HIV-Associated Urogenital Malignancies.

PubMed

Hentrich, Marcus; Pfister, David

2017-01-01

Non-AIDS-defining malignancies (NADM) are a leading cause of morbidity and mortality for HIV-infected subjects. The risk of testicular germ cell cancer (GCC) and renal cell cancer is slightly increased in the setting of HIV, whereas there is a slightly decreased risk of prostate cancer and bladder cancer. As in industrialized countries the majority of people living with HIV are men, and people aged 55 and older now account for more than a quarter of persons living with HIV, both testis and prostate cancer are assumed to occur with increased frequency in HIV-infected subjects. Overall, treatments should be the same as in HIV-negative patients with urogenital malignancies. Since the introduction of combination antiretroviral therapy (cART) the outcome appears to have improved due to a decrease in HIV-related deaths. HIV-infected men who are treated with standard therapies for GCC now have a similar cancer-free survival compared with their HIV-negative counterparts. Screening and treatment for prostate cancer should follow recommendations established for HIV-negative men. During radio- or chemotherapy patients should receive concurrent cART but the drug-drug interaction potential must be taken into account. © 2017 S. Karger GmbH, Freiburg.

Lower Risk of Cancer in the Areas Inhabited by the German Minority in the Region of Opole, Poland.

PubMed

Chawińska, Ewa; Tukiendorf, Andrzej; Miszczyk, Leszek

2015-01-01

The lower risk of cancer in the areas inhabited by the German minority in the region of Opole, Poland, at the turn of the 1980's and 1990's has been already reported. A reanalysis of the present-day data was conducted. All the cancer cases (at all sites combined) registered within the years 2008-2012 with data collected by the Regional Cancer Registry in Opole were analyzed in this study. To estimate the risk of cancer in different spatial contexts, such as trends, clusters, and levels, modern geostatistical tools were applied. A statistically significant reduction of the cancer risk was reported in administrative units with ≥ 10% of the German minority. Average decreases in relative risk of 13% in men and 16% in women were estimated. The geographical patterns of the estimates are illustrated. The observed differences in the risk of cancer between the ethnic groups (Germans and repatriates) confirm a historical trend of the disease in the region of Opole, Poland. Some genetic, nutritional, or cultural aspects together with economic issues may play a role in the specified spatial disease patterns. © 2015 S. Karger GmbH, Freiburg.

Does food addiction exist? A phenomenological discussion based on the psychiatric classification of substance-related disorders and addiction.

PubMed

Albayrak, Ozgür; Wölfle, Sebastian Mathias; Hebebrand, Johannes

2012-01-01

The relationship between overeating, substance abuse and (behavioral) addiction is controversial. Medically established forms of addiction so far pertain to substance use disorders only. But the preliminary Diagnostic and Statistical Manual for Mental Disorders V (DSM V) suggests replacing the previous category 'Substance-Related Disorders' with 'Addiction and Related Disorders', thus for the first time allowing the diagnosis of behavioral addictions. In the past psychiatrists and psychologists have been reluctant to systematically delineate and classify the term behavioral addiction. However, there is a broad overlap between chemical and behavioral addiction including phenomenological, therapeutic, genetic, and neurobiological aspects. It is of interest to point out that the hormone leptin in itself has a pronounced effect on the reward system, thus suggesting an indirect link between overeating and 'chemical' addiction. Thus, leptin-deficient individuals could be classified as fulfilling criteria for food addiction. In our overview we first review psychological findings in chemical (substance-based) and subsequently in behavioral addiction to analyze the overlap. We discuss the diagnostic validity of food addiction, which in theory can be chemically and/or behaviorally based. Copyright © 2012 S. Karger GmbH, Freiburg.

Molecular Pathology: A Requirement for Precision Medicine in Cancer.

PubMed

Dietel, Manfred

2016-01-01

The increasing importance of targeting drugs and check-point inhibitors in the treatment of several tumor entities (breast, colon, lung, malignant melanoma, lymphoma, etc.) and the necessity of a companion diagnostic (HER2, (pan)RAS, EGFR, ALK, BRAF, ROS1, MET, PD-L1, etc.) is leading to new challenges for surgical pathology. Since almost all the biomarkers to be specifically detected are tissue based, a precise and reliable diagnostic is absolutely crucial. To meet this challenge surgical pathology has adapted a number of molecular methods (semi-quantitative immunohistochemistry, fluorescence in situ hybridization, PCR and its multiple variants, (pyro/Sanger) sequencing, next generation sequencing (amplicon, whole exome, whole genome), DNA arrays, methylation analyses, etc.) to be applicable for formalin-fixed paraffin-embedded tissue. Reading a patient's tissue as 'deeply' as possible and obtaining information on the morphological, genetic, proteomic and epigenetic background are the tasks of pathologists and molecular biologists and provide the clinicians with information relevant for precision medicine. Intensified cooperation between clinicians and pathologists will provide the basis of improved clinical drug selection and guide development of new cancer gene therapies and molecularly targeted drugs by research units and the pharmaceutical industry. © 2016 S. Karger GmbH, Freiburg.

The German Version of the Herth Hope Index (HHI-D): Development and Psychometric Properties.

PubMed

Geiser, Franziska; Zajackowski, Katharina; Conrad, Rupert; Imbierowicz, Katrin; Wegener, Ingo; Herth, Kaye A; Urbach, Anne Sarah

2015-01-01

The importance of hope is evident in clinical oncological care. Hope is associated with psychological and also physical functioning. However, there is still a dearth of empirical research on hope as a multidimensional concept. The Herth Hope Index is a reliable and valid instrument for the measurement of hope and is available in many languages. Until now no authorized German translation has been published and validated. After translation, the questionnaire was completed by 192 patients with different tumor entities in radiation therapy. Reliability, concurrent validity, and factor structure of the questionnaire were determined. Correlations were high with depression and anxiety as well as optimism and pessimism. As expected, correlations with coping styles were moderate. Internal consistency and test-retest reliability were satisfactory. We could not replicate the original 3-factor model. Application of the scree plot criterion in an exploratory factor analysis resulted in a single-factor structure. The Herth Hope Index - German Version (HHI-D) is a short, reliable, and valid instrument for the assessment of hope in patient populations. We recommend using only the HHI-D total score until further research gives more insights into possible factorial solutions and subscales. © 2015 S. Karger GmbH, Freiburg.

Are Allopathic and Holistic Medicine Incommensurable?

PubMed

Evangelatos, Nikolaos; Eliadi, Irini

2016-01-01

The shift from the Aristotelian to the Newtonian scientific paradigm gave birth to progresses in the natural, hard sciences and contributed to the emergence of modernity. Allopathic medicine gradually implemented those progresses, transforming itself into contemporary biomedicine. In the early 20th century, replacement of Newtonian physics by quantum mechanics and Einstein's theory of relativity resulted in a new paradigm shift in the natural, hard sciences. This shift gave birth to post-modern perceptions, which attempt to put those changes in context. Within this new context, holistic therapeutic approaches are considered more compatible with the new paradigm. Different paradigms in the natural, hard sciences are considered to be incommensurable (in the Kuhnian sense). This incommensurability is also transferred to the different societal contexts, the different «Weltanschauungen» that rely on different scientific paradigms. However, drawing on arguments that range from historical and philosophical to practical and sociological ones, we argue that, although based on different scientific paradigms, allopathic and holistic medicine are not incommensurable, but rather complementary. This may be related to the inherent attributes of medicine, a fact that reinforces the debate on its epistemological status. © 2016 S. Karger GmbH, Freiburg.

Topical Application of Honey on Surgical Wounds: A Randomized Clinical Trial.

PubMed

Goharshenasan, Peiman; Amini, Shahideh; Atria, Ali; Abtahi, Hamidreza; Khorasani, Ghasemali

2016-01-01

The antimicrobial and anti-inflammatory activity of honey and its ability to accelerate wound healing make it an attractive option in surgical wound care. We performed a randomized clinical trial to compare the efficacy of honey dressing with conventional dressing regarding the aesthetic outcome. Bilateral symmetric incisions in randomly selected plastic surgical patients were randomly covered postoperatively with conventional dressing and honey dressing for five days. The aesthetic outcome of the two sides was rated on a Visual Analog Scale by the surgeon and the patient and compared at month three and six after surgery. Seventy two symmetrical incisions in 52 patients were evaluated during the study. The mean width of the scar after the third and the sixth month was 3.64 +/- 0.83 mm and 3.49 +/- 0.87 mm on the side that received honey dressing and 5.43 +/- 0.05 mm and 5.30+/- 1.35 mm in the control group. Wilcoxon signed-rank test showed significant difference between honey and conventional dressing outcomes at third and sixth month (p < 0.001). The healing process of the surgical wound and its final aesthetic result could be improved by using honey dressing. © 2016 S. Karger GmbH, Freiburg.

Gastric Ulcer Hemorrhage - a Potential Life-Threatening Complication of Intragastric Balloon Treatment of Obesity.

PubMed

Mojkowska, Aleksandra; Gazdzinski, Stefan; Fraczek, Mariusz; Wyleżoł, Mariusz

2017-01-01

Some morbidly obese patients do not qualify for bariatric surgery due to general health contraindications. Intragastric balloon treatment might be a therapeutic option in the above-mentioned cases. It can prime super-obese patients with end-stage disease for bariatric surgery. As a neoadjuvant therapy before surgery, it leads to a downstage of the disease by preliminary weight reduction, to an improvement in general health and, in summary, to a reduction of the perioperative risk. It is generally considered to be a safe method. However, due to the wide range of possible complications and unusual symptoms after intragastric balloon treatment, an interdisciplinary, instead of only a surgical or endoscopic, treatment and follow-up might be recommended in these patients. We here describe a potential life-threatening complication in the form of gastric bleeding as a consequence of intragastric balloon treatment and simultaneous aspirin taking and Helicobacter pylori infection. There have been reports of some complications of intragastric balloon treatment. However, to the best of our knowledge there were no reports concerning life-threatening hemorrhage from gastric ulcer. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

[The effects of Cardiodoron on cardio-respiratory coordination--a literature review].

PubMed

Cysarz, D; Heckmann, C; Kümmell, H C

2002-10-01

In healthy subjects self-regulation of the organism establishes the order of rhythmical functions. This self-regulation is altered in patients suffering from idiopathic orthostatic syndrome resulting from disturbances of functional aspects only. Thus the cardio-respiratory coordination, which may serve as the representative of the order of rhythmical functions, is modified. In the case of idiopathic orthostatic syndrome the anthroposophic medicine offers the medicament Cardiodoron(r). Does it stimulate self-regulation in order to normalise the cardio-respiratory coordination? This claim is analysed by a systematic review of the literature. Only those publications were considered where the cardio-respiratory coordination was analysed in studies with patients or healthy subjects. The methods of the studies with patients and healthy subjects vary strongly. Nevertheless, a normalisation of the cardio-respiratory coordination could be found in studies with patients suffering from idiopathic orthostatic syndrome as well as in studies with healthy subjects. The studies show that the use of the medicament results in a normalisation of the cardiorespiratory coordination. By stimulating the self-regulation the medicament leads to an improvement of the order of rhythmical functions in the human organism. Copyright 2002 S. Karger GmbH, Freiburg

Is childhood obesity influenced by dog ownership? No cross-sectional or longitudinal evidence.

PubMed

Westgarth, Carri; Heron, Jon; Ness, Andrew R; Bundred, Peter; Gaskell, Rosalind M; Coyne, Karen; German, Alexander J; McCune, Sandra; Dawson, Susan

2012-01-01

To examine whether dog ownership is associated with lower risk of childhood obesity. Cross-sectional study of 7,759 children at age 7 years in the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK. In addition, longitudinal analyses were conducted between age 7 and 9 years. BMI at age 7 and 9 years was calculated from clinic-measured weight and height and standardised in reference to 1990 UK data. Dog ownership data were collected by carer questionnaire at various time points. After adjustment for confounding factors associated with dog ownership or obesity, there was no evidence of an association between obesity and dog ownership at 7 years OR = 1.18, 95% confidence interval = 0.88-1.59, p = 0.27), or dog ownership history. There was also no evidence for an effect of dog ownership on BMI change between 7 and 9 years, nor acquisition of a dog on the change in weight status of obese children between 7 and 9 years. This study provides no evidence for a protective effect of dog ownership on the development of childhood obesity. Further investigation is required to determine the impact of dog ownership on physical activity in overweight and obese children. Copyright © 2012 S. Karger GmbH, Freiburg

Selling dreams: an overview of slimming products' advertisements in Switzerland.

PubMed

Droz, Nadège; Marques-Vidal, Pedro

2014-01-01

The aim of this work was to assess weight loss claims of slimming products available in Switzerland. Between May 2008 and February 2013, 31 advertisements for 13 slimming products were analyzed. Total daily weight loss claims ranged between 300 g and 1 kg. 84% of the advertisements included the photograph of a woman, 61% showed a picture of a person before and after using the product, and 51% claimed that the product had improved marital relationships. The terms 'natural', 'miracle/extraordinary' and 'scientific' were present in 92%, 77% and 31% of the advertisements, respectively. Cost for one package of the product ranged between CHF 49.00 and 59.00 (USD 52.00 and 63.00), and no correlation was found between cost and weight loss claims. No differences were found for weight loss claims according to presence or absence of a picture or of the terms 'natural', 'miracle/extraordinary', and 'scientific'. Assuming that 5.3% of readers bought the product, yearly revenues would range between CHF 12.5 and 33.8 million (USD 13.4 and 36.2 million). In Switzerland, advertisements for slimming products use positive and reassuring terms to attract consumers, which are lured by unreachable, false promises of rapid and easy weight loss. © 2014 S. Karger GmbH, Freiburg.

Ethnic Inequalities in Overweight and Obesity Prevalence among Copenhagen Schoolchildren from 2002 to 2007.

PubMed

Pedersen, Dorthe Corfitzen; Aarestrup, Julie; Pearson, Seija; Baker, Jennifer Lyn

2016-01-01

The stabilization in levels of childhood overweight has masked increasing gaps among different ethnic and socioeconomic groups in several countries. To examine if levels and trends in childhood overweight and obesity differed by ethnicity and socioeconomic areas in Copenhagen schoolchildren. From measured heights and weights of 32,951 children 5-8 and 14-16 years of age, the prevalence of overweight (including obesity) and obesity were estimated using International Obesity Task Force criteria. Differences in prevalence levels and trends across six school years by ethnicity and socioeconomic areas were examined using logistic regression. The prevalence of overweight significantly decreased from 2002 to 2007 among the youngest Western girls and boys, showed no significant changes among the oldest non-Western girls and increased among the oldest non-Western boys. In all years, the youngest non-Western children had significantly higher levels of overweight than Western children. Although the prevalence of overweight tended to be higher in low socioeconomic areas as compared with high socioeconomic areas, few differences were statistically significant. Consistent trends in overweight across the years by socioeconomic area were not observed. Ethnic and social inequalities exist in childhood overweight among Copenhagen schoolchildren; thus appropriate interventions targeting high-risk groups are needed. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Determinants of Perceived Stress in Individuals with Obesity: Exploring the Relationship of Potentially Obesity-Related Factors and Perceived Stress.

PubMed

Junne, Florian; Ziser, Katrin; Giel, Katrin Elisabeth; Schag, Kathrin; Skoda, Eva; Mack, Isabelle; Niess, Andreas; Zipfel, Stephan; Teufel, Martin

2017-01-01

Associations of specific types of stress with increased food intake and subsequent weight gain have been demonstrated in animal models as well as in experimental and epidemiological studies on humans. This study explores the research question of to what extent potentially obesity-related factors determine perceived stress in individuals with obesity. N = 547 individuals with obesity participated in a cross-sectional study assessing perceived stress as the outcome variable and potential determinants of stress related to obesity. Based on the available evidence, a five factorial model of 'obesity-related obesogenic stressors' was hypothesized, including the dimensions, 'drive for thinness', 'impulse regulation', 'ineffectiveness', 'social insecurity', and 'body dissatisfaction'. The model was tested using multiple linear regression analyses. The five factorial model of 'potentially obesity-related stressors' resulted in a total variance explanation of adjusted R² = 0.616 for males and adjusted R² = 0.595 for females for perceived stress. The relative variance contribution of the five included factors differed substantially for the two sexes. The findings of this cross-sectional study support the hypothesized, potentially obesity-related factors: 'drive for thinness', 'impulse regulation', 'ineffectiveness', 'social insecurity', and 'body dissatisfaction' as relevant determinants of perceived stress in individuals with obesity. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Evaluation of selected speech parameters after prosthesis supply in patients with maxillary or mandibular defects.

PubMed

Müller, Rainer; Höhlein, Andreas; Wolf, Annette; Markwardt, Jutta; Schulz, Matthias C; Range, Ursula; Reitemeier, Bernd

2013-01-01

Ablative surgery of oropharyngeal tumors frequently leads to defects in the speech organs, resulting in impairment of speech up to the point of unintelligibility. The aim of the present study was the assessment of selected parameters of speech with and without resection prostheses. The speech sounds of 22 patients suffering from maxillary and mandibular defects were recorded using a digital audio tape (DAT) recorder with and without resection prostheses. Evaluation of the resonance and the production of the sounds /s/, /sch/, and /ch/ was performed by 2 experienced speech therapists. Additionally, the patients completed a non-standardized questionnaire containing a linguistic self-assessment. After prosthesis supply, the number of patients with rhinophonia aperta decreased from 7 to 2 while the number of patients with intelligible speech increased from 2 to 20. Correct production of the sounds /s/, /sch/, and /ch/ increased from 2 to 13 patients. A significant improvement of the evaluated parameters could be observed only in patients with maxillary defects. The linguistic self-assessment showed a higher satisfaction in patients with maxillary defects. In patients with maxillary defects due to ablative tumor surgery, an increase in speech performance and intelligibility is possible by supplying resection prostheses. © 2013 S. Karger GmbH, Freiburg.

Additional Prognostic Value of SUVmax Measured by F-18 FDG PET/CT over Biological Marker Expressions in Surgically Resected Cervical Cancer Patients.

PubMed

Yun, Man Soo; Kim, Seong-Jang; Pak, Kyoungjune; Lee, Chang Hun

2015-01-01

We compared the prognostic ability of the maximum standardized uptake value (SUVmax) and various biological marker expressions to predict recurrence in patients with surgically resected cervical cancer. A retrospective review identified 60 patients with cervical cancer who received [18F]fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) at the time of the diagnosis of cancer. The SUVmax, expressions of carbonic anhydrase-IX (CA-IX), glucose transporter 1 (GLUT-1), and vascular endothelial growth factor (VEGF), and known prognostic factors were investigated. The median follow-up time was 22.2 months (range 3.4-43.1 months). Using univariate analyses, the stage (stage II, p = 0.0066), SUVmax (> 6, p = 0.027), parametrial involvement (p < 0.0001), and positivity for CA-IX (p = 0.0191) were associated with recurrences of cervical cancer. With the Cox proportional hazard regression model, the SUVmax was a potent predictor for disease-free survival (DFS). Although CA-IX expression was related to DFS in the current study, the potent predictor for DFS was SUVmax. Therefore, SUVmax is of greater prognostic value than biological marker expression in patients with surgically resected cervical cancer. © 2015 S. Karger GmbH, Freiburg.

Internet Information for Patients on Cancer Diets - an Analysis of German Websites.

PubMed

Herth, Natalie; Kuenzel, Ulrike; Liebl, Patrick; Keinki, Christian; Zell, Joerg; Huebner, Jutta

2016-01-01

In recent years, the Internet has become an important source of information for cancer patients. Various cancer diets that are publicized on the Web promise significant benefits. The aim of our study was to evaluate the quality of online patient information about cancer diets. A patient's search for 'cancer diets' on German websites was simulated using the search engine Google. The websites were evaluated utilizing a standardized instrument with formal and content aspects. An analysis of 60 websites revealed that websites from nonprofit associations as well as self-help groups offer the best content and formal ranking. Websites whose owners aim to make a profit, practices that offer cancer diet therapies, and newspapers received the poorest quality score. The majority of content provided on the Web gets published by profit-oriented content groups. The divergence between profit-driven websites offering low-quality content and the few trustworthy websites on cancer diets is enormous. The information given online about cancer diets may turn out to be a hazardous pitfall. In order to present evidence-based information about cancer diets, online information should be replenished to create a more accurate picture and give higher visibility to the right information. © 2016 S. Karger GmbH, Freiburg.

Refeeding Syndrome: An Important Complication Following Obesity Surgery.

PubMed

Chiappetta, Sonja; Stein, Jürgen

2016-01-01

Refeeding syndrome (RFS) is an important and well-known complication in malnourished patients, but the incidence of RFS after obesity surgery is unknown and the awareness of RFS in obese patients as a postsurgical complication must be raised. We present a case of RFS subsequent to biliopancreatic diversion in a morbidly obese patient. A 48-year-old female patient with a BMI of 41.5 kg/m2 was transferred to our hospital due to Wernicke's Encephalopathy in a global malabsorptive syndrome after biliopancreatic diversion. Parenteral nutrition, vitamin supplementation and high-dosed intravenous thiamine supplementation were initiated. After 14 days, the patient started to develop acute respiratory failure, and neurological functions were impaired. Blood values showed significant electrolyte disturbances. RFS was diagnosed and managed according to the NICE guidelines. After 14 days, phosphate levels had returned to normal range, and neurological symptoms were improved. Extreme weight loss following obesity surgery has been shown to be associated with undernutrition. These patients are at high risk for evolving RFS, even though they may still be obese. Awareness of RFS as a postsurgical complication, the identification of patients at risk as well as prevention and correct management should be routinely performed at every bariatric center. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task.

PubMed

Boraxbekk, Carl-Johan; Stomby, Andreas; Ryberg, Mats; Lindahl, Bernt; Larsson, Christel; Nyberg, Lars; Olsson, Tommy

2015-01-01

It has been suggested that overweight is negatively associated with cognitive functions. The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women. 20 overweight postmenopausal women were randomized to either a modified paleolithic diet or a standard diet adhering to the Nordic Nutrition Recommendations for 6 months. We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions. Episodic memory performance improved significantly (p = 0.010) after the dietary interventions. Concomitantly, brain activity increased in the anterior part of the right hippocampus during memory encoding, without differences between diets. This was associated with decreased levels of plasma free fatty acids (FFA). Brain activity increased in pre-frontal cortex and superior/middle temporal gyri. The magnitude of increase correlated with waist circumference reduction. During episodic retrieval, brain activity decreased in inferior and middle frontal gyri, and increased in middle/superior temporal gyri. Diet-induced weight loss, associated with decreased levels of plasma FFA, improves episodic memory linked to increased hippocampal activity. © 2015 S. Karger GmbH, Freiburg.

Prevalence of Overweight and Obesity among Chinese Adults: Role of Adiposity Indicators and Age.

PubMed

Xu, Weili; Zhang, Hua; Paillard-Borg, Stephanie; Zhu, Hong; Qi, Xiuying; Rizzuto, Debora

2016-01-01

The role of different body fat indicators and age in assessing the prevalence of obesity is unclear. We aimed to examine to what extent different body fat indicators including BMI, waist circumference (WC) and waist-to-hip ratio (WHR) affect the prevalence of overweight and obesity among Chinese adults taking age into account. This population-based cross-sectional study included a random sample of 7,603 adults aged 20-79 years across entire Tianjin, China. BMI, WC, and WHR were used to define overweight and obesity following standard criteria. Prevalence rates were calculated and standardized using local age- and gender-specific census data. Logistic regression was used in data analysis. Using the combination of BMI, WC, and WHR, the prevalence of overweight and obesity was 69.8%, and increased with age till the age of 60 and a decline thereafter. The prevalence of overweight assessed by BMI was higher than that assessed by WC and WHR, while the prevalence of obesity defined by BMI was much lower than that defined by WC or WHR. The prevalence of overweight and obesity is about 70% among Chinese adults. Adiposity indicators and age play an important role in the prevalence of overweight and obesity. © 2016 S. Karger GmbH, Freiburg.

The Situation of Complementary and Alternative Medicine / Integrative Medicine in Finland: Genuine Research Is Needed.

PubMed

Zimmermann, Peter Josef; Aarva, Pauliina; Sorsa, Minna

The official acceptance of complementary and alternative medicine (CAM) or integrative medicine in the academic discussion and in health policies in Finland is still poor. This is in contradiction to the fact that modern Finnish citizens use CAM as much as any people elsewhere in the European Union, with rates of 28-46% of the general population, or even more. This was one of the reasons for the foundation of the Finnish Forum for Research in Integrative Medicine and Healthcare (SILF) in November 2014. A first challenge for the SILF was to facilitate a research seminar to address the issue of CAM research as a part of the Finnish academic research. The seminar was organized by the Department of Health Sciences of the University of Tampere on November 13, 2015. Almost one third of the more than 400 participants were health professionals, and again one-third out of this group were physicians. As a result of the seminar, a research network was inaugurated. Obviously there is an increasing interest of health professionals in CAM and maybe even a change of attitude towards CAM also in Finland. However, genuine Finnish CAM research is essential in order to open up the academic discussion. © 2017 S. Karger GmbH, Freiburg.

Effects of Endurance and Endurance Strength Training on Body Composition and Physical Capacity in Women with Abdominal Obesity.

PubMed

Skrypnik, Damian; Bogdański, Paweł; Mądry, Edyta; Karolkiewicz, Joanna; Ratajczak, Marzena; Kryściak, Jakub; Pupek-Musialik, Danuta; Walkowiak, Jarosław

2015-01-01

To compare the effects of endurance training with endurance strength training on the anthropometric, body composition, physical capacity, and circulatory parameters in obese women. 44 women with abdominal obesity were randomized into groups A and B, and asked to perform endurance (A) and endurance strength training (B) for 3 months, 3 times/week, for 60 min. Dual-energy X-ray absorptiometry and Graded Exercise Test were performed before and after training. Significant decreases in body mass, BMI, total body fat, total body fat mass, and waist and hip circumference were observed after both types of intervention. Marked increases in total body lean and total body fat-free mass were documented in group B. In both groups, significant increases in peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at ventilatory threshold were accompanied by noticeably decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure. No significant differences were noticed between groups for the investigated parameters. Our findings demonstrate evidence for a favorable and comparable effect of 3-month endurance and endurance strength training on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity. © 2015 S. Karger GmbH, Freiburg.

Fatigue in the general population of Colombia - normative values for the multidimensional fatigue inventory MFI-20.

PubMed

Hinz, Andreas; Barboza, Carolyn Finck; Barradas, Susana; Körner, Annett; Beierlein, Volker; Singer, Susanne

2013-01-01

Fatigue is a frequent symptom in cancer patients. In Europe and Northern America fatigue questionnaires were developed and tested, but their generalizability to other cultural contexts is largely unknown. The aim of this study is to provide normative values for the Multidimensional Fatigue Inventory (MFI-20) based on a representative sample of the general population in Colombia and to test psychometric properties. 1,500 individuals completed a questionnaire that contained the MFI-20, as well as other questionnaires, and questions on sociodemographic variables and chronic diseases. The mean values of the scales were marginally higher than those for 2 European samples. The mean value of the total score was 44.3 ± 14.1. Women were affected by fatigue more than men, and there was an almost linear age trend, with higher mean scores for older subjects. People with chronic diseases were affected by fatigue more than people without chronic conditions. The best psychometric properties were obtained for the total scale (sum score) of the MFI-20. The normative values presented here can help us to assess the individual burden of fatigue in a Latin American context. Psychometric properties of the MFI-20 in Colombia are similar to those obtained in Europe. © 2013 S. Karger GmbH, Freiburg.

Evaluation of Hypocaloric Diet With Protein Supplementation in Middle-Aged Sarcopenic Obese Women: A Pilot Study.

PubMed

Sammarco, Rosa; Marra, Maurizio; Di Guglielmo, Maria Luisa; Naccarato, Marianna; Contaldo, Franco; Poggiogalle, Eleonora; Donini, Lorenzo Maria; Pasanisi, Fabrizio

2017-01-01

The aim of this study was to evaluate the efficacy of a nutritional program, which is characterized by a different modulation of proteins, in adult patients with sarcopenic obesity. We studied 18 obese women aged 41-74 years. Obesity was diagnosed as fat mass > 34.8% and sarcopenia was defined when lean body mass was <90% of the subject's ideal fat free mass. All subjects were randomly assigned to different nutritional interventions: Hypocaloric diet plus placebo (A) and hypocaloric high-protein diet (1.2-1.4 g / kg body weight reference / day) (B). Anthropometric measurements, body composition, resting energy expenditure, handgrip test, Short Physical Performance Battery (SPPB), and SF-36 questionnaire were evaluated at baseline and after 4 months. Weight significantly decreased in both groups. Women with high-protein diet preserved lean body mass compared to low-calorie diet and improved significantly muscle strength; SPPB score did not change in both groups. SF-36 test showed a significant change for general health after 4 months in group B. In our study, sarcopenic obese patients with high-protein diet showed an improvement in muscle strength. Furthermore, dietary protein enrichment may represent a protection from the risk of sarcopenia following a hypocaloric diet. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Hypocaloric diet and regular moderate aerobic exercise is an effective strategy to reduce anthropometric parameters and oxidative stress in obese patients.

PubMed

Gutierrez-Lopez, Liliana; Garcia-Sanchez, Jose Ruben; Rincon-Viquez, Maria de Jesus; Lara-Padilla, Eleazar; Sierra-Vargas, Martha P; Olivares-Corichi, Ivonne M

2012-01-01

Studies show that diet and exercise are important in the treatment of obesity. The aim of this study was to determine whether additional regular moderate aerobic exercise during a treatment with hypocaloric diet has a beneficial effect on oxidative stress and molecular damage in the obese patient. Oxidative stress of 16 normal-weight (NW) and 32 obese 1 (O1) subjects (BMI 30-34.9 kg/m(2)) were established by biomarkers of oxidative stress in plasma. Recombinant human insulin was incubated with blood from NW or O1 subjects, and the molecular damage to the hormone was analyzed. Two groups of treatment, hypocaloric diet (HD) and hypocaloric diet plus regular moderate aerobic exercise (HDMAE), were formed, and their effects in obese subjects were analyzed. The data showed the presence of oxidative stress in O1 subjects. Molecular damage and polymerization of insulin was observed more frequently in the blood from O1 subjects. The treatment of O1 subjects with HD decreased the anthropometric parameters as well as oxidative stress and molecular damage, which was more effectively prevented by the treatment with HDMAE. HD and HDMAE treatments decreased anthropometric parameters, oxidative stress, and molecular damage in O1 subjects. Copyright © 2012 S. Karger GmbH, Freiburg.

Regulation of Hypertension for Secondary Prevention of Stroke: The Possible 'Bridging Function' of Acupuncture.

PubMed

Zheng, Haizhen; Han, Yuhui; Du, Yuzheng; Shi, Xuemin; Huang, Huiyuan; Yu, Xiaoyang; Tan, Xiaochan; Hu, Chunxiao; Wang, Yue; Zhou, Shiyuan

2018-01-01

Worldwide, stroke is the leading cause of mortality and disability, with hypertension being an independent risk factor for a secondary stroke. Acupuncture for the treatment of hypertension gains more attention in alternative and complementary medicine, but the results are inconsistent. Few studies regarding the secondary prevention of stroke by managing hypertension with acupuncture have been carried out as there are some problems regarding the antihypertensive drug status in the secondary prevention of stroke. Still, the potential of acupuncture in regulating the blood pressure for secondary stroke prevention deserves our focus. This review is based on papers recorded in the PubMed, Embase, and Web of Science databases, from their inception until March 28, 2017, and retrieved with the following search terms: hypertension and acupuncture, limited in spontaneously hypertensive rats (SHRs), stress-induced (or cold-induced) hypertensive or pre-hypertensive models. We find that, in these hypertensive animals, acupuncture could mainly influence factors related to the nervous system, oxidative stress, the endocrine system, cardiovascular function, and hemorheology, which are closely associated with the stroke outcome. This trend may give us a hint that acupuncture might well participate in the secondary prevention of stroke through these pathways when used in the management of hypertension. © 2018 S. Karger GmbH, Freiburg.

Intentions to Prevent Weight Gain in Older and Younger Adults; The Importance of Perceived Health and Appearance Consequences.

PubMed

Beeken, Rebecca J; Mahdi, Sundus; Johnson, Fiona; Meisel, Susanne F

2018-01-01

This study investigates whether health and appearance consequences predict intentions to prevent weight gain and whether these relationships differ in younger versus older adults and in men versus women. UK adults aged 18-26 years (younger adults; n = 584) or >45 years (older adults; n = 107) participated in an online survey. Logistic regression assessed associations between intentions to avoid gaining weight and age, gender as well as perceived negative consequences of weight gain for health and appearance. Co-variates were ethnicity, education, weight perception and perceived weight gain vulnerability. Interactions between age, gender and perceived health and appearance consequences of weight gain were also tested. Perceived negative appearance consequences of weight gain predicted weight gain prevention intentions (OR = 9.3, p < 0.001). Health concerns were not a significant predictor of intentions overall but were a strong predictor for older adults (age × health concern interaction: OR = 13.6, p > 0.01). Concerns about feeling unattractive predict intentions to prevent weight gain. However, health consequences of weight gain are only important motivators for older adults. Future research should identify ways to shift the focus of young people from appearance concerns towards the health benefits of maintaining a healthy weight. © 2018 The Author(s) Published by S. Karger GmbH, Freiburg.

Adolescent overweight, obesity and chronic disease-related health practices: mediation by body image.

PubMed

Farhat, Tilda; Iannotti, Ronald J; Caccavale, Laura J

2014-01-01

To examine whether body image mediates the association between overweight/obesity and chronic disease-related health practices (CDRHP), including lack of physical activity (PA), infrequent breakfast consumption (IBC), screen-based media use (SBM), and smoking. The 2006 Health Behaviors in School-Age Children survey was administered to a nationally representative sample of US students (n = 8,028) in grades 6-10 (mean age = 14.3 years). Outcome variables included self-reported measures of PA, SBM, IBC, and smoking. Body image was assessed with 5 items from the Body Investment Scale (α = 0.87) asking for agreement/disagreement with statements about one's body. Stratifying on gender, an initial regression model estimated the association between overweight/obesity and CDRHP. Mediation models that included body image were then compared to the initial model to determine the role of body image in the relationship between overweight/obesity and CDRHP. Among boys, body image mediated the relationships of overweight/obesity with SBM, and of obesity with IBC. Among girls, it mediated the relationships of obesity with PA, IBC, and smoking, and of overweight with SBM. As the prevalence of overweight/obesity among adolescent boys and girls remains high, efforts to improve their body image could result in less frequent engagement in CDRHP. © 2013 S. Karger GmbH, Freiburg.

Childhood Obesity Is a Chronic Disease Demanding Specific Health Care--a Position Statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO).

PubMed

Farpour-Lambert, Nathalie J; Baker, Jennifer L; Hassapidou, Maria; Holm, Jens Christian; Nowicka, Paulina; O'Malley, Grace; Weiss, Ram

2015-01-01

Childhood obesity is one of the greatest health challenges of the 21st century. The EASO COTF is convinced that classifying obesity as a chronic disease in children and adolescents is a crucial step for increasing individual and societal awareness, and for improving early diagnosis and intervention. Such a classification will enhance the development of novel preventive and treatment approaches, health care policies and systems, and the education of healthcare workers. The management of obesity prior to the appearance of co-morbidities may prevent their escalation into significant medical and psychosocial problems, and reduce their economic and societal impact. Childhood is a unique window of opportunity to influence lifetime effects on health, quality of life, prevention of non-communicable chronic diseases and disabilities. The Convention on the Rights of the Child by UNICEF states that parties shall strive to ensure that no child is deprived of his or her right of access to health care services. The EASO COTF is aiming to address these issues via educational activities for health care workers, identification of research agendas, and the promotion of collaborations among clinicians, researchers, health institutions, organizations and states across Europe. © 2015 S. Karger GmbH, Freiburg.

Oral Lactobacillus Counts Predict Weight Gain Susceptibility: A 6-Year Follow-Up Study.

PubMed

Rosing, Johanne Aviaja; Walker, Karen Christina; Jensen, Benjamin A H; Heitmann, Berit L

2017-01-01

Recent studies have shown an association between weight change and the makeup of the intestinal microbiota in humans. Specifically, Lactobacillus, a part of the entire gastrointestinal tract's microbiota, has been shown to contribute to weight regulation. We examined the association between the level of oral Lactobacillus and the subsequent 6-year weight change in a healthy population of 322 Danish adults aged 35-65 years at baseline. Prospective observational study. In unadjusted analysis the level of oral Lactobacillus was inversely associated with subsequent 6-year change in BMI. A statistically significant interaction between the baseline level of oral Lactobacillus and the consumption of complex carbohydrates was found, e.g. high oral Lactobacillus count predicted weight loss for those with a low intake of complex carbohydrates, while a medium intake of complex carbohydrates predicted diminished weight gain. A closer examination of these relations showed that BMI change and Lactobacillus level was unrelated for those with high complex carbohydrate consumption. A high level of oral Lactobacillus seems related to weight loss among those with medium and low intakes of complex carbohydrates. Absence, or a low level of oral Lactobacillus, may potentially be a novel marker to identify those at increased risk of weight gain. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Examining perceived stereotype threat among overweight/obese adults using a multi-threat framework.

PubMed

Carels, Robert A; Domoff, Sarah E; Burmeister, Jacob M; Koball, Afton M; Hinman, Nova G; Davis, Alan K; Wagner Oehlhof, Marissa; Leroy, Michelle; Bannon, Erin; Hoffmann, Debra A

2013-01-01

The Multi-Threat Framework accounts for potentially different forms of stereotype threat that differ in target (i.e., the individual or the group) and source (i.e., the self or others). This investigation examined how these different forms of perceived stereotype threat were related to concepts, such as group identity, stereotype endorsement, stigma consciousness, etc., among overweight and obese individuals. 216 adults completed an online survey. Participants' mean age was 23.6 (SD 10.1; range 18-64) years and mean BMI was 31.6 (SD 7.5) kg/m². Participants reported a history of feeling threatened by stereotypes related to weight. When reflecting on past experiences of perceived stereotype threat, participants reported greater levels of self/own stereotype threat compared to group stereotype threat. Level of stereotype threat was related to a number of personal characteristics (i.e., sex, BMI) and individual factors (i.e., group identity, stigma consciousness, fear of fat). Individuals who are overweight report a history of being threatened by negative stereotypes. The findings support the Multi-Threat Framework for stereotype threat based on body weight. Overweight individuals' susceptibility to stereotype threat may vary systematically depending on several factors. Future research should examine weight-related stereotypes' impact on cognitive and behavioral outcomes. Copyright © 2013 S. Karger GmbH, Freiburg

Survey of German non-medical practitioners regarding complementary and alternative medicine in oncology.

PubMed

Koehl, Benjamin; Muenstedt, Karsten; Micke, Oliver; Muecke, Ralph; Buentzel, Jens; Stoll, Christoph; Prott, Franz Josef; Dennert, Gabriele; Senf, Bianca; Huebner, Jutta

2014-01-01

In total, 40-70% of cancer patients use complementary or alternative medicine (CAM). Many of them ask for advice from non-medical practitioners (NMPs). Our aim was to investigate the attitude of NMPs regarding their treatments for cancer patients. A survey was performed on members of NMP associations, using an online questionnaire on diagnosis and treatment, goals for using CAM, communication with the oncologist, and sources of information. Of the 1,500 members of the NMP associations, 299 took part. The treatments were found to be heterogeneous. Homeopathy is used by 45% of the NMPs; 10% believe it to be a treatment directly against cancer. Herbal therapy, vitamins, orthomolecular medicine, ordinal therapy, mistletoe preparations, acupuncture, and cancer diets are used by more than 10% of the NMPs. None of the treatments is discussed with the respective physician on a regular basis. Many therapies provided by NMPs are biologically based and therefore may interfere with conventional cancer therapy. Thus, patients are at risk of interactions, especially as most NMPs do not adjust their therapies to those of the oncologist. Moreover, risks may arise from these CAM methods as NMPs partly believe them to be useful anticancer treatments. This may lead to the delay or even omission of effective therapies. © 2014 S. Karger GmbH, Freiburg.

Differences in aerobic fitness and lifestyle characteristics in preschoolers according to their weight status and sports club participation.

PubMed

Ebenegger, Vincent; Marques-Vidal, Pedro; Kriemler, Susi; Nydegger, Andreas; Zahner, Lukas; Niederer, Iris; Bürgi, Flavia; Puder, Jardena J

2012-01-01

This study assesses differences in adiposity, aerobic fitness, and lifestyle characteristics in preschoolers according to their weight status and sports club (SC) participation. As part of the Ballabeina study, 600 randomly selected preschoolers (mean age 5.1 ± 0.6 years; 50.2% girls) were analyzed. Body composition was measured by bioelectrical impedance, aerobic fitness by the 20-meter shuttle run test, and physical activity by accelerometers. Eating habits, media use, and SC participation were assessed by questionnaires. Overweight children (Swiss national percentiles) and children not participating in SC had both lower aerobic fitness and higher % body fat compared to their respective counterparts (all p ≤ 0.028). In addition, children not participating in SC were less physically active, had more media use, and ate less healthy compared to children participating in SC (all p ≤ 0.023). Controlling for parental sociocultural determinants attenuated differences in % body fat, in physical activity, and in eating habits. Aerobic fitness differs both according to weight status and SC participation in preschoolers. Furthermore, in view of the many differences in lifestyle behaviors, SC participation at this age could represent a more discriminatory indicator of healthy lifestyle characteristics than weight status. Copyright © 2012 S. Karger GmbH, Freiburg.

Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now?

PubMed

Dugas, Camille; Perron, Julie; Kearney, Michèle; Mercier, Roxanne; Tchernof, André; Marc, Isabelle; Weisnagel, S John; Robitaille, Julie

2017-01-01

Children exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing many health problems such as obesity. There is an urgent need to find new strategies to prevent obesity development among high-risk populations such as those children. Accordingly, the aim of this review was to summarize current knowledge on the postnatal prevention of childhood obesity in offspring born from mothers with GDM. Specifically, this review addresses the impact of breastfeeding, complementary feeding practices as well as dietary intake and physical activity during childhood on obesity risk of children exposed to GDM in utero. Furthermore, breast milk composition of diabetic mothers and its potential impact on growth is discussed. According to the available literature, breastfeeding may reduce obesity risk in children exposed to GDM in utero but a longer duration seems necessary to achieve its protective effect against obesity. Detailed analysis of breast milk composition of mothers with GDM will be necessary to fully understand the relationship between breastfeeding and obesity in this specific population. This review highlights the need for more studies addressing the impact of complementary feeding practices and lifestyle habits during childhood on obesity risk of children exposed to GDM in utero. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

[Homeopathy and structure of water: a physical model].

PubMed

Kratky, K W

2004-02-01

Formerly, the author has suggested a relatively simple water model. There, the dynamical structure of a typical water cluster was investigated, being represented by the movement of a ball in an abstract energy landscape. Now the above-mentioned model is investigated in more detail to answer the following question: Are essential claims of homeopathy concerning potentiation (diluting and shaking) in agreement with science? Equations of motion are employed that represent vibrations of clusters. For the computer experiments, the formalism of Nosé-Hoover is used, the surrounding water being interpreted as a heat bath. Diluting corresponds to a shift of the energy landscape towards the pure solvent (water), shaking is accompanied by an increase of the contact to the heat bath. There is a tendency of the ball to be caught in local valleys of the energy landscape (metastable states) if the temperature is not too high and if the liquid is not shaken. Thus, even for a given landscape there are a variety of structures being durable for some time. The computer experiments suggest that the repeated process of potentiation eventually results in a specific metastable state of the pure solvent. The initial substance helps to obtain this goal, but is no longer necessary at last. Copyright 2004 S. Karger GmbH, Freiburg

Weight change and workplace absenteeism in the HealthWorks study.

PubMed

VanWormer, Jeffrey J; Linde, Jennifer A; Harnack, Lisa J; Stovitz, Steven D; Jeffery, Robert W

2012-01-01

Little is known about the relationship between weight change and workplace absenteeism. The purpose of this study was to examine the degree to which weight change predicted 2-year absenteeism. A longitudinal analysis of 1,228 employees enrolled in a worksite-randomized controlled trial was performed. Participants were all working adults in the Minneapolis, MN, area (USA). The final model indicated a significant interaction between weight change and baseline BMI. The difference in absenteeism ranged from (mean ± SE) 3.2 ± 1.2 days among healthy weight employees who maintained their weight to 6.6 ± 1.1 days among obese employees who gained weight (and slightly higher among healthy weight employees who lost weight). The adjusted model also indicated that participants who were male, not depressed, nonsmokers, and had lower baseline absenteeism had significantly less workplace absenteeism relative to participants who were female, depressed, smokers, and had higher baseline absenteeism. Absenteeism was generally low in this sample, but healthy weight employees who maintained their body weight over 2 years had the fewest number of sick days. More research is needed in this area, but future workforce attendance interventions may be improved by focusing on the primary prevention of weight gain in healthy weight employees. Copyright © 2012 S. Karger GmbH, Freiburg.

Re-Irradiation of Locoregional NSCLC Recurrence Using Robotic Stereotactic Body Radiotherapy.

PubMed

Ceylan, Cemile; Hamacı, Andaç; Ayata, Hande; Berberoglu, Kezban; Kılıç, Ayhan; Güden, Metin; Engin, Kayıhan

2017-01-01

We evaluated the efficacy, toxicity, and dose responses of re-irradiation with stereotactic body radiotherapy (SBRT) in patients with recurrent non- small cell lung cancer (NSCLC) after previous irradiation. 28 patients were included. Previous median radiation doses were 54 and 66 Gy. The median interval time between previous radiotherapy and SBRT was 14 months. The median follow-up time after SBRT was 9 months (range 3-93 months). To evaluate the effectiveness of SBRT, local control, overall survival, and treatment-related toxicity were reported. SBRT doses and fractionation ranged from 60 to 30 Gy and from 3 to 8, respectively, according to previous doses, location of the recurrence, and interval time. 65% of tumor recurrences overlapped with previous treatment, while 35% of tumors recurred outside of the previous treatment. 4 patients had local progression after SBRT at their first follow-up. The Kaplan-Meier estimates of the 1- and 2-year actuarial overall survival were 71 and 42%, respectively. The mean survival following SBRT was 32.8 months, and the median survival was 21 months. No grade 3 or higher toxicities were observed. Robotic SBRT is a tolerable treatment option with manageable toxicity which can be used with radical or palliative intent in carefully selected patients with locally recurrent tumors after previous irradiation. © 2017 S. Karger GmbH, Freiburg.

State-of-the-Art Treatment and Novel Agents in Chronic Lymphocytic Leukemia.

PubMed

Cramer, Paula; Hallek, Michael; Eichhorst, Barbara

2016-01-01

Chemoimmunotherapy is the established first-line treatment of patients with chronic lymphocytic leukemia (CLL) who do not display the high-risk genetic features del(17p) and/or TP53 mutation: Physically fit patients without or with only mild comorbidities should receive fludarabine, cyclophosphamide and rituximab, while bendamustine and rituximab can be considered in fit elderly patients of over 65 years and in patients with a higher risk of infections. Patients with relevant coexisting conditions should receive chlorambucil with a CD20 antibody, preferably obinutuzumab. Patients with a del(17p) and/or TP53 mutation respond poorly to conventional chemo(immuno)therapies. However, the recently approved BTK and PI3K inhibitors ibrutinib and idelalisib have the best efficacy ever documented in patients with these high-risk genomic alterations and/or refractory CLL. The choice between ibrutinib and idelalisib should be based on the patients' comorbidities and concomitant medications since both agents have a distinct toxicity profile, although they are generally well tolerated in the majority of patients. For treatment of patients with a late relapse, chemoimmunotherapy instead of kinase inhibitors is still a reasonable approach, but has to be determined for every patient individually. Further targeted drugs and their combinations are currently being evaluated in clinical trials and have the potential to eradicate all residual CLL cells and thus lead to a cure of CLL. © 2016 S. Karger GmbH, Freiburg.

The CUPCIG (CAM-Use in Primary Care in Germany) Study:Part I-Pain. Study Protocol of a Pilot-trial to Assess Feasibility, Acceptability and Perceived Effectiveness of CAM in Pain Disorders in Primary Care.

PubMed

Schencking, Martin; Sönnichsen, Andreas; Bassüner, Susanne; Redaelli, Marcus

2015-01-01

There is limited valid data available on CAM procedures for chronic joint and neuropathic pain in primary care in Germany. Indiviual CAM qualifications of the general practitioners (GPs) and the potential of cost reduction through CAM treatment are almost unknown. The aim of this pilot trial preceding the main study is to examine the survey mode, to estimate the response rate by GPs with or without an additional qualification for CAM, and to identify the status quo in therapeutic approaches for chronic pain disorders in primary care. This is a cross-sectional study with an ex post facto design among German GPs consisting of 2 parts: In a first step, a pilot trial precedes the main study targeting 200 GPs with and 200 GPs without additional qualification in CAM in a selected region. The results of the CUPCIG study comprise the distribution of pain types treated in primary care practices, the GPs' attitude toward complementary pain therapy, pharmacological or CAM treatment, the estimate of cost reduction through CAM treatment of pain, the application of diverse CAM procedures, and biographical data. The CUPCIG study serves to compile pain therapy approaches in primary care in Germany with respect to the individual CAM expertise of the GPs. © 2015 S. Karger GmbH, Freiburg.

Pretreatment Pokemon Level as a Predictor of Response to Cisplatin and Paclitaxel in Patients with Unresectable Non-Small Cell Lung Cancer.

PubMed

Zhang, Quan-Le; Xing, Xi-Zhi; Li, Feng-Yan; Xing, Ya-Juan; Li, Jing

2015-01-01

We firstly investigated the expression of Pokemon in patients with non-small cell lung cancer (NSCLC), then characterized the role of Pokemon in evaluating the response to combined cisplatin and paclitaxel chemotherapy and prognosis. In this study, 61 patients with previously untreated locally advanced or metastatic NSCLC were treated with a combination chemotherapy comprising cisplatin and paclitaxel. The correlation between serum expression of Pokemon and effectiveness of chemotherapy was assessed. The expression level of Pokemon in NSCLC patients was higher than that in healthy controls (p = 0.000), and was correlated with tumor size and TNM stage (p < 0.05). Kaplan-Meier analysis and Cox proportional hazard model demonstrated a poor response and shorter survival time in patients with pretreatment Pokemon levels in excess of 135.09 ng/ml compared to those with Pokemon levels below 135.09 ng/ml (p = 0.013). Pokemon ≥ 135.09 ng/ml was an independent risk factor for survival time in NSCLC patients undergoing combination chemotherapy (p = 0.018). The serum level of Pokemon correlated with efficacy of cisplatin and paclitaxel combination chemotherapy and survival time, which indicated that Pokemon may be a potentially useful biomarker for predicting treatment effectiveness of first-line chemotherapy and prognosis in NSCLC. © 2015 S. Karger GmbH, Freiburg.

[COPD und Klangtherapie: Pilotstudie zur Wirksamkeit einer Behandlung mit Körpertambura bei COPD-Patienten].

PubMed

Hartwig, Bernhard; Schmidt, Stefan; Hartwig, Isabella

2016-01-01

Hintergrund: Erkrankungen der Atemorgane treten mit steigendem Alter öfter auf, nehmen weltweit zu und sind häufige Ursachen für Morbidität und Mortalität. In dieser Pilotstudie wurde der Frage nachgegangen, ob eine einmalige 10-minütige Behandlung mit einer Körpertambura eine signifikante und effektive Verbesserung der Lungenfunktion von Patienten mit chronisch-obstruktiver Lungenerkrankung (COPD; GOLD-Stadium A oder B) erbringen kann. Patienten und Methoden: 54 Probanden konnten je zur Hälfte in eine Behandlungsgruppe (Körpertambura) und eine aktive Kontrollgruppe (Atemtherapie) randomisiert werden. Eine Bestimmung der Lungenfunktionsmessparameter «Einsekundenkapazität» (FEV1) und «inspiratorische Vitalkapazität» (IVC) zu den Zeitpunkten T1 (Baseline), T2 (direkt nach Behandlung) und als Follow-up etwa 3 Wochen nach T1 (T3). Ergebnisse: Die Behandlungsgruppe zeigte sich der Kontrollgruppe in beiden Werten signifikant überlegen. Die Zeit-×-Gruppe-Interaktion (Varianzanalyse) ergab p = 0,001 (FEV1) bzw. p = 0,04 (IVC). Die Behandlungsgruppe zeigte bei beiden Werten eine Verbesserung von klinischer Relevanz. Schlussfolgerung: Diese Ergebnisse zeigen, dass die Klangbehandlung mittels einer Körpertambura - neben den schulmedizinischen, leitliniengerechten Therapien - eine zusätzliche, nebenwirkungsarme, aber durchaus klinisch wirksame Option für die Behandlung von COPD-Patienten darstellen kann, um deren Lebensqualität zu stabilisieren und zu verbessern. © 2016 S. Karger GmbH, Freiburg.

Immune Checkpoint Inhibitors in the Treatment of Patients with Neuroendocrine Neoplasia.

PubMed

Weber, Matthias M; Fottner, Christian

2018-01-01

Well-differentiated neuroendocrine neoplasms (NENs) are usually controlled by antiproliferative, local ablative and/or radionuclide therapies, whereas poorly differentiated NENs generally require cytotoxic chemotherapy. However, treatment options for patients with advanced/metastatic high-grade NENs remain limited. Review of the literature and international congress abstracts on the efficacy and safety of immunotherapy by checkpoint inhibition in advanced/metastatic NENs. Evidence points to an important role of immune phenomena in the pathogenesis and treatment of neuroendocrine tumors (NETs). Programmed cell death 1 (PD-1) protein and its ligand are mainly expressed in poorly differentiated NENs. Microsatellite instability and high mutational load are more pronounced in high-grade NENs and may predict response to immunotherapy. Clinical experience of immune checkpoint blockade mainly exists for Merkel cell carcinoma, a high-grade cutaneous neuroendocrine carcinoma (NEC), which has led to approval of the anti-PD-1 antibody avelumab. In addition, there is anecdotal evidence for the efficacy of checkpoint inhibitors in large-cell lung NECs, ovarian NECs and others, including gastroenteropancreatic NENs. Currently, phase II studies investigate PDR001, pembrolizumab, combined durvalumab and tremelimumab, and avelumab treatment in patients with advanced/metastatic NENs. Immune checkpoint inhibitors are a promising therapeutic option, especially in progressive NECs or high-grade NETs with high tumor burden, microsatellite instability, and/or mutational load. © 2018 S. Karger GmbH, Freiburg.

Impact of Soy Foods on the Development of Breast Cancer and the Prognosis of Breast Cancer Patients.

PubMed

Messina, Mark

2016-01-01

The relationship between soy food intake and breast cancer has been rigorously investigated for more than 25 years. The identification of isoflavones as possible chemopreventive agents helped fuel this line of investigation. These diphenolic compounds, which are found in uniquely-rich amounts in soy beans, possess both estrogen-dependent and -independent properties that potentially inhibit the development of breast cancer. Observational studies show that among Asian women higher soy consumption is associated with an approximate 30% reduction in risk of developing breast cancer. However, evidence suggests that for soy to reduce breast cancer risk consumption must occur early in life, that is during childhood and/or adolescence. Despite the interest in the role of soy in reducing breast cancer risk concerns have arisen that soy foods, because they contain isoflavones, may increase the likelihood of high-risk women developing breast cancer and worsen the prognosis of breast cancer patients. However, extensive clinical and epidemiologic data show these concerns to be unfounded. Clinical trials consistently show that isoflavone intake does not adversely affect markers of breast cancer risk, including mammographic density and cell proliferation. Furthermore, prospective epidemiologic studies involving over 11,000 women from the USA and China show that postdiagnosis soy intake statistically significantly reduces recurrence and improves survival. © 2016 S. Karger GmbH, Freiburg.

Long-Term Weight Maintenance Strategies Are Experienced as a Burden by Persons Who Have Lost Weight Compared to Persons with a lifetime Normal, Stable Weight.

PubMed

Kruseman, Maaike; Schmutz, Noémi; Carrard, Isabelle

2017-01-01

To assess dietary intake, eating patterns, physical activity and eating behaviors, and to explore strategies and perceptions of the experience of weight maintenance in weight loss maintainers (weight loss maintenance (WLM) ≥ 10% weight loss maintained for ≥1 year) and in matched controls with a lifetime stable normal weight. Volunteers (32) were recruited by a snowball procedure in this cross-sectional, mixed-methods study. Diet, physical activity, and eating behaviors were assessed with validated questionnaires. Strategies and experiences were investigated during interviews. Descriptive coding, thematic analysis (qualitative data) as well as descriptive analysis and t-tests (quantitative data) were performed. Both groups had similar energy and macronutrient consumption. Those in the WLM group reported higher levels of exercise and scored higher on several dimensions of eating disorders. Four themes - 'food choices,' 'quantities and portion control,' 'physical activity', and 'burden' - emerged from the qualitative data. Both groups used similar weight maintenance strategies, but those in the WLM group experienced a higher burden, expressing effortful control which contrasted with the control group's confidence in their internal cues. Our results show an additional burden related with maintaining weight loss compared to keeping a stable normal weight. They provide evidence to devise interventions that will address the difficulty of regulating intake. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

A tale of Persian cupping therapy: 1001 potential applications and avenues for research.

PubMed

Bamfarahnak, Hossein; Azizi, Amir; Noorafshan, Ali; Mohagheghzadeh, Abdolali

2014-01-01

Cupping therapy (CT) is one of the oldest medical techniques available, and is still used in several cultures instead of or as an adjunct or complement to 'western academic' medicine. Moreover, CT (wet or dry) is claimed to have therapeutic effects in many types of disorders which do not fully respond to conventional medicine or for which no effective treatment is available. However, no recent reviews of the clinical practice of cupping are available to the best of our knowledge. We describe the applications of CT as used in Traditional Iranian Medicine (TIM). Several databases were searched for relevant literature. In addition, we studied the main traditional treatises on TIM regarding the history and practice of CT. Information about current practices was obtained from a systematic survey among practitioners. Our results suggest that CT is currently prescribed for up to 120 diseases and disorders that are difficult to treat, including cutaneous (21.7%), musculoskeletal (15%), and central nervous system (13.3%) disorders. Moreover, TIM treatises note 25 specific sites on the body surface which correspond to certain diseases, and on which wet-cupping therapy has therapeutic effects. Additional clinical studies of CT may lead to findings on new therapeutic methods and may shed light on mechanisms of disease and illness that are not fully understood in conventional medicine. © 2014 S. Karger GmbH, Freiburg.

Impact of Weight-Related Discrimination, Body Dissatisfaction and Self-Stigma on the Desire to Weigh Less.

PubMed

Jung, Franziska; Spahlholz, Jenny; Hilbert, Anja; Riedel-Heller, Steffi G; Luck-Sikorski, Claudia

2017-01-01

Currently, health care professionals plead for stabilization of weight and improving health conditions rather than focusing on weight loss only. Individuals with obesity have been shown to report weight loss goals that are much higher than what has been suggested by guidelines. The aim was to determine whether weight discrimination and body dissatisfaction have an impact on how much weight an individual with obesity wants to lose. In this representative telephone survey, 878 participants with obesity were asked about their experiences with weight stigma, their body image concerns, and about the amount of weight they would like to weigh using random digital dialing and Kish selection grid to ensure random selection of participants. Regression analysis reveals that being female, having a higher BMI, being younger, and trying to lose weight was related to a greater discrepancy between current weight and desired weight. The discrepancy between current weight and desired weight was greater when participants reported discrimination due to their weight as well as internalized stigma and body image concerns. Independent on the weight loss method, treating obesity should include realistic weight loss goals without being affected by social pressure or weight stigma, especially since stigma can result in further weight gain and decline health issues related to obesity and overweight. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Complementary medicine for cancer patients in general practice: qualitative interviews with german general practitioners.

PubMed

Dahlhaus, Anne; Siebenhofer, Andrea; Guethlin, Corina

2015-01-01

The aim of this study was to investigate how general practitioners react when their cancer patients show interest in complementary medicine, and how their reaction is related to their knowledge in the field. We conducted semi-structured interviews with 10 German general practitioners. Interviewees came from 5 different federal states and varied in terms of urban/rural setting, single/joint practice, additional certifications, gender and length of professional experience. Interviews were electronically recorded, transcribed and then analysed using qualitative content analysis according to Mayring. General practitioners feel largely responsible for providing information on complementary medicine to their cancer patients. However, uncertainty and a lack of knowledge concerning CAM lead mainly to reactive responses to patients' needs, and the general practitioners base their recommendations on personal experiences and attitudes. They wish to support their cancer patients and thus, in order to keep their patients' hopes up and maintain a trusting relationship, sometimes support complementary medicine, regardless of their own convictions. Although general practitioners see themselves as an important source of information on complementary medicine for their cancer patients, they also speak of their uncertainties and lack of knowledge. General practitioners would profit from training in complementary medicine enabling them to discuss this topic with their cancer patients in a proactive, open and honest manner. © 2015 S. Karger GmbH, Freiburg

[Clinical remission of an HLA B27-positive sacroiliitis on vegan diet].

PubMed

Huber, R; Herdrich, A; Rostock, M; Vogel, T

2001-08-01

Positive effects of fasting and vegan diet in patients with rheumatic diseases are reported in the literature. We present a 33-year-old patient with double-sided HLA B27-positive sacroiliitis, which was diagnosed by magnetic resonance tomography. Since about 10 years he therefore had pain in the iliosacral region. Numerous sessions of physiotherapy, a cure treatment, and treatment with sulfasalazine and doxycycline were not effective. The patient was dependent on the daily intake of the nonsteroidal antirheumatics meloxicam 2 x 7.5 mg and ibuprofen 400-800 mg and the analgetic tramadol 50-150 mg, but evening and night pain and morning stiffness persisted under this treatment. We recommended a temporary vegan diet, i.e. to completely avoid animal fats and proteins. 3-4 days after changing on vegan diet the complaints improved distinctly and persistently. After consumption of meat 6 weeks later, complaints worsened. Consequent vegan diet again resulted in significant improvement of the pain and morning stiffness. At follow-up 3 months after the initial contact, tramadol and ibuprofen intakes had been stopped, meloxicam had been reduced to 1 x 7.5 mg. The patient was almost completely free of complaints. It was demonstrated that in a single case of sacroiliitis which was refractory to other treatment, vegan diet resulted in a convincingly improvement of complaints. Copyright 2001 S. Karger GmbH, Freiburg

Fasting therapy for treating and preventing disease - current state of evidence.

PubMed

Michalsen, Andreas; Li, Chenying

2013-01-01

Periods of deliberate fasting with restriction of solid food intake are practiced worldwide, mostly based on traditional, cultural or religious reasons. There is large empirical and observational evidence that medically supervised modified fasting (fasting cure, 200-500 kcal nutritional intake per day) with periods of 7-21 days is efficacious in the treatment of rheumatic diseases, chronic pain syndromes, hypertension, and metabolic syndrome. The beneficial effects of fasting followed by vegetarian diet in rheumatoid arthritis are confirmed by randomized controlled trials. Further beneficial effects of fasting are supported by observational data and abundant evidence from experimental research which found caloric restriction and intermittent fasting being associated with deceleration or prevention of most chronic degenerative and chronic inflammatory diseases. Intermittent fasting may also be useful as an accompanying treatment during chemotherapy of cancer. A further beneficial effect of fasting relates to improvements in sustainable lifestyle modification and adoption of a healthy diet, possibly mediated by fasting-induced mood enhancement. Various identified mechanisms of fasting point to its potential health-promoting effects, e.g., fasting-induced neuroendocrine activation and hormetic stress response, increased production of neurotrophic factors, reduced mitochondrial oxidative stress, general decrease of signals associated with aging, and promotion of autophagy. Fasting therapy might contribute to the prevention and treatment of chronic diseases and should be further evaluated in controlled clinical trials and observational studies. © 2014 S. Karger GmbH, Freiburg.

[Effects of Monochord Music on Heart Rate Variability and Self-Reports of Relaxation in Healthy Adults].

PubMed

Gäbel, Christine; Garrido, Natalia; Koenig, Julian; Hillecke, Thomas Karl; Warth, Marco

Music-based interventions are considered an effective and low-cost treatment option for stress-related symptoms. The present study aimed to examine the trajectories of the psychophysiological response in apparently healthy participants during a music-based relaxation intervention compared to a verbal relaxation exercise. 70 participants were assigned to either receptive live music (experimental group) or a prerecorded verbal relaxation exercise (control group). Self-ratings of relaxation were assessed before and after each intervention on visual analogue scales and the Relaxation Inventory (RI). The heart rate variability (HRV) was continuously recorded throughout the sessions. Statistical analysis focused on HRV parameters indicative of parasympathetic cardiovascular outflow. We found significant quadratic main effects for time on the mean R-R interval (heart rate), the high-frequency power of HRV (indicative of parasympathetic activity), and the self-ratings of relaxation in both groups. A significant group × time interaction was observed for the cognitive tension subscale of the RI. Participants in both groups showed psychophysiological changes indicative of greater relaxation over the course of the interventions. However, differences between groups were only marginal. Music might be effective in relieving stress and promoting relaxation by altering the autonomic nervous system function. Future studies need to explore the long-term outcomes of such interventions. © 2017 S. Karger GmbH, Freiburg.

