 eV. Scanning transmission electron microscopy and energy-dispersive x-ray spectroscopy measurements reveal a truncated shape of the quantum wells with In contents of (15 ± 5)%.

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We present electrically driven luminescence from single InGaN quantum dots embedded into a light emitting diode structure grown by metal-organic vapor-phase epitaxy. Single sharp emission lines in the green spectral region can be identified. Temperature dependent measurements demonstrate thermal stability of the emission of a single quantum dot up to 150 K. These results are an important step towards applications like electrically driven single-photon emitters, which are a basis for applications incorporating plastic optical fibers as well as for modern concepts of free space quantum cryptography.

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Whether the differences in the clinical picture and in the pathogenesis between rheumatoid arthritis (RA) and ankylosing spondylitis (AS) will lead to different therapeutic approaches is unclear at present. Since anti-TNF-alpha agents and other biologics are not efficacious in all patients new developments are clearly needed.

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