Weight Bias: A Systematic Review of Characteristics and Psychometric Properties of Self-Report Questionnaires.

PubMed

Lacroix, Emilie; Alberga, Angela; Russell-Mathew, Shelly; McLaren, Lindsay; von Ranson, Kristin

2017-01-01

People living with overweight and obesity often experience weight-based stigmatization. Investigations of the prevalence and correlates of weight bias and evaluation of weight bias reduction interventions depend upon psychometrically-sound measurement. Our paper is the first to comprehensively evaluate the psychometric properties, use of people-first language within items, and suitability for use with various populations of available self-report measures of weight bias. We searched five electronic databases to identify English-language self-report questionnaires of weight bias. We rated each questionnaire's psychometric properties based on initial validation reports and subsequent use, and examined item language. Our systematic review identified 40 original self-report questionnaires. Most questionnaires were brief, demonstrated adequate internal consistency, and tapped key cognitive and affective dimensions of weight bias such as stereotypes and blaming. Current psychometric evidence is incomplete for many questionnaires, particularly with regard to the properties of test-retest reliability, sensitivity to change as well as discriminant and structural validity. Most questionnaires were developed prior to debate surrounding terminology preferences, and do not employ people-first language in the items administered to participants. We provide information and recommendations for clinicians and researchers in selecting psychometrically sound measures of weight bias for various purposes and populations, and discuss future directions to improve measurement of this construct. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Mind the gap! Lay and medical perceptions of risks associated with the use of alternative treatment and conventional medicine.

PubMed

Salamonsen, Anita

2015-01-01

Studies on the widespread use of complementary and alternative medicine (CAM) demonstrate that CAM users base their treatment decisions on both subjective, experience-based knowledge and medical knowledge. The aim of this study was to explore lay and medical risk perceptions associated with CAM and conventional medicine. In this explorative qualitative study, we conducted in-depth interviews with 25 Norwegian CAM users with cancer or multiple sclerosis and 12 doctors. The interviews revealed fundamental differences in risk perceptions influencing treatment decisions and risk communication in a clinical setting. While CAM users considered conventional medicine as potentially risky and related this to experiences of severe adverse effects, CAM was perceived as natural and safe. Doctors' risk perceptions were quite the contrary, mainly because of lack of scientific evidence for CAM as a safe and beneficial treatment option. For the safety of CAM users, such divergent risk perceptions may have far-reaching consequences. CAM users should be taken seriously with their self-perception as decision-makers considering their approaches to experiences, knowledge, and science. An awareness of differing lay and medical risk perceptions associated with CAM and conventional medicine in research, doctor-patient communication, and education of patients and doctors is thus important to optimize patient safety in complex health care systems. © 2015 S. Karger GmbH, Freiburg.

Stress-relieving effects of short-term balneotherapy - a randomized controlled pilot study in healthy adults.

PubMed

Matzer, Franziska; Nagele, Eva; Bahadori, Babak; Dam, Karl; Fazekas, Christian

2014-01-01

Stress-relieving effects of balneotherapy compared to progressive muscle relaxation (PMR) and to resting were investigated by measuring subjective relaxation and salivary cortisol. It was also examined whether participants with a high versus low stress level would have a different relaxation response. A sample of healthy volunteers was randomized to balneotherapy, PMR, or a resting control group, each intervention lasting for 25 min. Pre- and post-intervention salivary cortisol samples were collected, and participants rated their status of relaxation on a quantitative scale. In addition, 3 questionnaires were applied to detect participants' stress level and bodily complaints. 49 healthy participants were recruited (65.3% female). In a pre-post comparison, salivary cortisol decreased (F = 23.53, p < 0.001) and subjective relaxation ratings increased (F = 132.18, p < 0.001) in all 3 groups. Study participants in the balneotherapy group rated themselves as more relaxed after the intervention as compared to the other groups (F = 5.22, p < 0.009). Participants with a high versus low stress level differed in somatic symptoms and in morning cortisol levels, but showed a similar relaxation response. Findings suggest that compared to PMR and resting, balneotherapy seems to be more beneficial with regard to subjective relaxation effects and similarly beneficial with regard to a decrease in salivary cortisol. © 2014 S. Karger GmbH, Freiburg.

Association between Body Composition and Motor Performance in Preschool Children.

PubMed

Kakebeeke, Tanja H; Lanzi, Stefano; Zysset, Annina E; Arhab, Amar; Messerli-Bürgy, Nadine; Stuelb, Kerstin; Leeger-Aschmann, Claudia S; Schmutz, Einat A; Meyer, Andrea H; Kriemler, Susi; Munsch, Simone; Jenni, Oskar G; Puder, Jardena J

2017-01-01

Being overweight makes physical movement more difficult. Our aim was to investigate the association between body composition and motor performance in preschool children. A total of 476 predominantly normal-weight preschool children (age 3.9 ± 0.7 years; m/f: 251/225; BMI 16.0 ± 1.4 kg/m2) participated in the Swiss Preschoolers' Health Study (SPLASHY). Body composition assessments included skinfold thickness, waist circumference (WC), and BMI. The Zurich Neuromotor Assessment (ZNA) was used to assess gross and fine motor tasks. After adjustment for age, sex, socioeconomic status, sociocultural characteristics, and physical activity (assessed with accelerometers), skinfold thickness and WC were both inversely correlated with jumping sideward (gross motor task β-coefficient -1.92, p = 0.027; and -3.34, p = 0.014, respectively), while BMI was positively correlated with running performance (gross motor task β-coefficient 9.12, p = 0.001). No significant associations were found between body composition measures and fine motor tasks. The inverse associations between skinfold thickness or WC and jumping sideward indicates that children with high fat mass may be less proficient in certain gross motor tasks. The positive association between BMI and running suggests that BMI might be an indicator of fat-free (i.e., muscle) mass in predominately normal-weight preschool children. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling.

PubMed

Lucchese, Marcello; Borisenko, Oleg; Mantovani, Lorenzo Giovanni; Cortesi, Paolo Angelo; Cesana, Giancarlo; Adam, Daniel; Burdukova, Elisabeth; Lukyanov, Vasily; Di Lorenzo, Nicola

2017-01-01

To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Insulin sensitivity deteriorates after short-term lifestyle intervention in the insulin sensitive phenotype of obesity.

PubMed

Gilardini, Luisa; Vallone, Luciana; Cottafava, Raffaella; Redaelli, Gabriella; Croci, Marina; Conti, Antonio; Pasqualinotto, Lucia; Invitti, Cecilia

2012-01-01

To investigate the effects of a 3-month lifestyle intervention on insulin sensitivity and its related cardiometabolic factors in obese patients. Anthropometry, body composition, oral glucose tolerance test, lipids, alanine aminotransferase, insulin sensitivity (insulinogenic index (ISI), homeostasis model assessment, β-cell performance (disposition index)) were evaluated in 263 obese women and 93 obese men before and after 3 months of hypocaloric low fat/high protein diet associated with physical activity 30 min/day. Patients were divided into 3 groups according to the intervention-induced ISI changes: group 1 (decrease), group 2 (stability) and group 3 (increase). Insulin sensitivity and the disposition index were significantly higher before the intervention in group 1 than in group 3. BMI, waist circumference, and fat mass significantly decreased in groups 1 and 3 in both sexes. β-cell performance decreased in group 1 and increased in group 3. Metabolic variables improved in group 3, whereas glucose levels increased in women of group 1. The post-intervention insulin sensitivity was lower in group 1 than in group 3. Lifestyle intervention induces changes in insulin sensitivity and metabolic factors that depend on the pre-intervention degree of insulin sensitivity. Weight loss leads to metabolic benefits in insulin-resistant, obese patients, whereas it may paradoxically worsen the metabolic conditions in the insulin-sensitive phenotype of obesity. Copyright © 2012 S. Karger GmbH, Freiburg.

Prevalence of 'Food Addiction' as Measured with the Yale Food Addiction Scale 2.0 in a Representative German Sample and Its Association with Sex, Age and Weight Categories.

PubMed

Hauck, Carolin; Weiß, Annegret; Schulte, Erica Marla; Meule, Adrian; Ellrott, Thomas

2017-01-01

To assess the prevalence and correlates of addictive-like eating behavior in Germany. The German version of the Yale Food Addiction Scale (YFAS) 2.0 was used to investigate, for the first time, the prevalence of 'food addiction' in a representative sample aged 18-65 years (N = 1,034). The prevalence of 'food addiction' measured by the YFAS 2.0 was 7.9%. Individuals meeting criteria for 'food addiction' had higher BMI and were younger than individuals not meeting the threshold. Underweight (15.0%) and obese (17.2%) individuals exhibited the highest prevalence rate of 'food addiction'. Addictive-like eating was not associated with sex, education level, or place of residence. YFAS 2.0 'food addiction' was met by nearly 8% of the population. There is a non-linear relationship between addictive-like eating and BMI, with the highest prevalence among underweight and obese persons. These findings suggest that 'food addiction' may be a contributor to overeating but may also reflect a distinct phenotype of problematic eating behavior not synonymous with obesity. Further, the elevated prevalence of YFAS 2.0 'food addiction' among underweight individuals may reflect an overlap with eating disorders and warrants attention in future research. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Association between Childhood Obesity and Neighbourhood Accessibility to Fast-Food Outlets: A Nationwide 6-Year Follow-Up Study of 944,487 Children.

PubMed

Hamano, Tsuyoshi; Li, Xinjun; Sundquist, Jan; Sundquist, Kristina

2017-01-01

The aim of this 6-year follow-up study was to examine whether neighbourhood accessibility to fast-food outlets was associated with diagnosed childhood obesity, after adjustment for neighbourhood- and individual-level socio-demographic factors. This 6-year follow-up study comprised 484,677 boys and 459,810 girls aged 0-14 years in Sweden. The follow-up period ran from January 1, 2005, until hospitalisation/out-patient treatment for obesity, death, emigration or the end of the study period on December 31, 2010. Multilevel logistic regression models (individual-level factors at the first level and neighbourhood-level factors at the second level) were used to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs). We identified 6,968 obesity cases (3,878 boys and 3,090 girls) during the follow-up period. Higher odds of childhood obesity for those living in neighbourhoods with accessibility to fast-food outlets was observed (OR = 1.14, 95% CI = 1.07-1.22) that remained significant after adjustments (OR = 1.06, 95% CI = 1.00-1.13). This prospective nationwide study showed that the neighbourhood accessibility to fast-food outlets was independently associated with increased odds of diagnosed childhood obesity. This finding implicates that residential environments should be considered when developing health promotion programmes. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function.

PubMed

Goossens, Gijs H

2017-01-01

The current obesity epidemic poses a major public health issue since obesity predisposes towards several chronic diseases. BMI and total adiposity are positively correlated with cardiometabolic disease risk at the population level. However, body fat distribution and an impaired adipose tissue function, rather than total fat mass, better predict insulin resistance and related complications at the individual level. Adipose tissue dysfunction is determined by an impaired adipose tissue expandability, adipocyte hypertrophy, altered lipid metabolism, and local inflammation. Recent human studies suggest that adipose tissue oxygenation may be a key factor herein. A subgroup of obese individuals - the 'metabolically healthy obese' (MHO) - have a better adipose tissue function, less ectopic fat storage, and are more insulin sensitive than obese metabolically unhealthy persons, emphasizing the central role of adipose tissue function in metabolic health. However, controversy has surrounded the idea that metabolically healthy obesity may be considered really healthy since MHO individuals are at increased (cardio)metabolic disease risk and may have a lower quality of life than normal weight subjects due to other comorbidities. Detailed metabolic phenotyping of obese persons will be invaluable in understanding the pathophysiology of metabolic disturbances, and is needed to identify high-risk individuals or subgroups, thereby paving the way for optimization of prevention and treatment strategies to combat cardiometabolic diseases. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

The key role of psychosocial risk on therapeutic outcome in obese children and adolescents. Results from a longitudinal multicenter study.

PubMed

Röbl, Markus; de Souza, Martin; Schiel, Ralf; Gellhaus, Ines; Zwiauer, Karl; Holl, Reinhard W; Wiegand, Susanna

2013-01-01

Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software for longitudinal multicenter documentation. 12,305 (19.8%) attended care for 6-24 months, undergoing an intensive therapy period and subsequent follow-ups for up to 3 years. A cumulative social risk score was calculated based on different risk indicators. Migration background, low education, and parental employment significantly influenced the outcome of lifestyle intervention. The observed BMI-SDS reduction was significantly higher in the subgroup with low social risks factors (Δ BMI-SDS -0.19) compared to those presenting moderate (Δ BMI-SDS -0.14) and high social risk (Δ BMI-SDS -0.11). Our data underline the effect of children's social setting on the outcome of multidimensional lifestyle intervention. The presence of a high social risk burden is a negative predictor for successful weight loss. Specific therapeutic programs need to be developed for disadvantaged children and adolescents. Copyright © 2013 S. Karger GmbH, Freiburg

Beneficial Effects of a Dietary Weight Loss Intervention on Human Gut Microbiome Diversity and Metabolism Are Not Sustained during Weight Maintenance.

PubMed

Heinsen, Femke-Anouska; Fangmann, Daniela; Müller, Nike; Schulte, Dominik M; Rühlemann, Malte C; Türk, Kathrin; Settgast, Ute; Lieb, Wolfgang; Baines, John F; Schreiber, Stefan; Franke, Andre; Laudes, Matthias

2016-01-01

In the present study, we examined the effect of a very low-calorie diet(VLCD)-based obesity program on human gut microbiome diversity and metabolism during weight loss and weight maintenance. Obese subjects underwent 3 months of VLCD followed by 3 months of weight maintenance. A lean and an obese control group were included. The microbiome was characterized by performing high-throughput dual-indexed 16S rDNA amplicon sequencing. At baseline, a significant difference in the Firmicutes/Bacteroidetes ratio between the lean and obese individuals was observed (p = 0.047). The VLCD resulted in significant alterations in gut microbiome diversity from baseline to 3 months (p = 0.0053). Acinetobacter represented an indicator species for the observed effect (indicator value = 0.998, p = 0.006). Metabolic analyses revealed alterations of the bacterial riboflavin pathway from baseline to 3 months (pnom = 0.0078). These changes in diversity and bacterial metabolism induced by VLCD diminished during the weight maintenance phase, despite sustained reductions in body weight and sustained improvements of insulin sensitivity. The present data show that a VLCD is able to beneficially alter both gut microbiome diversity and metabolism in obese humans, but that these changes are not sustained during weight maintenance. This finding might suggest that the microbiome should be targeted during obesity programs. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Prevention and treatment of chemotherapy-induced neutropenia with the biosimilar filgrastim: a non-interventional observational study of clinical practice patterns.

PubMed

Tesch, Hans; Ulshöfer, Thomas; Vehling-Kaiser, Ursula; Ottillinger, Bertram; Bulenda, Dietmar; Turner, Matthew

2015-01-01

Biosimilars are similar but non-identical versions of existing biological drugs. The HEXAFIL study was an observational study that assessed the clinical usage, safety and efficacy of the biosimilar filgrastim in routine clinical practice in Germany. A total of 1,337 cancer patients received the biosimilar filgrastim for primary prophylaxis (PP), secondary prophylaxis (SP) or interventional treatment (TX) plus chemotherapy. Data including neutropenic complications and adverse events (AEs) were documented for up to 3 consecutive cycles. In cycle 1, 44.9% of the patients received the biosimilar filgrastim as PP, 31.0% as SP, and 23.6% as TX. Approximately 90% of the patients required no modifications to their chemotherapy regimen, with lower rates among the PP/SP versus the TX patients. Neutropenic complications occurred in 7.9%, 6.9%, and 3.9% of the patients (cycles 1, 2, and 3, respectively). Only 1.8% of the patients experienced febrile neutropenia during cycle 1. Earlier and longer filgrastim treatment reduced grade 3/4 leukopenia and neutropenic complications. The observed safety/tolerability profile was as expected; the most common AE (4.3%) was musculoskeletal back/bone pain. In this observational real-life study of clinical practice, the biosimilar filgrastim was effective and well tolerated, with results consistent with those reported in phase II and phase III trials. © 2015 S. Karger GmbH, Freiburg.

Obesity-related adipokines predict patient-reported shoulder pain.

PubMed

Gandhi, Rajiv; Perruccio, Anthony V; Rizek, Randy; Dessouki, Omar; Evans, Heather M K; Mahomed, Nizar N

2013-01-01

Increasingly, an inflammatory modulating effect of adipokines within synovial joints is being recognized. To date, there has been no work examining a potential association between the presence of adipokines in the shoulder and patient-reported outcomes. This study undertakes an investigation assessing these potential links. 50 osteoarthritis patients scheduled for shoulder surgery completed a pre-surgery questionnaire capturing demographic information including validated, patient-reported function (Disabilities of the Arm, Shoulder, and Hand questionnaire) and pain (Short Form McGill Pain Questionnaire) measures. Synovial fluid (SF) samples were analyzed for leptin, adiponectin, and resistin levels using Milliplex MAP assays. Linear regression modeling was used to assess the association between adipokine levels and patient-reported outcomes, adjusted for age, sex, BMI, and disease severity. 54% of the cohort was female (n = 27). The mean age (SD) of the sample was 62.9 (9.9) years and the mean BMI (SD) was 28.1 (5.4) kg/m(2). From regression analyses, greater SF leptin and adiponectin levels, but not regarding resistin, were found to be associated with greater pain (p < 0.05). Adipokine levels were not associated with functional outcome scores. The identified association between shoulder-derived SF leptin and adiponectin and shoulder pain is likely explained by the pro-inflammatory characteristics of the adipokines and represents potentially important therapeutic targets. © 2013 S. Karger GmbH, Freiburg.

Predictors of BMI Vary along the BMI Range of German Adults - Results of the German National Nutrition Survey II.

PubMed

Moon, Kilson; Krems, Carolin; Heuer, Thorsten; Roth, Alexander; Hoffmann, Ingrid

2017-01-01

The objective of the study was to identify predictors of BMI in German adults by considering the BMI distribution and to determine whether the association between BMI and its predictors varies along the BMI distribution. The sample included 9,214 adults aged 18-80 years from the German National Nutrition Survey II (NVS II). Quantile regression analyses were conducted to examine the association between BMI and the following predictors: age, sports activities, socio-economic status (SES), healthy eating index-NVS II (HEI-NVS II), dietary knowledge, sleeping duration and energy intake as well as status of smoking, partner relationship and self-reported health. Age, SES, self-reported health status, sports activities and energy intake were the strongest predictors of BMI. The important outcome of this study is that the association between BMI and its predictors varies along the BMI distribution. Especially, energy intake, health status and SES were marginally associated with BMI in normal-weight subjects; this relationships became stronger in the range of overweight, and were strongest in the range of obesity. Predictors of BMI and the strength of these associations vary across the BMI distribution in German adults. Consequently, to identify predictors of BMI, the entire BMI distribution should be considered. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

[Vegetarische und vegane Ernährung bei Kindern - Stand der Forschung und Forschungsbedarf].

PubMed

Keller, Markus; Müller, Stine

2016-01-01

Die Praxis vegetarischer Ernährungsformen ist in Deutschland im letzten Jahrzehnt deutlich angestiegen. Allerdings ist der Anteil vegetarischer und veganer Kinder dabei unbekannt. Studien mit Erwachsenen zeigen das präventive Potenzial, aber auch potenzielle Schwachstellen pflanzenbasierter Kostformen. Die Vorteile und Risiken einer vegetarischen bzw. veganen Ernährung im Kindesalter wurden bisher jedoch relativ selten untersucht. Außerdem lassen das unterschiedliche Alter der Kinder, das heterogene Studiendesign sowie die teilweise geringe Probandenzahl der Studien keine verbindlichen Aussagen zu. In dieser Übersichtsarbeit werden die Ergebnisse der wenigen Studien zu vegetarisch und vegan ernährten Kindern (< 12 Jahren) in Nordamerika und Europa zusammengefasst. Demnach lag die Zufuhr von Nahrungsenergie und Makronährstoffen vegetarischer und veganer Kinder meist näher an den Empfehlungen der Fachgesellschaften als die Ernährung gleichaltriger Mischkostkinder. Ebenso wiesen vegetarisch und vegan ernährte Kinder eine höhere Zufuhr von und bessere Versorgung mit verschiedenen Vitaminen und Mineralstoffen auf. Häufiger zeigten sich jedoch Defizite bei Vitamin B12, Zink, Kalzium, Eisen und Vitamin D. Das Wachstum und die Entwicklung vegetarisch und vegan ernährter Kinder entsprachen weitgehend den Referenzstandards, wobei sie dazu tendierten, leichter, schlanker und (< 5 Jahren) auch kleiner zu sein. Aufgrund der unzureichenden Studienlage besteht erheblicher Forschungsbedarf zu den Auswirkungen einer vegetarischen und veganen Ernährung im Kindesalter. © 2016 S. Karger GmbH, Freiburg.

Sociocultural Influence on Obesity and Lifestyle in Children: A Study of Daily Activities, Leisure Time Behavior, Motor Skills, and Weight Status.

PubMed

Hilpert, Martin; Brockmeier, Konrad; Dordel, Sigrid; Koch, Benjamin; Weiß, Verena; Ferrari, Nina; Tokarski, Walter; Graf, Christine

2017-01-01

Juvenile overweight is increasing, and effective preventive measures are needed. After years of arbitrarily assigning these measures disregarding socioeconomic and/or cultural differences, it has become necessary to tailor interventions more specific to these target groups. Providing data for such an intervention is the objective of this study. Influencing variables on children's weight status, motor skills and lifestyle have been analyzed among 997 first graders (53.2% male) involved in the Children's Health InterventionaL Trial (CHILT). Median age was 6.9 years; 7.3% were obese, 8.8% were overweight. Children with low socioeconomic status (SES) were more likely to be obese (p = 0.029). Low SES (p ˂ 0.001), migration background (p = 0.001) and low sports activity levels (p = 0.007) contributed most to an increased consumption of television. Migration background (p = 0.003) and male gender (p < 0.001) were the strongest factors in predicting a greater consumption of computer/video games. Children with higher SES (p = 0.02), lower BMI (p = 0.035), and males (p = 0.001) performed better in motor tests. Children with a low SES and migration background were more likely to exhibit unfavorable health behavior patterns, higher BMI scores, and poorer motor skills. Interventions should integrate motivational and targeting strategies and consider cultural and educational differences to address these vulnerable groups. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Role of the VDR Bsm I and Apa I polymorphisms in the risk of colorectal cancer in Kashmir.

PubMed

Rasool, Sabha; Kadla, Showkat A; Rasool, Vamiq; Qazi, Falak; Khan, Tanzeela; Shah, Nisar A; Ganai, Bashir A

2014-01-01

A case-control study aiming to evaluate the relationship between Bsm I and Apa I restriction fragment gene polymorphisms and colorectal cancer (CRC) was carried out in Kashmir, including a total of 368 subjects (180 cases and 188 controls). DNA samples extracted from the blood of the subjects were analyzed for 3' untranslated region (3' UTR) Apa I and Bsm I polymorphisms using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). A statistically significant 2.7-fold increased risk was observed in individuals found homozygous for the presence of the 'b' allele, in comparison to subjects homozygous for the 'B' allele (odds ratio (OR) 2.7, 95% confidence interval (CI) 1.49-4.86 (Bsm I)), and a statistically insignificant 2-fold increased risk was found among individuals with the 'aa' genotype, as compared to subjects with the 'AA' genotype (OR 2.017, 95% CI 0.86-4.7). Our study also yielded statistically significant results when the Apa I polymorphism was stratified by age (≤ 50 years) and dwelling area (rural area), and the Bsm I polymorphism by gender (male gender), suggesting a possible role of Apa I and Bsm I polymorphisms in the etiology of CRC in Kashmir. We conclude that Apa I and Bsm I single-nucleotide polymorphisms (SNPs) in the vitamin D receptor gene (VDR) might be associated with susceptibility to CRC among Kashmiris. © 2014 S. Karger GmbH, Freiburg.

CONIFER - Non-Interventional Study to Evaluate Therapy Monitoring During Deferasirox Treatment of Iron Toxicity in Myelodysplastic Syndrome Patients with Transfusional Iron Overload.

PubMed

Bruch, Harald-Robert; Dencausse, Yves; Heßling, Jörg; Michl, Gerlinde; Schlag, Rudolf; Skorupa, Alexandra; Schneider-Schranz, Cornelia; Wolf, Sebastian; Schulte, Clemens; Tesch, Hans

2016-01-01

The non-interventional study CONIFER was designed to assess the safety and clinical practicability of deferasirox for the treatment of transfusional iron overload in myelodysplastic syndrome (MDS) patients. Patients included in the study were diagnosed with MDS and received at least 1 treatment with deferasirox. The observation period covered the time from the initial visit until the last follow-up. The data of 99 patients with MDS scored mainly as International Prognostic Scoring System (IPSS) low and intermediate 1 were evaluated. The mean age of the participants was 75 years and 58% of the patients were male. Iron overload was assessed by serum ferritin level (mean baseline serum ferritin 2,080 ± 1,244 µg/l). Patients were treated for a mean duration of 16 months (mean daily dose at baseline 11.8 ± 7.0 mg/kg). Stratification of serum ferritin levels by deferasirox dose showed a reduction at the higher but no reduction at the lower dose (< 15 mg/kg vs. ≥ 15 mg/kg and < 20 mg/kg vs. ≥ 20 mg/kg). The majority of patients (81%) were affected by at least 1 adverse event, with decreased renal creatinine clearance being the most frequent. Higher doses (≥ 15 mg/kg) of deferasirox effectively and safely reduced serum ferritin levels in MDS patients with transfusional iron overload. © 2016 S. Karger GmbH, Freiburg.

[Homöopathisch-phytotherapeutische Behandlung des Reizdarmsyndroms mit Magen-Darm-Entoxin N®: Eine Anwendungsbeobachtung].

PubMed

Märtens, Diane; Range, Natasha; Günnewich, Nils; Gruber, Nicola; Schmidt, Stefan

Hintergrund: In dieser Anwendungsbeobachtung wird zum ersten Mal die Behandlung des Reizdarmsyndroms (RDS) mit einem homöopathisch-phytotherapeutischen Komplexpräparat beschrieben. Methodik: Ziel der 6-wöchigen Therapie mit dem Magen-Darm-Entoxin N® war die Reduzierung der RDS-Symptomatik sowie die Verbesserung der Lebensqualität. Zielkriterien waren die Veränderungen in der Irritable Bowel Syndrome - Severity Scoring System (IBS-SSS) und der Irritable Bowel Syndrome - Quality-of-Life Scale (IBS-QoL). Die Patient/innen (N = 41; Alter 44,0 ± 15,74 Jahre) wurden zu gleichen Teilen in einer Hausarztpraxis (N = 20) und einer Heilpraktikerpraxis (N = 21) rekrutiert. Ergebnisse: Der IBS-QoL-Score verringerte sich signifikant (prä: 35,9 ± 16,3; post: 20,1 ± 13,4; t = 8,504; p < 0,001). Die Effektstärke betrug 1,34 (Cohens d). Der IBS-SSS-Score verringerte sich ebenfalls signifikant (prä: 239,4 ± 83,4; post: 123,7 ± 80,9; t = 7,825; p < 0,001) mit einer Effektstärke von d = 1,24. Die Neben- und Wechselwirkungen waren minimal und signifikante Unterschiede zwischen beiden Praxen wurden nicht gefunden. Schlussfolgerungen: Magen-Darm-Entoxin N® ist eine sichere und sinnvolle Therapieoption bei der Behandlung des RDS. Allerdings sollten randomisierte kontrollierte Studien folgen, um die Spezifizität der Ergebnisse dieser Anwendungsbeobachtung zu stützen. © 2017 S. Karger GmbH, Freiburg.

Distress in cancer patients and their caregivers and association with the caregivers' perception of dyadic communication.

PubMed

Haun, Markus W; Sklenarova, Halina; Brechtel, Anette; Herzog, Wolfgang; Hartmann, Mechthild

2014-01-01

Discrepancies within cancer-affected couples can disrupt security within the dyadic relationship during cancer treatment. This study investigated the patients' and caregivers' distress and associations between the caregivers' perception of the patients' degree of open communication and their distress. In a cross-sectional survey, 189 pairs of cancer patients (31% gastrointestinal, 34% lung, 35% urological cancers) and their partners were assessed for distress (QSC-R10), depression and anxiety (PHQ-2/GAD-2). The caregivers also reported their perception of the patients' degree of disclosure regarding cancer-relevant topics (CCAT-F Disclosure subscale), caregiver strain (CSI), and unmet needs (SCNS-P&C). Prevalences of clinically significant distress were calculated. Associations were calculated between the caregivers' and the patients' ratings and between the caregivers' distress and their perception of the patients' degree of disclosure. 33% of the caregivers and 25% of the patients exhibited significant anxiety, with a tendency towards a higher frequency in the caregivers (p = 0.10). The prevalence of depression was lower but equally high in caregivers and patients. The caregivers' perceived non-disclosure by the patients was primarily associated with their anxiety (r = 0.31), disease-specific distress (r = 0.32), and psychological/emotional needs (r = 0.35). The identification of caregivers reporting problems in communicating with patients should be pursued in clinical practice as this might indicate that caregivers are particularly burdened. © 2014 S. Karger GmbH, Freiburg.

Improving Peripheral and Central Vascular Adjustments during Exercise through a Training Program in Adolescents with Obesity.

PubMed

Julian, Valérie; Thivel, David; Pereira, Bruno; Costes, Frédéric; Richard, Ruddy; Duclos, Martine

2016-01-01

The effects of a training program (TP) on muscle microvascularization during exercise remained to be explored in adolescents with obesity. We hypothesized that a TP would lead to better microvascular adaptations to exercise in skeletal muscle. 15 inactive adolescents followed a 12-week TP where both peripheral (muscular microvascularization) and central (cardiac) adaptations to exercise (40 min exercise set at 70% V̇O2peak) were assessed before and after intervention. Microvascular adaptations were evaluated in the Musculus vastus lateralis with near-infrared spectroscopy, by measurement of muscular blood volume (IR-BV) and tissue oxygen saturation (IR-SO2). Central adaptations were evaluated using thoracic impedance. The TP favored lower BMI (p < 0.001), lower total and abdominal fat (p < 0.001), and a trend for the decrease in insulin resistance index (p = 0.07). V̇O2peak relative to weight (p = 0.008) and maximum power output increased (p = 0.0003). A smaller initial drop in IR-BV and IR-SO2 (p < 0.001), a prompter return of these parameters to their base values, and a higher IR-BV and IR-SO2 all times taken together (p < 0.001) were observed after completing the TP. Concerning central adaptation, cardiac output decreased (p < 0.001). We demonstrate for the first time by noninvasive techniques that a training program induces peripheral and central vascular adaptations to exercise in adolescents with obesity. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Feasibility, Validity, and Reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale for Adults in Inpatients with Severe Obesity.

PubMed

Manzoni, Gian Mauro; Rossi, Alessandro; Marazzi, Nicoletta; Agosti, Fiorenza; De Col, Alessandra; Pietrabissa, Giada; Castelnuovo, Gianluca; Molinari, Enrico; Sartorio, Allessandro

2018-01-01

This study was aimed to examine the feasibility, validity, and reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL™ MFS) for adult inpatients with severe obesity. 200 inpatients (81% females) with severe obesity (BMI ≥ 35 kg/m2) completed the PedsQL MFS (General Fatigue, Sleep/Rest Fatigue and Cognitive Fatigue domains), the Fatigue Severity Scale, and the Center for Epidemiologic Studies Depression Scale immediately after admission to a 3-week residential body weight reduction program. A randomized subsample of 48 patients re-completed the PedsQL MFS after 3 days. Confirmatory factor analysis showed that a modified hierarchical model with two items moved from the Sleep/Rest Fatigue domain to the General Fatigue domain and a second-order latent factor best fitted the data. Internal consistency and test-retest reliabilities were acceptable to high in all scales, and small to high statistically significant correlations were found with all convergent measures, with the exception of BMI. Significant floor effects were found in two scales (Cognitive Fatigue and Sleep/Rest Fatigue). The Italian modified PedsQL MFS for adults showed to be a valid and reliable tool for the assessment of fatigue in inpatients with severe obesity. Future studies should assess its discriminant validity as well as its responsiveness to weight reduction. © 2018 The Author(s) Published by S. Karger GmbH, Freiburg.

Entanglement model of homeopathy as an example of generalized entanglement predicted by weak quantum theory.

PubMed

Walach, H

2003-08-01

Homeopathy is scientifically banned, both for lack of consistent empirical findings, but more so for lack of a sound theoretical model to explain its purported effects. This paper makes an attempt to introduce an explanatory idea based on a generalized version of quantum mechanics (QM), the weak quantum theory (WQT). WQT uses the algebraic formalism of QM proper, but drops some restrictions and definitions typical for QM. This results in a general axiomatic framework similar to QM, but more generalized and applicable to all possible systems. Most notably, WQT predicts entanglement, which in QM is known as Einstein-Podolsky-Rosen (EPR) correlatedness within quantum systems. According to WQT, this entanglement is not only tied to quantum systems, but is to be expected whenever a global and a local variable describing a system are complementary. This idea is used here to reconstruct homeopathy as an exemplification of generalized entanglement as predicted by WQT. It transpires that homeopathy uses two instances of generalized entanglement: one between the remedy and the original substance (potentiation principle) and one between the individual symptoms of a patient and the general symptoms of a remedy picture (similarity principle). By bringing these two elements together, double entanglement ensues, which is reminiscent of cryptographic and teleportation applications of entanglement in QM proper. Homeopathy could be a macroscopic analogue to quantum teleportation. This model is exemplified and some predictions are derived, which make it possible to test the model. Copyright 2003 S. Karger GmbH, Freiburg

Association of peripheral total and differential leukocyte counts with obesity-related complications in young adults.

PubMed

Yoshimura, Aya; Ohnishi, Shunsuke; Orito, Chieko; Kawahara, Yukako; Takasaki, Hiroyo; Takeda, Hiroshi; Sakamoto, Naoya; Hashino, Satoshi

2015-01-01

Obesity has been demonstrated to be associated with elevated leukocytes in adults and children. This study assessed the associations between peripheral total and differential leukocyte counts and obesity-related complications in young adults. 12 obese (median age 21.5 (range 19-28) years, median BMI 35.7 (range 32.0-44.9) kg/m(2)) and 11 normal (median age 23 (range 18-27) years, median BMI 19.5 (range 18.1-21.7) kg/m(2)) adults were enrolled. Complete blood count and serum levels of liver enzymes, fasting blood glucose, insulin and lipids were measured, and the homeostasis model assessment of insulin resistance was calculated. Fat mass was calculated using a bioimpedance analysis device, and ultrasonography was performed to measure fat thickness and to detect fatty change of the liver. Total leukocyte and monocyte counts were significantly increased in obese young adults. Total leukocyte count was associated with liver enzyme levels, insulin resistance as well as visceral and subcutaneous fat thickness. Neutrophil count was associated with insulin resistance. Lymphocyte count was associated with serum liver enzymes, insulin resistance, and dyslipidemia. Monocyte count was associated with serum liver enzyme, insulin resistance, visceral and subcutaneous fat thickness, body fat mass, and percentage body fat. The results of this study suggest that chronic low-grade systemic inflammation is associated with obesity-related complications such as nonalcoholic fatty liver disease, insulin resistance, and dyslipidemia in young adults. © 2015 S. Karger GmbH, Freiburg.

Factors associated with low self-esteem in children with overweight.

PubMed

Danielsen, Yngvild Sørebø; Stormark, Kjell Morten; Nordhus, Inger Hilde; Mæhle, Magne; Sand, Liv; Ekornås, Belinda; Pallesen, Ståle

2012-01-01

Low self-esteem is one of the main psychosocial factors related to childhood overweight. Yet not all overweight children are affected. Little is known about what characterises the group of overweight children with the lowest self-esteem. Our aim was to identify factors related to low domain-specific self-esteem in children with overweight/obesity. Children (aged 10-13; N = 5,185) and parents from a large population-based sample completed the Eating Disturbance Scale, the Self-Perception Profile for Children, and questions about bullying and socio-economic status (SES). Parents reported the child's weight and height. 545 children with overweight/obesity were identified in the overall sample and selected for the current analyses. Self-esteem scores from this group were compared to scores from children with normal weight. Factors examined in relation to self-esteem in children with overweight/obesity were: age, gender, SES, disturbed eating, bullying, parents' evaluation of weight status and degree of overweight. Children with overweight scored significantly lower than normal-weight children on all self-esteem domains. Athletic competence and physical appearance were most impaired. Disturbed eating and bullying were related to low physical appearance as well as scholastic, social and athletic self-esteem. Being female, a pre-teen, having a higher BMI and being evaluated as overweight by parents were associated with lower satisfaction with physical appearance. Disturbed eating and bullying are significantly related to low self-esteem in the overweight group. Copyright © 2012 S. Karger GmbH, Freiburg.

Methylenetetrahydrofolate reductase polymorphisms and susceptibility to acute lymphoblastic leukemia in a Chinese population: a meta-analysis.

PubMed

Xiao, Yi; Deng, Tao-Ran; Su, Chang-Liang; Shang, Zhen

2014-01-01

Although many epidemiologic studies have investigated the methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and their association with acute lymphoblastic leukemia (ALL), definitive conclusions cannot be drawn. To clarify the effects of MTHFR polymorphisms on the risk of ALL, a meta-analysis was performed in a Chinese population. A computerized literature search was carried out in PubMed, the Chinese Biomedicine (CBM) database, China National Knowledge Infrastructure (CNKI) platform, and the Wanfang database (Chinese) to collect relevant articles. A total of 11 articles including 1,738 ALL cases and 2,438 controls were included in this meta-analysis. Overall, a significantly decreased association was found between the MTHFR C677T polymorphism and ALL risk when all studies in Chinese populations were pooled into the meta-analysis. In subgroup analyses stratified by age, ethnicity, and source of controls, the same results were observed in children, in population-based studies, and in people with no stated ethnicity. However, a significantly increased association was also found for MTHFR C677T in hospital-based studies, and for MTHFR A1298C in people with no stated ethnicity. Our results suggest that the MTHFR C677T and A1298C polymorphisms may be potential biomarkers for ALL risk in Chinese populations, and studies with a larger sample size and wider population spectrum are required before definitive conclusions can be drawn. © 2014 S. Karger GmbH, Freiburg.

Seasonal variation of lipid-lowering effects of complex spa therapy.

PubMed

Strauss-Blasche, G; Ekmekcioglu, C; Leibetseder, V; Marktl, W

2003-04-01

It has been shown that spa therapy has a lipid-lowering effect. Also, seasonal variations in spa therapy effects have been found for some outcome measures. The aim of the present study is to investigate whether the lipid-lowering effects of spa therapy as a complex health intervention also are subject to seasonal variation. The effect of 3-week resident spa therapy at the Austrian spa Bad Tatzmannsdorf was studied in 395 patients with moderate musculoskeletal chronic pain over a time of 2 years. Spa therapy included balneotherapy, exercise therapy, and dietary measures. Total cholesterol (CHOL), HDL, LDL, triglycerides (TG), and the CHOL/HDL ratio were assessed at the beginning and end of therapy. Spa therapy was associated with a decrease of CHOL, HDL, and LDL (p < 0.001). TG and CHOL/HDL did not change. The decrease of lipids was smaller for older patients, females, and normal weight individuals. CHOL decrease showed a seasonal variation independent of weight loss (p = 0.04), being largest in fall (-6.1%) and smallest in spring (-2.4%). CHOL and CHOL/HDL for obese individuals showed the greatest decrease in winter (-10% for CHOL, -9% for CHOL/HDL ratio), whereas corresponding measures increased for normal-weight subjects. The lipid-lowering effect of spa therapy could be confirmed; it is partly moderated by season. The results suggest that the effect of some components of spa therapy such as exercise therapy, diet, and relaxation may be subject to seasonal variation. Copyright 2003 S. Karger GmbH, Freiburg

Muscle Strength and Fitness in Pediatric Obesity: a Systematic Review from the European Childhood Obesity Group.

PubMed

Thivel, David; Ring-Dimitriou, Susanne; Weghuber, Daniel; Frelut, Marie-Laure; O'Malley, Grace

2016-01-01

The increasing prevalence of paediatric obesity and related metabolic complications has been mainly associated with lower aerobic fitness while less is known regarding potential musculoskeletal impairments. The purpose of the present systematic review was to report the evidence regarding muscular fitness in children and adolescents with obesity. A systematic article search was conducted between November 2014 and June 2015 using MEDLINE, EMBASE, CINAHL psycINFO, SPORTDiscus and SocINDEX. Articles published in English and reporting results on muscle strength and muscular fitness in children and adolescents aged 6 to 18 years were eligible. Of 548 identified titles, 36 studies were included for analyses. While laboratory-based studies described higher absolute muscular fitness in youth with obesity compared with their lean peers, these differences are negated when corrected for body weight and lean mass, then supporting field-based investigations. All interventional studies reviewed led to improved muscular fitness in youth with obesity. Children and adolescents with obesity display impaired muscular fitness compared to healthy-weight peers, which seems mainly due to factors such as excessive body weight and increased inertia of the body. Our analysis also points out the lack of information regarding the role of age, maturation or sex in the current literature and reveals that routinely used field tests analysing overall daily muscular fitness in children with obesity provide satisfactory results when compared to laboratory-based data. © 2016 S. Karger GmbH, Freiburg.

Treatment Modification in Young Breast Cancer Patients.

PubMed

Scharl, Anton; Salterberg, Annette; Untch, Michael; Liedtke, Cornelia; Stickeler, Elmar; Papathemelis, Thomas

2016-01-01

Patients not older than 40 years are referred to as young patients. These women benefit from chemo-, endocrine and anti-HER2 therapy to a similar degree as older women. Surgery and radiation therapy also follow the same recommendations. This manuscript deals with the following topics that need special consideration in young women: endocrine therapy and ovarian suppression; fertility protection and family planning; and genetic counselling. There is an on-going debate on whether tamoxifen is sufficient as an endocrine treatment in young patients with endocrine-responsive tumours or whether suppression of ovarian function in combination with tamoxifen or aromatase inhibitor should be preferred. Recent data suggest a benefit from ovarian suppression plus exemestane in women of 35 years or younger with high-risk breast cancer. However, increased side effects bear the risk of lesser compliance, which eventually results in higher mortality. Child bearing is nowadays frequently postponed to the 4th decade of life, thereby increasing the number of women who have not yet finished their reproductive desires when diagnosed with breast cancer. These patients are in urgent need of counselling for fertility protection. Breast cancer diagnosis at young age is an indication for a possible mutation in breast cancer susceptibility genes. This has an impact on the cancer risk of the whole family, especially the offspring. Drugs that are specifically targeted to cancer cells with genetic alterations that impair DNA repair are already entering the arsenal of oncologists. © 2016 S. Karger GmbH, Freiburg.

The Association between Sleep Duration and Non-Alcoholic Fatty Liver Disease among Japanese Men and Women.

PubMed

Imaizumi, Hiromichi; Takahashi, Atsushi; Tanji, Nobuo; Abe, Kazumichi; Sato, Yuji; Anzai, Yukio; Watanabe, Hiroshi; Ohira, Hiromasa

2015-01-01

To examine the relationship between sleep duration and non-alcoholic fatty liver disease (NAFLD). We evaluated 3,968 subjects who underwent health check-ups from June 2012 to May 2013 at the Watari Hospital Health Center in Fukushima Prefecture in Japan. Fatty liver was detected by ultrasonography. Sleep duration and lifestyle factors were estimated using a questionnaire. Sleep duration was categorized into the following groups: ≤ 6, 6 to ≤ 7, >7 to ≤ 8, and >8 h. The four sleep duration groups were compared using the χ(2) test and Kruskal-Wallis test. In total, 2,172 subjects were enrolled. The overall prevalence of NAFLD was 29.6% (men, 38.0%; women, 25.3%). The proportion of NAFLD tended to decrease as sleep duration increased in men. The proportion with NAFLD was lowest in the group with a sleep duration of 6 to ≤ 7 h and highest in the groups with sleep durations of ≤ 6 and >8 h in women. The distribution showed a U-shaped curve. The age-adjusted odds ratio (OR) (95% confidence interval (CI)) for subjects with NAFLD with a sleep duration ≤ 6 h compared to the reference (6 to ≤ 7 h) was 1.44 (1.06-1.96) in women. Sleep shortage tends to be associated with NAFLD in women and may be mediated by body adiposity. © 2015 S. Karger GmbH, Freiburg.

Study, Design and Fabricate a Cold Crucible System

DTIC Science & Technology

1975-03-31

Fritz iuettinger Blektronik GmbH, Freiburg, Germany) tuned to operate at approximately 4 megahertz. Using kilogram charges of zirconia powder , densification...ut’. rho skull was filled with stabilized zirconia powder and approximate’Iy 10 grams of zirconium metal chips (1/8" diameter) were buried In the...show the results of Run M-tO. A 700 gram zirconia powder charge (Johnson Matthey Chemicals, Ltd., 99.992 purity) was used with 10 wt % yttria (Rare Earth

Insights into the Freiburg Anatomical Institute during National Socialism, 1933-1945.

PubMed

Hildebrandt, Sabine

2016-05-01

The Anatomical Institute at the Albert-Ludwigs-Universität Freiburg is among the anatomical departments for which a comprehensive account of its history during National Socialism (NS) is still missing. Previous investigations (such as in: Grün et al., 2002) have revealed the political activities of some anatomists, but, in the absence of relevant body-registers, a more comprehensive examination of the anatomical body procurement has not been attempted. The inspection of records in university and municipal archives allows insight into the activities in the institute within the historical context. The Freiburg Institute shared the experience of the impact of NS politics with other German anatomies. Four anatomists were dismissed because of NS racial discrimination, and chairman von Möllendorf left for political reasons. His successor Nauck's appointment was politically motivated, as he was a staunch Nazi. His colleagues were also members of NS political organizations. Body procurement was controversial between the public and the anatomists in Freiburg prior to and following the Third Reich, and much of the anatomists' efforts focused on the improvement of the body supply. In 1935, and, again during the war, the number of bodies was sufficient for anatomical education. Among the traditional sources of body procurement were increasing numbers of NS victims. Forty-four of them can be identified, among them 21 forced laborers and their children who died of so-called natural causes, and 22 men who had been executed at Stuttgart prison on April 6, 1943. While the victims' names have been ascertained, their biographies still need restoration to ensure an appropriate commemoration. Copyright © 2016 Elsevier GmbH. All rights reserved.

Comparison of Efficacy and Safety of Liraglutide 3.0 mg in Individuals with BMI above and below 35 kg/m²: A Post-hoc Analysis.

PubMed

le Roux, Carel; Aroda, Vanita; Hemmingsson, Joanna; Cancino, Ana Paula; Christensen, Rune; Pi-Sunyer, Xavier

2017-01-01

To investigate whether the efficacy and safety of liraglutide 3.0 mg differed between two subgroups, BMI 27 to <35 and BMI ≥ 35 kg/m², in individuals without and with type 2 diabetes (T2D). A post-hoc analysis of two 56-week, randomized, double-blind, placebo-controlled trials (SCALE Obesity and Prediabetes; SCALE Diabetes). Subgroup differences in treatment effects of liraglutide 3.0 mg were evaluated by testing the interaction between treatment group and baseline BMI subgroup. Significantly greater weight loss (0-56 weeks) was observed with liraglutide 3.0 mg versus placebo in all patient groups while on treatment. There was no evidence that the weight-lowering effect of liraglutide 3.0 mg differed between BMI subgroups (interaction p > 0.05). Similarly, for most secondary endpoints significantly greater improvements were observed with liraglutide 3.0 mg versus placebo, with no indication treatment effects differing between subgroups. The safety profile of liraglutide 3.0 mg was broadly similar across BMI subgroups. This post-hoc analysis did not indicate any differences in the treatment effects, or safety profile, of liraglutide 3.0 mg for individuals with BMI 27 to <35 or ≥35 kg/m². Liraglutide 3.0 mg can therefore be considered for individuals with a BMI of ≥35 as well as for those with a BMI of 27 to <35 kg/m². © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Workload and quality of life of medical doctors in the field of oncology in Germany--a survey of the working group quality of life of the AIO for the study group of internal oncology.

PubMed

Hipp, Matthias; Pilz, Lothar; Al-Batran, Salah E; Hautmann, Matthias G; Hofheinz, Ralf-Dieter

2015-01-01

An increasing number of surveys have investigated professional stress and satisfaction among oncologists. Coevally, structural development has changed the oncological working environment. This survey investigated the quality of life and job stress among German oncological physicians. A 48-item questionnaire, which included the 'Stress questionnaire of physicians and nurses' (FBAS), was developed by the 'Quality of life' working group of the Internal oncology study group (AIO), and distributed anonymously at the annual meeting of the AIO working group in 2010. Descriptive statistics as well as univariate and multivariate analysis were performed. 261 oncologists, mostly male (64%), older than 40 years (38%), and medical specialists (78%), took part in the survey. 'Structural conditions' were identified as causing the highest mean stress levels, followed by 'professional and private life'. Female participants showed a significantly lower global quality of life than male participants (p = 0.020). 'Structural conditions' induced more stress among younger oncologists < 50 years old (p < 0.001). Qualification status was influenced by gender (p < 0.001); the multivariate analysis described the dependence of gender (p = 0.0045), working situation (p = 0.0317) and global stress (p = 0.0008). Structural conditions, age younger than 50 years and female gender were identified as stress risk factors among the AIO members, and showed that job stress is present in German oncology. Further research is warranted to develop evidence-based intervention strategies. © 2015 S. Karger GmbH, Freiburg.

[Non-reciprocal social exchange is a health risk: a medical sociological research model].

PubMed

Siegrist, J

2002-02-01

Contrary to a reductionist disease concept prevailing in molecular medicine, a systemic disease concept is emphasised in this sociopsychosomatic approach towards analysing disease as a result of disturbed social exchange among people. More precisely, violations of the norms of social reciprocity in core social roles in adult life, in particular in the work role, are assumed to trigger stressful experience with adverse long-term consequences for health. The model of effort-reward imbalance at work provides an illustrative case of nonreciprocal social exchange. It defines distinct conditions in which an imbalance between high efforts spent and low rewards received in turn is maintained by the workers. In this model social rewards are analysed in terms of money, esteem and promotion prospect including job security. The contribution summarises results from 6 international prospective and cross-sectional epidemiological investigations testing the model of effort-reward imbalance at work with regard to different health indicators (especially coronary heart disease, hypertension, depression, alcohol dependence). In all instances an elevated risk of illness is observed among those who experience non-reciprocal social exchange in terms of effort-reward imbalance at work, compared to people who are free from this type of stressful experience. Results are derived from logistic regression analysis adjusting for the effects of potential confounders. In view of this evidence the medical sociological approach outlined here may be helpful in contrasting a reductionist concept of disease with a systemic concept centred around the sociopsychosomatic aspects of human health and disease. Copyright 2002 S. Karger GmbH, Freiburg

Perceived Health Status: Is Obesity Perceived as a Risk Factor and Disease?

PubMed

Visscher, Tommy L S; Lakerveld, Jeroen; Olsen, Nanna; Küpers, Leanne; Ramalho, Sofia; Keaver, Laura; Brei, Christina; Bjune, Jan-Inge; Ezquerro, Silvia; Yumuk, Volkan

2017-01-01

One might expect that a perception of obesity being a risk factor and disease, contributes to effective obesity prevention and management strategies. However, obesity rates continue to increase worldwide. The question arises whether obesity is truly perceived as a risk factor and a disease. This paper aims at describing perception of obesity as risk factor and disease among individuals seeking care, individuals not seeking care, the society, and different professionals having a role in the field of obesity. The paper is a reflection of the lecture on the topic that was given at the EASO's New Investigators United's Summer School 2016 in Portugal and the discussion with the new investigators and other senior speakers. Individual obese patients seeking help are very much aware of obesity being a risk factor and disease, but perceptions regarding obesity seem to be flawed among those who do not seek help for obesity. Also, misperceptions regarding obesity play a role at different levels, including society, different political levels, the fields of health care and social work, prevention organizations, and the food and marketing industry. The food and marketing industry has an enormous role in changing perceptions by the society and policy makers. Obesity rates will continue to increase as long as individuals, the society, and professionals at different levels have false interpretations of the severity of obesity. Severe action is needed against those who are playing a role in maintaining false perceptions of obesity as a risk factor and disease. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Evaluation of the Obesity Genes FTO and MC4R for Contribution to the Risk of Large Artery Atherosclerotic Stroke in a Chinese Population.

PubMed

Song, Zhi; Qiu, Lingling; Hu, Zhongyang; Liu, Jia; Liu, Ding; Hou, Deren

2016-01-01

Obesity is a well-established risk factor for large artery atherosclerotic (LAA) stroke. The aim of the study was to explore whether obesity genes, such as MC4R and FTO, contribute to LAA stroke risk in the Chinese Han population. 322 LAA stroke patients and 473 controls were recruited. Gene polymorphism of MC4R (rs17782313) and FTO (rs8050136 and rs9939609) were genotyped. No differences were observed in genotype frequencies of variants of FTO (rs8050136 and rs9939609) or MC4R (rs17782313) between LAA stroke patients and control subjects. However, rs17782313 of the MC4R gene was associated with LAA stroke susceptibility in smokers (rs17782313: p = 0.020, OR (95% CI) = 1.55 (1.07-2.23)) in the stratified analysis. Furthermore, multifactor dimensionality reduction analysis revealed that the combination of MC4R variant (rs17782313), hypertension and smoking habit was significantly associated with increased risk of LAA stroke (p < 0.0001, OR (95% CI) = 6.57 (4.79-9.01)). Our study indicated that the synergistic effects of MC4R variants, hypertension, and smoking habit contribute significantly to the risk of LAA stroke in the Chinese Han population. The finding revealed that obesity gene MC4R contribute to the risk of LAA stroke via a synergistic mechanism, which will provide new insight into the genetic architecture of LAA stroke. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

[Improvement of Stress Resistance and Quality of Life of Adults with Nervous Restlessness after Treatment with a Passion Flower Dry Extract].

PubMed

Gibbert, Judith; Kreimendahl, Fabian; Lebert, Jennifer; Rychlik, Reinhard; Trompetter, Inga

The passion flower dried ethanolic extract investigated in this non-interventional study has well-documented calmative effects and good tolerability. We investigated the effects of this extract on the stress resistance (resilience) and quality of life (QoL) of patients suffering from nervous restlessness. The addiction potential of the drug and the course of symptoms were also evaluated. Adult patients aged ≤ 95 years with the diagnosis 'nervous restlessness' were treated for 12 weeks with a dried ethanolic extract of passion flower (Passiflora incarnata L.). Standardized questionnaires were used to evaluate the resilience (RS-13), QoL (EQ-5D including EQ-VAS), and the addiction potential (BDEPQ). After 12 weeks of treatment, significant (p < 0.001) improvements were measured in the patients' resilience (RS-13: from 52.1 to 67.7 points) and QoL (EQ-VAS: from 47.9 to 75.0 points). Also, the mean BDEPQ score was significantly (p < 0.001) reduced (from 23.0 to 19.3 points). The mean values of all accompanying symptoms (inner restlessness, sleep disturbance, exhaustion, fear, lack of concentration, transpiration, nausea, trembling, and palpitation) improved significantly (p < 0.001). Tolerability of treatment was rated as 'very good' or 'good' by the majority of the patients. Three cases of mild adverse events (tiredness) were reported. The passion flower extract investigated in the present study appears to be effective in improving resilience and QoL in patients suffering from nervous restlessness and is well tolerated. © 2017 S. Karger GmbH, Freiburg.

Brain PET imaging in obesity and food addiction: current evidence and hypothesis.

PubMed

Iozzo, Patricia; Guiducci, Letizia; Guzzardi, Maria Angela; Pagotto, Uberto

2012-01-01

The ongoing epidemics of obesity is one main health concern of the present time. Overeating in some obese individuals shares similarities with the loss of control and compulsive behavior observed in drug-addicted subjects, suggesting that obesity may involve food addiction. Here, we review the contributions provided by the use of positron emission tomography to the current understanding of the cerebral control of obesity and food intake in humans. The available studies have shown that multiple areas in the brain are involved with the reward properties of food, such as prefrontal, orbitofrontal, somatosensory cortices, insula, thalamus, hypothalamus, amygdala, and others. This review summarizes the current evidence, supporting the concepts that i) regions involved in the somatosensory response to food sight, taste, and smell are activated by palatable foods and may be hyperresponsive in obese individuals, ii) areas controlling executive drive seem to overreact to the anticipation of pleasure during cue exposure, and iii) those involved in cognitive control and inhibitory behavior may be resistant to the perception of reward after food exposure in obese subjects. All of these features may stimulate, for different reasons, ingestion of highly palatable and energy-rich foods. Though these same regions are similarly involved in drug abusers and game-addicted individuals, any direct resemblance may be an oversimplification, especially as the heterogeneities between studies and the prevalent exclusion of sensitive groups still limit a coherent interpretation of the findings. Further work is required to comprehensively tackle the multifaceted phenotype of obesity and identify the role of food dependency in its pathophysiology. Copyright © 2012 S. Karger GmbH, Freiburg.

Inter-Rater Reliability of Neck Reflex Points in Women with Chronic Neck Pain.

PubMed

Weinschenk, Stefan; Göllner, Richard; Hollmann, Markus W; Hotz, Lorenz; Picardi, Susanne; Hubbert, Katharina; Strowitzki, Thomas; Meuser, Thomas

2016-01-01

Neck reflex points (NRP) are tender soft tissue areas of the cervical region that display reflectory changes in response to chronic inflammations of correlated regions in the visceral cranium. Six bilateral areas, NRP C0, C1, C2, C3, C4 and C7, are detectable by palpating the lateral neck. We investigated the inter-rater reliability of NRP to assess their potential clinical relevance. 32 consecutive patients with chronic neck pain were examined for NRP tenderness by an experienced physician and an inexperienced medical student in a blinded design. A detailed description of the palpation technique is included in this section. Absence of pain was defined as pain index (PI) = 0, slight tenderness = 1, and marked pain = 2. Findings were evaluated either by pair-wise Cohen's kappa (ĸ) or by percentage of agreement (PA). Examiners identified 40% and 41% of positive NRP, respectively (PI > 0, physician: 155, student: 157) with a slight preference for the left side (1.2:1). The number of patients identified with >6 positive NRP by the examiners was similar (13 vs. 12 patients). ĸ values ranged from 0.52 to 0.95. The overall kappa was ĸ = 0.80 for the left and ĸ = 0.74 for the right side. PA varied from 78.1% to 96.9% with strongest agreement at NRP C0, NRP C2, and NRP C7. Inter-rater agreement was independent of patients' age, gender, body mass index and examiner's experience. The high reproducibility suggests the clinical relevance of NRP in women. © 2016 S. Karger GmbH, Freiburg.

Effect of Restriction of Foods with High Fructose Corn Syrup Content on Metabolic Indices and Fatty Liver in Obese Children.

PubMed

Ibarra-Reynoso, Lorena Del Rocio; López-Lemus, Hilda Lissette; Garay-Sevilla, Ma Eugenia; Malacara, Juan Manuel

2017-01-01

We examined the effect of restriction of foods with high fructose content in obese school children. In a clinical study, we selected 54 obese children 6 to 11 years old with high fructose consumption (>70 g/day) in order indicate dietary fructose restriction (<20 g/day) for 6 weeks. Anthropometry, liver ultrasound as well as glucose, insulin, lipids, leptin, IGFBP1, and RBP4 serum levels were collected. The group of children had 80% adherence and reported decreased fructose consumption (110 ± 38.6 to 11.4 ± 12.0 g/day) and also a significant decrease in caloric (2,384 ± 568 to 1,757 ± 387 kcal/day) and carbohydrate consumption (302 ± 80.4 to 203 ± 56.0 g/day). The severity of steatosis improved significantly after fructose restriction (p < 0.000001). However, no changes in BMI, systolic blood pressure, or diastolic blood pressure were found. Only triglyceride levels decreased (1.44 ± 0.43 to 1.31 ± 0.38 mmol/l), High-densitiy lipoprotein cholesterol showed a marginal increase (1.45 ± 0.19 to 1.56 ± 0.44 mmol/l). Insulin resistance and RBP4 did not change. In school children, the restriction of high fructose foods with a decrease of caloric and carbohydrate intake at 6 weeks did not induce weight loss; however, triglyceride levels and hepatic steatosis decreased. Differences with other studies in regard to weight loss may be explained by adaptive changes on metabolic expenditure. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Injections of Local Anesthetics into the Pharyngeal Region Reduce Trapezius Muscle Tenderness.

PubMed

Weinschenk, Stefan; Hollmann, Markus W; Göllner, Richard; Picardi, Susanne; Strowitzki, Thomas; Diehl, Leon; Hotz, Lorenz; Meuser, Thomas

2016-01-01

Neck pain is a frequent reason for seeking medical advice. Neuroanatomical findings suggest a close connection between the pharynx and the trapezius region. Irritation of the pharynx may induce tenderness of this area. Specific tender points, called neck reflex points (NRPs), can be identified here with high reproducibility. We hypothesized that therapeutic local anesthesia (TLA; or neural therapy, NT) in the pharyngeal region can reduce tenderness in patients with therapy-resistant neck pain. 17 consecutive female patients with chronic cervical pain and positive trapezius NRPs received bilateral injections of 0.5 ml 1% procaine into the palatine velum. The NRPs were assessed using a 3-level pain index (PI = 0, 1, or 2) before and 3-5 min after each injection. We found a significant reduction in tenderness of the NRP of the trapezius region (NRP C7) immediately after TLA/NT. 30 positive NRPs were found before therapy and only 13 after therapy (p < 0.01). The average PI of the NRP C7 was 1.24 ± 0.77 before and 0.35 ± 0.59 after therapy (right side), and 1.34 ± 0.59 before and 0.59 ± 0.69 after therapy (left side). The pre- and post-therapy PI values were significantly different on both the right and left sides of the trapezius region (p < 0.01). No adverse effects were observed. Pharyngeal irritation may induce and maintain therapy-resistant cervical pain in patients with chronic pharyngeal disease. These patients could benefit from remote TLA/NT injections in the pharyngeal region. © 2016 S. Karger GmbH, Freiburg.

Why Do Students Engage in Elective Courses on Acupuncture and Homeopathy at Medical School? A Survey.

PubMed

Jocham, Alexandra; Berberat, Pascal O; Schneider, Antonius; Linde, Klaus

We aimed to investigate why medical students in Germany participate in elective courses on acupuncture or homeopathy. The study was a nationwide, cross-sectional survey. Elective courses on acupuncture and homeopathy in the academic half-year 2013/14 were identified by inquiries directed to all 37 German medical schools, to student initiatives, and organizations supporting such courses. Participants of courses were asked to fill in a questionnaire consisting of a free-text question on their motives and closed questions regarding personal experiences, personal environment, evidence, role of the therapy as a complement to conventional medicine, and opportunistic aspects in relation to the therapy chosen. Students participating in 16 of 18 identified acupuncture courses (n = 220) and 12 of 13 identified homeopathy courses (n = 113) filled in the questionnaire. Content analysis of the free text showed that personal experience, a feeling that conventional medicine is somehow incomplete, the belief that acupuncture or homeopathy could help to overcome this shortcoming, and positive characteristics attributed to the therapies were the main motives for participation. Quantitative analyses showed that own experiences and considering the therapy a useful complement to conventional medicine were similarly rated motives in both groups, while opportunistic aspects played almost no role. The influence of the personal environment was more important among homeopathy students, while acupuncture students considered their therapy better backed by evidence. In our survey, personal experiences and the belief that acupuncture or homeopathy allows grasping the patient more holistically were primary motives for participation. © 2017 S. Karger GmbH, Freiburg.

A Systematic Review of the Application And Correlates of YFAS-Diagnosed 'Food Addiction' in Humans: Are Eating-Related 'Addictions' a Cause for Concern or Empty Concepts?

PubMed

Long, Cecilia G; Blundell, John E; Finlayson, Graham

2015-01-01

The proposition of so-called 'food addiction' (FA) in the scientific literature has stimulated a recent surge in research and debate. The concept of FA is controversial, and opinion is divided. Many of the findings depend upon the use of a single instrument called the Yale Food Addiction Scale (YFAS). This review systematically examined FA, as defined by the YFAS, reported in 40 experimental human studies published in or after 2009. The results indicated that much of the literature makes the supposition that food addiction is an accepted neurobiological disease, consistent with substance use disorders; an interpretation based on very limited data. This raises the question as to whether those individuals who meet the YFAS criteria for diagnosis are truly 'addicted' to food or if they experience significant impairment to their psychological wellbeing and quality of life as would be expected in clinically recognised addictive disorders. At the present time, little research has investigated the extent to which a psychometric self-assessment of FA symptomatology can elucidate a harmful relationship with target foods in the diet. A positive YFAS diagnosis is usually positively associated with BMI and strongly linked with the presence of binge eating, but certain exceptions within the literature were revealed. Further clarification is required as to whether so-called FA is sufficiently different to existing conditions and traits to warrant classification as a distinctive disease phenotype rather than an expression of strong habits and preferences. © 2015 S. Karger GmbH, Freiburg.

Symptoms and Needs of Head and Neck Cancer Patients at Diagnosis of Incurability - Prevalences, Clinical Implications, and Feasibility of a Prospective Longitudinal Multicenter Cohort Study.

PubMed

Alt-Epping, Bernd; Seidel, Wiebke; Vogt, Jeannette; Mehnert, Anja; Thomas, Michael; van Oorschot, Birgitt; Wolff, Hendrik; Schliephake, Henning; Canis, Martin; Dröge, Leif H; Nauck, Friedemann; Lordick, Florian

2016-01-01

Little is known about the physical symptoms and psychosocial burden of patients at the time of diagnosis of an incurable situation, although cancer treatment guidelines demand early assessment and integration of palliative care concepts, beginning from the diagnosis of incurability. Therefore, we initiated a prospective longitudinal multicenter cohort study assessing the symptoms and needs of patients suffering from incurable cancer (various entities), from the time of diagnosing incurability (i.e., before palliative anticancer treatment was initiated) and in 3-monthly intervals thereafter, by using validated self-reporting tools. Here, we focus on patients with head and neck cancer and present preliminary results on symptoms and need prevalences, on clinical implications, and on the feasibility of a methodologically complex assessment procedure in a particularly vulnerable study population. 22 patients completed the first visit. The Eastern Cooperative Oncology Group (ECOG) performance scores and most physical symptoms and psychosocial items varied between the extremes, from a virtually uncompromised condition to extremely perceived symptoms and needs. If intense face-to-face study support was provided, the study concept proved to be feasible, despite the complexity of assessment, problems in interdisciplinary and patient communication, comorbidities, and early death from complications. The striking variability in the perceived symptom and need intensities requires a highly individualized approach. For clinical purposes, a less complex screening procedure would be desirable, in order to enable a routine, early and comprehensive support, including palliative care services. © 2016 S. Karger GmbH, Freiburg.

Association Study of Three Gene Polymorphisms Recently Identified by a Genome-Wide Association Study with Obesity-Related Phenotypes in Chinese Children.

PubMed

Song, Qi-Ying; Song, Jie-Yun; Wang, Yang; Wang, Shuo; Yang, Yi-De; Meng, Xiang-Rui; Ma, Jun; Wang, Hai-Jun; Wang, Yan

2017-01-01

This study aimed to examine associations of three single-nucleotide polymorphisms (SNPs) with obesity-related phenotypes in Chinese children. These SNPs were identified by a recent genome-wide association (GWA) study among European children. Given that varied genetic backgrounds across different ethnicity may result in different association, it is necessary to study these associations in a different ethnic population. A total of 3,922 children, including 2,191 normal-weight, 873 overweight and 858 obese children, from three independent studies were included in the study. Logistic and linear regressions were performed, and meta-analyses were conducted to assess the associations between the SNPs and obesity-related phenotypes. The pooled odds ratios of the A-allele of rs564343 in PACS1 for obesity and severe obesity were 1.180 (p = 0.03) and 1.312 (p = 0.004), respectively. We also found that rs564343 was nominally associated with BMI, BMI standard deviation score (BMI-SDS), waist circumference, and waist-to-height ratio (p < 0.05). We showed for the first time that the rs564343 in PACS1 was associated with risk of severe obesity in a non-European population. This SNP was also found to be associated with common obesity and various obesity-related phenotypes in Chinese children, which had not been reported in the original study. The results demonstrated the value of conducting genetic researches in populations with different ethnicity. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Effects of a Weight Loss Program on Metabolic Syndrome, Eating Disorders and Psychological Outcomes: Mediation by Endocannabinoids?

PubMed

Pataky, Zoltan; Carrard, Isabelle; Gay, Valerie; Thomas, Aurélien; Carpentier, Anne; Bobbioni-Harsch, Elisabetta; Golay, Alain

2018-01-01

To evaluate the effects of weight loss on endocannabinoids, cardiometabolic and psychological parameters, eating disorders (ED) as well as quality of life (QoL) and to elucidate the role of endocannabinoids in metabolic syndrome (MS). In total, 114 patients with obesity were prospectively included in a 12-month weight loss program. Plasma endocannabinoids were measured by mass spectrometry; ED, psychological and QoL-related parameters were evaluated by self-reported questionnaires; physical activity was measured by accelerometer. Nutritional assessment was done by a 3-day food diary. Among completers (n = 87), body weight decreased in 35 patients (-9.1 ± 8.6 kg), remained stable in 39 patients, and increased in 13 patients (+5.8 ± 3.4 kg). 75% of patients with MS at baseline were free of MS at follow-up, and their baseline plasma N-palmitoylethanolamide (PEA) values were significantly lower when compared to patients with persisting MS. At baseline, there was a positive relationship between PEA and waist circumference (p = 0.005, R2 = 0.08), fasting glucose (p < 0.0001, R2 = 0.12), total cholesterol (p = 0.001, R2 = 0.11), triglycerides (p = 0.001, R2 = 0.11), LDL-cholesterol (p = 0.03, R2 = 0.05) as well as depression score (p = 0.002, R2 = 0.29). Plasma PEA might play a role in metabolic improvement after weight loss. Even in subjects without weight loss, a multidisciplinary intervention improves psychological outcomes, ED, and QoL. © 2018 The Author(s) Published by S. Karger GmbH, Freiburg.

[Frequency of the common cold in healthy subjects during exposure to a lectin-rich and a lectin-poor mistletoe preparation in a randomized, double-blind, placebo-controlled study].

PubMed

Huber, R; Klein, R; Lüdtke, R; Werner, M

2001-12-01

Mistletoe preparations have immunomodulatory properties in vitro and in vivo. We wanted to investigate whether or not these properties have an effect on the frequency of the common cold in healthy subjects. During a randomized, placebo-controlled, double-blind study 16 volunteers received the mistletoe lectin(ML)-poor preparation Iscador Pini(R) (IP), 16 the ML-rich preparation Iscador Quercus spezial(R) (IQ), and 16 placebo (physiological saline solution) twice a week subcutaneously for 12 weeks. Weekly during weeks 1-12 and finally at week 26, a careful history of common cold symptoms was taken. Because the frequency of the common cold was not the main outcome criterion in this study, the number of cases needed to treat was not adjusted to this criterion. The mean frequency of the common cold during the 12 weeks of injection was 1.5 in the placebo, 1.4 in the IP and 1.1 in the IQ group. During this period in 2.3 (placebo), 1.9 (IP) and 1.4 (IQ) weeks symptoms of common cold were present. The difference in favor to IQ lasted until the end of the observation period in week 26. It was, however, not significant. Leukocyte and granulocyte count as well as C-reactive protein were not different between the groups. The study showed a trend (p = 0.4, exact Kruskal- Wallis test) to reduced frequency and duration of the common cold in subjects who were exposed to IQ. Copyright 2001 S. Karger GmbH, Freiburg

Homeopathy: meta-analyses of pooled clinical data.

PubMed

Hahn, Robert G

2013-01-01

In the first decade of the evidence-based era, which began in the mid-1990s, meta-analyses were used to scrutinize homeopathy for evidence of beneficial effects in medical conditions. In this review, meta-analyses including pooled data from placebo-controlled clinical trials of homeopathy and the aftermath in the form of debate articles were analyzed. In 1997 Klaus Linde and co-workers identified 89 clinical trials that showed an overall odds ratio of 2.45 in favor of homeopathy over placebo. There was a trend toward smaller benefit from studies of the highest quality, but the 10 trials with the highest Jadad score still showed homeopathy had a statistically significant effect. These results challenged academics to perform alternative analyses that, to demonstrate the lack of effect, relied on extensive exclusion of studies, often to the degree that conclusions were based on only 5-10% of the material, or on virtual data. The ultimate argument against homeopathy is the 'funnel plot' published by Aijing Shang's research group in 2005. However, the funnel plot is flawed when applied to a mixture of diseases, because studies with expected strong treatments effects are, for ethical reasons, powered lower than studies with expected weak or unclear treatment effects. To conclude that homeopathy lacks clinical effect, more than 90% of the available clinical trials had to be disregarded. Alternatively, flawed statistical methods had to be applied. Future meta-analyses should focus on the use of homeopathy in specific diseases or groups of diseases instead of pooling data from all clinical trials. © 2013 S. Karger GmbH, Freiburg.

An approach to the concept of tonic: suggested definitions and historical aspects.

PubMed

Götti, Robert P; Melzer, Jörg; Saller, Reinhard

2014-01-01

In traditional medicine, especially CAM, the concept of (herbal) tonics has a long history in the different medical systems (TEN -- Traditional European Naturopathy; TCM - Traditional Chinese Medicine). Nevertheless, the ideas concerning the function of a tonic differ, e.g., stimulation of body functions, strengthening of organ function, enhancement of adaption, and well-being. Although no exact pharmacodynamic or pharmacokinetic properties of tonics can be given, the following general definition, even in the transcultural comparison between European and Chinese concepts, seems meaningful: A tonic is an agent that has the capability to restore and/or maintain the physiological functioning of an organ system, leading to the subjective feeling of well-being of the patient treated with it. © 2014 S. Karger AG, Freiburg.

Overcoming Cost Implications of Mutational Analysis in Patients with Gastrointestinal Stromal Tumors: A Pragmatic Approach.

PubMed

Schöffski, Patrick; Wozniak, Agnieszka; Schöffski, Oliver; van Eycken, Liesbet; Debiec-Rychter, Maria

2016-01-01

Genetic analysis of tissue derived from patients with advanced gastrointestinal stromal tumors (GISTs) is not uniformly applied on a national and international level, even though mutational data can provide clinically relevant prognostic and predictive information, especially in patients qualifying for treatment with expensive targeted agents. The current article describes the rationale for genetic testing of GIST tissue, looks at financial implications associated with such analysis and speculates on potential cost savings introduced by routine mutational testing and tailored use of tyrosine kinase inhibitors based on genotyping. This work is based on a hypothetical analysis of epidemiological data, drug costs, reimbursement criteria and market research figures. The cost burden for routine genotyping of important genes in GISTs, especially in patients at high risk for relapse after primary surgery and in advanced, inoperable metastatic disease, is relatively low. The early identification of GISTs with primary resistance mutations should be the basis for personalized GIST treatment and reimbursement of drugs. As illustrated by Belgian figures, the exclusive use of a drug such as imatinib in patients who are likely to benefit from the agent based on genetic information can lead to significant cost savings, which outweigh the costs for testing. Mutational analysis of GIST should be considered early in all patients at risk for relapse after curative surgery and in the case of advanced, inoperable, metastatic disease. The costs for the actual genotyping should not be used as an argument against profiling of the tumor. The adjuvant and palliative systemic treatment of GISTs should be personalized based on the genotype and other known prognostic and predictive factors. Reimbursement criteria for essential agents such as imatinib should be adapted accordingly. © 2016 S. Karger GmbH, Freiburg.

Implementation of an Integrative Oncological Concept in the Daily Care of a German Certified Breast Cancer Center.

PubMed

Schad, Friedemann; Thronicke, Anja; Merkle, Antje; Steele, Megan L; Kröz, Matthias; Herbstreit, Cornelia; Matthes, Harald

2018-01-01

In recent decades the concept of integrative medicine has attracted growing interest in patients and professionals. At the Gemeinschaftskrankenhaus Havelhöhe (GKH), a hospital specialized in anthroposophical medicine, a breast cancer center (BCC) has been successfully certified for more than 5 years. The objective of the present study was to analyze how integrative strategies were implemented in the daily care of primary breast cancer patients. Clinical, demographic, and follow-up data as well as information on non-pharmacological interventions were analyzed. In addition, BCC quality measures were compared with data of the National Breast Cancer Benchmarking Report 2016. Between 2011 and 2016, 741 primary breast cancer patients (median age 57.4 years) were treated at the GKH BCC. 91.5% of the patients showed Union for International Cancer Control (UICC) stage 0, I, II, or III and 8.2% were in UICC stage IV. 97% of the patients underwent surgery, 53% radiation, 38% had hormone therapy, and 25% received cytostatic drugs. 96% of the patients received non-pharmacological interventions and 32% received Viscum album L. Follow-up was performed in up to 93% of the patients 2 years after first diagnosis. Compared to nationwide benchmarking BCCs, the GKH BCC met the requirements in central items. The results of the present study show that integrative therapies offered by the concept of anthroposophical medicine can be implemented in the daily care and treatment of a certified BCC. However, as national guidelines on integrative concepts in oncology are missing, further studies are needed for a systematic evaluation of integrative treatment and care concepts in this field. © 2018 The Author(s). Published by S. Karger GmbH, Freiburg.

[The Application of Bryophyllum pinnatum Preparations in Obstetrics and Gynaecology – a Multicenter, Prospective Observational Study].

PubMed

Fürer, Karin; Simões-Wüst, Ana Paula; Winkler, Alice; Amsler, Nadine; Schnelle, Martin; von Mandach, Ursula

2015-01-01

Bryophyllum pinnatum has been introduced in anthroposophic medicine in Europe and is nowadays also widely used in conventional medicine. The aim of this study was to assess the prescriptions in the field of gynaecology and obstetrics in Switzerland and to document potential effects and possible adverse events of B. pinnatum. Private practices and clinics for obstetrics and gynaecology were asked to document each prescription of B. pinnatum for their female patients during 31 months with an online questionnaire. At the University Hospital Zurich, at the Cantonal Hospital Winterthur as well as at 2 private practices, a total of 174 women and 208 prescriptions of B. pinnatum were recorded (several prescriptions per patient were possible). Most of the patients were pregnant (87%). B. pinnatum was prescribed as a tocolytic agent to 83% of all patients and to 95% of all pregnant patients and showed a good or a very good effectiveness. Further, 14% of the patients received B. pinnatum for sedation against their restlessness during the day and 5% for sedation against sleep problems. A decrease of the restlessness was achieved for these 2 indications. 13% of the patients suffered from a hyperactive bladder and in two-thirds of them the effectiveness of the treatment with B. pinnatum was classified as very good. In 92% of the cases, Bryophyllum 50% chewable tablets were prescribed. In conventional gynaecology and obstetrics, B. pinnatum is predominantly prescribed for pregnant women in case of prematurel abour, against restlessness and for hyperactive bladder. B. pinnatum showed a good effectiveness with a high benefit in the treatment of hyperactivity-associated health problems. © 2015 S. Karger GmbH, Freiburg.

S100A8/A9 (Calprotectin), Interleukin-6, and C-Reactive Protein in Obesity and Diabetes before and after Roux-en-Y Gastric Bypass Surgery.

PubMed

Lylloff, Louise; Bathum, Lise; Madsbad, Sten; Grundtvig, Josefine Liv Gilling; Nordgaard-Lassen, Inge; Fenger, Mogens

2017-01-01

In obesity, which is a major contributor to insulin resistance and diabetes, the circulating level of S100A8/A9 (calprotectin) is elevated and declines after Roux-en-Y gastric bypass surgery (RYGB). However, studies on S100A8/A9 and the pathophysiological mechanisms in insulin resistance and diabetes are few and contradictory. We studied 48 subjects who underwent RYGB, comprising a non-diabetic control group and two diabetic groups in whom diabetes either regressed or persisted, 6-12 months post-surgically. S100A8/A9, interleukin 6 (IL-6) as well as other inflammatory and diabetes-related markers were measured pre- and post-surgically. Significant and similar decreases of BMI were found in all groups. S100A8/A9 and IL-6 decreased significantly in the group with diabetes remission and in the control group, but not in the group with persistent diabetes. The relative changes in S100A8/A9 and IL-6 correlated significantly (r = 0.905, p = 0.005) only in the group with persistent diabetes. In contrast, leukocyte count and C-reactive protein correlated significantly to S100A8/A9 only in the control group. Our study is suggestive of S100A8/A9 and IL-6 being related to a persistent diabetes status post-surgically and of different pathophysiological mechanisms being involved in the post-surgical changes in the three groups, despite similar decreases in BMI. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Effects of bergamot ( Citrus bergamia (Risso) Wright & Arn.) essential oil aromatherapy on mood states, parasympathetic nervous system activity, and salivary cortisol levels in 41 healthy females.

PubMed

Watanabe, Eri; Kuchta, Kenny; Kimura, Mari; Rauwald, Hans Wilhelm; Kamei, Tsutomu; Imanishi, Jiro

2015-01-01

Bergamot essential oil (BEO) is commonly used against psychological stress and anxiety in aromatherapy. The primary aim of the present study was to obtain first clinical evidence for these psychological and physiological effects. A secondary aim was to achieve some fundamental understanding of the relevant pharmacological processes. Endocrinological, physiological, and psychological effects of BEO vapor inhalation on 41 healthy females were tested using a random crossover study design. Volunteers were exposed to 3 experimental setups (rest (R), rest + water vapor (RW), rest + water vapor + bergamot essential oil (RWB)) for 15 min each. Immediately after each setup, saliva samples were collected and the volunteers rested for 10 min. Subsequently, they completed the Profile of Mood States, State-Trait Anxiety Inventory, and Fatigue Self-Check List. High-frequency (HF) heart rate values, an indicator for parasympathetic nervous system activity, were calculated from heart rate variability values measured both during the 15 min of the experiment and during the subsequent 10 min of rest. Salivary cortisol (CS) levels in the saliva samples were analyzed using ELISA. CS of all 3 conditions R, RW, and RWB were found to be significantly distinct (p = 0.003). In the subsequent multiple comparison test, the CS value of RWB was significantly lower when compared to the R setup. When comparing the HF values of the RWB setup during the 10 min of rest after the experiment to those of RW, this parameter was significantly increased (p = 0.026) in the RWB setup for which scores for negative emotions and fatigue were also improved. These results demonstrate that BEO inhaled together with water vapor exerts psychological and physiological effects in a relatively short time. © 2015 S. Karger GmbH, Freiburg.

Lifetime Self-Harm Behaviors Are Not More Prevalent in Bariatric Surgery Candidates than in Community Controls with Obesity.

PubMed

Müller, Astrid; Claes, Laurence; Smits, Dirk; Schag, Kathrin; de Zwaan, Martina

2018-01-01

The study aimed at investigating the lifetime prevalence of 22 self-harm behaviors in bariatric surgery candidates (pre-bariatric surgery group; PSG) compared to community controls with obesity (obese community group; OCG). The Self-Harm Inventory (SHI) was administered to the PSG (n = 139, BMI ≥ 35 kg/m2) and to the OCG (n = 122, BMI ≥ 35 kg/m2). Group comparison of cumulative SHI scores indicated a trend towards less endorsed SHI items in the PSG compared to the OCG (medianPSG = 1.00, IQRPSG = 2.00, medianOCG = 1.00, IQROCG = 2.25, U = 7.241, p = 0.033, η2 = 0.02). No significant group differences were found with regard to the rate of suicide attempts (12.4% vs. 9.4% for OCG vs. PSG). At least one type of lifetime self-harm behavior was admitted by 51.8% of the PSG and 63.9% of the OCG (χ2(1) = 3.91, p = 0.048). The results of logistic regressions using Firth's bias reduction method with at least one SHI item endorsed as dependent variable, group as categorical predictor (PSG as baseline), and age or BMI or PHQ-4 as continuous control variable indicated that only PHQ-4 had a positive effect on the odds ratio. The results suggest that self-harm (including suicidal attempts) is not more prevalent in bariatric surgery candidates than in community control participants with obesity. Further studies are needed to investigate self-harm in bariatric surgery patients, prior and following surgery, compared to non-operated patients with obesity. © 2018 The Author(s) Published by S. Karger GmbH, Freiburg.

Therapeutic fasting in patients with metabolic syndrome and impaired insulin resistance.

PubMed

Stange, Rainer; Pflugbeil, Christine; Michalsen, Andreas; Uehleke, Bernhard

2013-01-01

In this study, we evaluated whether a short- to mid-term fasting therapy (7-18 days) might improve insulin resistance according to the homeostasis model assessment for insulin resistance (HOMA-IR), measured during mid-term (80 days) follow-up observation in patients with metabolic syndrome. In this open label observational study in inpatients, criteria of metabolic syndrome were defined. Before medically controlled Buchinger fasting, a wash-out period for hypoglycemic agents was conducted. Further evaluation was carried out on day 80. 25 patients (13 males, 12 females, mean age 61.3 years) were included in this study (mean fasting duration 11.5 days). Out of 16 inpatients with type 2 diabetes, 4 had been treated with metformin, 3 with insulin, and 1 with glimepiride before the intervention. After therapy, body mass index (BMI), fasting insulin, fasting glucose, and HOMA-IR were all significantly reduced. Compared to baseline, HOMA-IR decreased by 33% in all patients, by 38% in patients with type 2 diabetes, and by 23% in patients without diabetes. At day 80, BMI further improved, while other parameters showed complete (insulin) or partial (glucose, HOMA-IR) rebound. At this time, HOMA-IR values showed an only insignificant improvement in 15% of all patients, in 20% of patients with type 2 diabetes, and in 6% of patients without diabetes. There was no correlation between change in BMI and change in HOMA-IR (r(2) = 0.008, baseline minus day 80). No serious side effects were observed. Fasting as a safe and acceptable procedure may cause short- and mid-term improvement of increased insulin resistance (HOMA-IR). Patients with type 2 diabetes benefit more than those without diabetes. A possible clinical significance of this effect should be explored in larger and controlled clinical trials. © 2014 S. Karger GmbH, Freiburg.

Effect of High-Intensity Interval Training on Plasma Omentin-1 Concentration in Overweight/Obese and Normal-Weight Youth.

PubMed

Ouerghi, Nejmeddine; Ben Fradj, Mohamed Kacem; Bezrati, Ikram; Feki, Moncef; Kaabachi, Naziha; Bouassida, Anissa

2017-01-01

Omentin-1 is a recently discovered adipokine, mainly produced by visceral adipose tissue, which is thought to improve insulin sensitivity. The study aimed to assess the association of plasma omentin-1 with cardiometabolic traits and physical performance and to test its response to high-intensity interval training (HIIT) in obese and normal-weight subjects. Nine overweight/obese (OG) and 9 normal-weight (NWG) young men performed an 8-week HIIT program. Body composition, physical performance, homeostasis model assessment index for insulin resistance (HOMA-IR) as well as plasma omentin-1and lipid levels were assessed before and after the HIIT program. Baseline plasma omentin-1 was lower in OG than NWG men (359 ± 138 vs. 470 ± 114 ng/ml; p = 0.052). Plasma omentin-1 was related to body fat (r = -0.57; p = 0.03) and LDL-cholesterol (r = -0.49; p = 0.04). There was a trend towards significant association of omentin-1 with BMI (r = -0.47; p = 0.06) and VO2max (r = 0.41; p = 0.09). However, no association was observed with HOMA-IR. Following the HIIT program, omentin-1 concentrations have significantly (p < 0.01) increased in OG (359 ± 138 to 455 ± 126 ng/ml) and NWG men (470 ± 114 to 572 ± 115 ng/ml). In parallel, the cardiometabolic profile has improved with a significant decrease of HOMA-IR in OG. HIIT resulted in a plasma omentin-1 increase and an improvement with regard to cardiometabolic traits in the OG men, which may contribute to modulate insulin sensitivity. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Neighbourhood deprivation, individual-level familial and socio-demographic factors and diagnosed childhood obesity: a nationwide multilevel study from Sweden.

PubMed

Li, Xinjun; Memarian, Ensieh; Sundquist, Jan; Zöller, Bengt; Sundquist, Kristina

2014-01-01

To examine whether there is an association between neighbourhood deprivation and diagnosed childhood obesity, after accounting for family- and individual-level socio-demographic characteristics. An open cohort of all children aged 0-14 years was followed between January 1, 2000 and December 31, 2010. Childhood residential locations were geocoded and classified according to neighbourhood deprivation. Data were analysed by multilevel logistic regression, with family- and individual-level characteristics at the first level and level of neighbourhood deprivation at the second level. During the study period, among a total of 948,062 children, 10,799 were diagnosed with childhood obesity. Age-adjusted cumulative incidence for diagnosed childhood obesity increased with increasing level of neighbourhood deprivation. Incidence of diagnosed childhood obesity increased with increasing neighbourhood-level deprivation across all family and individual-level socio-demographic categories. The odds ratio (OR) for diagnosed childhood obesity for those living in high-deprivation neighbourhoods versus those living in low-deprivation neighbourhoods was 2.44 (95% confidence interval (CI) = 2.22-2.68). High neighbourhood deprivation remained significantly associated with higher odds of diagnosed childhood obesity after adjustment for family- and individual-level socio-demographic characteristics (OR = 1.70, 95% CI = 1.55-1.89). Age, middle level family income, maternal marital status, low level education, living in large cities, advanced paternal and maternal age, family history of obesity, parental history of diabetes, chronic obstructive pulmonary disease, alcoholism and personal history of diabetes were all associated with higher odds of diagnosed childhood obesity. Our results suggest that neighbourhood characteristics affect the odds of diagnosed childhood obesity independently of family- and individual-level socio-demographic characteristics. © 2014 S. Karger GmbH, Freiburg.

The Influence of Various Parameters on the Success of Sensor-Controlled Scalp Cooling in Preventing Chemotherapy-Induced Alopecia.

PubMed

Schaffrin-Nabe, Dörthe; Schmitz, Inge; Josten-Nabe, Anke; von Hehn, Ulrike; Voigtmann, Rudolf

2015-01-01

The influence of systemic comorbidities on the success of scalp cooling during chemotherapy (CT) is widely unexplored. Comorbidities often require additional medication which itself can occasionally cause alopecia. This study investigates the influence of selected parameters on the efficacy of scalp cooling for the prevention of CT-induced alopecia. 226 cancer patients were treated with various CT regimens in combination with sensor-controlled scalp cooling. 136 breast cancer patients received (neo)adjuvant therapy, and 76 of these patients received epirubicine and cyclophosphamide (4× EC 3w) followed by paclitaxel (12× T w). The following parameters were prospectively investigated: chemotherapy-induced alopecia, systemic comorbidities and co-medication, nicotine abuse, hair treatment, menopausal status, and trichologic status. Scalp cooling was successful (no or not visible hair loss; common toxicity criteria 0-1) in 65% of all patients, in 65% of the 136 breast cancer patients, and in 68% of the 76 patients receiving EC/T. In this subgroup, premenopausal patients (p = 0.009) and those without systemic comorbidities (p = 0.003), without co-medication (p < 0.001) and with high hair density (p = 0.038) showed less hair loss during CT; an effect was also seen for nicotine abuse (p = 0.023). Hair length and hair treatment had no significant influence. Sensor-controlled scalp cooling represents an effective addition to supportive cancer therapy. The success of scalp cooling depends on the applied CT regimen. Parameters like menopausal status, systemic comorbidities, medication, nicotine abuse, and original hair density also influence the outcome of hair loss prevention. © 2015 S. Karger GmbH, Freiburg.

Analysis of the discriminative methods for diagnosis of benign and malignant solitary pulmonary nodules based on serum markers.

PubMed

Wang, Wanping; Liu, Mingyue; Wang, Jing; Tian, Rui; Dong, Junqiang; Liu, Qi; Zhao, Xianping; Wang, Yuanfang

2014-01-01

Screening indexes of tumor serum markers for benign and malignant solitary pulmonary nodules (SPNs) were analyzed to find the optimum method for diagnosis. Enzyme-linked immunosorbent assays, an automatic immune analyzer and radioimmunoassay methods were used to examine the levels of 8 serum markers in 164 SPN patients, and the sensitivity for differential diagnosis of malignant or benign SPN was compared for detection using a single plasma marker or a combination of markers. The results for serological indicators that closely relate to benign and malignant SPNs were screened using the Fisher discriminant analysis and a non-conditional logistic regression analysis method, respectively. The results were then verified by the k-means clustering analysis method. The sensitivity when using a combination of serum markers to detect SPN was higher than that using a single marker. By Fisher discriminant analysis, cytokeratin 19 fragments (CYFRA21-1), carbohydrate antigen 125 (CA125), squamous cell carcinoma antigen (SCC) and breast cancer antigen (CA153), which relate to the benign and malignant SPNs, were screened. Through non-conditional logistic regression analysis, CYFRA21-1, SCC and CA153 were obtained. Using the k-means clustering analysis, the cophenetic correlation coefficient (0.940) obtained by the Fisher discriminant analysis was higher than that obtained with logistic regression analysis (0.875). This study indicated that the Fisher discriminant analysis functioned better in screening out serum markers to recognize the benign and malignant SPN. The combined detection of CYFRA21-1, CA125, SCC and CA153 is an effective way to distinguish benign and malignant SPN, and will find an important clinical application in the early diagnosis of SPN. © 2014 S. Karger GmbH, Freiburg.

Dementia: treating patients and caregivers with complementary and alternative medicine--results of a clinical expert conference using the World Café method.

PubMed

Teut, Michael; Bloedt, Susanne; Baur, Roland; Betsch, Frederik; Elies, Michael; Fruehwald, Maria; Fuesgen, Ingo; Kerckhoff, Annette; Krüger, Eckard; Schimpf, Dorothee; Schnabel, Katharina; Walach, Harald; Warme, Britta; Warning, Albercht; Wilkens, Johannes; Witt, Claudia M

2013-01-01

In Germany the number of inhabitants with dementia is expected to increase from 1.2 million at present to 2.3 million in 2050. Our aim was to investigate which treatments complementary and alternative medicine (CAM) experts consider to be of therapeutic use in developing treatment strategies and hypotheses for further clinical studies. In a participatory group workshop the 'World Café' method was used. As questions we asked: 1) 'Based on your clinical experience, which CAM therapies are effective in the treatment of patients with dementia? 2) Based on your clinical experience, which CAM therapies are effective in the treatment of lay and professional caregivers of patients with dementia?, and 3) How should a CAM treatment program look like?' Further Delphi rounds were used to reach consensus and summarize the results. The 2-day workshop took place in January 2012 in Berlin. A total of 17 experts participated. The most important subject in the treatment was the need to understand patients' biographies in order to individualize the therapy. Therapy itself consists of the therapeutic relationship, nonmedical therapies such as sports, massage, music and arts therapy as well as medical treatment such as herbal or homeopathic medicines. With regard to caregivers the most important aim is to prevent or reduce psychological distress, e.g., by mind-body programs. Instead of single treatments, more general elements such as understanding the patients' biographies, therapeutic relationships, individualizing, networking, and self-care emerged as main results. An integrative treatment program should connect outpatient and inpatient care as well as all experts. CAM training courses should be offered to doctors, nurses, and caregivers. Future clinical studies should focus on complex intervention programs integrating these key elements. © 2013 S. Karger GmbH, Freiburg.

Differential Associations of Walking and Cycling with Body Weight, Body Fat and Fat Distribution - the ACTI-Cités Project.

PubMed

Menai, Mehdi; Charreire, Hélène; Galan, Pilar; Simon, Chantal; Nazare, Julie-Anne; Perchoux, Camille; Weber, Christiane; Enaux, Christophe; Hercberg, Serge; Fezeu, Léopold; Oppert, Jean-Michel

2018-06-22

Research on the associations between walking and cycling with obesity-related phenotypes is growing but relies mostly on the use of BMI. The purpose of this study was to analyze associations of walking and cycling behaviors assessed separately with various obesity markers in French adults. In 12,776 adult participants (71.3% women) of the on-going NutriNet Santé web-cohort, we assessed by self-report past-month walking and cycling (for commuting, errands and leisure), and obesity measures were taken during a visit at a clinical center (weight, height, waist circumference, and percent body fat by bioimpedance). In analyses not taking into account other types of physical activity (household, leisure), walking more than 2.5 h/week was associated in women with lower weight (-1.8 kg), waist circumference (-1.7 cm) and percent body fat (-1.1%) (all p < 0.001). Cycling more than 1.5 h/week was associated in men and women with lower weight (-4.3 and -1.4 kg, respectively), waist circumference (-4.4 and -2.1 cm, respectively), and percent body fat (-2.5 and -1.9 % respectively) (all p < 0.001). Results were unaltered when analyses were further adjusted on household and leisure physical activity. These results show important differences between walking and cycling in their association with obesity markers in men and women. These findings provide some evidence for the need to consider separately walking and cycling when designing public health measures for prevention of obesity in adults. © 2018 The Author(s) Published by S. Karger GmbH, Freiburg.

Documentation of normal and leukemic myelopoietic progenitor cells with high-resolution phase-contrast time-lapse cinematography.

PubMed

Boll, I T

2001-08-01

The high-resolution phase-contrast, time-lapse cinematography using oil immersion lenses and 16-mm film demonstrates the kinetic cell events as maturation, locomotion, mitosis, and apoptosis of cells cultivated at 37 degrees C for up to 10 days. 0.5 v/v frozen-thawed sera with presumably high cytokine concentrations were added to the plasma or agar clot. Vital progenitor cells from human bone marrow and blood have a large, bright, unstructured nucleus with a large nucleolus and a narrow rim of cytoplasm (nuclear/cytoplasmic volume ratio = 0.7). Their nuclei are 6-14 micrometer in diameter and double their volume within 8 h. Many (70%) move at a mean speed of 2 micrometer/min, and many (30%) multiply with alpha-2alpha mitoses, generating progenitor cell families. Various disturbances during the course of mitosis lead to the formation of polyploid cells, thereby yielding the megakaryocytic cell line. Some of the progenitor cells undergo asymmetric alpha-alphan mitoses: One of the two initially identical daughter cells remains a progenitor cell in the morphological sense, whereas the other daughter cell - depending on the size of its mother cell - matures in the same culture medium to form a granulocytopoietic, monocytopoietic or erythrocytopoietic cell line. - In acute myeloid leukemias (AML), the blasts and their nuclei are slightly larger than the corresponding progenitor cells and move faster (5 micrometer/min). Symmetric alpha-2alpha mitoses permit unlimited multiplication of the leukemic blasts if contact with cytotoxic lymphocytes does not render them apoptotic. This results in more stromal cells than normal. Granulocytopenia, monocytopenia, and anemia occur due to the genetic impairment of signaling control for asymmetric alpha-alphan mitoses, and thrombocytopenia occurs due to the reduction in polyploidization. Copyright 2001 S. Karger GmbH, Freiburg

Quality Profiling at the TCM Hospital Bad Kötzting - Examples from an Ongoing Systematic Patient Documentation.

PubMed

Weidenhammer, Wolfgang; Melchart, Dieter

2016-01-01

Quality profiling is practiced at the TCM hospital Bad Kötzting since its establishment 25 years ago. The profiling comprises assessment of treatment effectiveness andsafety, structural features, staff qualification as well as diagnostic and therapeutic processes. Findings regarding patients, intervention and outcome profiles are presented by appropriate examples. Data of each in-patient were systematically collected by physicians and via self-reports at admission, discharge and follow-up. Over the years the system was adjusted several times resulting in a data pool of about 19,000 in-patients by end of 2014. Patients are 52 years old on average, 70% are female, and suffering from the main complaint since 7 years (median). The diagnostic spectrum changed over the years according to the development towards a psychosomatic focus. For TCM acupuncture therapy 222 different acupoints were used in 7.7 different localisations on average per individual treatment. The mean intensity of the main complaint decreased clinically relevant (Cohen's d = 1.11 at discharge and 0.93 at follow-up). After the hospital stay the number of days of sick leave declined from 51.3 days by 40% per patient and year. Depressive disorders as most common mental illness decreased significantly decreased significantly at discharge (ICD symptom rating; Cohen's d = -1.01). 29.8% of patients met the criteria for a metabolic syndrome diagnosis according to the International Diabetes Federation (IDF). In this group of cases, triglycerides, cholesterol and blood glucose improved markedly at discharge. The presented quality control measures clearly contribute to an enhanced transparency in terms of a comprehensive quality profile. The findings from various outcome parameters indicate that patients benefit from the treatment. © 2016 S. Karger GmbH, Freiburg.

[Balneotherapy and spa therapy of rheumatic diseases in Turkey: a systematic review].

PubMed

Karagülle, M Z; Karagülle, M

2004-02-01

Turkey has a lot of thermal and mineral springs and is looking back on a still vivid tradition of spa therapy and balneotherapy, applied especially for the treatment of rheumatic diseases. This tradition is predominantly empiric and intuitive, however, it has assumed some important aspects of modern balneotherapeutic methods as well. This article is aimed at presenting the characteristics of traditional and modern balneological and spa therapy forms in Turkey. The studies which have been conducted between 1990 and 2000 in different spas in Turkey on the efficacy and effectiveness of spa therapy and balneotherapy for rheumatic diseases have been searched and analyzed independent of their design. A descriptive evaluation of the studies was carried out. A total of 15 published studies have been found and analyzed. The investigations have been carried out in 8 different spa resorts in Turkey. In these studies the effectiveness and efficacy of different balneological and spa therapies on a variety of rheumatic diseases (from osteoarthritis to fibromyalgia and from rheumatoid arthritis to low back pain) could be shown. Nearly all studied balneotherapeutic modalities were applied as bathing cures. Only in one study peloid therapy was applied. Balneotherapeutic therapy was applied in a modern and traditional way, and both open and stationary spa therapy forms were used at the same time. The review has shown the effectiveness of the investigated spa therapy and balneotherapy forms. It could be concluded that nearly all forms of spa therapy and balneotherapy used for the treatment of rheumatic diseases in Turkey are effective. A definitive conclusion, however, is not possible because of the heterogeneity of the study designs, methodological flaws, and the publication bias. In future good quality randomized controlled trials are needed. Copyright 2004 S. Karger GmbH, Freiburg

[Acupuncture Therapy versus Disease-modifying Antirheumatic Drugs for the Treatment of Ankylosing Spondylitis--a Meta-analysis].

PubMed

Lv, Zheng-tao; Zhou, Xiang; Chen, An-min

2015-01-01

We conducted a meta-analysis evaluating the efficacy and safety of acupuncture compared to disease-modifying antirheumatic drugs in patients with ankylosing spondylitis. Four databases including Pubmed, EMBASE, Cochrane library, and ISI Web of Science were searched in December 2014, taking also the reference section into account. Randomized controlled trials that aimed to assess the efficacy of acupuncture therapy were identified. The inclusion criteria for the outcome measurements were the clinical effect, ESR, occipital wall test, chest expansion, CRP and finger ground distance. Finally, six studies met these inclusion criteria. Two reviewers screened each article independently and were blinded to the findings of each other. We analyzed data from 6 RCTs involving 541 participants. Acupuncture therapy could further improve the clinical effect (OR = 3.01; 95% CI, 1.48-6.13; P = 0.002) and reduce ESR level (SMD = -0.77; 95% CI, -1.46 to -0.08; P = 0.03) compared to DMARDs; a combination of acupuncture and DMARDs could further improve clinical effect (OR = 3.20, 95% CI, 1.36-7.54; P = 0.008), occipital-wall distance (SMD = -0.84; 95% CI, -1.37 to -0.31; P = 0.002), chest expansion (SMD = 0.38; 95% CI, 0.16-0.60; P = 0.0009), and finger-ground distance (SMD = -0.48; 95% CI, -0.87 to -0.09; P = 0.02) as compared to DMARDs treatment alone. Our findings support that acupuncture therapy could be an option to relieve symptoms associated with AS. These results should be interpreted cautiously due to the generally poor methodological qualities of the included trials. © 2015 S. Karger GmbH, Freiburg.

Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs.

PubMed

Gilardini, Luisa; Redaelli, Gabriella; Croci, Marina; Conti, Antonio; Pasqualinotto, Lucia; Invitti, Cecilia

2016-01-01

To assess the effect of a lifestyle intervention in lowering/normalizing blood pressure (BP) levels in hypertensive (controlled or not) obese patients. In this prospective observational study, 490 obese hypertensive patients, 389 controlled (BP < 140/90 mm Hg; CH) and 101 uncontrolled (BP ≥ 140/90 mm Hg; UH) attended a 3-month lifestyle intervention. Before and after the intervention we assessed weight, waist circumference, fat mass, BP, metabolic and renal variables, and physical activity. A multivariate regression model was used to determine the predictors of BP changes. 18.9% of CH and 20.0% of UH were on ≥ 3 antihypertensive drugs. Weight change (average -4.9 ± 2.7%) was independent of the antihypertensive drugs employed. Systolic BP (SBP) decreased by 23 mm Hg and diastolic BP (DBP) by 9 mm Hg, in patients with UH most of whom (89%) normalized BP levels (in 49% after a weight loss < 5%). Age, gender, whole and central obesity, concomitance of type 2 diabetes, chronic renal disease, physical activity intensification, and pharmacological therapy did not affect BP lowering. In the regression analysis with SBP change as dependent variable, weight reduction (β = 0.523, p = 0.005) and group (UH vs. CH, β = -19.40, p = 0.0005) remained associated with SBP reduction. When DBP change was entered as dependent variable, baseline uric acid remained associated with DBP reduction (β = 0.824, p < 0.05). Lifestyle interventions are useful for all obese hypertensive patients in most of whom a modest weight loss is sufficient to normalize BP levels avoiding the aggressive use of multiple antihypertensive drugs. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Reduction of Portion Size and Eating Rate Is Associated with BMI-SDS Reduction in Overweight and Obese Children and Adolescents: Results on Eating and Nutrition Behaviour from the Observational KgAS Study.

PubMed

Torbahn, Gabriel; Gellhaus, Ines; Koch, Benjamin; von Kries, Rüdiger; Obermeier, Viola; Holl, Reinhard W; Fink, Katharina; van Egmond-Fröhlich, Andreas

2017-01-01

Treatment of paediatric obesity focuses on changes of nutrition and eating behaviour and physical activity. The evaluation of the patient education programme by KgAS was utilised to analyse the association of changes of portion size, eating rate and dietary habits with BMI-SDS reductions. Patients (n = 297) were examined at the beginning and at the end of treatment and after 1-year follow-up at different out-patient centres. Their parents completed questionnaires including estimation of children's portion size, eating rate and frequency of food intake. Associations of 1- and 2-year changes in BMI-SDS and behaviour were calculated for patients with complete data in BMI-SDS, portion size, eating rate, frequency of green, yellow and red food intake (n = 131) by multiple linear regression models. Significant changes were found in the desired direction for BMI-SDS, portion size, eating rate and the intake of unfavourable red food items both after 1 and 2 years as well as for the consumption of favourable green food items after 1 year. Significant positive associations with BMI-SDS reduction after 1 and 2 years were detected for portion size (Cohen's f2 0.13 and 0.09) and eating rate (Cohen's f2 0.20 and 0.10), respectively. Reduced portion sizes and eating rates are associated with BMI-SDS reduction after 1 and 2 years. These findings suggest to focus on appropriate portion sizes and reduced eating rates in patient education programmes. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Guideline Adherence Regarding the Use of Expensive Drugs in Daily Practice: The Examples of Trastuzumab in Breast Cancer and Bortezomib in Multiple Myeloma.

PubMed

Boons, Christel C L M; Wagner, Cordula; Hugtenburg, Jacqueline G

2016-01-01

The present study was designed to obtain insights into guideline adherence regarding the use of expensive drugs in The Netherlands in daily practice and into the patients' perspective on the decision-making process. A retrospective review of medical charts regarding the use of trastuzumab in early and metastatic breast cancer (EBC/MBC) and bortezomib in multiple myeloma (MM) was conducted. Prescription according to clinical practice guidelines was assessed. The review was supplemented with patient interviews. Of 702 adjuvant-treated EBC patients, 97% had a documented human epidermal growth factor receptor 2 (HER2) testing (23% HER2 positive). 92% (147/160) of the HER2-positive EBC patients were treated with trastuzumab. Of 594 MBC patients, 81% had a documented HER2 testing (19% HER2 positive). 82% (75/91) of the HER2-positive MBC patients were treated with trastuzumab. Of 68 MM patients, 50% were treated with bortezomib. Reasons not to treat were consistent with the guidelines. Patients were generally satisfied with the decision-making process; improvements in patient education were suggested (e.g., repeating the information given, adding information on side effects). Guidelines were generally well followed with respect to trastuzumab and bortezomib, indicating that funding did not influence the treatment decisions of physicians. In view of the growing numbers of both cancer patients and expensive new anticancer drugs, and increasing budget constraints, it is unclear whether the present-day policies will guarantee a similar level of guideline adherence. Patient involvement in decision-making could be increased by improving the patient education on treatment. © 2016 S. Karger GmbH, Freiburg.

Preclinical development of a vaccine 'against smoking'.

PubMed

Cerny, E H; Lévy, R; Mauel, J; Mpandi, M; Mutter, M; Henzelin-Nkubana, C; Patiny, L; Tuchscherer, G; Cerny, T

2002-10-01

Nicotine is the main culprit for dependence on tobacco-containing products, which in turn are a major etiologic factor for cardiovascular diseases and cancer. This publication describes a vaccine, which elicits antibodies against nicotine. The antibodies in the blood stream intercept the nicotine molecule on its way to its receptors and greatly diminish the nicotine influx to the brain shortly after smoking. The nicotine molecule is chemically linked to cholera toxin B as a carrier protein in order to induce antibodies. The potential to elicit antibodies after subcutaneous as well as intranasal immunization is evaluated. In order to simulate realistic conditions, nicotine pumps delivering the nicotine equivalent of 5 packages of cigarettes for 4 weeks are implanted into the mice 1 week prior to vaccination. The protective effect of the vaccine is measured 5 weeks after vaccination by comparing the influx of radiolabeled nicotine in the brains of vaccinated and non-vaccinated animals 5 min after challenge with the nicotine equivalent of 2 cigarettes. The polyclonal antibodies induced by the vaccine show a mean avidity of 1.8 x 10(7) l/Mol. Subcutaneous immunization elicits high antibody levels of the IgG class, and significant IgA antibody levels in the saliva of vaccinated mice can be found after intranasal vaccination. The protective effect also in the animals with implanted nicotine pumps is significant: less than 10% of radiolabeled nicotine found in the brains of non-vaccinated animals can be found in the brains of vaccinated animals. These data provide credible evidence that a vaccine can break the vicious circle between smoking and instant gratification by intercepting the nicotine molecule. Astonishingly, there is no sign of exhaustion of specific antibodies even under extreme conditions, which makes it highly unlikely that a smoker can overcome the protective effect of the vaccine by smoking more. Finally, the high titers of specific antibodies after 1 year let us hope that booster vaccinations are probably only necessary in intervals of years. Copyright 2002 S. Karger GmbH, Freiburg

[Efficacy of Arnica in varicose vein surgery: results of a randomized, double-blind, placebo-controlled pilot study].

PubMed

Wolf, M; Tamaschke, C; Mayer, W; Heger, M

2003-10-01

In homeopathy ARNICA is widely used as a woundhealing medication and for the treatment of hematomas. In this pilot study the efficacy and safety of ARNICA D12 in patients following varicose vein surgery were investigated. Prospective, randomized, double-blind, placebo-controlled pilot trial according to ICH GCP guidelines. The study was conducted by a surgeon at the Angiosurgical Clinic, Berlin- Buch. After randomized allocation, 60 patients received either ARNICA D12 or placebo. Start of medication occurred the evening before operation with 5 globules. On the operation day one preoperative and hourly postoperative dosages after awakening were given. On days 2-14 of the study 5 globules 3 times a day were given. OUTCOME CRITERIA: Surface (in cm(2) and using a three-point verbal rating scale) and intensity of hematomas induced by operation, complications of wound healing, and intensity of pain (five-point verbal rating scale) as well as efficacy and safety of the study medication were assessed. Hematoma surface was reduced (from day 7 to day 14) under ARNICA by 75.5% and under placebo by 71.5% (p = 0.4726). The comparison of hematoma surface (small, medium, large) using the verbal rating scale yielded a value of p = 0.1260. Pain score decreased by 1.0 +/- 2.2 points under ARNICA and 0.3 +/- 0.8 points under placebo (p = 0.1977). Remission or improvement of pain was observed in 43.3% of patients in the ARNICA group and in 27.6% of patients in the placebo group. Tolerability was rated as very good in all cases. The results of this pilot study showed a trend towards a beneficial effect of ARNICA D12 with regard to reduction of hematoma and pain during the postoperative course. For a statistically significant proof of efficacy of ARNICA D12 in patients following varicose vein surgery a larger sample size is necessary. Copyright 2003 S. Karger GmbH, Freiburg

[Postoperative adjuvante Therapie mit einem Mistelextrakt (Viscum album ssp. album) bei Hündinnen mit Mammatumoren].

PubMed

Biegel, Ulrike; Stratmann, Nina; Knauf, Yvonne; Ruess, Katja; Reif, Marcus; Wehrend, Axel

2017-01-01

Hintergrund: Canine Mammatumoren (CMT) sind wegen ihrer Häufigkeit und hohen Malignitätsrate eine Herausforderung für die Veterinärmedizin. Bisher ist noch keine postoperative adjuvante Therapie als wirksamer Standard etabliert und in den nächsten Jahren wohl auch nicht zu erwarten. Zusätzlich ist die Frage nach der Verträglichkeit einer adjuvanten Therapie mit Erhaltung oder Verbesserung der Lebensqualität (LQ) wichtig. Die Therapie mit Mistelextrakten (Viscum album L.; VAE) ist in der Humanonkologie nach adjuvanter Tumorbasistherapie (Chemotherapie und Bestrahlung) eine sehr häufig verwendete, zusätzliche adjuvante Behandlungsmethode. Auch bei verschiedenen Tierarten werden inzwischen Mistelpräparate in der Onkologie erfolgreich angewendet. Methoden: Überprüfung von Wirkung und Nutzen einer postoperativen, adjuvanten Misteltherapie beim CMT sowie Erfassung der LQ unter der VAE-Behandlung. Ausgewertet wurden 56 Hündinnen mit Mammaadenokarzinom, 33 ausschließlich operierte Kontrolltiere und 23 operierte Tiere, die adjuvant VAE erhielten. Ergebnisse: Die mediane Überlebenszeit (MST) aller Tiere (n = 56) betrug 32 Monate (Interquartilbereich 13-51 Monate). Im deskriptiven Vergleich der Überlebenszeiten (ST) nach Kaplan-Meier waren nach 12, 24, 36 bzw. 48 Monaten noch 24, 20, 15 bzw. 5 Hündinnen (entsprechend 72,7%, 60,6%, 45,1%, 12,4%) der Kontrollgruppe sowie 19, 14, 11 und 1 Hündin (82,6%, 60,9%, 47,8%, 4,3%) der VAE-Gruppe am Leben. Die VAE-Therapie führte zu einem geringeren Gesamtversterberisiko, das statistisch nicht signifikant war (Hazard Ratio (HR) 0,530, 95%-Konfidenzintervall (KI) 0,222-1,262; p = 0,15). Tendenziell (p = 0,07) zeigte sich eine Verringerung des tumorbedingten Sterberisikos auf 25% (HR 0,251, 95%-KI 0,056-1,122). Schlussfolgerungen: Es kann eine Tendenz zur Senkung des tumorbedingten Sterberisikos der VAE-Gruppe bei guter Verträglichkeit der Therapie angenommen werden. Die LQ der Tiere blieb über die gesamte Beobachtungszeit auf hohem Niveau stabil. © 2017 S. Karger GmbH, Freiburg.

Antibakterielle In-vitro-Wirksamkeit ätherischer Öle gegen veterinärmedizinisch relevante Keime klinischer Isolate von Hunden, Katzen und Pferden.

PubMed

Bismarck, Doris; Schneider, Marianne; Müller, Elisabeth

Einleitung: Ätherische Öle sind die Grundlage der Aromatherapie. Unter anderem wird ihnen eine antibakterielle Wirkung zugeschrieben. In dieser Studie sollte die In-vitro-Wirksamkeit ätherischer Öle gegen ein breites Spektrum veterinärmedizinisch relevanter Erreger getestet werden. Methoden: Die antibakterielle Aktivität von 16 ätherischen Ölen wurde mittels Agardiffusionstest bestimmt. Getestet wurden grampositive und gramnegative Erreger, die aus klinischen Isolaten von Hunden, Katzen und Pferden aus der veterinärmedizinischen Routinediagnostik stammten. Die Einteilung der Wirksamkeit in nicht, gering-, mittel- und hochgradig wirksam erfolgte anhand der Größe der Hemmhofradien des Bakterienwachstums. Ergebnisse: Generell zeigten sich sowohl grampositive als auch gramnegative Erreger empfindlich gegen einige der getesteten ätherischen Öle. Nicht nur gegen Staphylokokken, sondern auch gegen Methicillin-resistente Stämme der Staphylokokken wiesen die ätherischen Öle in vitro eine nicht zu vernachlässigende Wirkung auf. Pasteurella multocida stellte sich als eher sensibler Keim heraus, während Pseudomonas aeruginosa als vollkommen resistenter Keim eine Ausnahme bildete. Teebaum-, Oregano-, und Bergbohnenkrautöl waren die potentesten Öle. Zusätzlich zeigten sich bei den grampositiven Erregern Lemongrasöl und bei den gramnegativen Erregern Thymianöl als gut wirksam. Schlussfolgerung: Ätherische Öle verfügen in vitro über eine antibakterielle Aktivität gegen klinische Isolate von Hunden, Katzen und Pferden. Diese Studie bietet eine Grundlage für die Anwendung ätherischer Öle in der Veterinärmedizin. Es zeichneten sich Tendenzen im Wirkspektrum einzelner ätherischer Öle bzw. im Grad der Wirksamkeit ätherischer Öle hinsichtlich einzelner Erregerspezies ab, allerdings lässt sich keine sichere Vorhersage über ihre Wirksamkeit gegen einen spezifischen Keim eines individuellen Patienten treffen. Deswegen sollte vor einer Therapie mit ätherischen Ölen deren individuelle Wirksamkeit mittels Aromatogramm getestet werden. © 2017 The Author(s). Published by S. Karger GmbH, Freiburg.

Cupping for chronic nonspecific neck pain: a 2-year follow-up.

PubMed

Lauche, Romy; Cramer, Holger; Langhorst, Jost; Dobos, Gustav

2013-01-01

Several trials have shown that cupping might be an effective treatment for chronic nonspecific neck pain, but little is known about the long-term effectiveness. This study aimed to investigate long-term effects of a short series of cupping; therefore additional follow-up measurements were conducted 2 years after completion of 3 studies. Participants from 3 randomized waitlist controlled trials on cupping for chronic nonspecific neck pain were followed 2 years after treatment. Outcome measures included neck pain intensity (100 mm Visual Analog Scale; VAS), functional disability (Neck Disability Index, NDI), and health-related quality of life (Short Form 36 Health Survey Questionnaire; SF-36). 133 of 150 patients had received cupping treatment and were contacted; 82 of them (61.7%) returned the follow-up questionnaires. No effect was found for neck pain intensity, but for physical function (∆ NDI: -3.15; 95% CI: -5.89; -0.41; p = 0.025) and quality of life (∆ physical component summary: 2.97; 95% CI: 0.97; 4.97; p = 0.004; ∆ bodily pain: 14.53; 95 % CI: 9.67; 19.39; p < 0.001). Mean duration of cupping effect was 8.9 ± 8.7 months with 16 patients reporting that neck pain had not yet reached the level before cupping. The majority of the patients did not continue cupping therapy, mostly due to lack of providers, costs or loss of interest. A series of cupping treatments did not influence neck pain intensity on the longer term, however significant increases were found for physical function and quality of life in patients with chronic nonspecific neck pain. Due to the considerable drop-out rate conclusions are limited. There is evidence suggesting that cupping treatment might have sustainable effects in some patients. Further randomized controlled trials with long-term follow-up are urgently needed for conclusive judgment of long-term effectiveness. © 2013 S. Karger GmbH, Freiburg.

European Guidelines for Obesity Management in Adults.

PubMed

Yumuk, Volkan; Tsigos, Constantine; Fried, Martin; Schindler, Karin; Busetto, Luca; Micic, Dragan; Toplak, Hermann

2015-01-01

Obesity is a chronic metabolic disease characterised by an increase of body fat stores. It is a gateway to ill health, and it has become one of the leading causes of disability and death, affecting not only adults but also children and adolescents worldwide. In clinical practice, the body fatness is estimated by BMI, and the accumulation of intra-abdominal fat (marker for higher metabolic and cardiovascular disease risk) can be assessed by waist circumference. Complex interactions between biological, behavioural, social and environmental factors are involved in regulation of energy balance and fat stores. A comprehensive history, physical examination and laboratory assessment relevant to the patient's obesity should be obtained. Appropriate goals of weight management emphasise realistic weight loss to achieve a reduction in health risks and should include promotion of weight loss, maintenance and prevention of weight regain. Management of co-morbidities and improving quality of life of obese patients are also included in treatment aims. Balanced hypocaloric diets result in clinically meaningful weight loss regardless of which macronutrients they emphasise. Aerobic training is the optimal mode of exercise for reducing fat mass while a programme including resistance training is needed for increasing lean mass in middle-aged and overweight/obese individuals. Cognitive behavioural therapy directly addresses behaviours that require change for successful weight loss and weight loss maintenance. Pharmacotherapy can help patients to maintain compliance and ameliorate obesity-related health risks. Surgery is the most effective treatment for morbid obesity in terms of long-term weight loss. A comprehensive obesity management can only be accomplished by a multidisciplinary obesity management team. We conclude that physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment. Treatment should be based on good clinical care, and evidence-based interventions; should focus on realistic goals and lifelong multidisciplinary management. © 2015 S. Karger GmbH, Freiburg.

Energy gap in the aetiology of body weight gain and obesity: a challenging concept with a complex evaluation and pitfalls.

PubMed

Schutz, Yves; Byrne, Nuala M; Dulloo, Abdul; Hills, Andrew P

2014-01-01

The concept of energy gap(s) is useful for understanding the consequence of a small daily, weekly, or monthly positive energy balance and the inconspicuous shift in weight gain ultimately leading to overweight and obesity. Energy gap is a dynamic concept: an initial positive energy gap incurred via an increase in energy intake (or a decrease in physical activity) is not constant, may fade out with time if the initial conditions are maintained, and depends on the 'efficiency' with which the readjustment of the energy imbalance gap occurs with time. The metabolic response to an energy imbalance gap and the magnitude of the energy gap(s) can be estimated by at least two methods, i.e. i) assessment by longitudinal overfeeding studies, imposing (by design) an initial positive energy imbalance gap; ii) retrospective assessment based on epidemiological surveys, whereby the accumulated endogenous energy storage per unit of time is calculated from the change in body weight and body composition. In order to illustrate the difficulty of accurately assessing an energy gap we have used, as an illustrative example, a recent epidemiological study which tracked changes in total energy intake (estimated by gross food availability) and body weight over 3 decades in the US, combined with total energy expenditure prediction from body weight using doubly labelled water data. At the population level, the study attempted to assess the cause of the energy gap purported to be entirely due to increased food intake. Based on an estimate of change in energy intake judged to be more reliable (i.e. in the same study population) and together with calculations of simple energetic indices, our analysis suggests that conclusions about the fundamental causes of obesity development in a population (excess intake vs. low physical activity or both) is clouded by a high level of uncertainty. © 2014 S. Karger GmbH, Freiburg.

Long-Term (7 Years) Follow-Up of Roux-en-Y Gastric Bypass on Obese Adolescent Patients (<18 Years).

PubMed

Vilallonga, Ramon; Himpens, Jacques; van de Vrande, Simon

2016-01-01

Few data are available about obesity surgery in adolescent patients. To assess long-term outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients <18 years. University Hospital, Europe. A retrospective study of prospectively collected data of patients <18 years (childhood group; ChG) (n = 28) treated by LRYGB of which 19 were available for follow-up between 2.4 and 10.2 years (mean 7.2 years). This group of patients was matched with an adult control group (AdG) of randomly chosen patients with similar characteristics who underwent LRYGB during the same period. The extensive survey included a telephonic questionnaire. 19 (12 females) of the 28 patients (67.9%) were available for follow-up. Preoperatively, 3 had type 2 diabetes mellitus (T2DM), 1 arterial hypertension, 5 dyslipidemia and 1 sleep apnea. In the ChG, average BMI after 7 years dropped from 38.9 kg/m2 preoperatively to 27.5 kg/m2. In the AdG, average BMI decreased from 39.4 to 27.1 kg/m2 in the same time period (nonsignificant between groups). One patient in the ChG needed a reoperation (internal hernia) versus 3 patients in the AdG (1 leak, 2 obstructions). All patients resolved their initial comorbidities. Two of 12 female patients in the ChG became pregnant 6 and 8 years after surgery, respectively, despite seemingly adequate oral contraception. Compliance with postoperative guidelines was good in 16/19 patients in ChG and in 14/18 patients in the AdG. Overall degree of satisfaction was high: 8.2/10 (SD 1.2, range 6-10) in the ChG and 8.9/10 (SD 1.7, range 5-10) in the AdG. LRYGB seems to be safe, provide good weight loss, and cure comorbidities in an adolescent population. Satisfaction degree is high. Inadvertent pregnancy despite conventional contraception is a possible issue. © 2016 S. Karger GmbH, Freiburg.

Design of a Self-Management Program for Children Aged 6-12 Years with Type 1 Diabetes Mellitus at the Community Hospital Herdecke, Germany.

PubMed

Berger, Bettina; Sethe, Dominik; Hilgard, Dörte; Martin, David; Heusser, Peter

Children with type 1 diabetes mellitus (T1DM) must replace lacking endogenous insulin by daily insulin injections or insulin pumps. Standards of treatment include educational programs enabling self-management. The program 'Herdecker Kids with Diabetes' (HeKiDi) is based on an anthroposophic understanding of the human being and intends to provide an individualized, patient-oriented approach to developing diabetes-related and comprehensive human competencies. Analysis of the HeKiDi program for children (6-12 years) with T1DM as the first part of an evaluation of a complex intervention. Ethnographic approach, following the Consolidated Criteria for Reporting Qualitative Research (COREQ), including field observations and interviews with responsible persons, content analysis of materials for determining the structure and the curriculum, presented according to the Template for Intervention Description and Replication (TIDieR). The curriculum follows the standard but adds a learning circle between the child and the therapeutic team comprising 3 stages: (1) perception of the abilities and needs of the individual child supported by adult mentors themselves suffering from T1DM, (2) reflection within the therapeutic team, and (3) daily feedback to the child. Curricular Learning Objectives: Children feel recognized and supported in their individual developmental and diabetes-related competencies and develop motoric, artistic, communicative, and social skills to strengthen their self-efficacy and to understand T1DM as a lifelong awareness process. The curriculum including its associated learning goals and methods was presented. The program was explained and shown to be reproducible. Whether this program truly leads to better outcomes in regard to self-efficacy and hemoglobin A1c (HbA1c, glycated hemoglobin) and how parents and children perceive this will have to be assessed using a comparative interventional study. © 2017 S. Karger GmbH, Freiburg.

Towards an animal model of food addiction.

PubMed

de Jong, Johannes W; Vanderschuren, Louk J M J; Adan, Roger A H

2012-01-01

The dramatically increasing prevalence of obesity, associated with potentially life-threatening health problems, including cardiovascular diseases and type II diabetes, poses an enormous public health problem. It has been proposed that the obesity epidemic can be explained by the concept of 'food addiction'. In this review we focus on possible similarities between binge eating disorder (BED), which is highly prevalent in the obese population, and drug addiction. Indeed, both behavioral and neural similarities between addiction and BED have been demonstrated. Behavioral similarities are reflected in the overlap in DSM-IV criteria for drug addiction with the (suggested) criteria for BED and by food addiction-like behavior in animals after prolonged intermittent access to palatable food. Neural similarities include the overlap in brain regions involved in food and drug craving. Decreased dopamine D2 receptor availability in the striatum has been found in animal models of binge eating, after cocaine self-administration in animals as well as in drug addiction and obesity in humans. To further explore the neurobiological basis of food addiction, it is essential to have an animal model to test the addictive potential of palatable food. A recently developed animal model for drug addiction involves three behavioral characteristics that are based on the DSM-IV criteria: i) extremely high motivation to obtain the drug, ii) difficulty in limiting drug seeking even in periods of explicit non-availability, iii) continuation of drug-seeking despite negative consequences. Indeed, it has been shown that a subgroup of rats, after prolonged cocaine self-administration, scores positive on these three criteria. If food possesses addictive properties, then food-addicted rats should also meet these criteria while searching for and consuming food. In this review we discuss evidence from literature regarding food addiction-like behavior. We also suggest future experiments that could further contribute to our understanding of behavioral and neural commonalities and differences between obesity and drug addiction. Copyright © 2012 S. Karger GmbH, Freiburg.

Personality Profiles, Values and Empathy: Differences between Lacto-Ovo-Vegetarians and Vegans.

PubMed

Kessler, Christian S; Holler, Sophie; Joy, Sebastian; Dhruva, Anand; Michalsen, Andreas; Dobos, Gustav; Cramer, Holger

2016-01-01

Vegetarian nutrition is gaining increasing public attention worldwide. While some studies have examined differences in motivations and personality traits between vegetarians and omnivores, only few studies have considered differences in motivations and personality traits between the 2 largest vegetarian subgroups: lacto-ovo-vegetarians and vegans. To examine differences between lacto-ovo-vegetarians and vegans in the distribution patterns of motives, values, empathy, and personality profiles. An anonymous online survey was performed in January 2014. Group differences between vegetarians and vegans in their initial motives for the choice of nutritional approaches, health-related quality of life (World Health Organization Quality of Life-BREF (WHOQOL-BREF)), personality traits (Big Five Inventory-SOEP (BFI-S)), values (Portraits Value Questionnaire (PVQ)), and empathy (Empathizing Scale) were analyzed by univariate analyses of covariance; P values were adjusted for multiple testing. 10,184 individuals completed the survey; 4,427 (43.5%) were vegetarians and 4,822 (47.3%) were vegans. Regarding the initial motives for the choice of nutritional approaches, vegans rated food taste, love of animals, and global/humanitarian reasons as more important, and the influence of their social environment as less important than did vegetarians. Compared to vegetarians, vegans had higher values on physical, psychological, and social quality of life on the WHOQOL-BREF, and scored lower on neuroticism and higher on openness on the BFI-S. In the PVQ, vegans scored lower than vegetarians on power/might, achievement, safety, conformity, and tradition and higher on self-determination and universalism. Vegans had higher empathy than vegetarians (all p < 0.001). This survey suggests that vegans have more open and compatible personality traits, are more universalistic, empathic, and ethically oriented, and have a slightly higher quality of life when compared to vegetarians. Given the small absolute size of these differences, further research is needed to evaluate whether these group differences are relevant in everyday life and can be confirmed in other populations. © 2016 S. Karger GmbH, Freiburg.

Metabolic and psychological response to 7-day fasting in obese patients with and without metabolic syndrome.

PubMed

Li, Chenying; Ostermann, Thomas; Hardt, Monika; Lüdtke, Rainer; Broecker-Preuss, Martina; Dobos, Gustav; Michalsen, Andreas

2013-01-01

Extended modified fasting is a frequently practiced tradition in Europe. It is claimed to improve the cardiometabolic state and physical and psychological well-being by an evolutionary co-developed adaptation response. We aimed to investigate the cardiometabolic and psychological effects of a 7-day fast and differences of these responses between patients with or without metabolic syndrome (MetS). We investigated 30 female subjects (49.0 ± 8.1 years, BMI 30.4 ± 6.7 kg/m(2)) with (n = 12) and without (n = 18) MetS. All subjects participated in a 7-day fast according to Buchinger with a nutritional energy intake of 300 kcal/day and stepwise reintroduction of solid food thereafter. Outcomes were assessed baseline and after fasting and included measures of metabolic and glucoregulatory control, adipokines as well as psychological well-being as assessed by Profile of Mood States (POMS) and Hospital Anxiety and Depression Scale (HADS). Mean weight decreased from 85.4 ± 18.8 kg to 79.7 ± 18.2 kg accompanied by systolic/diastolic blood pressure (BP) reduction of -16.2 mm Hg (95% CI: -9.1; -23.3 mm Hg) and -6.0 mm Hg (95% CI: -1.8; -10.3 mm Hg), each p < 0.001 and p = 0.005. Fasting led to marked decreases of levels of LDL-cholesterol, leptin, and insulin and increases of levels of adiponectin, leptin receptors, and resistin. Fasting-induced mood enhancement was reflected by decreased anxiety, depression, fatigue, and improved vigor. Patients with MetS showed some greater changes in B P, LDL-cholesterol, triglycerides, adiponectin, leptin, and sleep quality. Fasting was well-tolerated. Our results point to marked beneficial responses to 7-day modified fasting and a potential role in the prevention of the MetS. Randomized trials with longer observation periods should test the clinical effectiveness of fasting in metabolic diseases. © 2014 S. Karger GmbH, Freiburg.

Potential of nor-Ursodeoxycholic Acid in Cholestatic and Metabolic Disorders.

PubMed

Trauner, Michael; Halilbasic, Emina; Claudel, Thierry; Steinacher, Daniel; Fuchs, Claudia; Moustafa, Tarek; Pollheimer, Marion; Krones, Elisabeth; Kienbacher, Christian; Traussnigg, Stefan; Kazemi-Shirazi, Lili; Munda, Petra; Hofer, Harald; Fickert, Peter; Paumgartner, Gustav

2015-01-01

24-nor-ursodeoxycholic acid (norUDCA) is a side-chain shortened derivate of ursodeoxycholic acid (UDCA). Since norUDCA is only ineffectively conjugated with glycine or taurine, it has specific physicochemical and therapeutic properties distinct from UDCA. Nonamidated norUDCA undergoes cholehepatic shunting enabling 'ductular targeting' and inducing a bicarbonate-rich hypercholeresis, with cholangioprotective effects. At the same time it has direct anti-inflammatory, antilipotoxic, anti fibrotic, and antiproliferative properties targeting various liver cell populations. norUDCA appears to be one of the most promising novel treatment approaches targeting the liver and the bile duct system at multifactorial and multicellular levels. This review article is a summary of a lecture given at the XXIII International Bile Acid Meeting (Falk Symposium 194) on 'Bile Acids as Signal Integrators and Metabolic Modulators' held in Freiburg, October 8-9, 2014, and summarizes the recent progress with norUDCA as a novel therapeutic approach in cholestatic and metabolic (liver) disorders. 2015 S. Karger AG, Basel.

Visual acuity testing in diabetic subjects: the decimal progression chart versus the Freiburg visual acuity test.

PubMed

Loumann Knudsen, Lars

2003-08-01

To study reproducibility and biological variation of visual acuity in diabetic maculopathy, using two different visual acuity tests, the decimal progression chart and the Freiburg visual acuity test. Twenty-two eyes in 11 diabetic subjects were examined several times within a 12-month period using both visual acuity tests. The most commonly used visual acuity test in Denmark (the decimal progression chart) was compared to the Freiburg visual acuity test (automated testing) in a paired study. Correlation analysis revealed agreement between the two methods (r(2)=0.79; slope=0.82; y-axis intercept=0.01). The mean visual acuity was found to be 15% higher (P<0.0001) with the decimal progression chart than with the Freiburg visual acuity test. The reproducibility was the same in both tests (coefficient of variation: 12% for each test); however, the variation within the 12-month examination period differed significantly. The coefficient of variation was 17% using the decimal progression chart, 35% with the Freiburg visual acuity test. The reproducibility of the two visual acuity tests is comparable under optimal testing conditions in diabetic subjects with macular oedema. However, it appears that the Freiburg visual acuity test is significantly better for detection of biological variation.

Treatment outcomes in patients with migraine: an ex-post-facto comparison of two in-patient facilities.

PubMed

Weidenhammer, W; Linde, K; Melchart, D

2004-08-01

In two hospitals we performed an open, prospective observational study on patients with chronic headache as a measure of internal quality assurance using identical methods. Available data were subordinately analysed in order to compare both studies. Are the patient samples of both hospitals comparable? If not, which form of statistical adjustment is recommended? Are there differences in the outcome measures of both facilities? The outcomes were defined as differences between baseline values and values at discharge from hospital, respectively 6 months after. Frequency of headache attacks, intensity of pain, intensity of general complaints as well as of concomitant symptoms, and quality of life were determined in advance as dependent variables. To compare both patient groups univariate analysis of variance without and with inclusion of covariates were used. For calculating propensity scores (conditional probability of belonging to one of two groups) a logistic regression with the same covariates serving as independent variables was performed. 426 patients with the main diagnosis "Migraine" and complete data sets concerning the covariates were selected for analysis. 87% of patients are female, the mean age is 45.5 +/- 11.7 years (range 14-73 yrs). 4 out of 11 potential covariates show statistically significant differences between the patients of both hospitals. Correct classification of patients by means of the propensity score succeeds in 67%. Comparing the outcomes at discharge from hospital, significant differences between both groups exist which are, with one exception, not affected by controlling for covariates. 6 months after discharge two of the initial differences between both patient groups are no longer present. These findings are independent from the statistical technique of risk adjustment. Because of the observed differences between both patient groups it is recommended to adjust data by regression analysis in order to enhance comparability. The choice for one of the two proposed techniques is secondary. With respect to the analyses clear differences between both hospitals exist in short-term outcomes, disappearing 6 months later. Copyright 2004 S. Karger GmbH, Freiburg

[Cardiodoron® bei Patienten mit Schlafstörungen - Ergebnisse einer prospektiven Beobachtungsstudie].

PubMed

Rother, Claudia; Schnelle, Martin

Hintergrund: Schlafstörungen gehören zu den häufigsten gesundheitlichen Problemen der heutigen Zeit. Stress und die dadurch bedingte innere Anspannung sowie eine unrhythmische Lebensführung z.B. durch Schichtarbeit sind bekannte auslösende Faktoren. Weniger bekannt ist, dass auch funktionelle Herz-Kreislauf-Beschwerden zu Störungen des Schlafs führen können und dass deren Behandlung zu einer Verbesserung der Schlafqualität beiträgt. Ganzheitlich betrachtet geht es daher um die Wiederherstellung einer gesunden Rhythmik, insbesondere des Herz-/Atem- sowie des Schlaf-Wach-Rhythmus, die Cardiodoron®, eine Heilpflanzenkomposition aus Primula veris, Hyoscyamus niger und Onopordum acanthium, unterstützt. Patienten und Methoden: Mittels einer prospektiven, multizentrischen Beobachtungsstudie sollte ermittelt werden, wie sich funktionelle Herz-Kreislauf-Beschwerden und/oder Schlafstörungen unter der Behandlung mit Cardiodoron® (Dilution) über 3-6 Monate entwickeln. Im Zeitraum von September 2009 bis März 2012 dokumentierten 92 Ärzte 501 Patienten, von denen 380 über Schlafstörungen klagten und deren Daten in dieser Publikation näher betrachtet werden. Nach einer Aufnahmeuntersuchung erfolgte nach 90 Tagen eine Abschlussuntersuchung und bei Fortführung der Therapie nach nochmals 90 Tagen eine Follow-up-Untersuchung. Neben 30 ärztlicherseits bewerteten Symptomen beurteilten die Patienten ihr Befinden mittels Pittsburgh Sleep Quality Index (PSQI) nach Buysse und der Beschwerden-Liste nach von Zerssen (B-L und B-L'). Ergebnisse: Unter der Cardiodoron®-Therapie gingen bei guter Verträglichkeit sowohl die Ausprägung der Schlafstörungen (um 65% von 2,0 auf 0,7 Punkte) als auch die erfassten 30 Symptome (um 59% von 24,3 auf 9,9 Punkte) deutlich zurück (p < 0,01). Weiterhin reduzierten sich der PSQI und der Gesamtwert der Beschwerden-Liste signifikant (p < 0,0001) um 60% bzw. 56% (von 12,2 auf 4,8 bzw. von 25,6 auf 11,4 Punkte). Schlussfolgerungen: Bei Patienten mit Schlafstörungen (mit oder ohne funktionelle Herz-Kreislauf-Beschwerden) kann die Ausprägung der Beschwerden mit Cardiodoron® deutlich gesenkt werden. Cardiodoron® ist gut verträglich. © 2016 S. Karger GmbH, Freiburg.

Cannabis and cannabinoids: pharmacology and rationale for clinical use.

PubMed

Pertwee, R G

1999-10-01

It is now known that there are at least two types of cannabinoid receptors. These are CB1 receptors, present mainly on central and peripheral neurones, and CB2 receptors, present mainly on immune cells. Endogenous cannabinoid receptor agonists ('endocannabinoids') have also been identified. The discovery of this 'endogenous cannabinoid system' has led to the development of selective CB1 and CB2 receptor ligands and fueled renewed interest in the clinical potential of cannabinoids. Two cannabinoid CB1 receptor agonists are already used clinically, as antiemetics or as appetite stimulants. These are D 9 - tetrahydrocannabinol (THC) and nabilone. Other possible uses for CB1 receptor agonists include the suppression of muscle spasm/spasticity associated with multiple sclerosis or spinal cord injury, the relief of chronic pain and the management of glaucoma and bronchial asthma. CB1 receptor antagonists may also have clinical applications, e. g. as appetite suppressants and in the management of schizophrenia or disorders of cognition and memory. So too may CB2 receptor ligands and drugs that activate cannabinoid receptors indirectly by augmenting endocannabinoid levels at cannabinoid receptors. When taken orally, THC seems to undergo variable absorption and to have a narrow 'therapeutic window' (dose range in which it is effective without producing significant unwanted effects). This makes it difficult to predict an oral dose that will be both effective and tolerable to a patient and indicates a need for better cannabinoid formulations and modes of administration. For the therapeutic potential of cannabis or CB1 receptor agonists to be fully exploited, it will be important to establish objectively and conclusively (a) whether these agents have efficacy against selected symptoms that is of clinical significance and, if so, whether the benefits outweigh the risks, (b) whether cannabis has therapeutic advantages over individual cannabinoids, (c) whether there is a need for additional drug treatments to manage any of the disorders against which cannabinoids are effective, and (d) whether it will be possible to develop drugs that have reduced psychotropic activity and yet retain the ability to act through CB1 receptors to produce their sought-after effects. Copyright 1999 S. Karger GmbH, Freiburg

[Administration of Cardiodoron® in patients with functional cardiovascular disorders and/or sleep disorders--results of a prospective, non-interventional study].

PubMed

Rother, Claudia

2013-01-01

Functional cardiovascular disorders (FCD) can be attributed to around 25-40% of all heart patients, i.e. organic causes are not detectable. Characteristic symptoms are tachycardia, palpitations, cardiac arrhythmia, hyperventilation, vertigo, vasovagal syncopes and sleep disorders, with the latter being a problem of its own. Disturbed vegetative rhythms form the basis of these diseases. The medicinal product Cardiodoron counteracts the dysfunctional vegetative rhythmicity with 3 medicinal plants--Primula veris (common cowslip), Hyoscyamus niger (black henbane) and Onopordum acanthium (cotton thistle). By means of a prospective, multicentre, non-interventional study, the development of disease-specific disorders during treatment with Cardiodoron (drops) was supposed to be shown. Between September 2009 and March 2012, 92 physicians documented 501 patients suffering from functional cardiovascular and/or sleep disorders who have been treated with Cardiodoron for 3-6 months. After an initial examination, a final examination after 90 (± 10) days and, in case of continuation of therapy, a follow-up examination after 90 (± 10) days were carried out. Besides 30 symptoms assessed by the physicians, the patients rated their condition on the basis of the complaints list according to v. Zerssen (B-L and B-L') and the Pittsburgh Sleep Quality Index (PSQI) according to Buysse. The severity of functional cardiovascular disorders as well as sleep disorders was significantly reduced. The same applies for all of the documented 30 disease-specific symptoms. Furthermore, the total score of the complaints list was significantly reduced as well as the PSQI. The largest effect regarding all parameters was detectable after 3 months. Continuation of Cardiodoron therapy stabilised the symptomatology once more and resulted in further improvement. On average, patients reported initial improvement after 13 days of treatment. Tolerability was almost consistently assessed with 'very good / good'. Accordingly, the acceptance of the preparation by the patients was good, which resulted in a very good compliance of 70%. 52% of the patients used additional therapies. Cardiodoron shows positive effects in medical practice; it is a well-tolerated medicinal product for treatment of functional cardiovascular and/or sleep disorders with or without concomitant therapies. © 2013 S. Karger GmbH, Freiburg.

[The Freiburg monosyllable word test in postoperative cochlear implant diagnostics].

PubMed

Hey, M; Brademann, G; Ambrosch, P

2016-08-01

The Freiburg monosyllable word test represents a central tool of postoperative cochlear implant (CI) diagnostics. The objective of this study is to test the equivalence of different word lists by analysing word comprehension. For patients whose CI has been implanted for more than 5 years, the distribution of suprathreshold speech intelligibility outcomes will also be analysed. In a retrospective data analysis, speech understanding for 626 CI users word correct scores were evaluated using a total of 5211 lists with 20 words each. The analysis of word comprehension within each list shows differences in mean and in the kind of distribution function. There are lists which show a significant difference of their mean word recognition to the overall mean. The Freiburg monosyllable word test is easy to administer at suprathreshold speech level for CI recipients, and typically has a saturation level above 80 %. The Freiburg monosyllable word test can be performed successfully by the majority of CI patients. The limited balance of the test lists elicits the conclusion that an adaptive test procedure with the Freiburg monosyllable test does not make sense. The Freiburg monosyllable test can be restructured by resorting all words across lists, or by omitting individual words of a test list to increase the reliability of the test. The results show that speech intelligibility in quiet should also be investigated in CI recipients al levels below 70 dB.

The role of complexity metrics in a multi-institutional dosimetry audit of VMAT

PubMed Central

Agnew, Christina E; Hussein, Mohammad; Tsang, Yatman; McWilliam, Alan; Hounsell, Alan R; Clark, Catharine H

2016-01-01

Objective: To demonstrate the benefit of complexity metrics such as the modulation complexity score (MCS) and monitor units (MUs) in multi-institutional audits of volumetric-modulated arc therapy (VMAT) delivery. Methods: 39 VMAT treatment plans were analysed using MCS and MU. A virtual phantom planning exercise was planned and independently measured using the PTW Octavius® phantom and seven29® 2D array (PTW-Freiburg GmbH, Freiburg, Germany). MCS and MU were compared with the median gamma index pass rates (2%/2 and 3%/3 mm) and plan quality. The treatment planning systems (TPS) were grouped by VMAT modelling being specifically designed for the linear accelerator manufacturer's own treatment delivery system (Type 1) or independent of vendor for VMAT delivery (Type 2). Differences in plan complexity (MCS and MU) between TPS types were compared. Results: For Varian® linear accelerators (Varian® Medical Systems, Inc., Palo Alto, CA), MCS and MU were significantly correlated with gamma pass rates. Type 2 TPS created poorer quality, more complex plans with significantly higher MUs and MCS than Type 1 TPS. Plan quality was significantly correlated with MU for Type 2 plans. A statistically significant correlation was observed between MU and MCS for all plans (R = −0.84, p < 0.01). Conclusion: MU and MCS have a role in assessing plan complexity in audits along with plan quality metrics. Plan complexity metrics give some indication of plan deliverability but should be analysed with plan quality. Advances in knowledge: Complexity metrics were investigated for a national rotational audit involving 34 institutions and they showed value. The metrics found that more complex plans were created for planning systems which were independent of vendor for VMAT delivery. PMID:26511276

Dosimetric characterization of a single crystal diamond detector in X-ray beams for preclinical research.

PubMed

Kampfer, Severin; Cho, Nathan; Combs, Stephanie E; Wilkens, Jan J

2018-05-29

The aim of this study was to investigate a single crystal diamond detector, the microDiamond detector from PTW (PTW-Freiburg, Freiburg, Germany), concerning the particular requirements in the set-up and energy range used in small animal radiotherapy (RT) research (around 220kV). We tested it to find out the minimal required pre-irradiation dose, the dose linearity, dose rate dependency and the angular response as well as usability in the small animal radiation research platform, SARRP (Xstrahl Ltd., Camberley, UK). For a stable signal in the range of energies used in the study, we found a required pre-irradiation dose of 10Gy. The dose linearity and dose rate dependence measurements showed a very good performance of the microDiamond detector. Regarding the effect of angular dependency, the variation of the response signal is less than 0.5% within the first 15° of the polar angle. In the azimuthal angle, however, there are differences in detector response up to 20%, depending on the range of energies used in the study. In addition, we compared the detector to a radiosensitive film for a profile measurement of a 5×5mm 2 irradiation field. Both methods showed a good accordance with the field size, however, the film has a steeper dose gradient in the penumbra region but also a higher noise than the microDiamond detector. We demonstrated that the microDiamond detector is a useful measurement tool for small animal RT research due to its small size. Nevertheless, it seems to be very important to verify the response of the detector in the given set-up and energy range. Copyright © 2018. Published by Elsevier GmbH.

The role of complexity metrics in a multi-institutional dosimetry audit of VMAT.

PubMed

McGarry, Conor K; Agnew, Christina E; Hussein, Mohammad; Tsang, Yatman; McWilliam, Alan; Hounsell, Alan R; Clark, Catharine H

2016-01-01

To demonstrate the benefit of complexity metrics such as the modulation complexity score (MCS) and monitor units (MUs) in multi-institutional audits of volumetric-modulated arc therapy (VMAT) delivery. 39 VMAT treatment plans were analysed using MCS and MU. A virtual phantom planning exercise was planned and independently measured using the PTW Octavius(®) phantom and seven29(®) 2D array (PTW-Freiburg GmbH, Freiburg, Germany). MCS and MU were compared with the median gamma index pass rates (2%/2 and 3%/3 mm) and plan quality. The treatment planning systems (TPS) were grouped by VMAT modelling being specifically designed for the linear accelerator manufacturer's own treatment delivery system (Type 1) or independent of vendor for VMAT delivery (Type 2). Differences in plan complexity (MCS and MU) between TPS types were compared. For Varian(®) linear accelerators (Varian(®) Medical Systems, Inc., Palo Alto, CA), MCS and MU were significantly correlated with gamma pass rates. Type 2 TPS created poorer quality, more complex plans with significantly higher MUs and MCS than Type 1 TPS. Plan quality was significantly correlated with MU for Type 2 plans. A statistically significant correlation was observed between MU and MCS for all plans (R = -0.84, p < 0.01). MU and MCS have a role in assessing plan complexity in audits along with plan quality metrics. Plan complexity metrics give some indication of plan deliverability but should be analysed with plan quality. Complexity metrics were investigated for a national rotational audit involving 34 institutions and they showed value. The metrics found that more complex plans were created for planning systems which were independent of vendor for VMAT delivery.

Variations of traffic related air pollution on different time scales in Szeged, Hungary and Freiburg, Germany

NASA Astrophysics Data System (ADS)

Makra, László; Mayer, Helmut; Mika, János; Sánta, Tamás; Holst, Jutta

Economic activities and everyday life may create weekly variations in concentrations of air pollutants in urban settings. The present study contributes to this experience on the example of two typical medium-sized towns in Central Europe, Szeged and Freiburg considering the following air pollutants: NO, NO 2, O 3, O x and PM 10. Five-year data sets of hourly observations (1997-2001) collected in downtown traffic junctions are analysed. In addition, the effect of the weekly variation on the diurnal course of the air pollutants is also demonstrated, which is especially important when we consider the possible extremes of these traffic related air pollutants. Since the annual variation of the pollutants explains only a minor part of the total variance and, furthermore, the weekly variation behaves rather similarly in the different seasons, the weekly variation of the diurnal peaks is quantified for the whole year. The average annual variations of NO, NO 2, O 3 and O x are very similar for both Szeged and Freiburg. Annual levels of NO 2 and O 3 are moderately higher, while those of PM 10 are extremely higher in Szeged, which is reflected in their average weekly and diurnal variations, too. In Freiburg the diurnal variation of PM 10 shows a clear daily course with only one wave, compared to that for Szeged with the shape of a double wave. In Szeged, highest percentile values of NO and NO 2 occur mostly in the evening, while in Freiburg either in the mourning or in the evening and generally there is very little difference between them. In Szeged, maximum of O 3 peak values, while in Freiburg minimum of them are found on weekends.

[The Freiburg speech intelligibility test : A pillar of speech audiometry in German-speaking countries].

PubMed

Hoth, S

2016-08-01

The Freiburg speech intelligibility test according to DIN 45621 was introduced around 60 years ago. For decades, and still today, the Freiburg test has been a standard whose relevance extends far beyond pure audiometry. It is used primarily to determine the speech perception threshold (based on two-digit numbers) and the ability to discriminate speech at suprathreshold presentation levels (based on monosyllabic nouns). Moreover, it is a measure of the degree of disability, the requirement for and success of technical hearing aids (auxiliaries directives), and the compensation for disability and handicap (Königstein recommendation). In differential audiological diagnostics, the Freiburg test contributes to the distinction between low- and high-frequency hearing loss, as well as to identification of conductive, sensory, neural, and central disorders. Currently, the phonemic and perceptual balance of the monosyllabic test lists is subject to critical discussions. Obvious deficiencies exist for testing speech recognition in noise. In this respect, alternatives such as sentence or rhyme tests in closed-answer inventories are discussed.

Promotion of family-friendliness at the Medical Faculty of Freiburg - taking stock of study participation.

PubMed

Binninger, Sabine; Brüstle, Peter; Korinthenberg, Rudolf; Streitlein-Böhme, Irmgard

2012-01-01

The survey on family-friendly study organisation in medical schools conducted by the University Hospital in Ulm has identified a need for improvement in various respects in Freiburg. Due to the specific structure of medical school and the high amount of mandatory lectures, students with children face serious problems in balancing family life and their studies at the same time. On the other hand, the freer, modular structure of the clinical curriculum in Freiburg has been mainly rated as positive by the interviewees. In order to improve the situation of students with children, the interviewees favour a more flexible curriculum in general as well as an increase in information and advice services offered by the faculty. In the first place, the results of the study encourage us to maintain the modular structure in the final two clinical years in Freiburg in view of current curriculum developments. Additionally, we aim to offer targeted support to students with children. Furthermore, a wider range of e-learning supported lectures is to help students manage their studies with childcare and family obligations.

Effect of a High-Protein Diet versus Standard-Protein Diet on Weight Loss and Biomarkers of Metabolic Syndrome: A Randomized Clinical Trial.

PubMed

Campos-Nonato, Ismael; Hernandez, Lucia; Barquera, Simon

2017-01-01

Some studies have shown that protein-enriched diets can lead to greater weight loss and improvements in biomarkers of metabolic syndrome (MeS) than standard protein diets. Therefore, the aim of this study was to determine the effect of increased protein intake on weight loss in Mexican adults with MeS. Randomized controlled trial in 118 adults aged 47.4 ± 11.5 years and meeting the established criteria for MeS were randomized to prescribed hypocaloric diets (500 kcal less than resting metabolic rate) providing either 0.8 g/kg body weight (standard protein diet (SPD)) or 1.34 g/kg body weight (higher protein diet (HPD)) for 6 months. Body weight, waist circumference, percent body fat by bioimpedance analysis, fasting blood glucose, fasting insulin, hemoglobin A1c, total cholesterol, high-density lipoprotein (HDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol, triglycerides, C-reactive protein, creatinine, blood urea nitrogen, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase were measured at baseline, 3 months and at 6 months. There were 105 subjects (51 for SPD and 54 for HPD) who completed the trial. Overall weight loss was 5.1 ± 3.6 kg in the SPD group compared to 7.0 ± 3.7 kg in the in HPD group. Both groups lost a significant percent of centimeters of waist circumference (SPD -6.5 ± 2.6 cm and HPD -8.8 ± 2.6 cm). There was no statistical difference Except for the varying weight losses the two groups did not show any further differences overall. However in the subgroup judged to be adherent more than 75% of the time with the prescribed diets, there was a significant difference in mean weight loss (SPD -5.8% vs. HPD -9.5%) after adjusting for baseline BMI. Both groups demonstrated significant decreases in waist circumference, glucose, insulin, triglycerides, and VLDL cholesterol, but there were no differences between the groups. There were no changes in blood tests for liver or renal function. There were no significant differences in weight loss and biomarkers of MeS when the overall group was examined, but the participants with more adherence rate in the HPD group lost significantly more weight than adherent participants in the SPD group. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Which subtype of functional dyspepsia patients responses better to acupuncture? A retrospective analysis of a randomized controlled trial.

PubMed

Ma, Tingting; Zeng, Fang; Li, Ying; Wang, Chieh-Mei; Tian, Xiaoping; Yu, Shuyuan; Zhao, Ling; Wu, Xi; Yang, Min; Wang, Dejun; Liang, Fanrong

2015-01-01

Whether subgroups of functional dyspepsia (FD) should be treated with different approaches is controversially discussed in research. As our previous study has demonstrated the effect of acupuncture in FD treatment, we now further analyze the therapeutic effect of acupuncture in the treatment of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). A retrospective analysis was conducted in 465 eligible PDS patients and 241 EPS patients. 4 acupuncture groups (group A: specific acupoints along the stomach meridian; group B: non-specific acupoints along the stomach meridian; group C: alarm and transport acupoints; group D: specific acupoints along the gallbladder meridian) were compared with a non-acupoint sham acupuncture group and an itopride group. The patients were treated in 5 consecutive sessions per week for 4 weeks and were followed-up for 12 weeks afterwards. Primary outcome of the study was defined as response rate and symptom improvement as measured by the Symptom Index of Dyspepsia, while secondary outcome was designated as improvement in quality of life (QoL) as determined by the Nepean Dyspepsia Index. Symptoms of dyspepsia and QoL were improved from baseline in all groups. In EPS patients, no statistically significant differences could be observed in response rate (p = 0.239) and symptoms improvement (p = 0.344 for epigastric pain; p = 0.465 for epigastric burning). In contrast, PDS patients of the acupuncture group A showed higher response rate (53.2% vs. 19.7%, p<0.001; 53.2% vs. 35.1%, p = 0.025) and score change in postprandial fullness (1.01 vs. 0.27, p<0.001; 1.01 vs. 0.57, p<0.001), early satiation (0.81 vs. 0.21, p<0.001; 0.81 vs. 0.39, p=0.001), and QoL (14.5 vs. 4.33, p<0.001; 14.5 vs. 8.5, p<0.001) compared to the sham acupuncture and itopride group. FD patients with PDS responded better to the acupuncture therapies, especially at the specific acupoints along the stomach meridian. The positive therapeutic effect of acupuncture on PDS was correlated with the improvement in postprandial fullness. ClinicalTrial.gov NCT00599677. © 2015 S. Karger GmbH, Freiburg.

[From Swiss herbs to the global plant system and individual use--a biographic approach to Alfred Vogel].

PubMed

Melzer, J

2003-04-01

Even 100 years after the birth of Alfred Vogel there is a lack of reliable data about his life as a non-doctoral therapist in the fields of naturopathy and phytotherapy. Which documents about A. Vogel do exist, which facts do they prove about his career and which interpretations of his point of view of phytotherapy do they allow. With the methods in medical history (heuristic, critic, interpretation) video, audio and written documents from the A. Vogel Museum and A. Vogel publisher in Teufen, the A. Vogel collection in the Museum in Aesch and the Bioforce AG in Roggwil have been examined. From 1923 to 1932 A. Vogel runs a grocer's shop or a herb and health-food store in Basel and later Bern, Zürich and Solothurn. The economic success of his health-food stores and his interest in the field of naturopathy enable him to take part in a training to become a 'natural doctor' and in 1933 he is registered by the 'Natural Doctors Association of Switzerland'. From 1935 on he is working as a nutritionalist in his own spa pension in Trogen and produces plant extracts in his 'Laboratory Bioforce'. From 1937 to 1957 he has a spa hotel in Teufen and is producer of extracts from fresh plants. He is able to travel all continents of the world from 1958 on, in order to observe customs and medical habits of different tribes. He writes about his findings in his own magazine and books. His knowledge about the usage of herbs in different cultures inspires his production of herbal extracts in his company. In 1963, to meet the increasing sales of his products, he founds the where he, until the early 1990s, takes part in the adjustment of the recipes to the new pharmaceutic-medical standards. Because of his work as a 'natural doctor' A. Vogel becomes one of Switzerland's best known non-doctoral therapists in the 20th century. The publication of his collected wisdom in a lay-like language is a contribution to the tradition and popularity in this field through which, as well as through the development of extracts from fresh plants, he becomes a promoter of phytotherapy. Copyright 2003 S. Karger GmbH, Freiburg

10. Freiburger Symposium 2011 der SCG-Division Industrielle Chemie Technology Progress, Success Key for our Production Sites.

PubMed

Naef, Olivier

2012-01-01

This short paper presents the abstracts of the different presentations during 10. Freiburger Symposium 2011 der SCG-Division Industrielle Chemie: Technology Progress, Success key for our production sites held Thursday and Friday, September 29 and 30, 2011 at the Ecole d'ingénieurs et d'architectes de Fribourg (Switzerland).

Freiburg RNA tools: a central online resource for RNA-focused research and teaching.

PubMed

Raden, Martin; Ali, Syed M; Alkhnbashi, Omer S; Busch, Anke; Costa, Fabrizio; Davis, Jason A; Eggenhofer, Florian; Gelhausen, Rick; Georg, Jens; Heyne, Steffen; Hiller, Michael; Kundu, Kousik; Kleinkauf, Robert; Lott, Steffen C; Mohamed, Mostafa M; Mattheis, Alexander; Miladi, Milad; Richter, Andreas S; Will, Sebastian; Wolff, Joachim; Wright, Patrick R; Backofen, Rolf

2018-05-21

The Freiburg RNA tools webserver is a well established online resource for RNA-focused research. It provides a unified user interface and comprehensive result visualization for efficient command line tools. The webserver includes RNA-RNA interaction prediction (IntaRNA, CopraRNA, metaMIR), sRNA homology search (GLASSgo), sequence-structure alignments (LocARNA, MARNA, CARNA, ExpaRNA), CRISPR repeat classification (CRISPRmap), sequence design (antaRNA, INFO-RNA, SECISDesign), structure aberration evaluation of point mutations (RaSE), and RNA/protein-family models visualization (CMV), and other methods. Open education resources offer interactive visualizations of RNA structure and RNA-RNA interaction prediction as well as basic and advanced sequence alignment algorithms. The services are freely available at http://rna.informatik.uni-freiburg.de.

A comparison of dental caries levels in two communities with different oral health prevention strategies stratified in different social classes.

PubMed

Sagheri, Darius; McLoughlin, Jacinta; Clarkson, John J

2007-01-01

To compare dental caries levels of schoolchildren stratified in different social classes whose domestic water supply had been fluoridated since birth (Dublin) with those living in an area where fluoridated salt was available (Freiburg). A representative, random sample of twelve-year-old children was examined and dental caries was recorded using World Health Organization criteria. A total of 699 twelve-year-old children were examined, 377 were children in Dublin and 322 in Freiburg. In Dublin the mean decayed, missing, and filled permanent teeth (DMFT) was 0.80 and in Freiburg it was 0.69. An examination of the distribution of the DMFT score revealed that its distribution is highly positively skewed. For this reason this study provides summary analyses based on medians and inter-quartile range and nonparametric rank sum tests. In both cities caries levels of children in social class 1 (highest) were considerably lower when compared with the other social classes regardless of the fluoride intervention model used. The caries levels showed a reduced disparity between children in social class 2 (medium) and 3 (lowest) in Dublin compared with those in social class 2 and 3 in Freiburg. The evidence from this study confirmed that water fluoridation has reduced the gap in dental caries experience between medium and lower social classes in Dublin compared with the greater difference in caries experience between the equivalent social classes in Freiburg. The results from this study established the important role of salt fluoridation where water fluoridation is not feasible.

Gender differences in coping with tension-type headaches.

PubMed

Rollnik, Jens D; Karst, Matthias; Piepenbrock, Siegfried; Gehrke, A; Dengler, Reinhard; Fink, Matthias

2003-01-01

To study gender differences of coping with illness strategies in tension-type headaches. We enrolled 89 subjects (50 women, 39 men) suffering from episodic (n = 37) and chronic (n = 52) tension-type headaches (TTH). Patients were required to answer a Freiburg Questionnaire of Coping with Illness (FQCI), a Von Zerssen Depression Scale (D-S), quality-of-life questionnaires, and a headache home diary (over 4 weeks). In addition, pressure pain thresholds (temporal muscles) and Total Tenderness Scores were obtained. While pain intensity, frequency and quality-of-life parameters were basically the same for female and male EPISODIC TTH sufferers, women scored significantly higher on the F3 subscale (distracting and encouraging) of the FQCI and tended to score higher on the F1 subscale (depressive). Among CHRONIC TTH patients, women reported the pain to be more intense (VAS), were more depressed (D-S), and scored lower on several quality-of-life scores. Female chronic TTH sufferers scored significantly lower on the F2 subscale (active coping) and tended to score higher on F5 (denying). We conclude that pessimistic coping with illness strategies are more frequent in female episodic and chronic TTH sufferers. We would like to recommend special psychologic intervention in particular to female chronic TTH sufferers which would offer counseling in developing active coping skills. Copyright 2003 S. Karger AG, Basel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stelljes, T. S., E-mail: tenzin.s.stelljes@uni-oldenburg.de; Looe, H. K.; Chofor, N.

Purpose: The dosimetric properties of the OCTAVIUS Detector 1500 (OD1500) ionization chamber array (PTW-Freiburg, Freiburg, Germany) have been investigated. A comparative study was carried out with the OCTAVIUS Detector 729 and OCTAVIUS Detector 1000 SRS arrays. Methods: The OD1500 array is an air vented ionization chamber array with 1405 detectors in a 27 × 27 cm{sup 2} measurement area arranged in a checkerboard pattern with a chamber-to-chamber distance of 10 mm in each row. A sampling step width of 5 mm can be achieved by merging two measurements shifted by 5 mm, thus fulfilling the Nyquist theorem for intensity modulatedmore » dose distributions. The stability, linearity, and dose per pulse dependence were investigated using a Semiflex 31013 chamber (PTW-Freiburg, Freiburg, Germany) as a reference detector. The effective depth of measurement was determined by measuring TPR curves with the array and a Roos chamber type 31004 (PTW-Freiburg, Freiburg, Germany). Comparative output factor measurements were performed with the array, the Semiflex 31010 ionization chamber and the Diode 60012 (both PTW-Freiburg, Freiburg, Germany). The energy dependence of the OD1500 was measured by comparing the array’s readings to those of a Semiflex 31010 ionization chamber for varying mean photon energies at the depth of measurement, applying to the Semiflex chamber readings the correction factor k{sub NR} for nonreference conditions. The Gaussian lateral dose response function of a single array detector was determined by searching the convolution kernel suitable to convert the slit beam profiles measured with a Diode 60012 into those measured with the array’s central chamber. An intensity modulated dose distribution measured with the array was verified by comparing a OD1500 measurement to TPS calculations and film measurements. Results: The stability and interchamber sensitivity variation of the OD1500 array were within ±0.2% and ±0.58%, respectively. Dose linearity was within 1% over the range from 5 to 1000 MU. The effective point of measurement of the OD1500 for dose measurements in RW3 phantoms was determined to be (8.7 ± 0.2) mm below its front surface. Output factors showed deviations below 1% for field sizes exceeding 4 × 4 cm{sup 2}. The dose per pulse dependence was smaller than 0.4% for doses per pulse from 0.2 to 1 mGy. The energy dependence of the array did not exceed ±0.9%. The parameter σ of the Gaussian lateral dose response function was determined as σ{sub 6MV} = (2.07 ± 0.02) mm for 6 MV and σ{sub 15MV} = (2.09 ± 0.02) mm for 15 MV. An IMRT verification showed passing rates well above 90% for a local 3 mm/3% criterion. Conclusions: The OD1500 array’s dosimetric properties showed the applicability of the array for clinical dosimetry with the possibility to increase the spatial sampling frequency and the coverage of a dose distribution with the sensitive areas of ionization chambers by merging two measurements.« less

Dynamos of the Sun, Stars, and Planets - Preface

NASA Astrophysics Data System (ADS)

Stix, M.

2005-04-01

The conference ``Dynamos of the Sun, Stars, and Planets'' was organized by the Kiepenheuer-Institut für Sonnenphysik Freiburg, and was held at the University of Freiburg from 4th to 6th October 2004. About 50 participants attended the conference, with 8 review lectures, 20 contributed talks, and 6 posters. With only few exceptions, these contributions appear in the present issue of Astronomische Nachrichten. This preface summarizes the discussion of the closing session.

[Psychological Care for a High Risk Group of Refugees - Concept of Care for the Yazidi Women and Children of the Sonderkontingent Baden-Württemberg in Freiburg].

PubMed

Hillebrecht, Jennifer; Helmes, Almut; Bengel, Jürgen

2018-03-01

After the genocide of Shingal in August 2014 in Northern Iraq, the humanitarian admissions program Sonderkontingent Baden-Württemberg "Schutzbedürftiger Frauen und Kinder aus dem Nordirak" was implemented. 1100 persons, most of them Yazidis, were hosted by different municipalities in Germany. The target group is a particularly vulnerable group of persons with a high risk for developing post-traumatic stress disorder. We present the concept of care in Freiburg for 205 Yazidi women and children in Freiburg. A stepped-care approach was developed for the psychological care to introduce the Yazidi people to the daily life and to the health care system in Germany. An outreach of psychological services and an interdisciplinary and multidisciplinary cooperation of all services involved were crucial. © Georg Thieme Verlag KG Stuttgart · New York.

SU-E-T-202: Comparison of 4D-Measurement-Guided Dose Reconstructions (MGDR) with COMPASS and OCTAVIUS 4D System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leung, R; Wong, M; Lee, V

2015-06-15

Purpose: To cross-validate the MGDR of COMPASS (IBA dosimetry, GmbH, Germany) and OCTAVIUS 4D system (PTW, Freiburg, Germany). Methods: Volumetric-modulated arc plans (5 head-and-neck and 3 prostate) collapsed to 40° gantry on the OCTAVIUS 4D phantom in QA mode on Monaco v5.0 (Elekta, CMS, Maryland Heights, MO) were delivered on a Elekta Agility linac. This study was divided into two parts: (1) error-free measurements by gantry-mounted EvolutionXX 2D array were reconstructed in COMPASS (IBA dosimetry, GmbH, Germany), and by OCTAVIUS 1500 array in Versoft v6.1 (PTW, Freiburg, Germany) to obtain the 3D doses (COM4D and OCTA4D). COM4D and OCTA4D weremore » compared to the raw measurement (OCTA3D) at the same detector plane for which OCTAVIUS 1500 was perpendicular to 0° gantry axis while the plans were delivered at gantry 40°; (2) beam steering errors of energy (Hump=-2%) and symmetry (2T=+2%) were introduced during the delivery of 5 plans to compare the MGDR doses COM4D-Hump (COM4D-2T), OCTA4D-Hump (OCTA4D-2T), with raw doses OCTA3D-Hump (OCTA3D-2T) and with OCTA3D to assess the error reconstruction and detection ability of MGDR tools. All comparisons used Υ-criteria of 2%(local dose)/2mm and 3%/3mm. Results: Averaged Υ passing rates were 85% and 96% for COM4D,and 94% and 99% for OCTA4D at 2%/2mm and 3%/3mm criteria respectively. For error reconstruction, COM4D-Hump (COM4D-2T) showed 81% (93%) at 2%/2mm and 94% (98%) at 3%/3mm, while OCTA4D-Hump (OCTA4D-2T) showed 96% (96%) at 2%/2mm and 99% (99%) at 3%/3mm. For error detection, OCTA3D doses were compared to COM4D-Hump (COM4D-2T) showing Υ passing rates of 93% (93%) at 2%/2mm and 98% (98%), and to OCTA4D-Hump (OCTA4D -2T) showing 94% (99%) at 2%/2mm and 81% (96%) at 3%/3mm, respectively. Conclusion: OCTAVIUS MGDR showed better agreement to raw measurements in both error- and error-free comparisons. COMPASS MGDR deviated from the raw measurements possibly owing to beam modeling uncertainty.« less

SU-F-P-58: Squamous Cell and Basal Cell Carcinoma of the Skin Treated with a Freiburg Flap Applicator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dou, K; Li, B; Jacobs, M

Purpose: To treat squamous cell and basal cell carcinoma of the skin with the Freiburg flap applicator using a high dose rate modality of an Elekta Flexitron or MicroSelectron for radiation delivery by compensating the dose deviation resulting from the incomplete scatter environment. Methods: Patients were selected to have lesions greater than or equal to 2cm. A mask might be needed depending on special locations. The lesions on the eyelid and face presented in this research were, however, treated without a mask. Cutting the flap into a shape conformal to the target and attaching it to the mask were usedmore » in order to make the treatment reproducible. Patients were scanned with a Philips Big Bore Brilliant CT. A 1cm margin was added to the lesion. An Elekta Oncentra Brachy treatment planning system ver. 4.3 was used for treatment planning. 40 Gy in 10 or 8 fractions was prescribed to the 1cm depth. The Freiburg flap was aligned and verified by CT scanning prior to treatment. Results: Three patients with squamous cell and basal cell carcinoma of the skin were treated with the Freiburg flap applicator. Lesion sizes ranged from 2cm to 6 cm in a maximum dimension. With treatment planning, we made a dose correction for compensating the dose deviation resulting from the incomplete scatter environment of the flap applicators exposed to air. The flap was also covered by a 4cm bolus in order to obtain more back scattered radiation during treatment. Six month follow up showed a very good cosmetic result. Conclusion: The Freiburg flap brachytherapy offers a non-invasive skin cancer treatment with a high skin dose delivered to the tumor while a low dose sparing the surrounding health tissue. It is a promising alternative to skin cancer surgery or external beam radiation therapy.« less

Aerospace Medicine and Biology. A Continuing Bibliography with Indexes

DTIC Science & Technology

1987-12-01

GLYCERALDEHYDE AS A SOURCE OF SIMULATION ABOUT THE ORIGIN OF LIFE ENERGY AND MONOMERS FOR PREBIOTIC CONDENSATION URSULA NIESERT (Freiburg, Universitaet, Freiburg...primitive prebiotic replication system. The adsorption of Poly-C, Poly-U, Poly-A, Poly-G, and 5’-AMP, 5’-GMP, 5’-CMP and 5’-UMP onto gypsum was studied. It...Cambridge University Press. 1986. 378 p. For individual titles see A87-49035 to A87-49049. Topics discussed include prebiotic systems and evolutionary

[Kombinierte Anwendung von Strahlentherapie und adjuvanter Therapie mit einem Mistelextrakt (Viscum album L.) zur Behandlung des oralen malignen Melanoms beim Hund: Eine retrospektive Studie].

PubMed

von Bodungen, Uta; Ruess, Katja; Reif, Marcus; Biegel, Ulrike

2017-01-01

Hintergrund: Orale maligne Melanome (OMM) des Hundes zeichnen sich durch schnelles Wachstum, lokale Invasion und hohe Metastasierungsraten aus. Extrakte auf Basis von Viscum album L. (VAE) werden zunehmend in der Krebstherapie sowohl in der Human- als auch in der Veterinärmedizin eingesetzt. Ziel unserer Studie war es zu untersuchen, inwieweit die adjuvante Therapie mit VAE eine therapeutische Option zur Behandlung von OMM ist. Besonderes Augenmerk galt dabei der Überlebenszeit und möglichen Nebenwirkungen. Tiere und Methoden: 26 Hunde mit OMM, die in einem der größten veterinäronkologischen Zentren der Schweiz allesamt eine Strahlentherapie erhielten (teilweise nach operativer Tumorresektion) wurden in die retrospektive Studie eingeschlossen: 18 Hunde wurden mit VAE behandelt (1 ml VAE (Iscador®) in ansteigenden Konzentrationen von 0,1 bis 20 mg/ml subkutan 3-mal pro Woche (VAE-Gruppe), 8 erhielten keine adjuvante Behandlung (Vergleichsgruppe). Wir verglichen die Größenentwicklung der OMM sowie die Überlebenszeit. Ergebnisse: Patienten mit Bestrahlung und adjuvanter VAE-Therapie zeigten mit 236 Tagen eine signifikant längere mediane Überlebenszeit im Vergleich zu Patienten mit Bestrahlung, aber ohne adjuvante VAE-Therapie (49 Tage; Log-Rank-Test: p = 0,0047). Die VAE-Therapie verlängerte die Überlebenszeit um mehr als zwei Drittel (Hazard Ratio (HR) = 0,30, 95%-Konfidenzintervall (KI) 0,11-0,86; p = 0,024), während ein höheres Tumorstadium gemäß UICC (Union internationale contre le cancer) einen statistischen Trend zur Verdopplung des Sterberisikos zeigte (UICC-Stadium III/IV vs. I/II: HR = 2,12, 95%-KI 0,88-5,12; p = 0,095). Zwei Patienten zeigten milde Nebenwirkungen während der VAE-Behandlung. Einer der beiden zeigte 1 Tag lang ein selbstlimitiertes Fieber, bei dem anderen Patienten reduzierten wir die Dosis von einem konzentrierteren zu einem weniger konzentrierten VAE (Serie 0) aufgrund von Müdigkeit, die daraufhin verschwand. Schlussfolgerungen: VAE ist eine sichere, nebenwirkungsarme Behandlung und scheint sich positiv auf die Überlebenszeit von Hunden mit OMM auszuwirken. Somit ist dieser therapeutische Ansatz es wert, vermehrt bei der adjuvant zur Strahlentherapie eingesetzten Behandlung des OMM in Betracht gezogen zu werden. Die verglichenen Gruppen waren jedoch klein, divers und nicht konsistent hinsichtlich aller prognostischen Parameter. Eine prospektive Studie mit einer größeren Studienpopulation wäre daher von Interesse. © 2017 S. Karger GmbH, Freiburg.

The strength of polyaxial locking interfaces of distal radius plates.

PubMed

Hoffmeier, Konrad L; Hofmann, Gunther O; Mückley, Thomas

2009-10-01

Currently available polyaxial locking plates represent the consequent enhancement of fixed-angle, first-generation locking plates. In contrast to fixed-angle locking plates which are sufficiently investigated, the strength of the new polyaxial locking options has not yet been evaluated biomechanically. This study investigates the mechanical strength of single polyaxial interfaces of different volar radius plates. Single screw-plate interfaces of the implants Palmar 2.7 (Königsee Implantate und Instrumente zur Osteosynthese GmbH, Allendorf, Germany), VariAx (Stryker Leibinger GmbH & Co. KG, Freiburg, Germany) und Viper (Integra LifeSciences Corporation, Plainsboro, NJ, USA) were tested by cantilever bending. The strength of 0 degrees, 10 degrees and 20 degrees screw locking angle was obtained during static and dynamic loading. The Palmar 2.7 interfaces showed greater ultimate strength and fatigue strength than the interfaces of the other implants. The strength of the VariAx interfaces was about 60% of Palmar 2.7 in both, static and dynamic loading. No dynamic testing was applied to the Viper plate because of its low ultimate strength. By static loading, an increase in screw locking angle caused a reduction of strength for the Palmar 2.7 and Viper locking interfaces. No influence was observed for the VariAx locking interfaces. During dynamic loading; angulation had no influence on the locking strength of Palmar 2.7. However, reduction of locking strength with increasing screw angulation was observed for VariAx. The strength of the polyaxial locking interfaces differs remarkably between the examined implants. Depending on the implant an increase of the screw locking angle causes a reduction of ultimate or fatigue strength, but not in all cases a significant impact was observed.

(Integrity of pressure components of nuclear power plants)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Merkle, J.G.

1989-11-03

The traveler attended the 15th annual MPA Seminar at the University of Stuttgart and the European Symposium on Elastic-Plastic Fracture Mechanics (EPFM) at Freiburg, FRG. Following the symposium the traveler made visits to the IWM Laboratory in Freiburg, FRG, the GKSS Research Center in Geesthacht, FRG, the Welding Institute in Cambridge, UK, and the Structural Integrity Centre at Risley, Warrington, UK. Principal subjects of discussion during the laboratory visits were the measurement of fracture toughness in the upper transition temperature range and the possibility of cooperative analytical and experimental efforts concerning the effects of biaxial stresses on fracture toughness formore » finite length surface cracks in plates and pressure vessel cylinders.« less

SU-E-T-09: A Clinical Implementation and Optimized Dosimetry Study of Freiberg Flap Skin Surface Treatment in High Dose Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Syh, J; Syh, J; Patel, B

Purpose: This case study was designated to confirm the optimized plan was used to treat skin surface of left leg in three stages. 1. To evaluate dose distribution and plan quality by alternating of the source loading catheters pattern in flexible Freiberg Flap skin surface (FFSS) applicator. 2. To investigate any impact on Dose Volume Histogram (DVH) of large superficial surface target volume coverage. 3. To compare the dose distribution if it was treated with electron beam. Methods: The Freiburg Flap is a flexible mesh style surface mold for skin radiation or intraoperative surface treatments. The Freiburg Flap consists ofmore » multiple spheres that are attached to each other, holding and guiding up to 18 treatment catheters. The Freiburg Flap also ensures a constant distance of 5mm from the treatment catheter to the surface. Three treatment trials with individual planning optimization were employed: 18 channels, 9 channels of FF and 6 MeV electron beam. The comparisons were highlighted in target coverage, dose conformity and dose sparing of surrounding tissues. Results: The first 18 channels brachytherapy plan was generated with 18 catheters inside the skin-wrapped up flap (Figure 1A). A second 9 catheters plan was generated associated with the same calculation points which were assigned to match prescription for target coverage as 18 catheters plan (Figure 1B). The optimized inverse plan was employed to reduce the dose to adjacent structures such as tibia or fibula. The comparison of DVH’s was depicted on Figure 2. External beam of electron RT plan was depicted in Figure 3. Overcall comparisons among these three were illustrated in Conclusion: The 9-channel Freiburg flap flexible skin applicator offers a reasonably acceptable plan without compromising the coverage. Electron beam was discouraged to use to treat curved skin surface because of low target coverage and high dose in adjacent tissues.« less

Next generation and biosimilar monoclonal antibodies

PubMed Central

2011-01-01

The Next Generation and Biosimilar Monoclonal Antibodies: Essential Considerations Towards Regulatory Acceptance in Europe workshop, organized by the European Centre of Regulatory Affairs Freiburg (EUCRAF), was held February 3–4, 2011 in Freiburg, Germany. The workshop attracted over 100 attendees from 15 countries, including regulators from 11 agencies, who interacted over the course of two days. The speakers presented their authoritative views on monoclonal antibodies (mAbs) as attractive targets for development, the experience to date with the regulatory process for biosimilar medicinal products, the European Medicines Agency draft guideline on biosimilar mAbs, as well as key elements in the development of mAbs. Participants engaged in many lively discussions, and much speculation on the nature of the quality, non-clinical and clinical requirements for authorization of biosimilar mAbs. PMID:21487235

PREFACE: XXV International Conference on Photonic, Electronic and Atomic Collisions

NASA Astrophysics Data System (ADS)

Becker, Uwe; Moshammer, Robert; Mokler, Paul; Ullrich, Joachim

2007-07-01

The XXVth ICPEAC in Freiburg marked a notable anniversary in collision physics: half a century ago the first conference in the series of International Conferences on the Physics of Electronic and Atomic Collisions (ICPEAC) was held in New York (1958). Since then, the development of electronic and atomic collision physics has seen tremendous progress. Starting during a time, when this field was regarded as somehow out-of-date, certainly not being in the main stream compared to particle and high-energy physics, it has expanded in a rather exceptional and unforeseen way. Over the years the original scope on electronic, atomic and heavy-ion collision physics was extended substantially to include upcoming expanding fields like synchrotron-radiation and strong-field laser-based atomic and molecular physics giving rise to a change of name to 'Photonic', Electronic and Atomic Collisions (ICPEAC) being used for the first time for the ICPEAC in Santa Fee in 2001. Nowadays, the ICPEAC has opened its agenda even more widely to other fields of atomic and molecular physics, such as interactions with clusters, bio-molecules and surfaces, to cold collisions, coherent control, femto- and attosecond physics and, with the Freiburg conference, to the application of free-electron lasers in the vacuum ultraviolet and soft x-ray regime, a field of potentially huge future impact in essentially all areas of science. In this larger context the XXVth ICPEAC in Freiburg with more than 800 participants set new standards. Representatives from all fields of Atomic, Molecular and Photon-based science came together and had very fruitful, inter-disciplinary discussions. This new forum of collision-based AMP physics will serve as a showcase example of future conferences, bridging not only the gap between different fields of collision physics but also, equally important, between different continents and cultures. The next ICPEAC is going to take place in Kalamazoo in North America, the one after that in Belfast back in Europe, and the subsequent one, 2013 in Lanzhou, will be the first one ever held in China. A great perspective for this ever-growing field of science! Uwe Becker (Fritz-Haber-Institut, Berlin) Robert Moshammer (Max-Planck-Institut für Kernphysik, Heidelberg) Paul Mokler (Gesellschaft für Schwerionenforschung, Darmstadt) Joachim Ullrich (Max-Planck-Institut für Kernphysik, Heidelberg) Editors Relaxed atmosphere for discussions during coffee breaks at ICPEAC XXV in Freiburg. The PDF file contains details of previous conferences, sponsors, exhibitors and committees.

Stress, burnout and health in the clinical period of dental education.

PubMed

Pöhlmann, K; Jonas, I; Ruf, S; Harzer, W

2005-05-01

The study examined the extent of stress, burnout and health problems experienced by fourth and fifth year dental students from the three universities of Dresden, Freiburg and Bern. The objectives of the study were to: (i) identify frequent sources of stress and to report the prevalence rates of burnout and health problems in dental students, (ii) determine the rate of students suffering from severe burnout symptoms and (iii) identify stress factors related to the burnout symptoms of emotional exhaustion and depersonalization. A total of 161 dental students from Dresden, Freiburg and Bern participated in the study. They completed the Psychosocial Stress Inventory, the Maslach Burnout Inventory and the Health Survey Questionnaire. Frequent sources of stress were limitation of leisure time, examination anxiety and the transition stress that was related to the adaptation to the demands of the clinical phase of dental education. Few differences existed between the students of the fourth and the fifth study year. Study-related stress was lowest in Bern and considerably higher in Dresden. Differences of mean levels of burnout symptoms were found only for the burnout dimension of emotional exhaustion. Students from Dresden and Freiburg were more emotionally exhausted than students from Bern, students from Dresden also reported more health problems than students from Bern or Freiburg. Ten per cent of the dental students suffered from severe emotional exhaustion, 17% complained about a severe lack of accomplishment and 28% reported severe depersonalization symptoms. Forty-four per cent of the variance of emotional exhaustion was explained by study-related factors such as lack of leisure time, examination anxiety and transition stress. The only predictor of depersonalization was a lack of social integration, accounting for 3% of the variance. A lack of social integration may be an indicator of low social competence which may cause difficulties in dealing with patients adequately and therefore result in depersonalization. The results indicate a need to identify the group of students who may have insufficient social skills for dealing adequately with the patients, and to train them accordingly.

Modified physiologically equivalent temperature—basics and applications for western European climate

NASA Astrophysics Data System (ADS)

Chen, Yung-Chang; Matzarakis, Andreas

2018-05-01

A new thermal index, the modified physiologically equivalent temperature (mPET) has been developed for universal application in different climate zones. The mPET has been improved against the weaknesses of the original physiologically equivalent temperature (PET) by enhancing evaluation of the humidity and clothing variability. The principles of mPET and differences between original PET and mPET are introduced and discussed in this study. Furthermore, this study has also evidenced the usability of mPET with climatic data in Freiburg, which is located in Western Europe. Comparisons of PET, mPET, and Universal Thermal Climate Index (UTCI) have shown that mPET gives a more realistic estimation of human thermal sensation than the other two thermal indices (PET, UTCI) for the thermal conditions in Freiburg. Additionally, a comparison of physiological parameters between mPET model and PET model (Munich Energy Balance Model for Individual, namely MEMI) is proposed. The core temperatures and skin temperatures of PET model vary more violently to a low temperature during cold stress than the mPET model. It can be regarded as that the mPET model gives a more realistic core temperature and mean skin temperature than the PET model. Statistical regression analysis of mPET based on the air temperature, mean radiant temperature, vapor pressure, and wind speed has been carried out. The R square (0.995) has shown a well co-relationship between human biometeorological factors and mPET. The regression coefficient of each factor represents the influence of the each factor on changing mPET (i.e., ±1 °C of T a = ± 0.54 °C of mPET). The first-order regression has been considered predicting a more realistic estimation of mPET at Freiburg during 2003 than the other higher order regression model, because the predicted mPET from the first-order regression has less difference from mPET calculated from measurement data. Statistic tests recognize that mPET can effectively evaluate the influences of all human biometeorological factors on thermal environments. Moreover, a first-order regression function can also predict the thermal evaluations of the mPET by using human biometeorological factors in Freiburg.

Reviews in Modern Astronomy: Vol. 17: The Sun and Planetary Systems - Paradigms for the Universe

NASA Astrophysics Data System (ADS)

Schielicke, Reinhard E.

2004-09-01

Volume 17 continues the Reviews of Modern Astronomy with fourteen invited reviews and Highlight Contributions which were presented during the International Scientific Conference of the Society on "The Sun and Planetary Systems", held at Freiburg, Germany, September 15 to 20, 2003. The Karl Schwarzschild medal 2003 was awarded to Professor Erika Boehm-Vitense, Seattle, USA. Her lecture with the title "What Hyades F Stars tell us about Heating Mechanisms in Stellar Transition Layers and Coronae" opened the meeting. The talk presented by the Ludwig Biermann-Prize winner 2003, Dr Luis R. Bellot Rubio, Freiburg i. Br., Germany, dealt with the topic "The Structure of Sunspots as Inferred from Spectropolarimetric Measurements". Other contributions to the meeting published in this volume discuss, among other subjects, solar physics, formation of planets and interferometric imaging in astronomy.

Herbert Falk: a vital force in the renaissance of bile acid research and bile acid therapy.

PubMed

Hofmann, Alan F

2011-01-01

Herbert Falk died on August 8, 2008, after a long illness. It was his vision that initiated the Bile Acid Meetings and brought to market chenodeoxycholic acid and ursodeoxycholic acid for the dissolution of cholesterol gallstones as well as the successful treatment of cholestatic liver disease. The 1st Bile Acid Meeting was a small workshop held at the University Hospital of Freiburg in 1970. Great interest in the topic was evident at that small meeting and led to a larger meeting in 1972, whose scope included both the basic and clinical aspects of bile acids. These meetings have continued at biennial intervals, the 2010 meeting being the 21st. The program has always included discussions of the most fundamental aspects of bile acid biosynthesis and metabolism as well as clinical applications of bile acid therapy. The meetings featured brief presentations, ample time for discussion, and imaginative social programs. They have always been flawlessly organized. Social programs usually included a hike through the beautiful countryside of the Black Forest followed by dinner in a rustic restaurant. Herbert Falk took part in these programs, personally welcoming every participant. In the warm glow of the 'Badische' hospitality, friendships developed, and scientific collaborations were often arranged. From a scientific standpoint, there has been enormous progress in understanding the chemistry and biology of bile acids. Herbert Falk established the Windaus Prize in 1978, and the prize has been given to individuals whose contributions moved the field forward. These bile acid meetings have been marvelous, rewarding experiences. We must all be grateful to Herbert Falk's vision in establishing the Falk Foundation that has so generously sponsored these meetings. We also express our gratitude to his widow, Ursula Falk, who continues this worthy tradition. Copyright © 2011 S. Karger AG, Basel.

antaRNA: ant colony-based RNA sequence design.

PubMed

Kleinkauf, Robert; Mann, Martin; Backofen, Rolf

2015-10-01

RNA sequence design is studied at least as long as the classical folding problem. Although for the latter the functional fold of an RNA molecule is to be found ,: inverse folding tries to identify RNA sequences that fold into a function-specific target structure. In combination with RNA-based biotechnology and synthetic biology ,: reliable RNA sequence design becomes a crucial step to generate novel biochemical components. In this article ,: the computational tool antaRNA is presented. It is capable of compiling RNA sequences for a given structure that comply in addition with an adjustable full range objective GC-content distribution ,: specific sequence constraints and additional fuzzy structure constraints. antaRNA applies ant colony optimization meta-heuristics and its superior performance is shown on a biological datasets. http://www.bioinf.uni-freiburg.de/Software/antaRNA CONTACT: backofen@informatik.uni-freiburg.de Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press.

Memory-efficient RNA energy landscape exploration

PubMed Central

Mann, Martin; Kucharík, Marcel; Flamm, Christoph; Wolfinger, Michael T.

2014-01-01

Motivation: Energy landscapes provide a valuable means for studying the folding dynamics of short RNA molecules in detail by modeling all possible structures and their transitions. Higher abstraction levels based on a macro-state decomposition of the landscape enable the study of larger systems; however, they are still restricted by huge memory requirements of exact approaches. Results: We present a highly parallelizable local enumeration scheme that enables the computation of exact macro-state transition models with highly reduced memory requirements. The approach is evaluated on RNA secondary structure landscapes using a gradient basin definition for macro-states. Furthermore, we demonstrate the need for exact transition models by comparing two barrier-based approaches, and perform a detailed investigation of gradient basins in RNA energy landscapes. Availability and implementation: Source code is part of the C++ Energy Landscape Library available at http://www.bioinf.uni-freiburg.de/Software/. Contact: mmann@informatik.uni-freiburg.de Supplementary information: Supplementary data are available at Bioinformatics online. PMID:24833804

Scientific information repository assisting reflectance spectrometry in legal medicine.

PubMed

Belenki, Liudmila; Sterzik, Vera; Bohnert, Michael; Zimmermann, Klaus; Liehr, Andreas W

2012-06-01

Reflectance spectrometry is a fast and reliable method for the characterization of human skin if the spectra are analyzed with respect to a physical model describing the optical properties of human skin. For a field study performed at the Institute of Legal Medicine and the Freiburg Materials Research Center of the University of Freiburg, a scientific information repository has been developed, which is a variant of an electronic laboratory notebook and assists in the acquisition, management, and high-throughput analysis of reflectance spectra in heterogeneous research environments. At the core of the repository is a database management system hosting the master data. It is filled with primary data via a graphical user interface (GUI) programmed in Java, which also enables the user to browse the database and access the results of data analysis. The latter is carried out via Matlab, Python, and C programs, which retrieve the primary data from the scientific information repository, perform the analysis, and store the results in the database for further usage.

[Results of a standardized survey on the medical use of cannabis products in the German-speaking area].

PubMed

Schnelle, M; Grotenhermen, F; Reif, M; Gorter, R W

1999-10-01

The plant Cannabis sativa has a long history of medical use in the treatment of pain and spasms, the promotion of sleep, and the suppression of nausea and vomiting. However, in the early 70s cannabis was classified in the Narcotic Acts in countries all over the world as having no therapeutic benefit; therefore, it cannot be prescribed by physicians or dispensed by pharmacists. In the light of this contradictory situation an increasing number of patients practices a self-prescription with cannabis products for relieving a variety of symptoms. An anonymous standardized survey of the medical use of cannabis and cannabis products of patients in Germany, Austria and Switzerland was conducted by the Association for Cannabis as Medicine (Cologne, Germany). During about one year 170 subjects participated in this survey; questionnaires of 128 patients could be included into the evaluation. 68% of these participants were males, 32% females, with a total mean age of 37.5 (+/- 9.6) years. The most frequently mentioned indications for medicinal cannabis use were depression (12.0%), multiple sclerosis (10.8%), HIV-infection (9.0%), migraine (6.6%), asthma (6.0%), back pain (5.4%), hepatitis C (4. 8%), sleeping disorders (4.8%), epilepsy (3.6%), spasticity (3.6%), headache (3.6%), alcoholism (3.0%), glaucoma (3.0%), nausea (3.0%), disk prolapse (2.4%), and spinal cord injury (2.4%). The majority of patients used natural cannabis products such as marihuana, hashish and an alcoholic tincture; in just 5 cases dronabinol (Marinol) was taken by prescription. About half of the 128 participants of the survey (52.4%) had used cannabis as a recreational drug before the onset of their illness. To date 14.3% took cannabis orally, 49.2% by inhalation and in 36.5% of cases both application modes were used. 72.2% of the patients stated the symptoms of their illness to have 'much improved' after cannabis ingestion, 23.4% stated to have 'slightly improved', 4.8% experienced 'no change' and 1.6% described that their symptoms got 'worse'. Being asked for the satisfaction with their therapeutic use of cannabis 60.8% stated to be 'very satisfied', 24.0% 'satisfied', 11.2% 'partly satisfied' and 4.0% were 'not satisfied'. 70.8% experienced no side effects, 26.4% described 'moderate' and 3.3% 'strong' side effects. 84.1% of patients have not felt any need for dose escalation during the last 3 months, 11.0% had to increase their cannabis dose 'moderately' and 4.8% 'strongly' in order to maintain the therapeutic effects. Thus, this survey demonstrates a successful use of cannabis products for the treatment of a multitude of various illnesses and symptoms. This use was usually accompanied only by slight and in general acceptable side effects. Because the patient group responding to this survey is presumably highly selected, no conclusions can be drawn about the quantity of wanted and unwanted effects of the medicinal use of the hemp plant for particular indications. Copyright 1999 S. Karger GmbH, Freiburg

Prospective, comparative cohort studies and their contribution to the benefit assessments of therapeutic options: heart failure treatment with and without Hawthorn special extract WS 1442.

PubMed

Habs, M

2004-08-01

In addition to testing a drug for its efficacy, pharmacological quality and safety, current policies are increasingly demanding evaluations of the therapeutic benefits provided by a drug in general practice with "non-selected" patients and increasingly restrictive economic considerations. One of the trials which addresses this task is the WISO cohort study (Efficacy and socio-economic relevance of treatment of chronic heart failure stage NYHA II with Crataegus extract WS 1442). It compares two different therapeutic strategies in the treatment of heart failure stage NYHA II, i.e. a conventional medication and a therapy which also includes hawthorn special extract WS 1442 (Crataegutt novo 450) in addition to chemical-synthetic drugs. In contrast to clinical trials, the patients in cohort studies are expressly not randomised and the physician in charge independently chooses the administered treatment. This comparative, non-interventional observation provides well-founded evidence of the "real-world effectiveness" of the tested preparation. 952 patients with heart failure (NYHA II) were enrolled in the study by 217 general practitioners. 588 patients received Crataegus special extract WS 1442 (Crataegutt novo 450) either as an add-on therapy or as a monotherapy (Crataegus cohort) and 364 patients received therapy without hawthorn (comparative cohort). These two groups had the same indication (heart failure NYHA II) but were significantly different regarding gender, age and concomitant cardiovascular disease. Basically, in view of the free choice of therapy made by the physician in charge, such differences are to be expected in comparative observational studies. A sufficient degree of patient comparability was provided by means of the matched-pairs technique, which replaced the randomisation procedure normally used in clinical studies. After 2 years, 130 patient pairs generated by this technique could be included in the interim assessment. The clinical symptoms with regard to all parameters investigated showed the same or a more pronounced improvement in the Crataegus cohort in the course of 2 years. After 2 years, the three cardinal symptoms of heart failure--fatigue (p = 0.036), stress dyspnoea (p = 0.020) and palpitations (p = 0.048)--were significantly less marked in the Crataegus cohort than in the comparative cohort. The particular design of the cohort study also provides valuable additional information: (1) Hawthorn special extract WS 1442 was prescribed in registered cardiological practices for the treatment of patients with heart failure stage NYHA II, partly as an alternative and partly as a supplement to the used chemical-synthetic drugs. (2) Favourable effects on the clinical symptoms were achieved although the patients in the Crataegus cohort received markedly fewer chemical-synthetic drugs than the patients in the comparative cohort (ACE-inhibitors: 36 vs. 54%, p = 0.004; cardiac glycosides: 18 vs. 37%, p = 0.001; diuretics: 49 vs. 61%, p = 0.061; beta-blockers: 22 vs. 33%, p = 0.052). The data show a clear benefit for patients with heart failure stage NYHA II treated with WS 1442. The single or add-on administration in addition to a chemical-synthetic medication resulted in objective improvements at comparable costs. Copyright 2004 S. Karger GmbH, Freiburg

Plurilingualism, Linguistic Representations and Multiple Identities: Crossing the Frontiers

ERIC Educational Resources Information Center

Stratilaki, Sofia

2012-01-01

This article is concerned with the conditions and stakes of building competence in multiple languages in learners who, due to their language biographies or the educational system, are studying in prestigious institutional school environments, such as the French-German schools of Buc (Versailles), Freiburg (Breisgau) and Saarbrucken (Saarland). In…

Ignoring History: The Flawed Effort to Divorce Reconnaissance From Security in Modern Cavalry Transformation

DTIC Science & Technology

2006-06-16

Weapons of the Waffen -SS: From Small Arms to Tanks (Wellingsborough: Patrick Stephens, Limited, 1988), 106. 47 McCarthy, 29. 48 Schnieder,193-197. 49...book of the German army in the twentieth century). Freiburg, Germany: Podzun- Pallas, 1990. Quarrie, Bruce, Weapons of the Waffen -SS: From Small Arms

Effects of Stimulus Duration and Choice Delay on Visual Categorization in Pigeons

ERIC Educational Resources Information Center

Lazareva, Olga F.; Wasserman, Edward A.

2009-01-01

We [Lazareva, O. F., Freiburger, K. L., & Wasserman, E. A. (2004). "Pigeons concurrently categorize photographs at both basic and superordinate levels." "Psychonomic Bulletin and Review," 11, 1111-1117] previously trained four pigeons to classify color photographs into their basic-level categories (cars, chairs, flowers, or people) or into their…

Greetings from Poland

ERIC Educational Resources Information Center

Burczyk, Krystyna

2011-01-01

In this article, the author discusses the creativity of origami and discusses a model she designed in May 2008 in Freiburg at the 20th International Origami Convention of Origami Deutschland. The model resulted from her investigation of a geometric model that exposes the centre part of a square paper sheet. The base model of the series called…

Lecture and Tutorial via the Internet - Experiences from a Pilot Project Connecting Five Universities.

ERIC Educational Resources Information Center

Wulf, Volker; Schinzel, Britta

This paper reports on a pilot project in which German universities in Freiburg, Constance, Mannheim, Stuttgart, and Ulm connected computer science departments via the Internet for a summer 1997 telelecture and teletutorial on computers and society. The first section provides background on telelearning and introduces the case study. The second…

Personality of Elite Male and Female Chess Players and Its Relation to Chess Skill

ERIC Educational Resources Information Center

Vollstadt-Klein, Sabine; Grimm, Oliver; Kirsch, Peter; Bilalic, Merim

2010-01-01

Whereas a lot of studies examine cognitive processes in chess players, personality profiles of elite chess players are still not described well. The aim of this study was to examine personality of strong chess experts and its influence on chess skill. We tested elite male and female chess players with Freiburg Personality Inventory Revised…

Treatment of a Focal Articular Cartilage Defect of the Talus with Polymer-Based Autologous Chondrocyte Implantation: A 12-Year Follow-Up Period.

PubMed

Kreuz, Peter Cornelius; Kalkreuth, Richard Horst; Niemeyer, Philipp; Uhl, Markus; Erggelet, Christoph

Autologous chondrocyte implantation (ACI) is a first-line treatment option for large articular cartilage defects. Although well-established for cartilage defects in the knee, studies of the long-term outcomes of matrix-assisted ACI to treat cartilage defects in the ankle are rare. In the present report, we describe for the first time the long-term clinical and radiologic results 12 years after polymer-based matrix-assisted ACI treat a full-thickness talar cartilage defect in a 25-year-old male patient. The clinical outcome was assessed using the visual analog scale and Freiburg ankle score, magnetic resonance imaging evaluation using the Henderson-Kreuz scoring system and T2 mapping. Clinical assessment revealed improved visual analog scale and Freiburg ankle scores. The radiologic analysis and T2 relaxation time values indicated the formation of hyaline-like repair tissue. Polymer-based autologous chondrocytes has been shown to be a safe and clinically effective long-term treatment of articular cartilage defects in the talus. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Why education can foster sustainability in the fashion market

NASA Astrophysics Data System (ADS)

Grundmeier, A.-M.

2017-10-01

This project focuses on exploring sustainable-oriented options for young people as they are the primary target group of an accelerating fashion industry. The fast fashion market has major problems along its globally organised supply chain regarding its social and environmental compatibility. The project is conducted within a greater urban area, using the city of Freiburg exemplarily. Pupils of the Staudinger Gesamtschule, the only comprehensive school in Freiburg, engage themselves exploratively in the perspective of sustainability within the fashion market and create a catalogue of measures for sustainable-oriented handling. The main focus of this research project is to evaluate sustainable-oriented course of actions by interviewing selected consumers and active participants as well as protagonists of the fashion market and textile research field. The empirical social research is conducted by using guidelines as an interviewing technique when contacting commercial and product enterprises as well as research institutes and welfare institutions. Explorations and interviews give pupils the opportunity to become familiar with the fields of work and its individual sustainability options within the fashion market. The project is promoted by the programme “Our Common Future” of the Robert Bosch Foundation, Germany.

Performance parameters of a liquid filled ionization chamber array

DOE Office of Scientific and Technical Information (OSTI.GOV)

Poppe, B.; Stelljes, T. S.; Looe, H. K.

2013-08-15

Purpose: In this work, the properties of the two-dimensional liquid filled ionization chamber array Octavius 1000SRS (PTW-Freiburg, Germany) for use in clinical photon-beam dosimetry are investigated.Methods: Measurements were carried out at an Elekta Synergy and Siemens Primus accelerator. For measurements of stability, linearity, and saturation effects of the 1000SRS array a Semiflex 31013 ionization chamber (PTW-Freiburg, Germany) was used as a reference. The effective point of measurement was determined by TPR measurements of the array in comparison with a Roos chamber (type 31004, PTW-Freiburg, Germany). The response of the array with varying field size and depth of measurement was evaluatedmore » using a Semiflex 31010 ionization chamber as a reference. Output factor measurements were carried out with a Semiflex 31010 ionization chamber, a diode (type 60012, PTW-Freiburg, Germany), and the detector array under investigation. The dose response function for a single detector of the array was determined by measuring 1 cm wide slit-beam dose profiles and comparing them against diode-measured profiles. Theoretical aspects of the low pass properties and of the sampling frequency of the detector array were evaluated. Dose profiles measured with the array and the diode detector were compared, and an intensity modulated radiation therapy (IMRT) field was verified using the Gamma-Index method and the visualization of line dose profiles.Results: The array showed a short and long term stability better than 0.1% and 0.2%, respectively. Fluctuations in linearity were found to be within ±0.2% for the vendor specified dose range. Saturation effects were found to be similar to those reported in other studies for liquid-filled ionization chambers. The detector's relative response varied with field size and depth of measurement, showing a small energy dependence accounting for maximum signal deviations of ±2.6% from the reference condition for the setup used. The σ-values of the Gaussian dose response function for a single detector of the array were found to be (0.72 ± 0.25) mm at 6 MV and (0.74 ± 0.25) mm at 15 MV and the corresponding low pass cutoff frequencies are 0.22 and 0.21 mm{sup −1}, respectively. For the inner 5 × 5 cm{sup 2} region and the outer 11 × 11 cm{sup 2} region of the array the Nyquist theorem is fulfilled for maximum sampling frequencies of 0.2 and 0.1 mm{sup −1}, respectively. An IMRT field verification with a Gamma-Index analysis yielded a passing rate of 95.2% for a 3 mm/3% criterion with a TPS calculation as reference.Conclusions: This study shows the applicability of the Octavius 1000SRS in modern dosimetry. Output factor and dose profile measurements illustrated the applicability of the array in small field and stereotactic dosimetry. The high spatial resolution ensures adequate measurements of dose profiles in regular and intensity modulated photon-beam fields.« less

Quantitative Voxel-to-Voxel Comparison of TriBeam and DCT Strontium Titanate Three-Dimensional Data Sets (Postprint)

DTIC Science & Technology

2015-02-09

Peter Gumbsch Karlsruhe Institute of Technology Melanie Syha European Synchrotron Radiation Facility Peter Gumbsch Fraunhofer IWM 9...REPORT DOCUMENTATION PAGE Cont’d 6. AUTHOR(S) 3) Melanie Syha - ESRF 4) Peter Gumbsch - Fraunhofer IWM 7. PERFORMING ORGANIZATION NAME(S...4) Fraunhofer IWM , Woelerstr. 11, 79108 Freiburg, Germany Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std

ED-MEDIA/ED-TELECOM 98 World Conference on Educational Multimedia and Hypermedia & World Conference on Educational Telecommunications. Proceedings (10th, Freiburg, Germany, June 20-25, 1998).

ERIC Educational Resources Information Center

Ottmann, Thomas, Ed.; Tomek, Ivan, Ed.

This collection presents papers pertaining to the wide area of educational multimedia/hypermedia and telecommunications. The conference serves as a forum for the dissemination of information on the research, development, and applications in all areas of multimedia/hypermedia and telecommunications in education across all disciplines and levels.…

A graph kernel approach for alignment-free domain–peptide interaction prediction with an application to human SH3 domains

PubMed Central

Kundu, Kousik; Costa, Fabrizio; Backofen, Rolf

2013-01-01

Motivation: State-of-the-art experimental data for determining binding specificities of peptide recognition modules (PRMs) is obtained by high-throughput approaches like peptide arrays. Most prediction tools applicable to this kind of data are based on an initial multiple alignment of the peptide ligands. Building an initial alignment can be error-prone, especially in the case of the proline-rich peptides bound by the SH3 domains. Results: Here, we present a machine-learning approach based on an efficient graph-kernel technique to predict the specificity of a large set of 70 human SH3 domains, which are an important class of PRMs. The graph-kernel strategy allows us to (i) integrate several types of physico-chemical information for each amino acid, (ii) consider high-order correlations between these features and (iii) eliminate the need for an initial peptide alignment. We build specialized models for each human SH3 domain and achieve competitive predictive performance of 0.73 area under precision-recall curve, compared with 0.27 area under precision-recall curve for state-of-the-art methods based on position weight matrices. We show that better models can be obtained when we use information on the noninteracting peptides (negative examples), which is currently not used by the state-of-the art approaches based on position weight matrices. To this end, we analyze two strategies to identify subsets of high confidence negative data. The techniques introduced here are more general and hence can also be used for any other protein domains, which interact with short peptides (i.e. other PRMs). Availability: The program with the predictive models can be found at http://www.bioinf.uni-freiburg.de/Software/SH3PepInt/SH3PepInt.tar.gz. We also provide a genome-wide prediction for all 70 human SH3 domains, which can be found under http://www.bioinf.uni-freiburg.de/Software/SH3PepInt/Genome-Wide-Predictions.tar.gz. Contact: backofen@informatik.uni-freiburg.de Supplementary information: Supplementary data are available at Bioinformatics online. PMID:23813002

First mass development of Aedes albopictus (Diptera: Culicidae)-its surveillance and control in Germany.

PubMed

Becker, Norbert; Schön, Stefanie; Klein, Alexandra-Maria; Ferstl, Ina; Kizgin, Ali; Tannich, Egbert; Kuhn, Carola; Pluskota, Björn; Jöst, Artur

2017-03-01

The Asian tiger mosquito Aedes albopictus has undergone a dramatic expansion of its range in the last few decades. Since its first detection in 2007 in Germany at the motorway A5 coming from Italy via Switzerland to Germany, it has been continuously introduced by vehicles, most probably from Italy. After a hint from an alert gardener in an allotment garden area in Freiburg, Southwest Germany, in 2015, a surveillance programme was started focusing on the garden area and adjacent areas as well as most of the cemeteries as potential infestation areas. The surveillance programme confirmed a high infestation of the allotment garden. The container index (CI) exceeded almost 30% in August 2015. In lethal gravid Aedes traps (GATs) and BG-Sentinel traps, 4038 adults were caught. It could be proven that the Aedes population is more or less still spatially restricted to the allotment garden area which is adjacent to a train station where trucks from Novara, Italy, arrive loaded on trains. Outside the garden area, only a few breeding sites with developmental stages and adults were found within a radius of approximately 600 m from the highly infested garden area. It is most likely that Ae. albopictus females are constantly introduced as 'blind passengers' to Freiburg via trucks from Italy to Freiburg, Germany. After the first detection of the mass development of Ae. albopictus immediate and comprehensive control measures were initiated to reduce or even eliminate the Aedes population. Citizen awareness, especially of the gardeners, was increased by providing thorough information about the biology and control of Ae. albopictus. Beside environmental management, tablets based on Bacillus thuringiensis israelensis (Bti) were applied. The success of the control activities by the gardeners is reflected by the data gained during monthly inspection of the garden plots. The number of gardens without any container increased from 17% in July to 22% in August and 35% in September, 2015, resulting in a successful reduction of the Ae. albopictus population. The study underlines the importance of a comprehensive surveillance programme to assess the population density of Ae. albopictus as a basis for integrated control activities.

Software for Avionics.

DTIC Science & Technology

1983-01-01

fonctions gfinbrales et lea uti- litaires fournis en particulier grice 41 UNIX, sont intfigrfs aelon divers points de vue: - par leur accas 41 travers le...Are They Really A Problem? Proceedings, 2nd International Conference On Software Engineering, pp 91-68. Long acCA : IEEE Computer Society. Britton...CD The Hague. Nc KLEINSCIIMIDT, M. Dr Fa. LITEF. Poatfach 774. 7800 Freiburg i. Br., Ge KLEMM, R. Dr FGAN- FFM , D 5 307 Watchberg-Werthhoven. Ge KLENK

Development of Solar Research

NASA Astrophysics Data System (ADS)

Wittmann, Axel D.; Wolfschmidt, Gudrun; Duerbeck, Hilmar W.

Originally based on a workshop on “Development of Solar Research”, held in Freiburg/Breisgau, this book contains articles on megalithic structures, the Nebra sky-disk, ancient sun cults, the observation of sunspots, the photography of the sun during eclipses, eclipse maps and expeditions, solar telescopes, solar physics during the Nazi era, archives of solar observations, scientific ballooning for solar research, site-testing on the Canary Islands, as well as on international cooperation.

Preliminary results from the MAESTRO 1 Campaign over the Black Forest

NASA Technical Reports Server (NTRS)

Churchill, P. N.; Degrandi, G.; Sieber, A. J.

1990-01-01

The Joint Research Center (JRC) Ispra and the European Space Agency (ESA) have co-sponsored the deployment of the National Aeronautics and Space Agency (NASA) and Jet Propulsion Laboratory (JPL), C-, L-, and P-band polarimetric synthetic aperture radar (SAR) in Europe in mid-August 1989. This deployment represents the first opportunity for European agencies and institutes to evaluate the current state of the art of multifrequency polarimetric imaging technology over European Test Sites. Of particular interest to the Joint Research Center (JRC) Ispra is the Black Forest Test Site at Freiburg in the Federal Republic of Germany. This Test Site incorporates the Villingen region of the Black Forest to the south-west of Germany. This paper reports upon the activities undertaken in preparation for the MAESTRO 1 Campaign in the Black Forest Test Site. In particular this paper reports upon the ground data collection campaign for the Freiburg Test Site where extensive and intensive ground data measurements were undertaken. These measurements were based upon standard ground data collection protocols developed for forestry by the JRC and utilized throughout Europe for the MAESTRO 1 Campaign. The paper then goes on to present preliminary results derived from the SAR data using the JRC-developed software for polarimetric data interpretation, POLTOOL.

[Psychotherapy of Asperger syndrome in adults].

PubMed

Fangmeier, T; Lichtblau, A; Peters, J; Biscaldi-Schäfer, M; Ebert, D; van Elst, L T

2011-05-01

There is an increase in awareness in professionals that the Asperger syndrome (AS) in adulthood is associated with specific problems and burdens which may well differ from those in childhood and adolescence. The core symptoms of AS generally persist into adulthood, however in contrast to childhood and adolescence there is no specific support system for adults in Germany. Also the environment of the afflicted patient changes thus producing different challenges and problems. In addition a subgroup of patients with high functioning AS primarily presents in adulthood generally due to secondary psychosocial problems, depression or anxiety. Difficulties in social interaction, problems with modified daily routines and unforeseen situations cause severe frustration for the majority of the patients. While several therapy programs have been developed and implemented for children and adolescents, for adults there are none. Also there is a lack of comprehensive concepts addressing the specific needs of adult patients with AS. From an economic perspective this is particularly unfortunate since affected people often have good or excellent partial abilities and might be very valuable employees. In this article existing therapeutic concepts for AS are summarized and a newly designed group therapy program for adult patients with Asperger syndrome in Freiburg is introduced (Freiburg Asperger-spezifische Therapie für Erwachsene, FASTER) which specifically addresses the needs and problems of adult patients with AS.

East Europe Report

DTIC Science & Technology

1986-09-02

the administra- tion". \\ \\ Eawel Kluta of the Paris Commune Shipyards in Gdynia spoke about the need to revise the working style of the ZSMP. He...takes the form of a "distressing servility to fashion" especially to "emanations of certain snobs from Paris , London» Freiburg, Lausanne and other...a grave, or a catacomb , which, it is true, still frightens them from time to time. People no longer pay heed to the life hereafter, the existence

Beginning of the End: The Leadership of SS Obersturmbannfuehrer Jochen Peiper

DTIC Science & Technology

2004-06-17

of Rudolf Lehmann and Ralf Tiemann on the Leibstandarte are based on the Bundesarchiven (National Archives) in Koblenz and Freiburg in Germany...Hans Schmidt, Paul Hausser, Richard Schulze-Kossens, Rudolf Lehmann, and Ralf Tiemann. Some German sources are at odds with American sources, but that...or a constitution. Among the men who set up the first military training for the Waffen-SS were Felix Steiner and Cassius Freiherr (Baron) von

Alfred Bentz - Erdölgeologe in schwieriger Zeit, 1938-1947

NASA Astrophysics Data System (ADS)

Seibold, E.; Seibold, I.

2002-12-01

Alfred Bentz was the leading oil geologist in Germany during the Third Reich, the World War II and thereafter. His relevant activities are treated here mainly on the base of documents in the Geologenarchiv Freiburg. In spite of his prominent position during the Nazi Regime he can obviously not be blamed for personal guilt. As a loyal civil servant he was embedded in the tragic German fate in these years.

Thin Film Materials and Devices for Resistive Temperature Sensing Applications

DTIC Science & Technology

2015-05-21

materials are metals, their alloys, semiconducting materials, and thermistor materials such as spinels of manganese, cobalt and nickel oxides. 16 10...improved by doping of the thin films to increase the available carriers for transport. In the case of SiGe:H thin films, Ajmera et al. and Saint John et al...Conference, Freiburg, Fed. Rep. of Germany, 1989. [55] M. Stutzmann, J. Stuke and H. Dersch, "Electron Spin Resonance of Doped Glow-discharge

On-demand provisioning of HEP compute resources on cloud sites and shared HPC centers

NASA Astrophysics Data System (ADS)

Erli, G.; Fischer, F.; Fleig, G.; Giffels, M.; Hauth, T.; Quast, G.; Schnepf, M.; Heese, J.; Leppert, K.; Arnaez de Pedro, J.; Sträter, R.

2017-10-01

This contribution reports on solutions, experiences and recent developments with the dynamic, on-demand provisioning of remote computing resources for analysis and simulation workflows. Local resources of a physics institute are extended by private and commercial cloud sites, ranging from the inclusion of desktop clusters over institute clusters to HPC centers. Rather than relying on dedicated HEP computing centers, it is nowadays more reasonable and flexible to utilize remote computing capacity via virtualization techniques or container concepts. We report on recent experience from incorporating a remote HPC center (NEMO Cluster, Freiburg University) and resources dynamically requested from the commercial provider 1&1 Internet SE into our intitute’s computing infrastructure. The Freiburg HPC resources are requested via the standard batch system, allowing HPC and HEP applications to be executed simultaneously, such that regular batch jobs run side by side to virtual machines managed via OpenStack [1]. For the inclusion of the 1&1 commercial resources, a Python API and SDK as well as the possibility to upload images were available. Large scale tests prove the capability to serve the scientific use case in the European 1&1 datacenters. The described environment at the Institute of Experimental Nuclear Physics (IEKP) at KIT serves the needs of researchers participating in the CMS and Belle II experiments. In total, resources exceeding half a million CPU hours have been provided by remote sites.

Outcomes and special considerations of cochlear implantation in waardenburg syndrome.

PubMed

Kontorinis, Georgios; Lenarz, Thomas; Giourgas, Alexandros; Durisin, Martin; Lesinski-Schiedat, Anke

2011-08-01

The objective of this study was a state-of-the-art analysis of cochlear implantation in patients with Waardenburg syndrome (WS). Twenty-five patients with WS treated with cochlear implants in our department from 1990 to 2010. The 25 patients with WS underwent 35 cochlear implantations. Hearing outcome was evaluated using HSM sentence test in 65 dB in quiet, Freiburg Monosyllabic Test, and categories of auditory performance for children and compared with that of a control group. Anatomic abnormalities of the inner ear were examined using magnetic resonance imaging and computed tomography of the temporal bones. The mean follow-up time was 8.3 years (range, 0.3-18.3 yr). The majority achieved favorable postimplantation performance with mean HSM scores of 75.3% (range, 22.6%-99%) and Freiburg Monosyllabic Test scores of 67.8% (range, 14%-95%). However, in 4 cases, the results were less satisfactory. The comparison with the control group did not reveal any statistical significance (p = 0.56). In 6 patients (24%), behavioral disorders caused temporary difficulties during the rehabilitation procedure. Except of isolated large vestibule in 1 patient, the radiological assessment of the 50 temporal bones did not reveal any temporal bone abnormalities. Most patients with WS performed well with cochlear implants. However, WS is related to behavioral disorders that may cause temporary rehabilitation difficulties. Finally, temporal bone malformations that could affect cochlear implantation are notcharacteristic of WS.

Response to Stoesz and Karger's Article, "Reinventing Social Work Accreditation"

ERIC Educational Resources Information Center

Watkins, Julia M.

2009-01-01

The article by David Stoesz and Howard J. Karger, "Reinventing Social Work Accreditation," is misleading and erroneous in its assumptions, makes unsubstantiated assertions, and demonstrates an ideological shallowness on the part of the authors in their understanding of social work education, the Council on Social Work Education, and the…

Active tectonics of the southeastern Upper Rhine Graben, Freiburg area (Germany)

NASA Astrophysics Data System (ADS)

Nivière, B.; Bruestle, A.; Bertrand, G.; Carretier, S.; Behrmann, J.; Gourry, J.-C.

2008-03-01

The Upper Rhine Graben has two Plio-Quaternary depocentres usually interpreted as resulting from tectonic reactivation. The southern basin, near Freiburg im Breisgau (Germany), contains up to 250 m of sediments. Beneath the younger alluvial deposits related to the current drainage system, a former river network deeply entrenched in the substratum reveals a very low regional base level of early Pleistocene age. The offset of channels at faults allows us to infer a Pleistocene reactivation of the syn-rift fault pattern and the estimation of slip rates. Maximum vertical movements along the faults have not exceeded 0.1 mm/yr since the middle Pleistocene. Current activity is concentrated along the westernmost faults. Morphologic markers indicate late Pleistocene reactivation of the Rhine River fault, and geophysical prospecting suggests a near-surface offset of young sedimentary deposits. The size of the fault segments potentially reactivated suggests that earthquakes with magnitude larger than Mw=6.3 could be expected in the area with a return interval of about 8000 years. Extrapolated to the duration of the Plio-Pleistocene, the strain rate estimates reveal that the tectonic forcing may account for only one-third to one-half of the whole thickness of the Plio-Pleistocene sediments of the basin fill. Thus other processes must be invoked to understand the growth of the Plio-Pleistocene basin. Especially the piracy of the Rhine River to the north during the early Pleistocene could explain these effects.

The covariance of air quality conditions in six cities in Southern Germany - The role of meteorology.

PubMed

Dimitriou, Konstantinos; Kassomenos, Pavlos

2017-01-01

This paper analyzed air quality in six cities in Southern Germany (Ulm, Augsburg, Konstanz, Freiburg, Stuttgart and Munich), in conjunction with the prevailing synoptic conditions. Air quality was estimated through the calculation of a daily Air Stress Index (ASI) constituted by five independent components, each one expressing the contribution of one of the five main pollutants (PM 10 , O 3 , SO 2 , NO 2 and CO) to the total air stress. As it was deduced from ASI components, PM 10 from combustion sources and photochemically produced tropospheric O 3 are the most hazardous pollutants at the studied sites, throughout cold and warm periods respectively, yet PM 10 contribute substantially to the overall air stress during both seasons. The influence of anticyclonic high pressure systems, leading to atmospheric stagnation, was associated with increased ASI values, mainly due to the entrapment of PM 10 . Moderate air stress was generally estimated in all cities however a cleaner atmosphere was detected principally in Freiburg when North Europe was dominated by low pressure systems. Daily events of notably escalated ASI values were further analyzed with backward air mass trajectories. Throughout cold period, ASI episodes were commonly related to eastern airflows carrying exogenous PM 10 originated from eastern continental Europe. During warm period, ASI episodes were connected to the arrival of regionally circulated air parcels reflecting lack of dispersion and accumulation of pollutants in accordance with the synoptic analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

Freiburg Questionnaire of linguistic pragmatics (FQLP): psychometric properties based on a psychiatric sample.

PubMed

Riedel, Andreas; Suh, Heejung; Haser, Verena; Hermann, Ismene; Ebert, Dieter; Riemann, Dieter; Bubl, Emanuel; Tebartz van Elst, Ludger; Hölzel, Lars P

2014-12-24

Asperger's Syndrome (AS) is an autism spectrum disorder that is characterized by significant difficulties in social interaction and nonverbal communication, and restricted and repetitive patterns of behavior and interests. Difficulties with respect to pragmatic speech, reading emotional and social cues, differentiating between fact and fiction, and taking into account the influence of context on a statement are commonly described features. However, hitherto established questionnaires did not focus on these symptoms. In this study we present a short (11 questions) questionnaire which focuses on self-rated pragmatic speech abilities, the Freiburg Questionnaire of linguistic pragmatics (FQLP). Psychometric properties of the questionnaire were explored in a sample of 57 patients with Asperger's Syndrome, 66 patients with other psychiatric disorders, and a convenience sample of 56 people. Reliability analysis showed a high Cronbach's α. Strong correlations could be demonstrated for the FQLP with the Autism Quotient and the Empathy Quotient. Concerning divergent validity a moderate correlation was found between the FQLP and self-rated symptoms of personality disorders. No significant correlation was found between the FQLP and the vocabulary skills. The receiver operating characteristics curve showed an excellent diagnostic accuracy of the FQLP (.97). As the control group consisted of people without mental disorder and patients with different psychiatric disorders, the results indicate that the construct examined by the FQLP is quite specific to the peculiarities of AS. The FQLP is a reliable, brief and valid instrument. First results regarding sensitivity and specificity are highly promising.

Comparison of learning preferences of Turkish children who had been applied cochlear implantation in Turkey and Germany according to theory of multiple intelligence.

PubMed

Sahli, Sanem; Laszig, Roland; Aschendorff, Antje; Kroeger, Stefanie; Wesarg, Thomas; Belgin, Erol

2011-12-01

The aim of the study is to determinate the using dominant multiple intelligence types and compare the learning preferences of Turkish cochlear implanted children aged four to ten in Turkey and Germany according to Theory of multiple intelligence. The study has been conducted on a total of 80 children and four groups in Freiburg/Germany and Ankara/Turkey. The applications have been done in University of Freiburg, Cochlear Implant Center in Germany, and University of Hacettepe, ENT Department, Audiology and Speech Pathology Section in Turkey. In this study, the data have been collected by means of General Information Form and Cochlear Implant Information Form applied to parents. To determine the dominant multiple intelligence types of children, the TIMI (Teele Inventory of Multiple Intelligences) which was developed by Sue Teele have been used. The study results exposed that there was not a statistically significant difference on dominant intelligence areas and averages of scores of multiple intelligence types in control groups (p>0.05). Although, the dominant intelligence areas were different (except for first dominant intelligence) in cochlear implanted children in Turkey and Germany, there was not a statistically significant difference on averages of scores of dominant multiple intelligence types. Every hearing impaired child who started training, should be evaluated in terms of multiple intelligence areas and identified strengths and weaknesses. Multiple intelligence activities should be used in their educational programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Implant dentistry curriculum in undergraduate education: part 2-program at the Albert-Ludwigs University, Freiburg, Germany.

PubMed

Kroeplin, Birgit S; Strub, Joerg R

2011-01-01

The aim of this study was to describe the didactic and clinical undergraduate implant dentistry program of the Albert-Ludwigs University, Freiburg, Germany, with emphasis on the clinical implant experience. A detailed description of the implant curriculum at Albert-Ludwigs University is given with documented exemplary cases and additional flow charts. All students participate in 28 hours of lectures and approximately 64 hours of seminars with hands-on courses and gain clinical experience. All undergraduate students are eligible to place and restore oral implants. Emphasis is placed on prosthetic-driven planning of implant positions, three-dimensional imaging, and computer-guided implant placement. Implant restorations performed by undergraduate students comprise single crowns and small multiunit fixed dental prostheses in partially edentulous posterior maxillae and anterior or posterior mandibles, implant-retained overdentures (snap attachment) in edentulous patients, and telescopic fixed-removable dental prostheses on remaining teeth and strategically placed additional implants. Over the past 2.5 years, 51 patients were treated with 97 dental implants placed by students in the undergraduate program. Seventy-one restorations were inserted: 60.6% single crowns, 7% fixed dental protheses, 21.1% overdentures, and 11.3% telescopic fixed-removable dental prostheses. The implant survival rate was 98.9%. Because survival rates for dental implants placed and restored by students are comparable to those of experienced dentists, oral implant dentistry should be implemented as part of the undergraduate dental curriculum.

Impact of the Medical Faculty on Study Success in Freiburg: Results from Graduate Surveys.

PubMed

Biller, Silke; Boeker, Martin; Fabry, Götz; Giesler, Marianne

2015-01-01

Using the data from graduate surveys, this study aims to analyze which factors related to teaching and learning at the Freiburg Faculty of Medicine can influence study success. Study success and the factors influencing it have long been the subject of investigation, with study success being measured in terms of easily quantifiable indicators (final grades, student satisfaction, etc.). In recent years, it has also frequently been assessed in terms of graduate competency levels. Graduate surveys are considered suitable instruments for measuring these dimensions of study success. Data from three Freiburg graduate surveys conducted one and a half years after graduation were drawn upon for the analysis. Study success was operationalized using four indicators: results on the written section of the M2 exam, self-assessment of medical expertise and scientific expertise, and student satisfaction. Using multiple regression analyses, the predictive power was calculated for selected variables, also measured by the graduate surveys, for the different study success indicators. It was possible to identify models that contribute slightly or moderately to the prediction of study success. The score earned on the university entrance qualification demonstrated itself to be the strongest predictor for forecasting the M2 written exam: R(2) is between 0.08 and 0.22 for the three surveys. Different variables specific to degree program structure and teaching are helpful for predicting medical expertise (R(2)=0.04-0.32) and student satisfaction (R(2)=0.12-0.35). The two variables, structure and curricular sequencing of the degree program and combination of theory and practice, show themselves to be significant, sample-invariant predictors (β-weight(Structure)=0.21-0.58, β-weight(Combination)=0.27-0.56). For scientific expertise, no sample-independent predictors could be determined. Factors describing teaching hardly provide any assistance when predicting the written M2 exam score, which makes sense to the extent that teaching goes far beyond the heavily knowledge-based content of the written M2 exam. The lack of predictability for scientific expertise is most likely explained in that these have been only rarely included in the curriculum and often inexplicitly so. The variable combination of theory and practice appears to be significant for imparting medical expertise and the development of student satisfaction. The extent to which these relationships are practically relevant needs to be explored in further studies. A specific limitation is that the measurement of expertise and skill is based solely on self-assessments.

Curt Teichert - Dokumente zu einer Emigration (Dänemark - Australien - USA)

NASA Astrophysics Data System (ADS)

Seibold, Eugen; Seibold, Ilse

2008-05-01

Curt Teichert (Königsberg 1905—Arlington, Virginia 1996) provides in his life story examples of the many hardships and difficulties encountered by emigrants who were fortunate to escape Hitleŕs regime. He was a great paleontologist and stratigrapher whose fieldwork on four continents involved nearly every fossil group; his interests were focussed mainly on the Paleozoic and the Triassic. His results and critical remarks on many general topics filled numerous publications. Remarkably, he accomplished all this under partly very unfavorable working conditions. He donated his scientific correspondence from his times in Germany, Denmark and Australia to the Geological Archive in Freiburg. The following article makes use of these documents. Teichert’s professional career started in Germany in the scientifically exciting nineteen-twenties; he worked at the universities in Königsberg, Munich and Freiburg/Breisgau. In Freiburg, however, he had serious disagreements with the Director of the Geological Institute there—this in spite of his investigations having produced some excellent results. The times around 1930 were a period of a global economic crisis, and, like many others, he could only survive financially by getting fellowships from different institutions and payments for publications. In 1933, his situation in Germany became even more critical: this was because he had married a “Non-Aryan”. However, he was able to work in Copenhagen from the end of 1933; this was largely a result of his having participated in 1931 1932 in an expedition to Greenland led by the Dane Lauge Koch. Unfortunately, he could not get a permanent position in Copenhagen because the relations between him and the influential Koch became very unpleasant. Noting Hitleŕs war preparation, Teichert tried to escape from Europe. He wrote many touching letters to correspondents around the globe, receiving mostly disappointing answers. Finally, in 1937, he succeeded in getting the post of a research paleontologist at the University of Perth, in Western Australia. There he worked very successfully, both in the field and in the laboratory. Additionally, he cooperated with the University in lecturing, and contributed much to its collections. His wife Gertrud assisted him always in his work, with great effectiveness. Yet tenure still eluded him, even after seven years of hard work—tenure was what he wanted, understandably, especially after such a long period of uncertainty. Finally, he succeeded in getting tenure in Eastern Australia , but moved then to the USA in 1954. There his outstanding scientific qualities were fully recognized, both in the Geological Survey and in several universities, also as an editor of several classic publications.

77 FR 20526 - Airworthiness Directives; 328 Support Services GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... directive (AD) for all 328 Support Services GmbH (Type Certificate previously held by AvCraft Aerospace GmbH... GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier... applies to 328 Support Services GmbH (Type Certificate previously held by AvCraft Aerospace GmbH...

Proceedings of the European Seminar on Industrial Software Engineering (2nd) Held in Freiburg (Germany, F.R.) on 9-10 May 1985,

DTIC Science & Technology

1985-05-10

synchronisation , 8% cache bus monitoring ). 6. Conclusions Since the 1950’s, fault tolerance has been used to improve the reliability of hardware systems ...description. The operation may use other operations supplied with the system , here e.g. HIRE EMPLOYEE, ENTER MGR SAL etc . HIRE MRNAGR (X:PERSOW) nsot ACTOR (X...hardware design and in the operating systems software and they have developed a number of products which are of a commercial standard and of wide

77 FR 12163 - Airworthiness Directives; 328 Support Services GmbH (Type Certificate Previously Held by AvCraft...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

... Airworthiness Directives; 328 Support Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier Luftfahrt GmbH) Airplanes AGENCY: Federal Aviation Administration (FAA... directive (AD) for all 328 Support Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH...

76 FR 42031 - Airworthiness Directives; 328 Support Services GmbH (Type Certificate Previously Held by AvCraft...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

... Airworthiness Directives; 328 Support Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier Luftfahrt GmbH) Model 328-100 and -300 Airplanes AGENCY: Federal Aviation... 328 Support Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild...

78 FR 52872 - Airworthiness Directives; 328 Support Services GmbH (Type Certificate Previously Held by AvCraft...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier Luftfahrt GmbH) Airplanes AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... certain 328 Support Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild...

Accelerated Loss of TCR Repertoire Diversity in Common Variable Immunodeficiency

PubMed Central

Wong, Gabriel K.; Millar, David; Penny, Sarah; Heather, James M.; Mistry, Punam; Buettner, Nico; Bryon, Jane; Huissoon, Aarnoud P.

2016-01-01

Although common variable immunodeficiency (CVID) has long been considered as a group of primary Ab deficiencies, growing experimental data now suggest a global disruption of the entire adaptive immune response in a segment of patients. Oligoclonality of the TCR repertoire was previously demonstrated; however, the manner in which it relates to other B cell and T cell findings reported in CVID remains unclear. Using a combination approach of high-throughput TCRβ sequencing and multiparametric flow cytometry, we compared the TCR repertoire diversity between various subgroups of CVID patients according to their B cell immunophenotypes. Our data suggest that the reduction in repertoire diversity is predominantly restricted to those patients with severely reduced class-switched memory B cells and an elevated level of CD21lo B cells (Freiburg 1a), and may be driven by a reduced number of naive T cells unmasking underlying memory clonality. Moreover, our data indicate that this loss in repertoire diversity progresses with advancing age far exceeding the expected physiological rate. Radiological evidence supports the loss in thymic volume, correlating with the decrease in repertoire diversity. Evidence now suggests that primary thymic failure along with other well-described B cell abnormalities play an important role in the pathophysiology in Freiburg group 1a patients. Clinically, our findings emphasize the integration of combined B and T cell testing to identify those patients at the greatest risk for infection. Future work should focus on investigating the link between thymic failure and the severe reduction in class-switched memory B cells, while gathering longitudinal laboratory data to examine the progressive nature of the disease. PMID:27481850

Effect of gender on the hearing performance of adult cochlear implant patients.

PubMed

Lenarz, Minoo; Sönmez, Hasibe; Joseph, Gert; Büchner, Andreas; Lenarz, Thomas

2012-05-01

To evaluate the role of gender on the hearing performance of postlingually deafened adult patients with cochlear implants. Individual retrospective cohort study. There were 638 postlingually deafened adults (280 men and 358 women) selected for a retrospective evaluation of their hearing performance with cochlear implants. Both genders underwent the same surgical and rehabilitative procedures and benefited from the latest technological advances available. There was no significant difference in the age, duration of deafness, and preoperative hearing performance between the genders. The test battery was composed of the Freiburger Monosyllabic Test, Speech Tracking, and the Hochmair-Schulz-Moser (HSM) sentence test in quiet and in 10-dB noise. The results of 5 years of follow-up are presented here. Genders showed a similar performance in Freiburger Monosyllabic Test and Speech Tracking Test. However, in the HSM test in noise, men performed slightly better than women in all of the follow-up sessions, which was statistically significant at 2 and 4 years after implantation. Although normal-hearing women use more predictive cognitive strategies in speech comprehension and are supposed to have a more efficient declarative memory system, this may not necessarily lead to a better adaptation to the altered auditory information delivered by a cochlear implant. Our study showed that in more complex listening situations such as speech tests in noise, men tend to perform slightly better than women. Gender may have an influence on the hearing performance of postlingually deafened adults with cochlear implants. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Temporal Sensitivity Measured Shortly After Cochlear Implantation Predicts 6-Month Speech Recognition Outcome.

PubMed

Erb, Julia; Ludwig, Alexandra Annemarie; Kunke, Dunja; Fuchs, Michael; Obleser, Jonas

2018-04-24

Psychoacoustic tests assessed shortly after cochlear implantation are useful predictors of the rehabilitative speech outcome. While largely independent, both spectral and temporal resolution tests are important to provide an accurate prediction of speech recognition. However, rapid tests of temporal sensitivity are currently lacking. Here, we propose a simple amplitude modulation rate discrimination (AMRD) paradigm that is validated by predicting future speech recognition in adult cochlear implant (CI) patients. In 34 newly implanted patients, we used an adaptive AMRD paradigm, where broadband noise was modulated at the speech-relevant rate of ~4 Hz. In a longitudinal study, speech recognition in quiet was assessed using the closed-set Freiburger number test shortly after cochlear implantation (t0) as well as the open-set Freiburger monosyllabic word test 6 months later (t6). Both AMRD thresholds at t0 (r = -0.51) and speech recognition scores at t0 (r = 0.56) predicted speech recognition scores at t6. However, AMRD and speech recognition at t0 were uncorrelated, suggesting that those measures capture partially distinct perceptual abilities. A multiple regression model predicting 6-month speech recognition outcome with deafness duration and speech recognition at t0 improved from adjusted R = 0.30 to adjusted R = 0.44 when AMRD threshold was added as a predictor. These findings identify AMRD thresholds as a reliable, nonredundant predictor above and beyond established speech tests for CI outcome. This AMRD test could potentially be developed into a rapid clinical temporal-resolution test to be integrated into the postoperative test battery to improve the reliability of speech outcome prognosis.

77 FR 3583 - Airworthiness Directives; 328 Support Services GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... Airworthiness Directives; 328 Support Services GmbH Airplanes AGENCY: Federal Aviation Administration (FAA... directive (AD) for all 328 Support Services GmbH (Type Certificate previously held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier Luftfahrt GmbH) Model 328-100 and 328-300 airplanes. This AD was prompted by...

76 FR 77159 - Airworthiness Directives; 328 Support Services GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-12

... Services GmbH Airplanes AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... Services GmbH (Type Certificate previously held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier Luftfahrt GmbH) Model 328-100 and -300 airplanes that would supersede an existing AD. This proposed AD...

76 FR 54145 - Airworthiness Directives; 328 Support Services GmbH (Type Certificate Previously Held by AvCraft...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

... Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier Luftfahrt GmbH) Model 328-100 Airplanes AGENCY: Federal Aviation Administration (FAA), DOT. [[Page 54146... Services GmbH, Global Support Center, P.O. Box 1252, D-82231 Wessling, Federal Republic of Germany...

75 FR 75159 - Airworthiness Directives; 328 Support Services GmbH (Type Certificate Previously Held by AvCraft...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-02

... Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier Luftfahrt GmbH) Model 328-100 and -300 Airplanes AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... Services GmbH, Global Support Center, P.O. Box 1252, D-82231 Wessling, Federal Republic of Germany...

76 FR 19721 - Airworthiness Directives; 328 Support Services GmbH (Type Certificate Previously Held by AvCraft...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

... Services GmbH (Type Certificate Previously Held by AvCraft Aerospace GmbH; Fairchild Dornier GmbH; Dornier Luftfahrt GmbH) Model 328-100 and -300 Airplanes AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... information identified in this proposed AD, contact 328 Support Services GmbH, Global Support Center, P.O. Box...

Challenging the current approaches to multiple myeloma- and other cancer-related bone diseases: from bisphosphonates to targeted therapy.

PubMed

Kleber, Martina; Udi, Josefina; Metzke, Barbara; Terpos, Evangelos; Roodmann, G David; Morgan, Gareth; Dispenzieri, Angela; Einsele, Hermann; Wäsch, Ralph; Engelhardt, Monika

2012-06-01

An international myeloma meeting entitled "Challenging the current approaches to multiple myeloma- and other cancer-related bone diseases: from bisphosphonates to targeted therapy" was held in Freiburg, Germany in July 2011 to discuss novel insights into and approaches to myeloma bone disease and other bone-seeking tumors. This review briefly summarizes the most prominent data of the meeting and current literature on our understanding of bone disease, the role of imaging techniques, operative interventions and systemic bone-seeking treatment, all of which should further improve our future therapeutic choices.

75 FR 7936 - Airworthiness Directives; SCHEIBE-Flugzeugbau GmbH Model SF 25C Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... Airworthiness Directives; SCHEIBE-Flugzeugbau GmbH Model SF 25C Gliders AGENCY: Federal Aviation Administration.... Relevant Service Information SCHEIBE-Flugzeugbau GmbH has issued SCHEIBE AIRCRAFT GMBH Service Bulletin 653... SCHEIBE-Flugzeugbau GmbH: Amendment 39-16208; Docket No. FAA-2010-0125; Directorate Identifier 2010-CE-005...

SPARSE: quadratic time simultaneous alignment and folding of RNAs without sequence-based heuristics

PubMed Central

Will, Sebastian; Otto, Christina; Miladi, Milad; Möhl, Mathias; Backofen, Rolf

2015-01-01

Motivation: RNA-Seq experiments have revealed a multitude of novel ncRNAs. The gold standard for their analysis based on simultaneous alignment and folding suffers from extreme time complexity of O(n6). Subsequently, numerous faster ‘Sankoff-style’ approaches have been suggested. Commonly, the performance of such methods relies on sequence-based heuristics that restrict the search space to optimal or near-optimal sequence alignments; however, the accuracy of sequence-based methods breaks down for RNAs with sequence identities below 60%. Alignment approaches like LocARNA that do not require sequence-based heuristics, have been limited to high complexity (≥ quartic time). Results: Breaking this barrier, we introduce the novel Sankoff-style algorithm ‘sparsified prediction and alignment of RNAs based on their structure ensembles (SPARSE)’, which runs in quadratic time without sequence-based heuristics. To achieve this low complexity, on par with sequence alignment algorithms, SPARSE features strong sparsification based on structural properties of the RNA ensembles. Following PMcomp, SPARSE gains further speed-up from lightweight energy computation. Although all existing lightweight Sankoff-style methods restrict Sankoff’s original model by disallowing loop deletions and insertions, SPARSE transfers the Sankoff algorithm to the lightweight energy model completely for the first time. Compared with LocARNA, SPARSE achieves similar alignment and better folding quality in significantly less time (speedup: 3.7). At similar run-time, it aligns low sequence identity instances substantially more accurate than RAF, which uses sequence-based heuristics. Availability and implementation: SPARSE is freely available at http://www.bioinf.uni-freiburg.de/Software/SPARSE. Contact: backofen@informatik.uni-freiburg.de Supplementary information: Supplementary data are available at Bioinformatics online. PMID:25838465

Insomnia with objective short sleep duration is associated with longer duration of insomnia in the Freiburg Insomnia Cohort compared to insomnia with normal sleep duration, but not with hypertension

PubMed Central

Johann, Anna F.; Hertenstein, Elisabeth; Kyle, Simon D.; Baglioni, Chiara; Feige, Bernd; Nissen, Christoph; McGinness, Alastair J.; Riemann, Dieter; Spiegelhalder, Kai

2017-01-01

Study objectives To replicate the association between insomnia with objective short sleep duration and hypertension, type 2 diabetes and duration of insomnia. Design Retrospective case-control study. Setting Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg. Participants 328 patients with primary insomnia classified according to DSM-IV criteria (125 males, 203 females, 44.3 ± 12.2 years). Interventions N/A Measurements All participants were investigated using polysomnography, blood pressure measurements, and fasting routine laboratory. Results Insomnia patients with short sleep duration (< 6 hours) in the first night of laboratory sleep presented with a longer duration of insomnia compared to those with normal sleep duration (≥ 6 hours) in the first night of laboratory sleep. Insomnia patients who were categorised as short sleepers in either night were not more likely to suffer from hypertension (systolic blood pressure of ≥ 140 mm Hg, diastolic blood pressure of ≥ 90 mm Hg, or a previously established diagnosis). Data analysis showed that insomnia patients with objective short sleep duration were not more likely to suffer from type 2 diabetes (fasting plasma glucose level of ≥ 126 mg/dl, or a previously established diagnosis). However, the diabetes analysis was only based on a very small number of diabetes cases. As a new finding, insomnia patients who were categorised as short sleepers in either night presented with increases in liver enzyme levels. Conclusions The finding on insomnia duration supports the concept of two distinct sub-groups of insomnia, namely insomnia with, and without, objectively determined short sleep duration. However, our data challenges previous findings that insomnia patients with short sleep duration are more likely to suffer from hypertension. PMID:28746413

Insomnia with objective short sleep duration is associated with longer duration of insomnia in the Freiburg Insomnia Cohort compared to insomnia with normal sleep duration, but not with hypertension.

PubMed

Johann, Anna F; Hertenstein, Elisabeth; Kyle, Simon D; Baglioni, Chiara; Feige, Bernd; Nissen, Christoph; McGinness, Alastair J; Riemann, Dieter; Spiegelhalder, Kai

2017-01-01

To replicate the association between insomnia with objective short sleep duration and hypertension, type 2 diabetes and duration of insomnia. Retrospective case-control study. Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg. 328 patients with primary insomnia classified according to DSM-IV criteria (125 males, 203 females, 44.3 ± 12.2 years). N/A. All participants were investigated using polysomnography, blood pressure measurements, and fasting routine laboratory. Insomnia patients with short sleep duration (< 6 hours) in the first night of laboratory sleep presented with a longer duration of insomnia compared to those with normal sleep duration (≥ 6 hours) in the first night of laboratory sleep. Insomnia patients who were categorised as short sleepers in either night were not more likely to suffer from hypertension (systolic blood pressure of ≥ 140 mm Hg, diastolic blood pressure of ≥ 90 mm Hg, or a previously established diagnosis). Data analysis showed that insomnia patients with objective short sleep duration were not more likely to suffer from type 2 diabetes (fasting plasma glucose level of ≥ 126 mg/dl, or a previously established diagnosis). However, the diabetes analysis was only based on a very small number of diabetes cases. As a new finding, insomnia patients who were categorised as short sleepers in either night presented with increases in liver enzyme levels. The finding on insomnia duration supports the concept of two distinct sub-groups of insomnia, namely insomnia with, and without, objectively determined short sleep duration. However, our data challenges previous findings that insomnia patients with short sleep duration are more likely to suffer from hypertension.

Using the Freiburg Acuity and Contrast Test to measure visual performance in USAF personnel after PRK.

PubMed

Dennis, Richard J; Beer, Jeremy M A; Baldwin, J Bruce; Ivan, Douglas J; Lorusso, Frank J; Thompson, William T

2004-07-01

Photorefractive keratectomy (PRK) may be an alternative to spectacle and contact lens wear for United States Air Force (USAF) aircrew and may offer some distinct advantages in operational situations. However, any residual corneal haze or scar formation from PRK could exacerbate the disabling effects of a bright glare source on a complex visual task. The USAF recently completed a longitudinal clinical evaluation of the long-term effects of PRK on visual performance, including the experiment described herein. After baseline data were collected, 20 nonflying active duty USAF personnel underwent PRK. Visual performance was then measured at 6, 12, and 24 months after PRK. Visual acuity (VA) and contrast sensitivity (CS) data were collected by using the Freiburg Acuity and Contrast Test (FrACT), with the subject viewing half of the runs through a polycarbonate windscreen. Experimental runs were completed under 3 glare conditions: no glare source and with either a broadband or a green laser (532-nm) glare annulus (luminance approximately 6090 cd/m) surrounding the Landolt C stimulus. Systematic effects of PRK on VA relative to baseline were not identified. However, VA was almost 2 full Snellen lines worse with the laser glare source in place versus the broadband glare source. A significant drop-off was observed in CS performance after PRK under conditions of no glare and broadband glare; this was the case both with and without the windscreen. As with VA, laser glare disrupted CS performance significantly and more than broadband glare did. PRK does not appear to have affected VA, but the changes in CS might represent a true decline in visual performance. The greater disruptive effects from laser versus broadband glare may be a result of increased masking from coherent spatial noise (speckle) surrounding the laser stimulus.

Sci-Thur PM – Brachytherapy 06: 3D Printed Surface Applicators for High Dose Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clarke, Scott; Yewondwossen, Mammo; Robar, James

Purpose: The purpose of this work is to develop a new applicator for administering high dose rate (HDR) brachytherapy using 3D printing technology. Primary advantages of using a 3D printed applicator will be to offer a more streamlined approach for therapists and patients while achieving better conformity, reproducibility, and patient specific applicators. Methods: A phantom study was conducted to measure the effectiveness of a 3D printed surface applicator by analyzing tumours on three locations of the body: the foot, nose, and scalp. The applicator was designed using Eclipse and further modified using Blender to create the catheter tunnels before beingmore » printed on a Lulzbot Taz 5 3D printer. A radiation plan was made using Oncentra Brachytherapy for a control treatment option using Freiburg Flaps and one with the novel method of a 3D printed applicator. A comparative analysis was made using D90, D100, V100, V150, and V200 Results: The 3D printed applicator showed comparable dose coverage with significant improvements on highly irregular surfaces when analyzed against a plan made using Freiburg Flaps. Although both plans exhibited complete tumour coverage, the 3D applicator showed improvements in D90 and V150 and the 3D applicator had a dose homogeneity index (DHI) of 0.99 compared to a DHI of 0.97 for the control. Therapist prep time also dropped significantly due to the lack of need for a thermoplastic mesh. Conclusions: 3D printed applicators for treatment of superficial sites proved to offer more patient convenience, less prep time, better conformity and tighter margins.« less

High dose rate brachytherapy with customized applicators for malignant facial skin lesions.

PubMed

Jumeau, R; Renard-Oldrini, S; Courrech, F; Buchheit, I; Oldrini, G; Vogin, G; Peiffert, D

2016-07-01

Brachytherapy is a well-known treatment in the management of skin tumors. For facial or scalp lesions, applicators have been developed to deliver non-invasive treatment. We present cases treated with customized applicators with high dose rate system. Patients with poor performance status treated for malignant skin lesions of the scalp or the facial skin between 2011 and 2014 were studied. Afterloading devices were chosen between Freiburg(®) Flap, silicone-mold or wax applicators. The clinical target volume (CTV) was created by adding margins to lesions (10mm to 20mm). The dose schedules were 25Gy in five fractions for postoperative lesions, 30Gy in six fractions for exclusive treatments and a single session of 8Gy could be considered for palliative treatments. In 30 months, 11 patients received a treatment for a total of 12 lesions. The median age was 80 years. The median follow-up was 17 months and the 2-year local control rate was 91%. The mean CTV surface was 41.1cm(2) with a mean thickness of 6.1mm. We conceived three wax applicators, used our silicone-mold eight times and the Freiburg(®) Flap one time. We observed only low-grade radiodermitis (grade I: 50%, grade II: 33%), and no high-grade skin toxicity. High dose rate brachytherapy with customized applicators for facial skin and scalp lesions is efficient and safe. It is a good modality to treat complex lesions in patients unfit for invasive treatment. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Thermal comfort in an east-west oriented street canyon in Freiburg (Germany) under hot summer conditions

NASA Astrophysics Data System (ADS)

Ali-Toudert, F.; Mayer, H.

2007-01-01

Field-measurements were conducted in an urban street canyon with an east-west orientation, and a height-to-width ratio H/W = 1 during cloudless summer weather in 2003 in Freiburg, Germany. This experimental work adds to the knowledge available on the microclimate of an urban canyon and its impact on human comfort. Air temperature T a , air humidity VP, wind speed v and direction dd were measured continuously. All short-wave and long-wave radiation fluxes from the 3D surroundings were also measured. The degree of comfort was defined in terms of physiologically equivalent temperature (PET). Furthermore, the data gathered within the canyon were compared to data collected by a permanent urban climate station with the aim of furthering the understanding of microclimatic changes due to street geometry. Changes in the meteorological variables T a , v and dd in the canyon in comparison to an unobstructed roof level location were found to be in good agreement with previous studies, i.e., a small increase of T a in the canyon adjacent to irradiated surfaces, and a good correlation of v and dd between canyon and roof levels. The daily dynamics of canyon facet irradiances and their impacts on the heat gained by a pedestrian were strongly dependent on street geometry and orientation. Thermal stress was mostly attributable to solar exposure. Under cloudless summer weather, a standing body was found to absorb, on average, 74% of heat in the form of long-wave irradiance and 26% as short-wave irradiance. Shading the pedestrian as well as the surrounding surfaces is, hence, the first strategy in mitigating heat stress in summer under hot conditions.

a Man-Portable Imu-Free Mobile Mapping System

NASA Astrophysics Data System (ADS)

Nüchter, A.; Borrmann, D.; Koch, P.; Kühn, M.; May, S.

2015-08-01

Mobile mapping systems are commonly mounted on cars, ships and robots. The data is directly geo-referenced using GPS data and expensive IMU (inertial measurement systems). Driven by the need for flexible, indoor mapping systems we present an inexpensive mobile mapping solution that can be mounted on a backpack. It combines a horizontally mounted 2D profiler with a constantly spinning 3D laser scanner. The initial system featuring a low-cost MEMS IMU was revealed and demonstrated at MoLaS: Technology Workshop Mobile Laser Scanning at Fraunhofer IPM in Freiburg in November 2014. In this paper, we present an IMU-free solution.

From perceptive fields to Gestalt.

PubMed

Spillmann, Lothar

2006-01-01

Studies on visual psychophysics and perception conducted in the Freiburg psychophysics laboratory during the last 35 years are reviewed. Many of these were inspired by single-cell neurophysiology in cat and monkey. The aim was to correlate perceptual phenomena and their effects to possible neuronal mechanisms from retina to visual cortex and beyond. Topics discussed include perceptive field organization, figure-ground segregation and grouping, fading and filling-in, and long-range color interaction. While some of these studies succeeded in linking perception to neuronal response patterns, others require further investigation. The task of probing the human brain with perceptual phenomena continues to be a challenge for the future.

78 FR 44039 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... GmbH (Eurocopter) Model MBB-BK 117 C-2 helicopters with a jettisonable sliding door (door) installed... airworthiness directive (AD): Eurocopter Deutschland GmbH Helicopters (Eurocopter): Docket No. FAA-2013-0642...

77 FR 75073 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Supplemental notice... proposed airworthiness directive (AD) for Eurocopter Deutschland GmbH (Eurocopter) Model BO-105A, BO- 105C... airworthiness directive (AD): Eurocopter Deutschland GmbH: Docket No. FAA-2011-1285; Directorate Identifier 2010...

78 FR 42409 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA...) for Eurocopter Deutschland GmbH (Eurocopter) Model MBB-BK 117 C-2 helicopters. This AD requires... directive (AD): 2013-12-05 Eurocopter Deutschland GmbH Helicopters: Amendment 39- 17483; Docket No. FAA-2013...

78 FR 30791 - Airworthiness Directives; Alexander Schleicher GmbH & Co. Segelflugzeugbau Sailplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Schleicher GmbH & Co. Segelflugzeugbau Sailplanes AGENCY: Federal Aviation Administration (FAA), Department... new airworthiness directive (AD) for all Alexander Schleicher GmbH & Co. Segelflugzeugbau Models AS... proposed AD, contact Alexander Schleicher GmbH & Co Segelflugzeugbau, Stra[szlig]e 1 D-- 36163 Poppenhausen...

78 FR 7312 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration, DOT. ACTION: Notice of proposed... Deutschland GmbH (Eurocopter) Model MBB-BK 117 C-2 helicopters. This proposed AD would require changing the... new Airworthiness Directive (AD): Eurocopter Deutschland GmbH: Docket No. FAA-2013-0021; Directorate...

77 FR 37790 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... Eurocopter Deutschland GmbH (ECD) Model EC135 helicopters. The existing EAD, which was previously sent to all... new airworthiness directive (AD): 2012-11-02 Eurocopter Deutschland GmbH: Amendment 39-17065; Docket...

77 FR 42958 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... airworthiness directive (AD) for Eurocopter Deutschland GmbH (ECD) Model MBB-BK 117 (all versions) and BO-105LS... Eurocopter Deutschland GmbH Helicopters: Amendment 39- 17113; Docket No. FAA-2012-0704; Directorate...

77 FR 21400 - Airworthiness Directives; DG Flugzeugbau GmbH Sailplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... Airworthiness Directives; DG Flugzeugbau GmbH Sailplanes AGENCY: Federal Aviation Administration (FAA... directive (AD) for DG Flugzeugbau GmbH Models DG-500 Elan Orion, DG-500 Elan Trainer, DG-500/ 20 Elan, and...., Washington, DC 20590. For service information identified in this AD, contact DG Flugzeugbau GmbH, Otto...

78 FR 77380 - Airworthiness Directives; Dornier Luftfahrt GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... GmbH Airplanes AGENCY: Federal Aviation Administration (FAA), Department of Transportation (DOT... (AD) for Dornier Luftfahrt GmbH Models Dornier 228-100, 228-101, 228-200, 228- 201, 228-202, and 228... holidays. For service information identified in this proposed AD, contact RUAG Aerospace Services GmbH...

78 FR 31394 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... airworthiness directive (AD) for Eurocopter Deutschland GmbH (ECD) Model MBB-BK 117 C-2 helicopters. This AD... directive (AD): 2013-10-05 Eurocopter Deutschland GmbH Helicopters: Amendment 39- 17458; Docket No. FAA-2013...

78 FR 67013 - Airworthiness Directives; DG Flugzeugbau GmbH Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... Airworthiness Directives; DG Flugzeugbau GmbH Gliders AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... Flugzeugbau GmbH Models DG-800A, DG-800B, DG-500MB gliders. This AD results from mandatory continuing... holidays. For service information identified in this AD, contact DG- Flugzeugbau GmbH, 76646 Bruchsal...

78 FR 25361 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT... Deutschland GmbH (Eurocopter) Model MBB-BK 117 C-2 helicopters. This AD requires inspecting the long tail... directive (AD): 2013-03-18 Eurocopter Deutschland GmbH (Eurocopter): Amendment 39- 17352; Docket No. FAA...

78 FR 4090 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-18

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... GmbH (Eurocopter) Model MBB-BK 117 C-2 helicopters. This proposed AD would require determining if a... amends Sec. 39.13 by adding the following new airworthiness directive (AD): Eurocopter Deutschland GmbH...

78 FR 69320 - Airworthiness Directives; DORNIER LUFTFAHRT GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... GmbH Airplanes AGENCY: Federal Aviation Administration (FAA), Department of Transportation (DOT... (AD) for all DORNIER LUFTFAHRT GmbH Model 228-212 airplanes. This proposed AD results from mandatory... proposed AD, contact RUAG Aerospace Services GmbH, Dornier 228 Customer Support, P.O. Box 1253, 82231...

77 FR 2234 - Airworthiness Directives; DG Flugzeugbau GmbH Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Airworthiness Directives; DG Flugzeugbau GmbH Gliders AGENCY: Federal Aviation Administration (FAA), Department... new airworthiness directive (AD) for DG Flugzeugbau GmbH Models DG-500 Elan Orion, DG-500 Elan Trainer... DG- Flugzeugbau GmbH, Otto-Lilienthal-Weg 2, 76646 Bruchsal, Federal Republic of Germany; telephone...

78 FR 9792 - Airworthiness Directives; DG Flugzeugbau GmbH Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... Airworthiness Directives; DG Flugzeugbau GmbH Gliders AGENCY: Federal Aviation Administration (FAA), Department... (AD) for DG Flugzeugbau GmbH Model DG-1000T gliders equipped with Solo Kleinmotoren Model 2350 C..., contact Solo Kleinmotoren GmbH, Postfach 60 01 52, D 71050 Sindelfingen, Germany; telephone: +49 07031-301...

78 FR 70216 - Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-25

... Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines AGENCY: Federal Aviation... all Thielert Aircraft Engines GmbH TAE 125-01 reciprocating engines. This AD requires applying sealant... directive (AD): 2013-24-06 Thielert Aircraft Engines GmbH: Amendment 39-17680; Docket No. FAA-2013-0561...

78 FR 44050 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... Deutschland GmbH (Eurocopter) Model EC135P2+ and EC135T2+ helicopters. This proposed AD would require... adding the following new airworthiness directive (AD): Eurocopter Deutschland GmbH Helicopters: Docket No...

CpG Oligodeoxynucleotide and Montanide ISA 51 Adjuvant Combination Enhanced the Protective Efficacy of a Subunit Malaria Vaccine

DTIC Science & Technology

2004-02-01

Doolan, D. L., and S. L. Hoffman. 2002. Nucleic acid vaccines against ma- laria. Chem. Immunol. 80, p. 308–320. In P. Perlman and M. Troye - Bloomberg (ed...and M. T. Troye - Blomberg (ed.), Malaria immunology. Karger, Basel, Switzerland, Germany. 30. Kumar, S., F. Villinger, M. Oakley, J. C. Aguiar, T. R...and pathology, p. 204–221. In P. Perlman and M. T. Troye -Blomberg (ed.), Malaria immunology. Karger, Basel, Switzerland. 32. Ling, I. T., S. A. Ogun

78 FR 40642 - Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-08

... Industries GmbH Airplanes AGENCY: Federal Aviation Administration (FAA), Department of Transportation (DOT... (AD) for Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG airplanes. This... Diamond Aircraft Industries GmbH, N.A. Otto-Str.5, A-2700 Wiener Neustadt, Austria; telephone: +43 2622...

78 FR 18920 - Airworthiness Directives; Austro Engine GmbH Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

...-0164; Directorate Identifier 2013-NE-10-AD] RIN 2120-AA64 Airworthiness Directives; Austro Engine GmbH...). SUMMARY: We propose to adopt a new airworthiness directive (AD) for all Austro Engine GmbH model E4.... Fax: 202-493-2251. For service information identified in this proposed AD, contact Austro Engine GmbH...

77 FR 19063 - Airworthiness Directives; DG Flugzeugbau GmbH Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... Airworthiness Directives; DG Flugzeugbau GmbH Gliders AGENCY: Federal Aviation Administration (FAA), Department... (AD) for DG Flugzeugbau GmbH Models DG-500 Elan Orion, DG-500 Elan Trainer, DG-500/ 20 Elan, DG-500/22... identified in this AD, contact DG- Flugzeugbau GmbH, Otto-Lilienthal-Weg 2, 76646 Bruchsal, Federal Republic...

78 FR 59223 - Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

... Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes AGENCY: Federal Aviation Administration... airworthiness directive (AD) for Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG... information identified in this AD, contact Diamond Aircraft Industries GmbH, N.A. Otto-Str.5, A-2700 Wiener...

78 FR 65869 - Airworthiness Directives; DG Flugzeugbau GmbH Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... Directives; DG Flugzeugbau GmbH Gliders AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final... Flugzeugbau GmbH Model DG-1000T glider equipped with a Solo Kleinmotoren Model 2350 C engine. This AD results... in this AD, contact Solo Kleinmotoren GmbH, Postfach 60 01 52, D 71050 Sindelfingen, Germany...

77 FR 35890 - Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... Industries GmbH Airplanes AGENCY: Federal Aviation Administration (FAA), Department of Transportation (DOT... (AD) for certain Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG airplanes... information identified in this proposed AD, contact Diamond Aircraft Industries GmbH, N.A. Otto-Stra[szlig]e 5...

77 FR 13488 - Airworthiness Directives; Thielert Aircraft Engines GmbH (TAE) Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... Airworthiness Directives; Thielert Aircraft Engines GmbH (TAE) Reciprocating Engines AGENCY: Federal Aviation... this AD, contact Thielert Aircraft Engines GmbH, Platanenstrasse 14 D-09350, Lichtenstein, Germany... following new AD: 2010-11-09R1 Thielert Aircraft Engines GmbH: Amendment 39-16972; Docket No. FAA-2009-0201...

78 FR 65169 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... Deutschland GmbH (Eurocopter) Model EC135 P1, P2, P2+, T1, T2, and T2+ helicopters. This AD requires... GmbH: Amendment 39-17629; Docket No. FAA-2013-0446; Directorate Identifier 2010-SW-007-AD. (a...

78 FR 72568 - Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes AGENCY: Federal Aviation Administration... airworthiness directive (AD) for Diamond Aircraft Industries GmbH Models DA40 and DA40F airplanes. This AD..., contact Diamond Aircraft Industries GmbH, N.A. Otto-Str.5, A-2700 Wiener Neustadt, Austria; telephone: +43...

77 FR 65503 - Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... Industries GmbH Airplanes AGENCY: Federal Aviation Administration (FAA), Department of Transportation (DOT... (AD) for Diamond Aircraft Industries GmbH Models DA 42, DA 42 M-NG, and DA 42 NG airplanes. This... Diamond Aircraft Industries GmbH, N.A. Otto-Stra[szlig]e 5, A-2700 Wiener Neustadt, Austria, telephone...

77 FR 43736 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-26

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration, DOT. ACTION: Notice of proposed... Deutschland GmbH (Eurocopter) Model MBB-BK 117 C-2 helicopters. This proposed AD is prompted by the discovery... Deutschland GmbH: Docket No. FAA-2012-0773; Directorate Identifier 2009-SW-71-AD. (a) Applicability This AD...

78 FR 40047 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... GmbH (ECD) Model EC135 and MBB-BK 117 C-2 helicopters. This proposed AD is prompted by the discovery... amends Sec. 39.13 by adding the following new airworthiness directive (AD): Eurocopter Deutschland GmbH...

78 FR 30793 - Airworthiness Directives; Eurocopter Deutschland GmbH Model Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Deutschland GmbH Model Helicopters AGENCY: Federal Aviation Administration (FAA) DOT. ACTION: Notice of... Deutschland GmbH (Eurocopter) Model EC135 P1, P2, P2+, T1, T2, and T2+ helicopters to require inspecting each...): Eurocopter Deutschland GmbH: Docket No. FAA-2013-0446; Directorate Identifier 2010-SW-007-AD. (a...

77 FR 27661 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... Deutschland GmbH (ECD) model EC135 helicopters, except the EC 135 P2+ and T2+. This proposed AD was prompted...) Applicability This AD applies to all Eurocopter Deutschland GmbH (ECD) Model EC135 helicopters, except EC 135 P2...

77 FR 55105 - Airbus Operations GmbH Grant of Exemption No. 10611

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

...] Airbus Operations GmbH Grant of Exemption No. 10611 AGENCY: Federal Aviation Administration (FAA), DOT... Exemption Docket No.: FAA-2012-0429. Petitioner: Airbus Operations GmbH. Sections of 14 CFR Affected: Part... Operations GmbH. The exemption from 14 CFR 121.344(f) and Appendix M is granted to the extent necessary to...

77 FR 71487 - Airworthiness Directives; Stemme GmbH & Co. KG Powered Sailplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-03

... Airworthiness Directives; Stemme GmbH & Co. KG Powered Sailplanes AGENCY: Federal Aviation Administration (FAA... directive (AD) for all Stemme GmbH & Co. KG Models S10, S10-V, and S10-VT powered sailplanes. This AD... damage to the sailplane and/or injury of occupants. Prompted by these findings, Stemme GmbH developed a...

77 FR 72913 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-07

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... Eurocopter Deutschland GmbH (ECD) Model EC135 helicopters, except the EC 135 P2+ and T2+. This AD requires... apply to all Eurocopter Deutschland GmbH (ECD) model EC135 helicopters, except the EC 135 P2+ and T2...

[Influence of personality traits on reaction performance in volunteers after a single administration of placebo, crotylbarbital and caffeine].

PubMed

Meyer, F P; Walther, T; Walther, H

1983-01-01

We examined the influence of single applications of placebo, caffeine (7 mg/kg), and crotylbarbital (2 mg/kg) on reaction and attention performance in 15 volunteers. A newly developed reaction-time apparatus permits the reaction time to be split for differentiation between initiation time and movement time. Moreover, simple and complex attention performance can be quantified. The volunteers were selected as to the dimensions of "introversion/extraversion" and "emotional lability/stability" by means of the Freiburg Personality Inventory. Labile volunteers responded to placebo faster than stables. Caffeine improved mainly the performance of introverted subjects. Crotylbarbital was without influence on the reaction time at the threshold dose applied.

Psychotherapy and transsexualism.

PubMed

Seikowski, K

2007-12-01

We questioned whether transsexuals always require the psychotherapy demanded by the health insurance system in Germany. For this purpose, we examined 430 transsexuals who came to our facility between 1988 and 2006. At the first consultation after the history was taken, they filled out standardised questionnaires, which are needed for proper diagnosis of psychotherapeutic treatment. These questionnaires included the Complaint Questionnaire (BFB), the Behaviour Questionnaire (VFB) and the Freiburg Personality Inventory (FPI-A). It was found that two-thirds of all transsexuals do not require deeper psychotherapy. However, there was evidence of personality deficits in a subgroup of transsexuals for whom supportive psychotherapy should be recommended. The conditions under which psychotherapy and other forms of support are successful are discussed.

77 FR 44116 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-27

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... Eurocopter Deutschland GmbH (ECD) MBB-BK 117 A-3, MBB-BK 117 A-4, MBB- BK B-1, MBB-BK 117 B-2, and MBB-BK C-1... directive (AD): 2012-14-14 Eurocopter Deutschland GmbH Helicopters: Amendment 39- 17128; Docket No. FAA-2012...

78 FR 2223 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... GmbH (Eurocopter) Model BO-105A, BO-105C, BO- 105S, BO-105LS A-1, BO-105LS A-3, EC135 P1, EC135 P2... new airworthiness directive (AD): Eurocopter Deutschland GmbH: Docket No. FAA-2012-1305; Directorate...

77 FR 57531 - Airworthiness Directives; Stemme GmbH & Co. KG Powered Sailplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-18

...-0982; Directorate Identifier 2012-CE-035-AD] RIN 2120-AA64 Airworthiness Directives; Stemme GmbH & Co... directive (AD) for all Stemme GmbH & Co. KG Models S10, S10-V, and S10-VT powered sailplanes. This proposed... injury of occupants. Prompted by these findings, Stemme GmbH developed a procedure for identification of...

76 FR 76068 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... GmbH Model BO-105A, BO-105C, BO-105LS A-1, BO- 105LS A-3, and BO-105S helicopters. This proposed AD... airworthy main rotor blade. Note 1: Eurocopter Deutschland GmbH Emergency Alert Service Bulletin No. BO105...

78 FR 56597 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-13

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... Deutschland GmbH (ECD) Model EC135P1, EC135P2, EC135P2+, EC135T1, EC135T2, and EC135T2+ helicopters with... directive (AD): 2013-18-05 Eurocopter Deutschland GmbH: Amendment 39-17578; Docket No. FAA-2013-0398...

78 FR 37446 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-21

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... Deutschland GmbH (Eurocopter) Model BO-105A, BO-105C, BO- 105S, BO-105LS A-1, BO-105LS A-3, EC135 P1, EC135 P2... new airworthiness directive (AD): 2013-11-15 Eurocopter Deutschland GmbH: Amendment 39-17475; Docket...

78 FR 26715 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-08

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... GmbH (ECD) Model EC135P1, EC135P2, EC135P2+, EC135T1, EC135T2, and EC135T2+ helicopters with certain... airworthiness directive (AD): Eurocopter Deutschland GmbH: Docket No. FAA-2013-0398; Directorate Identifier 2011...

78 FR 52410 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... Deutschland GmbH (ECD) Model BO-105A, BO-105C, BO-105S, BO- 105LS A-1, BO-105LS A-3, MBB-BK 117 A-1, MBB-BK... directive (AD): 2013-16-13 Eurocopter Deutschland GmbH (ECD): Amendment 39-17551; Docket No. FAA-2012-0887...

78 FR 49115 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA...) that was published in the Federal Register. The AD applies to certain Eurocopter Deutschland GmbH...

76 FR 32019 - Notice of Receipt of Petition for Decision That Nonconforming 2008-2010 M&V GmbH Siegmar Fzb...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

...-0062; Notice 1] Notice of Receipt of Petition for Decision That Nonconforming 2008-2010 M&V GmbH..., DOT. ACTION: Notice of receipt of petition for decision that nonconforming 2008-2010 M&V GmbH Siegmar... Highway Traffic Safety Administration (NHTSA) of a petition for a decision that 2008-2010 M&V GmbH Siegmar...

75 FR 52292 - Airworthiness Directives; Diamond Aircraft Industries GmbH Models DA 40 and DA 40F Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-25

... Industries GmbH Models DA 40 and DA 40F Airplanes AGENCY: Federal Aviation Administration (FAA), Department... new airworthiness directive (AD) for all Diamond Aircraft Industries GmbH Models DA 40 and DA 40F... received information from Diamond Aircraft Industries GmbH that the Models DA 40 and DA 40F airplanes have...

77 FR 20321 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-04

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... Deutschland GmbH (ECD) MBB-BK 117 A-3, MBB-BK 117 A-4, MBB- BK B-1, MBB-BK 117 B-2, and MBB-BK C-1 helicopters... Eurocopter Deutschland GmbH (ECD) Model MBB-BK 117 A-4 model. The EASA AD makes no mention of this model. The...

76 FR 76293 - Airworthiness Directives; BRP-Powertrain GmbH & Co. KG Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-07

... Airworthiness Directives; BRP-Powertrain GmbH & Co. KG Reciprocating Engines AGENCY: Federal Aviation... directive (AD) for BRP- Powertrain GmbH & Co. KG Rotax 912 F2, 912 F3, 912 F4, 912 S2, 912 S3, 912 S4, 914...-Powertrain GmbH & Co. KG, Rotax Aircraft Engines, Mandatory Alert Service Bulletins (ASB) Nos. ASB-912-059...

Historical glacier outlines from digitized topographic maps of the Swiss Alps

NASA Astrophysics Data System (ADS)

Freudiger, Daphné; Mennekes, David; Seibert, Jan; Weiler, Markus

2018-04-01

Since the end of the Little Ice Age around 1850, the total glacier area of the central European Alps has considerably decreased. In order to understand the changes in glacier coverage at various scales and to model past and future streamflow accurately, long-term and large-scale datasets of glacier outlines are needed. To fill the gap between the morphologically reconstructed glacier outlines from the moraine extent corresponding to the time period around 1850 and the first complete dataset of glacier areas in the Swiss Alps from aerial photographs in 1973, glacier areas from 80 sheets of a historical topographic map (the Siegfried map) were manually digitized for the publication years 1878-1918 (further called first period, with most sheets being published around 1900) and 1917-1944 (further called second period, with most sheets being published around 1935). The accuracy of the digitized glacier areas was then assessed through a two-step validation process: the data were (1) visually and (2) quantitatively compared to glacier area datasets of the years 1850, 1973, 2003, and 2010, which were derived from different sources, at the large scale, basin scale, and locally. The validation showed that at least 70 % of the digitized glaciers were comparable to the outlines from the other datasets and were therefore plausible. Furthermore, the inaccuracy of the manual digitization was found to be less than 5 %. The presented datasets of glacier outlines for the first and second periods are a valuable source of information for long-term glacier mass balance or hydrological modelling in glacierized basins. The uncertainty of the historical topographic maps should be considered during the interpretation of the results. The datasets can be downloaded from the FreiDok plus data repository (https://freidok.uni-freiburg.de/data/15008, https://doi.org/10.6094/UNIFR/15008).

SU-E-T-81: A Study On Correlation Between Gamma Analysis for Midline and Lateralized Tumors Using VMAT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kumar, Syam; Anjana

Purpose: To evaluate the fluence for the midline and lateralized tumors for VMAT technique using 2D seven29 detector array combined with the Octavius phantom. Methods: 60 cases that are already being treated with volumetric modulated arc therapy (VMAT) have selected for this study. This includes tumors situated at the medial and lateral. Medial refers to the tumor situated at the midline of the body and lateral means toward the side or away from the midline of the body. Verification plans were created for each treatment plan in Varian Eclipse treatment planning system (version10, Varian medical systems, Palo Alto,CA) with themore » 2D Seven29 detector array and the Octavius phantom(PTW, Freiburg, Germany). Measurements were performed on a Varian Clinac 2100 iX, linear accelerator equipped with a millennium 120 leaf collimator. Analysis was done by comparing the fluence measured for the tumors situated on the midline and tumors situated laterally. Results: Fluence measured for all the delivered plans were analyzed using Verisoft software (PTW, Freiburg, Germany). The gamma pass percentage for midline tumors were found to be higher compared with the lateralized ones. The standard deviation between gamma values for midline and lateralized tumors is 2.18 and 3.5 respectively. Also the standard deviation between the point doses for midline and lateralized tumors is 0.38 and 0.29 respectively. The average gamma passing rate for midline tumors is 96.55% and for lateralized tumors are 94.94% for 3%DD and 3mm DTA criteria. From the T test, it was found that there is no significant difference between the gamma pass percentage between midline and lateralized tumors with p value of 0.28. Conclusion: There is no particular correlation found in the gamma pass criteria for midline and lateralized tumors.« less

Determination of the active volumes of solid-state photon-beam dosimetry detectors using the PTB proton microbeam.

PubMed

Poppinga, Daniela; Delfs, Bjoern; Meyners, Jutta; Langner, Frank; Giesen, Ulrich; Harder, Dietrich; Poppe, Bjoern; Looe, Hui K

2018-05-04

This study aims at the experimental determination of the diameters and thicknesses of the active volumes of solid-state photon-beam detectors for clinical dosimetry. The 10 MeV proton microbeam of the PTB (Physikalisch-Technische Bundesanstalt, Braunschweig) was used to examine two synthetic diamond detectors, type microDiamond (PTW Freiburg, Germany), and the silicon detectors Diode E (PTW Freiburg, Germany) and Razor Diode (Iba Dosimetry, Germany). The knowledge of the dimensions of their active volumes is essential for their Monte Carlo simulation and their applications in small-field photon-beam dosimetry. The diameter of the active detector volume was determined from the detector current profile recorded by radially scanning the proton microbeam across the detector. The thickness of the active detector volume was determined from the detector's electrical current, the number of protons incident per time interval and their mean stopping power in the active volume. The mean energy of the protons entering this volume was assessed by comparing the measured and the simulated influence of the thickness of a stack of aluminum preabsorber foils on the detector signal. For all detector types investigated, the diameters measured for the active volume closely agreed with the manufacturers' data. For the silicon Diode E detector, the thickness determined for the active volume agreed with the manufacturer's data, while for the microDiamond detectors and the Razor Diode, the thicknesses measured slightly exceeded those stated by the manufacturers. The PTB microbeam facility was used to analyze the diameters and thicknesses of the active volumes of photon dosimetry detectors for the first time. A new method of determining the thickness values with an uncertainty of ±10% was applied. The results appear useful for further consolidating detailed geometrical knowledge of the solid-state detectors investigated, which are used in clinical small-field photon-beam dosimetry. © 2018 American Association of Physicists in Medicine.

A diamond detector in the dosimetry of high-energy electron and photon beams.

PubMed

Laub, W U; Kaulich, T W; Nüsslin, F

1999-09-01

A diamond detector type 60003 (PTW Freiburg) was examined for the purpose of dosimetry with 4-20 MeV electron beams and 4-25 MV photon beams. Results were compared with those obtained by using a Markus chamber for electron beams and an ionization chamber for photon beams. Dose distributions were measured in a water phantom with the detector connected to a Unidos electrometer (PTW Freiburg). After a pre-irradiation of about 5 Gy the diamond detector shows a stability in response which is better than that of an ionization chamber. The current of the diamond detector was measured under variation of photon beam dose rate between 0.1 and 7 Gy min(-1). Different FSDs were chosen. Furthermore the pulse repetition frequency and the depth of the detector were changed. The electron beam dose rate was varied between 0.23 and 4.6 Gy min(-1) by changing the pulse-repetition frequency. The response shows no energy dependence within the covered photon-beam energy range. Between 4 MeV and 18 MeV electron beam energy it shows only a small energy dependence of about 2%, as expected from theory. For smaller electron energies the response increases significantly and an influence of the contact material used for the diamond detector can be surmised. A slight sublinearity of the current and dose rate was found. Detector current and dose rate are related by the expression i alpha Ddelta, where i is the detector current, D is the dose rate and delta is a correction factor of approximately 0.963. Depth-dose curves of photon beams, measured with the diamond detector, show a slight overestimation compared with measurements with the ionization chamber. This overestimation is compensated for by the above correction term. The superior spatial resolution of the diamond detector leads to minor deviations between depth-dose curves of electron beams measured with a Markus chamber and a diamond detector.

Evidences of Pleistocene tectonic deformations along the SE border of the Upper Rhine Graben (Freiburg area, Germany)

NASA Astrophysics Data System (ADS)

Brüstle, A.; Nivière, B.; Bertrand, G.; Gourry, J. C.; Carretier, S.; Fracassi, U.; Winter, T.

2003-04-01

The Upper Rhine Graben (URG) is a NNE-trending continental rift that was mostly active from Upper Eocene to Lower Miocene. However, the relatively well-preserved topography of its shoulders, at the scale of the whole basin, suggests a Pleistocene reactivation of its borders. We evaluate here such a possibility along its SE border, in the vincinity of Freiburg (Germany). Despite a continuous but diffuse seismic activity, evidences of near-surface deformations are not yet described. We coupled at the regional and local scales a multi-disciplinary approach, including morphological and geological analyses, to identify the markers of an assumed Pleistocene deformation. The imagery analysis reveals that the Oligocene structural pattern is yet well-marked in the topography by continuous escarpments, few tenth of kilometers long and from 20--30 to 300--500 m high. The correlation of boreholes allowed us to build isohypse and isopach maps of the Quaternary deposits and to propose a river system evolution scenario for the Quaternary. More interesting are the local depocenters located above the hanging wall of the faults and suggesting a Pleistocene tectonic reactivation. Thus, a minimum Pleistocene vertical offset of about 30 m can be illustrated above the main border fault. We then focused on the western Rhine river fault where very young deposits are suspected to have recorded a wechselian deformation. The morphological aspect of the scarp (location above the structural fault, linearity and continuity of the scarp, topographic tilting and presence of hanging valleys...), borehole data and electric tomography survey realized across the scarplet, located at toe of the main scarp, testify of a possible deformation. In particular, a ˜15 m vertical offset of the Wechselian deposits is illustrated in two localities, along the fault, where trenching will be performed in a near future to validate the ages of deformed deposits and obtain information on the strain scenario.

Interactions between a Candidate Gene for Migration (ADCYAP1), Morphology and Sex Predict Spring Arrival in Blackcap Populations.

PubMed

Mettler, Raeann; Segelbacher, Gernot; Schaefer, H Martin

2015-01-01

Avian research has begun to reveal associations between candidate genes and migratory behaviors of captive birds, yet few studies utilize genotypic, morphometric, and phenological data from wild individuals. Previous studies have identified an association between ADCYAP1 polymorphism and autumn migratory behavior (restlessness, or zugunruhe), but little is known about the relationship between ADCYAP1 and spring migratory behavior. The timing of spring migration and arrival to the breeding ground are phenological traits which could be particularly favorable for establishing territories and acquiring mates, thus important to fitness and reproductive success. Here, we investigated how individual genotypic ADCYAP1 variation and phenotypic variation (wing length and shape) of blackcaps (Sylvia atricapilla) affect spring arrival date across nine natural populations in Europe. We hypothesized that longer alleles should be associated with earlier spring arrival dates and expected the effect on arrival date to be stronger for males as they arrive earlier. However, we found that longer wings were associated with earlier spring arrival to the breeding grounds for females, but not for males. Another female-specific effect indicated an interaction between ADCYAP1 allele size and wing pointedness on the response of spring arrival: greater allele size had a positive effect on spring arrival date for females with rounder wings, while a negative effect was apparent for females with more pointed wings. Also, female heterozygotes with pointed wing tips arrived significantly earlier than both homozygotes with pointed wings and heterozygotes with round wings. Stable isotope ratios (δ2H) of a subset of blackcaps captured in Freiburg in 2011 allowed us also to assign individuals to their main overwintering areas in northwest (NW) and southwest (SW) Europe. NW males arrived significantly earlier to the Freiburg breeding site than both SW males and females in 2011. NW females had more pointed wing tips compared to SW females, but no difference in ADCYAP1 allele size was found between the different migration routes.

Audience-response systems for evaluation of pediatric lectures – comparison with a classic end-of-term online-based evaluation

PubMed Central

Bode, Sebastian Felix Nepomuk; Straub, Christine; Giesler, Marianne; Biller, Silke; Forster, Johannes; Krüger, Marcus

2015-01-01

Aim: Course evaluations are often conducted and analyzed well after the course has taken place. By using a digital audience response system (ARS), it is possible to collect, view and discuss feedback during or directly following a course or lecture session. This paper analyzes a student evaluation of a lecture course with ARS to determine if significant differences exist between the results of the ARS lecture evaluation and those of the online evaluation at the end of the semester. In terms of the overall evaluation, consideration is given to the level of students’ prior knowledge, the presentation of the lecture material by the lecturers and the relevance of the lecture topic for students. Method: During the 2011-12 winter semester, the lecture on Pediatrics at the Freiburg Center for Pediatric and Adolescent Medicine (Zentrum für Kinder- und Jugendmedizin (ZKJ) Freiburg) was evaluated using ARS. Thirty-four lectures were evaluated by an average of 22 (range 8-44) students, who responded to four questions each time an evaluation took place. Results: On a 6-point Likert scale (1=very good to 6=deficient), the students rated their level of preparedness with a mean of 3.18, the presentation of the lecture with 2.44, and the relevance of the lecture topic with 2.19. The overall evaluation of the lecture course by means of ARS resulted in 2.31. The online evaluation conducted at the end of the semester yielded a score of 2.45. Highly significant correlations were seen between the results of the ARS for the overall evaluation, assessment of prior knowledge, lecture presentation, and the estimated relevance of the lecture topic. Conclusion: The use of ARS is suitable for immediate evaluation of lectures, in particular regarding timely feedback for the individual lecturerlecturers. In comparison with an end-of-term evaluation, ARS yielded a better assessment. PMID:26038683

Spatial variations of earthquake occurrence and coseismic deformation in the Upper Rhine Graben, Central Europe

NASA Astrophysics Data System (ADS)

Barth, A.; Ritter, J. R. R.; Wenzel, F.

2015-05-01

Seismic activity in the densely populated Upper Rhine Graben (URG) is an aspect in the public, political, and industrial decision making process. The spatial analysis of magnitude-frequency distributions provides valuable information about local seismicity patterns and regional seismic hazard assessment and can be used also as a proxy for coseismic deformation to explore the seismo-tectonic setting of the URG. We combine five instrumental and one historic earthquake bulletins to obtain for the first time a consistent database for events with local magnitudes ML ≥ 2.0 in the whole URG and use it for the determination of magnitude frequencies. The data processing results in a dataset with 274 Poisson distributed instrumentally recorded earthquakes within the URG between 01/1971 and 02/2012 and 34 historic events since the year 1250. Our analysis reveals significant b-value variations along the URG that allow us to differentiate four distinct sections (I-IV) with significant differences in earthquake magnitude distributions: I: Basel region in the Swiss-France-German border region (b = 0.83), II: region between Mulhouse and Freiburg in the southern URG (b = 1.42), III: central URG (b = 0.93), and IV: northern URG (b = 1.06). High b-values and thus a relatively low amount of high magnitude events in the Freiburg section are possibly a consequence of strongly segmented, small-scale structures that are not able to accumulate high stresses. We use the obtained magnitude-frequency distributions and representative source mechanisms for each section to determine coseismic displacement rates. A maximum horizontal displacement rate of 41 μm/a around Basel is found whereas only 8 μm/a are derived for the central and northern URG. A comparison with geodetic and geological constraints implies that the coseismic displacement rates cover less than 10% of the overall displacement rates, suggesting a high amount of aseismic deformation in the URG.

78 FR 39339 - Importer of Controlled Substances; Notice of Registration; SA INTL GMBH C/O., Sigma Aldrich Co., LLC

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

... Registration; SA INTL GMBH C/O., Sigma Aldrich Co., LLC By Notice dated March 20, 2013, and published in the Federal Register on March 28, 2013, 78 FR 19015, SA INTL GMBH C/O., Sigma Aldrich Co. LLC., 3500 Dekalb... registration of SA INTL GMBH C/O., Sigma Aldrich Co. LLC., to import the basic classes of controlled substances...

77 FR 49705 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... Deutschland GmbH Model MBB-BK 117 C-2 helicopters. A page reference of the rotorcraft flight manual in the...

TU-G-BRD-04: A Round Robin Dosimetry Intercomparison of Gamma Stereotactic Radiosurgery Calibration Protocols

DOE Office of Scientific and Technical Information (OSTI.GOV)

Drzymala, R; Alvarez, P; Bednarz, G

2015-06-15

Purpose: The purpose of this multi-institutional study was to compare two new gamma stereotactic radiosurgery (GSRS) dosimetry protocols to existing calibration methods. The ultimate goal was to guide AAPM Task Group 178 in recommending a standard GSRS dosimetry protocol. Methods: Nine centers (ten GSRS units) participated in the study. Each institution made eight sets of dose rate measurements: six with two different ionization chambers in three different 160mm-diameter spherical phantoms (ABS plastic, Solid Water and liquid water), and two using the same ionization chambers with a custom in-air positioning jig. Absolute dose rates were calculated using a newly proposed formalismmore » by the IAEA working group for small and non-standard radiation fields and with a new air-kerma based protocol. The new IAEA protocol requires an in-water ionization chamber calibration and uses previously reported Monte-Carlo generated factors to account for the material composition of the phantom, the type of ionization chamber, and the unique GSRS beam configuration. Results obtained with the new dose calibration protocols were compared to dose rates determined by the AAPM TG-21 and TG-51 protocols, with TG-21 considered as the standard. Results: Averaged over all institutions, ionization chambers and phantoms, the mean dose rate determined with the new IAEA protocol relative to that determined with TG-21 in the ABS phantom was 1.000 with a standard deviation of 0.008. For TG-51, the average ratio was 0.991 with a standard deviation of 0.013, and for the new in-air formalism it was 1.008 with a standard deviation of 0.012. Conclusion: Average results with both of the new protocols agreed with TG-21 to within one standard deviation. TG-51, which does not take into account the unique GSRS beam configuration or phantom material, was not expected to perform as well as the new protocols. The new IAEA protocol showed remarkably good agreement with TG-21. Conflict of Interests: Paula Petti, Josef Novotny, Gennady Neyman and Steve Goetsch are consultants for Elekta Instrument A/B; Elekta Instrument AB, PTW Freiburg GmbH, Standard Imaging, Inc., and The Phantom Laboratory, Inc. loaned equipment for use in these experiments; The University of Wisconsin Accredited Dosimetry Calibration Laboratory provided calibration services.« less

77 FR 27659 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed... Deutschland GmbH (ECD) Model BO-105A, BO-105C, and BO-105S helicopters. This proposed AD is prompted by...

2015 Materials Research Society Spring Meeting

DTIC Science & Technology

2016-05-12

State University, Raleigh, NC 27695  Eicke R. Weber, Fraunhofer Institute for  Solar  Energy Systems, Freiburg, Germany    Symposium Highlights:  The...emission from fossil fuels.  Materials hold the key to  advanced renewable energy technologies including  solar  cells, batteries, fuel cells, and catalysis...systems. For example, among renewable energy technologies,  solar  energy is  a limitless source of energy, and photovoltaic energy conversion is one of the

Jack D. Fellows: Congressional Science Fellow

NASA Astrophysics Data System (ADS)

Jack D. Fellows has been selected as the 1983-84 AGU Congressional Science Fellow. Last week he began his 1-year stint on Capitol Hill as AGU's seventh Congressional Science Fellow.Fellows received his Ph.D. earlier this year from the civil engineering department at the University of Maryland, College Park. For his dissertation he developed a management system using regional geographic information for hydrologic models. His work applied remote sensing data to the decision-making processes of regional planning organizations concerned with hydrology and natural resource management. The Maryland National Capital Park and Planning Commission has integrated Fellows' work into their programs on water resource and environmental planning; his approach also is being used for forest and water resource planning near Freiburg, Baden-Wurtemberg, West Germany.

Thick Nano-Crystalline Diamond films for fusion applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dawedeit, Christoph

This Diplomarbeit deals with the characterization of 9 differently grown diamond samples. Several techniques were used to determine the quality of these specimens for inertial confinement fusion targets. The quality of chemical vapor deposition diamond is usually considered in terms of the proportion of sp3-bonded carbon to sp2-bonded carbon in the sample. For fusion targets smoothness, Hydrogen content and density of the diamonds are further important characteristics. These characteristics are analyzed in this thesis. The research for thesis was done at Lawrence Livermore National Laboratory in collaboration with the Fraunhofer Institut für angewandte Festkörperphysik Freiburg, Germany. Additionally the Lehrstuhl fuermore » Nukleartechnik at Technical University of Germany supported the work.« less

SBML-PET-MPI: a parallel parameter estimation tool for Systems Biology Markup Language based models.

PubMed

Zi, Zhike

2011-04-01

Parameter estimation is crucial for the modeling and dynamic analysis of biological systems. However, implementing parameter estimation is time consuming and computationally demanding. Here, we introduced a parallel parameter estimation tool for Systems Biology Markup Language (SBML)-based models (SBML-PET-MPI). SBML-PET-MPI allows the user to perform parameter estimation and parameter uncertainty analysis by collectively fitting multiple experimental datasets. The tool is developed and parallelized using the message passing interface (MPI) protocol, which provides good scalability with the number of processors. SBML-PET-MPI is freely available for non-commercial use at http://www.bioss.uni-freiburg.de/cms/sbml-pet-mpi.html or http://sites.google.com/site/sbmlpetmpi/.

76 FR 23169 - Airworthiness Directives; DG Flugzeugbau GmbH Glaser-Dirks Model DG-808C Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-26

... Directives; DG Flugzeugbau GmbH Glaser-Dirks Model DG-808C Gliders AGENCY: Federal Aviation Administration... applies to DG Flugzeugbau GmbH Glaser-Dirks Models DG-808C gliders, serial numbers 8-316 B 216 X 1 through...

78 FR 1728 - Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-09

... scheduled maintenance, whichever occurs first, do the following. (1) Remove the oil filler plug and check... Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines AGENCY: Federal Aviation... all Thielert Aircraft Engines GmbH (TAE) TAE 125-02-99 and TAE 125-02-114 reciprocating engines. This...

78 FR 1733 - Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-09

... Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines AGENCY: Federal Aviation... (AD) for all Thielert Aircraft Engines GmbH models TAE 125-01, TAE 125-02- 99, and TAE 125-02-114 reciprocating engines. That AD currently requires installation of full-authority digital electronic control...

78 FR 67020 - Airworthiness Directives; Eurocopter Deutschland GmbH (ECD) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... Airworthiness Directives; Eurocopter Deutschland GmbH (ECD) Helicopters AGENCY: Federal Aviation Administration... the AD Docket at http://www.regulations.gov . (h) Subject Joint Aircraft Service Component (JASC) Code..., of Eurocopter Deutschland GmbH Flight Manual BO 105 C/CS, Revision 5, dated March 12, 2010. (ii...

78 FR 37150 - Airworthiness Directives; Eurocopter Deutschland GmbH (ECD) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... Deutschland GmbH (ECD) Helicopters AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of...): Eurocopter Deutschland GmbH (ECD): Docket No. FAA-2013-0519; Directorate Identifier 2010-SW-068-AD. (a... European Aviation Safety Agency AD No. 2010-0128, dated June 25, 2010. (h) Subject Joint Aircraft Service...

77 FR 71359 - Airworthiness Directives; DG Flugzeugbau GmbH Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-30

...H Gliders AGENCY: Federal Aviation Administration (FAA), Department of Transportation (DOT). ACTION... DG Flugzeugbau GmbH Model DG-1000T gliders equipped with Solo Kleinmotoren Model 2350 C engines. This... proposed AD, contact Solo Kleinmotoren GmbH, Postfach 60 01 52, D 71050 Sindelfingen, Germany; telephone...

77 FR 37777 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... directive (AD) for all Eurocopter Deutschland GmbH (ECD) Model MBB-BK 117 C-2 helicopters. That AD currently... Safety Agency AD No. 2011-0162, dated August 30, 2011. (h) Subject Joint Aircraft Service Component (JASC...

77 FR 2236 - Airworthiness Directives; DG Flugzeugbau GmbH Sailplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

...H Sailplanes AGENCY: Federal Aviation Administration (FAA), Department of Transportation (DOT... are revising an earlier NPRM for DG Flugzeugbau GmbH DG-500 Elan series sailplanes and Models DG-500M... information identified in this proposed AD, DG Flugzeugbau GmbH, Otto-Lilienthal-Weg 2, 76646 Bruchsal...

78 FR 52412 - Airworthiness Directives; Eurocopter Deutschland GmbH (ECD) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

... Airworthiness Directives; Eurocopter Deutschland GmbH (ECD) Helicopters AGENCY: Federal Aviation Administration... new airworthiness directive (AD): 2013-16-20 Eurocopter Deutschland GmbH (ECD): Amendment 39-17558... the EASA AD at http://www.regulations.gov in Docket No. FAA-2013-0020. (h) Subject Joint Aircraft...

76 FR 82110 - Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines AGENCY: Federal Aviation...) for Thielert Aircraft Engines GmbH models TAE 125-02-99 and TAE 125-01 reciprocating engines. That AD... flight hours to within 600 flight hours for TAE 125-01 reciprocating engines. This AD was prompted by the...

76 FR 68636 - Airworthiness Directives; Thielert Aircraft Engines GmbH (TAE) Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-07

... Airworthiness Directives; Thielert Aircraft Engines GmbH (TAE) Reciprocating Engines AGENCY: Federal Aviation... airworthiness directive (AD) for Thielert Aircraft Engines GmbH (TAE) Models TAE 125-01 and TAE 125- 02-99 reciprocating engines. That AD currently requires replacement of certain part numbers (P/Ns) and serial numbers...

78 FR 22170 - Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... Service. [FR Doc. 2013-07500 Filed 4-12-13; 8:45 am] BILLING CODE 4910-13-P ... Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes AGENCY: Federal Aviation Administration... airworthiness directive (AD) for Diamond Aircraft Industries GmbH Models DA 42, DA 42 M-NG, and DA 42NG...

78 FR 26241 - Airworthiness Directives; Diamond Aircraft Industries GmbH Powered Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-06

... Airworthiness Directives; Diamond Aircraft Industries GmbH Powered Gliders AGENCY: Federal Aviation... directive (AD) for certain Diamond Aircraft Industries GmbH Models HK 36 R, HK 36 TS, and HK 36 TTS powered... removing the Model H-36 from the Applicability. This AD was prompted by reports of installation of an...

77 FR 69558 - Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-20

... Airworthiness Directives; Eurocopter Deutschland GmbH Helicopters AGENCY: Federal Aviation Administration (FAA... airworthiness directive (AD) for Eurocopter Deutschland GmbH (ECD) Model EC135 P1, EC135 P2, EC135 P2+, EC135 T1... with this AD through an AMOC. (h) Additional Information (1) Eurocopter Emergency Alert Service...

INFO-RNA--a server for fast inverse RNA folding satisfying sequence constraints.

PubMed

Busch, Anke; Backofen, Rolf

2007-07-01

INFO-RNA is a new web server for designing RNA sequences that fold into a user given secondary structure. Furthermore, constraints on the sequence can be specified, e.g. one can restrict sequence positions to a fixed nucleotide or to a set of nucleotides. Moreover, the user can allow violations of the constraints at some positions, which can be advantageous in complicated cases. The INFO-RNA web server allows biologists to design RNA sequences in an automatic manner. It is clearly and intuitively arranged and easy to use. The procedure is fast, as most applications are completed within seconds and it proceeds better and faster than other existing tools. The INFO-RNA web server is freely available at http://www.bioinf.uni-freiburg.de/Software/INFO-RNA/

INFO-RNA—a server for fast inverse RNA folding satisfying sequence constraints

PubMed Central

Busch, Anke; Backofen, Rolf

2007-01-01

INFO-RNA is a new web server for designing RNA sequences that fold into a user given secondary structure. Furthermore, constraints on the sequence can be specified, e.g. one can restrict sequence positions to a fixed nucleotide or to a set of nucleotides. Moreover, the user can allow violations of the constraints at some positions, which can be advantageous in complicated cases. The INFO-RNA web server allows biologists to design RNA sequences in an automatic manner. It is clearly and intuitively arranged and easy to use. The procedure is fast, as most applications are completed within seconds and it proceeds better and faster than other existing tools. The INFO-RNA web server is freely available at http://www.bioinf.uni-freiburg.de/Software/INFO-RNA/ PMID:17452349

[Education, advanced and further training in the field "psychology in rehabilitation"].

PubMed

Bengel, J; Gall, H; Grande, G; Küch, D; Mittag, O; Schmucker, D; Spijkers, W; Arling, V; Jahed, J; Lutze, B; Morfeld, M

2014-04-01

The commission for vocational training, training and further education of the German Society of Rehabilitation Science tends to discuss and to give recommendations for various professions in rehabilitation. The working group, which is led by J. Bengel/Freiburg and M. Morfeld/Magdeburg-Stendal created an inventory of Rehabilitation Psychology. The training programs for Rehabilitation Psychology at universities and universities of applied science in Germany are based on a job profile of psychologists in medical and vocational rehabilitation. The different universities have diverse priorities focusing on Rehabilitation Psychology. The offer changes because of the adaption of requirements and implementation of Bologna Reform. The training and further education offers are specific and available for large indication areas. Finally outstanding issues and problems are pointed out. © Georg Thieme Verlag KG Stuttgart · New York.

EDITORIAL: The 7th International Workshop on Micro and Nanotechnologies for Power Generation and Energy Conversion Applications (PowerMEMS 2007)

NASA Astrophysics Data System (ADS)

Hebling, C.; Woias, P.

2008-10-01

This special issue of Journal of Micromechanics and Microengineering (JMM) contains a selection of papers from the 7th International Workshop on Micro and Nanotechnologies for Power Generation and Energy Conversion (PowerMEMS 2007). The workshop was held in Freiburg, Germany on 27-29 November 2007 under the joint organization of the Fraunhofer Institute for Solar Energy Systems (FhG-ISE), Freiburg and the Department of Microsystems Engineering (IMTEK) of the Albert-Ludwig-University of Freiburg. PowerMEMS 2007 continues a series of workshops initiated in 2000 in Japan to create an annual discussion forum in the emerging field of micro energy technology. With a single exception in 2001, the workshop has continued as an annual meeting ever since, with a continuous increase in the number of presentations and participants. The program of PowerMEMS 2007 was composed of 2 invited talks, 25 oral talks and 61 poster presentations. From these 88 presentations 16 have been selected for this special issue. It was at the end of 1959 when the Caltech physicist Richard Feynman gave his famous lecture entitled 'There Is Plenty of Room at the Bottom' in which he discussed the possibilities of miniaturization for both storage capacity ('Encyclopaedia Britannica on the head of a pin') as well as micro machining ('rearranging the atoms'), although there were absolutely no technological possibilities in sight for an adequate realization of such ideas. Now, nearly 50 years later, we not only have incredible knowledge about the nanoworld, but even more we are now able to generate microelectromechanical devices which, next to their electronic properties, can integrate physical and analytical functions. Today, Feynman might easily have added a second lecture entitled 'There is Plenty of Energy at the Bottom'. Micro energy technology has seen a tremendous rise in MEMS and material sciences and is regarded today as one of their hot topics. Also, there are more and more companies in this field trying to commercialize micro energy harvesting devices, micro thermo-photovoltaics or micro fuel cells in order to make an impact on our daily life. It is interesting to see the remarkable scientific dynamics and innovations in micro energy technology that have been mirrored in the scope of consecutive PowerMEMS workshops. Micro fuel cells, micro combustion systems and heat engines have been on-going topics from the beginning due to their promising power densities and high power levels up to hundreds of watts. At the other end of the power scale micro energy harvesting has entered the stage, with a remarkable growth rate of presentations during the last three workshops, towering over all other topics with 33 presentations at PowerMEMS 2007. Another significant trend is the slow but steady emergence of electronic energy management as a future key technology. As Guest Editors of this special issue we would like to express our appreciation to the members of the Organizing Committee and the Technical Program Committee of PowerMEMS for their on-going efforts. By selecting the research fields mentioned above they formed the PowerMEMS 2007 program as a comprehensive digest of today's micro energy technology that is reflected, along with selected high quality publications, in this special issue of JMM. We hope that this work will stimulate further innovative research in micro energy technology and will help to mark the trail for further progress in this exciting field of MEMS science and technology.

Clinical radiation therapy measurements with a new commercial synthetic single crystal diamond detector

PubMed Central

Crilly, Richard

2014-01-01

A commercial version of a synthetic single crystal diamond detector (SCDD) in a Schottky diode configuration was recently released as the new type 60019 microDiamond detector (PTW‐Freiburg, Germany). In this study we investigate the dosimetric properties of this detector to independently confirm that findings from the developing group of the SCDDs still hold true for the commercial version of the SCDDs. We further explore if the use of the microDiamond detector can be expanded to high‐energy photon beams of up to 15 MV and to large field measurements. Measurements were performed with an Elekta Synergy linear accelerator delivering 6, 10, and 15 MV X‐rays, as well as 6, 9, 12, 15, and 20 MeV electron beams. The dependence of the microdiamond detector response on absorbed dose after connecting the detector was investigated. Furthermore, the dark current of the diamond detector was observed after irradiation. Results are compared to similar results from measurements with a diamond detector type 60003. Energy dependency was investigated, as well. Photon depth‐dose curves were measured for field sizes 3×3,10×10, and 30×30cm2. PDDs were measured with the Semiflex type 31010 detector, microLion type 31018 detector, P Diode type 60016, SRS Diode type 60018, and the microDiamond type 60019 detector (all PTW‐Freiburg). Photon profiles were measured at a depth of 10 cm. Electron depth‐dose curves normalized to the dose maximum were measured with the 14×14cm2 electron cone. PDDs were measured with a Markus chamber type 23343, an E Diode type 60017 and the microDiamond type 60019 detector (all PTW‐Freiburg). Profiles were measured with the E Diode and microDiamond at half of D90,D90,D70, and D50 depths and for electron cone sizes of 6×6cm2, 14×14cm2, and 20×20cm2. Within a tolerance of 0.5% detector response of the investigated detector was stable without any preirradiation. After preirradition with approximately 250 cGy the detector response was stable within 0.1%. A dark current after irradiation was not observed. The microDiamond detector shows no energy dependence in high energy photon or electron dosimetry. Electron PDD measurements with the E Diode and microDiamond are in good agreement. However, compared to E Diode measurements, dose values in the bremsstrahlungs region are about 0.5% lower when measured with the microDiamond detector. Markus detector measurements agree with E Diode measurements in the bremsstrahlungs region. For depths larger than dmax, depth‐dose curves of photon beams measured with the microDiamond detector are in close agreement to those measured with the microLion detector for small fields and with those measured with a Semiflex 0.125 cc ionization chamber for large fields. Differences are in the range of 0.25% and less. For profile measurements, microDiamond detector measurements agree well with microLion and P Diode measurements in the high‐dose region of the profile and the penumbra region. For areas outside the open field, P Diode measurements are about 0.5%–1.0% higher than microDiamond and microLion measurements. Thus it becomes evident that the investigated diamond detector (type 60019) is suitable for a wide range of applications in high‐energy photon and electron dosimetry and is interesting for relative, as well as absolute, dosimetry. PACS numbers: 00.06, 80.87 PMID:25493512

78 FR 70327 - TÜV SÜD Product Services GmbH: Request for Renewal of Recognition

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-25

...[Uuml]V S[Uuml]D Product Services GmbH: Request for Renewal of Recognition AGENCY: Occupational Safety and Health Administration (OSHA), Labor ACTION: Notice. SUMMARY: This notice announces T[Uuml]V S[Uuml..., or denying the renewal of recognition. T[Uuml]V S[Uuml]D Product Services GmbH (TUVPSG) initially...

77 FR 3090 - Airworthiness Directives; BRP-POWERTRAIN GMBH & CO KG Rotax Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... Airworthiness Directives; BRP--POWERTRAIN GMBH & CO KG Rotax Reciprocating Engines AGENCY: Federal Aviation... BRP-- POWERTRAIN GMBH & CO KG Rotax 914 F2, 914 F3, and 914 F4 reciprocating engines. This AD results... of fuel pressure regulators, part number (P/N) 887130, installed on Rotax 914 F series engines, which...

75 FR 53661 - Ball Bearings and Parts Thereof From France, Germany, Italy, Japan, and the United Kingdom: Final...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

... successor-in-interest to the pre-acquisition myonic GmbH. Finally, we are announcing our revocation of the..., 2009. We invited interested parties to comment on the Preliminary Results. We received case and... determined that myonic GmbH is the successor-in-interest to the pre-acquisition myonic GmbH and invited...

78 FR 19015 - Importer of Controlled Substances; Notice of Application; SA INTL GMBH C/O., Sigma Aldrich Co. LLC

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application; SA INTL GMBH C/O., Sigma Aldrich Co. LLC Pursuant to Title 21 Code of Federal Regulations 1301.34 (a), this is notice that on February 1, 2013, SA INTL GMBH C/O., Sigma Aldrich Co. LLC., 3500 Dekalb...

77 FR 47106 - Manufacturer of Controlled Substances; Notice of Application; SA INTL GMBH C/O., Sigma Aldrich Co...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-07

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Manufacturer of Controlled Substances; Notice of Application; SA INTL GMBH C/O., Sigma Aldrich Co. LLC Pursuant to Title 21 Code of Federal Regulations 1301.34 (a), this is notice that on May 2, 2012, SA INTL GMBH C/O., Sigma Aldrich Co. LLC., 3500...

SU-F-T-138: Commissioning and Evaluating Dose Computation Models for a Dedicated Proton Line Scanning Beam Nozzle in Eclipse Treatment Planning System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsai, P; Chang Gung University, Taoyuan, Taiwan; Huang, H

Purpose: In this study, we present an effective method to derive low dose envelope of the proton in-air spot fluence at beam positions other than the isocenter to reduce amount of measurements required for planning commission. Also, we demonstrate commissioning and validation results of this method to the Eclipse treatment planning system (version 13.0.29) for a Sumitomo dedicated proton line scanning beam nozzle. Methods: The in-air spot profiles at five beam-axis positions (±200, ±100 and 0 mm) were obtained in trigger mode using a MP3 Water tank (PTW-Freiburg) and a pinpoint ionization chamber (model 31014, PTW-Freiburg). Low dose envelope (belowmore » 1% of the center dose) of the spot profile at isocenter was obtained by repeated point measurements to minimize dosimetry uncertainty. The double Gaussian (DG) model was used to fit and obtain optimal σ1, σ2 and their corresponding weightings through our in-house MATLAB (Mathworks) program. σ1, σ2 were assumed to expand linearly along the beam axis from a virtual source position calculated by back projecting fitted sigmas from the single Gaussian (SG) model. Absolute doses in water were validated using an Advanced Markus chamber at the depth of 2cm with Pristine Peak (BP) R90d ranging from 5–32 cm for 10×10 cm2 scanned fields. The field size factors were verified with square fields from 2 to 20 cm at 2cm and before BP depth. Results: The absolute dose outputs were found to be within ±3%. For field size factor, the agreement between calculated and measurement were within ±2% at 2cm and ±3% before BP, except for the field size below 2×2 cm2. Conclusion: The double Gaussian model was found to be sufficient for characterizing the Sumitomo dedicated proton line scanning nozzle. With our effective double Gaussian fitting method, we are able to save significant proton beam time with acceptable output accuracy.« less

A graph kernel approach for alignment-free domain-peptide interaction prediction with an application to human SH3 domains.

PubMed

Kundu, Kousik; Costa, Fabrizio; Backofen, Rolf

2013-07-01

State-of-the-art experimental data for determining binding specificities of peptide recognition modules (PRMs) is obtained by high-throughput approaches like peptide arrays. Most prediction tools applicable to this kind of data are based on an initial multiple alignment of the peptide ligands. Building an initial alignment can be error-prone, especially in the case of the proline-rich peptides bound by the SH3 domains. Here, we present a machine-learning approach based on an efficient graph-kernel technique to predict the specificity of a large set of 70 human SH3 domains, which are an important class of PRMs. The graph-kernel strategy allows us to (i) integrate several types of physico-chemical information for each amino acid, (ii) consider high-order correlations between these features and (iii) eliminate the need for an initial peptide alignment. We build specialized models for each human SH3 domain and achieve competitive predictive performance of 0.73 area under precision-recall curve, compared with 0.27 area under precision-recall curve for state-of-the-art methods based on position weight matrices. We show that better models can be obtained when we use information on the noninteracting peptides (negative examples), which is currently not used by the state-of-the art approaches based on position weight matrices. To this end, we analyze two strategies to identify subsets of high confidence negative data. The techniques introduced here are more general and hence can also be used for any other protein domains, which interact with short peptides (i.e. other PRMs). The program with the predictive models can be found at http://www.bioinf.uni-freiburg.de/Software/SH3PepInt/SH3PepInt.tar.gz. We also provide a genome-wide prediction for all 70 human SH3 domains, which can be found under http://www.bioinf.uni-freiburg.de/Software/SH3PepInt/Genome-Wide-Predictions.tar.gz. Supplementary data are available at Bioinformatics online.

SU-E-T-790: Validation of 4D Measurement-Guided Dose Reconstruction (MGDR) with OCTAVIUS 4D System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, V; Leung, R; Wong, M

2015-06-15

Purpose: To validate the MGDR of OCTAVIUS 4D system (PTW, Freiburg, Germany) for quality assurance (QA) of volumetric-modulated arc radiotherapy (VMAT). Methods: 4D-MGDR measurements were divided into two parts: 1) square fields from 2×2 to 25×25 cm{sup 2} at 0°, 10° and 45° gantry, and 2) 8 VMAT plans (5 nasopharyngeal and 3 prostate) collapsed to gantry 40° in QA mode in Monaco v5.0 (Elekta, CMS, Maryland Heights, MO) were delivered on the OCTAVIUS 4D phantom with the OCTAVIUS 1500 detector plane perpendicular to either the incident beam to obtain the reconstructed dose (OCTA4D) or the 0° gantry axis tomore » obtain the raw doses (OCTA3D) in Verisoft 6.1 (PTW, Freiburg, Germany). Raw measurements of OCTA3D were limited to < 45° gantry to avoid >0.5% variation of detector angular response with respect to 0° gantry as determined previously. Reconstructed OCTA4D and raw OCTA3D doses for all plans were compared at the same detector plane using γ criteria of 2% (local dose)/2mm and 3%/3mm criteria. Results: At gantry 0° and 10°, the γ results for all OCTA4D on detector plane coinciding with OCTA3D were over 90% at 2%/2mm except for the largest field (25×25 cm{sup 2} ) showing >88%. For square field at 45° gantry, γ passing rate is > 90% for fields smaller than 15x 15cm2 but < 80% for field size of 20 x20 cm{sup 2} upward. For VMAT, γ results showed 94% and 99% passing rate at 2%/2mm and 3%/3mm, respectively. Conclusion: OCTAVIUS 4D system has compromised accuracy in reconstructing dose away from the central beam axis, possibly due to the off-axis softening correction and errors of the percent depth dose data necessary as input for MGDR. Good results in VMAT delivery suggested that the system is relatively reliable for VMAT with small segments.« less

Walter Greiner: In Memoriam

NASA Astrophysics Data System (ADS)

Zen Vasconcellos, César; Coelho, Helio T.; Hess, Peter Otto

Walter Greiner (29 October 1935 - 6 October 2016) was a German theoretical physicist. His scientific research interests include the thematic areas of atomic physics, heavy ion physics, nuclear physics, elementary particle physics (particularly quantum electrodynamics and quantum chromodynamics). He is most known in Germany for his series of books in theoretical physics, but he is also well known around the world. Greiner was born on October 29, 1935, in Neuenbau, Sonnenberg, Germany. He studied physics at the University of Frankfurt (Goethe University in Frankfurt Am Main), receiving in this institution a BSci in physics and a Master’s degree in 1960 with a thesis on plasma-reactors, and a PhD in 1961 at the University of Freiburg under Hans Marshal, with a thesis on the nuclear polarization in μ-mesic atoms. During the period of 1962 to 1964 he was assistant professor at the University of Maryland, followed by a position as research associate at the University of Freiburg, in 1964. Starting in 1965, he became a full professor at the Institute for Theoretical Physics at Goethe University until 2003. Greiner has been a visiting professor to many universities and laboratories, including Florida State University, the University of Virginia, the University of California, the University of Melbourne, Vanderbilt University, Yale University, Oak Ridge National Laboratory and Los Alamos National Laboratory. In 2003, with Wolf Singer, he was the founding Director of the Frankfurt Institute for Advanced Studies (FIAS), and gave lectures and seminars in elementary particle physics. He died on October 6, 2016 at the age of 80. Walter Greiner was an excellent teacher, researcher, friend. And he was a great supporter of the series of events known by the acronyms IWARA - International Workshop on Astronomy and Relativistic Astrophysics, STARS - Caribbean Symposium on Cosmology, Gravitation, Nuclear and Astroparticle Physics, and SMFNS - International Symposium on Strong Electromagnetic Fields and Neutron Stars. Walter Greiner left us. But his memory will remain always alive among us who have had the privilege of knowing him and enjoy his wisdom and joy of living.

Rifts never die: Structure of the Upper Rhine Graben, and bearing on young and recent tectonics

NASA Astrophysics Data System (ADS)

Behrmann, J. H.

2003-04-01

The Upper Rhine Graben (URG) is a 300 km long, NNE trending, low-strain, small-displacement continental rift of mid-Tertiary age. Its structure can be adequately retrodeformed in 3D if sinistrally transtensive strain and displacement paths along the major faults and associated contact deformation in the wall rocks are restored. The overall structure of the URG is characterised by low listric curvature of the principal faults and large (16-20 km) depth to a basal detachment zone. This deformation geometry and kinematics inhibits block rotation, minimises displacement on individual faults, and apparently leads to strain dissipation into intricate fault networks and/or "en masse" fracturing of large rock volumes, and propagation of dominantly brittle deformation deep into the continental crust. A net result of such deformation may be permanent reduction of tensional and shear strength on a crustal scale, making oblique rifts like the URG particularly prone to tectonic reactivation. Continued Quaternary and recent tectonic activity of the URG is documented by the following phenomena: (1) strong local differential subsidence and sedimentary basin filling, especially in the northern and southern parts of the rift. (2) Formation of morphological scarps at the locations of some major faults and offset of Quaternary stata at depth, especially in the southern (Freiburg-Basel) segment (3) Changes in relative elevation of reference points along precise levelling traverses. (4) Considerable microearthquake activity (> 50 events since 1995 in the Freiburg area), concentrated in the middle and upper crust on or in the vicinity of depth projections of faults. One possible conclusion to be drawn from the URG data and observations is that rifts can remain in a near-critical mechanical state very long after formation, even if plate-scale principal stresses have changed orientations and/or differential magnitudes. Rates of movement and seismicity are up to one order of magnitude lower than in areas of active rifting. However, they may be large enough to define a sizeable geological risk to the human environment, especially by large earthquakes with very long recurrence time.

Lack of concordance amongst measurements of individual anaerobic threshold and maximal lactate steady state on a cycle ergometer.

PubMed

Arratibel-Imaz, Iñaki; Calleja-González, Julio; Emparanza, Jose Ignacio; Terrados, Nicolas; Mjaanes, Jeffrey M; Ostojic, Sergej M

2016-01-01

The calculation of exertion intensity, in which a change is produced in the metabolic processes which provide the energy to maintain physical work, has been defined as the anaerobic threshold (AT). The direct calculation of maximal lactate steady state (MLSS) would require exertion intensities over a long period of time and with sufficient rest periods which would prove significantly difficult for daily practice. Many protocols have been used for the indirect calculation of MLSS. The aim of this study is to determine if the results of measurements with 12 different AT calculation methods and calculation software [Keul, Simon, Stegmann, Bunc, Dickhuth (TKM and WLa), Dmax, Freiburg, Geiger-Hille, Log-Log, Lactate Minimum] can be used interchangeably, including the method of the fixed threshold of Mader/OBLA's 4 mmol/l and then to compare them with the direct measurement of MLSS. There were two parts to this research. Phase 1: results from 162 exertion tests chosen at random from the 1560 tests. Phase 2: sixteen athletes (n = 16) carried out different tests on five consecutive days. There was very high concordance among all the methods [intraclass correlation coefficient (ICC) > 0.90], except Log-Log in relation to the Stegamnn, Dmax, Dickhuth-WLa and Geiger-Hille. The Dickhuth-TKM showed a high tendency towards concordance, with Dmax (2.2 W) and Dickhuth-WLa (0.1 W). The Dickhuth-TKM method presented a high tendency to concordance with Dickhuth-WLa (0.5 W), Freiburg (7.4 W), MLSS (2.0 W), Bunc (8.9 W), Dmax (0.1 W). The calculation of MLSS power showed a high tendency to concordance, with Dickhuth-TKM (2 W), Dmax (2.1 W), Dickhuth-WLa (1.5 W). The fixed threshold of 4 mmol/l or OBLA produces slightly different and higher results than those obtained with all the methods analyzed, including MLSS, meaning an overestimation of power in the individual anaerobic threshold. The Dickhuth-TKM, Dmax and Dickhuth-WLa methods defined a high concordance on a cycle ergometer. Dickhuth-TKM, Dmax, Dickhuth-WLa described a high concordance with the power calculated to know the MLSS.

77 FR 54800 - Airworthiness Directives; Diamond Aircraft Industries GmbH Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... airworthiness directive (AD) for certain Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG... products. The MCAI states: During conversion of a DA 42 to a DA 42 NG, voids were detected in the adhesive... the following Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG airplanes...

My Lifelong Passion for Biochemistry and Anaerobic Microorganisms.

PubMed

Thauer, Rudolf Kurt

2015-01-01

Early parental influence led me first to medical school, but after developing a passion for biochemistry and sensing the need for a deeper foundation, I changed to chemistry. During breaks between semesters, I worked in various biochemistry labs to acquire a feeling for the different areas of investigation. The scientific puzzle that fascinated me most was the metabolism of the anaerobic bacterium Clostridium kluyveri, which I took on in 1965 in Karl Decker's lab in Freiburg, Germany. I quickly realized that little was known about the biochemistry of strict anaerobes such as clostridia, methanogens, acetogens, and sulfate-reducing bacteria and that these were ideal model organisms to study fundamental questions of energy conservation, CO2 fixation, and the evolution of metabolic pathways. My passion for anaerobes was born then and is unabated even after 50 years of study.

Environmental auditing in hospitals: approach and implementation in an university hospital.

PubMed

Dettenkofer, M; Kümmerer, K; Schuster, A; Mühlich, M; Scherrer, M; Daschner, F D

1997-05-01

Medical audit in infection control today is accepted as an important element in the quality assurance of health care. In contrast, environmental auditing, which was approved in 1993 by the Council of the European Communities for industry ("Eco-Management and Audit Scheme-EMAS), has not so far been used as a tool to control and reduce environmental pollution caused by medical care in hospitals. The aim of this study was to investigate, whether environmental auditing in hospitals is useful. This process should also be cost effective. In this paper, methodological and organizational issues are described. Initially an environmental review of activities at the University Hospital, Freiburg and an eco-analysis of the input and output were performed. The first results of the study and a critical discussion will be presented in another paper.

Further specimens of the Asian tiger mosquito Aedes albopictus (Diptera, Culicidae) trapped in southwest Germany.

PubMed

Kampen, Helge; Kronefeld, Mandy; Zielke, Dorothee; Werner, Doreen

2013-02-01

After two previous demonstrations of introductions of the Asian tiger mosquito, Aedes albopictus, into southern Germany in 2007 and 2011, another three specimens were trapped in the city of Freiburg in the Upper Rhine Valley. The females were caught in early September 2011 (n = 2) and mid-July 2012 (n = 1). The trap was located at a railway container station where cargo is transferred to trains from trucks predominantly coming from southern Europe where A. albopictus is widely distributed. The reported findings confirm vehicle transport of A. albopictus to be an important and probably frequent mode of importation, and suggest that more regular and intense monitoring for invasive mosquito species in the Upper Rhine Valley should be undertaken in order to detect an establishment and implement adequate control measures in good time.

Epidermolysis bullosa care in Germany.

PubMed

Bruckner-Tuderman, Leena

2010-04-01

Until 2003, no structures existed in Germany for special care of patients with rare diseases, such as epidermolysis bullosa (EB). At that point, the Federal Ministry of Education and Research announced a clinical research program-networks for rare diseases. The Network Epidermolysis Bullosa (EB Network), coordinated from the Department of Dermatology, University Medical Center Freiburg, has operated since October 2003 with the goal of improving diagnostics and clinical management, elucidating disease mechanisms, and development of novel therapies for EB (www.netzwerk-eb.de). Future goals of the EB Network include securing the clinical-diagnostic and IT structures established with grant support and focusing research on molecular disease mechanisms in EB and novel biologically valid therapies. Intensive collaborations with other networks for rare genetic diseases will generate durable structures in Germany and form a basis for future international consortia. Copyright 2010 Elsevier Inc. All rights reserved.

Infestation of the human kidney with Dioctophyma renale.

PubMed

Ignjatovic, Ivan; Stojkovic, Ivica; Kutlesic, Cedo; Tasic, Suzana

2003-01-01

Human infestation with Dioctophyma renale is presented. Clinical signs and diagnostic findings are unspecific. They are discussed and a conservative therapeutic approach is suggested. Copyright 2003 S. Karger AG, Basel

77 FR 75189 - Certain Light-Emitting Diodes and Products Containing Same; Commission Determination Not To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... Corporate Center USA, Hella, Inc., Automotive Lighting Reutlingen GmbH, Automotive Lighting LLC, Tecnologia..., Inc., Automotive Lighting Reutlingen GmbH, Automotive Lighting, LLC, and [[Page 75190

78 FR 76624 - Notice of Agreements Filed

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

... Marine, Ltd. Filing Party: Wade S. Hooker, Esq.; 211 Central Park W; New York, NY 10024. Synopsis: The... HLC Agreement. Parties: BBC Chartering & Logistics GmbH & Co. KG; Beluga Chartering GmbH; Chipolbrok...

Decarbonizing urban transport in European cities: four cases show possibly high co-benefits

NASA Astrophysics Data System (ADS)

Creutzig, Felix; Mühlhoff, Rainer; Römer, Julia

2012-12-01

Cities worldwide are increasingly becoming agents of climate change mitigation, while simultaneously aiming for other goals, such as improved accessibility and clean air. Based on stakeholder interviews and data analysis, we assess the current state of urban mobility in the four European cities of Barcelona, Malmö, Sofia and Freiburg. We then provide scenarios of increasingly ambitious policy packages, reducing greenhouse gas emissions from urban transport by up to 80% from 2010 to 2040. We find significant concurrent co-benefits in cleaner air, reduced noise ambience, fewer traffic-related injuries and deaths, more physical activity, less congestion and monetary fuel savings. Our scenarios suggest that non-motorized transport, especially bicycles, can occupy high modal shares, particularly in cities with less than 0.5 million inhabitants. We think that this kind of multi-criteria assessment of social costs and benefits is a useful complement to cost-benefit analysis of climate change mitigation measures.

Rewards of caregiving and coping strategies of caregivers of patients with mental illness.

PubMed

Bauer, Rita; Sterzinger, Linda; Koepke, Franziska; Spiessl, Hermann

2013-02-01

The study sought to broaden the focus of research on caregivers' burden by examining caregiving rewards and their relation to coping skills. Data from semistructured interviews with 60 family caregivers of patients with mental illness in Germany were examined by content analysis. Information was gathered with the Freiburg Questionnaire on Coping With Illness. Both t tests and regression analyses were used to analyze data. Caregivers made 413 statements about rewards, which were assigned to six categories. "Gratitude and affection from the patient" was the most frequently cited, and "active, problem-oriented coping" was the coping strategy most used. Three variables predicted identification of a greater number of rewards, explaining 39% of variance: "increased religiousness and searching for meaning," "caregiver's younger age," and "more statements about burden." To support caregivers, a shift in orientation from focusing on burden to emphasizing resources is necessary.

An epileptic seizures detection algorithm based on the empirical mode decomposition of EEG.

PubMed

Orosco, Lorena; Laciar, Eric; Correa, Agustina Garces; Torres, Abel; Graffigna, Juan P

2009-01-01

Epilepsy is a neurological disorder that affects around 50 million people worldwide. The seizure detection is an important component in the diagnosis of epilepsy. In this study, the Empirical Mode Decomposition (EMD) method was proposed on the development of an automatic epileptic seizure detection algorithm. The algorithm first computes the Intrinsic Mode Functions (IMFs) of EEG records, then calculates the energy of each IMF and performs the detection based on an energy threshold and a minimum duration decision. The algorithm was tested in 9 invasive EEG records provided and validated by the Epilepsy Center of the University Hospital of Freiburg. In 90 segments analyzed (39 with epileptic seizures) the sensitivity and specificity obtained with the method were of 56.41% and 75.86% respectively. It could be concluded that EMD is a promissory method for epileptic seizure detection in EEG records.

BIM LAU-PE: Seedlings in Microgravity

NASA Astrophysics Data System (ADS)

Gass, S.; Pennese, R.; Chapuis, D.; Dainesi, P.; Nebuloni, S.; Garcia, M.; Oriol, A.

2015-09-01

The effect of gravity on plant roots is an intensive subject of research. Sounding rockets represent a costeffective platform to study this effect under microgravity conditions. As part of the upcoming MASER 13 sounding rocket campaign, two experiments on Arabidopsis thaliana seedlings have been devised: GRAMAT and SPARC. These experiments are aimed at studying (1) the genes that are specifically switched on or off during microgravity, and (2) the position of auxin-transporting proteins during microgravity. To perform these experiments, RUAG Space Switzerland site of Nyon, in collaboration with the Swedish Space Corporation (SSC) and the University of Freiburg, has developed the BIM LAU-PE (Biolology In Microgravity Late Access Unit Plant Experiment). In the following an overview of the BIM LAU-PE design is presented, highlighting specific module design features and verifications performed. A particular emphasis is placed on the parabolic flight experiments, including results of the micro-g injection system validation.

Ethics consultation on demand: concepts, practical experiences and a case study.

PubMed

Reiter-Theil, S

2000-06-01

Despite the increasing interest in clinical ethics, ethics consultation as a professional service is still rare in Europe. In this paper I refer to examples in the United States. In Germany, university hospitals and medical faculties are still hesitant about establishing yet another "committee". One of the reasons for this hesitation lies in the ignorance that exists here about how to provide medical ethics services; another reason is that medical ethics itself is not yet institutionalised at many German universities. The most important obstacle, however, may be that medical ethics has not yet demonstrated its relevance to the needs of those caring for patients. The Centre for Ethics and Law, Freiburg, has therefore taken a different approach from that offered elsewhere: clinical ethics consultation is offered on demand, the consultation being available to clinician(s) in different forms. This paper describes our experiences with this approach; practical issues are illustrated by a case study.

[Borderline personality disorder and transsexualism].

PubMed

Seikowski, Kurt; Gollek, Sabine; Harth, Wolfgang; Reinhardt, Michaela

2008-04-01

The study addresses the question whether, as often assumed, the symptoms of borderline personality disorders occur more frequently in transsexuals or not. We examined 164 transsexuals. The subjects completed the following questionnaires: The Borderline-Personality Inventory (BPI), the Freiburg Personality Inventory (FPI) and the Questionnaire for Assessment of One's Own Body (FbeK). In 80 % of all the examined transsexuals, there was evidence of symptoms of neither a borderline personality disorder nor of other personality disorders. If borderline symptoms occurred, they were predictable from the variables depressivity, low composure, low sociability and lack of confidence in relation to the external appearance. The data obtained refute the often-assumed increased relationship between borderline personality disorders and transsexuality. It should be assumed that a borderline personality disorder is primarily a psychiatric illness, while transsexuality is a disorder of gender identity in which secondary borderline symptoms may arise in some cases.

Semi-supervised prediction of SH2-peptide interactions from imbalanced high-throughput data.

PubMed

Kundu, Kousik; Costa, Fabrizio; Huber, Michael; Reth, Michael; Backofen, Rolf

2013-01-01

Src homology 2 (SH2) domains are the largest family of the peptide-recognition modules (PRMs) that bind to phosphotyrosine containing peptides. Knowledge about binding partners of SH2-domains is key for a deeper understanding of different cellular processes. Given the high binding specificity of SH2, in-silico ligand peptide prediction is of great interest. Currently however, only a few approaches have been published for the prediction of SH2-peptide interactions. Their main shortcomings range from limited coverage, to restrictive modeling assumptions (they are mainly based on position specific scoring matrices and do not take into consideration complex amino acids inter-dependencies) and high computational complexity. We propose a simple yet effective machine learning approach for a large set of known human SH2 domains. We used comprehensive data from micro-array and peptide-array experiments on 51 human SH2 domains. In order to deal with the high data imbalance problem and the high signal-to-noise ration, we casted the problem in a semi-supervised setting. We report competitive predictive performance w.r.t. state-of-the-art. Specifically we obtain 0.83 AUC ROC and 0.93 AUC PR in comparison to 0.71 AUC ROC and 0.87 AUC PR previously achieved by the position specific scoring matrices (PSSMs) based SMALI approach. Our work provides three main contributions. First, we showed that better models can be obtained when the information on the non-interacting peptides (negative examples) is also used. Second, we improve performance when considering high order correlations between the ligand positions employing regularization techniques to effectively avoid overfitting issues. Third, we developed an approach to tackle the data imbalance problem using a semi-supervised strategy. Finally, we performed a genome-wide prediction of human SH2-peptide binding, uncovering several findings of biological relevance. We make our models and genome-wide predictions, for all the 51 SH2-domains, freely available to the scientific community under the following URLs: http://www.bioinf.uni-freiburg.de/Software/SH2PepInt/SH2PepInt.tar.gz and http://www.bioinf.uni-freiburg.de/Software/SH2PepInt/Genome-wide-predictions.tar.gz, respectively.

Video Salient Object Detection via Fully Convolutional Networks.

PubMed

Wang, Wenguan; Shen, Jianbing; Shao, Ling

This paper proposes a deep learning model to efficiently detect salient regions in videos. It addresses two important issues: 1) deep video saliency model training with the absence of sufficiently large and pixel-wise annotated video data and 2) fast video saliency training and detection. The proposed deep video saliency network consists of two modules, for capturing the spatial and temporal saliency information, respectively. The dynamic saliency model, explicitly incorporating saliency estimates from the static saliency model, directly produces spatiotemporal saliency inference without time-consuming optical flow computation. We further propose a novel data augmentation technique that simulates video training data from existing annotated image data sets, which enables our network to learn diverse saliency information and prevents overfitting with the limited number of training videos. Leveraging our synthetic video data (150K video sequences) and real videos, our deep video saliency model successfully learns both spatial and temporal saliency cues, thus producing accurate spatiotemporal saliency estimate. We advance the state-of-the-art on the densely annotated video segmentation data set (MAE of .06) and the Freiburg-Berkeley Motion Segmentation data set (MAE of .07), and do so with much improved speed (2 fps with all steps).This paper proposes a deep learning model to efficiently detect salient regions in videos. It addresses two important issues: 1) deep video saliency model training with the absence of sufficiently large and pixel-wise annotated video data and 2) fast video saliency training and detection. The proposed deep video saliency network consists of two modules, for capturing the spatial and temporal saliency information, respectively. The dynamic saliency model, explicitly incorporating saliency estimates from the static saliency model, directly produces spatiotemporal saliency inference without time-consuming optical flow computation. We further propose a novel data augmentation technique that simulates video training data from existing annotated image data sets, which enables our network to learn diverse saliency information and prevents overfitting with the limited number of training videos. Leveraging our synthetic video data (150K video sequences) and real videos, our deep video saliency model successfully learns both spatial and temporal saliency cues, thus producing accurate spatiotemporal saliency estimate. We advance the state-of-the-art on the densely annotated video segmentation data set (MAE of .06) and the Freiburg-Berkeley Motion Segmentation data set (MAE of .07), and do so with much improved speed (2 fps with all steps).

[Improving speech comprehension using a new cochlear implant speech processor].

PubMed

Müller-Deile, J; Kortmann, T; Hoppe, U; Hessel, H; Morsnowski, A

2009-06-01

The aim of this multicenter clinical field study was to assess the benefits of the new Freedom 24 sound processor for cochlear implant (CI) users implanted with the Nucleus 24 cochlear implant system. The study included 48 postlingually profoundly deaf experienced CI users who demonstrated speech comprehension performance with their current speech processor on the Oldenburg sentence test (OLSA) in quiet conditions of at least 80% correct scores and who were able to perform adaptive speech threshold testing using the OLSA in noisy conditions. Following baseline measures of speech comprehension performance with their current speech processor, subjects were upgraded to the Freedom 24 speech processor. After a take-home trial period of at least 2 weeks, subject performance was evaluated by measuring the speech reception threshold with the Freiburg multisyllabic word test and speech intelligibility with the Freiburg monosyllabic word test at 50 dB and 70 dB in the sound field. The results demonstrated highly significant benefits for speech comprehension with the new speech processor. Significant benefits for speech comprehension were also demonstrated with the new speech processor when tested in competing background noise.In contrast, use of the Abbreviated Profile of Hearing Aid Benefit (APHAB) did not prove to be a suitably sensitive assessment tool for comparative subjective self-assessment of hearing benefits with each processor. Use of the preprocessing algorithm known as adaptive dynamic range optimization (ADRO) in the Freedom 24 led to additional improvements over the standard upgrade map for speech comprehension in quiet and showed equivalent performance in noise. Through use of the preprocessing beam-forming algorithm BEAM, subjects demonstrated a highly significant improved signal-to-noise ratio for speech comprehension thresholds (i.e., signal-to-noise ratio for 50% speech comprehension scores) when tested with an adaptive procedure using the Oldenburg sentences in the clinical setting S(0)N(CI), with speech signal at 0 degrees and noise lateral to the CI at 90 degrees . With the convincing findings from our evaluations of this multicenter study cohort, a trial with the Freedom 24 sound processor for all suitable CI users is recommended. For evaluating the benefits of a new processor, the comparative assessment paradigm used in our study design would be considered ideal for use with individual patients.

78 FR 48795 - Airworthiness Directives; BRP-Powertrain GmbH & Co KG Rotax Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-12

..., contact BRP- Powertrain GmbH & Co KG, Welser Strasse 32, A-4623 Gunskirchen, Austria; Internet: http://www..., A-4623 Gunskirchen, Austria; Internet: http://www.FLYROTAX.com . (4) You may view this service...

75 FR 28294 - Notice Pursuant to the National Cooperative Research and Production Act of 1993-PXI Systems...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-20

... Instruments GmbH, Landshut-Altdorf, GERMANY; Keithly Instruments, Solon, OH; Elektrobit Austria GmbH, Vienna, AUSTRIA; DiagnoSYS Systems Ltd., Hampshire, UNITED KINGDOM; and Elma Electronic Inc., Fremont, CA, have...

Rupture of a renal artery aneurysm in pregnancy.

PubMed

Meabed, Ahmed H; Onuora, Vincent C; Al Turki, Mohammed; Koko, Abdelmoniem H; Al Jawini, Nasser

2002-01-01

Rupture of a renal artery aneurysm is a well-recognized phenomenon. The rupture usually occurs in late pregnancy. We report a case in whom this occurred in the first trimester of pregnancy. Copyright 2002 S. Karger AG, Basel

Adherence to Internet-Based Mobile-Supported Stress Management: A Pooled Analysis of Individual Participant Data From Three Randomized Controlled Trials

PubMed Central

Lehr, Dirk; Berking, Matthias; Riper, Heleen; Cuijpers, Pim; Ebert, David Daniel

2016-01-01

Background Nonadherence to treatment is a prevalent issue in Internet interventions. Guidance from health care professionals has been found to increase treatment adherence rates in Internet interventions for a range of physical and mental disorders. Evaluating different guidance formats of varying intensity is important, particularly with respect to improvement of effectiveness and cost-effectiveness. Identifying predictors of nonadherence allows for the opportunity to better adapt Internet interventions to the needs of participants especially at risk for discontinuing treatment. Objective The goal of this study was to investigate the influence of different guidance formats (content-focused guidance, adherence-focused guidance, and administrative guidance) on adherence and to identify predictors of nonadherence in an Internet-based mobile-supported stress management intervention (ie, GET.ON Stress) for employees. Methods The data from the groups who received the intervention were pooled from three randomized controlled trials (RCTs) that evaluated the efficacy of the same Internet-based mobile-supported stress management intervention (N=395). The RCTs only differed in terms of the guidance format (content-focused guidance vs waitlist control, adherence-focused guidance vs waitlist control, administrative guidance vs waitlist control). Adherence was defined by the number of completed treatment modules (0-7). An ANOVA was performed to compare the adherence rates from the different guidance formats. Multiple hierarchical linear regression analysis was conducted to evaluate predictors of nonadherence, which included gender, age, education, symptom-related factors, and hope for improvement. Results In all, 70.5% (93/132) of the content-focused guidance sample, 68.9% (91/132) of the adherence-focused guidance sample, and 42.0% (55/131) of the participants in the administrative guidance sample completed all treatment modules. Guidance had a significant effect on treatment adherence (F2,392=11.64, P<.001; ω2=.05). Participants in the content-focused guidance (mean 5.70, SD 2.32) and adherence-focused guidance samples (mean 5.58, SD 2.33) completed significantly more modules than participants in the administrative guidance sample (mean 4.36, SD 2.78; t223=4.53, P<.001; r=.29). Content-focused guidance was not significantly associated with higher adherence compared to adherence-focused guidance (t262=0.42, P=.67; r=.03). The effect size of r=.03 (95% CI –0.09 to 0.15) did not pass the equivalence margin of r=.20 and the upper bound of the 95% CI lay below the predefined margin, indicating equivalence between adherence-focused guidance and content-focused guidance. Beyond the influence of guidance, none of the predictors significantly predicted nonadherence. Conclusions Guidance has been shown to be an influential factor in promoting adherence to an Internet-based mobile-supported stress management intervention. Adherence-focused guidance, which included email reminders and feedback on demand, was equivalent to content-focused guidance with regular feedback while requiring only approximately a quarter of the coaching resources. This could be a promising discovery in terms of cost-effectiveness. However, even after considering guidance, sociodemographic, and symptom-related characteristics, most interindividual differences in nonadherence remain unexplained. Clinical Trial DRKS00004749; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL _ID=DRKS00004749 (Archived by WebCite at http://www.webcitation.org/6QiDk9Zn8); DRKS00005112; http://drks-neu.uniklinik-freiburg. de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005112 (Archived by WebCite at http://www.webcitation.org/6QiDysvev); DRKS00005384; http://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005384 (Archived by WebCite at http://www.webcitation.org/6QiE0xcpE) PMID:27357528

Adherence to Internet-Based Mobile-Supported Stress Management: A Pooled Analysis of Individual Participant Data From Three Randomized Controlled Trials.

PubMed

Zarski, Anna-Carlotta; Lehr, Dirk; Berking, Matthias; Riper, Heleen; Cuijpers, Pim; Ebert, David Daniel

2016-06-29

Nonadherence to treatment is a prevalent issue in Internet interventions. Guidance from health care professionals has been found to increase treatment adherence rates in Internet interventions for a range of physical and mental disorders. Evaluating different guidance formats of varying intensity is important, particularly with respect to improvement of effectiveness and cost-effectiveness. Identifying predictors of nonadherence allows for the opportunity to better adapt Internet interventions to the needs of participants especially at risk for discontinuing treatment. The goal of this study was to investigate the influence of different guidance formats (content-focused guidance, adherence-focused guidance, and administrative guidance) on adherence and to identify predictors of nonadherence in an Internet-based mobile-supported stress management intervention (ie, GET.ON Stress) for employees. The data from the groups who received the intervention were pooled from three randomized controlled trials (RCTs) that evaluated the efficacy of the same Internet-based mobile-supported stress management intervention (N=395). The RCTs only differed in terms of the guidance format (content-focused guidance vs waitlist control, adherence-focused guidance vs waitlist control, administrative guidance vs waitlist control). Adherence was defined by the number of completed treatment modules (0-7). An ANOVA was performed to compare the adherence rates from the different guidance formats. Multiple hierarchical linear regression analysis was conducted to evaluate predictors of nonadherence, which included gender, age, education, symptom-related factors, and hope for improvement. In all, 70.5% (93/132) of the content-focused guidance sample, 68.9% (91/132) of the adherence-focused guidance sample, and 42.0% (55/131) of the participants in the administrative guidance sample completed all treatment modules. Guidance had a significant effect on treatment adherence (F2,392=11.64, P<.001; ω(2)=.05). Participants in the content-focused guidance (mean 5.70, SD 2.32) and adherence-focused guidance samples (mean 5.58, SD 2.33) completed significantly more modules than participants in the administrative guidance sample (mean 4.36, SD 2.78; t223=4.53, P<.001; r=.29). Content-focused guidance was not significantly associated with higher adherence compared to adherence-focused guidance (t262=0.42, P=.67; r=.03). The effect size of r=.03 (95% CI -0.09 to 0.15) did not pass the equivalence margin of r=.20 and the upper bound of the 95% CI lay below the predefined margin, indicating equivalence between adherence-focused guidance and content-focused guidance. Beyond the influence of guidance, none of the predictors significantly predicted nonadherence. Guidance has been shown to be an influential factor in promoting adherence to an Internet-based mobile-supported stress management intervention. Adherence-focused guidance, which included email reminders and feedback on demand, was equivalent to content-focused guidance with regular feedback while requiring only approximately a quarter of the coaching resources. This could be a promising discovery in terms of cost-effectiveness. However, even after considering guidance, sociodemographic, and symptom-related characteristics, most interindividual differences in nonadherence remain unexplained. DRKS00004749; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL _ID=DRKS00004749 (Archived by WebCite at http://www.webcitation.org/6QiDk9Zn8); DRKS00005112; http://drks-neu.uniklinik-freiburg. de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005112 (Archived by WebCite at http://www.webcitation.org/6QiDysvev); DRKS00005384; http://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005384 (Archived by WebCite at http://www.webcitation.org/6QiE0xcpE).

Modelling skin penetration using the Laplace transform technique.

PubMed

Anissimov, Y G; Watkinson, A

2013-01-01

The Laplace transform is a convenient mathematical tool for solving ordinary and partial differential equations. The application of this technique to problems arising in drug penetration through the skin is reviewed in this paper. © 2013 S. Karger AG, Basel.

Did goethe describe attention deficit hyperactivity disorder?

PubMed

Bonazza, Sara; Scaglione, Cesa; Poppi, Massimo; Rizzo, Giovanni

2011-01-01

As early as 1846, the typical symptoms of attention deficit hyperactivity disorder (ADHD) were described by Heinrich Hoffmann (1809-1894). However, in Goethe's masterpiece Faust (1832), the character of Euphorion strongly suggests ADHD diagnosis. Copyright © 2011 S. Karger AG, Basel.

76 FR 58768 - Ball Bearings and Parts Thereof From France, Germany, and Italy; Amended Final Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-22

... determined for this company continues to be 5.47 percent. Germany: ``BSH Bosch and Siemens Hausgerate GmbH'' has been changed to ``BSH Bosch und Siemens Hausgerate GmbH;'' ``Volkswagon AG'' has been changed to...

77 FR 75973 - Ball Bearings and Parts Thereof From France, Germany, and Italy: Final Results of Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... third columns, the table is corrected to read as set forth below. Margin Company (percent) France: Audi... GmbH 0.00 Robert Bosch GmbH Power Tools and Hagglunds Drives........ 0.00 Italy: Audi AG 0.00 Bosch...

77 FR 16968 - Airworthiness Directives; Burkhart GROB Luft- und Raumfahrt GmbH Powered Sailplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-23

... verbal contact we receive about this proposed AD. Discussion The European Aviation Safety Agency (EASA...-200. (h) Related Information Refer to MCAI European Aviation Safety Agency (EAS) AD No. 2012- 0027...- und Raumfahrt GmbH Powered Sailplanes AGENCY: Federal Aviation Administration (FAA), Department of...

77 FR 32887 - Airworthiness Directives; Burkhart GROB Luft- und Raumfahrt GmbH Powered Sailplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-04

... Airworthiness Directives; Burkhart GROB Luft- und Raumfahrt GmbH Powered Sailplanes AGENCY: Federal Aviation... seaside and therefore exposed to a salty environment, causing the excessive corrosion. This condition, if... Programs,'' describes in more detail the scope of the Agency's authority. We are issuing this rulemaking...

76 FR 48047 - Airworthiness Directives; Diamond Aircraft Industries Powered Sailplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... 5 p.m., Monday through Friday, except Federal holidays. For service information identified in this... Service Information Diamond Aircraft Industries GmbH has issued Service Bulletin No. MSB 36-105/1, dated...-105, dated April 21, 2011, as specified in Diamond Aircraft Industries GmbH Service Bulletin No. MSB...

One Burn, One Standard

DTIC Science & Technology

2014-09-01

Johannes Kepler University Linz Software GmbH Research Department Medical Informatics Hagenberg, Austria Herbert L. Haller, MD Trauma Hospital Linz of...0000000000000004 Address correspondence to M. Giretzlehner, PhD, Johannes Kepler University Linz, RISC Software GmbH, Research Department Medical Informatics, Softwarepark 35, 4232 Hagenberg, Austria. One Burn, One Standard LETTER TO THE EDITOR

76 FR 22078 - Lightweight Thermal Paper From Germany: Notice of Final Results of the First Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

... DEPARTMENT OF COMMERCE International Trade Administration [A-428-840] Lightweight Thermal Paper... initiation of this antidumping duty administrative review naming Mitsubishi HiTec Paper Flensburg GmbH, Mitsubishi HiTec Paper Bielefeld GmbH and Mitsubishi International Corporation (``collectively, Mitsubishi...

77 FR 77091 - Notice of Receipt of Complaint; Solicitation of Comments Relating to the Public Interest

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... Certain Balloon Dissection Devices and Products Containing Same, DN 2925; the Commission is soliciting... importation of certain balloon dissection devices and products containing same. The complaint names as respondents Pajunk Medizintechnik GmbH of Germany, Pajunk Medizintechnolgie GmbH of Germany and Pajunk Medical...

76 FR 31457 - Airworthiness Directives; Diamond Aircraft Industries GmbH Model DA 42 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... Airworthiness Directives; Diamond Aircraft Industries GmbH Model DA 42 Airplanes AGENCY: Federal Aviation... reportedly found on DA 42 Main Landing Gear (MLG) Damper-to-Trailing Arm joints during standard maintenance... DA 42 Main Landing Gear (MLG) Damper-to-Trailing Arm joints during standard maintenance. Depending on...

76 FR 14346 - Airworthiness Directives; Diamond Aircraft Industries GmbH Model DA 42 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... Industries GmbH Model DA 42 Airplanes AGENCY: Federal Aviation Administration (FAA), Department of... been reportedly found on DA 42 Main Landing Gear (MLG) Damper-to-Trailing Arm joints during standard... condition for the specified products. The MCAI states: Cracks have been reportedly found on DA 42 Main...

[The correlation between personality characteristics and burnout syndrome in emergency ambulance workers].

PubMed

Bergmueller, A; Zavgorodnii, I; Zavgorodnia, N; Kapustnik, W; Boeckelmann, I

The work in Emergency Medical Ambulance Service is one of the professions, which is accompanied by high psychological and emotional stress. The aim was to determine the risk of professional burnout syndrome of Emergency Medical Ambulance Service staff and the relationship between burnout syndrome and personality. Ninety-seven doctors (57 women and 40 men, aged 37.0±12.21) of Emergency Medical Ambulance Service were interviewed using the MBI-GS questionnaire and the Freiburg personality questionnaire (FPI). Correlation and regression analysis were used. Nine (11.5%) of respondents had a risk of burnout syndrome and 28 (35.9%) had some symptoms. In the group, aged 45 years and older, the risk of burnout syndrome was not identified. The staff of Emergency Medical Ambulance Service is characterized by stable personality features. It is necessary to identify the prevalence of burnout syndrome and also to identity the causes for its prevention and development of measures on the increase of personal stress resilience.

[Children of mentally ill parents. A study of problem awareness in clinical routine practice].

PubMed

Bohus, M; Schehr, K; Berger-Sallawitz, F; Novelli-Fischer, U; Stieglitz, R D; Berger, M

1998-05-01

The risk of developing clinically relevant psychiatric disorders in the lifetime course is significantly greater among children of mentally ill parents. A child-adapted programme of information concerning the nature and symptomatology of parental illness is considered to be an important preventive factor, and lies within the domain of the psychiatrist's or therapist's responsibilities. During the developmental phase of a prevention project at Freiburg University's Department of Psychiatry and Psychotherapy, both clinical practice and the level of problem awareness among patients and the therapists were evaluated. Over a period of one year, consecutive interviews involving 114 patients with children under 18 years of age, as well as their respective therapists, were conducted. The results showed that: scarcely any exchanges between children and therapists took place; the extent to which children are informed about parental illness must be considered as small; a high percentage of such children are already evaluated by their parents as disturbed, and the pressing need for support exists.

Dose-dependent X-ray measurements using a 64×64 hybrid GaAs pixel detector with photon counting

NASA Astrophysics Data System (ADS)

Schwarz, C.; Campbell, M.; Goeppert, R.; Ludwig, J.; Mikulec, B.; Rogalla, M.; Runge, K.; Soeldner-Rembold, A.; Smith, K. M.; Snoeys, W.; Watt, J.

2001-03-01

New developments in medical imaging head towards semiconductor detectors flip-chip bonded to CMOS readout chips. In this work, detectors fabricated on SI-GaAs bulk material were bonded to Photon Counting Chips. This PCC consists of a matrix of 64×64 identical square pixels (170 μm×170 μm) with a 15-bit counter in each cell. We investigated the imaging properties of these detector systems under exposure of a dental X-ray tube. First, a dose calibration of the X-ray tube was performed. Fixed pattern noise in flood exposure images was determined for a fixed dose and an image correction method, which uses a gain map, was applied. For characterising the imaging properties, the signal-to-noise ratio (SNR) was calculated as function of exposure dose. Finally, the dynamic range of the system was estimated. Developed in the framework of the MEDIPIX collaboration: CERN, Universities of Freiburg, Glasgow, Naples and Pisa.

[Signs of the zodiac and personality].

PubMed

Angst, J; Scheidegger, P

1976-01-01

3074 young men resident in the canton of Zurich, representing 50% of the 19 year old male population, form the fully representative sample of our large scale investigation. We investigated whether personality traits measured by means of the differentiated "Freiburger personality inventory" (FPI) could in any way be correlated to the signs of the zodiac under which the young men were born. The statistical analysis did not reveal any correlation between signs of the zodiac and personality. The claim made by astrologers that people can be characterized according to their sign of the zodiac (sagitarius, taurus, cancer, scorpion) must be refuted. Of course the astrologically founded description of human personality does not base itself on the position of the sun only, however the latter does form a very essential part of the astrological evaluation of people. This, at any rate has been shown to be without any scientific basis. The fact that astrological evaluation of human personality is so popular nowadays can be explained by the fact that even modern people are inclined towards magical thinking.

The Platelia Aspergillus ELISA in diagnosis of invasive pulmonary aspergilosis (IPA).

PubMed

Siemann, M; Koch-Dörfler, M

2001-01-01

The sensitivity of a sandwich enzyme-linked immunosorbent assay (ELISA) for detecting Aspergillus galactomannan was evaluated with 66 serum samples and 113 specimens of the respiratory tract obtained from 52 patients with pulmonary diseases. The patients were divided into five groups: proven invasive pulmonary aspergillosis (IPA) (five patients), probable IPA (seven patients), Aspergillus colonization (eight patients) or unlikely Aspergillus infection (27 patients). Another five patients with doubtful diagnostic test results are discussed in detail. The results of the Platelia Aspergillus ELISA (Sanofi Pasteur, Freiburg, Germany) in testing specimens of the respiratory tract were 90% sensitivity in proven (serum 38%), 60% in probable (serum 37%) and 71% in Aspergillus colonization (serum 0%). Furthermore, 85% of the Aspergillus spp. from positive cultures of specimens of the respiratory tract were also detected in the ELISA. A total of 57% of the culture negative specimens of patients with a least one positive culture or proven aspergillosis in a series of specimens were positive in the ELISA.

Epileptic Seizure Prediction Using a New Similarity Index for Chaotic Signals

NASA Astrophysics Data System (ADS)

Niknazar, Hamid; Nasrabadi, Ali Motie

Epileptic seizures are generated by abnormal activity of neurons. The prediction of epileptic seizures is an important issue in the field of neurology, since it may improve the quality of life of patients suffering from drug resistant epilepsy. In this study a new similarity index based on symbolic dynamic techniques which can be used for extracting behavior of chaotic time series is presented. Using Freiburg EEG dataset, it is found that the method is able to detect the behavioral changes of the neural activity prior to epileptic seizures, so it can be used for prediction of epileptic seizure. A sensitivity of 63.75% with 0.33 false positive rate (FPR) in all 21 patients and sensitivity of 96.66% with 0.33 FPR in eight patients were achieved using the proposed method. Moreover, the method was evaluated by applying on Logistic and Tent map with different parameters to demonstrate its robustness and ability in determining similarity between two time series with the same chaotic characterization.

Testing and model-aided analysis of a 2 kW el PEMFC CHP-system

NASA Astrophysics Data System (ADS)

König, P.; Weber, A.; Lewald, N.; Aicher, T.; Jörissen, L.; Ivers-Tiffée, E.; Szolak, R.; Brendel, M.; Kaczerowski, J.

A prototype PEMFC CHP-system (combined heat and power) for decentralised energy supply in domestic applications has been installed in the Fuel Cell Testing Laboratory at the Institut für Werkstoffe der Elektrotechnik (IWE), Universität Karlsruhe (TH). The system, which was developed at the Zentrum für Sonnenenergie- und Wasserstoff-Forschung ZSW, Ulm (FC-stack) and the Fraunhofer-Institut für Solare Energiesysteme ISE, Freiburg (reformer) is operated and tested in close cooperation with the Stadtwerke Karlsruhe. The tests are carried out as part of the strategic project EDISon, which is supported by the German Federal Ministry of Economics and Technology (BMWA). The performance of the system is evaluated for different operating conditions. The tests include steady state measurements under different electrical and thermal loads as well as an analysis of the dynamic behaviour of the system during load changes. First results of these steady state and dynamic operation characteristics will be presented in this paper.

Eagle-eyed visual acuity: an experimental investigation of enhanced perception in autism.

PubMed

Ashwin, Emma; Ashwin, Chris; Rhydderch, Danielle; Howells, Jessica; Baron-Cohen, Simon

2009-01-01

Anecdotal accounts of sensory hypersensitivity in individuals with autism spectrum conditions (ASC) have been noted since the first reports of the condition. Over time, empirical evidence has supported the notion that those with ASC have superior visual abilities compared with control subjects. However, it remains unclear whether these abilities are specifically the result of differences in sensory thresholds (low-level processing), rather than higher-level cognitive processes. This study investigates visual threshold in n = 15 individuals with ASC and n = 15 individuals without ASC, using a standardized optometric test, the Freiburg Visual Acuity and Contrast Test, to investigate basic low-level visual acuity. Individuals with ASC have significantly better visual acuity (20:7) compared with control subjects (20:13)-acuity so superior that it lies in the region reported for birds of prey. The results of this study suggest that inclusion of sensory hypersensitivity in the diagnostic criteria for ASC may be warranted and that basic standardized tests of sensory thresholds may inform causal theories of ASC.

Coping strategies in episodic and chronic tension-type headache.

PubMed

Rollnik, J D; Karst, M; Fink, M; Dengler, R

2001-03-01

To study the importance of coping with illness strategies in tension-type headache (TTH). The pathophysiology of TTH is complex, and coping with illness strategies might contribute to the transformation to a chronic form. We examined 89 subjects (mean age, 45.6 +/- 14.8 years; range, 18 to 72 years) with episodic (n = 37) and chronic (n = 52) TTH. Patients were required to fill in a Freiburg Questionnaire of Coping with Illness (FQCI), a von Zerssen Depression Scale, quality-of-life questionnaires, and a headache home diary (over 4 weeks). In addition, pressure pain thresholds (temporal muscles) and total tenderness scores were obtained. Patients with chronic TTH exhibited poorer quality-of-life measures, slightly more depressive symptoms, and significantly stronger avoidance behavior and endurance strategies on FQCI scales F4 and F5 (P< .05). There was no difference between episodic and chronic TTH with respect to measures of muscle tenderness or pain thresholds. We conclude that disadvantageous coping with illness strategies might contribute to a transformation to chronic TTH.

77 FR 32507 - Brass Sheet and Strip From Germany: Notice of Rescission of Antidumping Duty Administrative Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... Germany: Notice of Rescission of Antidumping Duty Administrative Review AGENCY: Import Administration... and strip from Germany for the period of review (``POR''), March 1, 2011, through February 29, 2012.\\1... brass sheet and strip from Germany: Aurubis Stolberg GmbH & Co. KG (``Aurubis''), Carl Schreiber GmbH...

76 FR 19903 - Special Conditions: Diamond Aircraft Industry Model DA-40NG; Diesel Cycle Engine

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... DA-40NG the Austro Engine GmbH model E4 aircraft diesel engine (ADE) using turbine (jet) fuel. This... engine utilizing turbine (jet) fuel. The applicable airworthiness regulations do not contain adequate or...: Installation of the Austro Engine GmbH Model E4 ADE diesel engine utilizing turbine (jet) fuel. Discussion...

76 FR 64289 - Airworthiness Directives; Thielert Aircraft Engines GmbH (TAE) TAE 125-02-99 and TAE 125-02-114...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-18

... Engines GmbH (TAE) TAE 125-02-99 and TAE 125-02-114 Reciprocating Engines AGENCY: Federal Aviation... unsafe condition on an aviation product. The MCAI describes the unsafe condition as: In-flight engine shutdown incidents have been reported on aeroplanes equipped with TAE 125 engines. Preliminary...

75 FR 17084 - Airworthiness Directives; Thielert Aircraft Engines GmbH (TAE) Model TAE 125-01 Reciprocating...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-05

... Differences (f) None. Alternative Methods of Compliance (AMOCs) (g) The Manager, Engine Certification Office... Engines GmbH (TAE) Model TAE 125-01 Reciprocating Engines AGENCY: Federal Aviation Administration (FAA... 02-7250-18300R5, may cause a blow-by gas pressure increase inside the crankcase of the engine in...

75 FR 17632 - Airworthiness Directives; Bombardier-Rotax GmbH Type 912 F, 912 S, and 914 F Series Reciprocating...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... Bombardier-Rotax engines in Europe. Differences Between the Proposed AD and the Service Information Rotax... GmbH Type 912 F, 912 S, and 914 F Series Reciprocating Engines AGENCY: Federal Aviation Administration... and 914 F series reciprocating engines. That AD currently requires initial and repetitive visual...

76 FR 253 - Airworthiness Directives; ROLLADEN-SCHNEIDER Flugzeugbau GmbH Model LS6 Gliders

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... Airworthiness Directives; ROLLADEN-SCHNEIDER Flugzeugbau GmbH Model LS6 Gliders AGENCY: Federal Aviation... condition does not exist in the Model LS6-c gliders. FAA's Determination We are issuing this AD rescission... Model LS6 glider, and the unsafe condition described previously is not likely to exist or develop in the...

77 FR 50162 - Importer of Controlled Substances; Notice of Application; SA INTL GMBH C/O., Sigma Aldrich Co., LLC

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application; SA INTL GMBH C/O., Sigma Aldrich Co., LLC Correction In notice document 2012-19191 appearing on pages 47106-47108 in the issue of Tuesday, August 7, 2012, make the following corrections: 1. On page...

Black manganese-rich crusts on a Gothic cathedral

NASA Astrophysics Data System (ADS)

Macholdt, Dorothea S.; Herrmann, Siegfried; Jochum, Klaus Peter; Kilcoyne, A. L. David; Laubscher, Thomas; Pfisterer, Jonas H. K.; Pöhlker, Christopher; Schwager, Beate; Weber, Bettina; Weigand, Markus; Domke, Katrin F.; Andreae, Meinrat O.

2017-12-01

Black manganese-rich crusts are found worldwide on the façades of historical buildings. In this study, they were studied exemplarily on the façade of the Freiburger Münster (Freiburg Minster), Germany, and measured in-situ by portable X-ray fluorescence (XRF). The XRF was calibrated to allow the conversion from apparent mass fractions to Mn surface density (Mn mass per area), to compensate for the fact that portable XRF mass fraction measurements from thin layers violate the assumption of a homogeneous measurement volume. Additionally, 200-nm femtosecond laser ablation-inductively coupled plasma-mass spectrometry (fs LA-ICP-MS) measurements, scanning transmission X-ray microscopy-near edge X-ray absorption fine structure spectroscopy (STXM-NEXAFS), Raman spectroscopy, and imaging by light microscopy were conducted to obtain further insight into the crust material, such as potential biogenic contributions, element distributions, trace element compositions, and organic functional groups. While black crusts of various types are present at many places on the minster's facade, crusts rich in Mn (with a Mn surface density >150 μg cm-2) are restricted to a maximum height of about 7 m. The only exceptions are those developed on the Renaissance-Vorhalle (Renaissance Portico) at a height of about 8 m. This part of the façade had been cleaned and treated with a silicon resin as recently as 2003. These crusts thus accumulated over a period of only 12 years. Yet, they are exceptionally Mn-rich with a surface density of 1200 μg cm-2, and therefore require an accumulation rate of about 100 μg cm-2 Mn per year. Trace element analyses support the theory that vehicle emissions are responsible for most of the Mn supply. Lead, barium, and zinc correlate with manganese, indicating that tire material, brake pads, and resuspended road dust are likely to be the element sources. Microscopic investigations show no organisms on or in the Mn-rich crusts. In contrast, Mn-free black crusts sampled at greater heights (>8 m) exhibited fungal and cyanobacterial encrustation. Carbon-rich spots were found by STXM-NEXAFS underneath one of the Mn-rich crusts. However, these carbon occurrences originate from soot and polycyclic aromatic hydrocarbons (PAHs) deposited on top of the crust, rather than from organisms responsible for the crust's formation, as shown by STXM-NEXAFS and Raman spectroscopic measurements. Our results suggest that the crusts develop abiogenically, with vehicle emissions as dominant element sources.

75 FR 66342 - Airworthiness Directives; Thielert Aircraft Engines GmbH Models TAE 125-02-99 and TAE 125-02-114...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-28

... difference is to ensure that the compliance requirements for all engines in paragraph (e)(1) above are... Airworthiness Directives; Thielert Aircraft Engines GmbH Models TAE 125-02-99 and TAE 125-02-114 Reciprocating Engines AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed rulemaking (NPRM...

75 FR 39803 - Airworthiness Directives; Thielert Aircraft Engines GmbH Model TAE 125-01 Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... Airworthiness Directives; Thielert Aircraft Engines GmbH Model TAE 125-01 Reciprocating Engines AGENCY: Federal...-18300R5, may cause a blow-by gas pressure increase inside the crankcase of the engine in excess of the oil seal design pressure limits. Leaking engine oil may adversely affect the gearbox clutch or the engine...

75 FR 54462 - Airworthiness Directives; Bombardier-Rotax GmbH 912 F Series and 912 S Series Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... Airworthiness Directives; Bombardier-Rotax GmbH 912 F Series and 912 S Series Reciprocating Engines AGENCY... result in exceeding of the fuel pressure and might cause engine malfunction and/or massive fuel leakage... engine malfunction or a massive fuel leak. These conditions could cause loss of control of the airplane...

77 FR 4217 - Airworthiness Directives; Thielert Aircraft Engines GmbH Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-27

... sensitivity of friction disk Part Number (P/N) 05-7211- K010201 against possible misalignment of gearbox and..., Thielert Aircraft Engines GmbH has developed a new friction disk. We issued a notice of proposed rulemaking... all TAE 125-02-99 and TAE 125-02-114 reciprocating engines, replacing the friction disk, P/N 05- 7211...

76 FR 52937 - Ball Bearings and Parts Thereof From France, Germany, and Italy: Final Results of Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... programming and other errors in the margin calculations. Therefore, the final results are different from the... certain companies. We have corrected programming and other errors in the margins we included in the... Technologies GmbH; Italy--Schaeffler Italia S.r.l./WPB Water Pump Bearing GmbH & Co. KG/The Schaeffler Group...

77 FR 66534 - Airworthiness Directives; BRP-Powertrain GmbH & Co KG Rotax Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-06

... Rotax 912 F2; 912 F3; 912 F4; 912 S2; 912 S3; and 912 S4 reciprocating engines. The word ``not'' was...-Powertrain GmbH & Co KG Rotax 912 F2; 912 F3; 912 F4; 912 S2; 912 S3; and 912 S4 reciprocating engines. As...

Manufacturing of tattoo ink products today and in future: Europe.

PubMed

Michel, Ralf

2015-01-01

The article describes the European market situation and the legal framework in Europe. It shows the state-of-the-art production under ISO 9001:2008 quality management and describes the future of tattoo ink production based on good manufacturing practice guidelines for tattoo inks. © 2015 S. Karger AG, Basel.

Autism and our intestinal microbiota.

PubMed

Reddy, Bhaskara Lakshmi; Saier, Milton H

2015-01-01

Microbial products, released into the bloodstreams of mammals including humans, cross the blood-brain barrier and influence neurodevelopment. They can either promote or alleviate neurological disorders including autism spectrum disorders (ASD). This editorial describes how our microbiota influence our feelings, attitudes and mental states with particular reference to ASD. © 2015 S. Karger AG, Basel.

Agnosia, apraxia, callosal disconnection and other specific cognitive disorders.

PubMed

Acciarresi, Monica

2012-01-01

Cortical function deficits have long been studied by anatomoclinic correlations. Recent functional imaging studies have allowed scientists to better understand which cerebral areas and which networks are involved in cognitive function deficit. This chapter will review the current knowledge on agnosia, apraxia and callosal disconnection syndromes. Copyright © 2012 S. Karger AG, Basel.

Treatment of a delayed zipper injury.

PubMed

Mydlo, J H

2000-01-01

Penile zipper injuries have been reported occurring usually in the pediatric population, and occasionally in adults. Usually, the zipper can be dislodged with mineral oil or by breaking the median bar. When these attempts fail, a small elliptical incision may be used to remove the zipper and any devitalized tissue. Copyright 2000 S. Karger AG, Basel

A case of bipolar psychosis and transsexualism.

PubMed

Habermeyer, Elmar; Kamps, Ingrid; Kawohl, Wolfram

2003-01-01

A case of bipolar disorder and transsexualism is reported and discussed. The case report shows the problematic nature of the distinction between transsexualism and psychosis-induced transsexual desires. If there is a true comorbidity of these disorders, a subtly differentiated process to guide medical expert opinion and therapy is necessary. Copyright 2003 S. Karger AG, Basel

75 FR 52240 - Airworthiness Directives; Thielert Aircraft Engines GmbH (TAE) Models TAE 125-01 and TAE 125-02...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-25

..., 2010, or SB No. TM TAE 125-1011 P1, dated June 9, 2010, into any engine. FAA AD Differences (f) This AD... Airworthiness Directives; Thielert Aircraft Engines GmbH (TAE) Models TAE 125-01 and TAE 125-02-99 Reciprocating Engines AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule; request for comments...

76 FR 9963 - Airworthiness Directives; Thielert Aircraft Engines GmbH Models TAE 125-02-99 and TAE 125-02-114...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-23

... Airworthiness Directives; Thielert Aircraft Engines GmbH Models TAE 125-02-99 and TAE 125-02-114 Reciprocating Engines AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule. SUMMARY: We are adopting a... condition, if not corrected, could lead to in-flight cases of engine shutdown. We are issuing this AD to...

The National Shipbuilding Research Program. Evaluation of Shipbuilding CAD/CAM Systems (Phase I)

DTIC Science & Technology

1996-10-14

Industries Norddeutsche Itiormations Systems GmbH Odense Steel Shipyard Sener Ingenieria y Sistemas SMK Ingenieurburo Verolrne Scheepswerf Heusden b.v...Systems Logimatic Marine Consultants A/S Mitsubishi Heavy Industries Norddeutsche Informations Systems GmbH Odense Steel Shipyard Sener Ingenieria y...market share and business backlog . continue profitable operation in spite of relentless price and schedule competition 11.0 SENERMAR Sener Ingenieria

75 FR 75868 - Airworthiness Directives; Diamond Aircraft Industries GmbH Models DA 40 and DA 40F Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... Airworthiness Directives; Diamond Aircraft Industries GmbH Models DA 40 and DA 40F Airplanes AGENCY: Federal... of the Thielert Engine Owners Group commented that the Model DA 42 has the same door design and the same unsafe condition. He recommended that the AD also apply to the Model DA 42. The FAA has discussed...

75 FR 61046 - Airworthiness Directives; Bombardier-Rotax GmbH Type 912 F, 912 S, and 914 F Series Reciprocating...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... identified in this AD from BRP-Rotax GmbH & Co. KG, Welser Strasse 32, A-4623 Gunskirchen, Austria. The... looking at the S/ N in the area indicated by XXX, following ``Made in Austria,'' as shown on Figure 2 of... 32, A-4623 Gunskirchen, Austria, or go to rotax-aircraft-engines.com for a copy of this service...

77 FR 53154 - Airworthiness Directives; Thielert Aircraft Engines GmbH Models TAE 125-02-99 and TAE 125-02-114...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

... Airworthiness Directives; Thielert Aircraft Engines GmbH Models TAE 125-02-99 and TAE 125-02-114 Reciprocating...). SUMMARY: We propose to adopt a new airworthiness directive (AD) for all TAE 125-02-99 and TAE 125-02-114... 125-02-99 engine. This proposed AD would require inspection of the oil filler plug vent hole at the...

76 FR 12627 - Airworthiness Directives; Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG Airplanes AGENCY: Federal Aviation Administration (FAA... on Diamond aeroplanes, the majority of which were DA 40. In additional, at least 18 doors have been... conditions) while the aeroplane was parked. All DA 40 and DA 42 aeroplanes have a system installed that...

Robert Wartenberg, MD (1887-1956).

PubMed

Pearce, John M S

2018-01-01

Modern technologies have, to some degree, replaced the careful elicitation of neurological physical signs. Many 20th century texts and monographs were devoted to such clinical phenomena. Foremost among them were the assiduous writings of Robert Wartenberg who fled Hitler to enhance Neurology in San Francisco. His work and influences are outlined here. © 2018 S. Karger AG, Basel.

Regulation of tattoo ink production and the tattoo business in the US.

PubMed

Haugh, I M; Laumann, S L; Laumann, Anne E

2015-01-01

The production of tattoo ink and pigments in the US is unregulated. There are no guidelines or standards issued by national agencies. However, the practice of tattooing is regulated at the state and local levels but varies widely. Adverse events are addressed when a problem is reported. © 2015 S. Karger AG, Basel.

Cocaine-contaminated allogeneic bone marrow transplantation.

PubMed

Keung, Y K; Morgan, D; Cobos, E

2001-01-01

Should a person with history of drug addiction be categorically denied as a bone marrow donor? The answer to the question is controversial. We report a case of allogeneic bone marrow transplantation for refractory acute myeloid leukemia preceded by essential thrombocythemia. The donor used cocaine and marijuana the night before the bone marrow harvest. Copyright 2001 S. Karger AG, Basel

The Genetic Background of Neonatal Disease.

PubMed

Göpel, Wolfgang; Westermann, Eva; Pagel, Friederike

2018-01-01

More than 27,000 human genes have been sequenced and described. Only a few of these genes are relevant for common human diseases with regard to diagnostic or therapeutic purposes. This review describes the genetics of common traits and diseases with a particular focus on perspectives for drug discovery and drug therapy in neonates. © 2018 S. Karger AG, Basel.

L-shaped right-to-left crossed-fused renal ectopia with left dysplastic ureter.

PubMed

Song, Wei; Yang, Jinrui; Zhu, Liang; Liu, Longfei

2012-01-01

Crossed-fused renal ectopia is a relatively rare congenital malformation. Herein, we report a case of L-shaped right- to-left crossed-fused renal ectopia with a left dysplastic ureter in a 5-year-old girl. She underwent a left nephrectomy and the postoperative course was uneventful. Copyright © 2011 S. Karger AG, Basel.

deepTools2: a next generation web server for deep-sequencing data analysis.

PubMed

Ramírez, Fidel; Ryan, Devon P; Grüning, Björn; Bhardwaj, Vivek; Kilpert, Fabian; Richter, Andreas S; Heyne, Steffen; Dündar, Friederike; Manke, Thomas

2016-07-08

We present an update to our Galaxy-based web server for processing and visualizing deeply sequenced data. Its core tool set, deepTools, allows users to perform complete bioinformatic workflows ranging from quality controls and normalizations of aligned reads to integrative analyses, including clustering and visualization approaches. Since we first described our deepTools Galaxy server in 2014, we have implemented new solutions for many requests from the community and our users. Here, we introduce significant enhancements and new tools to further improve data visualization and interpretation. deepTools continue to be open to all users and freely available as a web service at deeptools.ie-freiburg.mpg.de The new deepTools2 suite can be easily deployed within any Galaxy framework via the toolshed repository, and we also provide source code for command line usage under Linux and Mac OS X. A public and documented API for access to deepTools functionality is also available. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

deepTools: a flexible platform for exploring deep-sequencing data.

PubMed

Ramírez, Fidel; Dündar, Friederike; Diehl, Sarah; Grüning, Björn A; Manke, Thomas

2014-07-01

We present a Galaxy based web server for processing and visualizing deeply sequenced data. The web server's core functionality consists of a suite of newly developed tools, called deepTools, that enable users with little bioinformatic background to explore the results of their sequencing experiments in a standardized setting. Users can upload pre-processed files with continuous data in standard formats and generate heatmaps and summary plots in a straight-forward, yet highly customizable manner. In addition, we offer several tools for the analysis of files containing aligned reads and enable efficient and reproducible generation of normalized coverage files. As a modular and open-source platform, deepTools can easily be expanded and customized to future demands and developments. The deepTools webserver is freely available at http://deeptools.ie-freiburg.mpg.de and is accompanied by extensive documentation and tutorials aimed at conveying the principles of deep-sequencing data analysis. The web server can be used without registration. deepTools can be installed locally either stand-alone or as part of Galaxy. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

Staphylococcus aureus food-poisoning outbreak associated with the consumption of ice-cream.

PubMed

Fetsch, A; Contzen, M; Hartelt, K; Kleiser, A; Maassen, S; Rau, J; Kraushaar, B; Layer, F; Strommenger, B

2014-09-18

In April 2013, a food poisoning outbreak caused by staphylococcal enterotoxins (SEs) in ice-cream occurred in Freiburg, Germany, among the 31 participants of a christening party. Of the 13 cases, seven were hospitalized or obtained ambulatory treatment. Different types of ice-cream, which was freshly produced at the hotel where the party took place, were found to contain SE and high amounts of coagulase positive staphylococci. Enterotoxigenic Staphylococcus aureus strains isolated from ice-cream and human cases were of the same spa-type (t127), harboured the sea gene and displayed identical phenotypic resistance-, Fourier transform infrared spectroscopy- (FT-IR) and microarray-profiles. Despite the strong microbiological and epidemiological evidence of ice-cream being the incriminated food vehicle of the outbreak, a common source of S. aureus from the ice-cream could not be deduced. As none of the employees carried the outbreak strain, either the equipment used for the production of the ice-cream or a contaminated ingredient is the most likely introduction source. Copyright © 2014 Elsevier B.V. All rights reserved.

The influence of personality traits on the subjective outcome of operative hallux valgus correction.

PubMed

Radl, Roman; Leithner, Andreas; Zacherl, Maximilian; Lackner, Ursula; Egger, Josef; Windhager, Reinhard

2004-10-01

We studied prospectively the influence of personality traits on the subjective outcome of a chevron osteotomy in 42 patients with hallux valgus. The mean age of patients was 48.3 (20-70) years. Personality traits were evaluated by the means of the Freiburg Personality Inventory (FPI-R). Three months postoperatively 37 patients were satisfied, and five patients not satisfied with the operative procedure. The preoperative AOFAS Score improved from an average of 48.7 (30-65) points to 87.9 (50-100) points. A comparison of satisfied and dissatisfied patients revealed statistically significant differences in the personality traits aggressiveness (p=0.003), extraversion (p=0.001) and health worries (p=0.04). The postoperative hallux valgus angle was 12.2+/-7.8 degrees and 13.4+/-8.3 degrees (p=0.74) among satisfied and not satisfied patients, respectively, and the intermetatarsal angle (I-II) was 7.4+/-2.5 degrees and 7.6+/-4 degrees (p=0.89), respectively. The results suggest that the patient's subjective result after the operative correction may be influenced by some individual, personality profiles.

Extraction of Cell-Wall Polysaccharide Antigen from Streptococci

PubMed Central

Slade, Hutton D.

1965-01-01

Slade, Hutton D. (Northwestern University Medical School, Chicago, Ill., and Max-Planck Institut für Immunbiologie, Freiburg, Germany). Extraction of cell-wall polysaccharide antigen from streptococci. J. Bacteriol. 90:667–672. 1965.—The carbohydrate grouping antigens in the cell walls of streptococci belonging to groups A, E, G, L, and T were extracted with 5% trichloroacetic acid at 90 C. The antigens were removed also from dry whole cells by extraction with trichloroacetic acid followed by treatment with phenol-water. Details of the methods are presented. The antigens obtained by use of either of these procedures were suitable for studies on immunological specificity and chemical structure. Quantitative enzymatic and chemical analyses of two group E antigens and one group T preparation showed the presence of l-rhamnose (22 to 44%), d-glucose (7 to 22%), d-galactose (T antigen only, 26%), glucosamine (2 to 16%), and galactosamine (T antigen only, 3%). In addition, analyses of A and G antigen preparations are presented. The protein and phosphate content of the A and E antigens were about 1% each. Quantitative precipitin curves of these antigens are presented. PMID:16562065

The psychosocial situation of obese children: Psychological factors and quality of life

PubMed Central

Korsten-Reck, U; Korsten, K; Haeberle, K; Kromeyer-Hauschild, K; Dickhuth, H H; Schulz, E

2009-01-01

The psychosocial situation of obese children at the beginning of the Freiburg Intervention Trial for Obese Children (FITOC) program influences the course and outcome of intervention therapy. At the beginning of FITOC, mothers of 30 children (12 ♂ age 10.5 ± 1.4, 18 ♀; 10.2 ± 1.3) rated the psychopathological symptoms using the Child Behavior Checklist (CBCL) and the quality of life of their children (Inventar zur Erfassung der Lebensqualität [ILK]). 46.6% of mothers rated their children to be disturbed (normal population group, 2% disturbed). There was no correlation between the body mass index of the child and the CBCL score. On the ILK, the obese children themselves selected “good” while the mother’s view of their childrens’ quality of life varied around “poor”. The stress on the mother increased with the degree of the child’s obesity and number of critical life events (p = 0.030). The CBCL and the ILK at the beginning of treatment serve as a good screening instrument for psychopathology and distress in children with obesity. PMID:22110318

The relationship between yoga involvement, mindfulness and psychological well-being.

PubMed

Gaiswinkler, L; Unterrainer, H F

2016-06-01

The aim of this study was to examine how different levels of yoga involvement are related to different parameters of mental health and illness. A total sample of 455 participants (410 females) were investigated by means of an internet survey. 362 yoga practitioners (327 females) rated their degree of yoga involvement on the Yoga Immersion Scale. A control group was comprised of 93 gymnastics practitioners (83 females). All participants completed the Multidimensional Inventory for Religious/Spiritual Well-Being, the Freiburger Mindfulness Inventory and the Brief Symptom Inventory for psychiatric symptoms. Highly involved yoga practitioners exhibited a significantly increased amount of mindfulness and religious/spiritual well-being (both p<0.01) and lower psychiatric symptoms such as depression (p<0.01) compared to those who were only marginally/moderately yoga-involved or who were in the gymnastics control group. In accordance with the literature, yoga practice might have its biggest impact on mental health when it is part of a practitioner's worldview. Further research focusing on the impact of yoga involvement in clinical groups is encouraged. Copyright © 2016 Elsevier Ltd. All rights reserved.

The effects of lossy compression on diagnostically relevant seizure information in EEG signals.

PubMed

Higgins, G; McGinley, B; Faul, S; McEvoy, R P; Glavin, M; Marnane, W P; Jones, E

2013-01-01

This paper examines the effects of compression on EEG signals, in the context of automated detection of epileptic seizures. Specifically, it examines the use of lossy compression on EEG signals in order to reduce the amount of data which has to be transmitted or stored, while having as little impact as possible on the information in the signal relevant to diagnosing epileptic seizures. Two popular compression methods, JPEG2000 and SPIHT, were used. A range of compression levels was selected for both algorithms in order to compress the signals with varying degrees of loss. This compression was applied to the database of epileptiform data provided by the University of Freiburg, Germany. The real-time EEG analysis for event detection automated seizure detection system was used in place of a trained clinician for scoring the reconstructed data. Results demonstrate that compression by a factor of up to 120:1 can be achieved, with minimal loss in seizure detection performance as measured by the area under the receiver operating characteristic curve of the seizure detection system.

[Interpersonal attention management inventory: a new instrument to capture different self- and external perception skills].

PubMed

Blaser, Klaus; Zlabinger, Milena; Hinterberger, Thilo

2014-01-01

The Interpersonal Attention Management Inventory (IAMI) represents a new instrument to capture self- and external perception skills. The underlying theoretical model assumes 3 mental locations of attention (the intrapersonal space, the extrapersonal space, and the external intrapersonal space) of the other. The IAMI was studied regarding its factor structure; it was shortened and statistical values as well as first reference values were calculated based on a larger sample (n = 1089). By factor analysis, the superordinate scales could be widely validated. The shortened version with 31 items and 3 superordinate scales shows a high reliability of the global value (Cronbach's α = 0.81) and, regarding the convergent validity, a modest correlation (r = 0.41) of the global value and mindfulness, measured with the Freiburg Mindfulness Inventory (FMI). Further validation studies are invited so that the IAMI can be used as an instrument for (course) diagnosis in the therapy of psychiatric disorders as well as for research in social neuroscience, e.g., in investigations on mindfulness, compassion, empathy, theory of mind, and self-boundaries.

A clinical assessment of cochlear implant recipient performance: implications for individualized map settings in specific environments.

PubMed

Hey, Matthias; Hocke, Thomas; Mauger, Stefan; Müller-Deile, Joachim

2016-11-01

Individual speech intelligibility was measured in quiet and noise for cochlear Implant recipients upgrading from the Freedom to the CP900 series sound processor. The postlingually deafened participants (n = 23) used either Nucleus CI24RE or CI512 cochlear implant, and currently wore a Freedom sound processor. A significant group mean improvement in speech intelligibility was found in quiet (Freiburg monosyllabic words at 50 dB SPL ) and in noise (adaptive Oldenburger sentences in noise) for the two CP900 series SmartSound programs compared to the Freedom program. Further analysis was carried out on individual's speech intelligibility outcomes in quiet and in noise. Results showed a significant improvement or decrement for some recipients when upgrading to the new programs. To further increase speech intelligibility outcomes when upgrading, an enhanced upgrade procedure is proposed that includes additional testing with different signal-processing schemes. Implications of this research are that future automated scene analysis and switching technologies could provide additional performance improvements by introducing individualized scene-dependent settings.

Stereoacuity versus fixation disparity as indicators for vergence accuracy under prismatic stress.

PubMed

Kromeier, Miriam; Schmitt, Christina; Bach, Michael; Kommerell, Guntram

2003-01-01

Fixation disparity has been widely used as an indicator for vergence accuracy under prismatic stress. However, the targets used for measuring fixation disparity contain artificial features in that the fusional contours are thinned out. We considered that stereoacuity might be a preferable indicator of vergence accuracy, as stereo targets represent natural viewing conditions. We measured fixation disparity with a computer adaptation of Ogle's test and stereoacuity with the automatic Freiburg Stereoacuity Test. Eight subjects were examined under increasing base-in and base-out prisms. The response of fixation disparity to prismatic stress revealed the curve types described by Ogle and Crone. All eight subjects reached a stereoscopic threshold below 10 arcsec. In seven subjects the stereoscopic threshold increased before double vision occurred. Our data suggest that stereoacuity is suitable to assess the range of binocular vision under prismatic stress. As stereoacuity bears the advantage over fixation disparity in that it can be measured without introducing artificial viewing conditions, we suggest exploring whether stereoacuity under prismatic stress would be more meaningful in the work-up of asthenopic patients than is fixation disparity.

[Reddish discoloration of the vascular intima in charred bodies].

PubMed

Stiller, Dankwart; Lang, Juliane; Kleiber, Manfred; Rüdiger Lessig; Bohnert, Michael

2015-01-01

During the autopsy of fire victims, one often sees intensive reddening of the inner vascular layers resembling changes due to putrefaction. To determine the frequency of this phenomenon and the circumstances under which it occurs, in particular the presence of putrescence, signs of vitality and the extent of destruction by the fire, the fire fatalities autopsied at the Institutes of Legal Medicine in Freiburg, Halle and Würzburg were analyzed. In the concrete study, 259 fire deaths were investigated retrospectively and 21 prospectively. The study material included 191 males and 68 females aged 0 to 93 years. Vital exposure to the fire was found in 70%, perimortal exposure in 23 % and postmortem exposure in 7% of the cases. Red discoloration of the intima of the central vessels was seen in 106 victims (41%). This finding is most likely caused by postmortem heat-induced hemolysis, which occurs when the temperature in the body rises above 52 °C due to the effect of external heat. Therefore, a reddish discoloration of the intima cannot be regarded as sign of vitality.

[Coping mechanisms of police officers with mental and psychosomatic symptoms after an event of potential psychotraumatic nature].

PubMed

Schütte, Nils; Bär, Olaf; Weiss, Udo; Heuft, Gereon

2009-01-01

This prospective study analyzes the coping mechanisms of police officers directly after an event of potential traumatic nature in the line of duty (e. g. use of firearms) as well as 6 months later. 59 police officers were contacted by professional crisis intervention teams of the police force. After an extended interview, an ICD-10 diagnosis, if applicable, was assigned. Six months later a diagnosis was derived by a clinician (Diplom-Psychologe) using a structured interview. Coping strategies were accessed by the FKV (Freiburger Fragebogen zur Krankheitsverarbeitung) questionnaire. Fourteen police officers (28%) received the diagnosis of a PTSD (ICD-10: F43.1) at 6 months. The coping mechanisms of the traumatized police officers were significantly elevated in a dysfunctional manner in the areas "emotional control and social retreat" (only directly after the event), "regression", "mistrust and pessimism", and "depressive processing". Because dysfunctional coping mechanisms impede the decline of the symptoms, it may be considered adequate to strengthen the coping mechanisms for functional coping with these symptoms, thereby focusing on the dysfunctional coping strategy specific to the police force, namely, emotional control.

Energy sustainable cities. From eco villages, eco districts towards zero carbon cities

NASA Astrophysics Data System (ADS)

Zaręba, Anna; Krzemińska, Alicja; Łach, Janusz

2017-11-01

Minimizing energy consumption is the effect of sustainable design technics as among many others: designing buildings with solar access and natural ventilation, using climate responsive design materials and effective insulation. Contemporary examples of zero-carbon cities: Masdar City, United Arab Emirates and Dongtan, China, confirm technical feasibility of renewable energy by implementation of solar PV and wind technologies. The ecological city - medium or high density urban settlement separated by greenspace causes the smallest possible ecological footprint on the surrounding countryside through efficient use of land and its resources, recycling used materials and converting waste to energy. This paper investigates the concept of energy sustainable cities, examines, how urban settlements might affect building energy design in eco-villages, eco-districts (e.g. Vauban, Freiburg in Germany, Bo01 Malmo in Sweden), and discuss the strategies for achieving Zero Emission Cities principles in densely populated areas. It is focused on low energy architectural design solutions which could be incorporated into urban settlements to create ecological villages, districts and cities, designed with consideration of environmental impact, required minimal inputs of energy, water, food, waste and pollution.

Coloseminal fistula complicating sigmoid diverticulitis.

PubMed

Barret, Maximilien; Cuenod, Charles-André; Jian, Raymond; Cellier, Christophe; Berger, Anne

2014-01-01

We report on a 32-year-old man with a history of chronic lower abdominal pain and urogenital symptoms, leading to the diagnosis of coloseminal fistula complicating diverticular disease. We reviewed the literature on this rare clinical entity and would like to stress the role of pelvic imaging with rectal contrast to investigate complicated forms of diverticular disease. 2014 S. Karger AG, Basel.

The great neurosis of Dr. Joseph Gerard.

PubMed

Lefrère, Jean-Jacques; Rouillon, Frédéric

2013-01-01

The Great Neurosis, of Dr. Joseph Gerard, was published in 1889 in Paris. The book, intended for the general public, shows the different varieties of neuroses through picturesque and instructive examples. Its scientific and medical value is poor, but provides us with the various meanings of the word 'neurosis' in the late nineteenth century. Copyright © 2013 S. Karger AG, Basel.

Effect of weight loss by bariatric surgery on the risk of miscarriage.

PubMed

Merhi, Zaher O; Pal, Lubna

2007-01-01

The aim of this paper is to appraise the literature with a view to establish whether weight loss by bariatric surgery has a beneficial effect on lowering the risk of miscarriage in morbidly obese women. Literature review revealed that weight loss by bariatric surgery on miscarriage rate has not been studied enough. 2007 S. Karger AG, Basel

Rectourethral fistula following LDR brachytherapy.

PubMed

Borchers, Holger; Pinkawa, Michael; Donner, Andreas; Wolter, Timm P; Pallua, Norbert; Eble, Michael J; Jakse, Gerhard

2009-01-01

Modern LDR brachytherapy has drastically reduced rectal toxicity and decreased the occurrence of rectourethral fistulas to <0.5% of patients. Therefore, symptoms of late-onset sequelae are often ignored initially. These fistulas cause severe patient morbidity and require interdisciplinary treatment. We report on the occurrence and management of a rectourethral fistula which occurred 4 years after (125)I seed implantation. Copyright 2009 S. Karger AG, Basel.

The instrumental phase of the voice program at the Utrecht school of acting.

PubMed

Schrama, Els

2008-01-01

What skills does a performer need in order to be able to say their lines on stage? What is the input of an actor to be audible and have a lively voice filled with imagination? To train the professional performer, we need to know the purpose and the way to arrive there. Copyright 2008 S. Karger AG, Basel.

Poor Rigor and Political Obduracy: Which Is the Horse and Which Is the Cart in Social Work Education?

ERIC Educational Resources Information Center

Felkner, William J.

2009-01-01

Stoesz and Karger contend that the Council on Social Work Education (CSWE) accreditation has poorly served the profession by perpetuating an environment of low standards epitomized by the very leaders responsible for the credibility of social work as an academic discipline. Graduates are "ill-prepared" and what qualifies as scholarship in the…

Predicting the Optical Properties of the West Florida Shelf: Resolving the Potential Impacts of a Terrestrial Boundary Condition on the Distribution of Colored Dissolved and Particulate Matter

DTIC Science & Technology

2004-12-08

Emiliania huxleyi (Haptophyceae): 19’ hexanoylox- measurements of organic matter and chlorophyll fluorescence in yfucoxanthin as antenna pigment. Journal of...M.B., Miiller-Karger, F.E., and the prymnesiophyte Emiliania huxleyi. Marine Ecology. 1989. Nitrogen exchange at the continental margin: a numerical

Femoral Access and Delivery of Continuous Renal Replacement Therapy Dose.

PubMed

Bellomo, Rinaldo; Mårtensson, Johan; Lo, Serigne; Kaukonen, Kirsi-Maija; Cass, Alan; Gallagher, Martin

2016-01-01

The study aims to describe the use of dialysis catheters in critically ill patients treated with continuous renal replacement therapy (CRRT) and to study the impact of femoral versus non-femoral access on CRRT dose. Statistical analysis and predictive modelling of data from the Randomized Evaluation of Normal vs. Augmented Level renal replacement therapy trial. The femoral vein was the first access site in 937 (67%) of 1,399 patients. These patients had higher Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores (p = 0.009) and lower pH (p < 0.001) but similar mortality to patients with non-femoral access (44 vs. 45%; p = 0.63). Lower body weight was independently associated with femoral access placement (OR 0.97, 95% CI 0.96-0.98). Femoral access was associated with a 1.03% lower CRRT dose (p = 0.05), but a 4.20% higher dose was achieved with 13.5 Fr catheters (p = 0.03). Femoral access was preferred in lighter and sicker patients. Catheter gauge had greater impact than catheter site in CRRT dose delivery. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=439581. © 2015 S. Karger AG, Basel.

The influence of religious moral beliefs on adolescents' mental stability.

PubMed

Pajević, Izet; Hasanović, Mevludin; Delić, Amra

2007-09-01

The aim of this paper is to determine the influence of religious moral beliefs on the stability of adolescents' mental health. The sample consists of 240 mentally and physically healthy male and female adolescents attending a high school, who are divided into groups equalized by gender (male and female), age (younger 15, older 18 years); school achievement (very good, average student); behaviour (excellent, average); family structure (complete family with satisfactory family relations), and level of exposure to psycho-social stress (they were not exposed to specific traumatizing events). Subjects were assessed with regard to the level of belief in some basic ethical principles that arise from religious moral values. The score of religious moral belief index was used to compare two groups of subjects. For sample selection the measuring instruments were used to assess the religious, moral and social profile of subject. For the assessment of personality structure a standardized test battery (Freiburg's Personality Questionnaire/ Das Freiburger Personlichkeitsinventar - FPI, Profile Index of Emotions - PIE, Life Style Questionnaire - OM) was used to assess personality profile, emotional profile and subject's defence orientation. The score of the moral belief index was negatively correlated to neuroticism and depressiveness (Pearson's r=-0.242, P<0.001; r=-0.311, P<0.001, respectively). Spontaneous and reactive aggressiveness and irritability were negatively correlated with the score of moral belief index (Pearson's r=-0.197, P=0.002; r=-0.147, P=0.023; r=-0.350, P<0.001, respectively). Emotional instability is negatively associated with the moral belief index of the investigated adolescents (Pearson's r=-0.324, P<0.001). The moral belief index was highly negatively correlated with repression (r=-0.206, P=0.001), regression (r=-0.325, P<0.001), compensation (r=-0.186, P=0.004), transfer (r=-0.290, P<0.001) and defensive orientation (r=-0.129, P=0.046). Verified intellectualisation and reactive formation are in positive correlation with the moral belief index among our investigated adolescents (Pearson's r=0.168, P=0.009; r=0.356; P<0.001, respectively). A higher index of religious moral beliefs in adolescents enables better control of impulses, providing better mental health stability. It enables neurotic conflicts typical for adolescence to be more easily overcome. It also causes healthier reactions to external stimuli. A higher index of religious moral beliefs of young people provides a healthier and more efficient mechanism of anger control and aggression control. It enables transformation of that psychical energy into neutral energy which supports the growth and development of personality, which is expressed through socially acceptable behaviour. In this way, it helps growth, development and socialization of the personality, leading to the improvement in mental health.

Veneered zirconia inlay-retained fixed dental prostheses: 10-Year results from a prospective clinical study.

PubMed

Rathmann, Friederike; Bömicke, Wolfgang; Rammelsberg, Peter; Ohlmann, Brigitte

2017-09-01

The purpose of this study was to evaluate the 10-year clinical performance of zirconia-based inlay-retained fixed dental prostheses (IRFDP). For replacement of a molar in 27 patients, 30 IRFDP were luted by use of different cements, Panavia F (Kuraray Europe GmbH) or Multilink Automix (Ivoclar Vivadent GmbH), with use of inlay/inlay, inlay/full-crown, or inlay/partial-crown retainers for anchorage. Frameworks were milled from yttria-stabilized zirconia (IPS e.maxZirCAD; Ivoclar Vivadent GmbH) and fully veneered with pressable ceramic (IPS e.max ZirPress; Ivoclar Vivadent GmbH). Before luting, the IRFDP were silica-coated (Rocatec; 3M Espe) and silanized (Monobond S; Ivoclar Vivadent GmbH). Complications (for example, chipping or delamination of the veneering ceramic, debonding, secondary caries, endodontic treatment, and abutment tooth fracture) and failure were reported, by use of standardized report forms, 2 weeks, 6 months, and 1, 2, and 10 years after cementation. Statistical analysis included Kaplan-Meier survival and success (complication-free survival) and Cox regression analysis (α=0.05 for all). During the 10-year observation period, the complications most often observed were chipping of the veneer and debonding. Twenty-five restorations failed and one participant dropped out. Cumulative 10-year survival and success were 12.1% and 0%, respectively. The design of the retainer, use of a dental dam, choice of cement, and location in the dental arch had no statistically significant effect on the occurrence of complications. Use of fully veneered zirconia-based IRFDP with this technique cannot be recommended. A large incidence of complications and poor survival were observed for fully veneered zirconia-based IRFDP, revealing an urgent need for further design improvements for this type of restoration. This, again, emphasizes the need for testing of new restoration designs in clinical trials before implementation in general dental practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Recent developments of advanced structures for space optics at Astrium, Germany

NASA Astrophysics Data System (ADS)

Stute, Thomas; Wulz, Georg; Scheulen, Dietmar

2003-12-01

The mechanical division of EADS Astrium GmbH, Friedrichshafen Germany, the former Dornier Satellitensystem GmbH is currently engaged with the development, manufacturing and testing of three different advanced dimensionally stable composite and ceramic material structures for satellite borne optics: -CFRP Camera Structure -Planck Telescope Reflectors -NIRSpec Optical Bench Breadboard for James Web Space Telescope The paper gives an overview over the requirements and the main structural features how these requirements are met. Special production aspects and available test results are reported.

Retinal Biochemistry, Physiology and Cell Biology.

PubMed

Smith, Ricardo Luiz; Sivaprasad, Sobha; Chong, Victor

2016-01-01

The vitreous, the vasculature of the retina, macular pigments, phototransduction, retinal pigment epithelium, Bruch's membrane and the extracellular matrix, all play an important role in the normal function of the retina as well as in diseases. Understanding the pathophysiology allows us to target treatment. As ocular angiogenesis, immunity and inflammation are covered elsewhere, those subjects will not be discussed in this chapter. © 2016 S. Karger AG, Basel.

Prevention of Cystitis: Travelling between the Imaginary and Reality.

PubMed

Vecchio, Mariacristina; Iroz, A; Seksek, I

2018-01-01

As a preventive strategy, increased water intake is often recommended to women affected by recurrent cystitis; however, clinical data are sparse and conflicting. This review evaluates the preventive approaches used as alternatives to obtain relief from the burden of cystitis and focuses on the effect of fluid intake on urinary tract infection. © 2018 The Author(s) Published by S. Karger AG, Basel.

Modulators and inhibitors of gamma- and beta-secretases.

PubMed

Schmidt, Boris; Baumann, Stefanie; Narlawar, Rajeshwar; Braun, Hannes A; Larbig, Gregor

2006-01-01

Most gene mutations associated with Alzheimer's disease point to the metabolism of amyloid precursor protein as a potential cause. The beta- and gamma-secretases are two executioners of amyloid precursor protein processing resulting in amyloid-beta. Significant progress has been made in the selective inhibition of both proteases, regardless of structural information for gamma-secretase. Several peptidic and nonpeptidic leads were identified for both targets. Copyright 2006 S. Karger AG, Basel.

Androgen deprivation treatment of sexual behavior.

PubMed

Houts, Frederick W; Taller, Inna; Tucker, Douglas E; Berlin, Fred S

2011-01-01

Gonadotropin-releasing hormone agonists are underutilized in patients seeking diminution of problematic sexual drives. This chapter reviews the literature on surgical castration of sex offenders, anti-androgen use and the rationale for providing androgen deprivation therapy, rather than selective serotonin reuptake inhibitors or more conservative interventions, for patients with paraphilias and excessive sexual drive. Discussions of informed consent, side effects, contraindications and case examples are provided. Copyright © 2011 S. Karger AG, Basel.

Congenital intraosseous cavernous hemangioma of the skull: an unusual case.

PubMed

Rumana, Makhdoomi; Khursheed, Nayil; Farhat, Mustafa; Othman, Salim; Masood, Laharwal

2013-01-01

Intraosseous hemangiomas are benign vascular malformations mostly seen in the spine. They rarely occur in the skull. The usual age-group involved is the 2nd to 4th decades, and females outnumber males. We hereby report a rare case of congenital intraosseous cavernous hemangioma of the skull bone in a male infant. The patient underwent total excision of the lesion. © 2014 S. Karger AG, Basel.

Salivary gland disease.

PubMed

Thomas, Bethan L; Brown, Jackie E; McGurk, Mark

2010-01-01

Salivary gland disease covers a wide range of pathological entities, including salivary gland-specific disease, as well as manifestations of systemic diseases. This chapter discusses the recent advances in managing obstructive salivary gland disease, the move from gland excision to gland preservation, the dilemmas in diagnosing and managing tumours of the salivary glands, and the international data collection to understand the aetiology and progression of Sjögren's disease. Copyright 2010 S. Karger AG, Basel.

Patients' health beliefs and coping prior to autologous peripheral stem cell transplantation.

PubMed

Frick, E; Fegg, M J; Tyroller, M; Fischer, N; Bumeder, I

2007-03-01

The aim of this study was to determine the associations between health locus of control (LoC), causal attributions and coping in tumour patients prior to autologous peripheral blood stem cell transplantation. Patients completed the Questionnaire of Health Related Control Expectancies, the Questionnaire of Personal Illness Causes (QPIC), and the Freiburg Questionnaire of Coping with Illness. A total of 126 patients (45% women; 54% suffering from a multiple myeloma, 29% from non-Hodgkin lymphomas, and 17% from other malignancies) participated in the study. Cluster analysis yielded four LoC clusters: 'fatalistic external', 'powerful others', 'yeah-sayer' and 'double external'. Self-blaming QPIC items were positively correlated with depressive coping, and 'fate or destiny' attributions with religious coping (P<0.001). The highest scores were found for 'active coping' in the LoC clusters 'powerful others' and 'yeah-sayer'. External LoC and an active coping style prevail before undergoing autologous peripheral blood stem cell transplantation, whereas the depressive coping is less frequent, associated with self-blaming causal attributions. Health beliefs include causal and control attributions, which can improve or impair the patient's adjustment. A mixture between internal and external attributions seems to be most adaptive.

Personality, depression, and premorbid lifestyle in twin pairs discordant for Parkinson's disease

PubMed Central

Heberlein, I.; Ludin, H.; Scholz, J.; Vieregge, P.

1998-01-01

Present personality traits (Freiburg personality inventory, FPI-R), depression (von Zerssen's depression scale), and self assessed state of health were evaluated in 15 twin pairs (six monozygotic and nine dizygotic; mean age 62.5 years) discordant for idiopathic Parkinson's disease and in 17 unrelated healthy control subjects. The twins had additional questionnaire based interviews on premorbid lifestyle.
For disability, twins with Parkinson's disease scored lower on FPI-R than controls in "achievement orientation" and "extraversion", higher in "inhibitedness", "somatic complaints", and "emotionality". They scored higher for depression and for state of health than unaffected twins and controls. For zygosity, monozygotic twins scored lower than dizygotic twins in "achievement orientation", "aggressiveness", and "strain". Monozygotic twins had less "achievement orientation" and "extraversion" and more "somatic complaints" than controls. Monozygotic twins had a lower within pair difference than dizygotic twins in "social orientation". During premorbid times the affected twin with later Parkinson's disease was estimated to have been "less often the leader" in the twin pair.
Although small in sample size, this twin study indicates a genetic impact for some personality features beyond the Parkinson's disease motor syndrome.

 PMID:9489545

Effect of the thermoplastic masks on dose distribution in the build-up region for photon beams

NASA Astrophysics Data System (ADS)

Półtorak, Michał; Fujak, Edyta; Kukołowicz, Paweł

2016-03-01

The aim of the study was to investigate the influence of thermoplastic masks material (Klarity Medical&Equipment Co., Guangzhou, China) with different diameters of holes (ϕ 0.25 cm and ϕ 0.40 cm) on the dose distribution in the build-up region for photon beams. Measurements were made for external radiation beams produced by the linear accelerator (TrueBeam, Varian Medical Systems, Inc., Palo Alto, CA, USA) using the Markus parallel plane ionization chamber and the Unidos electrometer (both from PTW, Freiburg, Germany). Measurements were made in a solid water phantom for two photon energies 6 MV and 15 MV, at 90 cm source to skin distance, for four fields of 5 cm × 5 cm, 10 cm × 10 cm, 15 cm × 15 cm and 20 cm × 20 cm. Compared to the open field, the maximum dose with mask was closer to the surface of the phantom by about 1.4 mm and 1.2 mm for 6 MV and 15 MV X-Rays, respectively. The surface dose increase from 10% to 42% for 6 MV and from 5% to 28% for 15 MV X-Rays.

INFO-RNA--a fast approach to inverse RNA folding.

PubMed

Busch, Anke; Backofen, Rolf

2006-08-01

The structure of RNA molecules is often crucial for their function. Therefore, secondary structure prediction has gained much interest. Here, we consider the inverse RNA folding problem, which means designing RNA sequences that fold into a given structure. We introduce a new algorithm for the inverse folding problem (INFO-RNA) that consists of two parts; a dynamic programming method for good initial sequences and a following improved stochastic local search that uses an effective neighbor selection method. During the initialization, we design a sequence that among all sequences adopts the given structure with the lowest possible energy. For the selection of neighbors during the search, we use a kind of look-ahead of one selection step applying an additional energy-based criterion. Afterwards, the pre-ordered neighbors are tested using the actual optimization criterion of minimizing the structure distance between the target structure and the mfe structure of the considered neighbor. We compared our algorithm to RNAinverse and RNA-SSD for artificial and biological test sets. Using INFO-RNA, we performed better than RNAinverse and in most cases, we gained better results than RNA-SSD, the probably best inverse RNA folding tool on the market. www.bioinf.uni-freiburg.de?Subpages/software.html.

[New aspects of complex chronic tinnitus. II: The lost silence: effects and psychotherapeutic possibilities in complex chronic tinnitus].

PubMed

Goebel, G; Keeser, W; Fichter, M; Rief, W

1991-01-01

"Complex tinnitus" is a diagnostic term denoting a disturbance pattern where the patient hears highly annoying and painful noises or sounds that do not originate from a recognisable external source and can be described only by the patient himself. It seems that the suffering mainly depends upon the extent to which the tinnitus is experienced as a phenomenon that is beyond control. Part I reports on an examination of the treatment success achieved with 28 consecutive patients who had been treated according to an integrative multimodal behavioural medicine concept. This resulted--despite continual loudness--in a decrease in the degree of unpleasantness of the tinnitus, by 17% (p less than 0.01) with corresponding normalisation of decisive symptom factors in Hopkins-Symptom-Check-List (SCL-90-R) and Freiburg Personality-Inventary (FPI-R). On the whole, 19 out of the total of 28 patients showed essential to marked improvement of the disturbance pattern. Part II presents a multidimensional tinnitus model and the essential psychotherapeutic focal points of a multimodal psychotherapy concept in complex chronic tinnitus, as well as the parallel phenomena in the chronic pain syndrome.

[New aspects of complex chronic tinnitus. I: Assessment of a multi-modality behavioral medicine treatment concept].

PubMed

Goebel, G; Keeser, W; Fichter, M; Rief, W

1991-01-01

"Complex tinnitus" is a diagnostic term denoting a disturbance pattern where the patient hears highly annoying and painful noises or sounds that do not originate from a recognisable external source and can be described only by the patient himself. It seems that the suffering mainly depends upon the extent to which the tinnitus is experienced as a phenomenon that is beyond control. Part I reports on an examination of the treatment success achieved with 28 consecutive patients who had been treated according to an integrative multimodal behavioural medicine concept. This resulted--despite continual loudness--in a decrease in the degree of unpleasantness of the tinnitus, by 17% (p less than 0.01) with corresponding normalisation of decisive symptom factors in Hopkins Symptom-Check-List (SCL-90-R) and Freiburg Personality-Inventary (FPI-R). On the whole, 19 out of the total of 28 patients showed essential to marked improvement of the disturbance pattern. Part II presents a multidimensional tinnitus model and the essential psychotherapeutic focal points of a multimodal psychotherapy concept in complex chronic tinnitus, as well as the parallel phenomena in the chronic pain syndrome.

[Possibilities for Universities to Influence Global Pricing of Medicines].

PubMed

Jaehn, Philipp; Inhoffen, Johannes; Scheer, Jana; Streicher, Felix; Gesine Huhn, Anna; Lance, Christopher

2017-07-01

People in countries of the global south are affected by a unique spectrum of diseases, while costs for health care are a huge burden in the context of poverty. Furthermore, non-communicable diseases increasingly play a role in these countries. The management of translational research, potential clinical applications and marketing of new drugs in Germany is thus getting more and more important for global health. Regarding this, universities have a particular responsibility for two reasons. First, through basic research, they contribute significantly to the development of new medicines. Second, the university is a public institution and has thus the responsibility to return the gained knowledge to the public. Marketing of publicly funded innovations should provide benefits to patients in wealthy and poor countries alike. As a first step towards this goal, we demand the introduction of a globally responsible licensing policy at German universities. Different mechanisms which have been described in the German speaking areas such as "Equitable Licensing" provide a basis for the realization of this ambitious aim and have been introduced successfully at the universities of Muenster, Tuebingen and Freiburg. © Georg Thieme Verlag KG Stuttgart · New York.

Assessment of Somatization and Medically Unexplained Symptoms in Later Life

PubMed Central

van Driel, T. J. W.; Hilderink, P. H.; Hanssen, D. J. C.; de Boer, P.; Rosmalen, J. G. M.; Oude Voshaar, R. C.

2017-01-01

The assessment of medically unexplained symptoms and “somatic symptom disorders” in older adults is challenging due to somatic multimorbidity, which threatens the validity of somatization questionnaires. In a systematic review study, the Patient Health Questionnaire–15 (PHQ-15) and the somatization subscale of the Symptom Checklist 90-item version (SCL-90 SOM) are recommended out of 40 questionnaires for usage in large-scale studies. While both scales measure physical symptoms which in younger persons often refer to unexplained symptoms, in older persons, these symptoms may originate from somatic diseases. Using empirical data, we show that PHQ-15 and SCL-90 SOM among older patients correlate with proxies of somatization as with somatic disease burden. Updating the previous systematic review, revealed six additional questionnaires. Cross-validation studies are needed as none of 46 identified scales met the criteria of suitability for an older population. Nonetheless, specific recommendations can be made for studying older persons, namely the SCL-90 SOM and PHQ-15 for population-based studies, the Freiburg Complaint List and somatization subscale of the Brief Symptom Inventory 53-item version for studies in primary care, and finally the Schedule for Evaluating Persistent Symptoms and Somatic Symptom Experiences Questionnaire for monitoring treatment studies. PMID:28745072

Children's Sleep Comic: development of a new diagnostic tool for children with sleep disorders.

PubMed

Schwerdtle, Barbara; Kanis, Julia; Kahl, Lena; Kübler, Andrea; Schlarb, Angelika A

2012-01-01

A solid diagnosis of sleep disorders in children should include both self-ratings and parent ratings. However, there are few standardized self-assessment instruments to meet this need. The Children's Sleep Comic is an adapted version of the unpublished German questionnaire "Freiburger Kinderschlafcomic" and provides pictures for items and responses. Because the drawings were outdated and allowed only for qualitative analysis, we revised the comic, tested its applicability in a target sample, and suggest a procedure for quantitative analysis. All items were updated and pictures were newly drawn. We used a sample of 201 children aged 5-10 years to test the applicability of the Children's Sleep Comic in young children and to run a preliminary analysis. The Children's Sleep Comic comprises 37 items covering relevant aspects of sleep disorders in children. Application took on average 30 minutes. The procedure was well accepted by the children, as reflected by the absence of any dropouts. First comparisons with established questionnaires indicated moderate correlations. The Children's Sleep Comic is appropriate for screening sleep behavior and sleep problems in children. The interactive procedure can foster a good relationship between the investigator and the child, and thus establish the basis for successful intervention if necessary.

Influence of air contaminants on planar, self-breathing hydrogen PEM fuel cells in an outdoor environment

NASA Astrophysics Data System (ADS)

Biesdorf, Johannes; Zamel, Nada; Kurz, Timo

2014-02-01

In this study, the effects of air contaminants on the operation of air-breathing fuel cells in an outdoor environment are investigated. For this purpose, a unique testing platform, which allows continuous operation of 30 cells at different locations, was developed. Three of these testing platforms were placed at different sites in Freiburg im Breisgau, Germany, with high variances of weather and pollution patterns. These locations range from a highly polluted place next to a busy highway to a location with virtually pure air at an altitude of 1205 m. The fuel cells were tested at all sites for over 4500 h in continuous operation. The degradation of the cells due to air pollutants was measured as a voltage decrease for three different operation loads and membranes from two different manufactures. As the temperature of the fuel cells has not been regulated, the irreversible degradation of the cell voltages could not be isolated from the dominant influence of the temperature in the raw data. With the use of the measured data, the impact of real mixtures of air contaminants was observed to be mainly reversible.

Premature Discontinuation of Prospective Clinical Studies Approved by a Research Ethics Committee - A Comparison of Randomised and Non-Randomised Studies.

PubMed

Blümle, Anette; Schandelmaier, Stefan; Oeller, Patrick; Kasenda, Benjamin; Briel, Matthias; von Elm, Erik

2016-01-01

Premature discontinuation of clinical studies affects about 25% of randomised controlled trials (RCTs) which raises concerns about waste of scarce resources for research. The risk of discontinuation of non-randomised prospective studies (NPSs) is yet unclear. To compare the proportion of discontinued studies between NPSs and RCTs that received ethical approval. We systematically surveyed prospective longitudinal clinical studies that were approved by a single REC in Freiburg, Germany between 2000 and 2002. We collected study characteristics, identified subsequent publications, and surveyed investigators to elucidate whether a study was discontinued and, if so, why. Of 917 approved studies, 547 were prospective longitudinal studies (306 RCTs and 241 NPSs). NPSs were on average smaller than RCTs, more frequently single centre and pilot studies, and less frequently funded by industry. NPSs were less frequently discontinued than RCTs: 32/221 (14%) versus 78/288 (27%, p<0.001, missing data excluded). Poor recruitment was the most frequent reason for discontinuation in both NPSs (36%) and RCTs (37%). Compared to RCTs, NPSs were at lower risk for discontinuation. Measures to reliably predict, sustain, and stimulate recruitment could prevent discontinuation of many RCTs but also of some NPSs.

Correlates and Predictors of Resilience among Baccalaureate Nursing Students.

PubMed

Mathad, Monali Devaraj; Pradhan, Balaram; Rajesh, Sasidharan K

2017-02-01

A growing body of literature recognizes the importance of resilience in the nursing profession. Both mindfulness and resilience aid in handling stress, stress increases the risk of rumination and/or worry especially in females and they are more empathetic than other healthcare students. To identify correlates and predictors of the resilience among nursing students. This is a descriptive correlation study and we have recruited 194 participants (1-4 th year B.Sc Nursing) from Government College of Nursing and NIMHANS College of Nursing in Bangalore, India. The following instruments were used to collect the data, Freiburg Mindfulness Inventory (FMI), Toronto Empathy Questionnaire (TEQ), Perseverative Thinking Questionnaire (PTQ) and Connor-Davidson Resilience Scale (CD-RISC). Data was analysed using Pearson's correlation test and multiple regression analysis. Resilience is significantly correlated with mindfulness, perseverative thinking and empathy in nursing students. Based on regression analysis this model accounted for almost 33% of variance in resilience. This result is of interest as mindfulness alone explained 23% of the variance and unproductive Repeated Negative Thinking (RNT) and RNT consuming mental capacity predicted 8% and 2% respectively. These results support the importance of resilience and mindfulness in nursing students. Hence, resilience and/or mindfulness enhancing interventions should be inculcated in nursing education.

[Integration of the radiotherapy irradiation planning in the digital workflow].

PubMed

Röhner, F; Schmucker, M; Henne, K; Momm, F; Bruggmoser, G; Grosu, A-L; Frommhold, H; Heinemann, F E

2013-02-01

At the Clinic of Radiotherapy at the University Hospital Freiburg, all relevant workflow is paperless. After implementing the Operating Schedule System (OSS) as a framework, all processes are being implemented into the departmental system MOSAIQ. Designing a digital workflow for radiotherapy irradiation planning is a large challenge, it requires interdisciplinary expertise and therefore the interfaces between the professions also have to be interdisciplinary. For every single step of radiotherapy irradiation planning, distinct responsibilities have to be defined and documented. All aspects of digital storage, backup and long-term availability of data were considered and have already been realized during the OSS project. After an analysis of the complete workflow and the statutory requirements, a detailed project plan was designed. In an interdisciplinary workgroup, problems were discussed and a detailed flowchart was developed. The new functionalities were implemented in a testing environment by the Clinical and Administrative IT Department (CAI). After extensive tests they were integrated into the new modular department system. The Clinic of Radiotherapy succeeded in realizing a completely digital workflow for radiotherapy irradiation planning. During the testing phase, our digital workflow was examined and afterwards was approved by the responsible authority.

Surface monitoring of microseismicity at the Decatur, Illinois, CO2 sequestration demonstration site

USGS Publications Warehouse

Kaven, Joern; Hickman, Stephen H.; McGarr, Arthur F.; Ellsworth, William L.

2015-01-01

Sequestration of CO2 into subsurface reservoirs can play an important role in limiting future emission of CO2 into the atmosphere (e.g., Benson and Cole, 2008). For geologic sequestration to become a viable option to reduce greenhouse gas emissions, large-volume injection of supercritical CO2 into deep sedimentary formations is required. These formations offer large pore volumes and good pore connectivity and are abundant (Bachu, 2003; U.S. Geological Survey Geologic Carbon Dioxide Storage Resources Assessment Team, 2013). However, hazards associated with injection of CO2 into deep formations require evaluation before widespread sequestration can be adopted safely (Zoback and Gorelick, 2012). One of these hazards is the potential to induce seismicity on pre-existing faults or fractures. If these faults or fractures are large and critically stressed, seismic events can occur with magnitudes large enough to pose a hazard to surface installations and, possibly more critical, the seal integrity of the cap rock. The Decatur, Illinois, carbon capture and storage (CCS) demonstration site is the first, and to date, only CCS project in the United States that injects a large volume of supercritical CO2 into a regionally extensive, undisturbed saline formation. The first phase of the Decatur CCS project was completed in November 2014 after injecting a million metric tons of supercritical CO2 over three years. This phase was led by the Illinois State Geological Survey (ISGS) and included seismic monitoring using deep borehole sensors, with a few sensors installed within the injection horizon. Although the deep borehole network provides a more comprehensive seismic catalog than is presented in this paper, these deep data are not publically available. We contend that for monitoring induced microseismicity as a possible seismic hazard and to elucidate the general patterns of microseismicity, the U.S. Geological Survey (USGS) surface and shallow borehole network described below provides an adequate event detection threshold. The formation targeted for injection is the Mount Simon Sandstone, which is laterally extensive, has high porosity and permeability and has the potential to host future CCS projects due to its favorable hydrologic characteristics and proximity to industrial sources of CO2 (Birkholzer and Zhou, 2009). At Decatur, CO2, a byproduct of ethanol production at the Archer Daniels Midland (ADM) facility, is compressed to supercritical state and injected at 2.1 km depth into the 460 m thick Mount Simon Sandstone. This sandstone has varying properties, ranging from the lower, fine- to coarse-grained sandstone with high permeability and porosity, to the middle and upper Mount Simon, which consist of planar, cross-bedded layers of varied permeability and porosity (Leetaru and Freiburg, 2014). The changes in permeability and porosity within the Mount Simon Sandstone, due to depositional and diagenetic differences, create horizontal baffles, which inhibit vertical flow and restrict the injected CO2 to remain near the injection horizon (Bowen et al., 2011). The lowest portion of the Mount Simon Sandstone overlying the Precambrian rhyolite basement is the Pre-Mount Simon interval, generally  < 15 m in thickness and composed of fine- to medium-grain size sandstone that is highly deformed (Leetaru and Freiburg, 2014). The basement rhyolite has a clayrich matrix and is fractured, with significant alterations within the fractures. The primary sealing cap rock is the Eau Claire Formation, a 100–150 m thick unit at a depth of roughly 1.69 km (Leetaru and Freiburg, 2014). The Maquoketa Shale Group and the New Albany Shale serve as secondary and tertiary seals at shallower depths of ∼820 and ∼650 m, respectively. The ISGS managed the Illinois Basin–Decatur Project (IBDP), a three-year project beginning in November 2011, during which carbon dioxide was injected at a rate of ∼1000 metric tons per day until November 2014 (Finley et al., 2011, 2013). ADM manages the Illinois Industrial CCS (ICCS) project, which will inject ∼3000 metric tons/day into a second injection well starting in the summer of 2015. The USGS began monitoring microseismicity with a 13- station seismic network at Decatur in July 2013 (Fig. 1). This network provides good detection capabilities and azimuthal (focal sphere) coverage for microseismicity with moment magnitudes (Mw) above about −0:5. Here, we report on 19 months of microseismicity monitoring at the Decatur CO2 sequestration site, which permits a detailed look at the evolution and character of injection-induced seismicity.

Magnetic Resonance Elastography Demonstrating Low Brain Stiffness in a Patient with Low-Pressure Hydrocephalus: Case Report.

PubMed

Olivero, William C; Wszalek, Tracey; Wang, Huan; Farahvar, Arash; Rieth, Sandra M; Johnson, Curtis L

2016-01-01

The authors describe the case of a 19-year-old female with shunted aqueductal stenosis who presented with low-pressure hydrocephalus that responded to negative pressure drainage. A magnetic resonance elastography scan performed 3 weeks later demonstrated very low brain tissue stiffness (high brain tissue compliance). An analysis of the importance of this finding in understanding this rare condition is discussed. © 2016 S. Karger AG, Basel.

Widespread eosinophilic pustular folliculitis in a nonimmunocompromised patient.

PubMed

Almodovar-Real, Ana; Molina-Leyva, Alejandro; Espiñeira-Carmona, María Jose; Ríos-Pelegrina, Rosa; Naranjo-Sintes, Ramón; Husein El-Ahmed, Husein

2014-01-01

We present a case of eosinophilic pustular folliculitis, a rare dermatosis which is often associated with HIV infection or internal malignancies. We report the case of a 66-year-old man with a medical history of hypertension. Histopathological examination showed a dense follicular inflammatory infiltrate with abundant eosinophils. The clinical response to indomethacin was excellent with no recurrence during the follow-up. The patient responded well to indomethacin treatment. © 2014 S. Karger AG, Basel.

Subtotal Occlusion of Left Anterior Coronary Artery in a Professional Athlete.

PubMed

Stamatopoulos, Panagiotis G; Dangas, George; Tsarouhas, Konstantinos; Ziogas, George; Tsitsimpikou, Christina; Stamatopoulos, Georgios; Chrousos, George

2018-06-13

Screening for cardiovascular disease in athletes is crucial to avoid life-threatening complications. Here, we present the case of a fairly asymptomatic young professional soccer player with several cardiovascular risk factors, who proved to have significant coronary artery disease on coronary computed tomography which was ordered based on clinical suspicion and his family history. Informed consent for publication was obtained from the patient. © 2018 S. Karger AG, Basel.

Chelating agents.

PubMed

Bergan, T; Klaveness, J; Aasen, A J

2001-01-01

The antibacterial activity of metal ions, metal chelates, and molecules with chelating ability for polyvalent cations have been evaluated. The chelator N, N'-ethylenebis[2-(2-hydroxyphenyl)-glycine] (EHPG) exerted moderate-to-good activity against isolates of pathogenic bacteria and fungi. Other chelating agents such as ethylenediamine-tetraacetic acid (EDTA) and diethylene-triamine-pentaacetic acid (DTPA) revealed weak-to-moderate activity. Metal chelation of ligands reduced the activity of EDTA and DTPA. Copyright 2001 S. Karger AG, Basel

Bronchial Aspiration of Capsule Endoscope.

PubMed

Buscot, Matthieu; Leroy, Sylvie; Pradelli, Johanna; Chaabane, Nouha; Hebuterne, Xavier; Marquette, Charles-Hugo; Filippi, Jerôme

2017-01-01

Capsule endoscope aspiration is an increasingly reported complication, potentially responsible for respiratory distress and asphyxia. This adverse event is primarily managed by rigid bronchoscopy when spontaneous expulsion does not occur. This complication is all the more detrimental to patients as it can delay or jeopardize further digestive exploration. We report direct repositioning of the capsule in the stomach at the same time as bronchoscopy, thus making second-line gastrointestinal endoscopy needless. © 2017 S. Karger AG, Basel.

European Materials Research Society Spring Meeting, E-MRS 󈨦 Scientific/Technical Symposia and Exhibition, Held in Congress Center - Palais de la Musique et des Congres - Strasbourg, France on June 16-19, 1998.

DTIC Science & Technology

1998-06-01

MICROPROCES- SING, H.-J. Kahlert and B. Burghardt, MicroLas Lasersystem GmbH, Robert- Bosch - Breite 10, 37079 Göttingen, Germany G-V2 14-30-14:45...Inst.f Phys. Chem., Univ. Göttingen, Tammannstr. 6, 37077 Göttingen, Germany, * present address: MicroLas Lasersystem GmbH, Robert- Bosch -Breite 10...SYNTHESIS OF CN-BCN LAYERS ON DIAMOND FILMS IN BORAZINE AND AMMONIA , M. Ugarov, V. Ageev. A. Karabutov, E. Loubnin, S. Pimenov, V. Konov, Natural

GENOSENSE Diagnostics GmbH.

PubMed

Schneeberger, Christian

2004-07-01

GENOSENSE Diagnostics GmbH, a company specialized in preventive genetic diagnostics, has committed itself to applying molecular medical knowledge to realizing the vision of individual, preventive and patient-tailored medicine. GENOSENSE offers a unique line of preventive genomic diagnostic profiles. Each profile focuses on a carefully selected set of polymorphisms associated with particular diseases or physiologic imbalances. GENOSENSE does not only provide the genetic test results, but highly capable medical experts 'translate' the results into a clinical language and assist the customer with established support regarding their medical interpretation. In addition, the company provides academic institutions and pharmaceutical companies with turnkey solutions for research-based projects.

Comparison of three noninvasive methods for hemoglobin screening of blood donors.

PubMed

Ardin, Sergey; Störmer, Melanie; Radojska, Stela; Oustianskaia, Larissa; Hahn, Moritz; Gathof, Birgit S

2015-02-01

To prevent phlebotomy of anemic individuals and to ensure hemoglobin (Hb) content of the blood units, Hb screening of blood donors before donation is essential. Hb values are mostly evaluated by measurement of capillary blood obtained from fingerstick. Rapid noninvasive methods have recently become available and may be preferred by donors and staff. The aim of this study was to evaluate for the first time all different noninvasive methods for Hb screening. Blood donors were screened for Hb levels in three different trials using three different noninvasive methods (Haemospect [MBR Optical Systems GmbH & Co. KG], NBM 200 [LMB Technology GmbH], Pronto-7 [Masimo Europe Ltd]) in comparison to the established fingerstick method (CompoLab Hb [Fresenius Kabi GmbH]) and to levels obtained from venous samples on a cell counter (Sysmex [Sysmex Europe GmbH]) as reference. The usability of the noninvasive methods was assessed with an especially developed survey. Technical failures occurred by using the Pronto-7 due to nail polish, skin color, or ambient light. The NBM 200 also showed a high sensitivity to ambient light and noticeably lower Hb levels for women than obtained from the Sysmex. The statistical analysis showed the following bias and standard deviation of differences of all methods in comparison to the venous results: Haemospect, -0.22 ± 1.24; NBM, 200 -0.12 ± 1.14; Pronto-7, -0.50 ± 0.99; and CompoLab Hb, -0.53 ± 0.81. Noninvasive Hb tests represent an attractive alternative by eliminating pain and reducing risks of blood contamination. The main problem for generating reliable results seems to be preanalytical variability in sampling. Despite the sensitivity to environmental stress, all methods are suitable for Hb measurement. © 2014 AABB.

A Review of Models of the Human Temperature Regulation System.

DTIC Science & Technology

1992-02-18

experiments to challenge the model and building new models, the researcher will benefit cptimally from its use. It appears that this process has been...during Cooling OUTPUTS: WWe W, Decreased by ?. W H~eating .. ___ > - W Constnt during Coolng IT OUTPUTS: U Increased by 7 We Haoling and Coaling Y. L.AT,)0...12, pp. 709-903, 1976. 43. Slonim, N.B., Environmental Physiology, Mosby, St.Louis, MO, 1974. 44. Sulman, S.G., Health , Weather, and Climate, Karger

Glucocorticoid receptor ligand binding in monocytic cells using a microplate assay.

PubMed

Jansen, J; Uitdehaag, B; Koper, J W; van Den Berg, T K

1999-01-01

Glucocorticoids have profound effects on macrophage function and are widely used as anti-inflammatory drugs. Glucocorticoids receptor (GR) ligand binding capacity is a major determinant of cellular glucocorticoid sensitivity. The number and affinity of GR can be measured in a whole cell binding assay using (3)H-dexamethasone. Here, we describe a rapid and simple microplate assay for GR measurement using the human promonocytic cell line THP-1. Copyright 2000 S. Karger AG, Basel.

Technologies in the evaluation of irritable bowel syndrome.

PubMed

Smout, A J P M; Azpiroz, F; Brummer, R-J; Coremans, G; Dapoigny, M; Müller-Lissner, S A; Pace, F; Stockbrügger, R M; Vatn, M; Whorwell, P J

2004-01-01

During a meeting in The Hague, The Netherlands, the IBiS Club evaluated the most important techniques that can be used in the investigation of irritable bowel syndrome, either in the context of scientific research or as a clinical diagnostic tool. In each of these, the relevance of findings made in irritable bowel syndrome was balanced against the applicability of the technique. The discussion of the group is summarized in this paper. Copyright 2004 S. Karger AG, Basel

Sarcoidal granuloma developing not only at the entry site of industrial lubricating oil, but also at a regional lymph node and entry points of venepuncture.

PubMed

Kogushi, Hazuki; Egawa, Kiyofumi; Ono, Tomomichi

2006-01-01

We describe a 40-year-old male who presented with sarcoidal granulomas not only at the entry site of an industrial lubricating oil containing silicone in the right thumb, but also in a regional lymph node and at the entry points of venepuncture in both forearms. Laboratory tests and chest X-ray showed no evidence of sarcoidosis. 2006 S. Karger AG, Basel

Transition of Care from Childhood to Adulthood: Turner Syndrome.

PubMed

Conway, Gerard

2018-01-01

Girls with Turner syndrome (TS) require special consideration during transition from childhood to adult care. During the transition years, treatment for short stature will be completed and sexual development induced in parallel with the peer group. The timing of sexual development may have later repercussions with respect to psychosocial development and partnership status. Late presentation of TS, which is so common, can result in additional difficulties with the transition process. © 2018 S. Karger AG, Basel.

[The 'Arbeitsgemeinschaft Gestose-Frauen e.V.': A self-help organization with extensive experience in the aftercare of women with preeclampsia or HELLP syndrome].

PubMed

Kuse, S; Wasser, M

2007-01-01

The 'Arbeitsgemeinschaft Gestose-Frauen e.V.' was founded in 1984 with a couple of sufferers and has advised more than 24,000 women so far. In addition to the care by the midwife and gynaecologist, this self-help organization offers the possibility to exchange experiences with other sufferers, but also to receive medical and psychological counselling. (c) 2007 S. Karger AG, Basel.

Samuel Thomas Soemmerring (1755-1830): The Naming of Cranial Nerves.

PubMed

Pearce, John M S

2017-01-01

Samuel Thomas Soemmerring was a Prussian polymathic doctor with remarkable achievements in anatomy, draftsmanship and inventions. His naming of 12 pairs of cranial nerves in his graduation thesis is of particular importance. He also gave original descriptions of the macula, sensory pathways and of the substantia nigra. His non-medical contributions were diverse and included criticism of the guillotine, invention of a telegraphic system, and discoveries in palaeontology. © 2017 S. Karger AG, Basel.

Granulosa cell tumor of the contralateral testis in a man with a history of cryptorchism.

PubMed

Guzzo, Thomas; Gerstein, Matthew; Mydlo, Jack H

2004-01-01

We report a case of adult-type testicular granulosa cell tumor in a 33-year-old man with a history of cryptorchism of the contralateral testis as well as Crohn's disease. The tumor was identified as a 1 x 1 x 1 cm mass on baseline ultrasound evaluation. CT evaluation of the patient revealed extensive mesenteric adenopathy, most likely secondary to his history of Crohn's disease. Copyright 2004 S. Karger AG, Basel

Two episodes of hemoperitoneum from luteal cysts rupture in a patient with congenital factor X deficiency.

PubMed

Dafopoulos, Konstantinos; Galazios, Georgios; Georgadakis, Georgios; Boulbou, Maria; Koutsoyiannis, Dimitrios; Plakopoulos, Apostolos; Anastasiadis, Panagiotis

2003-01-01

The clinical manifestation of two episodes of hemoperitoneum from ruptured corpus luteum cysts, during the luteal phase of the cycle in a young patient with the rare congenital factor X deficiency, is reported for the first time in literature. The correct diagnosis of the underlying disorder, the gynecological management and the regular follow-up can minimize the risks of this potentially life-threatening hematological disorder. Copyright 2003 S. Karger AG, Basel

A one-page summary report of genome sequencing for the healthy adult.

PubMed

Vassy, Jason L; McLaughlin, Heather M; McLaughlin, Heather L; MacRae, Calum A; Seidman, Christine E; Lautenbach, Denise; Krier, Joel B; Lane, William J; Kohane, Isaac S; Murray, Michael F; McGuire, Amy L; Rehm, Heidi L; Green, Robert C

2015-01-01

As genome sequencing technologies increasingly enter medical practice, genetics laboratories must communicate sequencing results effectively to nongeneticist physicians. We describe the design and delivery of a clinical genome sequencing report, including a one-page summary suitable for interpretation by primary care physicians. To illustrate our preliminary experience with this report, we summarize the genomic findings from 10 healthy participants in a study of genome sequencing in primary care. © 2015 S. Karger AG, Basel.

Dementia and art: neuronal intermediate filament inclusion disease and dissolution of artistic creativity.

PubMed

Budrys, Valmantas; Skullerud, Kari; Petroska, Donatas; Lengveniene, Jurate; Kaubrys, Gintaras

2007-01-01

The paper presents a new case of neuronal intermediate filament inclusion disease (NIFID), a recently described new variant of early-onset frontotemporal dementia. Documented with repetitive brain images, morphologically proven cases additionally endorse evolving the clinical and pathological phenotype of NIFID. For the first time the paper describes the probable influence of NIFID on the artistic creativity of an accomplished artist showing rapid dissolution of artistic talent. Copyright (c) 2007 S. Karger AG, Basel.

Retracted: Bacteria diversity overview and endoglucanase assessment from Himalayan Tapovan geothermal spring.

PubMed

Sahoo, Jitendra Kumar; Navani, Naveen Kumar; Pathania, Ranjana

2015-08-25

The above article from the Journal of Basic Microbiology, published online on 25 August 2015 in Wiley Online Library as Early View (http://onlinelibrary.wiley.com/doi/10.1002/jobm.201500135/pdf), has been retracted by agreement between Naveen Kumar Navani and Ranjana Pathania, the Editor-in-Chief and Wiley-VCH GmbH & Co. KGaA. The retraction has been agreed because the article has been submitted and approved for publication by Jitendra Kumar Sahoo without consent in any form by the named co-authors Naveen Kumar Navani and Ranjana Pathania. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Fluoride Penetration and Clearance Are Higher in Exopolysaccharide-Containing Bacterial Pellets.

PubMed

Spinola, Manuela S; Nóbrega, Diego Figueiredo; Del Bel Cury, Altair Antoninha; Ricomini Filho, Antonio Pedro; Cury, Jaime Aparecido; Tenuta, Livia Maria Andaló

2018-06-06

Extracellular polysaccharides (EPS) could increase the penetration of fluoride through dental biofilm, reducing its cariogenicity. We measured the concentration of fluoride in EPS-containing (EPS+) or not-containing (EPS-) Streptococcus mutans bacterial pellets resembling test biofilms, before and up to 60 min after a 0.05% NaF rinse in situ. Fluoride penetration and clearance were higher in EPS+ bacterial pellets. The data suggest that EPS enhances fluoride penetration, but also accelerates fluoride clearance from dental biofilms. © 2018 S. Karger AG, Basel.

CT Imaging Findings after Craniosynostosis Reconstructive Surgery.

PubMed

Ginat, Daniel Thomas; Lam, Daniel; Kuhn, Andrew Scott; Reid, Russell

2018-06-06

Several surgical options are available for treating the different types of craniosynostosis, including fronto-orbital advancement and remodeling, total or subtotal cranial vault remodeling, barrel stave osteotomy with cranial remodeling, endoscopic suturectomy, monobloc advancement and cranioplasty, and revision cranioplasty. High-resolution, low-dose CT with 3D reconstructed images and volumetric analysis can be useful for evaluating the craniofacial skeleton following surgery. The various types of craniosynostosis surgery and corresponding imaging findings are reviewed in this article. © 2018 S. Karger AG, Basel.

Comparative chromosomal localization of the canine-derived BAC clones containing LEP and IGF1 genes in four species of the family Canidae.

PubMed

Szczerbal, I; Rogalska-Niznik, N; Klukowska, J; Schelling, C; Dolf, G; Switonski, M

2003-01-01

In the present report we show the chromosomal localization of two BAC clones, carrying the leptin (LEP) and insuline-like growth factor 1 (IGF1) genes, respectively, in four species belonging to the family Canidae: the dog, red fox, arctic fox and the Chinese raccoon dog. The assignments are in agreement with earlier data obtained from comparative chromosome painting for the dog, red fox and arctic fox. Copyright 2003 S. Karger AG, Basel

Curcumin derivatives inhibit or modulate beta-amyloid precursor protein metabolism.

PubMed

Narlawar, Rajeshwar; Baumann, Karlheinz; Schubenel, Robert; Schmidt, Boris

2007-01-01

Curcumin-derived oxazoles and pyrazoles were synthesized in order to minimize the metal chelation properties of curcumin. The reduced rotational freedom and the absence of stereoisomers was anticipated to enhance the inhibition of gamma-secretase. Accordingly, the replacement of the 1,3-dicarbonyl moiety by isosteric heterocycles turned curcumin analogue oxazoles and pyrazoles into potent gamma-secretase inhibitors. Compounds 4a-i were found to be potent inhibitors of gamma-secretase and displayed activity in the low micromolar range. 2007 S. Karger AG, Basel

Diprosopus associated with neural tube defect and facial cleft in the first trimester.

PubMed

Bulbul, Y; Drummond, C L; Hillion, Y; Bidat, L; Ville, Y

2004-01-01

We report a case of diprosopus presenting with increased nuchal translucency of 5.3 mm at 14 weeks of gestation. Ultrasonographically, the fetus presented with micrognathia, anterior indentation of the cephalic pole, abnormal cerebral hemispheres with a cystic 4th ventricle and angulation of the spine. The fetal karyotype was normal (46,XX). Following termination of pregnancy, postmortem examination established the diagnosis of diprosopus tetraophthalmus with facial cleft of the 2 faces. Copyright 2004 S. Karger AG, Basel

Itch Management in Childhood.

PubMed

Fölster-Holst, Regina

2016-01-01

Itch in children is a very common symptom and is mainly related to a skin disease rather than an underlying systemic disorder. The most common dermatoses include atopic dermatitis, contact dermatitis, insect bites, scabies, and pediculosis capitis. There are specific diagnostic patterns which require the evaluation of a careful history and dermatological examination. For dermatological treatment, we have to consider that children, especially infants, show differences in physiology and pathophysiology, and also in pharmacokinetics and pharmacodynamics compared with adults. © 2016 S. Karger AG, Basel.

EAFI: Examination of Anomalous Fantasy and Imagination.

PubMed

Rasmussen, Andreas Rosén; Stephensen, Helene; Parnas, Josef

2018-05-14

The Examination of Anomalous Fantasy and Imagination (EAFI) is an instrument for a semistructured, phenomenological exploration of psychopathology of imagination. The EAFI provides a conceptual-descriptive framework to address such experiences. It consists of 16 main items, sometimes divided into subtypes. We suggest that the anomalies of imagination explored by the EAFI reflect an alteration in the structure of consciousness and belong to a fundamental, generative layer of psychopathology with relevance to differential diagnostic purposes. © 2018 S. Karger AG, Basel.

Iron deficiency thrombocytopenia: a case report.

PubMed

Shah, Binay Kumar; Shah, Tara

2011-01-01

To describe a rare case of thrombocytopenia secondary to iron deficiency. A 34-year-old woman presented with severe microcytic hypochromic anemia and thrombocytopenia. Her ferritin was 1 ng/dl. A diagnosis of iron deficiency anemia and thrombocytopenia was made and the patient was treated with packed red blood cell transfusion and intravenous iron. Thrombocytopenia rapidly improved to normal. This case showed that iron deficiency should be considered as a cause of thrombocytopenia in the appropriate setting after ruling out common causes. Copyright © 2011 S. Karger AG, Basel.

Heboidophrenia and Pseudo-Psychopathic Schizophrenia: Current Knowledge and Critical Perspective.

PubMed

De Page, Louis; Englebert, Jérôme

2018-06-26

In this article, based on literature review, we present an integrated description of heboidophrenia and pseudo-psychopathic schizophrenia. Both diagnostic constructs describe latent psychotic processes inextricably bound with psychopathic features. Although both have been described in different eras and research threads, they are that similar that we could not find divergences. We formulated operational criteria for clinical and research purpose. The recognition of this syndrome improves risk management, treatment, and legal decisions. © 2018 S. Karger AG, Basel.

Molecular imaging with targeted contrast ultrasound.

PubMed

Piedra, Mark; Allroggen, Achim; Lindner, Jonathan R

2009-01-01

Molecular imaging with contrast-enhanced ultrasound uses targeted microbubbles that are retained in diseased tissue. The resonant properties of these microbubbles produce acoustic signals in an ultrasound field. The microbubbles are targeted to diseased tissue by using certain chemical constituents in the microbubble shell or by attaching disease-specific ligands such as antibodies to the microbubble. In this review, we discuss the applications of this technique to pathological states in the cerebrovascular system including atherosclerosis, tumor angiogenesis, ischemia, intravascular thrombus, and inflammation. Copyright 2009 S. Karger AG, Basel.

Concurrent Koro and Cotard syndromes in a Spanish male patient with a psychotic depression and cerebrovascular disease.

PubMed

Alvarez, P; Puente, V M; Blasco, M J; Salgado, P; Merino, A; Bulbena, A

2012-01-01

Koro and Cotard syndromes are uncommon conditions described in a variety of psychiatric and medical disorders. The authors report the third case of a simultaneous presentation of both syndromes, in a 62-year-old inpatient Spanish male with major depressive disorder with psychotic features, parkinsonism and cognitive impairment. A discussion of the literature and the possible relationship between both syndromes and other neuropsychiatric disorders are presented. Copyright © 2012 S. Karger AG, Basel.

Sichuan Snub-Nosed Monkeys (Rhinopithecus roxellana) Consume Cicadas in the Qinling Mountains, China.

PubMed

Yang, Bin; Zhang, Peng; Garber, Paul A; Hedley, Richard; Li, Baoguo

2016-01-01

There is limited information on insectivory in folivorous primates. Here, we report that wild Sichuan snub-nosed monkeys (Rhinopithecus roxellana) consume cicadas (Karenia caelatata) in the Qinling Mountains of China. Our research suggests that snub-nosed monkeys expand their diet and prey on cicadas during summer and early autumn, possibly in response to increased availability of these insects and their relatively high protein and fat content relative to leaves. © 2016 S. Karger AG, Basel.

Advances in Machine Technology.

PubMed

Clark, William R; Villa, Gianluca; Neri, Mauro; Ronco, Claudio

2018-01-01

Continuous renal replacement therapy (CRRT) machines have evolved into devices specifically designed for critically ill over the past 40 years. In this chapter, a brief history of this evolution is first provided, with emphasis on the manner in which changes have been made to address the specific needs of the critically ill patient with acute kidney injury. Subsequently, specific examples of technology developments for CRRT machines are discussed, including the user interface, pumps, pressure monitoring, safety features, and anticoagulation capabilities. © 2018 S. Karger AG, Basel.

Painful orgasm in an adolescent after seminal-sparing cystoprostatectomy: a puzzling symptom.

PubMed

Angelini, Lorenzo; Castagnetti, Marco; Rigamonti, Waifro

2015-01-01

An 18-year-old boy, followed up after seminal-sparing cystectomy for bladder rhabdomyosarcoma, presented complaining of recurrent episodes of left scrotal/inguinal pain arising after orgasms. Full work-up ruled out disease recurrence, but showed enlarged seminal vesicles. Ligation of the vas deferens was unsuccessful. The patient was started on α-blockers to reduce vas contractions with improvement of symptoms. The possible pathophysiology and treatments of this symptom are discussed. 2014 S. Karger AG, Basel

Constitutional Trisomy 8 Mosaicism with Persistent Macrocytosis.

PubMed

Altıner, Şule; Kutlay, Nüket Y; İlhan, Osman

2016-01-01

Constitutional trisomy 8 mosaicism (CT8M) is a rare chromosomal abnormality. The phenotype varies from normal features to severe malformations. CT8M increases the risk of developing leukemia and myelodysplastic syndrome. As CT8M is very rare, its diagnosis can easily be overlooked, especially in cases with mild phenotypes. Here, we report the diagnostic process of a 40-year-old female patient with CT8M and discuss the importance of follow-up in monitoring for hematological malignancies. © 2016 S. Karger AG, Basel.

Downregulation of Checkpoint Protein Kinase 2 in the Urothelium of Healthy Male Tobacco Smokers.

PubMed

Breyer, Johannes; Denzinger, Stefan; Hartmann, Arndt; Otto, Wolfgang

2016-01-01

With this letter to the editor we present for the first time a study on CHEK2 expression in normal urothelium of healthy male smokers, former smokers and non-smokers. We could show a statistically significant downregulation of this DNA repair gene in current smokers compared to non-smokers, suggesting that smoking downregulates CHEK2 in normal urothelium, probably associated with an early step in carcinogenesis of urothelial bladder carcinoma. © 2016 S. Karger AG, Basel.

The rectum: a window to irritable bowel syndrome?

PubMed

Coremans, G; Azpiroz, F; Collins, S; Dapoigny, M; Müller-Lissner, S A; Pace, F; Smout, A; Stockbrügger, R W; Whorwell, P J

2002-01-01

This report summarizes current concepts and information gathered to date about the rectum in the irritable bowel syndrome (IBS) that were presented at the 10th meeting of IBiS Club held in Leuven, Belgium. A working group of experts in the field of IBS discussed whether the rectum or the whole colon is the better site to test in IBS patients and provided suggestions for a number of areas where further advances are required. Copyright 2002 S. Karger AG, Basel